Control of high common mode voltage during transthoracicdefibrillation

A high common mode voltage (V_cm) relative to earth ground is produced on the myocardium during the delivery of a defibrillator pulse and can generate a differential error signal when potential gradients are recorded with bipolar electrodes and isolation amplifiers. The error signal is proportional to V_cm, and therefore, a reduction in V_cm improves the accuracy of the potential gradient data. Experiments were conducted on 5 dogs to determine whether V_cm can be controlled using a bridge circuit. The bridge circuit consisted of a 5 kΩ power rheostat in parallel with the transthoracic resistance of the dog. The variable contact of the rheostat was connected to earth ground, and by adjusting the rheostat, V_cm on the myocardium could be varied. In each dog, 20 A shocks were delivered through stainless steel transthoracic electrodes. Point contact electrodes sutured to the epicardium were used to measure V_cm. It was determined that V_cm could be reduced to approximately zero at a given electrode on the heart. In addition, for the 5 dogs studied, the maximum measured V_cm on the heart was only 10% of the transthoracic voltage when the bridge circuit was balanced for an interior point in the heart     

Communication between patients with breast cancer and health care providers. Determinants and implications

BACKGROUND: This study evaluated the perceptions of patients with breast cancer of their medical interactions with providers. The determinants and psychological consequences of communication problems also were examined. METHODS: Ninety-seven patients with Stage I or II breast cancer completed a set of validated questionnaires before initiating postoperative therapy. Data on psychological distress were collected at baseline and 3-month follow-up, and multivariate models were fit to explain the relationship between pretreatment communication problems and subsequent psychological distress. Data on clinical variables were abstracted from medical records. RESULTS: A substantial proportion of patients (84%) reported difficulties communicating with the medical team. Communication problems were more common among patients who were less optimistic about their disease and had less assertive coping styles. Patient-reported communication problems were associated with increased anxiety, depression anger, and confusion at the 3-month follow-up. The association between communication problems and mood disturbance remained significant, although small, after adjusting for baseline mood disturbance, demographic, clinical, and coping style variables. CONCLUSION: Interventions that enhance communication between patients with breast cancer and their providers may improve patients' psychological adjustment to treatment. Conversely, interventions that lower distress and modify coping style may enhance communication.     

A New Approach to Two-View Motion Segmentation Using Global Dimension Minimization

We present a new approach to rigid-body motion segmentation from two views. We use a previously developed nonlinear embedding of two-view point correspondences into a 9-dimensional space and identify the different motions by segmenting lower-dimensional subspaces. In order to overcome nonuniform distributions along the subspaces, whose dimensions are unknown, we suggest the novel concept of global dimension and its minimization for clustering subspaces with some theoretical motivation. We propose a fast projected gradient algorithm for minimizing global dimension and thus segmenting motions from 2-views. We develop an outlier detection framework around the proposed method, and we present state-of-the-art results on outlier-free and outlier-corrupted two-view data for segmenting motion.     

Perceptions of tonal changes in normal laryngeal, esophageal, and artificial laryngeal male Cantonese speakers

PURPOSE: Present radiobiological studies for different cell lines in vitro demonstrate the equivalence and efficacy of continuous low-dose-rate brachytherapy (LDR-BT) and pulsed dose rate brachytherapy (PDR-BT) when using small and frequent dose pulses. The aim of this study was to examine monolayer fibroblast cultures in vitro to examine the biological effects of different pulse doses and dose rates under clinically conditions. MATERIAL AND METHODS: B14 cells, Hy B14 FAF 28, peritoneal fibroblasts, were cultured in multi-well plates and exposed to a PDR radiation source at a distance of 9 mm. The following PDR-schemes were compared: dose per pulse: 1 Gy, 2.5 Gy and 5 Gy to a total dose of 5 Gy/5 h (overall time), 10 Gy/10 h, 20 Gy/20 h and 30 Gy/30 h. The pulse duration for the examination of dose rate effects was 20 min, 30 min or 52 min corresponding by dye pulse dose rate of 300 cGy/h, 200 cGy/h or 115 cGy/h. Treatment endpoints were cell measured by dye exclusion test and clonogenic cell survival. RESULTS: Cell survival decreased for pulse doses of 5 Gy compared to 2.5 Gy or 1 Gy per pulse (mean dose rate 200 to 300 cGy/h). No differences were observed with dose rates during irradiation of 300 cGy/h, 200 cGy/h or 115 cGy/h (20 Gy/1 Gy). CONCLUSION: Radiobiological effects of PDR-RT are dependent on the dose per pulse, with differences in biological effects only with a dose per pulse of more than 2.5 Gy, considering the described in-vitro conditions. More examinations with a more pronounced difference in dose rate will be continued for evaluation of dose rate effects.     

Calibrated single-plunge bipolar electrode array for mapping myocardial vector fields in three dimensions during high-voltage transthoracic defibrillation

Mapping of the myocardial scalar electric potential during defibrillation is normally performed with unipolar electrodes connected to voltage dividers and a global potential reference. Unfortunately, vector potential gradients that are calculated from these data tend to exhibit a high sensitivity to measurement errors. This paper presents a calibrated single-plunge bipolar electrode array (EA) that avoids the error sensitivity of unipolar electrodes. The EA is triaxial, uses a local potential reference, and simultaneously measures all three components of the myocardial electric field vector. An electrode spacing of approximately 500 microm allows the EA to be direct-coupled to high-input-impedance, isolated, differential amplifiers and eliminates the need for voltage dividers. Calibration is performed with an electrolytic tank in which an accurately measured, uniform electric field is produced. For each EA, unique calibration matrices are determined which transform potential difference readings from the EA to orthogonal components of the electric field vector. Elements of the matrices are evaluated by least squares multiple regression analysis of data recorded during rotation of the electric field. The design of the electrolytic tank and electrode holder allows the electric field vector to be rotated globally with respect to the electrode axes. The calibration technique corrects for both field perturbation by the plunge electrode body and deviations from orthogonality of the electrode axes. A unique feature of this technique is that it eliminates the need for mechanical measurement of the electrode spacing. During calibration, only angular settings and voltages are recorded. For this study, ten EAs were calibrated and their root-mean-square (rms) errors evaluated. The mean of the vector magnitude rms errors over the set of ten EAs was 0.40% and the standard deviation 0.07%. Calibrated EAs were also tested for multisite mapping in four dogs during high-voltage transthoracic shocks.     

Resource Allocation in the Grid with Learning Agents

One of the main challenges in Grid computing is efficient allocation of resources (CPU – hours, network bandwidth, etc.) to the tasks submitted by users. Due to the lack of centralized control and the dynamic/stochastic nature of resource availability, any successful allocation mechanism should be highly distributed and robust to the changes in the Grid environment. Moreover, it is desirable to have an allocation mechanism that does not rely on the availability of coherent global information. In this paper we examine a simple algorithm for distributed resource allocation in a simplified Grid-like environment that meets the above requirements. Our system consists of a large number of heterogenous reinforcement learning agents that share common resources for their computational needs. There is no explicit communication or interaction between the agents: the only information that agents receive is the expected response time of a job it submitted to a particular resource, which serves as a reinforcement signal for the agent. The results of our experiments suggest that even simple reinforcement learning can indeed be used to achieve load balanced resource allocation in large scale heterogenous system.     

Top-down vs bottom-up methodologies in multi-agent system design

Traditionally, two alternative design approaches have been available to engineers: top-down and bottom-up. In the top-down approach, the design process starts with specifying the global system state and assuming that each component has global knowledge of the system, as in a centralized approach. The solution is then decentralized by replacing global knowledge with communication. In the bottom-up approach, on the other hand, the design starts with specifying requirements and capabilities of individual components, and the global behavior is said to emerge out of interactions among constituent components and between components and the environment. In this paper we present a comparative study of both approaches with particular emphasis on applications to multi-agent system engineering and robotics. We outline the generic characteristics of both approaches from the MAS perspective, and identify three elements that we believe should serve as criteria for how and when to apply either of the approaches. We demonstrate our analysis on a specific example of load balancing problem in robotics. We also show that under certain assumptions on the communication and the external environment, both bottom-up and top-down methodologies produce very similar solutions.

Genetic testing: Psychological aspects and implications.

As the number of genes associated with inherited disease continues to grow, researchers and practitioners in behavioral medicine will encounter complex psychological issues faced by individuals at risk for these diseases. A review of the literature concerning prenatal, carrier, and predictive genetic testing suggests that the severity of psychological risks posed by research-based genetic testing is not great. However, subgroups of individuals with particular psychological traits may be more vulnerable to adverse effects. Available data do not provide evidence that genetic testing promotes changes in health-related behaviors. Thus, although there may be less of a role for mental health professionals in the psychological counseling of genetic testing participants, there is a need for research and practice to facilitate health protective behaviors in response to genetic risk information. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A brief assessment of concerns associated with genetic testing for cancer: The multidimensional impact of cancer risk assessment (MICRA) questionnaire.

The Multidimensional Impact of Cancer Risk Assessment (MICRA) is a new tool to measure the specific impact of result disclosure after genetic testing. The authors compared its performance with that of questionnaires measuring general and cancer-specific distress. Participants (158 women) responded 1 month after they received genetic test results. The women were divided into 4 standard clinical test result groups: BRCA1/2 positive, BRCA1/2 negative, panel negative, and true negative. Factor analysis supported the formation of 3 subscales: Distress (6 items, α= .86), Uncertainty (9 items, α= .77), and Positive Experiences (4 items, α= .75). All 3 MICRA subscales differentiated participants who were BRCAI/2 positive from the other 3 groups. MICRA thus helps identify subgroups of vulnerable genetic testing participants. (PsycINFO Database Record (c) 2010 APA, all rights reserved)