scholarly journals 1700 Using Intra-Operative Imaging as A Tool to Provide Peer Review, Scoring, Feedback and Education for Hand and Wrist Trauma Cases - A Quality Improvement Project

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Smith ◽  
A Thompson ◽  
P Stanier ◽  
J Rooker ◽  
I Lowdon
Keyword(s):  
Final Report ◽  
X Rays ◽  
Improvement Project ◽  
X Ray ◽  
Constructive Feedback ◽  
Wrist Trauma ◽  
Specific Feedback ◽  
The Mean ◽  
Mean Time

Abstract Aim To improve the efficiency of intraoperative hand trauma x-ray review, introduce a scoring system for quality of fixation achieved and use this as an education and feedback tool for trainees. Method A large QI project in 2019 demonstrated that intra-operative images taken using the mini C-arm were not being reviewed. In March 2020 the first QI cycle introduced an Access database to ensure that as cases were removed from the trauma board, they were added to a review list. Each x-ray was also scored in the trauma meeting (good, acceptable, poor) to assess the radiographic quality of fixation. The second QI cycle identified the named surgeon for each case, allowing surgeon specific feedback. Finally, we trained all qualified users of the mini C-arm to upload their own images after each case, reducing the mean time to upload. Results This QI project has improved the review rate of mini C-arm images from 30% to 100% and every x-ray is scored. The mean time to review images has reduced from 4 days to less than 24 hours. All trainees can access their scores for imaged hand and wrist trauma and receive written constructive feedback. Conclusions This project ensures appropriate and prompt review of all hand and wrist trauma cases allowing early identification of any concerns. All x-rays are scored, and this process acts as an educational prompt in the trauma meeting. A final report can be printed for each trainee which can be uploaded to their portfolio to document their surgical progress.

scholarly journals EP.FRI.700 NCEPOD Acute Bowel Obstruction Report 2019:  A pilot study for review of quality of care provided to patients with acute bowel obstruction in a Surgical Emergency Unit

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Abhishek Dey ◽  
Antons Rudzats ◽  
Jeffrey Gilmour
Keyword(s):  
Bowel Obstruction ◽  
Retrospective Case ◽  
X Ray ◽  
Surgical Emergencies ◽  
The Mean ◽  
Pathway Of Care ◽  
In Transit ◽  
Mean Time ◽  
Larger Sample

Abstract Aims Acute bowel obstruction is one of the commonest surgical emergencies posing various diagnostic and therapeutic challenges. A review of care titled ‘Delay in Transit’ by NCEPOD delineated inadequacies in the pathway of care for patients with acute bowel obstruction nationwide, highlighting areas of improvement. This audit aims to assess key elements of management pathway in our centre and compare it to national statistics.  Methods A retrospective case note analysis was conducted for 24 randomly selected patients, aged above 15 years, admitted with a clinical diagnosis of acute bowel obstruction between December, 2018-December, 2019. Results Summary of some of NCEPOD recommendations, national and local performance The mean time to diagnosis was 8.5±6.6 hours, which was delayed if abdominal X-ray preceded the CT. Poor consultant review times may reflect failure to capture on records. Conclusion The management pathway, although faring well in some criteria, has scope for further improvement. Plans for an audit with a larger sample size will be implemented along with an enhanced pathway.

scholarly journals An Evaluation of Cellular Neural Networks for the Automatic Identification of Cephalometric Landmarks on Digital Images

2009 ◽  
Vol 2009 ◽  
pp. 1-12 ◽  
Author(s):  
Rosalia Leonardi ◽  
Daniela Giordano ◽  
Francesco Maiorana
Keyword(s):  
Neural Networks ◽  
Cellular Neural Networks ◽  
Automatic Identification ◽  
Cephalometric Analysis ◽  
X Rays ◽  
X Ray ◽  
Automatic Location ◽  
Landmark Identification ◽  
The Mean ◽  
Analogue To Digital

Several efforts have been made to completely automate cephalometric analysis by automatic landmark search. However, accuracy obtained was worse than manual identification in every study. The analogue-to-digital conversion of X-ray has been claimed to be the main problem. Therefore the aim of this investigation was to evaluate the accuracy of the Cellular Neural Networks approach for automatic location of cephalometric landmarks on softcopy of direct digital cephalometric X-rays. Forty-one, direct-digital lateral cephalometric radiographs were obtained by a Siemens Orthophos DS Ceph and were used in this study and 10 landmarks (N, A Point, Ba, Po, Pt, B Point, Pg, PM, UIE, LIE) were the object of automatic landmark identification. The mean errors and standard deviations from the best estimate of cephalometric points were calculated for each landmark. Differences in the mean errors of automatic and manual landmarking were compared with a 1-way analysis of variance. The analyses indicated that the differences were very small, and they were found at most within 0.59 mm. Furthermore, only few of these differences were statistically significant, but differences were so small to be in most instances clinically meaningless. Therefore the use of X-ray files with respect to scanned X-ray improved landmark accuracy of automatic detection. Investigations on softcopy of digital cephalometric X-rays, to search more landmarks in order to enable a complete automatic cephalometric analysis, are strongly encouraged.

scholarly journals Исследование этапов превращения кремния в карбид кремния в процессе атомного замещения методами полного внешнего отражения рентгеновских лучей и рентгеновской дифрактомерии

2022 ◽  
Vol 64 (3) ◽  
pp. 326
Author(s):  
С.А. Кукушкин ◽  
А.В. Осипов ◽  
Е.В. Осипова ◽  
В.М. Стожаров
Keyword(s):  
Structural Quality ◽  
Total External Reflection ◽  
X Rays ◽  
Reflection Method ◽  
X Ray Diffraction ◽  
Modified Technique ◽  
Substitution Method ◽  
X Ray ◽  
Sic Films

X-ray diffraction and total external reflection of X-rays (X-ray reflectometry) methods were used to study the successive stages of synthesis of epitaxial SiC films on Si (100) X-ray diffraction and total external X-ray reflection (XRD) methods were used to study successive stages of synthesis of epitaxial SiC films on Si (100) surfaces, (110) and (111) surfaces by the atom substitution method. The data on the transformation evolution of (100) surfaces were studied, (110) and (111) Si, into SiC surfaces. A comparative analysis of the X-ray structural quality of the SiC layers grown on Si by the atom substitution method with the quality of SiC layers grown by Advanced Epi by the standard CVD method. A modified technique for the total outer X-ray reflection method, based on measurements of the intensity of the reflected X-rays using a special parabolic mirror. It is shown that the method of total external reflection method makes it possible to obtain important information about the degree of surface roughness of SiC layers, the evolution of their crystal structure and plasmon energy in the process of Si to SiC conversion.

scholarly journals Assessment of aerobic bacteria killing activity of low energry X-rays in potatoes

2021 ◽  
Vol 5 (3) ◽  
pp. first
Author(s):  
Nguyễn An Sơn ◽  
Hai Van Cao ◽  
Trieu Ngoc Le ◽  
Giang Van Nguyen ◽  
Ha Thi Nguyet Nguyen ◽  
...  
Keyword(s):  
Nutritional Value ◽  
Agricultural Products ◽  
Food Irradiation ◽  
Aerobic Bacteria ◽  
X Rays ◽  
X Ray ◽  
Long Time ◽  
Bacteria Killing ◽  
Cover Up

Potato is one of popular agricultural products grown and used in the world with high effective economic and nutritional value. In potatoes, there are always have some harmful bacteria species due to the sources of exposure from the seed, soil as well as the post-harvest environment which make deceasing the quality and quantity of potatoes. Usually, irradiation with gamma isotope sources is used in food irradiation, however, the disadvantage of the gamma source is the safe shielding reason even without the use of irradiation. Nowadays, X-ray irradiation in food is one of the methods interest to storage in long time. The first advantage of X-ray irradiation is that most of aerobic bacteria in food is killed, but does it not change the quality of the potato. Moreever, the advantage of an X-ray generator is that it does not have to cover up radiation when not in use. In this study, we have used low energy X-rays emitted from X-ray generator MBR-1618R-BE (Hitachi -Japan) to study the ability to kill aerobic bacteria in potatoes grown in Da Lat. After preparation, potato samples were irradiated at doses ranging from 50 Gy to 5000 Gy. The irradiated samples were homogenized and inoculated on Nutrient Agar and incubated at 370C in an incubator to check the changes of aerobic bacteria. The research showed that the number of aerobic bacteria decreased dramatically to a dose of 1000 Gy (the aerobic bacteria was only less than 0,6%), despite a sharp increase in the dose of irradiation, this number decreased a little. The results also showed that D10 dose was 471,34 Gy.

scholarly journals Epidemiological and clinical characteristics of 671 COVID-19 patients in Henan Province, China

2020 ◽  
Vol 49 (4) ◽  
pp. 1085-1095
Author(s):  
Yifei Nie ◽  
Jitian Li ◽  
Xueyong Huang ◽  
Wanshen Guo ◽  
Xiaobai Zhang ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Case Series ◽  
Henan Province ◽  
X Rays ◽  
Illness Onset ◽  
Medical Disorders ◽  
History Of ◽  
The Mean ◽  
Wet Market ◽  
Mean Time

Abstract Background Despite many reports on the characteristics of coronavirus disease 2019 (COVID-19) in Wuhan, China, relatively little is known about the transmission features of COVID-19 outside Wuhan, especially at the provincial level. Methods We collected epidemiological, demographic, clinical, laboratory, radiological and occupation information, along with contact history, of 671 patients with laboratory-confirmed COVID-19 reported from January 23 to February 5, 2020, in Henan province, China. We described characteristics of these cases, compared the diagnostic accuracy and features of blood testing, computed tomography (CT) scans and X-rays, and analysed SARS-CoV-2 transmission sources and patients’ occupations in Henan province. Results The mean age of patients in this case series was 43 years, 56.2% were male and 22.4% had coexisting medical disorders. The death rate was 0.3%. Fourteen patients did not show any symptoms. Lymphocyte percentage was associated with disease severity (χ2 = 6.71, P = 0.035) but had a large variation in each sample group. The mean time from illness onset to diagnosis was 5.6 days. A total of 330 patients had ever lived in or visited Wuhan, 150 had contact with confirmed cases, 323 had been to a hospital and 119 had been to a wet market. There were 33 patients who did not have a traceable transmission source, with 21.2% of these being farmers and 15.2% being workmen. Conclusions Lymphocyte percentage was a sign of severe COVID-19 in general but was not a good diagnostic index. Longer time from illness onset to diagnosis was associated with higher COVID-19 severity, older age, higher likelihood of having coexisting cardiovascular diseases including hypertension, and being male. Farming was found to be a high-risk occupation in Henan province, China.

Isoelastic Cementless Total Hip Replacement in Rheumatoid Arthritis. Long-Term Results

1992 ◽  
Vol 2 (2) ◽  
pp. 43-46
Author(s):  
U. Fusco ◽  
R. Capelli ◽  
A. Avai ◽  
M. Gerundini ◽  
L. Colombini ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Hip Replacement ◽  
The Other ◽  
Long Term Results ◽  
X Rays ◽  
X Ray ◽  
The Mean ◽  
Cementless Total Hip Replacement

Between 1980 and 1987 we have implanted 46 isoelastic cementless THR in 40 patients affected with rheumatoid arthritis. We have reviewed 38 hips clinically and by X-ray. The mean follow-up was 8,5 years. Harris hip scores ranged from 30.6 preoperatively to 73,4 post-operatively when reviewed. While on the other hand Merle D'Aubigné hip scores ranged from 7,06 pre-operatively to 15,59 post-operatively. All patients have been satisfied, and X-rays showed an improvement for both Charnely and Gruen X-ray score.

scholarly journals X-Rays from Wolf-Rayet Stars Observed by the Einstein Observatory

1982 ◽  
Vol 99 ◽  
pp. 589-595
Author(s):  
W. T. Sanders ◽  
J. P. Cassinelli ◽  
K. A. van der Hucht
Keyword(s):  
Mean Value ◽  
Spectral Energy ◽  
X Rays ◽  
X Ray ◽  
Total Luminosity ◽  
Hydrogen Emission Lines ◽  
Flux Level ◽  
The Mean ◽  
Einstein Observatory ◽  
Thin Source

Preliminary results of three X-ray surveys are presented. Out of a sample of 20 stars, X-rays were detected from four Wolf-Rayet stars and two 08f+ stars. The detected stars have about the same mean value as 0 stars for the X-ray to total luminosity ratio, LX/L = 10−7, but exhibit a much larger variation about the mean. The spectral energy distributions are also found to be like that of 0 stars in that they do not exhibit large attenuation of X-rays softer than 1 keV. This indicates that for both the 0 stars and WR stars much of the X-ray emission is coming from hot wisps or shocks in the outer regions of the winds and not from a thin source at the base of the wind. The general spectral shape and flux level place severe restrictions on models that attribute the lack of hydrogen emission lines to extremely high temperatures of the gas in the wind.

Quality of febrile neutropenia management in a regional cancer center emergency department.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 104-104
Author(s):  
Priyanka Kapil ◽  
Katherine Enright
Keyword(s):  
Emergency Department ◽  
Febrile Neutropenia ◽  
Antibiotic Therapy ◽  
Cancer Site ◽  
Cancer Center ◽  
Time To Initiation ◽  
The Mean ◽  
The Impact ◽  
Mean Time

104 Background: ASCO's current guidelines for febrile neutropenia (FN) management support antibiotic administration within one hour of presentation to the emergency department (ED). Prompt initiation of antibiotic therapy is vital to decrease the likelihood of adverse outcomes. Many studies, however, have reported significant delays in antibiotic initiation with mean wait times far exceeding ASCO's guidelines. We aimed to assess the quality of FN management at a regional cancer centre ED. Methods: Patients undergoing chemotherapy who visited the ED at the Peel Regional Cancer Center in Ontario, Canada between 04/12 - 03/13 were identified using electronic medical records. Patients were excluded if there was no record of chemotherapy delivery within 30 days prior to ED visit. ICD-10 codes and chart data were used to identify patients who had presented for either fever or infection. The primary outcome measures were three major quality of health indicators; time to assessment by a physician, Canadian Triage and Acuity Scale (CTAS) score, and time to initiation of intravenous antibiotics. Results: In total 239 records were included in the analysis. CTAS score was concordant with recommendation for FN (level 1-2) in 85% of patients and did not vary based on primary cancer site (p = 0.17). The mean time to physician assessment was 97.2 min and the mean time to initiation of IV antibiotics was 194.7 min. Overall, 14.6% of patients received their first dose of antibiotic therapy within the recommended 1 hour window. Conclusions: Our audit identified a large margin for improvement in the time to initiation of antibiotic therapy for chemotherapy patients with suspected FN. Prompt recognition and initiation of standardized treatment pathways for FN in the ED may improve the time to initiation of antibiotic therapy. In an attempt to address this gap in quality we have developed and distributed a standardized wallet-sized fever card to all patients receiving cytotoxic chemotherapy within our regional cancer program. This card contains information pertaining to the current chemotherapy treatment and recommended ED treatment protocols for FN. An evaluation of the impact of these cards is ongoing.

The Utility of Preoperative Magnetic Resonance Imaging for Determining the Flexibility of Sagittal Imbalance

Neurosurgery ◽  
2017 ◽  
Vol 83 (3) ◽  
pp. 465-470
Author(s):  
Akshay Sharma ◽  
Sina Pourtaheri ◽  
Jason Savage ◽  
Iain Kalfas ◽  
Thomas E Mroz ◽  
...  
Keyword(s):  
Lumbar Lordosis ◽  
Surgical Planning ◽  
Pelvic Incidence ◽  
Sagittal Imbalance ◽  
X Rays ◽  
Resonance Imaging ◽  
Patient Counseling ◽  
X Ray ◽  
Preoperative Magnetic Resonance ◽  
The Mean

Abstract BACKGROUND Scoliosis X-rays are the gold standard for assessing preoperative lumbar lordosis; however, particularly for flexible lumbar deformities, it is difficult to predict from these images the extent of correction required, as standing radiographs cannot predict the thoracolumbar alignment after intraoperative positioning. OBJECTIVE To determine the utility of preoperative MRI in surgical planning for patients with flexible sagittal imbalance. METHODS We identified 138 patients with sagittal imbalance. Radiographic parameters including pelvic incidence and lumbar lordosis were obtained from images preoperatively. RESULTS The mean difference was 2.9° between the lumbar lordosis measured on supine MRI as compared to the intraoperative X-rays, as opposed to 5.53° between standing X-rays and intraoperative X-ray. In patients with flexible deformities (n = 24), the lumbar lordosis on MRI measured a discrepancy of 3.08°, as compared to a discrepancy of 11.46° when measured with standing X-ray. CONCLUSION MRI adequately determined which sagittal deformities were flexible. Furthermore, with flexible sagittal deformities, lumbar lordosis measured on MRI more accurately predicted the intraoperative lumbar lordosis than that measured on standing X-ray. The ability to preoperatively predict intraoperative lumbar lordosis with positioning helps with surgical planning and patient counseling regarding expectations and risks of surgery.

scholarly journals QUALITY CONTROL X RAYS MAMMOGRAPHY IN THE EFFORT MITIGATION INCREASING NUMBER OF CANCER PATIENTS

2017 ◽  
Vol 17 (1) ◽  
pp. 45
Author(s):  
Rini Safitri ◽  
Evi Yufita
Keyword(s):  
Breast Cancer ◽  
Quality Control ◽  
Early Stage ◽  
Input Voltage ◽  
Test Subject ◽  
X Rays ◽  
Radiographic Image ◽  
X Ray ◽  
Radiation Output

Abstract. Early detection of breast cancer is the first step in prevention that can be done by women, therefore when one is diagnosed with breast cancer, the appropriate treatment can be performed quickly and accurately. Early diagnosis of breast cancer can be a way of mitigation in preventing breast cancer through the use of mammography. Bureau of Radiology as said by The Joint Commission on Accreditation of Hospitals (JHCA) stated that one of the responsibilities of the radiology unit is to control the quality of service which aims to minimize the radiographic image repetition factor; as well as maximizes the quality of radiographic image. Quality control tests are an effort that is needed on the mammography X-ray diagnostics tools. This is done to maintain the quality of expected output. The parameters that are included within the radiation output are the magnitude of current and the voltage of tube that are produced; therefore they remained constant and correspond to the recommended standard. Bureau of Radiological Health, as said by JHCA mentioned that to control the quality of image which will minimize the radiographic image repetition and maximizes the quality of radiographic image. Therefore the radiation output will not be dangerous later. The early stage of the quality control test on the machine was conducted by setting all the filtrations which were placed to capture the x-ray on the x-ray plane tube with minimum value. Then, ionization chamber is placed on the test subject points; right after that the distance between it to the radiation source is noted. The x-ray film is place on a film on the compression table of the patient and the distance between film and the focus point is noted. This is then exposed using a target filter Mo/Mo by setting the current as well as variation the voltage and time. The standard voltage measurements are 20-33kVp. This data is from the observations of time exposure; the output value is then noted. The above procedure is conducted from the minimum voltage to the maximum voltage. The output ray is measured for each voltage. The same procedure is conducted to the target filter Mo/RH. The results obtained are that the greater the input voltage and current will subsequently produce greater doses, therefore the exposure has exceeded the standard limit 0.1 mHy with longer exposure time. The HVL density thickness on the mammography X-ray machine determined the quality of the beam and the doses of x-ray exposure on the mammography machine. The output stability of x-ray beam exposure in the mammography machine mode Mo/Mo still fulfill the standard which is the value of 69% Keywords: Quality Control, Sinar-X, mammography, Mp/Mo, Mo/RH

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