Contrast Reactions and Approaches to Staffing the Contrast Reaction Management Team.

RATIONALE AND OBJECTIVES: Managing contrast reactions is critical as contrast reactions can be life-threatening and unpredictable. Institutions need an effective system to handle these events. Currently, there is no standard practice for assigning trainees, radiologists, non-radiologist physicians, or other non-physician providers for management of contrast reaction. MATERIALS AND METHODS: The Association of Academic Radiologists (AAR) created a task force to address this gap. The AAR task force reviewed existing practices, studied available literature, and consulted experts related to contrast reaction management. The Society of Chairs of Academic Radiology Departments (SCARD) members were surveyed using a questionnaire focused on staffing strategies for contrast reaction management. RESULTS: The task force found disparities in contrast reactions management across institutions and healthcare providers. There is a lack of standardized protocols for assigning personnel for contrast reaction management. CONCLUSION: The AAR task force suggests developing standardized protocols for contrast reaction management. The protocols should outline clear roles for different healthcare providers involved in these events.

Characterization of high intensity progressive ultrasound beams in air at 300 kHz.

The majority of reported measurements on high intensity ultrasound beams in air are below 40 kHz and performed on standing waves inside of a guide. Here, experimental characterization of high intensity progressive and divergent sound beams in air at 300 kHz are presented. Measurements in this frequency range are challenging. Accurate characterization of high intensity sound beams requires a measurement bandwidth at least ten times the beam's primary frequency, as high intensity soundwaves steepen and form shocks and, therefore, contain significant signal power at harmonic frequencies. Hence, a measurement bandwidth of at least 3 MHz is required. Calibrated measurement microphones are generally not available in this frequency range. This limitation has been overcome by using a hydrophone with a calibrated response from 250 kHz to 20 MHz. A narrowband piezoelectric transducer is used as the source in this study, and it is capable of generating tone burst waveforms centered at 300 kHz with 160 dB sound pressure level surface pressure. Cumulative wave steepening and shock formation are observed in on-axis measurements. The source's surface vibration profile is measured using a scanning laser Doppler vibrometer, and the vibration profile is imported into a numerical wide-angle Khokhlov-Zabolotskaya-Kuznetsov simulation for comparison against measured on-axis waveforms.

Regulation of Estradiol Synthesis by Aromatase Interacting Partner in Breast (AIPB).

Estradiol is essential for the development of female sex characteristics and fertility. Postmenopausal women and breast cancer patients have high levels of estradiol. Aromatase catalyzes estradiol synthesis; however, the factors regulating aromatase activity are unknown. We identified a new 22-kDa protein, aromatase interacting partner in breast (AIPB), from the endoplasmic reticulum of human breast tissue. AIPB expression is reduced in tumorigenic breast and further reduced in triple-negative tumors. Like that of aromatase, AIPB expression is induced by nonsteroidal estrogen. We found that AIPB and aromatase interact in nontumorigenic and tumorigenic breast tissues and cells. In tumorigenic cells, conditional AIPB overexpression decreased estradiol, and blocking AIPB availability with an AIPB-binding antibody increased estradiol. Estradiol synthesis is highly increased in AIPB knockdown cells, suggesting that the newly identified AIPB protein is important for aromatase activity and a key modulator of estradiol synthesis. Thus, a change in AIPB protein expression may represent an early event in tumorigenesis and be predictive of an increased risk of developing breast cancer.

Towards acoustic particle velocity sensors in air using entrained balloons: Measurements and modeling.

In this article, the feasibility of using balloons for the measurement of acoustic particle velocity in air is investigated by exploring the behavior of an elastic balloon in air as it vibrates in response to an incident acoustic wave. This is motivated by the frequent use of neutrally buoyant spheres as underwater inertial particle velocity sensors. The results of experiments performed in an anechoic chamber are presented, in which a pair of laser Doppler vibrometers simultaneously captured the velocities of the front and back surfaces of a Mylar balloon in an acoustic field. From phase measurements, the motion is described in terms of contributions from odd-order vibration modes (including bulk translation) and even-order vibration modes. The measured entrainment factors for the balloon are seen to be in good agreement with a physical model based on the scattering from an entrained rigid sphere. This demonstrates the feasibility of using entrained balloons for direct measurement of acoustic particle velocity in air.

On the theoretical maximum achievable signal-to-noise ratio (SNR) of piezoelectric microphones.

A theoretical maximum achievable signal to noise ratio (SNR) for piezoelectric microphones is identified as a function of only microphone volume irrespective of architecture and construction details. For a given piezoelectric material, microphone SNR can be reduced to an expression containing only a dimensionless coupling coefficient and microphone volume. For a given material, the coupling coefficient has a theoretical upper bound defined by the most favorable deformation geometry. The ability to identify a theoretical maximum SNR as a function of only microphone size is surprising considering the numerous design variables and infinite design freedom afforded in the microphone design stage.

Thévenin acoustics.

Thévenin's theorem is commonly used in the analysis of acoustic transducers to provide a simplified representation of a transducer or its environment. The method may be extended to the analyses of other acoustic systems, without limitation to systems that have been reduced to analogous circuit models, and is particularly convenient in the analysis of acoustic scattering when the scattering object is mobile. In this paper, the method is illustrated through an alternative derivation of the well-known "mass law" for transmission through a partition, and is also applied to the case of acoustic scattering from a rigid, mobile cylinder of arbitrary size in an ideal plane progressive wave. Differences between the conventional solution approach for such problems and the Thévenin-inspired method are discussed, along with the potential benefits of taking such an approach for the simplification of other problems in physical acoustics.

A transmission-line model of back-cavity dynamics for in-plane pressure-differential microphones.

Pressure-differential microphones inspired by the hearing mechanism of a special parasitoid fly have been described previously. The designs employ a beam structure that rotates about two pivots over an enclosed back volume. The back volume is only partially enclosed due to open slits around the perimeter of the beam. The open slits enable incoming sound waves to affect the pressure profile in the microphone's back volume. The goal of this work is to study the net moment applied to pressure-differential microphones by an incoming sound wave, which in-turn requires modeling the acoustic pressure distribution within the back volume. A lumped-element distributed transmission-line model of the back volume is introduced for this purpose. It is discovered that the net applied moment follows a low-pass filter behavior such that, at frequencies below a corner frequency depending on geometrical parameters of the design, the applied moment is unaffected by the open slits. This is in contrast to the high-pass filter behavior introduced by barometric pressure vents in conventional omnidirectional microphones. The model accurately predicts observed curvature in the frequency response of a prototype pressure-differential microphone 2 mm × 1 mm × 0.5 mm in size and employing piezoelectric readout.

A Theoretical and Experimental Comparison of 3-3 and 3-1 Mode Piezoelectric Microelectromechanical Systems (MEMS).

Two piezoelectric transducer modes applied in microelectromechanical systems are (i) the 3-1 mode with parallel electrodes perpendicular to a vertical polarization vector, and (ii) the 3-3 mode which uses interdigitated (IDT) electrodes to realize an in-plane polarization vector. This study compares the two configurations by deriving a Norton equivalent representation of each approach - including expressions for output charge and device capacitance. The model is verified using a microfabricated device comprised of multiple epitaxial silicon beams with sol-gel deposited lead zirconate titanate at the surface. The beams have identical dimensions and are attached to a common moving element at their tip. The only difference between beams is electrode configuration - enabling a direct comparison. Capacitance and charge measurements verify the presented theory with high accuracy. The Norton equivalent representation is general and enables comparison of any figure of merit, including electromechanical coupling coefficient and signal to noise ratio. With respect to coupling coefficient, the experimentally validated theory in this work suggests that 3-3 mode IDT-electrode configurations offer the potential for modest improvements compared against 3-1 mode devices (less than 2×), and the only geometrical parameter affecting this ratio is the fill factor of the IDT electrode.

A rotational capacitive micromachined ultrasonic transducer (RCMUT) with an internally-sealed pivot.

Most capacitive micromachined ultrasonic transducers (CMUTs) are comprised of individual gap-closing parallel plates. We present an unconventional CMUT in which a vacuum-sealed cavity beneath a diaphragm layer comprises a mechanical structure that pivots and has a first rocking or rotational mode of vibration. The general ability to couple individual CMUT pistons under vacuum with mechanical structures to alter vibration mode frequencies and mode shapes is thus demonstrated. The particular prototype presented spans a distance of 250 µm and has a first rocking mode of vibration at 480 kHz. As a transmitter, the first mode radiates ultrasound in-plane along the surface. Frequency response characterization of a prototype is performed using laser Doppler vibrometry, and a pair of devices is used to perform ultrasonic pitch-catch measurements spanning a distance of 5 mm.

A broadband, capacitive, surface-micromachined, omnidirectional microphone with more than 200 kHz bandwidth.

A surface micromachined microphone is presented with 230 kHz bandwidth. The structure uses a 2.25 µm thick, 315 µm radius polysilicon diaphragm suspended above an 11 µm gap to form a variable parallel-plate capacitance. The back cavity of the microphone consists of the 11 µm thick air volume immediately behind the moving diaphragm and also an extended lateral cavity with a radius of 504 µm. The dynamic frequency response of the sensor in response to electrostatic signals is presented using laser Doppler vibrometry and indicates a system compliance of 0.4 nm/Pa in the flat-band of the response. The sensor is configured for acoustic signal detection using a charge amplifier, and signal-to-noise ratio measurements and simulations are presented. A resolution of 0.80 mPa/√Hz (32 dB sound pressure level in a 1 Hz bin) is achieved in the flat-band portion of the response extending from 10 kHz to 230 kHz. The proposed sensor design is motivated by defense and intelligence gathering applications that require broadband, airborne signal detection.

Towards a sub 15-dBA optical micromachined microphone.

Micromachined microphones with grating-based optical-interferometric readout have been demonstrated previously. These microphones are similar in construction to bottom-inlet capacitive microelectromechanical-system (MEMS) microphones, with the exception that optoelectronic emitters and detectors are placed inside the microphone's front or back cavity. A potential advantage of optical microphones in designing for low noise level is the use of highly-perforated microphone backplates to enable low-damping and low thermal-mechanical noise levels. This work presents an experimental study of a microphone diaphragm and backplate designed for optical readout and low thermal-mechanical noise. The backplate is 1 mm × 1 mm and is fabricated in a 2-µm-thick epitaxial silicon layer of a silicon-on-insulator wafer and contains a diffraction grating with 4-µm pitch etched at the center. The presented system has a measured thermal-mechanical noise level equal to 22.6 dBA. Through measurement of the electrostatic frequency response and measured noise spectra, a device model for the microphone system is verified. The model is in-turn used to identify design paths towards MEMS microphones with sub 15-dBA noise floors.

Micromachined piezoelectric microphones with in-plane directivity.

Micromachined piezoelectric microphones with in-plane directivity are introduced. A beam rotates about center torsional pivots and is attached to piezoelectrically active end-springs. Rotation of the beam in response to sound pressure gradients produces spring deflections, which, in turn, produce an open-circuit voltage at the piezoelectric films. Prototypes are presented that contain a 20-µm-thick silicon beam and end-springs with 900-nm-thick chemical solution deposited lead zirconate titanate atop the surface of the end-springs. Acoustic directivity measurements are presented that confirm device functionality.

Thermoacoustic sound generation from monolayer graphene for transparent and flexible sound sources.

Transparent and flexible loudspeakers are realized with large-area monolayer graphene. The acoustic performances are characterized according to the supporting substrate effect and geometrical configurations. The substrate effect on the thermoacoustic sound generation from graphene is studied by controlling the surface porosity of various substrates.

A numerical investigation of breast compression: a computer-aided design approach for prescribing boundary conditions.

Prior to performing an MRI-guided breast biopsy, the radiologist has to locate the suspect lesion with the breast compressed between rigid plates. However, the suspect lesion is typically identified from a diagnostic MRI exam with the breast hanging freely under the force of gravity. There are several challenges associated with localizing suspect lesions including, patient positioning, the visibility of the lesion may fade after contrast injection, menstrual cycles, and lesion deformation. Researchers have developed finite element analysis (FEA) methodologies that simulate breast compression with the intent of reducing these challenges. In this paper, we constructed a patient-specific finite element (FE) breast model from diagnostic MR images. In addition, we constructed surfaces corresponding to the biopsy MR volume and used them to deform the FE breast mesh. The predicted results suggest that the FE breast model, in its uncompressed configuration, can be compressed to replicate the perimeter of the biopsy MR volume. The simulated lesion displacement was within 3 mm of its actual position.

Micromachined Accelerometers With Optical Interferometric Read-Out and Integrated Electrostatic Actuation.

A micromachined accelerometer device structure with diffraction-based optical detection and integrated electrostatic actuation is introduced. The sensor consists of a bulk silicon proof mass electrode that moves vertically with respect to a rigid diffraction grating backplate electrode to provide interferometric detection resolution of the proof-mass displacement when illuminated with coherent light. The sensor architecture includes a monolithically integrated electrostatic actuation port that enables the application of precisely controlled broadband forces to the proof mass while the displacement is simultaneously and independently measured optically. This enables several useful features such as dynamic self-characterization and a variety of force-feedback modalities, including alteration of device dynamics in situ. These features are experimentally demonstrated with sensors that have been optoelectronically integrated into sub-cubic-millimeter volumes using an entirely surface-normal, rigid, and robust embodiment incorporating vertical cavity surface emitting lasers and integrated photodetector arrays. In addition to small form factor and high acceleration resolution, the ability to self-characterize and alter device dynamics in situ may be advantageous. This allows periodic calibration and in situ matching of sensor dynamics among an array of accelerometers or seismometers configured in a network.

Simulation of Thin-Film Damping and Thermal Mechanical Noise Spectra for Advanced Micromachined Microphone Structures.

In many micromachined sensors the thin (2-10 µm thick) air film between a compliant diaphragm and backplate electrode plays a dominant role in shaping both the dynamic and thermal noise characteristics of the device. Silicon microphone structures used in grating-based optical-interference microphones have recently been introduced that employ backplates with minimal area to achieve low damping and low thermal noise levels. Finite-element based modeling procedures based on 2-D discretization of the governing Reynolds equation are ideally suited for studying thin-film dynamics in such structures which utilize relatively complex backplate geometries. In this paper, the dynamic properties of both the diaphragm and thin air film are studied using a modal projection procedure in a commonly used finite element software and the results are used to simulate the dynamic frequency response of the coupled structure to internally generated electrostatic actuation pressure. The model is also extended to simulate thermal mechanical noise spectra of these advanced sensing structures. In all cases simulations are compared with measured data and show excellent agreement-demonstrating 0.8 pN/√Hz and 1.8 µPa/√Hz thermal force and thermal pressure noise levels, respectively, for the 1.5 mm diameter structures under study which have a fundamental diaphragm resonance-limited bandwidth near 20 kHz.

Impact of relative intensity noise of vertical-cavity surface-emitting lasers on optics-based micromachined audio and seismic sensors.

The relative intensity noise of vertical-cavity surface-emitting lasers (VCSELs) in the 100 mHz to 50 kHz frequency range is experimentally investigated using two representative single-mode VCSELs. Measurements in this frequency range are relevant to recently developed optical-based micromachined acoustic and accelerometer sensing structures that utilize VCSELs as the light source to form nearly monolithic 1 mm3 packages. Although this frequency regime is far lower than the gigahertz range relevant to optical communication applications for which VCSELs are primarily designed, the intensity noise is found to be low and well within the range of cancellation using basic reference detection principles.

Micromachined optical microphone structures with low thermal-mechanical noise levels.

Micromachined microphones with diffraction-based optical displacement detection have been introduced previously [Hall et al., J. Acoust. Soc. Am. 118, 3000-3009 (2005)]. The approach has the advantage of providing high displacement detection resolution of the microphone diaphragm independent of device size and capacitance-creating an unconstrained design space for the mechanical structure itself. Micromachined microphone structures with 1.5-mm-diam polysilicon diaphragms and monolithically integrated diffraction grating electrodes are presented in this work with backplate architectures that deviate substantially from traditional perforated plate designs. These structures have been designed for broadband frequency response and low thermal mechanical noise levels. Rigorous experimental characterization indicates a diaphragm displacement detection resolution of 20 fm radicalHz and a thermal mechanical induced diaphragm displacement noise density of 60 fm radicalHz, corresponding to an A-weighted sound pressure level detection limit of 24 dB(A) for these structures. Measured thermal mechanical displacement noise spectra are in excellent agreement with simulations based on system parameters derived from dynamic frequency response characterization measurements, which show a diaphragm resonance limited bandwidth of approximately 20 kHz. These designs are substantial improvements over initial prototypes presented previously. The high performance-to-size ratio achievable with this technology is expected to have an impact on a variety of instrumentation and hearing applications.

Molecular and functional comparison of 1,25-dihydroxyvitamin D(3) and the novel vitamin D receptor ligand, lithocholic acid, in activating transcription of cytochrome P450 3A4.

The vitamin D receptor (VDR) binds to and mediates the effects of the 1,25-dihydroxyvitamin D(3) (1,25(OH)(2)D(3)) hormone to alter gene transcription. A newly recognized VDR ligand is the carcinogenic bile acid, lithocholic acid (LCA). We demonstrate that, in HT-29 colon cancer cells, both LCA and 1,25(OH)(2)D(3) induce expression of cytochrome P450 3A4 (CYP3A4), an enzyme involved in cellular detoxification. We also show that LCA-VDR stimulates transcription of gene reporter constructs containing DR3 and ER6 vitamin D responsive elements (VDREs) from the human CYP3A4 gene. Utilizing gel mobility shift, pulldown, and mammalian two-hybrid assays, we observe that: (i) 1,25(OH)(2)D(3) enhances retinoid X receptor (RXR) heterodimerization with VDR more effectively than LCA, (ii) the 1,25(OH)(2)D(3)-liganded VDR-RXR heterodimer recruits full-length SRC-1 coactivator, whereas this interaction is minimal with LCA unless LXXLL-containing fragments of SRC-1 are employed, and (iii) both 1,25(OH)(2)D(3) and LCA enhance the binding of VDR to DRIP205/mediator, but unlike 1,25(OH)(2)D(3)-VDR, LCA-VDR does not interact detectably with NCoA-62 or TRIP1/SUG1, suggesting a different pattern of LCA-VDR comodulator association. Finally, residues in the human VDR (hVDR) ligand binding domain (LBD) were altered to create mutants unresponsive to 1,25(OH)(2)D(3)- and/or LCA-stimulated transactivation, identifying S237 and S225/S278 as critical for 1,25(OH)(2)D(3) and LCA action, respectively. Therefore, these two VDR ligands contact distinct residues in the binding pocket, perhaps generating unique receptor conformations that determine the degree of RXR and comodulator binding. We propose that VDR is a bifunctional regulator, with the 1,25(OH)(2)D(3)-liganded conformation facilitating high affinity endocrine actions, and the LCA-liganded configuration mediating local, lower affinity cellular detoxification by upregulation of CYP3A4 in the colon.

A grating-assisted resonant-cavity-enhanced optical displacement detection method for micromachined sensors.

We present an integrated optical displacement sensing method for microscale sensors which is based on an asymmetric Fabry-Perot etalon structure with an embedded phase-sensitive diffraction grating. Analytical modeling of the structure shows that the etalon significantly improves the detection sensitivity as compared to a regular optical interferometer and the embedded diffraction grating enables integration of optoelectronics in a small volume. The efficacy of the method is experimentally validated on a surface micromachined diffraction-based opto-acoustic sensor fabricated on a quartz wafer. A 15 nm silver layer is used to form the bottom mirror of the etalon structure with a sensor membrane and embedded diffraction grating made of aluminum. Comparison of the results with and without the etalon shows an 8 dB increase in detection sensitivity with the etalon structure, which should be further enhanced with the use of low-loss dielectric mirrors.