McCann Associates (United States)

Abstract Colorimetry is an essential tool in every part of colour. This article looks over our shoulders at the colour research of Maxwell, Wright, Land and Wyszecki to build a framework for colour. Then, the article looks forward to the needs of digital imaging's future. Colour is the fusion of today's imaging technology with our understanding of colour. Molecular physical chemistry describes the light–matter interactions, while human colour is controlled by neurons that compare light from the entire scene, covering a nearly 180° visual angle. This article's question asks about the information required by a future Model of Colour Appearance that is able to predict any scene: all natural scenes and any experimental display.

Este ensaio pretende analisar de que maneira o corpo esta representado para significar a Historia e as historias atraves das personagens do romance Transatlantic (2013), escrito pelo aclamado autor irlandes Colum McCann. Por um lado, levando em consideracao a “economia politica do corpo” postulada por Michel Foucault, o corpo pode ser entendido como um espaco de inscricao social, politica e historica. Por outro lado, trazendo o trabalho de Didier Anzier sobre o eu-pele para uma abordagem literaria, a presenca corporea humana pode tambem ser entendida como uma mediadora entre a Historia e a experiencia historica subjetiva. Em Transatlantic, mais precisamente no capitulo intitulado “1845-46 – Freeman”, McCann escreve sobre a travessia do Atlântico feita pelo orador e escritor Frederick Douglass a uma Irlanda devastada pela fome. Considerado um escravo em fuga e com esperancas de conseguir sua liberdade nessa viagem, Douglass admirou a brancura da pele irlandesa tanto quanto foi hostilizado por ser negro. Questoes pessoais, sociais, historicas sao ressignificadas pelo protagonista nesse encontro, o que e precisamente o foco da discussao no presente trabalho.

155 Background: Nausea and vomiting (NV) are tracked by CMS as 2 of 10 top drivers of potentially avoidable hospital admissions for patients with cancer. These admissions pose a savings opportunity, yet limited literature exists on the costs of chemotherapy-induced NV (CINV). Burke’s 2010 assessment of 19,139 patients from 2004-2007 found CINV hospitalizations cost $7,448 and comprised the majority of overall CINV events and costs vs ambulatory events. Rashid (2016) evaluated 1,682 patients with metastatic breast cancer from 2007-2011 and found CINV admissions cost $10,074 in 2013 US dollars. Using data from the US Agency for Healthcare Research and Quality ’s Healthcare Cost and Utilization Project website (HCUPnet), and after applying adjustment factors from recent literature, we evaluated the cost of NV hospitalizations. Methods: Data on US hospital discharges for NV (based on primary discharge diagnosis) were obtained for 2014 from HCUPnet. Charges were adjusted using Smith’s (2015) model showing commercial insurers paid 48.7% of their hospital charges. They were further modified to include professional fees equaling 26.4% of facilities paid amounts, as reported by Peterson (2015). The CPI-Medical rate was used to adjust costs to 2016 dollars. A US payer perspective was used. The proportion of total NV discharges due to CINV is not known; it is also unknown whether charges for CINV differ from those for NV overall. Results: HCUPnet reported 37,730 hospital discharges for NV, with mean charges of $23,603 per event. The mean payment to hospitals, after adjustment to reflect amounts insurers actually paid, was estimated at $11,232 per event. Adding physicians’ professional fees incurred in the hospital setting yet normally charged separately yielded a total hospitalization cost of $14,197 ($15,120 in 2016 US dollars). Conclusions: Hospitalization for NV is common and costly; adjusted paid amounts averaged > $15,000 per discharge, a level consistent with the CINV literature. This economic impact, in addition to the consequences for patients’ quality of life, suggests the need for continued advances in preventing CINV and optimizing compliance with national antiemetic guidelines, particularly for chemotherapy with high emetogenic potential.

Introduction: TIF has recently emerged as an effective therapy for GERD, however it is not recommended as first line therapy. Gold standard treatment for GERD is either long term PPIs or Nissen. While both TIF & Nissen have been compared with either PPIs or sham, head to head comparison of TIF vs NISSEN has not. We performed a systematic review and network meta-analysis of randomized controlled trials(RCTs) to assess the efficacy of TIF vs NISSEN for the treatment of GERD. Methods: Cochrane Central Register of Controlled Trials & MEDLINE from inception to May 1, 2016. Data were extracted independently by two authors. Methodological quality was assessed using the Cochrane risk of bias tool. A network meta-analysis was performed using the Bayesian methods under random-effects multiple treatment comparisons. Results were summarized as odds ratio along with credibility intervals. The ranking probability was assessed by surface under the cumulative ranking curve(SUCRA). To assess the impact of follow up time a meta-regression was performed on the Health Related Quality of Life(HRQOL). The Maude database was also reviewed for adverse events. Results: Overall 7 studies were included: 2 RCTs (n=173)TIF vs sham, 2 RCTs(n=120)TIF to PPIs, and 3 RCTs(n=835)Nissen vs PPI(Figure 1 summarizes these comparison). SUCRA ranking indicated TIF had the highest probability of symptomatic remission followed by Nissen, sham, then PPIs(0.96, 0.66, 0.35 and 0.042, respectively). Persistent esophagitis was highest in sham followed by TIF, Nissen, then PPIs(0.74, 0.69, 0.38 and 0.19). Nissen had the highest probability of achieving improved % time pH < 4 followed by PPIs, TIF, then sham(0.99, 0.64, 0.32, and 0.05), as well as increase in LES pressure followed by TIF then PPI(0.78, 0.72 and 0.01) Figure 2. Meta-regression showed a significant association between follow-up time and HRQOL for NISSEN but not TIF indicating follow up time was a significant confounder. Maude database revealed 54 adverse events with at least 28 hospitalizations and 14 esophageal perforations.Figure 1Figure 2Conclusion: Nissen has a higher ability to improve physiological parameters associated with GERD including improving LES pressure and % time pH < 4. PPIs were superior to all for reducing esophagitis. Although TIF appeared superior for achieving symptomatic remission this is likely related to shorter follow up time compared to Nissen and PPIs.

Introduction: RF ablation for GERD known as Stretta has appeared back on the market and was recommended by SAGES as an alternative treatment for GERD. Results related to efficacy assessed in randomized controlled trials have been conflicting and findings from previous systematic reviews were compromised due to serious deficiencies in conduct and reporting. We performed a systematic review to evaluate the totality of the evidence on the efficacy of Stretta for the management of GERD.Figure 1Methods: Primary outcomes were physiologic parameters of GERD: normalization of esophageal pH and augmentation of LESP. Secondary outcomes were:reduction in PPI and HRQOL. We searched MEDLINE and Cochrane Central Register of Controlled Trials (CENTRAL) from inception until 2/28/2014 and other databases. Data were pooled under a random effects model. The systematic review was performed as per standards of Cochrane collaboration. Results: Thirty-one studies were reviewed. Those excluded: non-randomized case series (14), duplicate studies (6), survey (1), and special population (5). Four trials enrolling a total of 168 patients were included. Three trials compared Stretta vs sham, whereas one trial compared Stretta to PPI. Overall quality of evidence was very low. Pooled results showed no difference between Stretta compared to sham or management with PPI for GERD for all outcomes (Table 1). Overall methodological quality of included studies was very low and prone to high risk of bias. Only 1 of 4 studies provided details on allocation concealment and 3 of 4 studies had reporting of outcomes data. All included studies were prone to outcome reporting bias as none reported how many patients had complete alleviation of symptoms, pH or LES. Conclusion: The totality of results from RCTs shows that RF ablation with Stretta is not associated with significant changes in physiological parameters, reduction in PPI or HRQOL compared to sham. Future studies are needed to provide a better understanding of the physiological mechanisms of Stretta and large good quality RCT to provide conclusive evidence. Until further good quality evidence is available, it not advisable for Medicare and commercial third party payers to reimburse for this endoscopic treatment for GERD.

Introduction The electrical impedance between defibrillator pads has a significant effect on the ability of defibrillators to deliver a therapeutic shock. A variety of technologies are used to deliver the chosen therapeutic shocks safely yet effectively across a wide range of patient impedances. Defibrillators will not deliver a shock above pre-set impedance. We assessed the hypothesis that devices which have pulse durations over 20ms may predispose the patient to spontaneous re-fibrillation after a successful shock. Methods Two defibrillators were tested. Device A (A) limited the current delivered and in high impedance patients would extend the pulse duration as needed to deliver the selected energy while staying below the current limit. Device B (B) would truncate the shock to restrict the pulse duration but operated with higher currents. A high impedance porcine model of ventricular fibrillation (VF) was created. Following pilot work we were unable to demonstrate any relationship between pig mass and impedance. Therefore to create high impedance it was necessary to place resistors in series with the pig between the defibrillator under test and the pads. Results From the pilot studies we determined that an impedance of approximately 95ohms resulted in a pulse duration of 20ms when device A delivered a 200J shock. A total of 5 anaesthetised pigs weighing 17-20kg (18.8kg) where used with 168 episodes of VF where impedance was greater than 100 ohms are included in the results. Two energies were tested for A (150 and 200J). B only delivers shocks at a single energy (150J). No re-fibrillation was observed in any patient after any shock. Conclusions This study failed to show any evidence of re-fibrillation even at pulse durations longer than 20ms with either device.

This chapter describes a pseudocolor technique used to visualized HDR images. Retinal Radiance ranges for Single- and Double-Density targets are very similar. Glare transforms uniform, equiluminant target patches into different gradients with unequal retinal radiances. The chapter uses pseudocolor lookup tables to compare two types of digital images. The first type represents the high - dynamic range of the targets scene contrast. The second type of image is the calculated retinal-image radiance. The chapter inspected the images on the retina using pseudocolor techniques. The calculated retinal image shows that there is no simple relationship between the retinal radiance of a pixel and its appearance between white and black. Observers report that the appearances of white and black squares are constant and uniform, despite the fact that the retinal stimuli are variable and non-uniform. Human vision uses complex spatial-image-processing to calculate appearance from retinal radiance arrays. Controlled Vocabulary Terms colorimetry; image processing