scholarly journals 721 Imaging for Suspected Bowel Obstruction in Pennine Acute Trust (PAT): A Comparison with the National Audit of Small Bowel Obstruction’s (NASBO) recommendations

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
K Foster ◽  
J Shah ◽  
S Bandyopadhyay ◽  
C Waugh ◽  
S Fawzy ◽  
...  
Keyword(s):  
Bowel Obstruction ◽  
National Audit ◽  
X Ray ◽  
Retrospective Audit ◽  
Computed Topography ◽  
Initial Imaging ◽  
The Cost ◽  
Acute Trust ◽  
Unnecessary Radiation ◽  
Rule Out

Abstract Background NASBO recommends Computed Topography (CT) over plain abdominal X-ray (AXR) for the investigation of bowel obstruction (BO). AXR is routinely used within PAT for investigation of BO which may be exposing patients to unnecessary radiation and adding unnecessary cost to the service. Method A retrospective audit collected data on patients with CT confirmed BO between July 2019 and February 2020. This looked at the percentage of patients who had both CT and AXR to investigate BO. The cost of these AXRs and the percentage of these AXRs that were normal were also calculated. Results A search identified 141 patients with CT proven BO. 81/141(57.4%) patients had both AXR and CT as a part of their initial investigations. Of those patients 26/81(32.1%) had no AXR features suggestive of BO. Only 12/81(14.8%) of those patients had serial AXRs following initial imaging. The cost for one AXR is £34.15 which means £2766.15 was spent on potentially unnecessary AXRs within this period. Conclusions PAT is performing potentially unnecessary AXRs which is exposing patients to unnecessary radiation and costing the trust. Plain AXRs do not rule out BO. We have recommended an investigation flowchart to PAT A&E departments to reduce unnecessary AXRs being performed.

scholarly journals Small Bowel Obstruction with Perforation Secondary to PillCam

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Toan Pham ◽  
Ashley Miller ◽  
Domenic La Paglia ◽  
Alvin Cham
Keyword(s):  
Small Bowel ◽  
Iron Deficiency ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Iron Deficiency Anaemia ◽  
Wireless Capsule Endoscopy ◽  
Deficiency Anaemia ◽  
X Ray ◽  
Computed Topography ◽  
Wireless Capsule

We present a case of a 63-year-old female who presented with small bowel obstruction and perforation secondary to a retained PillCam®. She initially presented with iron-deficiency anaemia (haemoglobin 44 g/L, ferritin 190 mcg/L). After unremarkable upper and lower gastrointestinal endoscopies and biopsies, she was referred for wireless capsule endoscopy (WCE). Four days afterwards she re-presented with small bowel obstruction and perforation related to the PillCam, which was confirmed on X-ray, on computed topography (CT), and at laparotomy.

Phase configuration, nanostructure, and mechanical behaviors in Ti-B-C-N thin films

2009 ◽  
Vol 24 (8) ◽  
pp. 2520-2527 ◽  
Author(s):  
Yonghao Lu ◽  
Junping Wang ◽  
Yaogen Shen ◽  
Dongbai Sun
Keyword(s):  
Thin Films ◽  
Photoelectron Spectroscopy ◽  
Solid Solution Hardening ◽  
Mechanical Behaviors ◽  
Additional Increase ◽  
N Content ◽  
X Ray ◽  
Nanocomposite Thin Films ◽  
The Cost ◽  
Nano Grains

A series of Ti-B-C-N thin films were deposited on Si (100) at 500 °C by incorporation of different amounts of N into Ti-B-C using reactive unbalanced dc magnetron sputtering in an Ar-N2 gas mixture. The effect of N content on phase configuration, nanostructure evolution, and mechanical behaviors was studied by x-ray diffraction, x-ray photoelectron spectroscopy, Raman spectroscopy, high-resolution transmission electron microscopy, and microindentation. It was found that the pure Ti-B-C was two-phased quasi-amorphous thin films comprising TiCx and TiB2. Incorporation of a small amount of N not only dissolved into TiCx but also promoted growth of TiCx nano-grains. As a result, nanocomposite thin films of nanocrystalline (nc-) TiCx(Ny) (x + y < 1) embedded into amorphous (a-) TiB2 were observed until nitrogen fully filled all carbon vacancy lattice (at that time x + y = 1). Additional increase of N content promoted formation of a-BN at the cost of TiB2, which produced nanocomposite thin films of nc-Ti(Cx,N1-x) embedded into a-(TiB2, BN). Formation of BN also decreased nanocrystalline size. Both microhardness and elastic modulus values were increased with an increase of N content and got their maximums at nanocomposite thin films consisting of nc-Ti(Cx,N1-x) and a-TiB2. Both values were decreased after formation of BN. Residual compressive stress value was successively decreased with an increase of N content. Enhancement of hardness was attributed to formation of nanocomposite structure and solid solution hardening.

A normal chest X-ray does not rule out the patient’s version

2021 ◽  
Author(s):  
Elena Forcén ◽  
María José Bernabé ◽  
Roberto Larrosa-Barrero
Keyword(s):  
X Ray ◽  
Normal Chest ◽  
Chest X Ray ◽  
Rule Out

scholarly journals Changing mass liner system for generation of soft X rays

1997 ◽  
Vol 15 (1) ◽  
pp. 133-138 ◽  
Author(s):  
A.M. Buyko ◽  
O.M. Burenkov ◽  
V.K. Chernyshev ◽  
S.F. Garanin ◽  
S.D. Kuznetsov ◽  
...  
Keyword(s):  
Current Pulse ◽  
High Precision ◽  
X Rays ◽  
Stored Energy ◽  
Single Experiment ◽  
X Ray ◽  
Liner System ◽  
The Cost

Powerful pulse installations are usually used to produce large yields of X-ray radiation. With an increase of the stored energy up to 100 MJ, the costof a single experiment on these installations becomes comparable to the cost of a shot with explosive magnetic generators (EMG), according to expert estimates. The physical scheme of a device with a changeable mass liner forlarge soft X-ray (in the range of 0.3 to 0.5 keV) yields eneration is investigated. The scheme investigated is substantially free from difficulties connected with high precision liners and fast switches for current pulse sharpening.

EP.FRI.390 Improving care for patients with acute bowel obstruction: A closed loop audit

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Benjamin Clayphan ◽  
Anna Fairclough ◽  
Jeff Lim ◽  
Roderick Alexander
Keyword(s):  
Ct Scan ◽  
Patient Outcomes ◽  
Bowel Obstruction ◽  
Care Pathway ◽  
Imaging Modality ◽  
Ct Scans ◽  
Abdominal Ct ◽  
Retrospective Audit ◽  
Raising Awareness ◽  
Time To Diagnosis

Abstract Aims Acute Bowel Obstruction (ABO) accounts for 10% of emergency surgical admissions and when surgery is required mortality can exceed 10%. Early diagnosis is associated with improved patient outcomes and timely acquisition of abdominal CT scans can help prevent delays. The NCEPOD 2020 report on ABO identified ‘delays in imaging’ as a key area for improvement in the care of these patients, with these delays being exacerbated if an abdominal X-ray (AXR) was performed as well as an abdominal CT. This study looks at ways to expedite the diagnosis of patients presenting with ABO.   Methods A retrospective audit of 77 patients admitted from A&E or SAU with ABO from April 2019 to February 2020 was conducted. Imaging modality, time-to-CT scan and time-to-diagnosis was recorded. Results and recommendations were presented locally and an evidence based ABO care pathway was implemented and publicised. 20 patients were audited prospectively, post care pathway implementation.  Results 70.1% of patients from the initial audit received a CT-scan and 42% of these patients received an AXR before their eventual CT-scan. The average wait for a definitive radiological diagnosis was 27.8hr. After implementation of the pathway only 18% of patients audited received both modes of imaging and the average time to diagnosis has been reduced to 10.7hr.  Conclusions Raising awareness of the appropriate and timely use of CT-scans in the diagnosis of ABO has reduced the number of concomitant AXR for these patients, expediting the making of a definitive diagnosis and improving patient outcomes. 

Develop artificial neural network numerical modeling to study fluid flow and heat transfer of dispersed nanoparticles through base liquid

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Tawfeeq Abdullah Alkanhal
Keyword(s):  
Heat Transfer ◽  
Hybrid Nanofluid ◽  
X Ray Diffraction ◽  
Content Type ◽  
X Ray ◽  
Flow And Heat Transfer ◽  
Heat Transfer Capacity ◽  
The Cost ◽  
Heat Transfers ◽  
Base Liquid

Purpose This paper aims to disperse the silicon dioxide in water (as the mono nanofluid [MN]) and then, carbon nanotube (CNT)-silica composite in water (as the hybrid nanofluid [HN]). Design/methodology/approach Nanofluids have gained lots of attention through the recent years. Due to their usage in the industries and also medical applications, they have high protentional to be studied in different aspects. The most common study for the nanofluids is to understand the heat transfer capacity for each material in each fluid. These material(s) or fluid(s) can be one (mono nanofluid) or more than one (hybrid nanofluid). Findings The mixture of two solids is to assess the unique properties of each material and also to decrease the cost of experiments. The heat transfers for both MN and HN were measured at volume fractions up to 1.0%, and temperatures up to 50°C. Also, the heat transfers were compared. By more CNT, thermal conductivity was enhanced about 17.39% (from 12.42% of MN to 29.81% of HN). Originality/value X-Ray diffraction and field emission scanning electron microscope (FESEM) were examined for mono solids and the composite. After the experimental study, for MN and HN, four novel correlations calculated.

Comparative Study of Time-Dependent PAES and XPS on a Ni/Pd Surface

2017 ◽  
Vol 373 ◽  
pp. 313-316 ◽  
Author(s):  
Samantha Zimnik ◽  
Christian Piochacz ◽  
Sebastian Vohburger ◽  
Christoph Hugenschmidt
Keyword(s):  
Photoelectron Spectroscopy ◽  
Electron Spectroscopy ◽  
Auger Electron ◽  
Structural Changes ◽  
Time Dependent ◽  
Xps Analysis ◽  
Time Constants ◽  
X Ray ◽  
Residual Gas ◽  
Rule Out

We report on time-dependent Positron annihilation induced Auger Electron Spectroscopy (PAES) study on 0.5 monolayers (ML) Ni on polycrystalline Pd accompanied by complementary X-ray induced Photoelectron Spectroscopy (XPS). The normalized PAES spectra showed a significant decrease in the Ni intensity and an increase in the Pd intensity as a function of time. To rule out varying influence on the elements e.g. from surface contaminates due to the residual gas, a time-dependent XPS analysis was performed on pure Ni and Pd as well as to analyze the main contaminants C and O. The O fraction was found to be constant within the measurement time and the time constants for C significantly differ from those of Ni and Pd in the PAES data. Consequently, it was concluded that the PAES data show a superposition of C contamination and structural changes at the surface of Ni/Pd.

scholarly journals Evaluation of Shell-Derived Calcium Oxide Catalysts for the Production of Biodiesel Esters from Cooking Oils

2021 ◽  
pp. 20-27
Author(s):  
Ngee Sing Chong ◽  
Francis Uchenna Okejiri ◽  
Saidi Abdulramoni ◽  
Shruthi Perna ◽  
Beng Guat Ooi
Keyword(s):  
Calcium Oxide ◽  
Waste Cooking Oil ◽  
Biodiesel Production ◽  
Molar Ratio ◽  
X Ray ◽  
Cooking Oil ◽  
Biodiesel Synthesis ◽  
Cooking Oils ◽  
The Cost ◽  
Percentage Conversion

Due to the high cost of feedstock and catalyst in biodiesel production, the viability of the biodiesel industry has been dependent on government subsidies or tax incentives. In order to reduce the cost of production, food wastes including eggshells and oyster shells have been used to prepare calcium oxide (CaO) catalysts for the transesterification reaction of biodiesel synthesis. The shells were calcined at 1000 °C for 4 hours to obtain CaO powders which were investigated as catalysts for the transesterification of waste cooking oil. The catalysts were characterized by Fourier Transform infrared (FTIR) spectroscopy, thermogravimetric analysis (TGA), X-ray powder diffraction (XRD), and X-ray fluorescence (XRF) spectroscopy. Reaction parameters such as methanol-to-oil molar ratio, CaO catalyst concentration, and reaction time were evaluated and optimized for the percentage conversion of cooking oil to biodiesel esters. The oyster-based CaO showed better catalytic activity when compared to the eggshell-based CaO under the same set of reaction conditions.

scholarly journals Comparison of methods for sensitivity correction in Talbot–Lau computed tomography

2021 ◽  
Author(s):  
Lina Felsner ◽  
Philipp Roser ◽  
Andreas Maier ◽  
Christian Riess
Keyword(s):  
Iterative Reconstruction ◽  
Phase Contrast ◽  
Reconstruction Algorithm ◽  
General Purpose ◽  
Contrast Imaging ◽  
X Ray ◽  
Iterative Reconstruction Algorithm ◽  
Inhomogeneous Phase ◽  
The Cost ◽  
Residual Errors

Abstract Purpose In Talbot–Lau X-ray phase contrast imaging, the measured phase value depends on the position of the object in the measurement setup. When imaging large objects, this may lead to inhomogeneous phase contributions within the object. These inhomogeneities introduce artifacts in tomographic reconstructions of the object. Methods In this work, we compare recently proposed approaches to correct such reconstruction artifacts. We compare an iterative reconstruction algorithm, a known operator network and a U-net. The methods are qualitatively and quantitatively compared on the Shepp–Logan phantom and on the anatomy of a human abdomen. We also perform a dedicated experiment on the noise behavior of the methods. Results All methods were able to reduce the specific artifacts in the reconstructions for the simulated and virtual real anatomy data. The results show method-specific residual errors that are indicative for the inherently different correction approaches. While all methods were able to correct the artifacts, we report a different noise behavior. Conclusion The iterative reconstruction performs very well, but at the cost of a high runtime. The known operator network shows consistently a very competitive performance. The U-net performs slightly worse, but has the benefit that it is a general-purpose network that does not require special application knowledge.

scholarly journals Is Routine Chest X-ray After Ultrasound and Intracavitary Electrocardiogram Guided Peripherally Inserted Central Catheter Insertion Choosing Wisely? A Population-based Retrospective Study of 2857 Patients With Cancer

2021 ◽  
Author(s):  
Yan-Fen Shen ◽  
Jing Dong ◽  
Xin-Peng Wang ◽  
Xiao-Zheng Wang ◽  
Yuan-Yuan Zheng ◽  
...  
Keyword(s):  
Venous Access ◽  
Population Based ◽  
X Ray ◽  
Patients With Cancer ◽  
Potential Risk Factors ◽  
Catheter Tip ◽  
Chest X Ray ◽  
Clinical Records ◽  
The Cost ◽  
Routine Chest

Abstract Background: In China, routine chest X-ray (CXR) is generally required for peripherally inserted central venous catheters (PICC) to determine the position of the catheter tip. The aim of this study is to assess the value of a routine post-procedural CXR in the era of ultrasound and intracavitary electrocardiography(IC-ECG) -guided PICC insertion. Methods: A retrospective population-based cohort study was conducted to review the clinical records of all patients who had PICCs in the Venous Access Center of Beijing Cancer Hospital between January 1, 2019 and June 30, 2020. The incidence of catheter misplacement after insertion was measured. A logistic regression analysis was performed to examine potential risk factors associated with PICC-related complications and a cost analysis to assess the economic impact of the use of CXR.Results: There were 2,857 samples from 2,647 patients included. The overall incidence of intraoperative and postoperative catheter misplacement was 7.4% (n=210) and 0.67% (n=19), respectively. There was a high risk of postoperative catheter misplacement when the left-arm was chosen for placement (OR: 10.478; 95% CI: 3.467-31.670; p<0.001). The cost of performing CXR for screening of PICC-related complications was $23,808 per year, and that of using CXR to diagnose one case of catheter misplacement was $1253.Conclusion: This study confirms that misplacement of PICCs guided by ultrasound and IC-ECG is rare and that postoperative CXR is very costly. In our setting, routine postoperative CXR is unnecessary and not a wise option.

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