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Disparity maps, occlusions, and occlusion filling results on the Middlebury College test images Map, Venus, and Tsukuba (from top to bottom). Occlusions are filled using SLS linear interpolation model.Display Omitted Highlights? Comprehensive study of different occlusions and their origins. ? Discussion of ambiguities in occlusion filling. ? Achieve higher accuracy in occlusion filling applying color homogeneity. ? Probabilistic definition of homogeneity to overcome user-defined thresholds. A number of stereo matching algorithms have been developed in the last few years, which also have successfully detected occlusions in stereo images. These algorithms typically fall short of a systematic study of occlusions; they predominantly emphasize matching and regard occlusion filling as a secondary operation. Filling occlusions, however, is useful in many applications such as image-based rendering where 3D models are desired to be as complete as possible. In this paper, we study occlusions in a systematic way and propose two algorithms to fill occlusions reliably by applying statistical modeling, visibility constraints, and scene constraints. We introduce a probabilistic, model-based filling order of the occluded points to maintain consistency in filling. Furthermore, we show how an ambiguity in the interpolation of the disparity value of an occluded point can safely be avoided using color homogeneity when the point's neighborhood consists of multiple scene surfaces. We perform a comparative study and show that statistically, the new algorithms deliver good quality results compared to existing algorithms.

Skin is the largest human organ, and it provides a first line of defense that includes physical, chemical, and immune mechanisms to combat environmental stress. Radiation is a prevalent environmental stressor. Radiation-induced skin damage ranges from photoaging and cutaneous carcinogenesis caused by UV exposure, to treatment-limiting radiation dermatitis associated with radiotherapy, to cutaneous radiation syndrome, a frequently fatal consequence of exposures from nuclear accidents. The major mechanism of skin injury common to these exposures is radiation-induced oxidative stress. Efforts to prevent or mitigate radiation damage have included development of antioxidants capable of reducing reactive oxygen species. Mitochondria are particularly susceptible to oxidative stress, and mitochondrial-dependent apoptosis plays a major role in radiation-induced tissue damage. We reasoned that targeting a redox cycling nitroxide to mitochondria could prevent reactive oxygen species accumulation, limiting downstream oxidative damage and preserving mitochondrial function. Here we show that in both mouse and human skin, topical application of a mitochondrially targeted antioxidant prevents and mitigates radiation-induced skin damage characterized by clinical dermatitis, loss of barrier function, inflammation, and fibrosis. Further, damage mitigation is associated with reduced apoptosis, preservation of the skin's antioxidant capacity, and reduction of irreversible DNA and protein oxidation associated with oxidative stress.

Artificial neural approach has been executed in various recorded, and a champion amongst the most understood widespread approximators. Neural framework has for quite a while been known for its ability to handle a complex nonlinear system without a logical model and can learn refined nonlinear associations gives. Theoretically, the most surely understood computation to set up the framework is the backpropagation (BP) count which relies on upon the minimization of the mean square error (MSE). This paper exhibits the improvement of quadriceps muscle model by utilizing counterfeit smart procedure named backpropagation neural network nonlinear autoregressive (BPNN-NAR) model in view of utilitarian electrical incitement (FES). A progression of tests utilizing FES was led. The information that is gotten is utilized to build up the quadriceps muscle model. 934 preparing information, 200 testing and 200 approval information set are utilized as a part of the improvement of muscle model. It was found that BPNN-NAR is suitable and efficient to model this type of data. A neural network model is the best approach for modelling non-linear models such as active properties of the quadriceps muscle with one input, namely output namely muscle force.

Artificial neural network has been implemented in many filed, and one of the most famous estimators. Neural network has long been known for its ability to handle a complex nonlinear system without a mathematical model and has the ability to learn sophisticated nonlinear relationships provides. Theoretically, the most common algorithm to train the network is the backpropagation (BP) algorithm which is based on the minimization of the mean square error (MSE). Subsequently, this paper displays the change of quadriceps muscle model by using fake savvy strategy named backpropagation neural system nonlinear autoregressive (BPNN-NAR) model in perspective of utilitarian electrical affectation (FES). A movement of tests using FES was driven. The data that is gotten is used to develop the quadriceps muscle model. 934 planning data, 200 testing and 200 endorsement data set are used as a part of the change of muscle model. It was found that BPNN-NARMA is suitable and efficient to model this type of data. A neural network model is the best approach for modelling nonlinear models such as active properties of the quadriceps muscle with one input, namely output namely muscle force.

Object Advances in the management of trauma-induced intracranial hematomas and hemorrhage (epidural, subdural, and intraparenchymal hemorrhage) have improved survival in these conditions over the last several decades. However, there is a paucity of research investigating the relation between patient age and outcomes of surgical treatment for these conditions. In this study, the authors examined the relation between patient age over 80 years and postoperative outcomes following closed head injury and craniotomy for intracranial hemorrhage. Methods A consecutive population of patients undergoing emergent craniotomy for evacuation of intracranial hematoma following closed head trauma between 2006 and 2009 was identified. Using multivariable logistic regression models, the authors assessed the relation between age (> 80 vs ≤ 80 years) and postoperative complications, intensive care unit stay, hospital stay, morbidity, and mortality. Results Of 103 patients, 27 were older than 80 years and 76 patients were 80 years of age or younger. Older age was associated with longer length of hospital stay (p = 0.014), a higher rate of complications (OR 5.74, 95% CI 1.29–25.34), and a higher likelihood of requiring rehabilitation (OR 3.28, 95% CI 1.13–9.74). However, there were no statistically significant differences between the age groups in 30-day mortality or ability to recover to functional baseline status. Conclusions The findings suggest that in comparison with younger patients, patients over 80 years of age may be similarly able to return to preinjury functional baselines but may require increased postoperative medical attention in the forms of rehabilitation and longer hospital stays. Prospective studies concerned with the relation between older age, perioperative parameters, and postoperative outcomes following craniotomy for intracranial hemorrhage are needed. Nonetheless, the findings of this study may allow for more informed decisions with respect to the care of elderly patients with intracranial hemorrhage.

Studies of organs in the thorax and abdomen have shown that these organs can move as much as 40 mm due to respiratory motion. Without compensation for this motion during the course of external beam radiation therapy, the dose coverage to target may be compromised. On the other hand, if compensation of this motion is by expansion of the margin around the target, a significant volume of normal tissue may be unnecessarily irradiated. In hypofractionated regimens, the issue of respiratory compensation becomes an important factor and is critical in single-fraction extracranial radiosurgery applications. CyberKnife is an image-guided radiosurgery system that consists of a 6-MV LINAC mounted to a robotic arm coupled through a control loop to a digital diagnostic x-ray imaging system. The robotic arm can point the beam anywhere in space with 6 degrees of freedom, without being constrained to a conventional isocenter. The CyberKnife has been recently upgraded with a real-time respiratory tracking and compensation system called Synchrony. Using external markers in conjunction with diagnostic x-ray images, Synchrony helps guide the robotic arm to move the radiation beam in real time such that the beam always remains aligned with the target. With the aid of Synchrony, the tumor motion can be tracked in three-dimensional space, and the motion-induced dosimetric change to target can be minimized with a limited margin. The working principles, advantages, limitations, and our clinical experience with this new technology will be discussed.

The purpose of this study was to evaluate the clinical implementation of tangential field IMRT using sliding window technique and to compare dosimetric parameters with 3-dimensional conformal radiation therapy (3DCRT). Twenty breast cancer patients were randomly selected for comparison of intensity modulated radiation therapy (IMRT)-based treatment plan with 3DCRT. Inverse treatment was performed using the sliding window technique, employing the Eclipse Planning System (version 7.1.59, Varian, Palo Alto, CA). The dosimetric parameters compared were V(95) (the percentage of target volume gettingor =95% of prescribed dose), V(105), V(110), and dose homogeneity index, DHI (percentage of target volume getting between 95% and 110% of prescribed dose). The mean V(95), DHI, V(105), and V(110) for target volume for IMRT vs. 3D were 90.6% (standard deviation [SD]: 3.2) vs. 91% (SD: 3.0), 87.7 (SD: 6.0) vs. 82.6 (SD: 7.8), 27.3% (SD: 20.3) vs. 49.4% (SD: 14.3), and 2.8 (SD: 5.6) vs. 8.4% (SD: 7.4), respectively. DHI was increased by 6.3% with IMRT compared to 3DCRT (p0.05). The reductions of V(105) and V(110) for the IMRT compared to 3DCRT were 44.7% and 66.3%, respectively (p0.01). The mean dose and V(30) for heart with IMRT were 2.3 (SD: 1.1) and 1.05 (SD: 1.5) respectively, which was a reduction by 6.8% and 7.9%, respectively, in comparison with 3D. Similarly, the mean dose and V(20) for the ipsilateral lung and the percentage of volume of contralateral volume lung receiving5% of prescribed dose with IMRT were reduced by 9.9%, 2.2%, and 35%, respectively. The mean of total monitor units used for IMRT and 3DCRT was about the same (397 vs. 387). The tangential field IMRT for intact breast using sliding window technique was successfully implemented in the clinic. We have now treated more than 1000 breast cancer patients with this technique. The dosimetric data suggest improved dose homogeneity in the breast and reduction in the dose to lung and heart for IMRT treatments, which may be of clinical value in potentially contributing to improved cosmetic results and reduced late treatment-related toxicity.

Osmotic demyelination syndromes are often progressive disorders, with clinical features ranging from a mild tremor or dysarthria to a progressive quadraparesis. Although rapid correction of serum sodium is known to be a potent causative factor, additional pathogenic factors exist, which appear critical in predisposing pontine and extrapontine glia to osmotic stress. Interestingly, several cases of osmotic demyelination have emerged where serum sodium was found to be within normal limits and minimal or no correction of a hypo or hypernatraemic state was implemented. We describe two cases – one of extra pontine and another of central-pontine myelinolysis, both of which have occurred in the context of relatively normal serum sodium. The first case illustrates the association of extrapontine myelinolysis with the traditional risk factor of alcoholic cirrhosis and intravenous fluid resuscitation, while the second, more unusual case, describes a patient who developed central pontine myelinolysis possibly in association with alpha interferon therapy.

A medical linear accelerator equipped with optical position tracking, ultrasound imaging, portal imaging, and radiographic imaging systems was installed at University of Pittsburgh Cancer Institute for the purpose of performing image-guided radiation therapy (IGRT) and image-guided radiosurgery (IGRS) in October 2005. We report the performance characteristics and quality assurance aspects of the kilovoltage cone-beam computed tomography (kV-CBCT) technique. This radiographic imaging system consists of a kilovoltage source and a large-area flat panel amorphous silicon detector mounted on the gantry of the medical linear accelerator via controlled arms. The performance characteristics and quality assurance aspects of this kV-CBCT technique involves alignment of the kilovoltage imaging system to the isocenter of the medical linear accelerator and assessment of (a) image contrast, (b) spatial accuracy of the images, (c) image uniformity, and (d) computed tomography (CT)-to-electron density conversion relationship were investigated. Using the image-guided tools, the alignment of the radiographic imaging system was assessed to be within a millimeter. The low-contrast resolution was found to be a 6-mm diameter hole at 1% contrast level and high-contrast resolution at 9 line pairs per centimeter. The spatial accuracy (50 mm +/- 1%), slice thickness (2.5 mm and 5.0 mm +/- 5%), and image uniformity (+/- 20 HU) were found to be within the manufacturer's specifications. The CT-to-electron density relationship was also determined. By using well-designed procedures and phantom, the number of parameter checks for quality assurance of the IGRT system can be carried out in a relatively short time.

Both men and women who sustain a fracture of the distal forearm run an increased risk of sustaining a subsequent hip fracture. Our study implies that these patients may not necessarily constitute a group in which osteoporosis screening is warranted. People who sustain a distal radius fracture run an increased risk of sustaining a subsequent hip fracture. However, many institutions only screen for osteoporosis at the time of a hip fracture. We aimed to determine the true incidence of preceding distal radius fractures in an Asian population of patients with a hip fracture aged 60 years or older and whether screening for osteoporosis earlier would be beneficial. We reviewed 22 parameters of 572 patients aged 60 years or older admitted after sustaining a hip fracture over a 3-year period. This included the occurrence or absence of a distal radius fracture in the 10 years preceding their hip fracture. Twenty-nine patients (5 %) had a fracture of the distal radius in the preceding decade. Univariate analyses suggested that hip fracture patients who had preceding distal radius fractures were older, female, have lower mean haemoglobin levels, and right-sided hip fractures. Of these factors, only age was found to have significant predictive value in a multivariate analysis. A number of institutions have started to screen for osteoporosis when a patient presents with a fracture of the distal radius because these patients may have an increased risk of a subsequent hip fracture. Our study implies that this may not be warranted. Implementing such a screening service from both cost and resource utilization point of view must be studied prospectively and in greater detail considering earlier screening may only be beneficial to a very small percentage of patients.

The implementation of tissue inhomogeneity correction in image-based treatment planning will improve the accuracy of radiation dose calculations for patients undergoing external-beam radiotherapy. Before the tissue inhomogeneity correction can be applied, the relationship between the computed tomography (CT) value and density must be established. This tissue characterization relationship allows the conversion of CT value in each voxel of the CT images into density for use in the dose calculations. This paper describes the proper procedure of establishing the CT value to density conversion relationship. A tissue characterization phantom with 17 inserts made of different materials was scanned using a GE Lightspeed Plus CT scanner (120 kVp). These images were then downloaded into the Eclipse and Pinnacle treatment planning systems. At the treatment planning workstation, the axial images were retrieved to determine the CT value of the inserts. A region of interest was drawn on the central portion of the insert and the mean CT value and its standard deviation were determined. The mean CT value was plotted against the density of the tissue inserts and fitted with bilinear equations. A new set of CT values vs. densities was generated from the bilinear equations and then entered into the treatment planning systems. The need to obtain CT values through the treatment planning system is very clear. The 2 treatment planning systems use different CT value ranges, one from −1024 to 3071 and the other from 0 to 4096. If the range is correct, it would result in inappropriate use of the conversion curve. In addition to the difference in the range of CT values, one treatment planning system uses physical density, while the other uses relative electron density.

Objectif Le depistage de drogues salivaires est d’un interet croissant en raison de son caractere non invasif et de la simplicite du prelevement. De nombreux dispositifs de depistage salivaire (OFC) sont commercialises sur le marche fournissant des stabilisateurs afin de preserver au mieux les analytes lors du trajet pour rejoindre les laboratoires d’analyse. L’ajout d’additifs qui permettent d’eviter la degradation des composes d’interet peuvent impacter l’analyse LC-MS. Dans ce travail, nous decrivons une procedure de nettoyage utilisant une methode d’extraction en echange d’ion (SPE), sur les deux dispositifs OFC les plus populaires, qui reduisent de maniere significative l’ajout d’additifs dans le tampon tout en gardant un taux de recouvrement important ainsi qu’une excellente reproductibilite. Methodes Le tampon et les echantillons de salive preleves par les dispositifs OFC puis extraits par SPE sont qualitativement analyses par LC-MS. La separation chromatographique a ete realisee sur une colonne Kinetex C18 (50 × 2,1 mm, 2,6 μm, Phenomenex) avec une phase mobile constituee de 0,1 % d’acide formique dans l’eau et le methanol. Un systeme Sciex 4000 QTRAP LC-MS/MS avec une source ESI a ete utilise pour la detection. Des plages de suppression d’ions ont ete identifiees via la T-infusion de la codeine post-column. Les echantillons ont ete caracterises en collectant les scans Q1 de 100 a 2000 Da sous les modes positifs et negatifs. Le recouvrement et la precision ont ete determines a l’aide du systeme Sciex API 5000 LC-MS/MS. Une colonne Kinetex Biphenyl (50 × 3,0 mm, 2,6 μm) connectee a un systeme LC Agilent 1260 a ete utilisee avec la meme phase mobile que celle de l’analyse qualitative. Les composes selectionnes sont : opiaces (morphine, 6-MAM, codeine), amphetamines (MDMA, MDEA, MDA), opiaces synthetiques (hydromorphone, hydrocodone), benzodiazepines (lorazepam, temazepam), THC-COOH, barbituriques (phenobarbital, pentobarbital), PCP et carisoprodol. Deux transitions MRM pour chaque analyte et une pour chaque standard interne deutere ont ete etudiees. La preparation d’echantillon a ete realisee avec les cartouches Strata-X-A (echange d’anions forts) et Strata-X-C (echange de cations forts) (Phenomenex). Le dispositif permet de prelever 1 mL de salive (dopee avec un standard interne), ensuite introduit dans un tube contenant le tampon stabilisateur pour la nuit. Avant l’extraction, 0,5 mL de ce melange a ete dilue (1 :2) avec une solution d’acide formique 1 % pour les composes basiques et une solution d’hydroxyde d’ammonium 1 % pour les composes acides. De nombreux solvants purs et dilues avec de l’eau ont ete testes pour l’etape de lavage sur les cartouches SPE afin de determiner l’impact de l’ajout d’additif du dispositif OFC sur le taux de recouvrement. Pour les composes acides, l’etape d’elution est composee d’un melange ACN : MeOH : HCOOH avec des ratios de 47,5 : 47,5 : 5 (%). De meme, les composes basiques ont ete elues avec un melange ACN : MeOH : NH4OH avec des ratios de 47,5 : 47,5 : 5 (%). Resultats Un lavage avec de l’acetone aqueuse a 50 % a permis d’eliminer la majorite des additifs utilises dans ces dispositifs OFC. La majorite des 49 drogues testees sont des composes basiques et les taux de recouvrement se situent entre 60 et 80 % pour le dispositif 1 et entre 63 et 93 % pour le dispositif 2. Les composes neutres meprobamate et carisoprodol n’ont pas ete bien retenus sur les sorbants SPE testes pour chacun des deux dispositifs. Les taux de recouvrement sont inferieurs a 16 %. La precision est bonne avec un coefficient de variation inferieur a 19 % pour tous les essais (n = 4). Conclusion Nous avons pu eliminer la majorite des additifs presents dans les dispositifs OFC avec le lavage constitue de 50 % d’acetone aqueuse. Cette procedure a permis d’obtenir de bons taux de recouvrement pour la plupart des analytes testes. En revanche, les composes neutres n’ont pas ete recuperes avec les recouvrements attendus.

Neural framework has for quite a while been known for its ability to handle a complex nonlinear system without a logical model and can learn refined nonlinear associations gives. Theoretically, the most surely understood computation to set up the framework is the backpropagation (BP) count which relies on upon the minimization of the mean square error (MSE). However, this algorithm is not totally efficient in the presence of outliers which usually exist in dynamic data. This paper exhibits the modelling of quadriceps muscle model by utilizing counterfeit smart procedures named consolidated backpropagation neural network nonlinear autoregressive (BPNN-NAR) and backpropagation neural network nonlinear autoregressive moving average (BPNN-NARMA) models in view of utilitarian electrical incitement (FES). We adapted particle swarm optimization (PSO) approach to enhance the performance of backpropagation algorithm. In this research, a progression of tests utilizing FES was led. The information that is gotten is utilized to build up the quadriceps muscle model. 934 preparing information, 200 testing and 200 approval information set are utilized as a part of the improvement of muscle model. It was found that both BPNN-NAR and BPNN-NARMA performed well in modelling this type of data. As a conclusion, the neural network time series models performed reasonably efficient for non-linear modelling such as active properties of the quadriceps muscle with one input, namely output namely muscle force.

Patients with advanced congestive heart failure (CHF) or chronic kidney disease (CKD) often have increased angiotensin II (Ang II) levels and cachexia. Ang II infusion in rodents causes sustained skeletal muscle wasting and decreases muscle regenerative potential through Ang II type 1 receptor (AT1R)-mediated signaling, likely contributing to the development of cachexia in CHF and CKD. However, the potential role of Ang II type 2 receptor (AT2R) signaling in skeletal muscle physiology is unknown. We found that AT2R expression was increased robustly in regenerating skeletal muscle after cardiotoxin (CTX)-induced muscle injury in vivo and differentiating myoblasts in vitro, suggesting that the increase in AT2R played an important role in regulating myoblast differentiation and muscle regeneration. To determine the potential role of AT2R in muscle regeneration, we infused C57BL/6 mice with the AT2R antagonist PD123319 during CTX-induced muscle regeneration. PD123319 reduced the size of regenerating myofibers and expression of the myoblast differentiation markers myogenin and embryonic myosin heavy chain. On the other hand, AT2R agonist CGP42112 infusion potentiated CTX injury-induced myogenin and embryonic myosin heavy chain expression and increased the size of regenerating myofibers. In cultured myoblasts, AT2R knockdown by siRNA suppressed myoblast differentiation marker expression and myoblast differentiation via up-regulation of phospho-ERK1/2, and ERK inhibitor treatment completely blocked the effect of AT2R knockdown. These data indicate that AT2R signaling positively regulates myoblast differentiation and potentiates skeletal muscle regenerative potential, providing a new therapeutic target in wasting disorders such as CHF and CKD.

To assess the long-term mechanical stability and accuracy of the patient positioning system (PPS) of the Leksell Gamma Knife(®) Perfexion™ (LGK PFX).The mechanical stability of the PPS of the LGK PFX was evaluated using measurements obtained between September 2007 and June 2011. Three methods were employed to measure the deviation of the coincidence of the radiological focus point (RFP) and the PPS calibration center point (CCP). In the first method, the onsite diode test tool with single diode detector was used together with the 4 mm collimator on a daily basis. In the second method, a service diode test tool with three diode detectors was used biannually at the time of the routine preventive maintenance. The test performed with the service diode test tool measured the deviations for all three collimators 4, 8, and 16 mm and also for three different positions of the PPS. The third method employed the conventional film pin-prick method. This test was performed annually for the 4 mm collimator at the time of the routine annual QA. To estimate the effect of the patient weight on the performance of the PPS, the focus precision tests were also conducted with varying weights on the PPS using a set of lead bricks.The average deviations measured from the 641 daily focus precision tests were 0.1 ± 0.1, 0.0 ± 0.0, and 0.0 ± 0.0 mm, respectively, for the 4 mm collimator in the X (left/right of the patient), Y (anterior/posterior of the patient), and Z (superior/inferior of the patient) directions. The average of the total radial deviations as measured during ten semiannual measurements with the service diode test tool were 0.070 ± 0.029, 0.060 ± 0.022, and 0.103 ± 0.028 mm, respectively for the central, long, and short diodes for the 4 mm collimator. Similarly, the average total radial deviations measured during the semiannual measurements for the 4, 8, and 16 mm collimators and using the central diode were 0.070 ± 0.029, 0.097 ± 0.025, 0.159 ± 0.028 mm, respectively. The average values of the deviations as obtained from the five annual film pin-prick tests for the 4 mm collimator were 0.10 ± 0.06, 0.06 ± 0.09, and 0.03 ± 0.03 mm for the X, Y, Z stereotactic directions, respectively. Only a minor change was observed in the total radial deviations of the PPS as a function of the simulated patient weight up to 202 kg on the PPS.Excellent long-term mechanical stability and high accuracy was observed for the PPS of the LGK PFX. No PPS recalibration or any adjustment in the PPS was needed during the monitored period of time. Similarly, the weight on the PPS did not cause any significant disturbance in the performance of the PPS for up to 202 kg simulated patient weight.

This article discusses an alternative approach to general anesthesia with the use of local anesthesia in minor operating procedure suites when performing in situ decompression of cubital tunnel syndrome for those patients who have mild to moderately severe symptoms and for those who fail to respond to conservative measures. Anterior transposition can easily be performed in the same setting if indicated all with local anesthesia.

This article evaluates the outcome of 42 consecutive zone 1 flexor tendon injuries treated by using micro bone anchors during the period 2003–2008. Patients were rehabilitated using the modified Belfast Regime. The range of motion at the distal interphalangeal joint was assessed using Moiemen’s classification. A total of 56% of patients achieved excellent or good results for range of motion at the distal interphalangeal joint and 23% had a poor outcome. The mean distal interphalangeal joint and proximal interphalangeal joint range of motion were 48° and 96°, respectively. A total of 94% of patients returned back to work by 12 weeks. One patient sustained a tendon rupture and one developed osteomyelitis. The mean QuickDASH score was 13.5 and 81% of patients were satisfied with their outcomes. This is the largest clinical study on the use of bone anchors for zone 1 tendon injuries. Our study demonstrated a low rate of complications and outcomes that compare favourably with other published techniques.

Zone 1 flexor tendon avulsion and laceration injuries are commonly managed by plastic surgeons. These injuries are traditionally repaired using the button pullout technique originally described by Bunnell in 1940. The morbidity related to this method is well documented and this has lead to the development of alternative repair methods. These include modifications of the pullout button technique, internal suture techniques and more recently techniques using bone anchors. However, at present no one technique has been shown to be superior to the others either in terms of outcome or low complication rates. This review examines the published techniques for dealing with these injuries with a view to providing the reader with the available outcome data for each repair type.

© 2012 Ibrahim et al., licensee InTech. This is an open access chapter distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. An Approach for Dynamic Characterisation of Passive Viscoelasticity and Estimation of Anthropometric Inertia Parameters of Paraplegic’s Knee Joint

Functional electrical stimulation (FES) can be used to restore motor function to individuals with spinal cord injuries (SCI). FES involves artificially inducing a current in specific motor neurons to generate a skeletal muscle contraction. FES induced movement control is a significantly challenging area for researchers. The challenge mainly arises due to muscle response characteristics such as fatigue, time-varying properties and nonlinear dynamics of paralyzed muscles [1]. Another challenge is due to certain motor reflexes such as spasticity. Spasticity is a reflex or uncontrolled response to something that excites the nerve endings and produces muscle contractions. These reflexes are often unpredictable and may impede joint movements [2].

Intervertebral disc degeneration (IDD) is the leading cause of debilitating spinal disorders such as chronic lower back pain. Aging is the greatest risk factor for IDD. Previously, we demonstrated IDD in a murine model of a progeroid syndrome caused by reduced expression of a key DNA repair enzyme. This led us to hypothesize that DNA damage promotes IDD. To test our hypothesis, we chronically exposed adult wild-type (Wt) and DNA repair-deficient Ercc1(-/Δ) mice to the cancer therapeutic agent mechlorethamine (MEC) or ionization radiation (IR) to induce DNA damage and measured the impact on disc structure. Proteoglycan, a major structural matrix constituent of the disc, was reduced 3-5× in the discs of MEC- and IR-exposed animals compared to untreated controls. Expression of the protease ADAMTS4 and aggrecan proteolytic fragments was significantly increased. Additionally, new PG synthesis was reduced 2-3× in MEC- and IR-treated discs compared to untreated controls. Both cellular senescence and apoptosis were increased in discs of treated animals. The effects were more severe in the DNA repair-deficient Ercc1(-/Δ) mice than in Wt littermates. Local irradiation of the vertebra in Wt mice elicited a similar reduction in PG. These data demonstrate that genotoxic stress drives degenerative changes associated with IDD.

Background Tobacco smoking rates are increasing in developing countries and so are tobacco-related chronic diseases. Reported figures from the WHO show rates of smoking in Egypt as high as 20% but limited information is available about smoking specifically among physicians and medical students. Materials and methods Final-year medical students of Cairo University were surveyed regarding their tobacco behavior and attitudes using a modified Global Health Professions Student Survey. We approached 220 students by randomly selecting clinical units into which they were assigned and requested completion of the survey. Results Ever users of some form of tobacco comprised 46.7% of students sampled, current users of cigarettes comprised 17.4%, and current users of water pipe 'sheesha' comprised 17.6%. The vast majority (87.7%) of students believed that smoking is a public health problem in Cairo and supported restriction of tobacco. Yet, only 58.5% stated that they were taught it is important for physicians to provide tobacco education materials to patients. Among ever users of cigarettes, 54.4% believed health professionals do not serve as health role models for patients, and only a small percentage of all students (34.2%) stated that they had received some form of training on smoking cessation in their medical curriculum to be able to instruct patients. Conclusion and recommendations A high rate of smoking was revealed among medical students in Cairo. Overall, approximately 23.4% of students were currently smoking cigarettes and/or sheesha, and 46.7% were ever users of some form of tobacco. A formal antitobacco program for medical students should be incorporated into their medical curriculum to change the attitudes of medical students and overcome the anticipated increase in chronic diseases in Egypt.

The objective of this article is to estimate and validate a logistic model of alcohol-impaired driving using previously ignored alcohol consumption behaviors, other risky behaviors, and demographic characteristics as independent variables.The determinants of impaired driving are estimated using the US Centers for Disease Control and Prevention's (CDC) Behavioral Risk Factor Surveillance System (BRFSS) surveys. Variables used in a logistic model to explain alcohol-impaired driving are not only standard sociodemographic variables and bingeing but also frequency of drinking and average quantity consumed, as well as other risky behaviors. We use interactions to understand how being female and being young affect impaired driving. Having estimated our model using the 1997 survey, we validated our model using the BRFSS data for 1999.Drinking 9 or more times in the past month doubled the odds of impaired driving. The greater average consumption of alcohol per session, the greater the odds of driving impaired, especially for persons in the highest quartile of alcohol consumed. Bingeing has the greatest effect on impaired driving. Seat belt use is the one risky behavior found to be related to such driving. Sociodemographic effects are consistent with earlier research. Being young (18-30) interacts with two of the alcohol consumption variables and being a woman interacts with always wearing a seat belt. Our model was robust in the validation analysis.All 3 dimensions of drinking behavior are important determinants of alcohol-impaired driving, including frequency and average quantity consumed. Including these factors in regressions improves the estimates of the effects of all variables.

Advances in the management of trauma-induced intracranial hematomas and hemorrhage (epidural, subdural, and intraparenchymal hemorrhage) have improved survival in these conditions over the last several decades. However, there is a paucity of research investigating the relation between patient age and outcomes of surgical treatment for these conditions. In this study, the authors examined the relation between patient age over 80 years and postoperative outcomes following closed head injury and craniotomy for intracranial hemorrhage.A consecutive population of patients undergoing emergent craniotomy for evacuation of intracranial hematoma following closed head trauma between 2006 and 2009 was identified. Using multivariable logistic regression models, the authors assessed the relation between age (80 vs ≤ 80 years) and postoperative complications, intensive care unit stay, hospital stay, morbidity, and mortality.Of 103 patients, 27 were older than 80 years and 76 patients were 80 years of age or younger. Older age was associated with longer length of hospital stay (p = 0.014), a higher rate of complications (OR 5.74, 95% CI 1.29-25.34), and a higher likelihood of requiring rehabilitation (OR 3.28, 95% CI 1.13-9.74). However, there were no statistically significant differences between the age groups in 30-day mortality or ability to recover to functional baseline status.The findings suggest that in comparison with younger patients, patients over 80 years of age may be similarly able to return to preinjury functional baselines but may require increased postoperative medical attention in the forms of rehabilitation and longer hospital stays. Prospective studies concerned with the relation between older age, perioperative parameters, and postoperative outcomes following craniotomy for intracranial hemorrhage are needed. Nonetheless, the findings of this study may allow for more informed decisions with respect to the care of elderly patients with intracranial hemorrhage.

FES induced movement control is a significantly challenging area due to complexity and non-linearity of musculo-skeletal system. The goal of this study is to design a cycle-to-cycle control of FES-induced swinging motion. In this approach only the quadriceps muscle is stimulated by controlling the amount of stimulation pulsewidth. This time dependent behaviour is successfully compensated for using a cycle-to cycle fuzzy controller, which computes the amount of knee extension stimulation on the basis of the achieved flexion angle in previous cycles. The capability of fuzzy control in automatic generation of stimulation burst duration is assessed in computer simulations using a musculo-skeletal model. This paper presents the development of a fuzzy logic control scheme based on discrete-time cycle to cycle control strategies without predefined trajectory. The results show the effectiveness of the approach in controlling FES-induced swinging motion

The use of electrical signals to restore the function of paralyzed muscles is called functional electrical stimulation (FES). FES is a promising method to restore mobility to individuals paralyzed due to spinal cord injury. FES induced movement control is a significantly challenging area, mainly emanating from various characteristics of the underlying physiological/biomechanical system. An approach of fuzzy trajectory tracking control of swinging motion optimized with genetic algorithm is presented. The results show the effectiveness of the approach in controlling FES-induced swinging motion. In this approach only the quadriceps muscle is stimulated to perform the swinging motion by controlling the amount of stimulation pulsewidth

Angiogenesis is a hallmark of tumor development and metastasis and now a validated target for cancer treatment. We previously reported that a novel dimer peptide (apoEdp) derived from the receptor binding region of human apolipoprotein E (apoE) inhibits virus-induced angiogenesis. However, its role in tumor anti-angiogenesis is unknown. This study demonstrates that apoEdp has anti-angiogenic property in vivo through reduction of tumor growth in a mouse model and ocular angiogenesis in a rabbit eye model. Our in vitro studies show that apoEdp inhibits human umbilical vein endothelial cell proliferation, migration, invasion and capillary tube formation. We document that apoEdp inhibits vascular endothelial growth factor-induced Flk-1 activation as well as downstream signaling pathways that involve c-Src, Akt, eNOS, FAK, and ERK1/2. These in vitro data suggest potential sites of the apoE dipeptide inhibition that could occur in vivo. This is the first evidence that a synthetic dimer peptide mimicking human apoE has anti-angiogenesis functions and could be an anti-tumor drug candidate.

Treatment of diseases of the posterior segment of the eye, such as age-related macular degeneration, cytomegalovirus retinitis, diabetic retinopathy, posterior uveitis and retinitis pigmentosa, requires novel drug delivery systems that can overcome the many barriers for efficacious delivery of therapeutic drug concentrations. This challenge has prompted the development of biodegradable and nonbiodegradable sustained-release systems for injection or transplantation into the vitreous as well as drug-loaded nanoparticles, microspheres and liposomes. These drug delivery systems utilize topical, systemic, subconjunctival, intravitreal, transscleral and iontophoretic routes of administration. The focus of research has been the development of methods that will increase the efficacy of spatiotemporal drug application, resulting in more successful therapy for patients with posterior segment diseases. This article summarizes recent advances in the research and development of drug delivery methods of the posterior chamber of the eye, with an emphasis on the use of implantable devices as well as micro- and nanoparticles.

In this paper, we propose a series of techniques to enhance the computational performance of existing Belief Propagation (BP) based stereo matching that relies on automatic estimation of the Markov random field (MRF) parameters. First, we show how convergence in matching can be achieved faster than with the existing message comparison technique by skipping comparisons in early inferences. Second, assuming that a stereo pair is captured with identical cameras, we apply a hypothesis called noise equivalence to pre-estimate the likelihood parameters and thus, avoid costly nested inferences to reduce the computational time. The likelihood parameters and intensity information are used for accelerated message propagation in image regions lacking gradients. Third, the prior model parameters are estimated with a combination of maximum likelihood (ML) estimation and disparity gradient constraint to further reduce the computational time. Supporting experiments for the proposed algorithms show encouraging results on ground truth test images.

Absolute measurements are presented for electron-impact single ionization of ${\mathrm{U}}^{10+}$, ${\mathrm{U}}^{13+}$, and ${\mathrm{U}}^{16+}$, and for double ionization of ${\mathrm{U}}^{10+}$ and ${\mathrm{U}}^{13+}$ from below the thresholds to 1500 eV. Metastable components are observed in all three incident-ion beams. The single-ionization cross sections are enhanced due to indirect ionization processes by factors of 4--20 near their peaks, and the double-ionization cross sections are apparently also dominated by indirect ionization. Good agreement is found with distorted-wave calculations for total ionization of ${\mathrm{U}}^{16+}$, the only case where detailed calculations are available for comparison. Individual or closely spaced resonances are clearly resolved in the single-ionization channels for ${\mathrm{U}}^{13+}$ and ${\mathrm{U}}^{16+}$.

In its quest for more reliability and higher recognition rates the face recognition community has been focusing more and more on 3D based recognition. Depth information adds another dimension to facial features and provides ways to minimize the effects of pose and illumination variations for achieving greater recognition accuracy. This chapter reviews, therefore, the major techniques for 3D face modeling, the first step in any 3D assisted face recognition system. The reviewed techniques are laser range scans, 3D from structured light projection, stereo vision, morphing, shape from motion, shape from space carving, and shape from shading. Concepts, accuracy, feasibility, and limitations of these techniques and their effectiveness for 3D face recognition are discussed.

Background Drug analysis from whole blood is gaining popularity due to a more complete measurement of analytes in the biological system. Historically, most drug screens have been performed using immunoassay and similar technologies. These techniques often lack specificity and sensitivity necessary for today's complex legal requirements. In this poster, we demonstrate a fast, robust technique for the screening of a broad range of drugs from whole blood utilizing SPE and tandem mass spectrometry. Forty-one compounds, which include opiates (both natural and synthetic), amphetamines, benzodiazepines, phenylpiperidines, a muscle relaxant, and some illicit drugs (PCP and cocaine metabolite) were tested. Objective Utilizing advanced sample preparation techniques we simplify a complicated matrix to allow for a fast and successful multi-component analysis by LC-MS/MS. Method Six pretreatment options for whole blood were investigated. The volume of whole blood used was 0.25 mL. A 5% zinc sulfate and acetonitrile combination worked for most classes. Benzodiazepines had a better overall response with 10% MeOH in ACN. However, there was not a single pretreatment procedure that worked well for all classes of compounds. The supernatant was loaded onto the Strata-XC 30 mg/3 mL cartridges. Salts and most endogenous components were removed using a two-step, 0.1% formic acid and 30% methanol, wash. Analytes were eluted using 2 × 500 uL of ammoniated IPA/ethyl acetate solution. Samples were then acidified and evaporated to dryness at 40–45 °C under a gentle nitrogen stream. The dry residue was re-suspended in mobile phase and injected onto the column. The chromatographic separation was performed on a Kinetex 2.6 um Biphenyl 50 × 3.0 mm column. The best choice of mobile phase was 0.1% formic acid in water and 0.1% formic acid in methanol. The detection was achieved on an AB Sciex Triple Quad 4500 and/or a 4000 QTrap LC-MS/MS system. All analytes were detected under positive polarity and MRM scan function using two mass transitions. A MRM-IDA-EPI combination scan was used on a small sample set to verify the analyte purity. Results A detection limit of 10 ng/mL was achieved for all tested analytes using this method. Tramadol, propoxyphene, fentanyl, carisoprodol and meprobamate produced strong signals. The absolute lowest detection levels for these analytes have not yet been determined. Although a full calibration method was not vigorously tested, the upper end of the calibration range was deemed to be 1000 ng/mL. A quadratic fit with 1/× weighting factor was employed for calibration purposes. Early eluting analytes were well separated from the ion suppression zone by a retention factor of two, or by three times the dead volume. Isomeric/isobaric compounds were completely resolved by the biphenyl LC column by at least a factor of 2. A resolution value of 3.2 was obtained for morphine and hydromorphone. Conclusion The described procedure provides a simple and reliable solution to screen a wide range of illicit and pain control compounds from a complicated matrix.

Spring Brake Orthosis (SBO) generates the swing phase of gait by employing a spring at the knee joint to store energy during the knee extension through quadriceps stimulation, which is then released to produce knee flexion. Spring parameters (for the knee flexion part) and the stimulus signal parameters (for the knee extension part) are the only optimizable quantities amongst the factors that determine the SBO generated knee joint trajectory. In this work, subject specific optimum spring parameters (spring constant, spring rest angle) for SBO purposes are obtained using genetic algorithms (GA). The integral of time-weighted absolute error (ITAE) between the reference and actual trajectory is defined as the cost function.

Rationale Due to the nature and sensation of CPAP, not all patients comply with the treatment. Factors such as age, degree of sleepiness, health status, BMI and sleep apnoea severity may influence CPAP adherence. We sought to determine if these and other factors, particularly socioeconomic status, influence CPAP compliance of our patients. Methods Demographic data (including age, sex, race and BMI), Epworth Sleepiness Score, Oxygen Desaturation Index (ODI; Desaturations/hour >4% SpO 2 ) and prescribed CPAP were retrospectively collected from all patients who had been issued CPAP between 2009 and 2013. In addition, the Index of Multiple Deprivation (IMD) Score and Rank were retrieved from the www.neighbourhood.statistics.gov.uk website. These parameters were then compared between CPAP “compliers” (≥4 hrs/night and ≥4 nights/week) and “non-compliers” ( Results We obtained complete data from 407 patients over the four years period. Compliance was achieved in 70.5% of patients. CPAP compliers had significantly worse sleep apnoea (ODI), degree of sleepiness (Epworth) and a higher BMI (Table 1); Conclusions Our data show a good level of compliance compared to previous reports (Shapiro et al . Sleep Breath 2010; 14: 323–25) and patient adherence at 12 months is better than previously reported (Bollig. Respir Care 2010; 55: 1230–9). Although ODI, Epworth and BMI were significantly higher in the CPAP compliers, the differences were only modest. Among the demographics tested, none seem to have a major influence on CPAP compliance in our cohort of patients.

Micro-electro-mechanical systems (MEMS) are found in area applications such as the automotive industry, the aviation industry, the semiconductor industry, the medical field, and various other fields where miniaturization is taking over. The accurate measurement of features on the surface of MEMS is an important tool for the assessment and monitoring of product quality. Presented here are the algorithms and results of 3D model reconstructions of MEMS devices using a variety of microscopic sensors. These sensors include an atomic force microscope, a scanning electron microscope, and a laser scanning confocal microscope. MEMS devices with micron-size features were first scanned with these microscopes. 3D models were then built and visualized using methods specific to each microscope. This allows for the models use in applications such as inspection, study of wear and tear, behavior, and reaction of such systems to pressure, heat, and friction.

This paper summarizes the various components of face recognition research conducted at the IRIS Lab. First, fusion of visual and thermal infrared (IR) images for robust face recognition is discussed. Two techniques are implemented: data fusion and decision fusion. With the knowledge that eyeglasses block the emission of thermal energy, an algorithm is designed to detect and replace eyeglasses with an eye template in thermal images. A commercial face recognition software (FaceIt/spl reg/) is used in the evaluation of the various fusion algorithms. Comparison results show that fusion-based face recognition outperforms individual visual or thermal face recognizers under illumination variations and facial expressions. Efforts in the 3D arena are also described. Results of high resolution stereo-based 3D reconstruction of faces are shown and analyzed, in a first approach, then in a second approach, a warping technique is applied to overlay color and thermal textures on 3D mannequin head models, obtained using a laser range scanner.