Revistas

Revista:
RADIATION PHYSICS AND CHEMISTRY
ISSN:
0969-806X

Año:
2023
Vol.:
204
Págs.:
110708

This work tackles the commissioning and validation of a novel combination of a synchrotron-based proton beam therapy system (Hitachi, Ltd.) for use with a Monte Carlo treatment planning system (TPS). Four crucial aspects in this configuration have been investigated: (1) Monte Carlo-based correction performed by the TPS to the measured integrated depth-dose curves (IDD), (2) circular spot modelling with a single Gaussian function to characterize the synchrotron physical spot, which is elliptical, (3) the modelling of the range shifter that enables using only one set of measurements in open beams, and (4) the Monte Carlo dose calculation model in small fields.Integrated depth-dose curves were measured with a PTW Bragg peak chamber and corrected, with a Monte Carlo model, to account for energy absorbed outside the detector. The elliptical spot was measured by IBA Lynx scintillator, EBT3 films and PTW microDiamond. The accuracy of the TPS (RayStation, RaySearch Laboratories) at spot modelling with a circular Gaussian function was assessed.The beam model was validated using spread-out Bragg peak (SOBP) fields. We took single-point doses at several depths through the central axis using a PTW Farmer chamber, for fields between 2 x 2cm and 30 x 30cm. We checked the range-shifter modelling from open-beam data. We tested clinical cases with film and an ioni-zation chamber array (IBA Matrix).Sigma differences for spots fitted using 2D images and 1D profiles to elliptical and circular Gaussian models were below 0.22 mm. Differences between SOBP measurements at single points and TPS calculations for all fields between 5 x 5 and 30 x 30cm were below 2.3%. Smaller fields had larger differences: up to 3.8% in the 2 x 2cm field. Mean differences at several depths along the central axis were generally below 1%. Differences in range -shifter doses were below 2.4%. Gamma test (3%, 3 mm) results for clinical cases were generally above 95% for Matrix and film.Approaches for modelling synchrotron proton beams have been validated. Dose values for open and range -shifter fields demonstrate accurate Monte Carlo correction for IDDs. Elliptical spots can be successfully modelled using a circular Gaussian, which is accurate for patient calculations and can be used for small fields. A double-Gaussian spot can improve small-field calculations. The range-shifter modelling approach, which reduces clinical commissioning time, is adequate.

Revista:
PHYSICS IN MEDICINE AND BIOLOGY
ISSN:
0031-9155

Año:
2023
Vol.:
68
N°:
1
Págs.:
015005

Objective. Periodic respiratory motion and inter-fraction variations are sources of geometric uncertainty in stereotactic body radiation therapy (SBRT) of pulmonary lesions. This study extensively evaluates and validates the separate and combined dosimetric effect of both factors using 4D-CT and daily 4D-cone beam CT (CBCT) dose accumulation scenarios. Approach. A first cohort of twenty early stage or metastatic disease lung cancer patients were retrospectively selected to evaluate each scenario. The planned-dose (3D(Ref)) was optimized on a 3D mid-position CT. To estimate the dosimetric impact of respiratory motion (4D(Ref)), inter-fractional variations (3D(Acc)) and the combined effect of both factors (4D(Acc)), three dose accumulation scenarios based on 4D-CT, daily mid-cone beam CT (CBCT) position and 4D-CBCT were implemented via CT-CT/CT-CBCT deformable image registration (DIR) techniques. Each scenario was compared to 3D(Ref.) A separate cohort of ten lung SBRT patients was selected to validate DIR techniques. The distance discordance metric (DDM) was implemented per voxel and per patient for tumor and organs at risk (OARs), and the dosimetric impact for CT-CBCT DIR geometric errors was calculated. Main results. Median and interquartile range (IQR) of the dose difference per voxel were 0.05/2.69 Gy and -0.12/2.68 Gy for 3DAcc-3DRef 4DAcc-3DRef. 4DRef-3DRef

Revista:
RADIATION PHYSICS AND CHEMISTRY
ISSN:
0969-806X

Año:
2023
Vol.:
208
Págs.:
110891

Background
It is widely accepted that Monte Carlo dose calculations offers a higher precision that the commercially available dose calculation algorithms. This advantage may be especially relevant for lung Stereotactic Body Radiation Therapy (SBRT), as this is a precise technique applied to an area of big inhomogeneity.
Purpose
We conducted a comparative study to reveal the differences between the doses calculated using the Collapsed Cone Convolution algorithm and the GAMOS/Geant4 Monte Carlo calculation for lung cancer patients treated with Stereotactic Body Radiation Therapy on an Elekta Versa HD linac.
Methods
For this study a set of ten patient treatments carried out at the Clínica Universidad de Navarra was selected. Theanalysis is based on the comparison of several dosimetric quantities for the Gross Tumor Volume (GTV) and several OrgansAt Risk (OARs), and also a gamma index calculation with distance-to-agreement set to 2 mm and dose difference to 3%, as recommended by ICRU to assess clinical impact. In order to guarantee a small uncertainty in the Monte Carlo calculation of the dosimetric quantities, we studied in detail the validity of different methods that may be used to determine this uncertainty.
To compensate for lung movements, a 4D-Cone-beam Computed Tomography (CBCT) was acquired before treatment, whichallowed us to identify eight respiratory phases using a temporal binning. Using commercial MIM software®, we performed a deformable image registration between the eight CT respiration phases to construct the 4D doses. The same procedure was applied for the Treatment Planning System (TPS) dose files and for the Monte Carlo dose files.
Results
The differences between the two algorithms reveal the known weaknesses of the Collapsed Cone Convolution (CCC) algorithm for the calculation of lateral doses and in regions of large density change. The comparison between the two algorithms for individual phase doses shows differences up to 5% of the GTV D95 or 3¿4 Gy in some OARs, which may have a clinical impact. Nevertheless these differences are reduced for the 4D dose in most quantities under study.
Conclusions
Comparing the dose calculated with a Collapsed Cone Convolution algorithm with GAMOS/Geant4 for ten patients and eight respiratory phases, we found some differences that could have a clinical impact. When combining the eight temporal phases into a 4D dose using the MIM Deformable Image Registration software, the differences diminished substantially.
Our statistical analysis concludes that dose uncertainty in the voxels with a maximum dose below a given percentage guarantees uncertainty in the dosimetric quantities below that figure.

Revista:
INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
ISSN:
1661-7827

Año:
2022
Vol.:
19
N°:
11
Págs.:
6934

Obstructive sleep apnea (OSA) is a common sleep disorder characterized by repetitive upper airway obstruction, intermittent hypoxemia, and recurrent awakenings during sleep. The most used treatment for this syndrome is a device that generates a positive airway pressure-Continuous Positive Airway Pressure (CPAP), but it works continuously, whether or not there is apnea. An alternative consists on systems that detect apnea episodes and produce a stimulus that eliminates them. Article focuses on the development of a simple and autonomous processing system for the detection of obstructive sleep apneas, using polysomnography (PSG) signals: electroencephalography (EEG), electromyography (EMG), respiratory effort (RE), respiratory flow (RF), and oxygen saturation (SO2). The system is evaluated using, as a gold standard, 20 PSG tests labeled by sleep experts and it performs two analyses. A first analysis detects awake/sleep stages and is based on the accumulated amplitude in a channel-dependent frequency range, according to the criteria of the American Academy of Sleep Medicine (AASM). The second analysis detects hypopneas and apneas, based on analysis of the breathing cycle and oxygen saturation. The results show a good estimation of sleep events, where for 75% of the cases of patients analyzed it is possible to determine the awake/asleep states with an effectiveness of >92% and apneas and hypopneas with an effectiveness of >55%, through a simple processing system that could be implemented in an electronic device to be used in possible OSA treatments.

Revista:
PHYSICS IN MEDICINE AND BIOLOGY
ISSN:
0031-9155

Año:
2021
Vol.:
66
N°:
3
Págs.:
035025

The purpose of this study was to devise and evaluate a method to quantify the dosimetric uncertainty produced by the interplay between the movement of multileaf collimator (MLC) and respiratory motion in lung stereotactic body radiation therapy (SBRT). The method calculates the dose distribution for all control points from a dynamic treatment in all respiratory phases. The methodology includes some characteristics of a patient's irregular breathing patterns. It selects, for each control point, the phases with maximum and minimum mean dose over the tumor and their corresponding adjacent phases, whenever necessary. According to this selection, the dose matrices from each control point are summed up to obtain two dose distributions in each phase, which are accumulated in the reference phase subsequently by Deformable Image Registration (DIR). D95 and Dmin,0.035cc were calculated over those accumulated dose distributions for Gross Tumor Volume (GTV), Planning Target Volume (PTV) - based on Internal Target Volume (ITV) approach - and Evaluation Target Volume (ETV), a novel concept that applies to 4D dose accumulation. With the ETV, DIR and interplay uncertainties are separated. The methodology also evaluated how variations in the breathing rate and field size affects the mean dose received by the GTV. The method was applied retrospectively in five patients treated with intensity modulated radiotherapy (IMRT) - minimum area defined by the leaves configuration at any control point was at least 4cm2-. Uncertainties in tumor coverage were small (in most patients, changes on D95 and Dmin,0.035cc were below 2% for GTV and ETV) but significant over- and under- dosages near ETV, which can be accentuated by highly irregular breathing. Uncertainties in mean dose for GTV tended to decrease exponentially with increasing field size and were reduced by an increase of breathing rate. The implementation of this method would be helpful to assess treatment quality in patients with irregular breathing. Furthermore, it could be used to study interplay uncertainties when small field sizes are used.

Autores:
Moscoso-Barrera, W. D.; Agudelo-Otalora, L. M.; Moreno-Giraldo, A. M.; et al.

Revista:
F1000RESEARCH
ISSN:
2046-1402

Año:
2021
Vol.:
10
Págs.:
197

Obstructive sleep apnoea-hypopnoea syndrome (OSA) is a respiratory disorder characterised by repetitive obstruction of the upper airway, leading to several interruptions during sleep. It is currently one of the main public health problems worldwide and one of the main cardiovascular risk factors in developed and intermediate developing countries, whose populations are increasing in rates of obesity and age. One of the common treatments for OSA is a continuous positive airway pressure (CPAP) device, which pumps air through a hose, reaches a mask that the patient has over his or her nose and travels the airway, keeping the upper airway open during sleep and avoiding episodes of airway collapse. The problem is that CPAP is not accepted by some patients due to a lack of adaptation, so alternative treatments may be needed. For some years, there have been explorations of treatments related to electrical stimulation of the muscles of the upper airway as therapy to reduce the number of episodes of apnoea (measured through the apnoea¿hypopnoea index) during the night, strengthening these muscles through stimulation. This is the protocol of the first clinical study of a rehabilitation device for home use that not only provides functional stimulation of the upper-airway dilator muscles but also provides sensory stimulation. This device works by strengthening the dilating muscles of the upper respiratory tract and improving the sensory capacity of the laryngo-pharyngeal tract and is based on existing publications on the effectiveness of functional and somatosensory neurostimulation through neuroplasticity in the recovery of neurological deficits.

Revista:
TRANSLATIONAL VISION SCIENCE & TECHNOLOGY
ISSN:
2164-2591

Año:
2021
Vol.:
10
N°:
13
Págs.:
26

Purpose: To measure the in vitro flow properties of the PRESERFLO implant for comparison with the theoretical resistance to flow. Methods: The PRESERFLO was designed to control the flow of aqueous humor according to the Hagen-Poiseuille (HP) equation. Scanning electron microscopy (SEM) was performed to analyze the ultrastructure, and flow measurements were carried out using a gravity-flow setup. Results: SEM images of the PRESERFLO showed luminal diameters of 67.73 x 65.95 mu m and 63.66 x 70.54 mu m. The total diameter was 337.2 mu m, and the wall was 154 mu m wide. The theoretical calculation of the resistance to flow (R) for an aqueous humor (AH) viscosity of 0.7185 centipoises (cP) was 1.3 mm Hg/(mu L/min). Hence, assuming a constant AH flow of 2 mu L/min, the pressure differential across the device (AP) was estimated to be 2.6 mm Hg. The gravity-flow experiment allowed us to measure the experimental resistance to flow, which was R-E = 1.301 mm Hg/(mu L/min), in agreement with the theoretical resistance to flow R given by the HP equation. Conclusions: The experimental and theoretical flow testing showed that the pressure drop across this device would not be large enough to avoid hypotony unless the resistance to outflow of the sub-Tenon space was sufficient to control the intraocular pressure in the early postoperative period. Translational Relevance: The fluid properties of glaucoma subconjunctival drainage devices determine their specific bleb-forming capacity and ability to avoid hypotony and therefore their safety and efficacy profile. Translational Relevance: The fluid properties of glaucoma subconjunctival drainage devices determine their specific bleb-forming capacity and ability to avoid hypotony and therefore their safety and efficacy profile.

Revista:
MEDICAL PHYSICS
ISSN:
0094-2405

Año:
2019
Vol.:
46
N°:
10
Págs.:
4346 - 4355

Purpose To use four-dimensional (4D) dose accumulation based on deformable image registration (DIR) to assess dosimetric uncertainty in lung stereotactic body radiation therapy (SBRT) treatment planning. A novel concept, the Evaluation Target Volume (ETV), was introduced to achieve this goal. Methods The internal target volume (ITV) approach was used for treatment planning for 11 patients receiving lung SBRT. Retrospectively, 4D dose calculation was done in Pinnacle v9.10. Total dose was accumulated in the reference phase using DIR with MIM. DIR was validated using landmarks introduced by an expert radiation oncologist. The 4D and three-dimensional (3D) dose distributions were compared within the gross tumor volume (GTV) and the planning target volume (PTV) using the D-95 and D-min (calculated as D-min,D-0.035cc) metrics. For lung involvement, the mean dose and V-20, V-10, and V-5 were used in the 3D to 4D dose comparison, and D-max (D-0.1cc) was used for all other organs at risk (OAR). The new evaluation target volume (ETV) was calculated by expanding the GTV in the reference phase in order to include geometrical uncertainties of the DIR, interobserver variability in the definition of the tumor, and uncertainties of imaging and delivery systems. D-95 and D-min,D-0.035cc metrics were then calculated on the basis of the ETV for 4D accumulated dose distributions, and these metrics were compared with those calculated from the PTV for 3D planned dose distributions.

Revista:
PHYSICAL REVIEW E
ISSN:
2470-0045

Año:
2019
Vol.:
99
N°:
2
Págs.:
023111

The cylindrical wall boundary layer of a closed cylinder split in two halves at the equator is studied experimentally. When these two parts rotate in exact corotation the internal flow is essentially in solid-body rotation at the angular velocity of both halves. When a slight difference between the rotation frequencies is established a secondary flow is created due to the differential rotation between both sides and restricted to the boundary layer. This behavior of the boundary layer is compared with theoretical and numerical results finding the ¿sandwich¿ structure of a Stewartson boundary layer. Time-dependent waves are observed near the cylindrical wall. Their behavior for different values of the control parameters are presented. Finally, a global recirculation mode is also found due to a symmetry-breaking induced between sides that appears because of a slight misalignment of the experimental setup, whose characteristics are compatible with the behavior of a precessing cylinder.

Revista:
APPLIED SCIENCES
ISSN:
2076-3417

Año:
2019
Vol.:
9
N°:
22
Págs.:
4904

We present a novel method to characterize the morphology of semicircular canals of the inner ear. Previous experimental works have a common nexus, the human-operator subjectivity. Although these methods are mostly automatic, they rely on a human decision to determine some particular anatomical positions. We implement a systematic analysis where there is no human subjectivity. Our approach is based on a specific magnetic resonance study done in a group of 20 volunteers. From the raw data, the proposed method defines the centerline of all three semicircular canals through a skeletonization process and computes the angle of the functional pair and other geometrical parameters. This approach allows us to assess the inter-operator effect on other methods. From our results, we conclude that, although an average geometry can be defined, the inner ear anatomy cannot be reduced to a single geometry as seen in previous experimental works. We observed a relevant variability of the geometrical parameters in our cohort of volunteers that hinders this usual simplification.

Revista:
DYSPHAGIA
ISSN:
0179-051X

Año:
2018
Vol.:
33
N°:
1
Págs.:
15 - 25

Recent studies have shown an association between alterations in laryngopharyngeal mechanosensitivity (LPMS) and dysphagia, obstructive sleep apnea, and chronic cough hypersensitivity syndrome. A previous reliability study of a new laryngopharyngeal endoscopic esthesiometer and rangefinder (LPEER) showed high intra- and inter-rater reliability; however, its accuracy has not been tested. We performed an accuracy study of the LPEER in a prospectively and consecutively recruited cohort of 118 patients at two tertiary care university hospitals. Most of the patients were suffering from dysphagia, and all of them underwent a standard clinical evaluation and fiberoptic endoscopic evaluation of swallowing with sensory testing (FEESST) using a new sensory testing protocol. The sensory test included determinations of the laryngeal adductor reflex threshold (LART), the cough reflex threshold (CRT) and the gag reflex threshold (GRT). Abnormalities on these reflex thresholds were evaluated for associations with major alterations in swallowing safety (pharyngeal residues, penetration, and aspiration). We evaluated the discriminative capacity of the LPMS test using ROC curves and the area under the curve (AUC-ROC) and its relationship with the eight-point penetration-aspiration scale (PAS) using the Spearman's ¿ correlation coefficient (SCC). We found a positive correlation between the PAS and LART (SCC 0.47; P < 0.001), CRT (SCC 0.46; P < 0.001) and GRT (SCC 0.34; P = 0.002). The AUC-ROC values for detecting a PAS ¿7 were as follows: LART, 0.83 (P < 0.0001); CRT, 0.79 (P < 0.0001); GRT, 0.72 (P < 0.0001). In this study, the LPEER showed good accuracy for evaluating LPMS. These results justify further validation studies in independent populations.

Revista:
CHAOS (EEUU)
ISSN:
1054-1500

Año:
2018
Vol.:
28
N°:
7
Págs.:
075514

The main objective of this work is the study and analysis of non-linearities forced through oscillating magnetic fields in a conducting fluid where the instabilities are triggered due to magnetohydrodynamic forces. Different geometries have been studied and different surface patterns that break the symmetries have been observed. First, an InGaSn drop of fluid where the system breaks the azimuthal and radial symmetries depending on the volume is observed. Second, we extend the study to an InGaSn annular configuration where the presence of patterns opens the door to discuss the possibility to extend these results to other configurations as biological systems, where the conducting fluid is an electrolyte. This configuration has an added interest, as it has been proposed that the vertigoes triggered on patients in an MRI test could be generated by the interaction of the magnetic field with the electrolyte present in the inner ear.

Revista:
PHYSICAL REVIEW E
ISSN:
2470-0045

Año:
2017
Vol.:
95
N°:
1
Págs.:
013101

We evaluate the effect of the aspect ratio, i.e., the distance between the propellers H divided by the diameter D, on the slow dynamics of a von Karman swirling flow driven by two propellers in a closed cylinder. We use a cell with a fixed diameter D but where the distance between the propellers can be turned continuously and where the inertia from the propellers can also be changed using different gears. No change on the dynamics is observed when the momentum of inertia is modified. Some dramatic changes of the shear layer position are observed modifying the aspect ratio Gamma = H/D. A bifurcation of the shear layer position appears. Whereas for low Gamma the shear layer position has a smooth evolution when turning the asymmetry between the rotation frequency of the propellers, for high Gamma the transition becomes abrupt and a symmetry breaking appears. Secondly we observe that the spontaneous reversals with large residence times already observed in this experiment for Gamma = 1 [de la Torre and Burguete, Phys. Rev. Lett. 99, 054101 (2007)] exist only in a narrow window of aspect ratio. We show using an experimental study of the mean flow structure and a numerical approach based on a Langevin equation with colored noise that the shear layer position seems to be decided by the mean flow structure, whereas the reversals are linked to the spatial distribution of the turbulent fluctuations in the cell.

Revista:
MEDICAL DOSIMETRY
ISSN:
0958-3947

Año:
2017
Vol.:
42
N°:
4
Págs.:
282 - 288

This study aimed to describe the commissioning of small field size radiosurgery cones in a 6-MV flattening filter free (FFF) beam and report our measured values. Four radiosurgery cones of diameters 5, 10, 12.5, and 15¿mm supplied by Elekta Medical were commissioned in a 6-MV FFF beam from an Elekta Versa linear accelerator. The extraction of a reference signal for measuring small fields in scanning mode is challenging. A transmission chamber was attached to the lower part of the collimators and used for percentage depth dose (PDD) and profile measurements in scanning mode with a stereotactic diode. Tissue-maximum ratios (TMR) and output factors (OF) for all collimators were measured with a stereotactic diode (IBA). TMR and the OF for the largest collimator were also acquired on a polystyrene phantom with a microionization chamber of 0.016¿cm3 volume (PTW Freiburg PinPoint 3D). Measured TMR with diode and PinPoint microionization chamber agreed very well with differences smaller than 1% for depths below 20¿cm, except for the smaller collimator, for which differences were always smaller than 2%. Calculated TMR were significantly different (up to 7%) from measured TMR. OF measured with diode and chamber showed a difference of 3.5%. The use of a transmission chamber allowed the measurement of the small-field dosimetric properties with a simple setup. The commissioning of radiosurgery cones in FFF beams has been performed with essentially the same procedures and recommended ...

Revista:
PHYSICAL REVIEW E
ISSN:
2470-0045

Año:
2017
Vol.:
96
N°:
1
Págs.:
013103

We present the experimental analysis of the instabilities generated on a large drop of liquid metal by a time-dependent magnetic field. The study is done exploring the range of tiny values of the control parameter (the ratio between the Lorentz forces and inertia) avoiding nonlinear effects. Two different instabilities break the symmetries generating spatial patterns that appear without a threshold for some specific frequencies (up to the experimental precision) and have been observed for parameter values two orders of magnitude lower than in previously published experiments [J. Fluid Mech. 239, 383 (1992)]. One of the instabilities corresponds to a boundary condition oscillation that generates surface waves and breaks the azimuthal symmetry. The other corresponds to a parametric forcing through a modulation of the Lorentz force. The competition between these two mechanisms produces time-dependent patterns near codimension-2 points.

Autores:
Giraldo-Cadavid, L. F. (Autor de correspondencia); Burguete, Javier; Rueda, F.; et al.
Revista:
EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY
ISSN:
0937-4477

Año:
2017
Vol.:
274
N°:
7
Págs.:
2861 - 2870

BACKGROUND:
There are not reliable methods for measuring laryngo-pharyngeal mechano-sensitivity (LPMS). We aimed to determine the reliability of a new method for measuring LPMS using a new laryngo-pharyngeal esthesiometer (LPEER) in a prospective cohort of dysphagic stroke and non-dysphagic patients. The patients underwent clinical and endoscopic evaluations of swallowing (FESSST). The LPMS assessments consisted of measurements by an expert and a novel rater of the laryngeal-adductor reflex threshold (LART), cough reflex threshold (CRT) and gag reflex threshold (GRT) using the LPEER. We assessed the Bland-Altman limits of agreement, the intraclass correlation coefficients (ICCs) and Spearman correlation coefficients (SCCs). For the inter-rater comparisons, we contrasted the expert and novel raters. A total of 1608 measurements were obtained from 34 dysphagic stroke patients and 33 non-dysphagic patients. The intra-rater ICCs for all reflex thresholds were >0.90. The inter-rater ICCs were 0.87 for the LART, 0.79 for the CRT and 0.70 for the GRT. The intra-rater SCCs for all reflex thresholds were above 0.88 (P¿<¿0.0001). The inter-rater SCC were 0.80 for the LART, 0.79 for the CRT and 0.70 for the GRT (all P¿<¿0.0001). The Bland-Altman plots revealed good agreement for the LART and CRT and moderate agreement for the GRT. The median normal value was 0.14 mN for the LART, 4.4 mN for the CRT and 11.9 mN for the GRT. The median thresholds values in patients with aspiration were LART: 1.31 mN; CRT: 32.9 mN and GRT: 32.9 mN (all P¿<¿0.006 vs normal thresholds). The LPEER exhibited substantial to excellent intra- and inter-rater reliability.

Autores:
Giraldo-Cadavid, L. F. ; Agudelo-Otalora, L. M.; Burguete, Javier; et al.
Revista:
BIOMEDICAL ENGINEERING ONLINE
ISSN:
1475-925X

Año:
2016
Vol.:
15
N°:
1
Págs.:
52

BACKGROUND:
Laryngo-pharyngeal mechano-sensitivity (LPMS) is involved in dysphagia, sleep apnea, stroke, irritable larynx syndrome and cough hypersensitivity syndrome among other disorders. These conditions are associated with a wide range of airway reflex abnormalities. However, the current device for exploring LPMS is limited because it assesses only the laryngeal adductor reflex during fiber-optic endoscopic evaluations of swallowing and requires a high degree of expertise to obtain reliable results, introducing intrinsic expert variability and subjectivity.
METHODS:
We designed, developed and validated a new air-pulse laryngo-pharyngeal endoscopic esthesiometer with a built-in laser range-finder (LPEER) based on the evaluation and control of air-pulse variability determinants and on intrinsic observer variability and subjectivity determinants of the distance, angle and site of stimulus impact. The LPEER was designed to be capable of delivering precise and accurate stimuli with a wide range of intensities that can explore most laryngo-pharyngeal reflexes.
RESULTS:
We initially explored the potential factors affecting the reliability of LPMS tests and included these factors in a multiple linear regression model. The following factors significantly affected the precision and accuracy of the test (P < 0.001): the tube conducting the air-pulses, the supply pressure of the system, the duration of the air-pulses, and the distance and angle between the end of the tube conducti

Autores:
Machicoane, N. ; López-Caballero, M. ; Fiabane, L.; et al.

Revista:
PHYSICAL REVIEW E
ISSN:
2470-0045

Año:
2016
Vol.:
93
Págs.:
023118

The long time dynamics of large particles trapped in two inhomogeneous turbulent shear flows is studied experimentally. Both flows present a common feature, a shear region that separates two colliding circulations, but with different spatial symmetries and temporal behaviors. Because large particles are less and less sensitive to flow fluctuations as their size increases, we observe the emergence of a slow dynamics corresponding to back-and-forth motions between two attractors, and a super-slow regime synchronized with flow reversals when they exist. Such dynamics is substantially reproduced by a one dimensional stochastic model of an over-damped particle trapped in a two-well potential, forced by a colored noise. An extended model is also proposed that reproduces observed dynamics and trapping without potential barrier: the key ingredient is the ratio between the time scales of the noise correlation and the particle dynamics. A total agreement with experiments requires the introduction of spatially inhomogeneous fluctuations and a suited confinement strength.

Revista:
JOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS
ISSN:
1526-9914

Año:
2015
Vol.:
16
N°:
5
Págs.:
306 - 321

Revista:
PHILOSOPHICAL TRANSACTIONS OF THE ROYAL SOCIETY A-MATHEMATICAL PHYSICAL AND ENGINEERING SCIENCES
ISSN:
1364-503X

Año:
2015
Vol.:
373
N°:
2056
Págs.:
20150113

We compare the dynamics obtained in two intermediate aspect ratio (diameter over height) experiments. These systems have rotational symmetry and consist of fluid layers that are destabilized using two different methods. The first one is a classical Bénard Marangoni experiment, where the destabilizing forces, buoyancy and surface tension, are created by temperature gradients. The second system consists of a large drop of liquid metal destabilized using oscillating magnetic fields. In this configuration, the instability is generated by a radial Lorentz force acting on the conducting fluid. Although there are many important differences between the two configurations, the dynamics are quite similar: the patterns break the rotational symmetry, and different azimuthal and radial wavenumbers appear depending on the experimental control parameters. These patterns in most cases are stationary, but for some parameters they exhibit different dynamical behaviours: rotations, transitions between different solutions or cyclic connections between different patterns

Revista:
PHYSICS IN MEDICINE AND BIOLOGY
ISSN:
0031-9155

Año:
2015
Vol.:
61
N°:
1
Págs.:
50 - 66

This paper presents a method to obtain the pencil-beam kernels that characterize a megavoltage photon beam generated in a flattening filter free (FFF) linear accelerator (linac) by deconvolution from experimental measurements at different depths. The formalism is applied to perform independent dose calculations in modulated fields. In our previous work a formalism was developed for ideal flat fluences exiting the linac's head. That framework could not deal with spatially varying energy fluences, so any deviation from the ideal flat fluence was treated as a perturbation. The present work addresses the necessity of implementing an exact analysis where any spatially varying fluence can be used such as those encountered in FFF beams. A major improvement introduced here is to handle the actual fluence in the deconvolution procedure. We studied the uncertainties associated to the kernel derivation with this method. Several Kodak EDR2 radiographic films were irradiated with a 10 MV FFF photon beam from two linacs from different vendors, at the depths of 5, 10, 15, and 20cm in polystyrene (RW3 water-equivalent phantom, PTW Freiburg, Germany). The irradiation field was a 50mm diameter circular field, collimated with a lead block. The 3D kernel for a FFF beam was obtained by deconvolution using the Hankel transform. A correction on the low dose part of the kernel was performed to reproduce accurately the experimental output factors. Error uncertainty in the kernel derivation procedure was estimated to be within 0.2%. Eighteen modulated fields used clinically in different treatment localizations were irradiated at four measurement depths (total of fifty-four film measurements). Comparison through the gamma-index to their corresponding calculated absolute dose distributions showed a number of passing points (3%, 3mm) mostly above 99%. This new procedure is more reliable and robust than the previous one. Its ability to perform accurate independent dose calculations was demonstrated.

Revista:
MEDICAL PHYSICS
ISSN:
0094-2405

Año:
2014
Vol.:
41
N°:
1
Págs.:
12102-11

Revista:
THE EUROPEAN PHYSICAL JOURNAL. SPECIAL TOPICS (ONLINE)
ISSN:
1951-6401

Año:
2014
Vol.:
223
Págs.:
9 - 20

In this work we review localized structures appearing in thermo-convective experiments performed in extended (large "aspect ratio") fluid layers. After a brief general review (not exhaustive), we focus on some results obtained in pure fluids in a Benard-Marangoni system with non-homogeneous heating where some structures of this kind appear. The experimental results are compared in reference to the most classical observed in binary mixtures experiments or simulations. In the Benard-Marangoni experiment we present the stability diagram where localized structures appear and the typical situations where these local mechanisms have been studied experimentally. Some new experimental results are also included. The authors want to honor Prof. H. Brand in his 60th. birthday and to thank him for helpful discussions.

Revista:
PHYSICAL REVIEW E
ISSN:
1539-3755

Año:
2013
Vol.:
87
N°:
3
Págs.:
032902-1 - 032902-7

We show evidence of the frozen dynamics (Kibble-Zurek mechanism) at the transition one-dimensional (1D) front of an extended 1D array of convective oscillators that undergo a secondary subcritical bifurcation. Results correspond to a global synchronization process from nonlocal coupling between the oscillating units. The quenched dynamics exhibits defect trapping at the synchronization front according to the Kibble-Zurek mechanism, predicted for condensed matter systems. A stronger subcriticality prevents the fronts from freezing defects during the quenched transitions. A synchronization model of supercritical oscillating units is proposed to explain differentiation mechanisms in morphogenesis above a critical crossing rate when the frequency of the individual oscillators becomes coherent. The phases of such oscillators are spatially coupled through a Kuramoto-Battogtokh term that leads to the experimentally observed subcriticality. As a consequence, we show that the Kibble-Zurek mechanism overcomes non-locality of a geometrical network above a critical crossing rate.

Revista:
PHYSICAL REVIEW LETTERS
ISSN:
0031-9007

Año:
2013
Vol.:
110
N°:
2
Págs.:
124501

The existence of energy cascades as signatures of conserved magnitudes is one of the universal characteristics of turbulent flows. In homogeneous 3D turbulence, the energy conservation produces a direct cascade from large to small scales, although in 2D, it produces an inverse cascade pointing towards small wave numbers. In this Letter, we present the first evidence of an inverse cascade in a fully developed 3D experimental turbulent flow where the conserved magnitude is the angular momentum. Two counter-rotating flows collide in a central region where very large fluctuations are produced, generating a turbulent drag that transfers the external torque between different fluid layers.

Revista:
INTERNATIONAL JOURNAL OF BIFURCATION AND CHAOS
ISSN:
0218-1274

Año:
2012
Vol.:
22
N°:
7
Págs.:
1250165-1 - 1250165-10

We present new experimental results on the quenching dynamics of an extended thermo-convective system (a network array of approximately 100 convective oscillators) going through a secondary subcritical bifurcation. We characterize a dynamical phase transition through the nature of the domain walls (1D-fronts) that connect the basic multicellular pattern with the new oscillating one. Two different mechanisms of the relaxing dynamics at the threshold are characterized depending on the crossing rate mu = d epsilon/dt vertical bar(epsilon=0) of the quenched transition. From the analysis of fronts, we show that these mechanisms follow different correlation length scales xi similar to mu(-sigma). Below a critical value mu(c), a slow response dynamics yields a spatiotemporal coherent front with weak coupling between oscillators. Above mu(c), for rapid quenches, defects are trapped at the front with a strong coupling between oscillators, similarly to the Kibble-Zurek mechanism in quenched phase transitions. These defects, pinned to the fronts, yield a strong decay of the correlation length.

Revista:
PHYSICAL REVIEW E
ISSN:
1539-3755

Año:
2012
Vol.:
86
N°:
6
Págs.:
066303

We present numerical simulations of the kinematic induction equation in order to examine the dynamo efficiency of an axisymmetric von Karman-like flow subject to time-dependent nonaxisymmetric velocity perturbations. The numerical model is based on the setup of the French von Karman-sodium dynamo (VKS) and on the flow measurements from a water experiment conducted at the University of Navarra in Pamplona, Spain. The principal experimental observations that are modeled in our simulations are nonaxisymmetric vortexlike structures which perform an azimuthal drift motion in the equatorial plane. Our simulations show that the interactions of these periodic flow perturbations with the fundamental drift of the magnetic eigenmode (including the special case of nondrifting fields) essentially determine the temporal behavior of the dynamo state. We find two distinct regimes of dynamo action that depend on the (prescribed) drift frequency of an (m=2) vortexlike flow perturbation. For comparatively slowly drifting vortices we observe a narrow window with enhanced growth rates and a drift of the magnetic eigenmode that is synchronized with the perturbation drift. The resonance-like enhancement of the growth rates takes place when the vortex drift frequency roughly equals the drift frequency of the magnetic eigenmode in the unperturbed system. Outside of this small window, the field generation is hampered compared to the unperturbed case, and the field amplitude of the magnetic eigenmode is modulated with approximately twice the vortex drift frequency. The abrupt transition between the resonant regime and the modulated regime is identified as a spectral exceptional point where eigenvalues (growth rates and frequencies) and eigenfunctions of two previously independent modes collapse. In the actual configuration the drift frequencies of the velocity perturbations that are observed in the water experiment are much larger than the fundamental drift frequency of the magnetic eigenmode that is obtained from our numerical simulations. Hence, we conclude that the fulfillment of the resonance condition might be unlikely in present day dynamo experiments. However, a possibility to increase the dynamo efficiency in the VKS experiment might be realized by an application of holes or fingers on the outer boundary in the equatorial plane. These mechanical distortions provoke an anchorage of the vortices at fixed positions thus allowing an adjustment of the temporal behavior of the nonaxisymmetric flow perturbations.

Revista:
Magnetohydrodynamics
ISSN:
0024-998X

Año:
2012
Vol.:
48
N°:
1
Págs.:
69 - 75

In this work, we analyze recent results concerning the instabilities created in a layer of liquid metal by the action of time-dependent magnetic fields. The experimental setup allows the characterization of different patterns very close to the threshold. For very low frequencies of the forcing field, the axisymmetric fluid layer destabilizes with different azimuthal wavenumbers. An improved analysis allows the characterization of different patterns for interaction parameter values as low a

Revista:
INTERNATIONAL JOURNAL OF COMPLEX SYSTEMS IN SCIENCE
ISSN:
2174-6036

Año:
2011
Vol.:
1
Págs.:
60 - 64

Revista:
MEDICAL PHYSICS
ISSN:
0094-2405

Año:
2010
Vol.:
37
N°:
9
Págs.:
4634 - 4642

Purpose: This article presents an improved pencil-beam dose calculation formalism based on an experimental kernel obtained by deconvolution. The new algorithm makes it possible to calculate the absorbed dose for all field sizes.
Methods: The authors have enhanced their previous work [J. D. Azcona and J. Burguete, Med. Phys. 35, 248-259 (2008)] by correcting the kernel tail representing the contribution to the absorbed dose far from the photon interaction point. The correction was performed by comparing the calculated and measured output factors. Dose distributions and absolute dose values calculated using the new formalism have been compared to measurements. The agreement between calculated and measured dose distributions was evaluated according to the gamma-index criteria. In addition, 35 individual intensity-modulated radiation therapy (IMRT) fields were calculated and measured in polystyrene using an ionization chamber. Furthermore, a series of 541 IMRT fields was calculated using the algorithm proposed here and using a commercial IMRT optimization and calculation software package. Comparisons were made between the calculations at single points located at the isocenter for all the beams, as well as between beams grouped by anatomic location.
Results: The percentage of points passing the gamma-index criteria (3%, 3 mm) when comparing calculated and measured dose distributions is generally greater than 99% for the cases studied. The agreement between the calculations and the experimental measurements generally lies in the +/- 2% interval for single points, with a mean value of 0.2%. The agreement between calculations using the proposed algorithm and using a commercial treatment planning system is also between +/- 5%.
Conclusions: An improved algorithm based on an experimental pencil-beam kernel obtained by deconvolution has been developed. It has been validated clinically and promises to be a valuable tool for IMRT quality assurance as an independent calculation system for monitor units and dose distributions. An important point is that the algorithm presented here uses an experimental kernel, which is therefore independent of Monte-Carlo-calculated kernels.

Revista:
International Journal of Bifurcation and Chaos
ISSN:
0218-1274

Año:
2010
Vol.:
20
N°:
3
Págs.:
835 - 847

In a quasi-1D thermal convective system consisting of a large array of nonlinearly coupled oscillators, clustering is the way to achieve a regime of mostly antiphase synchronized oscillators. This regime is characterized by a spatiotemporal doubling of traveling modes. As the dynamics is explored beyond a spatiotemporal chaos regime (STC) with weak coupling, new interacting modes emerge through a supercritical bifurcation. In this new regime, the system exhibits coherent subsystems of antiphase synchronized oscillators, which are stationary clusters following a spatiotemporal beating phenomena (ZZ regime). This regime is the result of a stronger coupling. We show from a phase mismatch model applied to each oscillator, that these phase coherent domains undergo a global phase instability, meanwhile the interactions between oscillators become nonlocal. For each value of the control parameter we find out the time-varying topology (link matrix) from the contact interactions between oscillators. The new characteristic spatiotemporal scales are extracted from the antiphase correlations at the time intervals defined by the link matrix. The interpretation of these experimental results contributes to widen the understanding of other complex systems exhibiting similar phase chaotic dynamics in 2D and 3D