Search

Image-guided high-intensity focused ultrasound (HIFU) has been increasingly used in medicine over the past few decades, and several systems for such have become commercially available. HIFU has passed regulatory approval around the world for the ablation of various solid tumors, the treatment of neurologic diseases, and the palliative management of bone metastases. The mechanical and thermal effects of focused ultrasound provide a possibility for histotripsy, supportive radiation therapy, and targeted drug delivery. The integration of imaging modalities into HIFU systems allows for precise temperature monitoring and accurate treatment planning, increasing the safety and efficiency of treatment. Preclinical and clinical results have demonstrated the potential of image-guided HIFU to reduce adverse effects and increase the quality of life postoperatively. Interventional nuclear image–guided HIFU is an attractive noninvasive option for the future.

High intensity focused ultrasound is used as a surgical tool to treat completely non-invasively several diseases. Examples of clinical applications are uterine fibroids, prostate cancer, thyroid nodules, and varicose veins. Precise targeting is key for improving the treatment outcome. A method for an automated, robot-assisted tracking system was developed and evaluated. A wireless ultrasound scanner was used to acquire images of the target, in this case, a blood vessel. The active contour approach by Chan and Vese was used to segment and track while moving the scanner along the target structure with a collaborative robotic arm. The performance was assessed using a custom made Agar phantom. The mean tracking error, which is defined as the remaining distance of the lesion to the images’ centre line, was 0.27 mm ± 0.18 mm.

Complex morphological traits are the product of many genes with transient or lasting developmental effects that interact in anatomical context. Mouse models are a key resource for disentangling such effects, because they offer myriad tools for manipulating the genome in a controlled environment. Unfortunately, phenotypic data are often obtained using laboratory-specific protocols, resulting in self-contained datasets that are difficult to relate to one another for larger scale analyses. To enable meta-analyses of morphological variation, particularly in the craniofacial complex and brain, we created MusMorph, a database of standardized mouse morphology data spanning numerous genotypes and developmental stages, including E10.5, E11.5, E14.5, E15.5, E18.5, and adulthood. To standardize data collection, we implemented an atlas-based phenotyping pipeline that combines techniques from image registration, deep learning, and morphometrics. Alongside stage-specific atlases, we provide aligned micro-computed tomography images, dense anatomical landmarks, and segmentations (if available) for each specimen (N=10,056). Our workflow is open-source to encourage transparency and reproducible data collection. The MusMorph data and scripts are available on FaceBase (www.facebase.org, doi.org/10.25550/3-HXMC) and GitHub (https://github.com/jaydevine/MusMorph).

Multimodality imaging has emerged from a vision thirty years ago to routine clinical use today. Positron emission tomography (PET)/magnetic resonance imaging (MRI) is still relatively new in this arena and particularly suitable for clinical research and technical development. PET/MRI-guidance for interventions opens up opportunities for novel treatments but at the same time demands certain technical and organizational requirements to be fulfilled. In this work, we aimed to demonstrate a practical setting and potential application of PET/MRI guidance of interventional procedures. The superior quantitative physiologic information of PET, the various unique imaging characteristics of MRI, and the reduced radiation exposure are the most relevant advantages of this technique. As a noninvasive interventional tool, focused ultrasound (FUS) ablation of tumor cells would benefit from PET/MRI for diagnostics, treatment planning and intervention. Yet, technical limitations might impeed preclinical research, given that PET/MRI sites are per se not designed as interventional suites. Nonetheless, several approaches have been offered in the past years to upgrade MRI suites for interventional purposes. Taking advantage of state of the art and easy-to-use technology it is possible to create a supporting infrastructure that is suitable for broad preclinical adaption. Several aspects are to be addressed, including remote control of the imaging system, display of the imaging results, communication technology, and implementation of additional devices such as a FUS platform and an MR-compatible robotic system for positioning of the FUS equipment. Feasibility could be demostrated with an examplary experimental setup for interventional PET/MRI. Most PET/MRI sites could allow for interventions with just a few add-ons and modifications, such as comunication, in room image display and sytems control. By unlocking this feature, and driving preclinical research in interventional PET/MRI, translation of the protocol and methodology into clinical settings seems feasible.

Focused ultrasound (FUS) has become an important non-invasive therapy for solid tumor ablation via thermal effects. The cavitation effect induced by FUS is thereby avoided but applied for lithotripsy, support drug delivery and the induction of blood vessel destruction for cancer therapy. In this study, head and neck cancer (FaDu), glioblastoma (T98G), and prostate cancer (PC-3) cells were exposed to FUS by using an in vitro FUS system followed by single-dose X-ray radiation therapy (RT) or water bath hyperthermia (HT). Sensitization effects of short FUS shots with cavitation (FUS-Cav) or without cavitation (FUS) to RT or HT (45 &deg, C, 30 min) were evaluated. FUS-Cav significantly increases the sensitivity of cancer cells to RT and HT by reducing long-term clonogenic survival, short-term cell metabolic activity, cell invasion, and induction of sonoporation. Our results demonstrated that short FUS treatment with cavitation has good potential to sensitize cancer cells to RT and HT non-invasively.

Due to comparatively long measurement times in PET/MR imaging, patient movement during the acquisition is likely. This leads to artefacts which have a negative impact on the visual assessment and quantitative validity of the image data and, in the worst case, lead to misinterpretations. Simultaneous PET/MR systems allow the registration of movements and enable correction of the PET data. In order to assess the effectiveness of the motion correction methods, it is necessary to carry out measurements on phantoms that are reproducibly moved. An experimental setup was developed for specific movements. An MR-compatible robotic system was used to generate rigid movements of a brain-like phantom acquired on a Siemens mMR. Different tools, either from the manufacturer or open-source software, were used to estimate and correct for motion. Different motion estimates were compared with the robot-induced motion. Results of motion correction of the PET data were evaluated by determining the segmented volume of a flask. The flask was a hotspot visible in both PET and MR, used to simulate a lesion. The experimental setup is suitable for the generation of reproducible movement patterns. The results showed the motion-corrected PET images have a decreased volume as expected. The evaluated motion correction methods produced corrected PET images that were less affected by motion.

Planning of interventions to treat cardiac arrhythmia requires a 3D patient specific model of the heart. Currently available commercial or free software dedicated to this task have important limitations for routinely use. Automatic algorithms are not robust enough while manual methods are time-consuming. Therefore, the project attempts to develop an optimal software tool. The heart model is generated from preoperative MR data-sets acquired with contrast agent and allows visualisation of damaged cardiac tissue. A requirement in the development of the software tool was the use of semi-automatic functions to be more robust. Once the patient image dataset has been loaded, the user selects a region of interest. Thresholding functions allow selecting the areas of high intensities which correspond to anatomical structures filled with contrast agent, namely cardiac cavities and blood vessels. Thereafter, the target-structure, for example the left ventricle, is coarsely selected by interactively outlining the gross shape. An active contour function adjusts automatically the initial contour to the image content. The result can still be manually improved using fast interaction tools. Finally, possible scar tissue located in the cavity muscle is automatically detected and visualized on the 3D heart model. The model is exported in format which is compatible with interventional devices at hospital. The evaluation of the software tool included two steps. Firstly, a comparison with two free software tools was performed on two image data sets of variable quality. Secondly, six scientists and physicians tested our tool and filled out a questionnaire. The performance of our software tool was visually judged more satisfactory than the free software, especially on the data set of lower quality. Professionals evaluated positively our functionalities regarding time taken, ease of use and quality of results. Improvements would consist in performing the planning based on different MR modalities.

Infrared thermography can be used as a pre-, intra- and post-operative imaging technique during medical treatment of patients. Modern infrared thermal cameras are capable of acquiring images with a high sensitivity of 10 mK and beyond. They provide a planar image of an examined 3D object in which this high sensitivity is only reached within a plane perpendicular to the camera axis and defined by the focus of the lens. Out of focus planes are blurred and temperature values are inaccurate. A new 3D infrared thermography system is built by combining a thermal camera with a depth camera. Multiple images at varying focal planes are acquired with the infrared camera using a motorized system. The sharp regions of individual images are projected onto the 3D object’s surface obtained by the depth camera. The system evaluation showed that deviation between measured temperature values and a ground truth is reduced with our system.

Knowing the location of the blood vessels supplying the skin and subcutaneous tissue is a requirement during the planning of tissue transfer in reconstructive surgery. Commonly used imaging techniques such as computed tomography angiography and indocyanine green angiography expose the patient to radiation or a contrast agent, respectively. Infrared thermal imaging was evaluated with success as a non-invasive alternative. To support the interpretation of thermograms, a method to automatically detect the perforators was developed and evaluated. A system consisting of a thermal camera, a PC and custom software was developed. The temperature variations of the skin surface were analysed to extract the perforator locations. A study was conducted to assess the performance of the algorithm by comparing the detection results of the algorithm with manually labelled thermal images by two clinicians of the deep inferior epigastric perforator flap of 20 healthy volunteers. The F measure, precision and recall were used to evaluate the system performance. The median F measure is 0.833, the median precision is 0.80, and the median recall is 0.907. The results of this study showed that it is possible to automatically and reliably detect the skin perforators in thermograms despite their weak temperature signature. Infrared thermal imaging is a non-invasive and contactless approach suitable for intraoperative use. Combined with a computer-assisted tool for the automatic detection of perforator vessels, it is a relevant alternative intraoperative imaging method to the standard indocyanine green angiography.

The aim of this study is to investigate static and dynamic infrared (IR) thermography for intra- and postoperative free-flap monitoring following oropharyngeal reconstruction. Sixteen patients with oropharyngeal reconstruction by free radial forearm flap were included in this prospective, clinical study (05/2013-08/2014). Prior ("intraop_pre") and following ("intraop_post") completion of the microvascular anastomoses, IR thermography was performed for intraoperative flap monitoring. Further IR images were acquired one day ("postop_1") and 10 days ("postop_10") after surgery for postoperative flap monitoring. Of the 16, 15 transferred free radial forearm flaps did not show any perfusion failure. A significant decreasing mean temperature difference (∆T: temperature difference between the flap surface and the surrounding tissue in Kelvin) was measured at all investigation points in comparison with the temperature difference at "intraop_pre" (mean values on all patients: ∆T intraop_pre = -2.64 K; ∆T intraop_post = -1.22 K, p

A large scientific community depends on the precise modelling of complex processes in particle cascades in various types of matter. These models are used most prevalently in cosmic-ray physics, astrophysical-neutrino physics, and gamma-ray astronomy. In this white paper, we summarize the necessary steps to ensure the evolution and future availability of optimal simulation tools. The purpose of this document is not to act as a strict blueprint for next-generation software, but to provide guidance for the vital aspects of its design. The topics considered here are driven by physics and scientific applications. Furthermore, the main consequences of implementation decisions on performance are outlined. We highlight the computational performance as an important aspect guiding the design since future scientific applications will heavily depend on an efficient use of computational resources., Comment: 17 pages, 2 figures, content matches published version

Cancers of the lung and bronchus are the leading cause of cancer deaths in men and women in the United States, and two-thirds of new lung cancer cases are diagnosed in patients over age 65. There are few dedicated clinical trials in the elderly, leading to both undertreatment and overtreatment biases. Even fit older adults experience age-related decline in physiologic reserve, and additional issues of polypharmacy, geriatric syndromes, and inadequate social support are not uncommon, leading to disparities in treatment and survival. This review discusses the challenges in balancing benefits and harms in management of lung cancer in elderly patients.

In this study, we demonstrate the embedding of non-classical heat conducting components (heat pipes) as a possible solution for heat management in tightly packed applications whereas heat spreading and heat guiding can be of extreme importance. Measurements results and simulations will describe the advantages of the presented technology. Further, this paper discusses possible bottlenecks and proposes solutions accordingly.

Embedding technology enables miniaturisation of electric and electronic components together with improved reliability and thermal stability in harsh environment. This work investigates in form of single case studies the environmental performance from cradle-to-gate of two new designed and fabricated power modules for electric vehicle application with the method of the Sustainable Process Index (SPI) or “ecological footprint”. The SPI results for a 500 W power module demonstrator for e-bikes is 461 m2.a/sample and for a 50 kW power module demonstrator for automotive application 18817 m2.a/sample. The life cycle impact assessments show, that the wafer manufacturing has the largest impact followed by the silver sinter paste, FR4 material and copper in case of the 500 W Demonstrator, and by the silver sinter paste in case of the 50 kW Demonstrator, respectively. These first results show, that there is further research needed to generate more precise life cycle inventory data for wafer fabrication, FR4 material manufacturing, and the fabrication of metallization sinter pastes including nano-particles.

An entirely novel multilayer printed circuit board technology called EmPower allows embedding of chip components like power diodes, MOSFETs (Metal-oxide Semiconductor Field Effect Transistors) or IGBTs (Insulated Gate Bi-polar Transistors) at a significantly reduced module thickness into a glass fiber reinforced epoxy-resin layer built-up. One major concern is to handle the power loss within the given small module volume and to investigate the thermomechanical stress conditions in the module after the embedding process. In this contribution the authors also show the full thermal characterization procedure of a B6-converter bridge of a 500W motor driver demonstrator module for a Pedelec (Pedal Electric Cycle). Results are compared to those obtained from a module fabricated with state-of-the-art SMT MOSFETs. Advancements like superior thermal performance, increase in efficiency, and reduction of weight and space requirement obtained with this embedding technology and the built-up concept for mass fabrication are also discussed.

A 3-phase high power inverter bridge for a 500 W PEDELEC motor fabricated using a novel embedding technology was benchmarked against a classically designed module using MOSFETs in a B6 Bridge. By operating each MOSFET individually in reverse mode and measuring the forward voltage during high current operation and after switching to a measuring current of 50 mA the junction temperature has been measured. Equivalent thermal resistances used for comparison have been calculated. By reverse modelling the thermal behaviour of the entire module including the MOSFETs' junction temperatures at full operation has been established. The study is extended to an embedded 50kW-demonstrator design for electric vehicle applications where the thermal resistances were studied and the maximum allowable boundary conditions predicted by simulation.

Mutations in the epidermal growth factor receptor gene (EGFR) represent one of the most frequent "actionable" alterations in non-small cell lung cancer (NSCLC). Typified by high response rates to targeted therapies, EGFR tyrosine kinase inhibitors (TKIs) are now established first-line treatment options and have transformed the treatment paradigm for NSCLC. With the recent breakthrough designation and approval of the third-generation EGFR TKI osimertinib, available systemic and local treatment options have expanded, requiring new clinical algorithms that take into account individual patient molecular and clinical profiles. In this International Association for the Study of Lung Cancer commissioned consensus statement, key pathologic, diagnostic, and therapeutic considerations, such as optimal choice of EGFR TKI and management of brain metastasis, are discussed. In addition, recommendations are made for clinical guidelines and research priorities, such as the role of repeat biopsies and use of circulating free DNA for molecularstudies. With the rapid pace of progress in treating EGFR-mutant NSCLC, this statement provides a state-of-the-art review of the contemporary issues in managing this unique subgroup of patients.

Lung cancer screening with LDCT is a complex and controversial topic, with inherent risks and benefits. Results from the large, prospective, randomized NLST show that lung cancer screening with LDCT can decrease lung cancer–specific mortality by 20% and even decrease all-cause mortality by 7%.8 The NLST results indicate that to prevent one death from lung cancer, 320 high-risk individuals must be screened with LDCT. However, the NLST findings have not been replicated yet in a separate cohort. Further analysis of the NLST is underway, including comparative effectiveness modeling. The cost-effectiveness and true benefit-to-risk ratio for lung cancer screening still must be determined. At some point, an acceptable level of risk will have to be deemed appropriate for the benefits of screening. The NCCN Lung Cancer Screening Panel recommends helical LDCT screening for select patients at high risk for lung cancer based on the NLST results, nonrandomized studies, and observational data. These guidelines discuss in detail the criteria for determining which patients are at high risk, and the algorithm provides recommendations for evaluating and following-up nodules detected on LDCT screening (e.g., solid and part-solid nodules). Smokers should always be encouraged to quit smoking tobacco (http://www.smokefree.gov/). Programs using behavioral counseling combined with medications that promote smoking cessation (approved by the FDA) can be very useful (see Treating Tobacco Use and Dependence: Quick Reference Guide for Clinicians; http://www.surgeongeneral.gov/tobacco/tobaqrg.htm). When considering lung cancer screening, it is important to have a full understanding of all risks and benefits related to screening with LDCT. As policies for implementing lung screening programs are designed, a focus on multidisciplinary programs (incorporating primary care doctors, pulmonologists, radiologists, thoracic surgeons, medical oncologists, and pathologists) will be helpful to optimize decision-making and minimize interventions for patients with benign lung disease.

Purpose – The purpose of this paper is to demonstrate the influence of material properties and fabrication technique on the performance of an embedded pressure sensor. Based on conducted theoretical analysis a suitable material and technological technique that gave the best behavior of designed sensor was chosen for its fabrication. This is verified on the example of a resonant pressure sensor, designed for operation in the MHz range.Design/methodology/approach – A sensor module is fabricated using the low temperature co‐fired ceramics (LTCC) technology and sputtering technique for electrodes deposition. The module comprises an inductor connected with a variable capacitor formed by the sensor membranes in a parallel LC circuit. An extensive parallel analysis of sensors performance for sensors with thick film (screen‐printed) and thin film (sputtered) electrodes is demonstrated. Mechanical and electrical parameters (Young's modulus and permittivity) of different tape materials that are considered for senso...

Objectives: This Phase I study determines the maximum tolerated dose (MTD) of stereotactic body radiotherapy (SBRT) for lung tumors. Methods: Eli- gible patients had biopsy proven cancer with a maxi- mum tumor size ≤ 5 cm. Total doses were escalated from 40 to 48, then to 56 Gy, delivered in 4 equal fractions administered 2 to 3 times per week on an IRB approved protocol. SBRT was administered us- ing 5 to 9 fixed beam arrangements with CT loca- lization. Internal target volumes (ITV) were based on breath hold scans or 4D CT simulation. The planning target volume (PTV) was defined as the ITV with a uniform 5 mm expansion. Dose limiting toxicity (DLT) was defined as any grade 3 or higher toxicity using the Radiation Therapy Oncology Group (RTOG) common toxicity criteria (CTC). Results: Between April 2004 and February 2008, 18 patients received the prescribed treatment (40 Gy n = 6, 48 Gy n = 7, 56 Gy n = 5). Seventeen of 18 patients had non-small cell lung cancer (1 with rectal cancer), four of whom were treated for an oligometastasis. The median age of the patients was 68, while the median Karnofsky performance status was 90. The mean tumor size was 2.6 cm (range 0.9 to 4.5 cm). One grade 3 pulmonary event occurred (at 48 Gy dose level) immediately following treatment with the onset of fever and shortness of breath that responded to antibiotics. No other DLTs occurred. Conclusions: SBRT utilizing patient specific target volumes without gating appears safe. The maximum tolerated dose was not reached.

This paper proposes a fully embedded resonant pressure sensor operating in the MHz range and realized in the standard low-temperature co-fired ceramics (LTCC) technology. Buried sensor design and usage of LTCC materials enable application of this sensor in high-temperature and chemically aggressive environments. Upgraded sensor and sensor-antenna models residing on an analytical concept are used for prediction of the system performance. Also, simulation results show that an increase of Young's modulus for the LTCC tape diminishes the sensor sensitivity. An experimental setup for wireless data retrieval is designed enabling precise measurement of the influence of pressure variation on the sensors resonant frequency. Experimentally attained results are compared with electrical characteristics determined by analytical calculations as well as those derived from electrical simulations.

PurposeThe purpose of this paper is to describe two new thick film paste systems (one glass‐based and the other polymer‐based) for insulating aluminium substrates and allowing components like high‐intensity light‐emitting diodes to be attached to a conductor deposited on the dielectric.Design/methodology/approachComparative measurements of the thermal resistance of different substrates mounted with metal‐oxide semiconductor field‐effect transistors were made.FindingsThe thermal advantages of these two technologies have been proved.Originality/valueThis paper presents useful comparative data from a replicated application using different combinations of substrates. The paper shows how the superior properties of the two new systems have been proven by thermal resistance measurements. From a thermal point of view, it is only the expensive 4 W m−1 K−1 insulated metal substrate that competes with the “low cost” systems.

Multiphase steels play an important role for the automotive industry. Their mechanical properties are strongly influenced by the microstructure. A quantitative description of the microstructure is necessary in order to optimise the properties of multiphase steels through a precise microstructure design. Using only light optical microscopy (LOM), the characterisation of multiphase steels cannot be achieved sufficiently due to the fact that very fine metallographic constituents are present, which are smaller than the optical resolution limit. This problem can be solved by using scanning electron microscope (SEM) images in addition to the light optical images. Within this work, we describe a method for automatic composing LOM and SEM images into a single feature image. In addition, a novel segment based approach is presented, which classifies different phases in images of multiphase steels. Thereby we use several features of the derived segments for the classification process.

A new type of integrated temperature and humidity sensor applying Low Temperature Cofired Ceramics technology (LTCC) has been developed and characterized. The proposed device is based on the detection of the difference of thermal conductivity between water vapor and dry air. In this approach, sensing elements are implemented using heated metal film resistors (Pt-elements), where one is exposed to the humid environment that causes the sensor element to cool down with increased humidity, while the other one is sealed from the environment. LTCC-tapes are used for the formation of caps as well are acting as substrate. Sensor design is based on finite element analyses (FEA) where the critical design parameters have been analyzed with regard to the performance characteristic of the device.

Background To develop an evidence-based approach to follow-up of patients after curative intent therapy for lung cancer. Methods Guidelines on lung cancer diagnosis and management published between 2002 and December 2005 were identified by a systematic review of the literature, and supplemental material appropriate to this topic was obtained by literature search of a computerized database (Medline) and review of the reference lists of relevant articles. Results Adequate follow-up by the specialist responsible for the curative intent therapy should be ensured to manage complications related to the curative intent therapy and should last at least 3 to 6 months. In addition, a surveillance program should be considered to detect recurrences of the primary lung cancer and/or development of a new primary lung cancer early enough to allow potentially curative retreatment. A standard surveillance program for these patients, coordinated by a multidisciplinary tumor board and overseen by the physician who diagnosed and initiated therapy for the original lung cancer, is recommended based on periodic visits with chest imaging studies and counseling patients on symptom recognition. Smoking cessation and, if indicated, facilitation in participation in special programs is recommended for all patients following curative intent therapy for lung cancer. Conclusions The current evidence favors follow-up of complications related to curative intent therapy, and a surveillance program at regular intervals with imaging and review of symptoms. Smoking cessation after curative intent therapy to prevent recurrence of lung cancer is strongly supported by the available evidence.

Gestützt auf eine Finite-Elemente-Analyse wurde ein kalorimetrischer Strömungssensor in Dickschichttechnik auf einem Stahlrohr aufgebaut. Die Sensorkennlinie wurde sowohl experimentell als auch aufgrund der numerischen Simulation ermittelt. Die erforderlichen Maßnahmen zur Erweiterung des linearen Kennlinienbereichs und zur Erhöhung des Signalpegels werden aufgezeigt.

Even though survival and quality of life are adversely affected by smoking among cancer patients, about one-third of cancer patients who smoked prior to their diagnosis continue to smoke. One barrier to the provision of smoking cessation treatments to cancer patients is the paucity of data on the characteristics of cancer patients who continue to smoke and a lack of data on correlates of quit motivation in this population. This descriptive study assessed demographic, medical, smoking history, and psychological characteristics of cancer patients in a smoking cessation program (N=111) and examined these characteristics as correlates of quit motivation. Methods used by patients to quit smoking were also queried. We found that: (1) most patients are Caucasian, married, diagnosed with head and neck (versus lung) cancer, highly addicted to nicotine, and in the contemplation or preparation stage of change; (2) most patients attempt to quit smoking without formal treatment, although 33-50% have used the transdermal nicotine patch, nicotine gum, or bupropion; (3) depressive symptoms, low quitting self-efficacy, low perceived risk, and low perceived benefits of quitting are prevalent among patients, but most patients do not endorse the perceived disadvantages of quitting or fatalistic beliefs; and (4) quit motivation is associated with higher quitting self-efficacy, risk perceptions, and perceived benefits of quitting, lower tobacco use and nicotine addiction, and shorter time since diagnosis. These findings can help guide the development of smoking cessation interventions for cancer patients.

Background. Despite the availability of smoking interventions for cancer patients, many eligible patients decline enrollment into such programs. We examined reasons patients provide for declining smoking treatment and compared treatment decliners to enrollees. Methods. Eligible cancer patients (N = 231) were offered smoking cessation treatment. During recruitment, demographic, medical (eg, cancer stage), and smoking-related behavioral (eg, readiness to quit) data were collected, and decliners stated a reason for refusal. Patients who enrolled in the cessation program (N = 109) were compared with those who declined (N = 122) in terms of recruitment data, and reasons for declining were compiled. Results. Decliners were significantly more likely to: (1) have head and neck cancer (vs lung cancer); (2) exhibit fewer physical symptoms (eg, shortness of breath); (3) report a lower readiness to quit smoking; (4) indicate no intention to quit smoking; and (5) smoke fewer cigarettes. A preference to quit without professional assistance was the most common reason for declining treatment. Conclusions. Our findings highlight important differences between patients who enroll in a smoking cessation program and those who decline and underscore the need for motivational interventions to facilitate enrollment into smoking interventions for cancer patients. © 2004 Wiley Periodicals, Inc. Head Neck26: 278–286, 2004

Even though continued smoking by cancer patients adversely affects survival and quality of life, about one third of patients who smoked prior to their diagnosis continue to smoke after their diagnosis. The implementation of smoking cessation treatments for cancer patients has been slowed by the lack of data on correlates of tobacco use in this population. Thus, this longitudinal study assessed demographic, medical, addiction, and psychological predictors of tobacco use among 74 head, neck, and lung cancer patients. Multivariable binary logistic regression analyses, with outcome categorized as smoker or nonsmoker, indicated that the likelihood that patients would be a smoker was associated with lower levels of perceived risk and a higher level of quitting cons. Multivariable nominal logistic regression, with outcome classified as continuous smoker, continuous quitter, relapser, or follow-up quitter, indicated that: (a). patients categorized as continuous smokers reported significantly lower quitting self-efficacy than follow-up quitters and continuous quitters, (b). relapsers reported a significantly lower level of quitting self-efficacy than either follow-up quitters or continuous quitters, and (c). continuous smokers exhibited a significantly lower level of risk perceptions than continuous abstainers. These findings can be useful for the development and evaluation of treatments to promote smoking cessation among cancer patients.

Although the NCI is presently investigating whether enhanced detection of lung tumors via spiral CT reduces lung cancer mortality, use of this technology for lung cancer screening is already widespread in the US. Few data are available concerning level of interest in, or awareness of, spiral CT for lung cancer screening, correlates of participation in screening, or potential reactions to screening results (i.e. smoking cessation) among high-risk individuals. One-hundred-and-seventy-two current or former smokers with no personal cancer history were queried about their awareness of spiral CT for lung cancer screening, received information about the procedure, and completed a survey that assessed interest in screening, correlates of screening interest (i.e. demographic, health, psychological), and expected effects of screening results on smoking. Seventy-seven percent of respondents were unaware of spiral CT for lung cancer screening and 62% expressed high interest in screening. Screening interest was positively related to screening self-efficacy, knowledge of asymptomatic illness, and perceived lung cancer risk. In the face of a positive scan, 52% of smokers said that they would quit, 43% said they would consider quitting, and 3% would continue smoking. If the scan was negative, 19% of smokers said that they would quit, 61% said they would consider quitting, and 20% would continue smoking. Finally, 59% of smokers were interested in smoking cessation counseling, with screening. These findings can help guide the design of psychological interventions to promote the utilization of spiral CT for early lung cancer detection as well as the development of protocols to promote behavior change within lung cancer screening programs, should future studies indicate that spiral CT screening can effectively reduce the overall lung cancer mortality rate.

Background In the treatment of lung cancer, the best outcome is achieved when the lesion is discovered in the intraepithelial (preinvasive) stage. However, intraepithelial neoplastic lesions are difficult to localize by conventional white-light bronchoscopy (WLB). Objective To determine if autofluorescence bronchoscopy, when used as an adjunct to WLB, could improve the bronchoscopist's ability to locate and remove biopsy specimens from areas suspicious of intraepithelial neoplasia as compared with WLB alone. Method A multicenter clinical trial was conducted in seven institutions in the United States and Canada. WLB followed by fluorescence examination with the light-induced fluorescence endoscopy (LIFE) device was performed in 173 subjects known or suspected to have lung cancer. Biopsy specimens were taken from all areas suspicious of moderate dysplasia or worse on WLB and/or LIFE examination. In addition, random biopsy specimens were also taken from other parts of the bronchial tree. Results The relative sensitivity of WLB+LIFE vs WLB alone was 6.3 for intraepithelial neoplastic lesions and 2.71 when invasive carcinomas were also included. The positive predictive value was 0.33 and 0.39 and the negative predictive value was 0.89 and 0.83, respectively, for WLB+LIFE and WLB alone. Conclusion Autofluorescence bronchoscopy, when used as an adjunct to standard WLB, enhances the bronchoscopist's ability to localize small neoplastic lesions, especially intraepithelial lesions that may have significant implication in the management of lung cancer in the future.

We are all well acquainted with the frightfully high incidence of lung cancer and the short survival of patients after the diagnosis has been made. The extremely low survival rate is attributable in part to the advanced stage of the disease at the time of diagnosis. The 5-year survival rate among patients with stage I lung cancer is approximately 70%, and it declines to about 5% among patients with stage IV lung cancer. The serendipitous discovery of lung cancer in asymptomatic people is currently the principal way in which stage I lung cancer is detected. Unfortunately, we have not left . . .

Surgical processes are complex entities characterized by expressive models and data. Recognizable activities define each surgical process. The principal limitation of current vision-based recognition methods is inefficiency due to the large amount of information captured during a surgical procedure. To overcome this technical challenge, we introduce a surgical gesture recognition system using temperature-based recognition.An infrared thermal camera was combined with a hierarchical temporal memory and was used during surgical procedures. The recordings were analyzed for recognition of surgical activities. The image sequence information acquired included hand temperatures. This datum was analyzed to perform gesture extraction and recognition based on heat differences between the surgeon's warm hands and the colder background of the environment.The system was validated by simulating a functional endoscopic sinus surgery, a common type of otolaryngologic surgery. The thermal camera was directed toward the hands of the surgeon while handling different instruments. The system achieved an online recognition accuracy of 96% with high precision and recall rates of approximately 60%.Vision-based recognition methods are the current best practice approaches for monitoring surgical processes. Problems of information overflow and extended recognition times in vision-based approaches were overcome by changing the spectral range to infrared. This change enables the real-time recognition of surgical activities and provides online monitoring information to surgical assistance systems and workflow management systems.

Bioinformatics, 29 (22), ISSN:1367-4803, ISSN:1460-2059

The term brachytherapy derives from the Greek brachos (short), signifying a technique based on a short distance of delivery. In this case, it also relates to delivery of radiation therapy.

The southern Pierre Auger Observatory has been detecting cosmic rays above 1018eV since 2004, exploiting a hybrid air shower detection technique, with 1660 water Cherenkov detectors together with 24 air fluorescence telescopes on a 3000 km2 site. As low energy enhancements to the observatory, 3 additional telescopes with elevated fields of view were built (HEAT). The detector density was increased in the HEAT fields of view by a factor of four in an area of about 25 km2. This setup enables unbiased hybrid data taking above 1017eV. The infilled area is also being equipped with large underground scintillator muon detectors (AMIGA). Finally, a prototype array of radio antenna stations (AERA), working from 30 to 80 MHz, has been installed in a part of the infill. Properties and status of AMIGA, HEAT, and AERA are presented.

Background: The goal of the study was to evaluate the masticatory efficacy in patients who had been provided with resection prostheses after tumor removal in the maxillary/ mandibular region. These patients complained of impairment of masticatory function. Patients and Methods: 3 groups of patients were compared under clinical-experimental conditions. A uniform chewing material was masticated by the participants under standardized conditions. A sieving procedure was used to evaluate the masticatory efficacy. Analysis of the particle sizes and particle masses obtained was performed with the aid of computers. Results: The results showed that the masticatory efficacy of the patients with resection prostheses was the lowest of the 3 groups compared. The number of existing supporting zones and the location of the defect were found to be important influencing factors. Recording of the dietary habits of all patients was performed using a standardized dietary questionnaire. These data were analyzed using the corresponding software of the German Nutrition Society. With regard to the patients with resection prostheses, it was revealed that they often switched to food that did not require mastication. Conclusions: A nutritional guideline for patients with resection prostheses was developed, which is available for downloading free of charge on the Internet. Hintergrund: Ziel der Untersuchung war die Prüfung der Kaueffektivität bei Patienten, die mit Resektionsprothesen nach Tumorentfernung im Kieferbereich versorgt worden waren. Diese Patienten klagten über eine Einschränkung der mastikatorischen Funktion. Patienten und Methoden: Unter klinisch xperimentellen Bedingungen erfolgte der Vergleich von 3 Patientengruppen. Unter standardisierten Bedingungen zerkleinerten die Patienten einheitliches Kaugut. Zur Bewertung der Kaueffektivität wurde ein Siebverfahren eingesetzt. Die Auswertung der ermittelten Partikelgrößen und Partikelmassen erfolgte computergestützt. Ergebnisse: Die Ergebnisse zeigten, dass im Vergleich der 3 Gruppen die Kaueffektivität der Patienten mit Resektionsprothesen am geringsten war. Die Zahl der vorhandenen Stützzonen des Restgebisses und die Defektlokalisation wurden als bedeutsame Einflussfaktoren ermittelt. Die Erfassung der Ernährungsgewohnheiten aller Patienten erfolgte mittels eines standardisierten Ernährungsfragebogens. Diese Daten wurden mit der zugehörigen Software der Deutschen Gesellschaft für Ernährung ausgewertet. Bei den Patienten mit Resektionsprothesen zeigte sich, dass diese auf Nahrungsmittel ausweichen, die kein Kauen erfordern. Schlussfolgerungen: Es wurde eine Ernährungsrichtlinie für Patienten mit Resektionsprothesen abgeleitet, die zum kostenfreien Herunterladen im Internet zur Verfügung steht. Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Clinicopathologic findings in three cases of inflammatory myofibroblastomas (so-called inflammatory pseudotumors) of the trachea and bronchi are reported. In all cases the myofibroblastic nature of the spindle cell proliferation was revealed using electron microscopic and immunohistochemical methods. In two of these cases, in which the lesions were incompletely excised to conserve the wall of the airways and the normal lungs, several recurrences over a period of many years were successfully managed endoscopically. These potentially recurring and locally invasive myofibroblastic lesions should be treated as low-grade neoplasms rather than reactive processes. However, if complete excision is not feasible, lung-sparing management is warranted because myofibroblastomas progress slowly and recurrences can be readily detected by bron choscopy. Int J Surg Pathol 2(2):93-98, 1994.

Personalized multimedia content which suits user preferences and the usage environment, and as a result improves the user experience, gains more importance. In this paper, we describe an architecture for personalized video adaptation and presentation for mobile applications which is guided by automatically generated annotations. By including this annotation information, more intelligent adaptation techniques can be realized which primarily reduce the quality of unimportant regions in case a bit rate reduction is necessary. Furthermore, a presentation layer is added to enable advanced multimedia viewers to adequately present the interesting parts of a video in case the user wants to zoom in. This architecture is the result of collaborative research done in the EU FP6 IST INTERMEDIA project.

Various LTCC-tape materials have been characterized regarding their RF-properties at elevated temperature by means of impedance measurement of square-shaped capacitor samples up to a frequency of 3 MHz. Parameters of an equivalent circuit were fitted to reconstruct the impedance characteristics and the parameters extracted. The activation energies of samples were derived from the impedance model.

This paper presents resonant force sensor designed for the operation in the MHz range and for 0 to 6 N load. The LTCC technology is implemented for the sensor fabrication and a wireless readout of the measured data is provided. Used LTCC tape is characterised in order to demonstrate its mechanical and electrical properties at room temperature. Also, theoretical model of the sensor is developed to predict its behaviour. Fabricated sensor performance is experimentally characterised and obtained results are in good agreement with the ones derived from the presented theoretical model.

The material properties (TCE, dielectric number, etc.) of different LTCC (Low Temperature Co-fired Ceramics) — tape materials were characterized separately and compared to the behavior of combinations of these tapes that were laminated and co-fired. The effects of different values of thermal expansion and change in dielectric number of the combined material stacks have been investigated by finite element analyses and verified using a wireless readout resonant temperature sensor as a demonstration device..

Local features have the ability to overcome the major drawback of traditional, holistic object detection approaches, because they are inherently invariant to geometric deformation and pose; in addition scale and rotation invariance can be easily achieved as well. However, the selection of discriminative feature locations and local descriptions is a complex task that has not been generally solved. In case of face detection, features must possess the discriminative power to differentiate between facial parts and cluttered backgrounds while they have to remain person agnostic. A multitude of suggestions for selecting facial features for tracking or identification / recognition can be found in literature, most of which rely on semi-automatic or manual definition of the feature locations. In contrast, fully automatic feature selection and generic description approaches like SIFT and SURF have been shown to provide excellent performance for rigid as well as non-rigid registration and even for object class recognition. While quantitative evaluations exist that give a hint on the registration performance of the competing designs, these scenarios are not directly transferable to object detection. In this paper we provide qualitative and quantitative analysis of existing interest point detectors as well as local descriptions in the context of face detection and localization.

A classical approach to video object segmentation is background subtraction. Background subtraction starts by estimating a model of the background image of a scene and then calculating the likeliness that a given pixel of the current camera image belongs to the background model. Typically this is done by subtracting the background image from a given frame, where the difference image is usually thresholded and post-processed to find object boundaries. In this paper we present a method for enhanced post-processing that exploits color and texture information of the original video frame. This way we are able to extract pixel-exact object boundaries. Based on direct color segmentation of the video frame, an iterative method analog to biological diffusion and physical heat transfer processes, spreads information from the difference image over segment boundaries. For this purpose, diffusion resistances are defined between adjacent segments, based on color and texture similarities and common contour length. An iterative process calculates and transfers the flux of 'difference energy' between segments of the difference image. The resulting image allows for easy segmentation by thresholding. Experimental results show the validity of our approach.

Various LTCC-tapes of different suppliers have been evaluated concerning their mechanical properties which are required for finite-element-analyses (FEA) in order to design mechanical operating sensors. Bending tests on fired tape samples have been conducted in order to investigate the influence of processing conditions, applied metallization as well as geometrical parameters on the mechanical characteristics. Additionally piezo-resistive thick-film sensors have been applied onto the LTCC-beam elements to correlate bending stress with the sensor signal.

Tracheobronchial stenosis, a serious problem in adults and children, has multiple causes and has been treated in many ways. While developing an international multicentre study to evaluate efficacy of airway stents, it was realised that no adequate description of central airway stenosis regarding type, location and degree has been published. Thus, comparing results of different treatment modalities in different centres has been difficult due to a lack of uniformity of classification. Reports are typically descriptive and precise classification schemes have not adequately addressed either for the trachea or the main bronchi. A standardised classification scheme was proposed with descriptive images and diagrams for rapid and uniform classification of central airway stenosis. The present authors' system divides stenosis into structural and dynamic types and further classifies the disease by degree of stenosis, location and transition zone. Multiple sites can be described and each is transformed into a simple numerical scoring system prompted by a diagram, which can be easily captured for subsequent uniform analysis across sites. A pilot validation of the system, with 18 pulmonologists of varying training background, showed strong precision and agreement between observers. Such a system will enhance the ability to study the effectiveness of treatment modalities for central airway stenosis.

A major challenge in 3D reconstruction is the computation of the fundamental matrix. Automatic computation from uncalibrated image pairs is performed from point correspondences. Due to imprecision and wrong correspondences, only an approximation of the true fundamental matrix can be computed. The quality of the fundamental matrix strongly depends on the location and number of point correspondences.Furthermore, the fundamental matrix is the only geometric constraint between two uncalibrated views, and hence it can be used for the detection of wrong point correspondences. This property is used by current algorithms like RANSAC, which computes the fundamental matrix from a restricted set of point correspondences. In most cases, not only wrong correspondences are disregarded, but also correct ones, which is due to the criterion used to eliminate outliers. In this context, a new criterion preserving a maximum of correct correspondences would be useful.In this paper we introduce a novel criterion for outlier elimination based on a probabilistic approach. The enhanced set of correspondences may be important for further computation towards a 3D reconstruction of the scene.