Workflow patterns and potential for optimization in endovascular stroke treatment across the world: results from a multinational survey

2020 ◽  
pp. neurintsurg-2020-015902
Author(s):  
Johanna Maria Ospel ◽  
Mohammed A Almekhlafi ◽  
Bijoy K Menon ◽  
Nima Kashani ◽  
René Chapot ◽  
...  
Keyword(s):  
Working Environment ◽  
Specific Information ◽  
Career Stage ◽  
X Rays ◽  
Ct Scanner ◽  
Treatment Delays ◽  
Stroke Treatment ◽  
Physician Characteristics ◽  
Set Up ◽  
Improve Patient

BackgroundThe benefit of endovascular treatment (EVT) is highly time-dependent, and treatment delays reduce patients’ chances to achieve a good outcome. In this survey-based study, we aimed to evaluate current in-hospital EVT workflow characteristics across different countries and hospital settings, and to quantify the time-savings that could be achieved by optimizing particular workflow steps.MethodsIn a multinational survey, neurointerventionalists were asked to provide specific information about EVT workflows in their current working environment. Workflow characteristics were summarized using descriptive statistics and stratified by country and physician characteristics, such as age, career stage, personal and institutional caseload.ResultsAmong 248 respondents from 48 countries, pre-notification of the neurointerventional team was used in 70% of cases. The emergency department (ED) and CT scanner, and the CT scanner and neuroangiography suite, were on different floors in 23% and 38%, respectively. Redundant procedures in the ED were often routinely performed, such as chest x-rays (in 6%). General anesthesia was the most frequently used anesthesia protocol for EVT (42%), and an anesthesiologist was available in 82% for this purpose. 52% of the participants used a pre-prepared EVT kit.ConclusionThe current structure of EVT workflows offers possibilities for improvement. While some bottlenecks, such as the spatial department set-up, cannot easily be resolved, pre-notification tools and pre-prepared EVT kits are more straightforward to implement and could help to reduce treatment delays, and thereby improve patient outcomes.

A Color Coded STEM/SEM Image Storage System

1981 ◽  
Vol 39 ◽  
pp. 272-273
Author(s):  
Y. Kokubo ◽  
W. H. Hardy ◽  
J. Dance ◽  
K. Jones
Keyword(s):  
Image Processing ◽  
Electron Beam ◽  
Storage System ◽  
Particle Analysis ◽  
Specific Information ◽  
X Rays ◽  
Sem Image ◽  
Backscattered Electrons ◽  
Wide Range ◽  
Scanning Electron

A color coded digital image processing is accomplished by using JEM100CX TEM SCAN and ORTEC’s LSI-11 computer based multi-channel analyzer (EEDS-II-System III) for image analysis and display. Color coding of the recorded image enables enhanced visualization of the image using mathematical techniques such as compression, gray scale expansion, gamma-processing, filtering, etc., without subjecting the sample to further electron beam irradiation once images have been stored in the memory.The powerful combination between a scanning electron microscope and computer is starting to be widely used 1) - 4) for the purpose of image processing and particle analysis. Especially, in scanning electron microscopy it is possible to get all information resulting from the interactions between the electron beam and specimen materials, by using different detectors for signals such as secondary electron, backscattered electrons, elastic scattered electrons, inelastic scattered electrons, un-scattered electrons, X-rays, etc., each of which contains specific information arising from their physical origin, study of a wide range of effects becomes possible.

scholarly journals More than XRF Mapping: STEAM (Statistically Tailored Elemental Angle Mapper) a Pioneering Analysis Protocol for Pigment Studies

2021 ◽  
Vol 11 (4) ◽  
pp. 1446
Author(s):  
Jacopo Orsilli ◽  
Anna Galli ◽  
Letizia Bonizzoni ◽  
Michele Caccia
Keyword(s):  
Cultural Heritage ◽  
Element Distribution ◽  
Elemental Distribution ◽  
X Rays ◽  
Spectral Angle Mapper ◽  
X Ray ◽  
Fluorescence Radiation ◽  
Set Up ◽  
Non Destructive ◽  
Analysis Protocol

Among the possible variants of X-Ray Fluorescence (XRF), applications exploiting scanning Macro-XRF (MA-XRF) are lately widespread as they allow the visualization of the element distribution maintaining a non-destructive approach. The surface is scanned with a focused or collimated X-ray beam of millimeters or less: analyzing the emitted fluorescence radiation, also elements present below the surface contribute to the elemental distribution image obtained, due to the penetrative nature of X-rays. The importance of this method in the investigation of historical paintings is so obvious—as the elemental distribution obtained can reveal hidden sub-surface layers, including changes made by the artist, or restorations, without any damage to the object—that recently specific international conferences have been held. The present paper summarizes the advantages and limitations of using MA-XRF considering it as an imaging technique, in synergy with other hyperspectral methods, or combining it with spot investigations. The most recent applications in the cultural Heritage field are taken into account, demonstrating how obtained 2D-XRF maps can be of great help in the diagnostic applied on Cultural Heritage materials. Moreover, a pioneering analysis protocol based on the Spectral Angle Mapper (SAM) algorithm is presented, unifying the MA-XRF standard approach with punctual XRF, exploiting information from the mapped area as a database to extend the comprehension to data outside the scanned region, and working independently from the acquisition set-up. Experimental application on some reference pigment layers and a painting by Giotto are presented as validation of the proposed method.

scholarly journals Wear and Friction Characteristics of 65Mn Steel for Spike-Tooth Harrow

Coatings ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 319
Author(s):  
Zhiguo Lu ◽  
Chuanyu Du ◽  
Qingcai Chen ◽  
Tianying Niu ◽  
Na Wang ◽  
...  
Keyword(s):  
Friction And Wear ◽  
Working Environment ◽  
Manganese Steel ◽  
Wear Loss ◽  
Variable Parameters ◽  
Wear Characteristics ◽  
Before And After ◽  
Set Up ◽  
Worn Surface ◽  
Friction And Wear Characteristics

The friction and wear characteristics of spike-tooth material (65Mn steel) of Spike-Tooth Harrow in a two-stage peanut harvester were studied in this paper. The friction and wear tests of pin and disc on 65 manganese steel were carried out on the tribometer, then the wear loss and the friction coefficient were studied. The wear loss of the pin was acquired by calculating the mass of the pin before and after the experiment using an electronic balance. According to the actual working environment of peanut spring-finger, four variable parameters are set up: load, speed, soil moisture and soil type. The friction and wear characteristics of pins were studied under different loads, speeds and different soil environments. After wearing, the worn surface of the material was observed by scanning microscope and the wear mechanism was studied. The experimental results show that the wear of the pin increases with the increase of load and decreases with the increase of rotational speed in the same rotation number. Especially in the case of the sandy soil with 20% in moisture, a maximum wear loss of the pin is achieved.

scholarly journals A large area diamond-based beam tagging hodoscope for ion therapy monitoring

2018 ◽  
Vol 170 ◽  
pp. 09005 ◽  
Author(s):  
M.-L. Gallin-Martel ◽  
L. Abbassi ◽  
A. Bes ◽  
G. Bosson ◽  
J. Collot ◽  
...  
Keyword(s):  
Detection Efficiency ◽  
Signal To Noise Ratio ◽  
Therapy Monitoring ◽  
Chemical Vapor ◽  
X Rays ◽  
Reaction Products ◽  
Large Area ◽  
Position Measurement ◽  
Set Up ◽  
Good Signal

The MoniDiam project is part of the French national collaboration CLaRyS (Contrôle en Ligne de l’hAdronthérapie par RaYonnements Secondaires) for on-line monitoring of hadron therapy. It relies on the imaging of nuclear reaction products that is related to the ion range. The goal here is to provide large area beam detectors with a high detection efficiency for carbon or proton beams giving time and position measurement at 100 MHz count rates (beam tagging hodoscope). High radiation hardness and intrinsic electronic properties make diamonds reliable and very fast detectors with a good signal to noise ratio. Commercial Chemical Vapor Deposited (CVD) poly-crystalline, heteroepitaxial and monocrystalline diamonds were studied. Their applicability as a particle detector was investigated using α and β radioactive sources, 95 MeV/u carbon ion beams at GANIL and 8.5 keV X-ray photon bunches from ESRF. This facility offers the unique capability of providing a focused (~1 μm) beam in bunches of 100 ps duration, with an almost uniform energy deposition in the irradiated detector volume, therefore mimicking the interaction of single ions. A signal rise time resolution ranging from 20 to 90 ps rms and an energy resolution of 7 to 9% were measured using diamonds with aluminum disk shaped surface metallization. This enabled us to conclude that polycrystalline CVD diamond detectors are good candidates for our beam tagging hodoscope development. Recently, double-side stripped metallized diamonds were tested using the XBIC (X Rays Beam Induced Current) set-up of the ID21 beamline at ESRF which permits us to evaluate the capability of diamond to be used as position sensitive detector. The final detector will consist in a mosaic arrangement of double-side stripped diamond sensors read out by a dedicated fast-integrated electronics of several hundreds of channels.

Een slechte start en dan?

2017 ◽  
Vol 33 (3) ◽  
Author(s):  
Henk-Jan Dirven ◽  
Wouter van der Torre ◽  
Seth van den Bossche
Keyword(s):  
Analysis Data ◽  
Working Environment ◽  
Work Situation ◽  
Financial Situation ◽  
Work Related ◽  
Self Employment ◽  
Level Of Satisfaction ◽  
Set Up ◽  
Employment Quality

A bad start and what then? The work situation of self-employed entrepreneurs with negative and positive start motives This article assesses the extent to which the quality of labor varies between solo self-employed who set up a business for negative reasons and those who started for positive reasons. A negative reason is, for example, not being able to find a suitable job as an employee; an example of a positive reason is wanting to be self-employed from the very beginning. Quality of labor is measured according to the person's financial situation, security of employment, quality of the working environment and work satisfaction. In the analysis, data are used from the Self-employment Survey conducted by Statistics Netherlands and TNO. Compared to self-employed persons with a positive motivation, those who were negatively motivated show lower performance in terms of their business's financial situation, income position, work-related mental fatigue (burn-out), self-perceived health status, concern about the business's future and the level of satisfaction. However, in absolute terms, the vast majority appear to be satisfied with their work situation, enthusiastic and not intending to quit self-employment.

scholarly journals Technical innovations and optimizations for intermediate ice-core drilling operations

2014 ◽  
Vol 55 (68) ◽  
pp. 243-252 ◽  
Author(s):  
Jack Triest ◽  
Robert Mulvaney ◽  
Olivier Alemany
Keyword(s):  
Ice Core ◽  
Working Environment ◽  
Column Height ◽  
Drill Fluid ◽  
Drilling Operations ◽  
Remote Sites ◽  
James Ross Island ◽  
Technical Innovations ◽  
Set Up ◽  
Core Storage

AbstractThe British Antarctic Survey, in collaboration with Laboratoire de Glaciologie et Géophysique de l’Environnement, has in recent years successfully drilled to bedrock on three remote sites around the Antarctic Peninsula. Based on the experience from the multi-season project at Berkner Island (948m depth, 2002–05) we optimized the drill set-up to better suit two subsequent single-season projects at James Ross Island (363m depth, 2008) and Fletcher Promontory (654m depth, 2012). The adaptations, as well as the reasons for them, are discussed in detail and include a drill tent set-up without a trench; drilling without a borehole casing with a relatively low fluid column height; and using a shorter drill. These optimizations were aimed at reducing cargo loads and installation time while maintaining good core quality, productivity and a safe working environment. In addition, we introduce a number of innovations, ranging from a new lightweight cable tensioning device and drill-head design to core storage and protection trays. To minimize the environmental impact, all the drill fluid was successfully recovered at both sites and we describe and evaluate this operation.

Abstract 352: Early Data From an Implementation Science Study Suggests the Need for Identification and Adoption of Best Practices to Improve the Timeliness of Stroke Treatment

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Lisa M Monk
Keyword(s):  
Best Practices ◽  
Acute Stroke ◽  
Care Delivery ◽  
Stroke Care ◽  
Early Data ◽  
Screening Tools ◽  
Stroke Severity ◽  
Ct Scanner ◽  
Acute Stroke Care ◽  
Stroke Treatment

There is a disconnect from discovery of best treatment options and application into clinical practice in a timely manner. The I M plementation of best Pr actices f O r acute stroke care-de v eloping and optimizing regional systems of Stroke Care (IMPROVE Stroke Care) goal is to develop a regional integrated stroke system that identifies, classifies, and treats patients with acute ischemic stroke more rapidly and effectively with reperfusion therapy. These improvements in acute stroke care delivery are expected to result in lower mortality, fewer recurrent strokes, and improved long term functional outcomes. Recent discoveries in stroke care and advancement in technology extends the window for both TPA administration and mechanical thombectomy. The challenge of implementing these latest advances are difficult considering the ability of hospitals to implement the original American Heart Association (AHA) Systems of Stroke Care recommendations. Early data from this project shows that the challenges continue to exist in recommendations that have been in place as early as 2005. EMS is not utilizing pre-hospital stroke screening tools, only 5% of the time, stroke severity tools, only 7% of the time, lytic checklists, 0% of the time, destination decision changed due to severity score, 0% of the time, and pre-notifying emergency rooms, only 63% of the time. Emergency departments door to CT <45 minutes, only 55% of the time, Lytic given in CT scanner, only 35% of the time, Door to lytic therapy< 45 minutes, 77% of the time, Door to Groin puncture, 81% of the time, and Door to TICI Flow 2c/3 flow <90 minutes, 39% of the time. The Systems of Stroke Care have recommendations that will improve time to treatment and outcomes for patients. This project is working to provide tools, guidance, data, and feedback to improve application of these recommendations and identify best practices and solutions to barriers.

scholarly journals Nanofocusing Optics for an X-Ray Free-Electron Laser Generating an Extreme Intensity of 100 EW/cm2 Using Total Reflection Mirrors

2020 ◽  
Vol 10 (7) ◽  
pp. 2611
Author(s):  
Hirokatsu Yumoto ◽  
Yuichi Inubushi ◽  
Taito Osaka ◽  
Ichiro Inoue ◽  
Takahisa Koyama ◽  
...  
Keyword(s):  
Photon Energy ◽  
Pulse Energy ◽  
Free Electron ◽  
Free Electron Laser ◽  
Total Reflection ◽  
Experimental Chamber ◽  
X Rays ◽  
X Ray ◽  
Set Up ◽  
Focused Beam

A nanofocusing optical system—referred to as 100 exa—for an X-ray free-electron laser (XFEL) was developed to generate an extremely high intensity of 100 EW/cm2 (1020 W/cm2) using total reflection mirrors. The system is based on Kirkpatrick-Baez geometry, with 250-mm-long elliptically figured mirrors optimized for the SPring-8 Angstrom Compact Free-Electron Laser (SACLA) XFEL facility. The nano-precision surface employed is coated with rhodium and offers a high reflectivity of 80%, with a photon energy of up to 12 keV, under total reflection conditions. Incident X-rays on the optics are reflected with a large spatial acceptance of over 900 μm. The focused beam is 210 nm × 120 nm (full width at half maximum) and was evaluated at a photon energy of 10 keV. The optics developed for 100 exa efficiently achieved an intensity of 1 × 1020 W/cm2 with a pulse duration of 7 fs and a pulse energy of 150 μJ (25% of the pulse energy generated at the light source). The experimental chamber, which can provide different stage arrangements and sample conditions, including vacuum environments and atmospheric-pressure helium, was set up with the focusing optics to meet the experimental requirements.

scholarly journals Single-shot electrons and protons time-resolved detection from high-intensity laser–solid matter interactions at SPARC_LAB

2019 ◽  
Vol 7 ◽  
Author(s):  
F. Bisesto ◽  
M. Galletti ◽  
M. P. Anania ◽  
M. Ferrario ◽  
R. Pompili ◽  
...  
Keyword(s):  
Intense Laser ◽  
Test Facility ◽  
Particle Accelerators ◽  
Single Shot ◽  
X Rays ◽  
Time Resolved ◽  
Laser Plasma Interactions ◽  
High Intensity Laser ◽  
Set Up ◽  
Intensity Laser

Laser–plasma interactions have been studied in detail over the past twenty years, as they show great potential for the next generation of particle accelerators. The interaction between an ultra-intense laser and a solid-state target produces a huge amount of particles: electrons and photons (X-rays and $\unicode[STIX]{x03B3}$ -rays) at early stages of the process, with protons and ions following them. At SPARC_LAB Test Facility we have set up two diagnostic lines to perform simultaneous temporally resolved measurements on both electrons and protons.

scholarly journals Automated Determination of Bone Age in a Modern Chinese Population

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Shao-Yan Zhang ◽  
Gang Liu ◽  
Chen-Guo Ma ◽  
Yi-San Han ◽  
Xun-Zhang Shen ◽  
...  
Keyword(s):  
Los Angeles ◽  
Chinese Population ◽  
Age Determination ◽  
Bone Age ◽  
Chinese Children ◽  
X Rays ◽  
Automated Method ◽  
Rating Method ◽  
Set Up

Rationale and Objective. Large studies have previously been performed to set up a Chinese bone age reference, but it has been difficult to compare the maturation of Chinese children with populations elsewhere due to the potential variability between raters in different parts of the world. We re-analysed the radiographs from a large study of normal Chinese children using an automated bone age rating method to establish a Chinese bone age reference, and to compare the tempo of maturation in the Chinese with other populations. Materials and Methods. X-rays from 2883 boys and 3143 girls aged 2–20 years from five Chinese cities, taken in 2005, were evaluated using the BoneXpert automated method. Results. Chinese children reached full maturity at the same age as previously studied Asian children from Los Angeles, but 0.6 years earlier than Caucasian children in Los Angeles. The Greulich-Pyle bone age method was adapted to the Chinese population creating a new bone age scale BX-China05. The standard deviation between BX-China05 and chronologic age was 1.01 years in boys aged 8–14, and 1.08 years in girls aged 7–12. Conclusion. By eliminating rater variability, the automated method provides a reliable and efficient standard for bone age determination in China.

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