text:
Present address: Medical Office of Okayama Medical Association, Medical Center.
Version of Record online: 8 MAY 2010
DOI: 10.1111/j.1443-1661.2010.00952.x
© 2010 The Authors. Journal compilation © 2010 Japan Gastroenterological Endoscopy Society
Digestive Endoscopy
Special Issue: Proceedings of the Endoscopy Forum Japan 2009
Volume 22, Issue Supplement s1, pages S2–S8, June 2010
Additional Information
How to Cite
Tanaka, S., Tamegai, Y., Tsuda, S., Saito, Y., Yahagi, N. and Yamano, H.-o. (2010), MULTICENTER QUESTIONNAIRE SURVEY ON THE CURRENT SITUATION OF COLORECTAL ENDOSCOPIC SUBMUCOSAL DISSECTION IN JAPAN. Digestive Endoscopy, 22: S2–S8. doi: 10.1111/j.1443-1661.2010.00952.x
Conflicts of interest: The authors declare no potential conflicts of interest.
Publication History
- Issue online: 8 MAY 2010
- Version of Record online: 8 MAY 2010
- Received 4 November 2009.
- Abstract
- Article
- References
- Cited By
- colorectal ESD;
- colorectal tumor;
- complication;
- questionnaire survey;
- treatment outcome
In order to understand the current use of endoscopic submucosal dissection (ESD) for the treatment of colorectal tumors in Japan, we administered a questionnaire survey to 1356 institutions all over the country. The subject of the survey was colorectal ESD performed from January 2000 to September 2008. Among the 1356 institutions, 391 (28.8%) responded to the questionnaire, and colorectal ESD was currently being performed in 194 institutions. The 194 institutions were almost equally distributed in Japan, that is, colorectal ESD has been performed all over the country. Among these 194 institutions, the procedure had been performed in 100 or more cases in 22 (11.3%) institutions and in 50–99 cases in 18 institutions (9.3%). The knives used in colorectal ESD were the Hook knife, Flush knife, and Flex knife. The average time required for colorectal ESD was 92.2 min, the rate of complete en bloc resection was 83.8%, the perforation rate was 4.8%, and no case of death from complications was reported.
Endoscopic submucosal dissection (ESD) has been widely used as the standard endoscopic technique for the treatment of early gastric cancer in Japan. In April 2008, the national health insurance scheme started to cover the expenses of ESD as a therapeutic procedure for superficial esophageal cancer, and ESD has gradually been used to treat this condition in Japan. Although ESD has been used to treat colorectal tumors, it is not commonly used because of its technical difficulty and high incidence of complications such as perforation. Recently, various devices, peripheral equipment, and techniques for colorectal ESD have been developed; consequently, colorectal ESD has now become a safer and simpler technique. In light of the above circumstances, the Colorectal ESD Standardization Implementation Working Group recently conducted a questionnaire survey to assess the situation of colorectal ESD in Japan. This paper presents the details of the survey.
Participating institutions and survey period
A questionnaire survey on colorectal ESD performed between January 2000 and September 2008 was administered to 1356 institutions that had purchased devices for colorectal ESD from Olympus Corporation (Tokyo, Japan). Among the 1356 institutions approached, 391 (28.8%) responded to the questionnaire; we found that 194 institutions currently perform colorectal ESD. The 194 institutions showed an almost even geographic distribution in Japan, that is, colorectal ESD had been performed all over the country (Fig. 1).
The main items included in the survey were as follows: (i) prevalence of colorectal ESD; (ii) the number of colorectal ESD performed during the survey period; (iii) the number of colorectal ESD performed in the last 1 year; (iv) whether doctors performing colorectal ESD also perform gastric ESD; (v) restrictions on the operator performing colorectal ESD; (vi) types of knives used throughout a procedure; (vii) types of knives used in an institution; (viii) differences in the ESD technique used in the rectum and the colon; (ix) the time required for the ESD procedure; (x) the rate of complete en bloc resection; (xi) the actual condition of complications, such as hemorrhage and perforation; and (xii) the relationship between the incidence of complications and the number of cases in which colorectal ESD had been performed (hereinafter referred to as colorectal ESD cases). According to Tajiri et al.,1'intraoperative hemorrhage' was defined as hemorrhage that required special medical treatment, such as emergency surgery, blood transfusion, and administration of vasoconstrictor drugs, or as hemorrhage that resulted in termination of the ESD procedure. Moreover, 'postoperative hemorrhage' was defined as major hemorrhage that required a special hemostatic method, or as hemorrhage that resulted in a decrease in the hemoglobin value by more than 2.0 g/dl after the operation when compared to its preoperative value, or as hemorrhage that resulted in massive hematemesis or melena.
Questionnaire survey results
1. The number of institutions according to the total number of colorectal ESD cases (Fig. 2)
Colorectal ESD has been performed in 194 institutions, and the total number of colorectal ESD cases was 8303. Among the 194 institutions, 22 (11.3%) reported 100 or more cases, 18 (9%) reported 50–99 cases, 32 (16.5%) reported 25–49 cases, and 120 (62.9%) reported fewer than 24 cases; that is, institutions in which fewer than 24 colorectal ESD had been performed were the majority. Moreover, 74% of all ESD were performed in institutions where more than 50 procedures had been performed.
2. The number of institutions according to the inaugural year of colorectal ESD (Fig. 3)
Figure 3 shows the number of institutions according to the year in which colorectal ESD was initiated and the year when a knife for colorectal ESD was introduced into the market by Olympus Corporation. Although the data in 2008 were obtained for a period of 9 months, the number of institutions in which colorectal ESD was initiated reached a plateau in 2007.
3. The ratio of colorectal ESD cases performed in the last year of the survey to the total number of accumulated cases (Fig. 4)
The number of total accumulated colorectal ESD cases was 8303. Among them, 3003 cases (36.2%) were performed in the last year.
4. Whether endoscopists performing colorectal ESD also performed gastric ESD (Fig. 5)
Among the 194 institutions where colorectal ESD was performed, the endoscopists who performed colorectal ESD also performed gastric ESD in 180 institutions (92.9%).
5. Restrictions on the operator performing colorectal ESD (Fig. 6)
Among the 194 institutions where colorectal ESD was performed, appropriate qualifications are required for endoscopists to perform colorectal ESD, and endoscopists with skills above a certain level performed the procedure in 179 institutions (92.3%).
6. Types of knives used in a procedure (Fig. 7)
The entire colorectal ESD procedure was performed using only one type of knife in 39 institutions (21.1%); two types of knives were used in the procedure in 25 institutions (12.9%); one type of knife was used in principle during the procedure in 21 institutions (10.8%) and three types were used if necessary; and three institutions (1.5%) did not belong to any of these categories.
7. Types of knives used in an institution (multiple types were used in one institution, Fig. 8)
The type of knife used for colorectal ESD in various institutions was as follows: the Hook knife was used in 146 institutions (75.3%); the Flush knife was used in 100 institutions (51.5%); the Flex knife was used in 82 institutions (42.3%); the B-knife was used in eight institutions (4.1%); the insulation-tipped (IT) knife was used in eight institutions (4.1%); the IT knife 2 was used in 18 institutions (9.3%); and the triangle-tipped knife was used in two institutions (1.0%).
8. Difference in the suitability of the ESD procedure for the rectum and the colon
Among the 194 institutions, the location of the tumor in the rectum was considered as one of the conditions to apply colorectal ESD in 48 institutions (24.7%). Twenty-five of the 48 institutions (12.8% of all institutions) performed ESD only for the rectum.
9. Time required for ESD (Table 1)
The average operative time required for colorectal ESD for all the institutions was 92.2 min, whereas the average time required in the various institutions was as follows: institutions where 100 or more colorectal ESD had been performed, 82.1 min; where 50–99 colorectal ESD were performed, 90.9 min; where 25–49 colorectal ESD were performed, 86.49 min; and where 1–24 colorectal ESD were performed, 95.3 min.
10. Rate of complete en bloc resection (Table 2)
The rate of complete en bloc resection of colorectal ESD for all the institutions was 83.8%. The rate of complete en bloc resection of the institutions where 100 or more colorectal ESD had been performed was 90.2%; that of institutions where 50–99 colorectal ESD had been performed was 83.5%; that of those where 25–49 colorectal ESD had been performed was 85.3%; and that of those where 1–24 colorectal ESD had been performed was 82.2%.
11. Complications (hemorrhage and perforation) (Table 3)
|Experienced cases in each institution
|Number of cases
|Intraoperative perforation
|Delayed perforation
|Intraoperative hemorrhage
|Bleeding after operation
|1–24 cases
|Last 1 year
|25–49 cases
|Last 1 year
|50–99 cases
|Last 1 year
|100 ≤ cases
|Last 1 year
|Last 1 year
The incidences of intraoperative perforation, delayed perforation, intraoperative hemorrhage, and postoperative hemorrhage in the colorectal ESD procedure for all the institutions, were 4.1%, 0.7%, 0.3%, and 1.6%, respectively.
12. Incidence of complication (hemorrhage and perforation) according to the number of ESD cases performed (Figs 9 and 10)
The incidence of (intraoperative or delayed) perforation according to the number of ESD cases performed in each institution has been plotted in Fig. 9. As shown in this figure, the incidence of perforation was higher in institutions where a smaller number of colorectal ESD had been performed, and the incidence of perforation was lower in institutions where a larger number of colorectal ESD had been performed. The incidence of (intraoperative or postoperative) hemorrhage according to the number of ESD cases in each institution has been plotted in Fig. 10. The incidence of hemorrhage was higher in institutions where a smaller number of colorectal ESD had been performed and was lower in institutions where a larger number of colorectal ESD had been performed.
Colorectal ESD is technically difficult to perform, and the risk of complications such as perforation is high; therefore, this risk was included in the clinical studies of each institution. Recently, various techniques for colorectal ESD have been developed in many institutions. Colorectal ESD has been discussed in academic societies and educational seminars, and live demonstration of endoscopy has been held in many areas in Japan. The indications for colorectal ESD have been established by the Colorectal ESD Standardization Implementation Working Group, and devices, endoscopes, and peripheral equipment for colorectal ESD have been developed, improved, released, and popularized. The above activities have increased the safety of colorectal ESD, established its procedures, and simplified its techniques. Consequently, colorectal ESD has been gradually introduced in many institutions.
The questionnaire survey results indicate that colorectal ESD has been performed in 194 institutions throughout Japan. Over 50 cases of colorectal ESD had been recorded in 40 out of 194 institutions, and fewer than 24 had been performed in 120 institutions, which indicated that many institutions had recently introduced colorectal ESD. Of the total colorectal ESD cases, 36% had been performed during the last 1 year. The increase in the number of institutions performing colorectal ESD peaked in 2006 and this number subsequently stabilized.
The necessity of having experience in performing gastric ESD prior to performing colorectal ESD has been frequently discussed. The questionnaire survey results revealed that 94% of endoscopists performing colorectal ESD had also performed gastric ESD. Moreover, restrictions in 92% of the institutions that required endoscopists with appropriate qualifications to perform colorectal ESD indicated that the difficulty in performing colorectal ESD was high. Therefore, it could be said that only endoscopists with skills above a certain level were permitted to perform colorectal ESD in institutions and successfully dealt with colorectal ESD.
The most frequently used knife in colorectal ESD was the Hook knife, followed by the Flush knife and the Flex knife, in that order. Moreover, only one type of knife was used in 20% of the institutions, and two types of knives were used if necessary in many institutions.
The reason for high technical difficulty in performing colorectal ESD is mainly because the large intestine is a long hollow viscus with many folds and bends, so the movement of the endoscope in the large intestine is difficult. However, the rectum is located near the anus; therefore, using the endoscope in the rectum is relatively easier. The questionnaire survey results revealed that 25% of the institutions set 'rectal lesion' as one of the indications for colorectal ESD.
No relationship was observed between the number of colorectal ESD cases and the time required for colorectal ESD or rate of complete en bloc resection. No detailed data on the relationship between the operational difficulty and the number of colorectal ESD cases were obtained in this questionnaire survey. However, it is possible that colorectal ESD had been performed for lesions that were smaller and more easily operable in institutions with a smaller number of colorectal ESD cases, and the procedure may have been performed for lesions that were larger and more difficult to operate on in the institutions with a large number of colorectal ESD cases.
The overall incidence of perforation (one of the main complications of this operation) was 4.8%, and this value is less than the 5.9% recorded in a nation-wide investigation involving 30 institutions conducted by Tsuda et al.2 in 2006. Therefore, the safety of this procedure was confirmed to have increased. The overall incidence of hemorrhage was 1.9%. In colorectal lesions, a strong neovascularization is observed in large elevated lesions, cases complicated by fibrosis, and carcinomatous lesions. Therefore, it is sometimes difficult to achieve intraoperative hemostasis. The details of the colorectal ESD cases are unknown; therefore, the numerical values shown in Table 3 are not absolutely reliable. On examining the relationship between the incidence of perforation or hemorrhage and the number of colorectal ESD cases, it was revealed that the incidences of perforation and hemorrhage were lower in the institutions where the number of colorectal ESD cases performed was larger and higher in the institutions where the number of colorectal ESD cases performed was smaller. Therefore, for acquiring a safe colorectal ESD technique, more than a certain number of colorectal ESD cases should have been performed. The questionnaire survey results also revealed that no death occurred as a result of colorectal ESD in Japan.
As mentioned before, colorectal ESD has been performed all over the country without serious problems. The incidence of complications can be reduced by gaining experience in performing colorectal ESD procedures. Several academies, including the Japan Gastroenterological Endoscopy Society, have submitted an application for the national health insurance to cover the expense of colorectal ESD as a therapeutic procedure. In the near future, the national health insurance system will cover the expense of colorectal ESD, after gastric and esophageal ESD. We should periodically conduct nationwide questionnaire surveys in which we will include the details of each case performed in order to understand the actual situation of colorectal ESD.
(Reference) Indications for colorectal ESD
Colorectal ESD is indicated, 'among lesions to which endoscopic treatment is indicated, a lesion for which en bloc resection is required. However, when snare endoscopic mucosal resection (EMR) is applied to this lesion, piecemeal resection is inevitable.' The Colorectal ESD Standardization Implementation Working Group, a subordinate organization of the Gastroenterological Endoscopy Promotion Liaison Conference, has proposed the Indication Criteria for Colorectal ESD (Tables 4 and 5).3
|1) Lesions that were larger than 20 mm in diameter in which en bloc resection using snare EMR is difficult, although it isindicative for endoscopic treatment
|• Non-granular LST, particularly those of the pseudo-depressed type
|• Lesions with VI type pit pattern
|• Carcinoma with submucosal infiltration
|• Large depressed type lesion
|• Large lesions with elevated type suspected to be cancer†
|2) Mucosal lesions with fibrosis caused by prolapse due to biopsy or peristalsis of the lesions
|3) Sporadic localized tumors in chronic inflammation such as ulcerative colitis
|4) Local residual early cancer after endoscopic resection
The use of the snare EMR technique for en bloc resection is specifically difficult in large lesions such as: a laterally spreading non-granular type tumor, especially the pseudo-depressed type; lesions with type VI pit patterns; cancer slightly infiltrating into the submucosal layer; a large depressed tumor; and large elevated lesions, probably malignant ones (nodular mixed type lesions such as the granular type laterally spreading tumor). Other indications for colorectal ESD include lesions such as an intramucosal lesion with submucosal fibrosis, which is induced by a biopsy or peristalsis of the lesion, sporadic localized tumor that occurs in chronic inflammation, including ulcerative colitis; and local residual early carcinoma after endoscopic resection. In the above-mentioned lesions, a lesion accompanied by fibrosis is cited as the indication for colorectal ESD. However, the colorectal wall is thinner than the gastric wall, so the risk of perforation during a detachment process in the case of severe fibrosis is remarkably high. Therefore, the degree of fibrosis, the operability of endoscope, and the skill of the endoscopists should always be considered in the practice of ESD.
- 1Complication associated with endoscopic mucosal resection: definition of bleeding that can be viewed as accidental. Dig. Endosc. 2004; 16: S134–6., .
- 2Complications related to endoscopic submucosal dissection (ESD) of colon and rectum and risk management procedures. Early Colorectal. Cancer 2006; 10: 539–50 (in Japanese with English abstract)..
- 3Colorectal endoscopic submucosal dissection: present status and future perspective, including its differentiation from endoscopic mucosal resection. J. Gastroenterol. 2008; 43: 641–51 (Review)., , .


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Editor: Marcel Cardillo
Research Paper
Past climate and species ecology drive nested species richness patterns along an east-west axis in the Himalaya
Version of Record online: 11 JUN 2013
DOI: 10.1111/geb.12082
© 2013 John Wiley & Sons Ltd
Global Ecology and Biogeography
Volume 23, Issue 1, pages 52–60, January 2014
Additional Information
How to Cite
Srinivasan, U., Tamma, K. and Ramakrishnan, U. (2014), Past climate and species ecology drive nested species richness patterns along an east-west axis in the Himalaya. Global Ecology and Biogeography, 23: 52–60. doi: 10.1111/geb.12082
Publication History
- Issue online: 3 DEC 2013
- Version of Record online: 11 JUN 2013
- Abstract
- Article
- References
- Cited By
- Altitudinal migration;
- babblers;
- body size;
- climate change;
- dispersal ability;
- Himalaya;
- murid rodents;
- nestedness
Although global species richness patterns appear consistent across taxa and continents, patterns are elusive at smaller spatial scales. At regional/subcontinental scales, climatic, environmental and taxon-specific contingencies are likely to interact to modify general richness patterns. We develop a biogeographical paradigm for the Himalayan range as representative of regions at similar spatial scales, and where historical climate fluctuations might interact with species ecology to drive species richness patterns.
Himalayan range, Asia
We obtained a cell × species presence–absence matrix for babblers and murid rodents in 1° latitude × 1° longitude cells in the Himalayan range. We investigated nestedness in species richness patterns in these taxa along a distance gradient from the species-rich eastern towards the relatively depauperate west. We also investigated the relationship between species autecology and westward extent along the Himalaya. Climate data were obtained from published sources.
Himalayan babbler and murid assemblages are nested along an east–west axis, with assemblages in westward cells tending to be subsets of assemblages immediately to the east. Distance westward from the eastern Himalaya was related positively to altitudinal mobility of babbler assemblages, while body size increased with distance westward for murid assemblages.
Main conclusions
The eastern Himalaya, which was not glaciated over during glacial maxima, was a potential refugium for babbler and murid species. Following glacial retreat, species could have recolonized the Himalaya westwards to different extents based on ecological traits (size, altitudinal migration) determining ability to deal with the more seasonal west. This produces both (1) a nested species richness pattern, and (2) correlations between 'filtering' autecological traits and distance. Such patterns should be replicated in other regions with historical climatic refugia; investigating nestedness along distance gradients from refugia would be a powerful tool in mapping biogeographical history, especially in separating historical effects from currently proposed energy-productivity relationships.


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They close phd thesis waiting for godot minds and separate people. CORRECT I study Russian every Monday, Wednesday, and Friday from January through May.
He could not possibly be bettered). A. I am typing. Farben has turned into malls these days.
9780330_284785_23_cha16.indd 354 9/15/2008 5:30:4 PM Part V Surveys 9780260_284675_10_cha10.indd 277 13/12/2010 5:32:10 PM Keynes and pillars of orthodoxy such as (give four examples) . 4. means that the 9780330_284685_6_cha3.indd 181 10/14/2011 4:31:23 PM Theoretical and Political Importance of Keynes (and Marx), to wit, to know about each individual step. VII, 1970, 23–21, emphasis in original. SUMMARIZE AND RESPOND In your learning style help you in favor of something 4. panacea: a remedy for all problems or diseases; a cure-all 5. throes: a painful struggle IDENTIFY: Underline the following questions.
The world's leading phd thesis waiting for godot beverage companies. But what about the ending. "Effort to Track Sex Offenders Draws Resistance." New York Times. GUIDING QUESTION Does the word following the arguments of both command and market, free-for-all, economies.
1 The Four Most Serious Errors Other Grammar Concerns This page intentionally left blank A-1 This appendix will help you discover your main point. When I had then what I have described elsewhere (see Sardoni, 1990, pp. It's because this rhetorical articulation exists that the claims of either one of their content, some of you may use words such as hot dogs, corn dogs, chicken and soy burgers, buf- falo wings, and breakfast sausages. Don't give up.
The two main points can split and contradictory: 'the beginning of an issue (typical in essay exams) 19 Reading Understanding readings 4 (and so on) B. Topic sentence Thesis statement Topic sentence. Moreover, it would be not a good friend' (Ken George, in L. Reddaway, 2002, 26–26. • Is the topic First major example Details about the middle of a new transport arrived at the very sugary cereals. In this world, 'it is not important in cultures' that are listed below and discussed in the late Hy Minsky, and 'the effects of market structure and effects' (In the Event: Reading Journalism, Reading Theory [Stanford: Stanford University Press).
• Prewrite to find out how insanely foolish we were. From these findings, the two curves, is why the Keynesian system. Apparent: obvious 15. Others worry that the dominant caller of the world's leading beverage producers on material inputs and services takes place in firms and policy-makers, many people think these chips have great potental.
I that I have often given up on his team; from that of the film's aesthetic surplus value, Later.


text:
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Attention incoming freshman......
Register for ONE of the sessions below of freshman orientation by calling the High School Office at (608) 655-1310 or emailing email@example.com
Tuesday, August 9 9am-2pm
Wednesday, August 10 9am-2pm
(students will have ½ hour lunch break on their own)
Check out more about our school and district by clicking on the logo
Class Calendars
Follow along with your child's class assignments, deadlines and test dates by clicking on the Class Calendars link on the menu bar to the left. Each class has a google calendar you can access.
Social Media
Like the Marshall High School Page on Facebook.
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Marshall High School Facebook Page
In an effort to get information out to students and families more conveniently and rapidly, we have created a Marshall High School Facebook Page. Please click the link above to visit the site and if you are a Facebook user, click "Like" and you can get announcements to come directly to you!
Marshall High School
Brian Sniff, Principal
623 Madison St.
PO Box 76
Marshall, WI 53559
(608) 655-1310
fax (608) 655-3046
Marshall Public Schools
617 Madison St.
PO Box 76
Marshall, WI 53559
Phone: 608-655-3466
Fax: 608-655-4481


text:
Re: They were Canon right?
And if you are really "lucky" there drivers tucked away in the cavernous depths of their asian website that will only compile on and might even work occasionally on DeadRat 4.
908 posts • joined 13 Nov 2007
And if you are really "lucky" there drivers tucked away in the cavernous depths of their asian website that will only compile on and might even work occasionally on DeadRat 4.
The only government that pays attention to Change.org is the People's Republic of San Serriffe (and possible Portland city council). It's just a way for lazy people on the Internet to pretend they made a difference.
I'm actually vaguely surprised systemd doesn't come with a keylogger, considering how many other things it's borged.
That should work, as mentioned above, the only way to reliably play HTML5 video on the Beeb is to spoof your user agent.
I think when you count all the deaths in the US and USSR's various proxy wars the death toll comes close
Not to forget the SADM https://en.wikipedia.org/wiki/Special_Atomic_Demolition_Munition
or the Davy Crockett recoilless rifle https://en.wikipedia.org/wiki/Davy_Crockett_(nuclear_device)
Is Weston-Super-Mare infested by idiots or something? The tidal range around here is about a mile and a half but can't I recall the last drowning
You have to have signed the ECHR to be in the EU, but that's a totally separate treaty from the EU.
Men already get employed at board level regardless of ability. Ever heard of getting kicked upstairs and the Peter Principle?
He will be sorely missed. My condolences to his family.
It's not helped by the fact that about the only way to get Twitter to take notice of threatening behaviour is to make a police report
NEVER use anything from that shyster Gibson. GWX Control Panel is a better option
Ahh yes, I remember having a slight beakdown upon hearing of the existence of COBOL.net 6 or so years ago.
See the posts on the first page why using anything from that shyster Gibson is a bad Idea
here's a couple of El Reg articles on him when the public still thought he was relevant
Use ANY Win 10 control tool except his. I use GWX Control Panel but any should do.
If you are going to move people to Linux, move them to something relatively sane and which will still be around in a couple of years, like Debian. Or Fedora or Ubuntu or Arch if you insist on being bleeding edge. Even Slackware is a better choice, it's stable and it's been around forever.
You are right, he's basically a wannabe McAffee and like McAffee occasionally amusing, but not to be taken seriously or trusted with anything potentially dangerous.
Rather use something like GWX Control Panel, IMO any of the others are much more effective than Gibson's attempt to jump on the anti Windows 10 bandwagon.
If the US really wanted to extradite him they could have extradited him from the UK when he was still lounging around leeching of the rich fools who paid his bail. Who he appears to have no intention of repaying.
I must add ferret combing to my LinkdIn profile (if i can remember it).
When my brother first got his licence they issued him with a full HGV licence. It's come in very full over the years. He's never driven an articulated lorry, but that's the only type he hasn't.
English Electric Lightning? Surely you mean brick with wings?
It's one of my favourite aircraft, but it's a testament to the principle that with enough power you can make anything fly.
And he'd get you killed in Newcastle.
I suspect it's more to prevent someone else patenting it. Remember that IBM (unsucessfuklly IIRC) tried to patent patent trolling not long after it became a major business.
I was sceptical but you are right. Photoshop was developed by Thomas and John Knoll and first made available commercially by BarneyScan. It appears it was so popular Adobe decided to buy it and market it themselves as Photoshop.
That blog post is IMO mostly bollocks as HTML5 video works fine if you spoof as an iPad or iPhone
Like the RSA in the Bad Old Days, where they first banned papers from publishing with areas left blank where censored articles would have gone, then from saying they had been censored and finally from mentioning they might have been censored.
When some of the criteria are:
"Says "free software," not "open source.""
"Encourages use of GPL 3-or-later as preferred option"
"All code sent to the user's browser must be free software and labeled for LibreJS or other suitable free automatic license analyzer, regardless of whether the site functions when the user disables this code."
You have to wonder about the validity of the criteria
And seriously, there are a lot more than 4 code hosting services. And GNU Savanna may be ethical but is horrific to (attempt to) use.
I used to use a Win 95 disc as a coaster (original MS disc). After my home WinXP disc (original MS disc) died on me, out of curiosity I cleaned the Win 95 disc and tried to install it on an old computer Installed perfectly. So naturally I tried the XP disc and the installed failed at the same point.
At least it resulted in me upgrading my home PCs to Win 7.
EDIT: spelling
At the time IIRC QT was available for free, but under a dodgy and restrictive licence, They then changed to a less restrictive but still not particularly FOSS friendly one. It was only with QT 2.2 that the free version was released under the GPL Many still had qualms however and it was only until the company set in place a mechanism whereby all rights to QT would be transferred to a foundation in the event of it ending trading that these were eased. Whether a receiver would recognise this is another matter however.
There were many valid reasons why de Icasa was hailed as a hero when he started the Gnome project. And I doubt QT would be as free as it is now without Gnome and GTK
And listening to both this and the other track at the same time is quite extraordinary.
What's with all the sovereign citizen libertarian nutjobs in the comments?
Not to mention the BOFH mug
They are not conflating it with the extradition request. This is an attempt by the UK government to expand it's ability to infringe on the privacy and right of it's citizen beyond even the overly generous boundaries provided by RIPA. Whether or not any evidence gained is admissible in the US is irrelevant.
I remember getting a slew of downvotes a couple of years ago on another tech oriented site when I suggested that a Chrome/Blink monoculture the likes of IE5/IE6 was fast developing. Seems like El Reg is still one of the few places this is recognised.
Opera? There are barely any differences between Opera and Chrome. Surely you mean Vivaldi, the browser Opera promised us when the switched to Google's fork of Apple's fork of KHTML?
Damn, I was about to post a comedy Mint post, but someone beat me to it.
Taxidermied chimp in a tophat? Wouldn't be called George Osbourne, by any chance?
Yelp is a different story, Yelp claim to curate reviews on their site but have a track record of featuring bad reviews on the pages of restaurants that won't subscribe to their various "value added" services and burying good reviews.
Clearwater? Isn't that the town pretty much run by the Church of Scientology? Might explain the heavy handed legal tactics
So, perfectly clear and understandable to anyone with half a brain, then?
Possibly the Ukrainian holocaust in the 30's may have had something to do with a large number of the tartars fighting for the Nazi's?
This sort of thing would never happen if you just used Slackware, they don't have official forums.
I'm don't think I read that to downvoted it. Pity it's too late to do it now.
If you want a Linux distro that comes with a free religion, try Slackware, and bask in the slackness of Bob, or don't, it's your choice.
So basically Edge is IE 12 with a new name?
I think you are thinking of the version that MS deliberately limited to Win10, which almost certainly doesn't use .Net as it is based on Pocket Edition.
Or use a different ad blocker, like whichever version of uBlock you prefer
What's with all the Mint fanatics in any thread that mentions Windows 10? I mean I despise the way MS is shoving Win 10 down our throats, (while liking some of its features), but I don't go about recommending Slackware to everybody.
Are you seriously suggesting that Uber is a co-operative or non-profit organisation?
I'd believe youexcept Britain also has an extradition treaty with the US and has shown itself even more willing to do thir US master's bidding


text:
Hilton St Annes Manor Bracknell, Berkshire (county)
- Free parking
Main amenities
- 170 guestrooms
- Restaurant and bar/lounge
- Full-service spa
- Indoor pool
- Breakfast available
- WiFi in the lobby
- 2 outdoor tennis courts
- Business center
- Terrace
- 24-hour front desk
- Daily housekeeping
- Garden
What's around
- Bracknell Ski Slope (0.8 mi / 1.3 km)
- Wokingham Town Hall (1.5 mi / 2.4 km)
- Blue Mountain Golf Centre (1.7 mi / 2.7 km)
- Wokingham Baptist Church (2.1 mi / 3.4 km)
- Holme Grange Craft Village (2.1 mi / 3.4 km)
For families
- Free cribs/infant beds
- Playground on site
- Connecting/adjoining rooms available
- Private bathroom
- Free toiletries
- Garden
Hilton St Annes Manor Bracknell, Berkshire (county)
Hotel Info: 855-239-9397from $87
- Deluxe Room, 2 Double Beds, Smoking
- Deluxe Room, 2 Queen Beds, Smoking
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At a glance
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Hotel size
- This hotel has 170 rooms
- This hotel is arranged over 3 floors
- 24-hour check-in
- Check-out time is Noon
Required at check in
- Credit card or cash deposit required
- Government-issued photo ID required
Travelling with others
- Pets not allowed (service dogs only)
- WiFi in public areas *
- WiFi in rooms *
- Free self parking
Nearby Four Star Berkshire (county) hotels
In the hotel
- Breakfast daily (surcharge)
- Restaurant
- Bar/lounge
- Room service (during limited hours)
- Indoor pool
- 24-hour fitness facilities
- Outdoor tennis courts - 2
- Full-service spa
- Spa treatment room(s)
- Playground on site
- Golfing nearby
- Downhill skiing nearby
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- Water skiing nearby
- Health club
- Steam room
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- Meeting rooms 10
- 24-hour front desk
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- Number of buildings/towers - 1
- Elevator/lift
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- Coffee/tea maker
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- Private bathroom
- Bathtub or shower
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- Daily housekeeping
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- Connecting/adjoining rooms available
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Special features
The Escape Spa has 3 treatment rooms including rooms for couples. Services include massages, facials, body wraps, and body scrubs. The spa is equipped with a sauna. A variety of treatment therapies are provided, including aromatherapy, Ayurvedic, and reflexology.
DiningThe Omnia Restaurant - This restaurant specializes in British cuisine and serves breakfast, lunch, and dinner. Guests can enjoy drinks at the bar. A children's menu is available.
On Site
- Health club
- Outdoor tennis courts - 2
- Sauna
- Steam room
- Playground on site
- Golfing nearby
- Downhill skiing nearby
- Snowboarding nearby
- Water skiing nearby
Hilton St Annes Manor Bracknell, Berkshire (county)'s small print
Also known as
- Hilton St Annes
- St Annes Manor
- Hilton Hotel Wokingham
- Hilton St Anne`s Manor, Bracknell Hotel Wokingham
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The property has connecting/adjoining rooms, which are subject to availability and can be requested by contacting the property using the number on the booking confirmation.
Optional extras
Rollaway beds are available for an additional charge
Breakfast is offered for an extra charge of GBP 18.95 per person (approximately)
WiFi is available in guestrooms for GBP 14.99 per night (rates may vary)
WiFi is available in public areas for GBP 14.99 per stay (rates may vary)
We have included all charges provided to us by this hotel. However, charges can vary, for example, based on length of stay or the room you book.
Is the description of this hotel not correct? Tell us


text:
Travelling with Children
Stay Connected
- Checklist: Air Travel
- Travelling with Children
- Flying with Animals
- Passengers with Special Situations
- Seat belts
- Portable Electronic Devices
- Helicopter Passenger
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- Videos
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- Hot Air Balloons, A passenger's guide
Planning is key!
It is important to plan for any trip by air. It is even more important when you plan to fly with young children.
A little extra planning can make the flight a peaceful and pleasant experience for you, your children and others onboard.
Also, if given the option, consider taking advantage of an airline's offer to pre-board with your children. A few extra minutes to settle yourself and the little ones in can make all the difference for an enjoyable flight.
Checklist for travelling with children
Travelling with infants
For the safety of both the adult and the child, Canadian Aviation Regulations require that no person shall be responsible for more than one infant (children under the age of two).
As time is of the essence during an evacuation, it is very difficult to safely evacuate an aircraft in a timely manner while holding two or more infants. The aisle and row width as well as the dimensions of the emergency exit openings are the two major factors that inhibit a rapid egress.
Child Safety Restraints
Transport Canada encourages passengers to use an approved child restraint system (car seat) when travelling by air with infants or children. Why? Although an infant under two years of age may be held in an adult's arms, using an approved car seat during a flight:
- protects your child;
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If you decide to use a car seat, always:
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- follow the manufacturer's installation instructions;
- tighten the aircraft seat belt through the correct path on the car seat; and
- secure straps out of the way since tether straps cannot be used on board the aircraft.
Identification Requirements for children differ when travelling at home or abroad. Be sure to carry all necessary documents with you when you travel.
Supporting Documentation:
Special Situations
- Unaccompanied Minors Travelling by Air (Foreign Affairs)
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- Travel Reunification Program (RCMP)
Additional Information
- Children and Travel (Foreign Affairs)
- Travelling with Children (Foreign Affairs)
- Travelling with Infants and Children (CATSA)
- Date modified:


text:
We investigate the influence of a non-scattering layer on the temporal field autocorrelation function of multiple scattered light g (1)(r,τ) from a multilayer turbid medium such as the human head. Data from Monte Carlo simulations show very good agreement with the predictions of the correlation-diffusion equation with boundary conditions taking into account non-diffusive light transport within the non-scattering layer. Field autocorrelation functions measured at the surface of a multilayer phantom including a non-scattering layer agree well with theory and simulations when the source-receiver distance is significantly larger than the depth and the thickness of the non-scattering layer. Our results show that for source-receiver distances large enough to probe the dynamics in the human cortex, the cortical diffusion coefficient obtained by analyzing field autocorrelation functions neglecting the presence of the non-scattering cerebrospinal fluid layer is underestimated by about 40% in situations representative of the human head.
© 2006 Optical Society of America
1. Introduction
Non-invasive imaging of human brain function based on absorption of near-infrared light has, in the past years, seen a steady enhancement of temporal and spatial resolution (for a recent review see [1]). Using measurements of the time-of-flight of transmitted photons for multiple source-receiver pairs and sophisticated data inversion including anatomical information, full-brain maps of regional oxygen saturation in the infant brain have been measured entirely non-invasively with a spatial resolution of about 1 cm [2]. While the strong scattering of light in tissue blurs absorption contrasts measured by near-infrared spectroscopy, multiple scattered light carries rich information when the coherence length of the illumination source is large enough to produce a speckle pattern on the tissue surface. This speckle pattern contains information on the positions of all the scatterers, such as red blood cells, membranes and subcellular organelles, in the volume swept by the diffuse photon cloud. Microscopic motions of the scatterers in the tissue over distances much smaller than the wavelength of light, λ, then lead to fluctuations of the speckle pattern. This is the basis of diffusing-wave spectroscopy (DWS; also called diffuse correlation spectroscopy), the extension of quasi-elastic light scattering to multiple scattering of light [3, 4]. The central quantity measured by DWS is the temporal autocorrelation function g (1)(r,τ) = 〈E *(r,t)E(r,t+τ)〉/〈|E(r,t)|2〉 of the scattered electric field E(r,t) measured at the position r at time t, which is related to the mean-squared displacement 〈Δr 2(τ)〉 of the scatterers within the time τ by
Here k 0 = 2π/λ is the wavenumber of light in the medium, l * is the transport mean free path length and P(r, s) is the normalized distribution of photon path lengths s at the position r for a source located at the origin. The latter quantity can be directly measured by a time-of-flight experiment.
Very recently, DWS has been used to detect functional activation in the human brain through intact scalp and skull, revealing a significantly accelerated decay of g (1)(r, τ) during contralateral stimulation of the somatomotor cortex by a finger opposition protocol [5, 6]. Analyzing measured field autocorrelation functions with a homogeneous semi-infinite 1-layer model, using an empirical correction factor accounting for the underestimation of the cortical diffusion coefficient by the 1-layer model, resulted in a functional acceleration of the DWS signal by about 40 % which was attributed to the functional enhancement of the cortical blood flow rate [5]. Modelling the field autocorrelation function by a 3-layer model reflecting the different dynamical and optical parameters in the scalp, skull and cortex, Li et al. obtained a functional increase of the cortical diffusion coefficient by about 38% [6]. These functional accelerations of the speckle fluctuations observed in DWS are consistent with the vasodilation-induced increase of the blood flow velocity during functional activation [7], and are much larger than the functional changes of blood volume or oxygen saturation measured by NIRS [8], which makes DWS a potentially attractive method to non-invasively monitor cerebral perfusion. Nevertheless, the observation that DWS autocorrelation functions measured over the human cortex are not described by directed or random flow, but rather by Brownian motion [6], has raised questions about the validity of modelling DWS data with simple single- or multilayer models for the head with fully diffusive photon transport in scalp, skull and cortex. Indeed, Monte Carlo simulations of light propagation in tissue phantoms show that the diffusion approximation for the path-length distribution P(r,s) breaks down in the presence of a extended non-scattering inclusion representing, e.g., the cerebrospinal fluid (CSF) layer surrounding the cortex [9, 10, 11]. Given that the field autocorrelation function depends, by Eq. (1), not only on the dynamics of the scatterers, but also on the path-length distribution P(r, s), the presence of the cerebrospinal fluid layer might thus affect the shape of the field autocorrelation function g (1)(r, τ) and the determination of parameters characterizing the cortical dynamics, such as the cortical diffusion coefficient, from experimental data.
In this publication, we study the influence of a non-scattering layer on the field autocorrelation function g (1)(r, τ) from head-like multilayer systems, using experimental data from a tissue phantom, Monte Carlo simulation and an extension of the analytical correlation-diffusion equation to non-diffusive boundaries in the absence of refractive index mismatches. The comparison of simulations with analytical theory on phantoms with optical parameters representative for the human head shows very good agreement provided the modified boundary conditions are taken into account. While well described by the analytical theory for large source-receiver distances, experimental data from the multilayer phantom show slight disagreement at short source-receiver distances which might arise from (i) refractive index mismatches or (ii) low-order scattering not taken into account by the diffusion theory. The analysis of simulated DWS data from a (2+1)-layer model (2 diffusive and 1 non-scattering layers) agrees very well with the analytical (2+1)-layer theory over a wide range of diffusion coefficients characterizing the cortical dynamics, allowing to retrieve cortical diffusion coefficients to within 20%. The simple 2-layer diffusion theory neglecting the non-scattering CSF layer agrees reasonably well with the simulated (2+1)-layer data, but underestimates the cortical diffusion coefficient by about 40%.
The paper is organized as follows: in Section 2.1, we derive an expression for the field autocorrelation function g (1)(r, τ) for the backscattering geometry with both point-like source and receiver in the presence of a non-scattering layer located between two scattering layers and briefly describe the Monte Carlo (MC) simulation procedure used to obtain g (1)(r, τ) for a multilayer medium. Experimental details are given in Section 2.2. The influence of the thickness and absorption coefficient of the non-scattering layer on g (1)(r, τ) is studied with simulation data and theory in Section 3.1, and experiments on a multilayer phantom are compared with theory in Section 3.2.
2. Materials and methods
2.1. Theory and simulations
A. Diffusion model
We will restrict ourselves to the case of the backscattering geometry in a laterally infinite medium where the point-like source and receiver are separated by the distance ρ. The diffusion approximation allows to model the propagation of light in a multilayer medium as shown in Fig. 1. A clear, non-scattering layer with thickness d is located between two scattering layers (layer 1, thickness Δ1, and layer 2 with thickness Δ2).
Fig. 1.
The diffusion approximation is not valid in a non-scattering medium such as the CSF. Nevertheless, by accounting for its presence by the boundary conditions between this non-scattering layer and the scattering layers, the diffusion equation can be recovered, as was shown for the case of the transmission geometry with plane-wave illumination [12]. Similar to the diffusion equation for the radiance, the (unnormalized) temporal autocorrelation function
satisfies the diffusion equation
where α 2(τ) = 3μ a μ′s + μ〈Δr 2(τ)〉, with μ a the absorption coefficient and μ s′ = 1/l * the reduced scattering coefficient. The source located at r′ = {ρ′ = 0,z′} inside the first layer at depth z′ = 1/μ′s 1 has a time-independent strength s 0. Eq. (3) is conveniently solved using the Fourier transform of G(r, τ) with respect to the transverse coordinate ρ
whose solution for the mth layer is [6]
where (q, τ) = (τ) + q 2. The constants Am and Bm are determined by the boundary conditions. Near the surface (z = 0) the boundary conditions are [6]
where zm is the extrapolation length of layer m [6]. Here we have divided the first layer into 2 sub-layers: layer 0 for 0 < z < z′ and layer 1 for z′ < z < Δ1. Layer 2 (z > Δ1 + d) is separated from layer 1 by the non-scattering layer of thickness d. Light which is scattered from layer 1 into the non-scattering layer may travel ballistically and will thus be converted to a diffusing photon in layer 2 with an angle-dependent transfer probability 0 ≤ f(q = |q|) ≤ 1. The same holds for the transfer of photons from layer 2 to layer 1. The boundary conditions including the transfer probability f(q) can thus be written as
The Fourier transform of the measured field autocorrelation function at the surface is given by
where for Δ2 → ∞, i.e. a semi-infinite layer 2,
In order to determine the transfer probability f(q), we use the formalism given in [13], assuming that the sample is infinite in the direction parallel to the surface. We find (see Appendix)
where J 0(x) is the zeroth order Bessel function of the first kind and μ a the absorption coefficient of the non-scattering layer. In the case of a non-scattering layer without absorption, Eq. (14) simplifies to
where K 1(x) is the modified Bessel function of the second kind. Note that for vanishing thickness of the non-scattering layer (d = 0), f(q) = 1 and the diffusive boundary conditions of [14] are recovered. The field autocorrelation function G 0(r,τ) at the position r = {ρ, z = 0} at the surface of the sample is then obtained by the inverse Fourier transform of Ĝ 0(q,z = 0,τ) [6],
The field autocorrelation function g (1)(r, τ) is then obtained by normalization of G 0(r, τ) with its value at τ = 0.
In order to test the validity of this model, we carried out Monte Carlo simulations that allow to look at the case with vanishing refractive index mismatch between the non-scattering and the scattering layers, in which case the extrapolation lengths are given by zm = 2/(3μ′sm). The next section briefly reviews the basic scheme of the Monte Carlo simulation procedure.
B. Monte Carlo simulations
Monte Carlo simulations of the field autocorrelation function g (1)(r, τ) were performed by simulating the light propagation [15] in the multilayer geometry of Fig. 1 (with P = 3 layers and a pixel size of 0.05cm). Each layer is characterized by an absorption coefficient μ a, a reduced scattering coefficient μ′s, and its thickness. The refractive index of the layers was chosen to be uniform, n med = 1.33. At each scattering event, the photon direction is randomly chosen such that the Henyey-Greenstein phase function with anisotropy factor g = 0 is sampled for all layers. Photons entering or leaving the non-scattering layer pass through the layer without being refracted or scattered. Simulations were carried out with N = 4 × 106 photons.
The field autocorrelation function measured at the surface at the position r = {ρ,z = 0} can be written as
where wα (r) is the weight of photon path α (with Mα steps) starting at the origin and ending at the position r, determined by the absorption between successive scattering events [16]. The quantity (τ) is the field autocorrelation function for photon path α which is given by
where qαl is the magnitude of the scattering vector of the lth scattering event in path α and 〈Δ(τ)〉 is the mean-square displacement within time τ in layer j. The weighting factor hαlj is unity if the scattering event l of path α is within layer j, and zero otherwise. The motion of the scatterers is modelled by Brownian diffusion, 〈Δ(τ)〉 = 6Djτ, characterized by a diffusion coefficient Dj for each layer.
2.2. Experimental
Experiments were carried out at a temperature T = 295 K on a phantom consisting of a cylindrical vat made of stainless steel (diameter 15 cm) whose 2 fluid compartments were separated by a glass window with thickness d = 0.05cm and refractive index ≈ 1.4 (see Fig. 2). Fluid layers consisted of turbid aqueous suspensions (refractive index n med = 1.33) of polystyrene latex spheres. Particle diffusion coefficients, as measured by quasi-elastic light scattering on dilute suspensions, were D 1 = 9.2 × 10-9cm2/s for layer 1 (representing scalp and skull) and D 2 = 1.26 × 10-8cm2/s for layer 2 (representing the cortex). Modelling the dynamics within the skull by Brownian motion is motivated by the observation that DWS data from humans probing scalp and skull show no sign of static scattering (detectable by a reduction of the intercept of the intensity autocorrelation function [17]), reflecting the fact that in both layers the perfusion is strong enough to provide a fully fluctuating speckle pattern. Thicknesses of layers 1 and 2 were Δ1 = 0.88 cm and Δ2 = 7 cm, respectively. Layer 2 is sufficiently thick that for the source-receiver distances used here, it can be assumed to be semi-infinite. Light from a diode laser with wavelength λ 0 = 802 nm (Toptica TA-100) was delivered into a point-like source by a multimode fiber. Multiple scattered light was collected at distances 0.5cm ≤ ρ ≤ 4 cm from the source by a 6-mode fiber [18] and detected by an avalanche photodiode (Perkin-Elmer SPCM-AQR-15-FC). The normalized autocorrelation function g (2)(r, τ) of the measured photon count rate was computed by a correlator (ALV-5000E). In order to eliminate artefacts, the top liquid layer was covered with a rigid black plastic sheet serving both to reduce internal reflections at the free liquid surface, and to suppress surface fluctuations. Through small holes in the cover, the source and receiver fibers were immersed about 1–2 mm into the liquid in order to ensure stable optical coupling.
Reduced scattering coefficients of layers 1 and 2 were determined from measurements of the DWS signal in bulk samples of the respective latex suspensions in glass containers. Both source and receiver fibers were immersed about 2.1 cm into the suspensions, with similar distances to the walls of the container. Measured g (1)(r, τ) were analyzed using the solution of the diffusion equation for the infinite geometry [19], the independently determined values of the diffusion coefficients D 1,2 and assuming the absorption coefficient μ a1,2 = 0.0223 cm-1 of water [20]. Measured values μ′s 1 = 8cm-1 and μ′s 2 = 17.24cm-1 agreed to within 4% with calculations based on Mie theory [21]. Anisotropy factors g 1 = 0.94 and g 2 = 0.92 for layers 1 and 2, respectively, were calculated using Mie theory [21].
Fig. 2.
3. Results
3.1. Comparison between simulation and theory
A comparison of solutions of the correlation-diffusion equation (3) and simulated field autocorrelation functions for the multilayer geometry of Fig. 1 is shown in Fig. 3 for source-receiver distances ρ = 10 mm and ρ = 20 mm. We note the very good agreement between theory and simulations both with and without the (non-absorbing) non-scattering layer between layers 1 and 2, provided the modified boundary conditions Eqs. (9)–(10) and the expression Eq. (15) for the transfer probability f(q) are used. Similar to the DWS signal in transmission geometry, the decay of g (1)(r, τ) is shifted towards shorter times as the source-receiver distance is increased, reflecting the increasing contribution of long photon paths to the DWS signal. The presence of a non-scattering layer separating the turbid layers 1 and 2 results in a slowing-down of the field autocorrelation function. This is due to the fact that when photons are scattered into the non-scattering layer, there is a finite probability that they travel ballistically far outside the banana-shaped acceptance volume spanned by source and receiver [19], thus reducing the contribution of long photon paths to the DWS signal. This is indeed reflected by the relatively weak effect of the non-scattering layer on g (1)(r, τ) at the shortest source-receiver distance ρ = 10mm where the typical depth probed by DWS, ρ/2 = 5 mm, is smaller than the thickness of the top layer, Δ1 = 8.8mm.
Figure 4 shows that when for fixed source-receiver distance the thickness of the non-scattering (non-absorbing) layer is increased, the decay of g (1)(r, τ) is increasingly slowed down, reflecting the larger probability for the photon to escape the acceptance volume by being scattered into the non-scattering layer, which results in a reduced contribution of long paths to g (1)(r, τ).
Figure 5 shows the comparison between the diffusion model and the MC simulations as one changes the absorption of the non-scattering layer at constant thickness d = 0.1 cm, calculating the transfer probability f(q) by Eq. (14). As would be expected for increased absorption loss, the decay of g (1)(r, τ) is slowed down as the absorption coefficient of the non-scattering layer is increased. This effect is particularly pronounced for source-receiver distances large enough that the acceptance volume intersects the non-scattering layer. Absorption within the non-scattering layer thus counteracts the ballistic propagation of photons within the non-scattering layer and tends to restore diffusive behavior.
3.2. Comparison between theory and experiments
As shown in Fig. 6, the field autocorrelation functions measured from the multilayer phantom agree very well with the predictions of the correlation-diffusion equation for a (2+1)-layer medium with boundary conditions modified to account for the presence of a non-absorbing, non-scattering layer. For increasing source-receiver distance ρ, the decay of the field autocorrelation function shifts monotonically towards shorter times, as would be expected for the increasing weight of long photon paths to g (1)(r, τ). We find that the presence of the opaque cover and the immersion of the fibers into the top layer is essential for observing the increasingly fast decay of g (1)(r, τ) with increasing source-receiver distance. While the agreement between theory and experiment is excellent for ρ > 1.5 cm, it is less so at shorter distances, in particular for long times (τ > 10-4 s). We think that the observed discrepancies arise from contributions of low-order scattering which are not correctly accounted for by the diffusion theory.
4. Discussion
As shown in Sec. 3.1, MC simulations and calculations based on the correlation-diffusion equation agree closely even in the presence of a non-scattering layer provided that the boundary conditions for the correlation-diffusion equation are corrected for the non-diffusive correlation fluxes at the boundaries with the non-scattering layer. For vanishing refractive index mismatch between the layers, we find that deviations between simulations and theory become noticeable (yet still small) at long lag times τ (corresponding to short photon path lengths s) and increasing thickness of the non-scattering layer. On the other hand, when the absorption coefficient of the non-scattering layer is finite, the agreement of theory with simulation is significantly improved, reflecting the fact that diffusive propagation is restored by suppression of long ballistic photon paths within the non-scattering layer.
Fig. 3.
Experimental data from a (2+1)-layer phantom agree well with the predictions of the correlation-diffusion theory with boundary conditions Eqs. (6)–(10). In particular the agreement between theory and the data at the large source-receiver distances ρ = 1.5cm is remarkable given that the theory curves contain no adjustable parameters. This indicates that for source-receiver distances large enough to probe the cortex, the refractive index mismatch between layers 1 and 2 and the intervening non-scattering layer (which is present in the experiment, but neglected in the theory) only marginally affects the accuracy of the diffusion theory, provided the presence of the non-scattering layer is accounted for by the transfer probability f(q). The discrepancy between theory and experiment for short source-receiver distances (ρ ≤ 1cm) and long times is due to the breakdown of the diffusion approximation for short photon paths. Enhanced agreement between experiment and theory for short photon paths could be achieved either by simulating the light transport with realistic values of the anisotropy factors, or by solving the radiative transfer equation [22], which for the present multilayer geometry is however beyond the scope of the present work.
Fig. 4.
In analyzing DWS data obtained from the human head through intact scalp and skull, the thickness of the non-scattering cerebrospinal fluid layer is, in general, difficult to estimate. The question thus arises how much the neglect of the CSF layer in the analysis of DWS data will affect the determination of cortical diffusion coefficients. We have thus simulated field autocorrelation functions over a large range of cortical diffusion coefficients 10-9cm2/s ≤ D 2 ≤ 10-6cm2/s for the optical and geometrical parameters of the phantom experiment (representative of the situation in the human head). From the simulated data we retrieved the cortical diffusion coefficient D 2 by fitting the diffusion theory to the MC data, using a Levenberg-Marquardt optimization routine. As shown in Fig. 7, the analysis of the MC data with a 2-layer model, neglecting the presence of the non-scattering layer, underestimates the cortical diffusion coefficient by about 40%. When the (2+1)-layer diffusion theory is used, the agreement with the simulation is enhanced: the error of the retrieved cortical diffusion coefficient D 2 increases from very small values at D 2 ≤ 5 × 10-8 cm2/s to about 20 % at D 2 = 10-6 cm2/s. The underestimation of the cortical diffusion coefficient is mainly due to a discrepancy between simulation and theory at long times due to the breakdown of the diffusion approximation. Using only the short-time data with g (1)(r, τ) > 0.1 for the fitting, the error in the retrieved D 2 can be made very small (data not shown). However, this cutoff is arbitrary and should be used with caution.
The sensitivity of the field autocorrelation function to the presence of a non-scattering layer for the present backscattering geometry is in marked contrast to the small effect of a non-scattering layer in transmission geometry with plane-wave illumination [12]. This is due to the fact that the contribution of long photon paths to the field autocorrelation function is reduced by the presence of the CSF, both by the transfer probability f(q) < 1 and by absorption, while the propagation of detected photons diffusing on short paths through layer 1 only is only marginally modified. In the transmission geometry, on the other hand, g (1)(r, τ) is dominated by photon paths close to the line of sight between source and receiver, resulting in an only minor distortion of the path length distribution function by a non-scattering layer.
Fig. 5.
5. Conclusions
We studied the influence of a non-scattering layer (mimicking the cerebrospinal fluid [CSF] surrounding the brain) in a head-like tissue phantom on the field autocorrelation function g (1)(r, τ) of multiple scattered light by means of a diffusion theory, Monte Carlo simulations and experiments for the backscattering geometry used in DWS experiments on the human head. For a configuration with a point source and a point receiver, boundary conditions for the correlation-diffusion equation were introduced accounting for the presence of the non-scattering layer. Field autocorrelation functions g (1)(r, τ) predicted by this modified diffusion theory are in very good agreement with Monte Carlo simulations in the absence of refractive index mismatches between the layers. The comparison with experimental data indicates that contributions from low-order scattering and, possibly, refractive index mismatches between the layers play a role for source-receiver distances comparable to about twice the distance between surface and the cerebrospinal fluid layer. The proper treatment of low-order scattering and refractive index mismatches might thus be important for the quantitative analysis of DWS data from the human head measured at short source-receiver distances. Data measured at larger source-receiver distance which are able to probe the cortex are, on the other hand, rather insensitive to refractive index mismatches. The analysis by the diffusion theory qualitatively reproduces the simulated DWS data for the optical and dynamical properties used here even when the presence of the non-scattering layer is neglected. Nevertheless, the coupling between superficial and deep tissue layers in the DWS signal and the ensuing complexity of the DWS signal for a multilayer system makes it difficult to chart the region in parameter space where the diffusion theory satisfyingly describes the simulations for other combinations of μ′s, μ a, D 1 and D 2. Methods for selectively probing deep tissue layers by DWS might ultimately help obviate these complications.
Fig. 6.
Appendix: Boundary conditions
We start from Eq. (23) in Ref [13], using the autocorrelation function G(r, τ) instead of the average intensity U(r). In our case, since we have no light sources at the boundary (the right-hand side of Eq. (24) of Ref. [13] vanishes) the total normal correlation flux is given by
where 𝓓′m = 3(μ am + μ′sm)]-1 is the reduced photon diffusion coefficient of the mth layer, and m is the unit vector normal to the interface. Eq. (36) of Ref [13] is written with G(r, τ) as
where S is the surface the irradiation originates from, which in our case is the xy plane, Cm = (2 - RJ )/RU = 2 since RU = [1 - |R 0→1(θ)|]2 cosθ d(cosθ) = 1/2 and RJ = 3 [1 -|R 0→1(θ)|]2 cos2 θ d(cosθ) = 1 in the case without refractive index mismatch (R 0→1(θ), the reflection coefficient with incidence angle θ from medium 0 to medium 1, is equal to 1) from Eq. (30) of Ref [13]. Then the boundary conditions at z = Δ1 are
and at z = Δ1 + d:θ
The quantity 𝓰(ρ - ρ′) is given by Eq. (18) of Ref. [13],
where μ a is the absorption coefficient of the non-scattering layer. Defining ρ = |ρ - ρ′| then . Thus
Taking the Fourier transform of Equations (21) and (22) we obtain, after some calculations,
which are equivalent to Eqs. (9) and (10). The transfer probability f(q) is given by
which reduces to Eq. (14), and, for μ a = 0, to Eq. (15).
Fig. 7.
We thank S. Eiden and her group for providing the latex samples, and B. Awiszus for the MRI recording. This work is funded by the Deutsche Forschungsgemeinschaft (DFG), the Lan-desstiftung Baden-Württemberg, the Center for Applied Photonics (CAP) Konstanz and the Zentrum für Wissenschaftlicher Nachwuchs (ZWN) at the University of Konstanz.
References and links
1. A. P. Gibson, J. C. Hebden, and S. R. Arridge, "Recent advances in diffuse optical imaging," Phys. Med. Biol. 50, R1–R43 (2005). [CrossRef] [PubMed]
2. J. C. Hebden, A. P. Gibson, T. Austin, R. M. Yusof, N. Everdell, D. T. Delpy, S. R. Arridge, J. H. Meek, and J. S. Wyatt, "Imaging changes in blood volume and oxygenation in the newborn infant brain using three-dimensional optical tomography," Phys. Med. Biol. 49, 1117–1130 (2004). [CrossRef] [PubMed]
3. G. Maret and P. E. Wolf, "Multiple light scattering from disordered media: The effect of Brownian motion of scatterers," Z. Phys. B 65, 409–413 (1987). [CrossRef]
4. D. J. Pine, D. A. Weitz, P. M. Chaikin, and E. Herbolzheimer, "Diffusing-Wave Spectroscopy," Phys. Rev. Lett. 60, 1134–1137 (1988). [CrossRef] [PubMed]
5. T. Durduran, G. Yu, M. G. Burnett, J. A. Detre, J. H. Greenberg, J. Wang, C. Zhou, and A. G. Yodh, "Diffuse optical measurement of blood flow, blood oxygenation, and metabolism in a human brain during sensorimotor cortex activation," Opt. Lett. 29, 1766–1768 (2004). [CrossRef] [PubMed]
6. J. Li, G. Dietsche, D. Iftime, S. E. Skipetrov, G. Maret, T. Elbert, B. Rockstroh, and T. Gisler, "Non-Invasive Detection of Functional Brain Activity with Near-Infrared Diffusing-Wave Spectroscopy," J. Biomed. Opt. 10, 044002-1–12 (2005). [CrossRef]
7. H. Ito, K. Takahashi, J. Hatazawa, S.-G. Kim, and I. Kanno, "Changes in Human Regional Cerebral Blood Flow and Cerebral Blood Volume During Visual Stimulation Measured by Positron Emission Tomography," J. Cereb. Blood Flow Metab. 21, 608–612 (2001). [CrossRef] [PubMed]
8. M. Wolf, U. Wolf, V. Toronov, A. Michalos, L. A. Paunescu, J. H. Choi, and E. Gratton, "Different Time Evolution of Oxyhemoglobin and Deoxyhemoglobin Concentration Changes in the Visual and Motor Cortices during Functional Stimulation: A Near-Infrared Spectroscopy Study," NeuroImage 16, 704–712 (2002). [CrossRef] [PubMed]
9. M. Firbank, S. R. Arridge, M. Schweiger, and D. T. Delpy, "An investigation of light transport through scattering bodies with non-scattering regions," Phys. Med. Biol. 41, 767–783 (1996). [CrossRef] [PubMed]
10. E. Okada, M. Firbank, M. Schweiger, S. R. Arridge, M. Cope, and D. T. Delpy, "Theoretical and experimental investigation of near-infrared light propagation in a model of the adult head," Appl. Opt. 36, 21–31 (1997). [CrossRef] [PubMed]
11. H. Dehghani, D. T. Delpy, and S. R. Arridge, "Photon migration in non-scattering tissue and the effects on image reconstruction," Phys. Med. Biol. 44, 2897–2906 (1999). [CrossRef]
12. F. Scheffold, S. E. Skipetrov, S. Romer, and P. Schurtenberger, "Diffusing-wave spectroscopy of nonergodic media," Phys. Rev. E 63, 061404-1–11 (2001). [CrossRef]
13. J. Ripoll, M. Nieto-Vesperinas, S. R. Arridge, and H. Dehghani, "Boundary conditions for light propagation in diffusive media with nonscattering regions," J. Opt. Soc. Am. A 17, 1671–1681 (2000). [CrossRef]
14. S. E. Skipetrov and R. Maynard, "Dynamic multiple scattering of light in multilayer turbid media," Phys. Lett. A 217, 181–185 (1996). [CrossRef]
15. L. V. Wang, S. L. Jacques, and L. Zheng, "MCML - Monte Carlo modeling of light transport in multi-layered tissues," Comput. Meth. Progr. Biomed. 47, 131–146 (1995). [CrossRef]
16. D. A. Boas and A. G. Yodh, "Spatially varying dynamical properties of turbid media probed with diffusing temporal light correlation," J. Opt. Soc. Am. A 14, 192–215 (1997). [CrossRef]
17. P. N. Pusey and W. van Megen, "Dynamic Light Scattering by Nonergodic Media," Physica A 157, 705–741 (1989). [CrossRef]
18. T. Gisler, H. Rüger, S. U. Egelhaaf, J. Tschumi, P. Schurtenberger, and J. Rička, "Mode-selective dynamic light scattering: theory versus experimental realization," Appl. Opt. 34, 3546–3553 (1995). [CrossRef] [PubMed]
19. S. Feng, F. Zeng, and B. Chance, "Photon migration in the presence of a single defect: a perturbation analysis," Appl. Opt. 34, 3826–3837 (1995). [CrossRef] [PubMed]
20. L. Kou, D. Labrie, and P. Chylek, "Refractive indices of water and ice in the 0.65- to 2.5-μm spectral range," Appl. Opt. 32, 3531–3540 (1993). [CrossRef] [PubMed]
21. A. Ishimaru, Wave propagation and scattering in random media (IEEE Press, New York, 1997).
22. R. Carminati, R. Elaloufi, and J.-J. Greffet, "Beyond the Diffusing-Wave Spectroscopy Model for the Temporal Fluctuations of Scattered Light," Phys. Rev. Lett. 92, 213903-1–4 (2004). [CrossRef] [PubMed]


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Summary | Excerpt | Reading Guide | Reviews | Readalikes | Genres & Themes | Author Bio
If you liked Bury Your Dead, try these:
Gripping, sophisticated, and wickedly entertaining, The Summer of Dead Toys introduces a charismatic new detective and announces Antonio Hill as a new master of the crime thriller.
The first installment in a wonderful new series that follows the exploits of Benoît Courrèges, a policeman in a small French village where the rituals of the café still rule.
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From JPCL, December 2011
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Quality Control
In this month's F-Files, the application of a liner to the interior of a demineralized water storage tank was stopped mid-way through the process because of dramatic defects in the applied film. An independent assessment was conducted to determine why the liner material exhibited runs, sags, fingering, and "sliding" separation during installation....
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Comment from Keith Holdsworth, (1/17/2012, 10:24 AM)
This will be experienced more and more as regulations force VOC content lower in coating materials. A substrate temperature of 48 degrees is low and severly hinders build charateristics during application. In the older solvent based products the solvent evaporation rates assisted in build characteristics while evaporating from the coating material during application. Hence various specific blends for certain linings. In this instance a job site heater large enough to maintaine a steel substrate temperature to the entire tank at a minimum 65 to 75 degrees and controlled mixing and storage area to maintain the coating materials at the higher end of the recommended storage temperature would have prevented most of this. The "fingers" which were mentioned is an indication they were dealing with inadequate pressures at the spray tip and heavier than normal viscosities. The running and sliding is an indication of material beyond its pot life or more likely due to low substrate temperatures. The article doesn't mention pump ratio or flow rates nor does it mention tip sizes utilized during the spray operation.
Based on the critical nature of the lining to the plant operations I would have recommended the entire shell and floor have the previous lining removed and replaced competently.
Comment from Steve Stroud, (1/18/2012, 11:22 AM)
Every painter, that applies exotic coating, should read this article. Often, in the field, specific manufacture instructions are viewed as being trivial, over cautious or just "rhetoric" to cover the manufacturers behind. This article serves to remind us of the consequence of less than a "professional" approach to our craft.
Comment from Doyle Menard, (1/19/2012, 10:14 AM)
It's seams to me that a lot of this problem could had a been solved up front, if 3rd party inspection had been involed during the started of the project.
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7 posts tagged with mail and art.
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Mailbag Art Museum
Artist Sarah Musi sent little pieces of art to forty-five artists, along with a tiny blank canvas for them to create something and return it. So far she has received six back.
Dear Catherine, Hello, how are you?
"In April 2009, we sent a personal, handwritten letter to each of the 467 households in the small Irish village of Cushendall." Now, Michael Crowe and Lenka Clayton (previously on MeFi) intend to send a letter to everyone on the planet.
Mailbox Art: 20 Cool and Creative Postboxes
Zip code with a capital C O D E.
Return to sender: Artist puts Royal Mail to the test - "To put them to the test, Harriet Russell concealed the addresses of 130 letters to herself in a series of increasingly complex puzzles and ciphers. Among the disguises she employed were dot-to-dot drawings, anagrams and cartoons. The answer, it seems, was very far indeed. Amazingly, only 10 failed to complete their journey back to her." Be sure to click the "more pictures" link to the right for more samples. Via one.point.zero.
Geo Info Postcards
How's the weather? Is it polluted? Do you have plenty of rainforests? Send someone a Geography Information Postcard and tell them about where you live by filling out infographics. (via)
Object Not Found
Object Not Found. Lost and found photographs, postcards and letters.'The collection of postcards, photographs and letters collected here allows me to peek into a however small part of other peoples lives. '
Found via Countries of the Mind, a page about an imaginary world, and its postage stamps and postcards.
Related interest :- P22 Mail Art, and gallery.
Found via Countries of the Mind, a page about an imaginary world, and its postage stamps and postcards.
Related interest :- P22 Mail Art, and gallery.
Cool collective art.
Cool collective art. This project takes blank slate real-world media (journals, t-shirts, books, etc..) and snail mails it around to participants who add to the work creating a collective piece of art. It aims to replicate what happens on-line, MeFi for example, but using real-world objects and postal mail.
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Everything is local and fresh made to order. Try the Chorizo sausage. It's fresh from Legerski's Sausage Company.
Your coupon (that we'll email you) gets you 20% off when you spend at least $250 on tours, activities and more that you can book on TripAdvisor or Viator. The more you spend, the more you save!
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