An interactive lung field segmentation scheme with automated capability

Feasible clinical application of any automated segmenting methodology demands more than just accuracy. Amendment to the automated delineation is necessary when the algorithm fails, however, integrated solution to such a scenario is largely absent in literature. Hence in this survey we devised an architecture that does both the automated and interactive lung field localizations using a single segmenting engine—random walker algorithm—so that intuitive amendment is only necessary when the automated generated delineation is unsatisfactory. The algorithm proceeds by first extracting 18 intensity profiles running horizontally, each of them equally spacing apart, and in each intensity profile three extreme points denoting the two lungs and the esophagus are determined through profile matching. This done, the algorithm removes profiles that do not intersect with the lung, and the rest of the extreme points are plugged into random walker algorithm to perform segmentation. The achieved accuracy in localization by the above was 0.8875 in terms of overlap measure (the maximum value for this parameter is 1) over 341 images. In the case where unsatisfactory delineation prompts amendment necessary, the user can interactively segment the lung by just a shift on some of the previous-determined points to the desired locations, and random walker algorithm is run again with the amended input. By such a fusion, the benefits of both the automated and interactive segmentation are shared in a single architecture.     

Evaluating opportunistic networks in disaster scenarios

Forwarding data in scenarios where devices have sporadic connectivity is a challenge. An example scenario is a disaster area, where forwarding information generated in the incident location, like victims' medical data, to a coordination point is critical for quick, accurate and coordinated intervention. New applications are being developed based on mobile devices and wireless opportunistic networks as a solution to destroyed or overused communication networks. But the performance of opportunistic routing methods applied to emergency scenarios is unknown today. In this paper, we compare and contrast the efficiency of the most significant opportunistic routing protocols through simulations in realistic disaster scenarios in order to show how the different characteristics of an emergency scenario impact in the behaviour of each one of them.     

Online hybrid traffic classifier for Peer-to-Peer systems based on network processors

It is estimated that 70% or more of broadband bandwidth is consumed by transmitting music, games, video and other content through Peer-to-Peer (P2P) clients. In order to detect, identify, and manage P2P traffic, some port, payload and transport layer feature based methods were proposed. Most of them were applied to offline traffic classification mainly due to the performance reason. In this paper, a network processors (NPs) based online hybrid traffic classifier is proposed. The designed hardware classifier is able to classify P2P traffic based on the static characteristic namely on line speed, and the Flexible Neural Tree(FNT) based software classifier helps learning and selecting P2P traffic attributes from the statistical characteristics of the P2P traffic. Experiment results illustrate that the hybrid classifier performs well for online classification of P2P traffic from gigabit network. The proposed framework also depicts good expansion capabilities to add new P2P features and to adapt to new P2P applications online.     

Diamorphine-bupivacaine mixture compared with plain bupivacaine for analgesia

We have studied the efficacy of two extradural infusions (10 ml h-1) in 50 patients in active labour. Patients in the diamorphine group (n = 25) received 0.0625% plain bupivacaine 6.25 mg h-1 mixed with 0.005% diamorphine 0.5 mg h-1 and those in the control group (n = 25) received 0.125% plain bupivacaine 12.5 mg h-1. Both groups received intermittent "top-ups" of 0.25% bupivacaine 10 ml when indicated. Although median pain scores during the infusion were similar in both groups, patients in the diamorphine group indicated greater satisfaction with the infusion (88% very satisfied, compared with 52% in the control group (P < 0.02)). There were no differences in the incidence of hypotension, instrumental vaginal delivery, number of "top-ups", duration of the second stage or extent of motor block. However, patients in the diamorphine group had a high incidence of pruritus (44%, compared with 0% in the control group (P < 0.01)).     

Lichtenstein herniotomy

All standard methods of hernia repair involve suturing together tissues which are not normally in apposition. This violates the basic surgical principle that tissue must never be approximated under tension and accounts for an unacceptable number of failures. Total reinforcement of the inguinal floor with a sheet of suitable biomaterial and employment of a "tension-free" technique is a more effective approach. Since June 1984, 3250 primary inguinal hernias have been repaired at the Lichtenstein Hernia Institute by the open tension-free technique using Marlex mesh. All operations were performed under local anesthesia. Patients were discharged from the hospital within two or four hours after the operation. The patients were followed from one to 8 years by physician examination. The follow-up rate was 87%. There were four recurrences. The causes of recurrence and how to avoid them are discussed.     

Life cycle energy and carbon footprint analysis of photovoltaic battery microgrid system in India

Electricity supply in India is from a centralized grid. Many parts of the country experience grid interruptions. Life cycle energy and environmental analysis has been done for a 27 kWp photovoltaic system which acts as grid backup for 3 h outage in an Indian urban residential scenario. This paper discusses energy requirements and carbon emission for a PV storage system for five different battery technologies in Indian context. This can be used as a metric for comparative analysis for new batteries, with an undeveloped market. The energy requirements for the components are quantified and are compared in terms of energy payback time (EPBT) and Net Energy Ratio (NER). All the calculations are done for Indian context. EPBT is found to be in the range of 2–4.5 years for all the systems, while NER is in the range of 6.6–2.52. NaS has the highest emission factor of 0.67 kgCO₂/kWh and the least for NiCd (0.091 kgCO₂/kWh). These factors can be used to select a PV battery option and to target selection of materials and systems based on the reported values.     

Selective vapor sorption by polymers and cavitands on acoustic wave sensors: is this molecular recognition?

Selectivity patterns for the sorption of organic vapors from the gas phase into cavitand monolayers on acoustic wave sensors are very similar to those seen for sorption of the same vapors by amorphous polymers, demonstrating that the vapor/cavitand selectivity patterns are determined primarily by solubility interactions. The amorphous polymers serve as controls demonstrating that the three-dimensional structure of a cavitand layer is not primarily responsible for the selectivity observed. Binding and selectivity in the examples cited are governed primarily by general dispersion interactions and not by specific oriented interactions that could lead to molecular recognition.     

Critical care medicine: opportunities and strategies for improvement

BACKGROUND: Like other areas of health care, critical care faces increasing pressure to improve the quality while reducing the cost of care. Strategies drawn from the literature and the authors' experiences are presented. STRATEGIES AND OPPORTUNITIES FOR IMPROVEMENTS: Ten process- or structure-related areas are targeted as strategically important focuses of improvement: (1) restructuring administrative lines to better suit key processes; (2) physician leadership in critical care units; (3) management training for critical care managers; (4) triage; (5) multidisciplinary critical care; (6) standardization of care; (7) developing alternatives to critical care units; (8) timeliness of care delivery; (9) appropriate use of critical care resources; and (10) tracking quality improvement. TIMELINESS OF CARE DELIVERY: Whatever the root cause(s) of unnecessary delays, the result is inefficient use of critical care resources-and ultimately either a need for more resources or longer wait times. Innovations designed to reduce wait times and waste, such as the establishment of a microchemistry stat laboratory, may prove valuable. APPROPRIATE USE OF CRITICAL CARE RESOURCES: Possible strategies for the appropriate use of critical care resources include better selection of well-informed patients who undergo procedures. Reduction in variation among physicians and organizations in providing therapies will also likely lead to a reduction in some high-risk procedures offering little or no benefit, and therefore a reduction in need for critical care services. Better preparation of patients and families should also make end-of-life decisions easier when questions of "futility" arise. Better information on outcomes and cost-effectiveness and consensus on withdrawal of critical care treatments represent two additional strategies.     

Rerouting of the intratemporal facial nerve: an analysis of the literature

Anterior rerouting of the intratemporal facial nerve in the infratemporal fossa approach is employed to access to the jugular bulb, hypotympanum, and lateral skull base, whereas posterior rerouting of the facial nerve, as employed in the transcochlear craniotomy, is most frequently used for surgery of the posterior fossa, cerebellopontine angle, prepontine region, and petrous apex. Facial nerve rerouting may lead to facial paresis or paralysis. This review of the literature is intended to define the physiologic "cost" of these procedures, so that the neurotologic surgeon can determine if the morbidity incurred in these techniques is worth the resultant exposure. Inconsistencies in reporting facial function places into question the validity of some of the cumulative data reported. Postoperatively, grades I-II facial nerve function was seen in 91% of patients undergoing short anterior rerouting, 74% of patients undergoing long anterior rerouting, and 26% of patients undergoing posterior complete rerouting. Although facial nerve rerouting allows unhindered exposure to previously inaccessible regions, it is achieved at the cost of facial nerve function. Facial nerve dysfunction increases with the length of facial nerve rerouted.