Matrix heater in the gravitational wave observatory GEO 600.

Large scale laser interferometric gravitational wave detectors (GWDs), such as GEO 600 require high quality optics to reach their design sensitivity. The inevitable surface imperfections, inhomogeneities, and light-absorption induced thermal lensing in the optics, can convert laser light from the fundamental mode to unwanted higher order modes, and pose challenges to the operation and sensitivity of the GWDs. Here we demonstrate the practical implementation of a thermal projection system which reduces those unwanted effects via targeted spatial heating of the optics. The thermal projector consists of 108 individually addressable heating elements which are imaged onto the beam splitter of GEO 600. We describe the optimization of the spatial heating profile and present the obtained results.

Influence of ECG sampling rate in fetal heart rate variability analysis.

Fetal hypoxia results in a fetal blood acidosis (pH<;7.10). In such a situation, the fetus develops several adaptation mechanisms regulated by the autonomic nervous system. Many studies demonstrated significant changes in heart rate variability in hypoxic fetuses. So, fetal heart rate variability analysis could be of precious help for fetal hypoxia prediction. Commonly used fetal heart rate variability analysis methods have been shown to be sensitive to the ECG signal sampling rate. Indeed, a low sampling rate could induce variability in the heart beat detection which will alter the heart rate variability estimation. In this paper, we introduce an original fetal heart rate variability analysis method. We hypothesize that this method will be less sensitive to ECG sampling frequency changes than common heart rate variability analysis methods. We then compared the results of this new heart rate variability analysis method with two different sampling frequencies (250-1000 Hz).

Does a body mass index greater than 25kg/m2 increase maternal and neonatal morbidity? A French historical cohort study.

OBJECTIVES: To evaluate, in a French multicenter cohort, the risk of C-section based on a high pre-pregnancy body mass index (BMI). Secondary objectives were to assess the risk of elective C-section, severe post-partum hemorrhage (>1L), severe perineal tears (3rd and 4th degree) and neonatal complications according to pre-pregnancy BMI. STUDY DESIGN: This historical cohort study analyzed records from the French AUDIPOG perinatal database. Inclusion criteria were deliveries≥22 weeks (or with a birth weight≥500g). Women with BMI<18.5kg/m2 (n=31,766) were excluded. After these exclusions, the study sample included 314,851 women between 1999 and 2009. Patients were classified among four BMI subgroups (normal: 18.5-24.9kg/m2, overweight: 25-29.9kg/m2, class I and II obesity: 30-39.9kg/m2 and class III obesity:≥40kg/m2). BMI was calculated using pre-pregnancy self-reported weight. Results were expressed as crude and adjusted relative risks (aRR). RESULTS: A C-section occurred in 16.4%, 22.7%, 28.8% and 39.4% of normal BMI, overweight, obese and class III obese women, respectively (P<10-4). aRR of C-section increased with BMI: 1.26 [95%CI: 1.22-1.30] for BMI between 25-29.9kg/m2; 1.39 [95%CI: 1.34-1.45] for BMI between 30-39.9kg/m2 and 1.72 [95%CI: 1.57-1.90] for BMI≥40kg/m2; but not the elective C-section. Neonatal complications were more frequent with increasing maternal BMI (BMI 25-29.9: aRR=1.09 [95%CI: 1.06-1.12]; BMI 30-39.9: aRR=1.20 [95%CI: 1.16-1.25]; BMI≥40: aRR=1.33 [95%CI: 1.21-1.45]). CONCLUSION: Our study confirmed that pre-pregnancy BMI is an important factor to consider because its elevation is associated with adverse obstetrical outcomes, especially cesarean delivery and neonatal complications.

A new analysis of heart rate variability in the assessment of fetal parasympathetic activity: An experimental study in a fetal sheep model.

Analysis of heart rate variability (HRV) is a recognized tool in the assessment of autonomic nervous system (ANS) activity. Indeed, both time and spectral analysis techniques enable us to obtain indexes that are related to the way the ANS regulates the heart rate. However, these techniques are limited in terms of the lack of thresholds of the numerical indexes, which is primarily due to high inter-subject variability. We proposed a new fetal HRV analysis method related to the parasympathetic activity of the ANS. The aim of this study was to evaluate the performance of our method compared to commonly used HRV analysis, with regard to i) the ability to detect changes in ANS activity and ii) inter-subject variability. This study was performed in seven sheep fetuses. In order to evaluate the sensitivity and specificity of our index in evaluating parasympathetic activity, we directly administered 2.5 mg intravenous atropine, to inhibit parasympathetic tone, and 5 mg propranolol to block sympathetic activity. Our index, as well as time analysis (root mean square of the successive differences; RMSSD) and spectral analysis (high frequency (HF) and low frequency (LF) spectral components obtained via fast Fourier transform), were measured before and after injection. Inter-subject variability was estimated by the coefficient of variance (%CV). In order to evaluate the ability of HRV parameters to detect fetal parasympathetic decrease, we also estimated the effect size for each HRV parameter before and after injections. As expected, our index, the HF spectral component, and the RMSSD were reduced after the atropine injection. Moreover, our index presented a higher effect size. The %CV was far lower for our index than for RMSSD, HF, and LF. Although LF decreased after propranolol administration, fetal stress index, RMSSD, and HF were not significantly different, confirming the fact that those indexes are specific to the parasympathetic nervous system. In conclusion, our method appeared to be effective in detecting parasympathetic inhibition. Moreover, inter-subject variability was much lower, and effect size higher, with our method compared to other HRV analysis methods.

Inter-observer reliability of 4 fetal heart rate classifications.

OBJECTIVE: Different classification of fetal heart rate (FHR) pattern have been proposed: FHR classified as either "reassuring" or "non-reassuring", the National Institute of Child Health and Human Development (NICHD) published in 2008 a 3-tier system, the French College of Gynecology and Obstetrics (CNGOF) recommended in 2013 a 5-tier system and recently in 2015, the Federation International of Gynecology and Obstetrics (FIGO) proposed a new classification based on a 3-tier system. Our objective was to assess the inter-observer reliability of these 4 existing classifications. STUDY DESIGN: Four observers reviewed 100 FHR without clinical information. FHR were obtained from term singleton pregnancies. Fetal heart rate patterns were classified by one 2-tier ("reassuring vs. non-reassuring"), two 3-tier (NICHD 2008 and FIGO 2015), and one 5-tier (CNGOF 2013) fetal heart classifications. RESULTS: The global agreement between observers was moderate for each classification: 0.58 (0.40-0.74) for the 2-tier, 0.48 (0.37-0.58) for the NICHD 2008, 0.58 (0.53-0.63) for the CNGOF 2013 and 0.59 (0.49-0.67) for the FIGO 2015 classification. When FHR was classified as reassuring, it was classified as normal in 85.5% for the NICHD 2008 and in 94.5% for the FIGO 2015. For the CNGOF 2013, 65.0% were classified as normal and 32.5% as quasi normal. There was strong concordance between FIGO category I and "reassuring" FHR (kappa=0.95). CONCLUSION: Inter-observer agreement of FHR interpretation is moderate whatever the classification used. To evaluate the superior interest of one classification, it will be interesting to compare their impact on need of second line techniques and on neonatal outcome.

Alignment sensing and control for squeezed vacuum states of light.

Beam alignment is an important practical aspect of the application of squeezed states of light. Misalignments in the detection of squeezed light result in a reduction of the observable squeezing level. In the case of squeezed vacuum fields that contain only very few photons, special measures must be taken in order to sense and control the alignment of the essentially dark beam. The GEO 600 gravitational wave detector employs a squeezed vacuum source to improve its detection sensitivity beyond the limits set by classical quantum shot noise. Here, we present our design and implementation of an alignment sensing and control scheme that ensures continuous optimal alignment of the squeezed vacuum field at GEO 600 on long time scales in the presence of free-swinging optics. This first demonstration of a squeezed light automatic alignment system will be of particular interest for future long-term applications of squeezed vacuum states of light.

[Maternal obesity and pregnancy: Evolution of prevalence and of place of birth]. / Obésité maternelle et grossesse : évolution de la prévalence et du lieu d'accouchement à partir des données AUDIPOG.

OBJECTIVE: The primary objective was to describe the evolution of the prevalence of maternal obesity in France. The secondary objectives were to assess changes in the French regions and the place of birth according to type (public/private) and level of care. MATERIAL AND METHODS: Study based population of all births between 1999 and 2009 included in the AUDIPOG database. Our judgment criterion was the body mass index (BMI) divided into classes. RESULTS: Seventy-four thousand and forty-six pregnancies were included. The mean BMI was 22.9±4.5kg/m(2) with an increase between 1999-2001 and 2008-2009 (22.6±4.3kg/m(2) versus 23.1±4.7kg/m(2), P<10(-4)). North was the first region in terms of overweight patients (18%) and obese (10.2%). There was an increase of the birth rate in public maternity, and level II and III regardless of BMI class. Only the class of patients with a BMI ≥40kg/m(2) delivered more frequently in level III with an increase between the first and the last period of the study (20.8% versus 36.8%, P=0.02). CONCLUSION: The BMI is still increasing with more and more patients with a BMI ≥40kg/m(2) referred to level III. This raises the question of the organization of care and follow-up of these patients.

Phase control of squeezed vacuum states of light in gravitational wave detectors.

Quantum noise will be the dominant noise source for the advanced laser interferometric gravitational wave detectors currently under construction. Squeezing-enhanced laser interferometers have been recently demonstrated as a viable technique to reduce quantum noise. We propose two new methods of generating an error signal for matching the longitudinal phase of squeezed vacuum states of light to the phase of the laser interferometer output field. Both provide a superior signal to the one used in previous demonstrations of squeezing applied to a gravitational-wave detector. We demonstrate that the new signals are less sensitive to misalignments and higher order modes, and result in an improved stability of the squeezing level. The new signals also offer the potential of reducing the overall rms phase noise and optical losses, each of which would contribute to achieving a higher level of squeezing. The new error signals are a pivotal development towards realizing the goal of 6 dB and more of squeezing in advanced detectors and beyond.

Assessment of apical periodontitis by MRI: a feasibility study.

PURPOSE: The purpose of this clinical feasibility study was to evaluate the applicability of magnetic resonance imaging (MRI) for the assessment of apical periodontitis in direct comparison with cone beam CT (CBCT). MATERIALS AND METHODS: 19 consecutive patients (average age 43 ±â€Š13 years) with 34 lesions in total (13 molars, 14 premolars and 7 front teeth) were enrolled in this feasibility study. Periapical lesions were defined as periapical radiolucencies (CBCT) or structural changes in the spongy bone signal (MRI), which were connected with the apical part of a root and with at least twice the width of the periodontal ligament space. The location and dimension of the lesions were compared between MRI and CBCT. RESULTS: While mainly mineralized tissue components such as teeth and bone were visible with CBCT, complimentary information of the soft tissue components was assessable with MRI. The MRI images provided sufficient diagnostic detail for the assessment of the main structures of interest. Heterogeneous contrast was observed within the lesion, with often a clear enhancement close to the apical foramen and the periodontal gap.  No difference for lesion visibility was observed between MRI and CBCT. The lesion dimensions corresponded well, but were slightly but significantly overestimated with MRI. A heterogeneous lesion appearance was observed in several patients. Four patients presented with a well circumscribed hyperintense signal in the vicinity of the apical foramen. CONCLUSION: The MRI capability of soft tissue characterization may facilitate detailed analysis of periapical lesions. This clinical study confirms the applicability of multi-contrast MRI for the identification of periapical lesions. KEY POINTS: MRI can be applied for the identification of periapical lesions without ionizing radiation exposure. MRI might facilitate more detailed characterization of periapical lesions. MRI might provide more accurate lesion dimensions as X-ray-based methods.

WE-G-BRA-05: Simulated Troubleshooting Session for Medical Physics Resident Rotations.

PURPOSE: Troubleshooting is a difficult to train, but critical skill for a clinical medical physicist. It is unlikely that residents will have opportunities to troubleshoot many real clinical scenarios during a typical 3 month rotation. The ability to analyze and correct abnormal clinical situations is imperative to providing safe radiation therapy care. We have developed a novel strategy to train medical physics residents to gain such important clinical physics skill. METHODS: Simulated troubleshooting sessions were designed for each rotation, featuring problematic clinical scenarios. The resident was required to troubleshoot each scenario in a given time frame. Using a brachytherapy rotation as an example, the transfer tubes connecting the afterloader to the Tandem and Ovoids (T&O) applicators were purposely inserted incorrectly. The resident was asked to deliver a dummy T&O plan in a reasonable time frame including troubleshooting all problems that may occur. Many simulated troubleshooting situations were presented to the resident. Two residents went through a 3 month brachytherapy rotation, one with and the other without the simulated troubleshooting session. All other rotation activities were the same. At the end of the rotation, an oral exam was given to test how well the residents understood the brachytherapy clinical practice. RESULTS: Both residents were able to pass the exam. However, the resident that received the troubleshooting session performed better'‴a superior understanding of the reasons behind the clinical practice and better troubleshooting skills were demonstrated. CONCLUSIONS: To train residents to better handle the clinical situations, it is important to include a simulated troubleshooting session into clinical rotations. Simulated troubleshooting sessions are excellent and necessary supplements to the clinical rotations for the residents to gain practical clinical skills.

WE-G-BRA-01: Development of a Web-Based Dosimetry Training Tool for Therapy and Dosimetry Education.

PURPOSE: Training in clinical dosimetry is an important component of radiation therapy, dosimetry, and medical physics training programs. Based on our in-house treatment planning system, PLanUNC, we are developing and assessing a web-based dosimetry teaching tool to augment existing training programs. METHODS: We surveyed radiation therapy program directors to assess the need for clinical dosimetry training tools. Based on survey results, we are developing a web-based dosimetry-training tool consisting of 10 modules containing didactic content based on the ASRT curriculum, student assessment, and hands-on treatment planning exercises. External content specialists reviewed the self-paced modules for accuracy and content validity. Two external dosimetry students were observed as they completed three sections, and were interviewed in-depth to evaluate the modules. This qualitative analysis combined features of usability testing with formative evaluation of instructional products. We revised the modules based on these data. Our next phase, quantitative evaluation, will assess the effectiveness of the modules, the quality of the interactivity and the degree of student engagement when completing the modules. RESULTS: Sixty-four percent of program directors indicated they had insufficient local resources for dosimetry training, and over 90% indicated interest in web-based training tools as teaching supplements. External evaluators indicated module content was appropriate and accurate. Students indicated the modules were easy to use with clear and understandable content. They were engaged when using the modules and motivated by the interactive components. They placed value on the exercises and the feedback they received. CONCLUSIONS: Inter-institutional evaluation improves the quality and generalizability of instructional modules. Carefully designed online learning modules are viewed as effective teaching tools by dosimetry students. The clinical dosimetry teaching tool will be made accessible to therapy and dosimetry training programs worldwide. This work is supported by NCI grant 5R25-CA134307.

Hippoboscid-transmitted Haemoproteus parasites (Haemosporida) infect Galapagos Pelecaniform birds: evidence from molecular and morphological studies, with a description of Haemoproteus iwa.

Haemosporidian parasites are widely distributed and common parasites of birds, and the application of molecular techniques has revealed remarkable diversity among their lineages. Four haemosporidian genera infect avian hosts (Plasmodium, Haemoproteus, Leucocytozoon and Fallisia), and Haemoproteus is split into two sub-genera based on morphological evidence and phylogenetic support for two divergent sister clades. One clade (Haemoproteus (Parahaemoproteus)) contains parasites developing in birds belonging to several different orders, except pigeons and doves (Columbiformes), while the other (Haemoproteus (Haemoproteus)) has previously been shown to only infect dove hosts. Here we provide molecular and morphological identification of Haemoproteus parasites from several seabird species that are closely related to those found in dove hosts. We also document a deeply divergent clade with two haemosporidian lineages recovered primarily from frigatebirds (Fregatidae, Pelecaniformes) that is sister to the hippoboscid-(Hippoboscidae) transmitted dove parasites. One of the lineages in this new clade of parasites belongs to Haemoproteus iwa and is distributed in two species of frigatebird (Fregata) hosts from Hawaii, the Galapagos Islands, the eastern Pacific and throughout the Caribbean Basin. Haemosporidian parasites are often considered rare in seabirds due in part to the lack or low activity of some dipteran vectors (e.g., mosquitos, biting midges) in marine and coastal environments; however, we show that H. iwa is prevalent and is very likely vectored among frigatebirds by hippoboscid flies which are abundant on frigatebirds and other seabirds. This study supports the existence of two sister clades of avian Haemoproteus in accord with the subgeneric classification of avian hemoproteids. Description of H. iwa from Galapagos Fregata minor is given based on morphology of blood stages and segments of the mitochondrial cytochrome b gene, which can be used for identification. This study shows that hippoboscid flies warrant more attention as vectors of avian Haemoproteus spp., particularly in marine and coastal environments.

To breed or not to breed: a seabird's response to extreme climatic events.

Intermittent breeding is an important life-history strategy that has rarely been quantified in the wild and for which drivers remain unclear. It may be the result of a trade-off between survival and reproduction, with individuals skipping breeding when breeding conditions are below a certain threshold. Heterogeneity in individual quality can also lead to heterogeneity in intermittent breeding. We modelled survival, recruitment and breeding probability of the red-footed booby (Sula sula), using a 19 year mark-recapture dataset involving more than 11,000 birds. We showed that skipping breeding was more likely in El-Niño years, correlated with an increase in the local sea surface temperature, supporting the hypothesis that it may be partly an adaptive strategy of birds to face the trade-off between survival and reproduction owing to environmental constraints. We also showed that the age-specific probability of first breeding attempt was synchronized among different age-classes and higher in El-Niño years. This result suggested that pre-breeders may benefit from lowered competition with experienced breeders in years of high skipping probabilities.

Long-term isolation of a highly mobile seabird on the Galapagos.

The Galapagos Islands are renowned for their high degree of endemism. Marine taxa inhabiting the archipelago might be expected to be an exception, because of their utilization of pelagic habitats-the dispersal barrier for terrestrial taxa-as foraging grounds. Magnificent frigatebirds (Fregata magnificens) have a highly vagile lifestyle and wide geographical distribution around the South and Central American coasts. Given the potentially high levels of gene flow among populations, the species provides a good test of the effectiveness of the Galapagos ecosystem in isolating populations of highly dispersive marine species. We studied patterns of genetic (mitochondrial DNA, microsatellites and nuclear introns) and morphological variation across the distribution of magnificent frigatebirds. Concordant with predictions from life-history traits, we found signatures of extensive gene flow over most of the range, even across the Isthmus of Panama, which is a major barrier to gene flow in other tropical seabirds. In contrast, individuals from the Galapagos were strongly differentiated from all conspecifics, and have probably been isolated for several hundred thousand years. Our finding is a powerful testimony to the evolutionary uniqueness of the taxa inhabiting the Galapagos archipelago and its associated marine ecosystems.

[Nanomedicine : Magnetic nanoparticles for drug delivery and hyperthermia - new chances for cancer therapy]. / Pharmakotherapie mittels Nanomedizin : Magnetische Nanopartikel für Drug Delivery und Hyperthermie - neue Chancen für die Krebsbehandlung.

The application of nanotechnology for the treatment, diagnosis, and monitoring of illnesses is summarized under the term nanomedicine. A particularly promising application is attributed to nanoparticular drug delivery systems. The goal of these new carrier systems is the selective enrichment of active substances in diseased tissue structures, an increase in bioavailability, the decrease of the active substance degradation and, above all, the reduction and/or avoidance of unwanted side effects. Apart from numerous nanosystems acting as carriers, the use of iron oxide nanoparticles has to be particularly emphasized. On the one hand, those particles are the carriers of the active substance and, on the other hand, can also be visualized with conventional imaging techniques (x-ray tomography, magnetic resonance imaging), called theranostic. In addition, they can be used for hyperthermia, another important supporting pillar of nanomedicine. Both procedures should lead to a personalized and goal-oriented therapy, which is of special medical and socioeconomic importance in view of the increasing number of cancer patients worldwide.

Monte carlo simulation of an X-ray pixel beam microirradiation system.

Monte Carlo simulations are used in the development of a nanotechnology-based multi-pixel beam array small animal microirradiation system. The microirradiation system uses carbon nanotube field emission technology to generate arrays of individually controllable X-ray pixel beams that electronically form irregular irradiation fields having intensity and temporal modulation without any mechanical motion. The microirradiation system, once developed, will be incorporated with the micro-CT system already developed that is based on the same nanotechnology to form an integrated image-guided and intensity-modulated microirradiation system for high-temporal-resolution small animal research. Prospective microirradiation designs were evaluated based on dosimetry calculated using EGSnrc-based Monte Carlo simulations. Design aspects studied included X-ray anode design, collimator design, and dosimetric considerations such as beam energy, dose rate, inhomogeneity correction, and the microirradiation treatment planning strategies. The dosimetric properties of beam energies between 80-400 kVp with varying filtration were studied, producing a pixel beam dose rate per current of 0.35-13 Gy per min per mA at the microirradiation isocenter. Using opposing multi-pixel-beam array pairs reduces the dose inhomogeneity between adjacent pixel beams to negligible levels near the isocenter and 20% near the mouse surface.