Progress Towards a Multi-Modal Capsule Endoscopy Device Featuring Microultrasound Imaging

Current clinical standards for endoscopy in the gastrointestinal (GI) tract combine high definition optics and ultrasound imaging to view the lumen superficially and through its thickness. However, these instruments are limited to the length of an endoscope and the only clinically available, autonomous devices able to travel the full length of the GI tract easily offer only video capsule endoscopy (VCE). Our work seeks to overcome this limitation with a device (“Sonopill”) for multimodal capsule endoscopy, providing optical and microultrasound (μUS) imaging and supporting sensors1. μUS transducers have been developed with multiple piezoelectric materials operating across a range of centre frequencies to study viability in the GI tract. Because of the combined constraints of μUS imaging and the low power / heat tolerance of autonomous devices, a hybrid approach has been taken to the transducer design, with separate transmit and receive arrays allowing multiple manufacturing approaches to maximise system efficiency. To explore these approaches fully, prototype devices have been developed with PVDF, high-frequency PZT and PMN-PT composites, and piezoelectric micromachined ultrasonic transducer arrays. Test capsules have been developed using 3D printing to investigate issues including power consumption, heat generation / dissipation, acoustic coupling, signal strength and capsule integrity. Because of the high functional density of the electronics in our proposed system, application specific integrated circuits (ASICs) have been developed to realise the ultrasound transmit and receive circuitry along with white-light and autofluorescence imaging with single-photon avalanche detectors (SPADs). The ultrasound ASIC has been developed and the SPAD electronics and optical subsystem have been validated experimentally. The functionality of various transducer materials has been examined as a function of frequency and ultrasound transducers have been developed to operate at centre frequencies in the range 15 - 50 MHz. Ex vivo testing of porcine tissue has been performed, generating images of interest to the clinical community, demonstrating the viability of the Sonopill concept

The impact of eHealth on the quality and safety of health care : a systematic overview

There is considerable international interest in exploiting the potential of digital solutions to enhance the quality and safety of health care. Implementations of transformative eHealth technologies are underway globally, often at very considerable cost. In order to assess the impact of eHealth solutions on the quality and safety of health care, and to inform policy decisions on eHealth deployments, we undertook a systematic review of systematic reviews assessing the effectiveness and consequences of various eHealth technologies on the quality and safety of care. Methods and Findings We developed novel search strategies, conceptual maps of health care quality, safety, and eHealth interventions, and then systematically identified, scrutinised, and synthesised the systematic review literature. Major biomedical databases were searched to identify systematic reviews published between 1997 and 2010. Related theoretical, methodological, and technical material was also reviewed. We identified 53 systematic reviews that focused on assessing the impact of eHealth interventions on the quality and/or safety of health care and 55 supplementary systematic reviews providing relevant supportive information. This systematic review literature was found to be generally of substandard quality with regards to methodology, reporting, and utility. We thematically categorised eHealth technologies into three main areas: (1) storing, managing, and transmission of data; (2) clinical decision support; and (3) facilitating care from a distance. We found that despite support from policymakers, there was relatively little empirical evidence to substantiate many of the claims made in relation to these technologies. Whether the success of those relatively few solutions identified to improve quality and safety would continue if these were deployed beyond the contexts in which they were originally developed, has yet to be established. Importantly, best practice guidelines in effective development and deployment strategies are lacking

Anxious/depressed symptoms are related to microstructural maturation of white matter in typically developing youths

AbstractThere are multiple recent reports of an association between anxious/depressed (A/D) symptomatology and the rate of cerebral cortical thickness maturation in typically developing youths. We investigated the degree to which anxious/depressed symptoms are tied to age-related microstructural changes in cerebral fiber pathways. The participants were part of the NIH MRI Study of Normal Brain Development. Child Behavior Checklist A/D scores and diffusion imaging were available for 175 youths (84 males, 91 females; 241 magnetic resonance imagings) at up to three visits. The participants ranged from 5.7 to 18.4 years of age at the time of the scan. Alignment of fractional anisotropy data was implemented using FSL/Tract-Based Spatial Statistics, and linear mixed model regression was carried out using SPSS. Child Behavior Checklist A/D was associated with the rate of microstructural development in several white matter pathways, including the bilateral anterior thalamic radiation, bilateral inferior longitudinal fasciculus, left superior longitudinal fasciculus, and right cingulum. Across these pathways, greater age-related fractional anisotropy increases were observed at lower levels of A/D. The results suggest that subclinical A/D symptoms are associated with the rate of microstructural development within several white matter pathways that have been implicated in affect regulation, as well as mood and anxiety psychopathology.</jats:p

Convolutional Networks for Fast, Energy-Efficient Neuromorphic Computing

Deep networks are now able to achieve human-level performance on a broad spectrum of recognition tasks. Independently, neuromorphic computing has now demonstrated unprecedented energy-efficiency through a new chip architecture based on spiking neurons, low precision synapses, and a scalable communication network. Here, we demonstrate that neuromorphic computing, despite its novel architectural primitives, can implement deep convolution networks that i) approach state-of-the-art classification accuracy across 8 standard datasets, encompassing vision and speech, ii) perform inference while preserving the hardware's underlying energy-efficiency and high throughput, running on the aforementioned datasets at between 1200 and 2600 frames per second and using between 25 and 275 mW (effectively > 6000 frames / sec / W) and iii) can be specified and trained using backpropagation with the same ease-of-use as contemporary deep learning. For the first time, the algorithmic power of deep learning can be merged with the efficiency of neuromorphic processors, bringing the promise of embedded, intelligent, brain-inspired computing one step closer.Comment: 7 pages, 6 figure

Implementing telephone triage in general practice: a process evaluation of a cluster randomised controlled trial

Background: Telephone triage represents one strategy to manage demand for face-to-face GP appointments in primary care. However, limited evidence exists of the challenges GP practices face in implementing telephone triage. We conducted a qualitative process evaluation alongside a UK-based cluster randomised trial (ESTEEM) which compared the impact of GP-led and nurse-led telephone triage with usual care on primary care workload, cost, patient experience, and safety for patients requesting a same-day GP consultation. The aim of the process study was to provide insights into the observed effects of the ESTEEM trial from the perspectives of staff and patients, and to specify the circumstances under which triage is likely to be successfully implemented. Here we report perspectives of staff. Methods: The intervention comprised implementation of either GP-led or nurse-led telephone triage for a period of 2-3 months. A qualitative evaluation was conducted using staff interviews recruited from eight general practices (4 GP triage, 4 Nurse triage) in the UK, implementing triage as part of the ESTEEM trial. Qualitative interviews were undertaken with 44 staff members in GP triage and nurse triage practices (16 GPs, 8 nurses, 7 practice managers, 13 administrative staff). Results: Staff reported diverse experiences and perceptions regarding the implementation of telephone triage, its effects on workload, and on the benefits of triage. Such diversity were explained by the different ways triage was organised, the staffing models used to support triage, how the introduction of triage was communicated across practice staff, and by how staff roles were reconfigured as a result of implementing triage. Conclusion: The findings from the process evaluation offer insight into the range of ways GP practices participating in ESTEEM implemented telephone triage, and the circumstances under which telephone triage can be successfully implemented beyond the context of a clinical trial. Staff experiences and perceptions of telephone triage are shaped by the way practices communicate with staff, prepare for and sustain the changes required to implement triage effectively, as well as by existing practice culture, and staff and patient behaviour arising in response to the changes made. Trial registration: Current Controlled Trials ISRCTN20687662. Registered 28 May 2009

High-resolution x-ray telescopes

High-energy astrophysics is a relatively young scientific field, made possible by space-borne telescopes. During the half-century history of x-ray astronomy, the sensitivity of focusing x-ray telescopes-through finer angular resolution and increased effective area-has improved by a factor of a 100 million. This technological advance has enabled numerous exciting discoveries and increasingly detailed study of the high-energy universe-including accreting (stellar-mass and super-massive) black holes, accreting and isolated neutron stars, pulsar-wind nebulae, shocked plasma in supernova remnants, and hot thermal plasma in clusters of galaxies. As the largest structures in the universe, galaxy clusters constitute a unique laboratory for measuring the gravitational effects of dark matter and of dark energy. Here, we review the history of high-resolution x-ray telescopes and highlight some of the scientific results enabled by these telescopes. Next, we describe the planned next-generation x-ray-astronomy facility-the International X-ray Observatory (IXO). We conclude with an overview of a concept for the next next-generation facility-Generation X. The scientific objectives of such a mission will require very large areas (about 10000 m2) of highly-nested lightweight grazing-incidence mirrors with exceptional (about 0.1-arcsecond) angular resolution. Achieving this angular resolution with lightweight mirrors will likely require on-orbit adjustment of alignment and figure.Comment: 19 pages, 11 figures, SPIE Conference 7803 "Adaptive X-ray Optics", part of SPIE Optics+Photonics 2010, San Diego CA, 2010 August 2-

Pathway to the PiezoElectronic Transduction Logic Device

The information age challenges computer technology to process an exponentially increasing computational load on a limited energy budget - a requirement that demands an exponential reduction in energy per operation. In digital logic circuits, the switching energy of present FET devices is intimately connected with the switching voltage, and can no longer be lowered sufficiently, limiting the ability of current technology to address the challenge. Quantum computing offers a leap forward in capability, but a clear advantage requires algorithms presently developed for only a small set of applications. Therefore, a new, general purpose, classical technology based on a different paradigm is needed to meet the ever increasing demand for data processing.Comment: in Nano Letters (2015

Si-compatible candidates for high-K dielectrics with the Pbnm perovskite structure

We analyze both experimentally (where possible) and theoretically from first-principles the dielectric tensor components and crystal structure of five classes of Pbnm perovskites. All of these materials are believed to be stable on silicon and are therefore promising candidates for high-K dielectrics. We also analyze the structure of these materials with various simple models, decompose the lattice contribution to the dielectric tensor into force constant matrix eigenmode contributions, explore a peculiar correlation between structural and dielectric anisotropies in these compounds and give phonon frequencies and infrared activities of those modes that are infrared-active. We find that CaZrO_3, SrZrO_3, LaHoO_3, and LaYO_3 are among the most promising candidates for high-K dielectrics among the compounds we considered.Comment: 17 pages, 9 figures, 4 tables. Supplementary information: http://link.aps.org/supplemental/10.1103/PhysRevB.82.064101 or http://www.physics.rutgers.edu/~sinisa/highk/supp.pd

Frequency analysis of vocalisations in relation to the growth in broiler chicken

Poultry is one of the lowest cost sources of animal protein in the world and, more than 40 billion chickens are produced every year globally. For reasons of public concern and due to the large number of animals involved, it is considered by many people to be important to take care of the welfare and health status of the chickens reared under intensive farm conditions. Precision Livestock Farming (PLF) can support the farmer in his day to day routine management through the use of sensors, cameras and microphones, and these have the potential to improve production and to enable monitoring of welfare status. In this context, the 7FP EU-PLF project aims to test the efficiency of the use of those sensors at farm level. In particular, the aim of this study was to record and analyse broiler vocalisations under normal farm conditions and to identify the relation between animal sounds, and growth trends. Recordings were made at regular intervals, for the entire short production life of the birds, in order to evaluate the variation of frequency and bandwidth of the sounds emitted by the animals during the cycle of production. The recordings were made in an automated, non-invasive and non-intrusive way and the sound data was compared with the weight of the birds automatically measured by a 'step on scale' placed on the floor of the broiler house. Sound analysis was performed based on the amplitude and frequency of the sound signal in audio files recorded at farm level. Through analysis of the sounds recorded, a significant correlation (P<0.001) between the frequencies of the vocalisations recorded and the weight of the broilers was found across all production cycles and farms assessed. The ongoing goal will be the development of a tool able to automatically detect the growth of the animals based on the frequency of the vocalisation emitted by the birds at different ages, and as a possible tool for determining deviations from their expected growth trend