National survey of mammographic facilities in 1985, 1988, and 1992

PURPOSE: To determine trends in mammography in the United States. MATERIALS AND METHODS: A sample of mammographic facilities was selected for each year of the Nationwide Evaluation of X-ray Trends. The same protocol was followed for the 1985, 1988, and 1992 surveys. Data were collected with use of the same imaging phantom for all three surveys and also with a different phantom in the 1988 and 1992 surveys. RESULTS: Of the 356 facilities surveyed in 1992, 59% claimed to be in compliance with the Health Care Financing Administration (HCFA) mammography requirements, 42% were accredited by the American College of Radiology (ACR), and 23% did not hold credentials from either the HCFA or the ACR. Since 1985, there has been a 34% improvement in acceptable phantom image quality score and a 20% decrease in the mean glandular dose. CONCLUSION: Mammography as practiced today is essentially a screen-film technique. Mammographic phantom image quality has improved considerably. The overall mean glandular dose has decreased primarily because of the elimination of xeroradiography.     

Parallel path consistency

Filtering algorithms are well accepted as a means of speeding up the solution of the consistent labeling problem (CLP). Despite the fact that path consistency does a better job of filtering than arc consistency, AC is still the preferred technique because it has a much lower time complexity. We are implementing parallel path consistency algorithms on multiprocessors and comparing their performance to the best sequential and parallel arc consistency algorithms.^(1,2) (See also work by Kerethoet al. ⁽³⁾ and Kasif⁽⁴⁾) Preliminary work has shown linear performance increases for parallelized path consistency and also shown that in many cases performance is significantly better than the theoretical worst case. These two results lead us to believe that parallel path consistency may be a superior filtering technique. Finally, we have implemented path consistency as an outer product computation and have obtained good results (e.g., linear speedup on a 64K-node Connection Machine 2).     

A prototype 3D optically interconnected neural network

We report the implementation of a prototype three-dimensional (3D) optoelectronic neural network that combines free-space optical interconnects with silicon-VLSI-based optoelectronic circuits. The prototype system consists of a 16-node input, 4-neuron hidden, and a single-neuron output layer, where the denser input-to-hidden-layer connections are optical. The input layer uses PLZT light modulators to generate optical outputs which are distributed over an optoelectronic neural network chip through space-invariant holographic optical interconnects. Optical interconnections provide negligible fan-out delay and allow compact, purely on-chip electronic H-tree type fan-in structure. The small prototype system achieves a measured 8-bit electronic fan-in precision and a calculated maximum speed of 640 million interconnections per second. The system was tested using synaptic weights learned off system and was shown to distinguish any vertical line from any horizontal one in an image of 4×4 pixels. New, more efficient light detector and small-area analog synapse circuits and denser optoelectronic neuron layouts are proposed to scale up the system. A high-speed, feed-forward optoelectronic synapse implementation density of up to 10⁴/cm² seems feasible using new synapse design. A scaling analysis of the system shows that the optically interconnected neural network implementation can provide higher fan-in speed and lower power consumption characteristics than a purely electronic, crossbar-based neural network implementation     

Desensitization of mutant acetylcholine receptors in transgenic mice reduces the amplitude of neuromuscular synaptic currents

While the slow onset of desensitization of nicotinic acetylcholine receptors (AChRs), relative to the rate of acetylcholine removal, excludes this kinetic state from shaping synaptic responses in normal neuromuscular transmission, its role in neuromuscular disorders has not been examined. The slow-channel congenital myasthenic syndrome (SCCMS) is a disorder caused by point mutations in the AChR subunit-encoding genes leading to kinetically abnormal (slow) channels, reduced miniature endplate current amplitudes (MEPCs), and degeneration of the postsynaptic membrane. Because of this complicated picture of kinetic and structural change in the neuromuscular junction, it is difficult to assess the importance of the multiple factors that may be responsible for the reduced endplate current amplitudes, and ultimately the clinical syndrome. In order to address this we have used a transgenic mouse model for the SCCMS that has slow AChR ion channels and reduced endplate responsiveness in the absence of any of the degenerative changes. We found that the reduction in MEPC amplitudes in these mice could not be explained by either reduced AChR number or by reduced AChR channel conductance. Rather, we found that the mutant AChRs in situ manifested an activity-dependent reduction in sensitivity that caused diminished MEPC and endplate current amplitude with nerve stimulation. This observation demonstrates that the basis for the reduction in MEPC amplitudes in the SCCMS may be multifactorial. Moreover, these findings demonstrate that, under conditions that alter their rate of desensitization, the kinetic properties of nicotinic AChRs can control the strength of synaptic responses.     

The quality management journey: the progress of health facilities in Australia

Many facilities in Australia have taken the Total Quality Management (TQM) step. The objective of this study was to examine progress of adopted formal quality systems in health. Sixty per cent of organizations surveyed have adopted formal systems. Of these, Deming adherents are the most common, followed by eclectic choices. Only 35% considered the quality transition as reasonably easy. There was no relationship between accreditation and formal quality systems identified. The most common improvement techniques were: flow charts, histograms, and cause and effect diagrams. Quality practitioners are happy to use several tools exceptionally well rather than have many tools at their disposal. The greatest impediment to the adoption of quality was the lack of top management support. This study did not support the view that clinicians are not readily actively supporting quality initiatives. Total Quality Management is not a mature concept; however, Chief Executive Officers are assured that rewards will be realized over time.     

Sexual dimorphism of circulating somatotropin, insulin-like growth factor I and II, insulin-like growth factor binding proteins, and insulin: relationships to growth rate and carcass characteristics in growing lambs

The effects of sex and age on patterns of circulating somatotropin (ST) concentration and plasma IGF-I, IGF-II, insulin, and IGF binding protein-3 (IGFBP-3) were studied in ram, wether, and ewe lambs (n = 7 or 8) sampled at mean ages of 81 (I1) and 158 d (I2). Between 81 and 158 d of age, rams grew more rapidly than wethers (P < .01), and wethers grew more rapidly than ewes (P < .01). The sex differences in growth were reflected in empty body weight at slaughter: rams > wethers > ewes (P < .05). Mean plasma ST concentrations, ST pulse amplitude, and integrated plasma ST concentrations were greater (P < .05) in rams than in ewes at I1 and I2. Characteristics of the ST plasma profile in wethers were generally intermediate between those of rams and ewes. The interpulse interval was greater in ewes than in wethers at I2. The IGF-I and IGFBP-3 concentrations were greater in rams than in ewes at both sampling times. Plasma IGF-II was greater in ewes than in rams at I2. Mean plasma ST was approximately two thirds less at I2 than at I1 regardless of sex. Mean plasma ST and IGF-I at both ages were positively correlated with growth. Mean plasma ST at I2 was negatively correlated with fatness at slaughter. Sex and age significantly affected patterns of circulating ST and concentrations of IGF-I and IGFBP-3 in prepubertal growing lambs, under conditions for which growth rates and composition were also sexually dimorphic.     

The development of a stress analysis code for nuclear graphite components in gas-cooled reactors

Most of the UK nuclear power reactors are gas-cooled and graphite moderated. As well as acting as a moderator the graphite also acts as a structural component providing channels for the coolant gas and control rods. For this reason the structural integrity assessments of nuclear graphite components is an essential element of reactor design. In order to perform graphite component stress analysis, the definition of the constitutive equation relating stress and strain for irradiated graphite is required. Apart from the usual elastic and thermal strains, irradiated graphite components are subject to additional strains due to fast neutron irradiation and radiolytic oxidation. In this paper a material model for nuclear graphite is presented along with an example of a stress analysis of a nuclear graphite moderator brick subject to both fast neutron irradiation and radiolytic oxidation.     

Ophthalmologic findings in Usher syndrome type 2A

Thirty-seven patients, comprising 24 familial cases and 13 isolated patients with Usher syndrome type II (USH2), underwent ophthalmologic examination. Based on the degree of hearing loss, normal vestibular function, and gene-linkage analysis, familial cases were assumed to have USH2A. An analysis of genetic heterogeneity failed to reveal the presence of a second locus in the Dutch population. Although the patients appear to belong to a genetically homogeneous group, remarkable ophthalmologic variability was found. Corrected visual acuity decreased with age and remarkable differences in visual acuity were found within one family. Fundoscopic findings were classified as type A if attenuated vessels and bone corpuscles in all quadrants were found or as type B if findings other than these were found. The prevalence of type A significantly increased with age.