The Dimorphos ejecta plume properties revealed by LICIACube

The Double Asteroid Redirection Test (DART) had an impact with Dimorphos (a satellite of the asteroid Didymos) on 26 September 20221. Ground-based observations showed that the Didymos system brightened by a factor of 8.3 after the impact because of ejecta, returning to the pre-impact brightness 23.7 days afterwards2. Hubble Space Telescope observations made from 15 minutes after impact to 18.5 days after, with a spatial resolution of 2.1 kilometres per pixel, showed a complex evolution of the ejecta3, consistent with other asteroid impact events. The momentum enhancement factor, determined using the measured binary period change4, ranges between 2.2 and 4.9, depending on the assumptions about the mass and density of Dimorphos5. Here we report observations from the LUKE and LEIA instruments on the LICIACube cube satellite, which was deployed 15 days in advance of the impact of DART. Data were taken from 71 seconds before the impact until 320 seconds afterwards. The ejecta plume was a cone with an aperture angle of 140 ± 4 degrees. The inner region of the plume was blue, becoming redder with increasing distance from Dimorphos. The ejecta plume exhibited a complex and inhomogeneous structure, characterized by filaments, dust grains and single or clustered boulders. The ejecta velocities ranged from a few tens of metres per second to about 500 metres per second.

Heavy-element production in a compact object merger observed by JWST

The mergers of binary compact objects such as neutron stars and black holes are of central interest to several areas of astrophysics, including as the progenitors of gamma-ray bursts (GRBs)1, sources of high-frequency gravitational waves (GWs)2 and likely production sites for heavy-element nucleosynthesis by means of rapid neutron capture (the r-process)3. Here we present observations of the exceptionally bright GRB 230307A. We show that GRB 230307A belongs to the class of long-duration GRBs associated with compact object mergers4-6 and contains a kilonova similar to AT2017gfo, associated with the GW merger GW170817 (refs. 7-12). We obtained James Webb Space Telescope (JWST) mid-infrared imaging and spectroscopy 29 and 61 days after the burst. The spectroscopy shows an emission line at 2.15 microns, which we interpret as tellurium (atomic mass A = 130) and a very red source, emitting most of its light in the mid-infrared owing to the production of lanthanides. These observations demonstrate that nucleosynthesis in GRBs can create r-process elements across a broad atomic mass range and play a central role in heavy-element nucleosynthesis across the Universe.

Bessel light beam for a surgical laser focusing telescope-a novel approach

As the demand for CO[Formula: see text] laser surgeries continues to grow, the quality of their main instrument, the laser micromanipulator, becomes increasingly important. However, in many surgery systems, a large ratio of the laser power is wasted due to the reflection from the mirror of a telescopic system, like a Cassegrain telescope, back to the laser side, which not only decreases the system's efficiency but can also damage the system itself. In this article, we introduce a new design of the micromanipulator telescope for CO[Formula: see text] laser surgery, which employs a Bessel beam to improve the system efficiency. As in the propagation of a Bessel beam, the power of the light beam can be transferred from the center to a ring shape, the whole power reflected from the first mirror can reach the second mirror and no power goes back to the second mirror hole. The micromanipulator telescope design and optimization are carried out using Zemax Optics Studio, and the integration of the Bessel beam into the system is implemented using MATLAB. Our simulation results show that by applying the appropriate Bessel beam, the system efficiency can reach more than 96%, and the normalized peak irradiance can increase by 40 to 73% for various working distances. In addition to increasing the system efficiency and normalized peak irradiance, resulting in a sharper surgical blade, the use of the Bessel beam enhances the depth of focus, making the system less sensitive to depth misalignment.

Reflective multi-immersion microscope objectives inspired by the Schmidt telescope

Imaging large, cleared samples requires microscope objectives that combine a large field of view (FOV) with a long working distance (WD) and a high numerical aperture (NA). Ideally, such objectives should be compatible with a wide range of immersion media, which is challenging to achieve with conventional lens-based objective designs. Here we introduce the multi-immersion 'Schmidt objective' consisting of a spherical mirror and an aspherical correction plate as a solution to this problem. We demonstrate that a multi-photon variant of the Schmidt objective is compatible with all homogeneous immersion media and achieves an NA of 1.08 at a refractive index of 1.56, 1.1-mm FOV and 11-mm WD. We highlight its versatility by imaging cleared samples in various media ranging from air and water to benzyl alcohol/benzyl benzoate, dibenzyl ether and ethyl cinnamate and by imaging of neuronal activity in larval zebrafish in vivo. In principle, the concept can be extended to any imaging modality, including wide-field, confocal and light-sheet microscopy.

Video telescope operating monitor-assisted surgery is equivalent to conventional surgery in treatment of cervical intervertebral disc herniation in dogs

OBJECTIVE

To compare the use of the video telescope operating monitor (VITOM) and use of a conventional unassisted surgical method for treatment of cervical intervertebral disc herniation in dogs.

ANIMALS

39 dogs with cervical intervertebral disc disease.

METHODS

Prospective study. Dogs were prospectively nonrandomly assigned to either the VITOM (n = 19) or conventional surgery (20) group depending on VITOM system availability. Signalment and preoperative neurologic status were recorded for all dogs. Preoperative and postoperative CT myelography was performed to compare intervertebral space location, spinal cord dimensions at the decompression level, ventral slot dimensions, and residual disc material. Surgical complications and postoperative neurologic outcomes were recorded. Data were compared between the 2 groups using fixed-effects or mixed-effects models to consider double reading of CT myelography images.

RESULTS

No significant differences were noted between the 2 groups regarding the decompression ratio (P = .85), vertebral length body ratio (P = .13), ventral slot width ratio (P = .39), residual disc material (P = .30), and sinus bleeding (P = .12). No significant differences were found between the 2 groups regarding postoperative neurologic grade (P = .17).

CLINICAL RELEVANCE

VITOM-assisted ventral slot decompression is equivalent to conventional surgery in treatment of cervical intervertebral disc herniation in dogs. The use of VITOM remains a good alternative to the conventional surgical method.

An improved camera model for oblique-viewing laparoscopes: high reprojection accuracy independent of telescope rotation

Objective. Oblique-viewing laparoscopes are popular in laparoscopic surgeries where the target anatomy is located in narrow areas. Their viewing direction can be shifted by telescope rotation without changing the laparoscope pose. This rotation also changes laparoscope camera parameters that are estimated by camera calibration to be able to reproject an anatomical model onto the laparoscopic view, creating augmented reality (AR). The aim of this study was to develop a camera model that accounts for these changes, achieving high reprojection accuracy for any telescope rotation.Approach. Camera parameters were acquired by calibrations encompassing a wide telescope rotation range. For those parameters showing periodic changes upon rotation, interpolation models were created and used to establish an updatable camera model. With this model, corner points of a tracked checkerboard were reprojected onto the checkerboard laparoscopic images, at random rotation angles. Root-mean-square reprojection errors (RMSEs) were calculated between the reprojected and imaged corner points.Main results. Reprojection RMSEs were low and approximately independent on telescope rotation angle, over a wide rotation range of 320°. The mean reprojection RMSE was 2.8±0.7 pixels for a conventional laparoscope and 3.6±0.7 pixels for a chip-on-the-tip (COTT) laparoscope, corresponding to 0.3±0.1 mm and 0.4±0.1 mm in world coordinates respectively. Worst-case reprojection errors were about 9 pixels (0.8 mm) for both laparoscopes.Significance. The camera model developed in this study improves on existing models for oblique-viewing laparoscopes because it provides high reprojection accuracy independent of the telescope rotation angle and is applicable for conventional and chip-on-a-tip oblique-viewing laparoscopes. The work presented here is an important step towards creating accurate AR in image-guided interventions where oblique-viewing laparoscopes are used while simultaneously providing the surgeon the flexibility to rotate the telescope to any desired rotation angle.Acronyms. CC: camera coordinates; CCToolbox: camera calibration toolbox; COTT: chip-on-the-tip; CS: camera sensor; DD: decentering distortion; FL: focal length; OTS: optical tracking system; PP: principal point; RD: radial distortion; SI: supplementary information;tHE:hand-eye translation component.

Detection of stellar light from quasar host galaxies at redshifts above 6

The detection of starlight from the host galaxies of quasars during the reionization epoch (z > 6) has been elusive, even with deep Hubble Space Telescope observations1,2. The current highest redshift quasar host detected3, at z = 4.5, required the magnifying effect of a foreground lensing galaxy. Low-luminosity quasars4-6 from the Hyper Suprime-Cam Subaru Strategic Program (HSC-SSP)7 mitigate the challenge of detecting their underlying, previously undetected host galaxies. Here we report rest-frame optical images and spectroscopy of two HSC-SSP quasars at z > 6 with the JWST. Using near-infrared camera imaging at 3.6 and 1.5 μm and subtracting the light from the unresolved quasars, we find that the host galaxies are massive (stellar masses of 13 × and 3.4 × 1010 M☉, respectively), compact and disc-like. Near-infrared spectroscopy at medium resolution shows stellar absorption lines in the more massive quasar, confirming the detection of the host. Velocity-broadened gas in the vicinity of these quasars enables measurements of their black hole masses (1.4 × 109 and 2.0 × 108 M☉, respectively). Their location in the black hole mass-stellar mass plane is consistent with the distribution at low redshift, suggesting that the relation between black holes and their host galaxies was already in place less than a billion years after the Big Bang.

Charge-Sign Dependent Cosmic-Ray Modulation Observed with the Calorimetric Electron Telescope on the International Space Station

We present the observation of a charge-sign dependent solar modulation of galactic cosmic rays (GCRs) with the Calorimetric Electron Telescope onboard the International Space Station over 6 yr, corresponding to the positive polarity of the solar magnetic field. The observed variation of proton count rate is consistent with the neutron monitor count rate, validating our methods for determining the proton count rate. It is observed by the Calorimetric Electron Telescope that both GCR electron and proton count rates at the same average rigidity vary in anticorrelation with the tilt angle of the heliospheric current sheet, while the amplitude of the variation is significantly larger in the electron count rate than in the proton count rate. We show that this observed charge-sign dependence is reproduced by a numerical "drift model" of the GCR transport in the heliosphere. This is a clear signature of the drift effect on the long-term solar modulation observed with a single detector.

[VITOM 3D exoscopic system compared to microsurgical technique in spinal surgery]

3D exoscopy based on Video Telescope Operating Monitor (VITOM) technology provides good visualization quality and portability. There are few data on comparison of extracorporeal telescoping with microsurgical techniques in spinal surgery.

OBJECTIVE

To compare the effectiveness of VITOM 3D exoscopy and microsurgical techniques in spinal surgery.

MATERIAL AND METHODS

A prospective study included 80 patients (54 men and 26 women). Two groups were distinguished: group 1 (ES, n=40) - VITOM 3D exoscopy, group 2 (SM, n=40) - Pentero 900 surgical microscope. We analyzed surgery time, postoperative rehabilitation, hospital-stay and complications. ES and microsurgical technique were compared using the questionnaire by Takahashi S. and rapid upper limb assessment (RULA).

RESULTS

Conventional microsurgical technique was characterized by less surgery time (p<0.05) and morbidity (p=0.02). Postoperative rehabilitation and hospital-stay were similar (p=0.26 and p=0.39, respectively). Image quality in ES was comparable to microsurgical technique in shallow accesses and manipulations perpendicular to skin incision. Availability of neurosurgical instruments at different depths of the wound channel was comparable in both groups. The limitation of ES was length of skin incision, depth of the wound and its visualization at certain angle. These features required expansion of surgical approach or conversion of intervention. In general, surgeons rated intraoperative posture comfort as comparable in both groups that was consistent with the RULA scale.

CONCLUSION

VITOM 3D exoscopy is an alternative to traditional microscopy and more ergonomically beneficial in spinal surgery in case of manipulations perpendicular to skin incision and shallow wide accesses. There are several important limitations of this device including difficult manipulations in narrow deep wounds and visualization under certain angle.

How Digital Technologies Enhance Telescopic and Conical Clinical Case Workflows

Telescopic and conical dental solutions for tooth-borne, implant-borne, and combination tooth/implant-borne removable dental prosthetics have a long and rich history. Traditionally, these restorations have been based on analog techniques. The integration of digital technologies, however, has had a profound impact on these solutions in numerous ways, helping to facilitate efficient fabrication of many technical and clinical facets of these dental prosthetics. This article examines how digital technologies impact telescopic and conical clinical case workflows and technical protocols. It discusses such aspects as intraoral scanning, photogrammetry, primary and secondary telescopes and cones, tertiary structures, and temporary restorations.

Detection system of the lobster eye telescope with large field of view

The lobster eye telescope is promising for large-field x ray imaging in astronomy. The special structure of the lobster eye system makes the focal plane a sphere, resulting in detector defocus when the field is large. In this study, we established a model based on the principle of lobster eye imaging and simulated the imaging at different image distances. The results reveal the relationship between the defocus and position accuracy and angular resolution. To ensure the optical performance of the large field lobster eye telescope, we propose a detection system design method using multiple detectors stitched together to form a spherical-like surface and apply it to the development of the Einstein Probe/wide-field x ray telescope (EP/WXT) submodule. About 70% of the detection area is out of focus within 0.5 mm. The scanning image of the integrated WXT submodule shows good uniformity of the point spread function (PSF) for various incident angles, and the effect of defocus on imaging is acceptable.

Carbon dioxide detected around alien world for first time

Webb telescope discovery offers clue to planet formation and promises insights on planetary habitability.

Deep learning exoplanets detection by combining real and synthetic data

Scientists and astronomers have attached great importance to the task of discovering new exoplanets, even more so if they are in the habitable zone. To date, more than 4300 exoplanets have been confirmed by NASA, using various discovery techniques, including planetary transits, in addition to the use of various databases provided by space and ground-based telescopes. This article proposes the development of a deep learning system for detecting planetary transits in Kepler Telescope light curves. The approach is based on related work from the literature and enhanced to validation with real light curves. A CNN classification model is trained from a mixture of real and synthetic data. The model is then validated only with unknown real data. The best ratio of synthetic data is determined by the performance of an optimisation technique and a sensitivity analysis. The precision, accuracy and true positive rate of the best model obtained are determined and compared with other similar works. The results demonstrate that the use of synthetic data on the training stage can improve the transit detection performance on real light curves.

Vision, Driving Exposure, and Collisions in Bioptic Drivers

SIGNIFICANCE

Lack of knowledge regarding the mileage driven by drivers with low vision who use bioptic telescopes could obscure the relationship between vision and road safety. This study provides data suggesting that worse vision is correlated with less mileage driven but more collisions per mile in bioptic drivers.

PURPOSE

The purpose of this study was to determine whether vision or demographic factors predict mileage driven in bioptic drivers and per-mile motor vehicle collision rate and also to compare the collision rate of bioptic drivers with previous estimates for the general population.

METHODS

Driver data were collected retrospectively from clinic records. Collision data were collected from the Ohio Bureau of Motor Vehicles database. Subjects were also asked to estimate their yearly mileage. Regression models were used to investigate relationships between vision and collision rates.

RESULTS

Seventy-three licensed Ohio bioptic drivers (36 male) were included. Mean ± standard deviation age was 51 ± 16 years. Mean logMAR visual acuity was 0.67 (approximately 20/100). Mean log contrast sensitivity was 1.57. Mean reported annual mileage was 9746. Age, sex, and previous (nonbioptic) driving experience were not associated with mileage. LogMAR visual acuity was inversely related to mileage (P = .02), and contrast sensitivity (P = .01) and horizontal visual field (P = .02) were directly associated with mileage. Visual acuity (P = .02) and visual field (P = .005), but not contrast sensitivity (P = .19), were associated with number of collisions.

CONCLUSIONS

Visual acuity, visual field, and contrast sensitivity were associated with driving exposure in bioptic drivers (with drivers with poorer vision reporting lower annual mileage), and poorer visual acuity and visual field were associated with more collisions. The per-mile collision rate for bioptic drivers was within the range of that previously reported for fully sighted drivers, although higher than would be expected for fully sighted drivers of similar age distribution.

Statistical analysis of a cluster-randomized clinical trial on adult general intensive care units in Brazil: TELE-critical care verSus usual Care On ICU PErformance (TELESCOPE) trial

Objective:

The TELE-critical Care verSus usual Care On ICU PErformance (TELESCOPE) trial aims to assess whether a complex telemedicine intervention in intensive care units, which focuses on daily multidisciplinary rounds performed by remote intensivists, will reduce intensive care unit length of stay compared to usual care.

Methods:

The TELESCOPE trial is a national, multicenter, controlled, open label, cluster randomized trial. The study tests the effectiveness of daily multidisciplinary rounds conducted by an intensivist through telemedicine in Brazilian intensive care units. The protocol was approved by the local Research Ethics Committee of the coordinating study center and by the local Research Ethics Committee from each of the 30 intensive care units, following Brazilian legislation. The trial is registered with ClinicalTrials. gov (NCT03920501). The primary outcome is intensive care unit length of stay, which will be analyzed accounting for the baseline period and cluster structure of the data and adjusted by prespecified covariates. Secondary exploratory outcomes included intensive care unit performance classification, in-hospital mortality, incidence of nosocomial infections, ventilator-free days at 28 days, rate of patients receiving oral or enteral feeding, rate of patients under light sedation or alert and calm, and rate of patients under normoxemia.

Conclusion:

According to the trial’s best practice, we report our statistical analysis prior to locking the database and beginning analyses. We anticipate that this reporting practice will prevent analysis bias and improve the interpretation of the reported results.

ClinicalTrials.gov registration: NCT03920501

From Nobeyama Radio Observatory to the international project ALMA -Evolution of millimeter and submillimeter wave astronomy in Japan

The establishment of the Nobeyama Radio Observatory (NRO) in 1982 was an important event that greatly influenced the subsequent development of Japanese astronomy. The 45 m radio telescope and the Nobeyama Millimeter Array (NMA) pushed Japanese radio astronomy to the forefront of the world. As a plan beyond the Nobeyama telescopes, the Japanese radio astronomy community considered a large array to achieve unprecedented resolution at millimeter and submillimeter wavelengths under the project name of the Large Millimeter and Submillimeter Array (LMSA). After long and patient discussions and negotiations with the United States and Europe, the LMSA plan eventually led to the ALMA (Atacama Large Millimeter/submillimeter Array) as an international joint project, and the ALMA was inaugurated in 2013. This paper reviews the process from the establishment of the NRO to the realization of the ALMA, including planning of the LMSA, international negotiations, site survey, instrumental developments, and initial science results.

Is the EHT black hole experiment a new experiment in the guise of an old experiment?

This paper analyzes the experiment presented in 2019 by the Event Horizon Telescope (EHT) Collaboration that unveiled the first image of the supermassive black hole at the center of galaxy M87. The intended aim of the paper is to assess whether the EHT Collaboration has made an "inference to the best explanation" (IBE) to conclude that the data effectively confirm the hypothesis that the object at the center of M87 is in fact a supermassive Kerr rotating black hole. I demonstrate that the EHT Collaboration has applied an IBE. It is shown that the hypothesis that at the center of M87 there is a supermassive Kerr rotating black hole was already the best explanation at the time in which the 2017 EHT experiment was conducted. My analysis is intertwined with considerations on realist and empiricist interpretations of IBE, which are used to assess whether the conclusion that the object at the center of M87 is a Kerr rotating black hole implies holding a realist commitment with respect to such object.

What Is the Survival of the Telescope Allograft Technique to Augment a Short Proximal Femur Segment in Children After Resection and Distal Femur Endoprosthesis Reconstruction for a Bone Sarcoma?

BACKGROUND

Large, malignant bone tumors and revision limb salvage procedures often result in the resection of extensive lengths of the involved bone segment, leaving a residual segment of bone that may be too short to support a standard intramedullary stem for endoprosthetic reconstruction. Telescope allografting, in which an allograft is used to augment the remaining bone segment by telescoping it into the residual bone segment, was described for situations in which residual bone stock is insufficient after tumor resection or prosthetic revision. Apart from one study that first described the procedure [15], there are no other studies reporting the outcome of this telescopic concept for restoring bone stock.

QUESTIONS/PURPOSES

For patients younger than 18 years who underwent the telescopic allograft technique to augment a short segment of the proximal femur after resection of bone sarcomas who also underwent endoprosthesis reconstruction of the distal femur, we asked: (1) What is the survivorship free from removal of the telescopic allograft and the endoprosthetic stem at 7 years after surgery? (2) What proportion of these reconstructions will heal to the host bone without delayed union or nonunion? (3) What is the functional outcome based on the Musculoskeletal Tumor Society (MSTS) score?

METHODS

We retrospectively studied our institutional database and identified 127 patients younger than 18 years who underwent surgery for a primary malignant bone tumor of the distal femur between December 2008 and October 2018. After excluding 16 patients undergoing amputation and rotationplasty and 57 patients undergoing recycled autograft/allograft reconstruction, 54 patients who underwent primary or revision distal femur endoprosthesis reconstruction were identified. Among these patients, we considered 15 patients who underwent telescopic allograft augmentation of the femur for analysis. One patient was lost to follow-up before 2 years but was not known to have died, leaving 14 for analysis at a median (range) 49 months (24 to 136 months) of follow-up. The indications for telescopic allograft augmentation of the femur in our institution were a proximal femur length of less than 120 mm after resection or resection of more than two-thirds of the total length of the femur. Ten of 14 patients underwent telescopic allograft augmentation as a revision procedure (distal femur resorption in five patients, endoprosthesis stem loosening in three patients, implant fracture in one patient, and infection in one patient), and the remaining four patients underwent telescopic allograft augmentation as a primary limb salvage procedure for large malignant bone tumors of the distal femur. The histologic diagnosis in all patients was osteosarcoma. At the time of telescopic allograft augmentation and reconstruction, the median age of the patients was 14 years (7 to 18 years). The size and the type of bone allograft to be used (femoral shaft or proximal femur) was planned before surgery, with consideration of the extent of resection, level of osteotomy, diameter of the host bone at the osteotomy site, and approximate diameter of the endoprosthesis stem to be used. The segment of the cylindrical allograft used for telescoping was thoroughly washed, prepared, and impacted onto the native femur to achieve telescoping and overlap. Serial digital radiographs were performed once a month for the first 6 months after the procedure, every 2 months until 1 year, and then every 6 months thereafter. Two surgeons in the department (at least one of which was involved in the surgery) retrieved and reviewed clinical notes and radiographs to determine the status of the telescopic allograft and endoprosthesis stem. We defined delayed union as radiological union at the osteotomy site more than 6 months after the procedure without additional surgery; we defined nonunion as no radiological evidence of callus formation at the osteotomy site 9 months after the procedure, necessitating additional surgery. The reviewers did not disagree about the definition of healing time. None of the patients missed radiographic follow-up. Kaplan-Meier survivorship free from removal of telescopic allograft and the endoprosthesis stem at 7 years after surgery was estimated. Patient function was assessed using the 1993 version of the MSTS [9], as determined by chart review of the institutional database performed by one of the surgeons from the department.

RESULTS

The survivorship free from removal of the telescopic allograft and endoprosthesis stem at 7 years after surgery was 80% (95% confidence interval 22% to 96%). The allograft united with the host bone in 100% (14 of 14) of the patients. Though 21% (3 of 14) had delayed union, no nonunions were seen. The median (range) MSTS score at the final follow-up interval was 27 (22 to 30).

CONCLUSION

Although this is a small group of patients, we believe that allograft segments help augment short bone stock of the proximal femur after long-segment resections, and the telescopic technique seems to be associated with a low proportion of nonunion or delayed union, which is one of the most common complications of allografts. Maintaining an adequate length of the proximal femur is important in preserving the hip, and this technique may be especially useful for young individuals who may undergo repeated revision procedures.

LEVEL OF EVIDENCE

Level IV, therapeutic study.

TELE-critical Care verSus usual Care On ICU PErformance (TELESCOPE): protocol for a cluster-randomised clinical trial on adult general ICUs in Brazil

INTRODUCTION

Daily multidisciplinary rounds (DMRs) consist of systematic patient-centred discussions aiming to establish joint therapeutic goals for the next 24 hours of intensive care unit (ICU) care. The aim of the present study protocol is to evaluate whether an intervention consisting of guided DMRs, supported by a remote specialist and audit/feedback on care performance will reduce ICU length of stay compared with a control group.

METHODS AND ANALYSIS

A multicentre, controlled, cluster-randomised superiority trial including 30 ICUs in Brazil (15 intervention and 15 control), from August 2019 to June 2021. In a parallel assignment, ICUs are randomised to a complex-intervention composed by daily rounds carried out through Tele-ICU by a remote ICU physician; development of local quality indicators dashboards coupled with monthly meetings with local leadership; and dissemination of evidence-based clinical protocols versus usual care. Primary outcome is ICU length of stay. Secondary outcomes include classification of the unit according to the profiles defined by the standardised resource use and the standardised mortality rate, hospital mortality, incidence of healthcare-associated infections, ventilator-free days at 28 days, patient-days receiving oral or enteral feeding, patient-days under light sedation or alert and calm, rate of patients under normoxaemia. All adult patients admitted after the beginning of the study in each participant ICU will be enrolled. Inclusion criteria (clusters): public Brazilian ICUs with a minimum of 8 ICU beds interested/committed to participating in the study. Exclusion criteria (clusters): units with fully established DMRs by an intensivist, specialised or step-down units.

ETHICS AND DISSEMINATION

The study protocol was approved by the institutional review board (IRB) of the coordinator centre, and by IRBs of each enrolled hospital/ICU. Statistical analysis protocol is being prepared for submission before the end of patient's enrolment. Results will be disseminated through conferences, peer-reviewed journals and to each participating unit.

TRIAL REGISTRATION NUMBER

NCT03920501; Pre-results.

Coincidence and reproducibility in the EHT black hole experiment

This paper discusses some philosophical aspects related to the recent publication of the experimental results of the 2017 black hole experiment, namely the first image of the supermassive black hole at the center of galaxy M87. In this paper I present a philosophical analysis of the 2017 Event Horizon Telescope (EHT) black hole experiment. I first present Hacking's philosophy of experimentation. Hacking gives his taxonomy of elements of laboratory science and distinguishes a list of elements. I show that the EHT experiment conforms to major elements from Hacking's list. I then describe with the help of Galison's Philosophy of the Shadow how the EHT Collaboration created the famous black hole image. Galison outlines three stages for the reconstruction of the black hole image: Socio-Epistemology, Mechanical Objectivity, after which there is an additional Socio-Epistemology stage. I subsequently present my own interpretation of the reconstruction of the black hole image and I discuss model fitting to data. I suggest that the main method used by the EHT Collaboration to assure trust in the results of the EHT experiment is what philosophers call the Argument from Coincidence. I show that using this method for the above purpose is problematic. I present two versions of the Argument from Coincidence: Hacking's Coincidence and Cartwright's Reproducibility by which I analyse the EHT experiment. The same estimation of the mass of the black hole is reproduced in four different procedures. The EHT Collaboration concludes: the value we have converged upon is robust. I analyse the mass measurements of the black hole with the help of Cartwright's notion of robustness. I show that the EHT Collaboration construe Coincidence/Reproducibility as Technological Agnosticism and I contrast this interpretation with van Fraassen's scientific agnosticism.

Making and Using Scientific Instruments in Japan: How Scholars and Craftsmen Cooperated, 1781-1853

This article examines five separate but interrelated cases concerning scientific instruments in eighteenth- and nineteenth-century Japan. Instruments like telescopes and clocks were not typically traded goods on the early modern Japanese market, but their use and production show us the inventive activities carried out in later Edo Japan. The first two cases highlight academic activities in Osaka, where scholars, in collaboration with craftsmen, made and used instruments in order to study Western natural sciences. Their activities were possible thanks to wealthy merchants, who promoted the active circulation of things and information. The three other cases are ingenious craftsmen who demonstrate the importance of their contact with academic intellectuals for making and elaborating optical and mechanical instruments. An analysis of their career paths reveals to what extent the goals and outcomes of their inventive activities were constrained and promoted by their social and occupational standing in the feudal society.

Subaru Telescope -History, active/adaptive optics, instruments, and scientific achievements

The Subaru Telescope^a) is an 8.2 m optical/infrared telescope constructed during 1991-1999 and has been operational since 2000 on the summit area of Maunakea, Hawaii, by the National Astronomical Observatory of Japan (NAOJ). This paper reviews the history, key engineering issues, and selected scientific achievements of the Subaru Telescope. The active optics for a thin primary mirror was the design backbone of the telescope to deliver a high-imaging performance. Adaptive optics with a laser-facility to generate an artificial guide-star improved the telescope vision to its diffraction limit by cancelling any atmospheric turbulence effect in real time. Various observational instruments, especially the wide-field camera, have enabled unique observational studies. Selected scientific topics include studies on cosmic reionization, weak/strong gravitational lensing, cosmological parameters, primordial black holes, the dynamical/chemical evolution/interactions of galaxies, neutron star mergers, supernovae, exoplanets, proto-planetary disks, and outliers of the solar system. The last described are operational statistics, plans and a note concerning the culture-and-science issues in Hawaii.

ABSOLUTE MEASUREMENT OF 14.57 MeV NEUTRON FLUENCE RATE USING PROTON RECOIL NEUTRON TELESCOPE

A single stage vacuum-type proton recoil neutron telescope (PRT) was used for accurate measurement of 14.57 MeV neutron fluence rate from an indigenously developed D-T neutron generator at Purnima, BARC. The telescope consists of a polyethylene radiator having 4 cm diameter and CsI (Tl) scintillation crystal having thickness 1.5 mm and 4 cm diameter separated by 20.5 cm kept in a vacuum chamber. The neutron detection efficiency of the telescope for 14.57 MeV neutrons was calculated analytically using n-p scattering cross section data from Evaluated Nuclear Data File VII and also evaluated using fluka simulation. The relativistic transformation of n-p differential scattering cross section from centre-of-mass to laboratory system was used for calculating the efficiency of PRT. The 14.57 MeV neutron fluence rate was also measured using copper foils. The comparison of fluence rate measured using PRT and copper foil activation techniques is presented in this paper. The total uncertainty in measurement using PRT and copper foil activation technique is found to be 3.93 and 6.97%, respectively.

CRaTER observations and permissible mission duration for human operations in deep space

Prolonged exposure to the galactic cosmic ray (GCR) environment is a potentially limiting factor for manned missions in deep space. Evaluating the risk associated with the expected GCR environment is an essential step in planning a deep space mission. This requires an understanding of how the local interstellar spectrum is modulated by the heliospheric magnetic field (HMF) and how observed solar activity is manifested in the HMF over time. While current GCR models agree reasonably well with measured observations of GCR flux on the first matter, they must rely on imperfect or loose correlations to describe the latter. It is more accurate to use dose rates directly measured by instruments in deep space to quantify the GCR condition for a given period of time. In this work, dose rates observed by the Cosmic Ray Telescope for the Effects of Radiation (CRaTER) instrument are used to obtain the local GCR intensity and composition as a function of time. A response function is constructed that relates observed dose rates to solar modulation potential using a series of Monte Carlo radiation transport calculations. The record of observed solar modulation potential vs. time is then used to calculate a recent historical record of permissible mission duration (PMD) according to NASA's permissible exposure limits (PEL). Tables are provided for extreme values of PMD. Additional tables include risk of exposure-induced death (at upper 95% confidence interval) accrual rates and NASA effective dose rates as a function of solar modulation potential, astronaut age, sex, and shielding thickness. The significance of the PMD values reported in relation to likely transit duration requirements for future exploration missions is discussed. There is general agreement between CRaTER observations and the prescription of solar modulation vs. time given by the Badhwar-O'Neill 2014 GCR model. However, CRaTER observations do capture the effects of significant heliospheric transients, among other features, that are missing from the prescription of solar modulation potential vs. time.

A novel approach for remote detection of bacteria using simple charge-coupled device cameras and telescope

We have designed, constructed, and utilized a charge-coupled device system, integrated with a small Newtonian telescope, capable of long distance recording of bacterial fluorescence and synchronous spectra for the detection of bacteria, their component molecules, and other species. This newly developed optical system utilizes commercial monochrome cameras that we have used to detect various bacterial strains, such as Escherichia coli, and determine their concentrations. In addition, using this system, we were able to differentiate between live and dead bacteria after treatment with ultraviolet light or antibiotics.

Evaluation of the Driving Safety of Visually Impaired Bioptic Drivers Based on Critical Events in Naturalistic Driving

Purpose

Visually impaired people may be allowed to drive if they wear bioptic telescopes. Bioptic driving safety is debatable, especially given that the telescopes are seldom used by most bioptic drivers. This preliminary study examined bioptic safety based on critical events that occurred in naturalistic daily driving.

Methods

Daily driving activities were recorded using in-car video recorders in 20 bioptic drivers (median age 55, visual acuity, 20/60-160) and 19 control subjects (median age 74) for two to eight weeks. In a secondary analysis, these subjects were compared with 44 cognitively impaired drivers with normal vision (median age 75).

Results

In 292 hours of driving by bioptic drivers and 169 hours by control drivers, seven bioptic drivers and three control drivers had eight and four near-collisions, respectively. Near-collision survival times were not significantly different between the two groups (hazard ratio [HR] = 1.93, P = 0.591) according to Cox hazards regression. Even without compensation for bioptic drivers' longer driving exposure, their odds ratio (OR) was not statistically significant (OR = 2.88, P = 0.18). When including cognitively impaired drivers with normal vision, cognition was a significant predictor of near collisions (HR = 3.86, P = 0.036), but vision loss was not (HR = 0.47, P = 0.317).

Conclusions

This preliminary study failed to find any evidence suggesting that bioptic drivers were more prone to near-collision than healthy drivers. Vision might be a less-significant factor than cognition.

Translational Relevance

Given that bioptic drivers use the telescope for less than 2% of the driving time, this study suggests that driving safety might not be substantially affected even when visual acuity is in the low vision range.

Bioptic Telescope Use in Naturalistic Driving by People with Visual Impairment

Purpose

The purpose of this study was to investigate the telescope use behaviors in natural daily driving of people with reduced visual acuity licensed to drive with a bioptic (a small spectacle-mounted telescope).

Methods

A large dataset (477 hours) of naturalistic driving was collected from 19 bioptic drivers (visual acuity 20/60 to 20/160 without the telescope). To reduce the data volume, a multiloss 50-layer deep residual neural network (ResNet-50) was used to detect potential bioptic telescope use events. Then, a total of 120 hours of selected video clips were reviewed and annotated in detail.

Results

The frequency of looking through their telescopes ranged from 4 to 308 times per hour (median: 27, interquartile range [IQR], 19-75), with each bioptic use lasting median 1.4 seconds (IQR, 1.2-1.8). Thus, participants spent only 1.6% (IQR, 0.7%-3.5%) driving time with their telescopes aiding their vision. Bioptic telescopes were used most often for checking the road ahead (84.8%), followed by looking at traffic lights (5.3%), and reading road signs (4.6%).

Conclusions

In daily driving, the bioptic drivers mostly (>98% of driving time) drove under low visual acuity conditions. The bioptic telescope was mainly used for observing road and traffic conditions in the distance for situational awareness. Only a small portion of usage was for road sign reading.

Translational Relevance

This study provides new insights into how the vision rehabilitation device-bioptic telescopes are used in daily driving. The findings may be helpful for designing bioptic driving training programs.

Hazard Detection With Monocular Bioptic Telescopes in a Driving Simulator

Purpose

In most states, people with reduced visual acuity may legally drive with the aid of a bioptic telescope. However, concerns have been raised that the ring scotoma may impair detection of peripheral hazards. Using a driving simulator, we tested the hypothesis that the fellow eye would be able to compensate for the ring scotoma when using a monocular telescope.

Methods

Sixteen bioptic users completed three drives with binocular viewing interleaved between three drives with monocular viewing. Forty pedestrians appeared and ran on the road for 1 second, including 26 within the ring scotoma, while participants were reading road signs through their own monocular telescopes. Head movements were analyzed to determine whether the pedestrian appeared before or only while using the telescope.

Results

For pedestrians that appeared only during bioptic use and were likely in the area of the ring scotoma, detection rates were significantly higher in binocular (fellow eye can compensate) than monocular (fellow eye patched) viewing (69% vs. 32%; P < 0.001); this was true for both current and noncurrent drivers. For pedestrians appearing before or after bioptic use, detection rates did not differ in binocular and monocular viewing. However, detection rates were even higher and reaction times shorter when the telescope was not being used.

Conclusions

Both current and noncurrent drivers'  fellow eyes were able to compensate, at least in part, for the ring scotoma.

Translational Relevance

When using monocular telescopes, the fellow eye reduces the impact of the ring scotoma on hazard detection in binocular viewing.

Q&amp;A: Stethoscopes and Telescopes

Ever since he was a boy, Temple family physician John Manning, MD, has been fascinated by space. Now, Dr. Manning is also an amateur photographer. About 10 years ago, he merged his interests in photography and space into his latest obsession: astrophotography.

Phosphine as a Biosignature Gas in Exoplanet Atmospheres

A long-term goal of exoplanet studies is the identification and detection of biosignature gases. Beyond the most discussed biosignature gas O₂, only a handful of gases have been considered in detail. In this study, we evaluate phosphine (PH₃). On Earth, PH₃ is associated with anaerobic ecosystems, and as such, it is a potential biosignature gas in anoxic exoplanets. We simulate the atmospheres of habitable terrestrial planets with CO₂- and H₂-dominated atmospheres and find that PH₃ can accumulate to detectable concentrations on planets with surface production fluxes of 10¹⁰ to 10¹⁴ cm^-2 s^-1 (corresponding to surface concentrations of 10s of ppb to 100s of ppm), depending on atmospheric composition and ultraviolet (UV) irradiation. While high, the surface flux values are comparable to the global terrestrial production rate of methane or CH₄ (10¹¹ cm^-2 s^-1) and below the maximum local terrestrial PH₃ production rate (10¹⁴ cm^-2 s^-1). As with other gases, PH₃ can more readily accumulate on low-UV planets, for example, planets orbiting quiet M dwarfs or with a photochemically generated UV shield. PH₃ has three strong spectral features such that in any atmosphere scenario one of the three will be unique compared with other dominant spectroscopic molecules. Phosphine's weakness as a biosignature gas is its high reactivity, requiring high outgassing rates for detectability. We calculate that tens of hours of JWST (James Webb Space Telescope) time are required for a potential detection of PH₃. Yet, because PH₃ is spectrally active in the same wavelength regions as other atmospherically important molecules (such as H₂O and CH₄), searches for PH₃ can be carried out at no additional observational cost to searches for other molecular species relevant to characterizing exoplanet habitability. Phosphine is a promising biosignature gas, as it has no known abiotic false positives on terrestrial planets from any source that could generate the high fluxes required for detection.

Vision with different presbyopia corrections simulated with a portable binocular visual simulator

Presbyopes can choose today among different corrections to provide them with functional vision at far and near, and the outcomes and patient satisfaction depend on the selection. In this study, we present a binocular and portable vision simulator, based on temporal multiplexing of two synchronized tunable lenses allowing see-through and programmable visual simulations of presbyopic corrections. Seventeen binocular corrections were tested: 3 Monofocal (Far, Intermediate, Near), 4 Simultaneous Vision (bifocal, trifocal), 2 Monovision (far and near in either eye) and 8 Modified Monovision corrections (Simultaneous vision in one eye, Monofocal in the other eye). Perceived visual quality was assessed through the simulated corrections in 8 cyclopleged subjects who viewed a composite realistic visual scene with high contrast letters and a landscape at far (4 m) and a high contrast text at intermediate (66 cm) and near (33 cm) distances. Perceptual scores were obtained on a scale of 0 to 5 (low to high perceived quality). Perceptual preference was assessed by judging 36 random image pairs (6 repetitions) viewed through 9 binocular presbyopic corrections using two-interval forced choice procedures. The average score, across far and near distances, was the highest for Monovision (4.4±0.3), followed by Modified Monovision (3.4±0.1), Simultaneous Vision (3.0±0.1) and Monofocal corrections (2.9±0.2). However, the mean difference between far and near was lower for Simultaneous Vision and Monovision (0.4±0.1 PS) than Modified Monovision (1.8±0.7) or monofocal corrections (3.3±1.5). A strong significant correlation was found between the perceptual scores and the percentages of energy in focus, for each correction and distance (R = 0.64, p<0.0001). Multivariate ANOVA revealed significant influence of observation distances (p<10-9) and patients (p = 0.01) on Perceptual Score. In conclusion, we have developed a binocular portable vision simulator that can simulate rapidly and non-invasively different combinations of presbyopic corrections. This tool has applications in systematic clinical evaluation of presbyopia corrections.

A half century of infrared astronomy - A personal recollection of the footprints in Japan

Since the new era of infrared astronomy was opened by the Two Micron Sky Survey by Neugebauer et al. in the early 1960s, about a half century has passed. During this time, observations have expanded rapidly and widely, to almost every field of astronomy, to reveal new perspectives on the universe. As a result, infrared astronomy has become one of the major branches of astronomy, along with optical, radio, X-ray as well as high-energy particle astronomy. In Japan, we started our infrared astronomical activities at a rather early time, under relatively poor technical and environmental conditions, and using somewhat unconventional methods to overcome these difficulties. Here, a brief survey is presented of developments concerning infrared astronomy during the past half century, while mainly recollecting our footprints in the stream of world activities.

A Catalog of Spectra, Albedos, and Colors of Solar System Bodies for Exoplanet Comparison

We present a catalog of spectra and geometric albedos, representative of the different types of solar system bodies, from 0.45 to 2.5 μm. We analyzed published calibrated, uncalibrated spectra, and albedos for solar system objects and derived a set of reference spectra and reference albedos for 19 objects that are representative of the diversity of bodies in our solar system. We also identified previously published data that appear contaminated. Our catalog provides a baseline for comparison of exoplanet observations to 19 bodies in our own solar system, which can assist in the prioritization of exoplanets for time intensive follow-up with next-generation extremely large telescopes and space-based direct observation missions. Using high- and low-resolution spectra of these solar system objects, we also derive colors for these bodies and explore how a color-color diagram could be used to initially distinguish between rocky, icy, and gaseous exoplanets. We explore how the colors of solar system analog bodies would change when orbiting different host stars. This catalog of solar system reference spectra and albedos is available for download through the Carl Sagan Institute.

DEVELOPMENT OF A HIGH-EFFICIENCY PROTON RECOIL TELESCOPE FOR D-T NEUTRON FLUENCE MEASUREMENT

A high-efficiency proton recoil telescope was developed to determine neutron fluences in neutron fields using the 3H(d,n)4He reaction. A 2-mm thick plastic scintillation detector was employed as a radiator to increase the detection efficiency and compensate for the energy loss of the recoil proton within. Two silicon detectors were employed as the ΔE and E detectors. The distance between the radiator and the E detector was varied between 50 and 150 mm. The telescope had detection efficiencies of 3.5 × 10-3 and 7.1 × 10-4 cm2 for distances of 50 and 100 mm, respectively, which were high enough to determine the neutron fluence in 14.8-MeV neutron fields, with a few thousand cm-2 s-1 fluence rate, within a few hours.

Implantable miniature telescope (IMT) for vision loss due to end-stage age-related macular degeneration

BACKGROUND

Age-related macular degeneration (AMD) causes progressive and irreversible damage to the retina, resulting in loss of central vision. AMD is the third leading cause of irreversible visual impairment worldwide and the leading cause of blindness in industrialized countries. Since AMD is more common in older individuals, the number of affected individuals will increase significantly as the population ages. The implantable miniature telescope (IMT) is an ophthalmic device developed to improve vision in individuals who have lost vision due to AMD. Once implanted, the IMT is used to enlarge objects in the central visual field and focus them onto healthy areas of the retina not affected by AMD, allowing individuals to recognize objects that they otherwise could not see. It is unclear whether and how much the IMT can improve vision in individuals with end-stage AMD.

OBJECTIVES

To assess the effectiveness and safety of the IMT in improving visual acuity and quality of life in people with late or advanced AMD.

SEARCH METHODS

We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2017, Issue 11); Ovid MEDLINE; Embase.com; PubMed; LILACS; AMED; Web of Science Conference Proceedings Citation Index-Science; OpenSIGLE; the metaRegister of Controlled Trials (mRCT) (last searched 27 June 2014); ClinicalTrials.gov; the ICTRP and the US Food and Drug Administration (FDA) Medical Devices database. The date of the search was 2 November 2017, with the exception of mRCT which is no longer in service.

SELECTION CRITERIA

We planned to include randomized controlled trials (RCTs) and quasi-randomized trials that compared the IMT versus no IMT.

DATA COLLECTION AND ANALYSIS

Two review authors independently assessed all studies for inclusion, using standard methodological procedures expected by Cochrane.

MAIN RESULTS

Our search yielded 1042 unique records. We removed irrelevant studies after screening titles and abstracts, and evaluated five full-text reports from four studies; three were non-randomized studies. There was one ongoing RCT that compared the OriLens intraocular telescope with standard low vision training in eyes with end-stage AMD. Results for this study are expected in 2020.

AUTHORS' CONCLUSIONS

We found no RCT or quasi-RCT and can draw no conclusion about the effectiveness and safety of the IMT in improving visual acuity in individuals with late or advanced AMD. Since the IMT is typically implanted monocularly based upon which eye has better best-corrected distance visual acuity, randomization between eyes within an individual may not be acceptable. Studies are needed that compare outcomes between individuals randomized to the device versus individuals not implanted, at least during study follow-up, who serve as controls.

The Habitability of Proxima Centauri b: Environmental States and Observational Discriminants

Proxima Centauri b provides an unprecedented opportunity to understand the evolution and nature of terrestrial planets orbiting M dwarfs. Although Proxima Cen b orbits within its star's habitable zone, multiple plausible evolutionary paths could have generated different environments that may or may not be habitable. Here, we use 1-D coupled climate-photochemical models to generate self-consistent atmospheres for several evolutionary scenarios, including high-O2, high-CO2, and more Earth-like atmospheres, with both oxic and anoxic compositions. We show that these modeled environments can be habitable or uninhabitable at Proxima Cen b's position in the habitable zone. We use radiative transfer models to generate synthetic spectra and thermal phase curves for these simulated environments, and use instrument models to explore our ability to discriminate between possible planetary states. These results are applicable not only to Proxima Cen b but to other terrestrial planets orbiting M dwarfs. Thermal phase curves may provide the first constraint on the existence of an atmosphere. We find that James Webb Space Telescope (JWST) observations longward of 10 μm could characterize atmospheric heat transport and molecular composition. Detection of ocean glint is unlikely with JWST but may be within the reach of larger-aperture telescopes. Direct imaging spectra may detect O4 absorption, which is diagnostic of massive water loss and O2 retention, rather than a photosynthetic biosphere. Similarly, strong CO2 and CO bands at wavelengths shortward of 2.5 μm would indicate a CO2-dominated atmosphere. If the planet is habitable and volatile-rich, direct imaging will be the best means of detecting habitability. Earth-like planets with microbial biospheres may be identified by the presence of CH4-which has a longer atmospheric lifetime under Proxima Centauri's incident UV-and either photosynthetically produced O2 or a hydrocarbon haze layer. Key Words: Planetary habitability and biosignatures-Planetary atmospheres-Exoplanets-Spectroscopic biosignatures-Planetary science-Proxima Centauri b. Astrobiology 18, 133-189.

Reflections on O2 as a Biosignature in Exoplanetary Atmospheres

Oxygenic photosynthesis is Earth's dominant metabolism, having evolved to harvest the largest expected energy source at the surface of most terrestrial habitable zone planets. Using CO₂ and H₂O-molecules that are expected to be abundant and widespread on habitable terrestrial planets-oxygenic photosynthesis is plausible as a significant planetary process with a global impact. Photosynthetic O₂ has long been considered particularly robust as a sign of life on a habitable exoplanet, due to the lack of known "false positives"-geological or photochemical processes that could also produce large quantities of stable O₂. O₂ has other advantages as a biosignature, including its high abundance and uniform distribution throughout the atmospheric column and its distinct, strong absorption in the visible and near-infrared. However, recent modeling work has shown that false positives for abundant oxygen or ozone could be produced by abiotic mechanisms, including photochemistry and atmospheric escape. Environmental factors for abiotic O₂ have been identified and will improve our ability to choose optimal targets and measurements to guard against false positives. Most of these false-positive mechanisms are dependent on properties of the host star and are often strongest for planets orbiting M dwarfs. In particular, selecting planets found within the conservative habitable zone and those orbiting host stars more massive than 0.4 M_⊙ (M3V and earlier) may help avoid planets with abundant abiotic O₂ generated by water loss. Searching for O₄ or CO in the planetary spectrum, or the lack of H₂O or CH₄, could help discriminate between abiotic and biological sources of O₂ or O₃. In advance of the next generation of telescopes, thorough evaluation of potential biosignatures-including likely environmental context and factors that could produce false positives-ultimately works to increase our confidence in life detection. Key Words: Biosignatures-Exoplanets-Oxygen-Photosynthesis-Planetary spectra. Astrobiology 17, 1022-1052.

VITOM 3D: Preliminary Experience in Cranial Surgery

BACKGROUND

Optimal vision and ergonomics are important factors contributing to achievement of good results during neurosurgical interventions. The operating microscope and the endoscope have partially filled the gap between the need for good surgical vision and maintenance of a comfortable posture during surgery. Recently, a new technology called video-assisted telescope operating monitor or exoscope has been used in cranial surgery. The main drawback with previous prototypes was lack of stereopsis. We present the first case report of cranial surgery performed using the VITOM 3D, an exoscope conjugating 4K resolution view and three-dimensional technology, and discuss advantages and disadvantages compared with the operating microscope.

CASE DESCRIPTION

A 50-year-old patient with vertigo and headache linked to a petrous ridge meningioma underwent surgery using the VITOM 3D. Complete removal of the tumor and resolution of symptoms were achieved. The telescope was maintained over the surgical field for the duration of the procedure; a video monitor was placed at 2 m from the surgeons; and a control unit allowed focusing, magnification, and repositioning of the camera.

CONCLUSIONS

VITOM 3D is a video system that has overcome the lack of stereopsis, a major drawback of previous exoscope models. It has many advantages regarding ergonomics, versatility, and depth of field compared with the operating microscope, but the holder arm and the mechanism of repositioning, refocusing, and magnification need to be ameliorated. Surgeons should continue to use the technology they feel confident with, unless a distinct advantage with newer technologies can be demonstrated.

SPACE DOSIMETRY MEASUREMENTS IN THE STRATOSPHERE USING DIFFERENT ACTIVE AND PASSIVE DOSIMETRY SYSTEMS

Several measurements have been performed on the cosmic radiation field from the surface of the Earth up to the maximum altitudes of research aeroplanes. However, there is only limited information about that between 15 and 30 km altitudes. In order to study the radiation environment in the stratosphere, an experiment was built by students from Hungarian universities that flew on board the BEXUS (Balloon Experiments for University Students) stratospheric balloon in Northern Sweden, from the ESRANGE Space Center. The main technical goals of the experiment were to test at the first time the TRITEL 3D silicon detector telescope system in close to space conditions and to develop a balloon technology platform for advanced cosmic radiation and dosimetric measurements. The main scientific goals were to give an assessment of the cosmic radiation field at the altitude of the BEXUS balloons, to use the TRITEL system to determine dosimetric and radiation quantities during the balloon flight and to intercompare the TRITEL and Pille results to provide a correction factor for the Pille measurements. To fulfil the scientific and technological objectives, several different dosimeter systems were included in the experiment: an advanced version of the TRITEL silicon detector telescope, Geiger-Müller (GM) counters and Pille thermoluminescent dosimeters. The float altitude of the BEXUS balloon was ∼28.6 km; the total flight time was ∼4 h. Measurement data from the active instruments were received in real time by the ground team during the mission. There were no failures in the operation of the system; everything worked as expected. This article presents the scientific goals and results in detail. From the TRITEL measurements, the linear energy transfer spectra, the average quality factor of the cosmic radiation as well as the absorbed dose and the dose equivalent were determined. Estimations for the uncertainty in the TRITEL measurements were given. The deposited energy spectra measured with the TRITEL instrument were compared with the count rates measured with the GM counters. The experiences and results gained in the frame of the project will be used in the evaluation of TRITEL data from measurements on board the International Space Station. As an outlook a short overview is given of the planned rocket radiation experiments based on the system used in the BEXUS programme.

Reflected Light from Giant Planets in Habitable Zones: Tapping into the Power of the Cross-Correlation Function

The direct detection of reflected light from exoplanets is an excellent probe for the characterization of their atmospheres. The greatest challenge for this task is the low planet-to-star flux ratio, which even in the most favourable case is of the order of 10-4 in the optical. This ratio decreases even more for planets in their host's habitable zone, typically lower than 10-7. To reach the signal-to-noise level required for such detections, we propose to unleash the power of the Cross Correlation Function in combination with the collecting power of next generation observing facilities. The technique we propose has already yielded positive results by detecting the reflected spectral signature of 51 Pegasi b (see Martins et al. 2015). In this work, we attempted to infer the number of hours required for the detection of several planets in their host's habitable zone using the aforementioned technique from theoretical EELT observations. Our results show that for 5 of the selected planets it should be possible to directly recover their reflected spectral signature.

SEEDS - Strategic explorations of exoplanets and disks with the Subaru Telescope

The first convincing detection of planets orbiting stars other than the Sun, or exoplanets, was made in 1995. In only 20 years, the number of the exoplanets including promising candidates has already accumulated to more than 5000. Most of the exoplanets discovered so far are detected by indirect methods because the direct imaging of exoplanets needs to overcome the extreme contrast between the bright central star and the faint planets. Using the large Subaru 8.2-m Telescope, a new high-contrast imager, HiCIAO, and second-generation adaptive optics (AO188), the most ambitious high-contrast direct imaging survey to date for giant planets and planet-forming disks has been conducted, the SEEDS project. In this review, we describe the aims and results of the SEEDS project for exoplanet/disk science. The completeness and uniformity of this systematic survey mean that the resulting data set will dominate this field of research for many years.

[Application of one-piece implant-supported detachable telescope retained fixed bridge in edentulous cases]

PURPOSE

To evaluate the clinical effectiveness of one-piece implant-supported detachable telescopic fixed bridge in edentulous patients.

METHODS

Seventeen patients were treated with one-piece implant-supported detachable telescopic fixed bridge. A total of 18 prostheses were fabricated with 8 in the upper jaws and 10 in the lower jaws.Fixed bridges retained by telescopic crowns were used as final prostheses, with milling titanium or all-ceramic abutments as primary crowns, gold-electroforming crowns as secondary crowns. Surveys about clinical and radiographic examination, satisfaction and prosthetic complications were conducted after 3 months,1 year, 2 years, 3 years after final rehabilitation. Data analysis was performed using SPSS 17.0 software package.

RESULTS

Radiography showed stable bone levels for all implants except 2 implants, which were observed slight marginal bone resorption. The results of one-way ANOVA showed that no significant difference in modified plaque index or modified sulcus blooding index was found during the follow-up period (P>0.05). The probing attachment level deteriorated by 1.5 mm during the first 3 years (P<0.05). Eighteen restoration provided sufficient fixation and stability. Two porcelain fractures occured but had no influence on restoration. The patients were highly satisfied with the outcomes. The frequency of prosthetic maintenance per patient per year was 0.11.

CONCLUSIONS

One-piece implant-supported detachable telescopic fixed bridge is an effective method with satisfactory long-term aesthetic and stable outcomes in edentulous patients.

Wink-controlled polarization-switched telescopic contact lenses

We describe a wink-controlled hands-free switching system for eye-borne telescopic vision, based on a previously tested fixed-magnification telescope embedded within scleral contact lenses. Here we integrate orthogonal polarizers into the contact lens covering the F/9.1 refractive 1× and F/9.6 catadioptric 2.8× vision paths, to allow switching via external liquid crystal shutters. We provide hands-free control by an infrared wink/blink monitor, using passive retroreflectors embedded within the contact lenses. We demonstrate system operation of the self-contained switching eyewear and the modified contact lenses with a life-size human eye model with mechanical "eyelids."

Surgical loupes at 5.0× magnification and the VIO soft-coagulation system can prevent postoperative pancreatic fistula in duct-to-mucosa pancreaticojejunostomy

BACKGROUND/AIM

Postoperative pancreatic fistula (POPF) remains a major complication after pancreaticoduodenectomy (PD). In this study, we examined whether our new method using surgical loupes at 5.0× magnification and the VIO soft coagulation system (SC) for duct-to-mucosa pancreaticojejunostomy (PJ) can prevent POPF.

PATIENTS AND METHODS

A retrospective cohort study was performed in 81 consecutive patients who underwent PD and duct-to-mucosa PJ for periampullary tumors by a single surgeon during a recent 5-year period from 2008 to 2012. These patients were divided into two groups according to the nature of the PJ; the conventional group (n=46) and the 5.0× loupes+SC group (n=35). Short-term surgical results including POPF were compared and an independent risk factor for POPF was identified using the stepwise logistic regression analysis in our series.

RESULTS

The rate of Grade B/C POPF was significantly decreased in the 5.0× loupes+SC group (2.9%) compared to that of the conventional group (9.9%, p=0.04). The absence of 5.0× loupes+SC for PJ was identified as the independent risk factor for Grade B/C POPF (odds ratio, 5.23; p-value, 0.03).

CONCLUSION

5.0× surgical loupes+SC for duct-to-mucosa PJ could be used as a novel technique for preventing POPF after PD.

Muographic imaging with a multi-layered telescope and its application to the study of the subsurface structure of a volcano

In conventional muography observations using two detectors for muon tracking, the accidental coincidence of vertical electromagnetic showers generates identical trajectories to the muon tracks. Although muography has favorable properties, which allow direct density measurements inside a volcano, the measured density is lower than the actual value due to these fortuitous trajectories. We performed muography of Usu volcano, and confirmed that, in comparison with a use of two detectors, background noise levels were reduced by more than one order of magnitude using seven detectors for selecting linear trajectories. The resultant muographic image showed a high-density region underneath the central region of Usu volcano. This picture is consistent with the magma intrusion model proposed in previous studies. To clarify the three-dimensional location and actual size of the detected high-density body, multidirectional muographic measurements are necessary.