Preliminary Scan Research Articles

Urgent MRI: when, what, and why—a single Italian center experience

PurposeThe aim of our study is to provide a list of clinical situations that might justify the performance of an urgent MRI (uMRI) based on clinical relevance, correlating the MRI findings with the clinical indications and the urgent management of patients.MethodsWe reviewed all uMRI scans of brain (buMRI) and spine (suMRI) performed in our Department from August 2020 to February 2024. We analyzed the main clinical indications, the neuroradiological findings, and the relevance of these results in the therapeutic decisions.ResultsThe main indication for buMRI was the evaluation of ischemic stroke detected at preliminary CT scan followed by coma, status epilepticus, suspected acute inflammatory diseases, trauma, suspicious of infective diseases, and pre-surgical evaluation of cerebral tumors. The main findings were: ischemia, acute inflammatory conditions, post-traumatic and post-ictal alterations, venous thrombosis, infective diseases, and cerebral tumors. 65% of patients underwent an urgent therapeutic intervention. The main indications for suMRI were clinical suspicion of myelopathy and radiculopathy including cauda equina syndrome secondary to trauma, neoplasms, inflammatory and infective diseases, degenerative changes, surgery, and vascular diseases. The main findings were: post-traumatic, degenerative and neoplastic myelopathy or radiculopathy, inflammatory and infective changes of the spinal cord, post-surgical fluid collections, and vascular diseases. About 77% of suMRI was followed by an urgent surgery.ConclusionsOur study showed an overall good correlation between buMRI-suMRI findings and the clinical indications for the examinations. Also, uMRI affected the urgent management in a good percentage of patients, proving the significance of uMRI findings.

Human-Centered Design and Benefit Realization Management in Digital Health Care Solution Development: Protocol for a Systematic Review.

Earlier research shows that a significant number of resources are wasted on software projects delivering less than the planned benefits. It has, however, been evidenced that adopting a human-centered design approach when designing health devices can be beneficial. This understanding from earlier research has raised our interest in investigating how human-centered design might contribute to realizing the potential benefits of health care software projects. To our current knowledge, this intersection of human-centered design and benefit realization management has not yet comprehensively and consistently been researched within the context of digital health care solutions. Therefore, there is a need for evidence synthesis using systematic reviews to address this potential research gap. The objective of this study is to examine if human-centered design helps benefit realization management processes in the development of digital health care solutions and thereby enables better benefit realization. We explore the evidence of assumed or confirmed benefits of using human-centered design in the health care domain and whether better results have been reported when the benefit realization management process is followed. This protocol was developed following the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) guidelines. The proposed review would use a planned and systematic approach to identify, evaluate, and synthesize relevant and recent studies (reported in English) to see if there is evidence that using human-centered design and benefit realization management has a positive effect on realizing set benefits in those projects. We will commence a systematic literature search using human-centered design, benefit realization management, and health care-related search terms within 5 repositories (ACM Digital Library, PubMed Central, Scopus, PubMed, and Web of Science). After removing duplicate results, a preliminary scan for titles and abstracts will be done by at least 2 reviewers. Any incongruities regarding whether to include articles for full-text review will be resolved by a third reviewer based on the predefined criteria. Initial queries of 2086 records have been executed and papers are being prescreened for inclusion. The search was initiated in December 2023 and the results are expected in 2024. We anticipate finding evidence of the use of human-centered design in the development of digital health care solutions. However, we expect evidence of benefitting from both human-centered design and benefit realization management in this context to be scarce. This protocol will guide the review of existing literature on the use of human-centered design and benefit realization management when developing digital health care solutions. The review will specifically focus on finding evidence of confirmed benefits derived from the use of human-centered design and benefit realization management. There may be an opportunity to gain a broader understanding of the tools or approaches that provide evidence of increased benefit realization within the health care domain. DERR1-10.2196/56125.

A110 INVOLVING STAKEHOLDERS TO DEVELOP BREASTFEEDING EDUCATIONAL RESOURCES FOR PATIENTS WITH INFLAMMATORY DISEASE

Abstract Background Inflammatory Bowel Disease (IBD) are incurable chronic inflammatory disease of the digestive tract that is often treated with immunosuppressive medications. Common IBD symptoms are frequent bowel movements that may be accompanied by blood, constipation, diarrhea, abdominal cramps and pain, fatigue, unintentional weight loss, and many more. Patients who are or are considering breastfeeding often face concerns and decisions about IBD medications and potential effects on breastfeeding and their breastfed infant, or they may have trouble with breastfeeding due to IBD symptoms. Despite the evident benefits of breastfeeding for infants, the rate of long-term breastfeeding amongst women with IBD is low at 55.2% at 6 months. A preliminary environmental scan revealed that there is a lack of informative educational resources for the population. Aims To develop a patient-centric educational resource that provides information and assurance on breastfeeding for a person living with IBD. Methods The study involved 4 stages: (1) phase 1 interview to collect perspectives and expertise, (2) prototype development, (3) phase 2 interview to obtain feedback on the prototype, and (4) prototype refinement. Participants included two groups: healthcare providers and IBD patients who have breastfed or are currently breastfeeding. All interviews were conducted remotely. Interview transcripts were coded to analyze the data. Results In total of 12 participants (6 healthcare providers and 6 patients) were recruited and completed the study. Through thematic analysis, three main themes were identified: 1) breastfeeding concerns that patients have prior to breastfeeding; 2) breastfeeding issues that patients experience while breastfeeding; 3) education format and content. These themes aided in the development and refinement of the prototype, which included graphics, easily digestible information, references, and short videos. The prototype is a webpage residing in a preconception and pregnancy in IBD website. Conclusions By involving the stakeholders, the intervention reflected the needs of patients and the expertise of healthcare providers. The main concern of IBD patients regarding breastfeeding was the IBD medication transfer via breastmilk and safety for breastfed infants. Interestingly, patients preferred to obtain information through short videos rather than the traditional counseling method that healthcare providers offer in clinics. These are included in the intervention. This study method can be applicable to other fields, to ensure that the needs of patients are well represented in patient education resources. Funding Agencies University of Toronto

Guidelines and Standard Frameworks for AI in Medicine: Protocol for a Systematic Literature Review.

Applications of artificial intelligence (AI) are pervasive in modern biomedical science. In fact, research results suggesting algorithms and AI models for different target diseases and conditions are continuously increasing. While this situation undoubtedly improves the outcome of AI models, health care providers are increasingly unsure which AI model to use due to multiple alternatives for a specific target and the "black box" nature of AI. Moreover, the fact that studies rarely use guidelines in developing and reporting AI models poses additional challenges in trusting and adapting models for practical implementation. This review protocol describes the planned steps and methods for a review of the synthesized evidence regarding the quality of available guidelines and frameworks to facilitate AI applications in medicine. We will commence a systematic literature search using medical subject headings terms for medicine, guidelines, and machine learning (ML). All available guidelines, standard frameworks, best practices, checklists, and recommendations will be included, irrespective of the study design. The search will be conducted on web-based repositories such as PubMed, Web of Science, and the EQUATOR (Enhancing the Quality and Transparency of Health Research) network. After removing duplicate results, a preliminary scan for titles will be done by 2 reviewers. After the first scan, the reviewers will rescan the selected literature for abstract review, and any incongruities about whether to include the article for full-text review or not will be resolved by the third and fourth reviewer based on the predefined criteria. A Google Scholar (Google LLC) search will also be performed to identify gray literature. The quality of identified guidelines will be evaluated using the Appraisal of Guidelines, Research, and Evaluation (AGREE II) tool. A descriptive summary and narrative synthesis will be carried out, and the details of critical appraisal and subgroup synthesis findings will be presented. The results will be reported using the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) reporting guidelines. Data analysis is currently underway, and we anticipate finalizing the review by November 2023. Guidelines and recommended frameworks for developing, reporting, and implementing AI studies have been developed by different experts to facilitate the reliable assessment of validity and consistent interpretation of ML models for medical applications. We postulate that a guideline supports the assessment of an ML model only if the quality and reliability of the guideline are high. Assessing the quality and aspects of available guidelines, recommendations, checklists, and frameworks-as will be done in the proposed review-will provide comprehensive insights into current gaps and help to formulate future research directions. DERR1-10.2196/47105.

Constructing scale, eroding responsibility: The politics of project boundaries in Canadian pipeline reviews

Decisions about whether to approve fossil fuel projects have major implications for climate change, biodiversity, and Indigenous rights. In Canada, cumulative effects tend to be only weakly assessed, with each project reviewed on its own terms. This paper investigates how fossil fuel companies strategically define project boundaries to facilitate resource extraction. Drawing on a preliminary scan of applications to Canadian federal review bodies from 2010 to 2022, complemented by detailed document analysis of three selected cases, we ask: in what ways have oil and gas proponents actively constructed scale through their project plans – with what consequences for regulatory scrutiny? Through careful reading of project applications, hearing documents, and company websites, we identify three strategies: (1) splitting work on the same infrastructure into multiple applications; (2) incrementally expanding a network; and (3) portraying interdependent facilities as stand-alone projects. These tactics are within the law, yet they narrow the scope of issues that regulators assess and make it more onerous for affected communities to participate in multiple reviews. Case studies of the Line 9 pipeline, BC Pipeline network, and Gazoduq/Énergie Saguenay facilities show how regulators exempted smaller projects from more rigorous assessment, deemed cumulative effects assessment unnecessary, and excluded broader issues such as climate change and successive encroachment on Indigenous lands. Our findings contribute to work on the material consequences of relational scale, decolonial critiques of Canada's environmental governance regime, and efforts to advance climate justice by articulating how the legal geographies of energy projects shape responsibility for climate action.

Debugging the FUMILIM minimization package

The suggested package FUMILIM, based on famous FUMILI minimization package, has the following advantages.Unlimited number of parameters (multi-set tasks).Ability to work with multidimensional experimental points, described by a vector function.The preliminary scan is envisaged for complicated tasks.For heavy user's functions the parallel fit is envisaged with the help of OpenMP service.Multi-optional user interface, including the option to ignore wrong experimental points.The package contains popular intrinsic user's functions. All of them can be used without the definition of the parameter initial values.There is a package of fast track reconstruction programs for working with detectors, including drift chambers. The capacity of these programs is about of 106 tracks per second (at 2.8 GHz).In the corrected version a number of bugs is fixed.The service for multi-set tasks has been essentially expanded.Information support of poorly converged tasks and removing of wrong experimental points is expanded.All programs are written in FORTRAN-90. New version program summaryProgram Title: FUMILIM v4CPC Library link to program files:https://doi.org/10.17632/xphc8ctxr3.3Licensing provisions: GPLv3Programming language: Fortran-90Journal reference of previous version: Comput. Phys. Commun. 251 (2020) 107202Does the new version supersede the previous version?: Yes.Reasons for the new version: To extend the class of solvable tasks, fixing a number of bugs.Summary of revisions:• A number of bugs is fixed.• The service for multi-set tasks has been essentially expanded.• Information support of poorly converged task and removing WP is expanded.• Fast programs are accelerated by ≃15%.• Organization of output options is slightly revised, which provided better comfort for users.• Settings of the package through the redefinition of numbers in common-blocks are replaced by calls to short subroutines. This makes the main program more compact. The old way of setting still works.Nature of problem: To minimize χ2-functional.Solution method: Least square method.

Retention strategies and barriers for millennial nurses: a scoping review.

The objectives of this scoping review were to explore the existing literature related to millennial nurse-retention strategies and barriers, to examine and conceptually map the evidence, to extract any differences between Generation Y and Generation Z nurses, and to identify any gaps in the literature. The millennial generation has become the largest group of nurses in the workforce. As nursing leaders grow to understand this generation's tendency to change employers frequently, organizations need to identify and implement strategies and reduce barriers to retain this generation as employees. Studies and reports including registered nurses born between 1980 and 2000 with any level of education preparation and in any setting or geographical location were included. Studies and reports that examined nurse-retention barriers and strategies were considered for inclusion. This review considered experimental and quasi-experimental study designs, analytical observational studies, case-control studies, analytical cross-sectional studies, descriptive observational studies, systematic reviews and meta-analyses, qualitative studies, and text and opinion papers. The review was conducted in accordance with the JBI methodology for scoping reviews. Studies and reports written in English after 2010 were included. The databases searched included MEDLINE, CINAHL, Embase, Scopus, Ovid HealthStar, and PsycINFO. The search for unpublished studies and reports included MedNar and ProQuest Dissertations and Theses. Eligible studies and reports underwent data extraction by two independent reviewers using a tool created by the authors. Along with a narrative summary, results are presented in a diagrammatic format that aligns with the review objectives and questions. Thirty-eight publications were included in the review. Strategies for millennial nurse retention were provided in 21 publications, barriers were provided in two publications, and 15 publications provided both strategies and barriers. No publications provided information on the differences between Generation Y and Generation Z. The findings from this scoping review were grouped into five concepts, with strategies and barriers for millennial retention identified for each of the concepts. Concepts identified included leadership, work environment, professional growth, professional fatigue, and self-actualization. The current evidence base shows that barriers to and strategies for millennial nurse retention commonly focus on the work environment and the relationships between nursing leadership and the bedside nurse. A preliminary scan of the evidence indicates that creating a healthy work environment that is collaborative, fair, flexible, challenging, and provides opportunities for growth may keep millennial nurses engaged. Having nursing leadership that models these values and leads by example may help millennial nurses to feel safe and supported; however, due to the methodology employed in this review, further rigorous research is needed to confirm this.

The three-center two-positron bond.

Computational studies have shown that one or more positrons can stabilize two repelling atomic anions through the formation of two-center positronic bonds. In the present work, we study the energetic stability of a system containing two positrons and three hydride anions, namely 2e+[H3 3-]. To this aim, we performed a preliminary scan of the potential energy surface of the system with both electrons and positrons in a spin singlet state, with a multi-component MP2 method, that was further refined with variational and diffusion Monte Carlo calculations, and confirmed an equilibrium geometry with D 3h symmetry. The local stability of 2e+[H3 3-] is demonstrated by analyzing the vertical detachment and adiabatic energy dissociation channels. Bonding properties of the positronic compound, such as the equilibrium interatomic distances, force constants, dissociation energies, and bonding densities are compared with those of the purely electronic H3 + and Li3 + systems. Through this analysis, we find compelling similarities between the 2e+[H3 3-] compound and the trilithium cation. Our results strongly point out the formation of a non-electronic three-center two-positron bond, analogous to the well-known three-center two-electron counterparts, which is fundamentally distinct from the two-center two-positron bond [D. Bressanini, J. Chem. Phys., 2021, 155, 054306], thus extending the concept of positron bonded molecules.

Intraoral Digital Scans for Fabricating Tooth-Supported Prostheses Using a Custom Intraoral Scan Body.

This article describes a technique to assistwith intraoraldigital scans forfabricating tooth-supportedprosthesesby using a customintraoralscan body when the extension of the scan or the clinical characteristics might compromise the reliability of the intraoral digital scan. A preliminary intraoral scan of the tooth preparations is used to design acustomintraoral scan body which is manufactured using polymethylmethacrylate and a 5-axis milling machine. A low-viscositypolyvinyl siloxane impression of the tooth preparations is obtained using the custom intraoral scan body. Subsequently, the custom intraoral scan body is digitized usingan intraoral scanner.A design softwareprogramis usedtoalignthe digitized customintraoral scan bodywiththepreliminaryintraoral scan to obtain the definitive virtual cast. This technique aims to reduce manual conventional laboratory procedures such as pouring dental impression or die trimming which might minimize inaccuracies on the virtual definitive cast.

Towards Ending Immunization Inequity.

Vaccine-preventable diseases (VPD) are responsible for a significant portion of mortality across the life course in both low-income countries and in medium- and high-income countries. Yet, countries are consistently below the adult influenza vaccination targets, with rates in recent times even falling in some areas. (1) The study Towards Ending Immunization Inequity seeks to understand the various factors that contribute to the accessibility and effectiveness of vaccine-related messages and campaigns including the effects of social determinants, with the knowledge that these opportunities for communication represent a unique policy lever to improving uptake rates of vaccination in the most at-risk communities. (2) To address this knowledge gap, a 3-phase mixed-methods study was conducted including a preliminary scan of existing vaccine schedules and NITAG recommendations, focus groups and a cross-sectional survey. (3) Study results indicated that social determinants play a key role in an individual’s knowledge of vaccine-related information including types of vaccines available, vaccination gateways, vaccine recommendations and vaccine safety. (4) However, knowing that social determinants can influence uptake rates does not readily create opportunities and entry points for governments to implement tangible actions. An accessible entry point to reducing and ending immunization inequity is through changes in public health messaging to reach those who are currently unreachable.

Environmental DNA metabarcoding for monitoring metazoan biodiversity in Antarctic nearshore ecosystems.

Antarctic benthic ecosystems support high biodiversity but their characterization is limited to a few well-studied areas, due to the extreme environment and remoteness making access and sampling difficult. Our aim was to compare water and sediment as sources of environmental DNA (eDNA) to better characterise Antarctic benthic communities and further develop practical approaches for DNA-based biodiversity assessment in remote environments. We used a cytochrome c oxidase subunit I (COI) metabarcoding approach to characterise metazoan communities in 26 nearshore sites across 12 locations in the Vestfold Hills (East Antarctica) based on DNA extracted from either sediment cores or filtered seawater. We detected a total of 99 metazoan species from 12 phyla across 26 sites, with similar numbers of species detected in sediment and water eDNA samples. However, significantly different communities were detected in the two sample types at sites where both were collected (i.e., where paired samples were available). For example, nematodes and echinoderms were more likely to be detected exclusively in sediment and water eDNA samples, respectively. eDNA from water and sediment core samples are complementary sample types, with epifauna more likely to be detected in water column samples and infauna in sediment. More reference DNA sequences are needed for infauna/meiofauna to increase the proportion of sequences and number of taxa that can be identified. Developing a better understanding of the temporal and spatial dynamics of eDNA at low temperatures would also aid interpretation of eDNA signals from polar environments. Our results provide a preliminary scan of benthic metazoan communities in the Vestfold Hills, with additional markers required to provide a comprehensive biodiversity survey. However, our study demonstrates the choice of sample type for eDNA studies of benthic ecosystems (sediment, water or both) needs to be carefully considered in light of the research or monitoring question of interest.

A Full Digital Workflow for the Duplication of an Existing Implant Retained Overdenture Prosthesis: A Novel Approach

The purpose of this clinical case report is to describe a fully digital workflow for the duplication of an existing implant retained overdenture, highlighting the benefits of digitally fabricated dentures. The patient presented with an existing mandibular implant retained overdenture on Locator attachments that needed to be replaced. The existing overdenture was duplicated/scanned with the use of an intraoral scanner and was 3D printed using acrylic resin. This resin duplicate was sectioned in the midline and served as a unilateral record base to digitally record maxillo-mandibular relationship. The occlusal relationship was scanned unilaterally with the record base (sectioned duplicate) in place, and the procedure was repeated for the opposite side. All scans (edentulous, bite registrations and preliminary scan) were superimposed and the software managed to position and stich everything together. A try-in copy denture (ProArtCAD Try in, Ivoclar Vivadent AG, Schaan, Liechtenstein) was milled in order to imitate the conventional wax teeth try-in. A definitive milled overdenture was fabricated and delivered. A reinforcing polyetheretherketone mesh was fabricated, utilizing computer assisted design/computer assisted manufacturing technology and was incorporated into the pre-designed customized space into the polymethylmethacrylate base, using indirect light-polymerized nano-filled composite resin (crea.lign; bredent GmbH & Co. KG). Occlusion was verified and the patient was instructed oral hygiene, home maintenance and was informed for the required recall visits.

Laser-induced scanning transfer deposition of silver electrodes on glass surfaces: A green and scalable technology

A pulsed laser ablation backwriting technique with high repetitive rates is implemented for the fabrication of silver coatings on glass surfaces. This method enables geometrical constraint-free deposition of metallic coatings. These exhibit sufficiently low electrical resistance to be used as electrodes in dielectric barrier discharge (DBD) plasma elements.Ambient air deposition of metallic silver electrodes on standard glass slides is explored using a sub-ns UV laser source, combined with hybrid beam scanning methods. The green nature of the overall deposition process includes a preliminary irradiation scan to homogenise the target surface before the subsequent backwriting step. Metal transfer is achieved by combining two phenomena within a simple beam scanning process: LIRT (laser-induced reverse transfer) of silver from the target to the glass, with a partial and secondary LIFT (Laser-Induced Forward Transfer) of silver from the glass to the target.Appropriate selection of pulse energy and pulse repetition rates, beam scanning velocities and target motion enable the growth of sufficiently thick Ag deposits on glass with the required low electrical resistivity and nearly 2D constraint-free geometry. This method avoids the use of vacuum and liquids, resulting in a cheap, facile and green methodology for the deposition of silver electrodes onto transparent substrate surfaces.

A Simple Method for Creating a High‐Content Microscope for Imaging Multiplexed Tissue Microarrays

High-throughput, high-content imaging technologies and multiplex slide scanning have become widely used. Advantages of these approaches include the ability to archive digital copies of slides, review slides as teams using virtual microscopy software, and standardize analytical approaches. The cost and hardware and software inflexibility of dedicated slide scanning devices can, however, complicate implementation. Here, we describe a simple method that allows any microscope to be used for slide scanning. The only requirements are that the microscope be equipped with a motorized filter turret or wheels (for multi-channel fluorescence) and a motorized xyz stage. This example uses MetaMorph software, but the same principles can be used with any microscope control software that includes a few standard functions and allows programming of simple command routines, or journals. The series of journals that implement the method perform key functions, including assistance in defining an unlimited number of regions of interest (ROI) and imaging parameters. Fully automated acquisition is rapid, taking less than 3 hr to image fifty 2.5-mm ROIs in four channels. Following acquisition, images can be easily stitched and displayed using open-source or commercial image-processing and virtual microscope applications. © 2021 Wiley Periodicals LLC. Basic Protocol 1: Hardware and software configuration Basic Protocol 2: Create a preliminary scan Basic Protocol 3: Select, save, and position ROIs Basic Protocol 4: Determine and set autofocus parameters Basic Protocol 5: Acquire tiled images Basic Protocol 6: Review the scans Basic Protocol 7: Reimage ROIs as needed Basic Protocol 8: Stitch, stack, and assemble images Basic Protocol 9: Repeat scanning for multiplex immunostaining or background subtraction.

One Danger and Eleven Types of Academic Disquiet Whilst Hunting for Cinematic Christ-figures

Christ-figures increasingly permeate the popular cinema, but hunting for them is not necessarily a benign or unproblematic activity. Following a selective review of the film and religion literature, and a preliminary scan of the popular cinema utilizing textually-based humanist film criticism as the guiding analytical lens, one danger and eleven types of academic disquiet were explicated herein. Namely: (1) When Factual Minimalism Equals Certainty: Holy Hope, (2) Misidentification: When Something Supposedly “Christian” Was Something Else, (3) When Nothing Equals Something: Creatio Ex Nihilo, (4) Spiritually Negating Christian Iconography: Form Versus Substance, (5) Some Problems with the Secular-is-Sacred Argument, (6) Film is Not a Substitute for Faith, Religion, or God, (7) Rewriting the Film: Aesthetic Violence?, (8) Tenuous Links, Strained Associations, and Uncertain Correspondences, (9) Rejecting Overt Religion for Covert Religion: Distorting Theology and Misdirecting Faith?, (10) From Symbolism Fatigue to Symbolism Cynicism, and (11) Pattern Appeasement: From Being Uncritical to Narrative Insights. It was concluded that being cognizant of the inherent dangers and sources of academic disquiet is a valuable means of expanding one’s visual and intellectual imagination, and also useful for the postmodern church. Further research into the subtextual sub-genre of the religion-and-film field was encouraged, warmly recommended, and is already long overdue.

Dual Energy on Dual Source CT in Abdominal Imaging

Establish whether virtual non-contrast images can replace real non-contrast images, avoiding the preliminary scan, thus saving the patient dose. Forty-one patients were studied on a second-generation dual-source scanner, triphasic were applied on all patients, arterial and venous phase was acquired in dual-energy. HU values of TNC and VNC scans were compared through ROI on liver, spleen, kidneys, aorta, muscle, and fat. Qualitative analysis of the data sets was performed by four readers and the values from 1 to 4 (1. poor, 2. fair, 3. good, 4. excellent.) were assigned to define the diagnostic quality of the images. Then the absorbed dose ratios between the virtual images and the pre-contrast and portal phase images were compared. HU values were analyzed with the t-test and the difference was statistically significant P<0.0001. Image quality was evaluated as excellent or good in 91,3% of TNC and 81,6% of VNC. At last, VNC showed a sensitive dose reduction -46% compared to conventional triphasic protocol. Overall VNC has shown a good image quality comparable to TNC. The dose reduction obtained from the extraction of images without iodine, avoiding further scans, suggests the use of the dual-energy protocol in many exams.

Dual Energy on Dual Source CT in Abdominal Imaging

Establish whether virtual non-contrast images can replace real non-contrast images, avoiding the preliminary scan,thus saving the patient dose.Forty-one patients were studied on a second-generation dual-source scanner, triphasic were applied on all patients,arterial and venous phase was acquired in dual-energy. HU values of TNC and VNC scans were compared throughROI on liver, spleen, kidneys, aorta, muscle, and fat. Qualitative analysis of the data sets was performed by four readers and the values from 1 to 4 (1. poor, 2. fair, 3. good, 4. excellent.) were assigned to define the diagnostic quality ofthe images. Then the absorbed dose ratios between the virtual images and the pre-contrast and portal phase imageswere compared.HU values were analyzed with the t-test and the difference was statistically significant P<0.0001. Image quality wasevaluated as excellent or good in 91,3% of TNC and 81,6% of VNC. At last, VNC showed a sensitive dose reduction-46% compared to conventional triphasic protocol.Overall VNC has shown a good image quality comparable to TNC. The dose reduction obtained from the extractionof images without iodine, avoiding further scans, suggests the use of the dual-energy protocol in many exams.

The final version of the FUMILIM minimization package

The suggested package FUMILIM, based on the famous FUMILI minimization package, has the following advantages: multi-optional user interface; speed advantage when the number of parameters is high enough; there are options to ignore wrong experimental points and correct experimental errors. The preliminary scan is envisaged for complicated tasks.The next version of FUMILIM is capable of working efficiently with multidimensional experimental points, described by a vector function.For heavy user’s functions the parallel fit is envisaged by means of OpenMP service.The package contains popular intrinsic user’s functions. All of them can be used without the definition of the parameter initial values.The program of plane track reconstruction via drift chambers and straws, which can be combined with single detectors, is also included in the package. The capacity of this program is about of 0.5⋅106 tracks per second (at 2.8 GHz).In the final version a number of new intrinsic and extrinsic subroutines are incorporated into the package, and some of the existing procedures have been upgraded. The list of acceptable formats of experimental points has been expanded. The user interface is revised, which is coordinated with a number of users. Expanded the ability to control the program via common blocks.All programs are written in FORTRAN-90.The investigation has been performed at the Veksler and Baldin Laboratory of High Energy Physics, JINR. Program summaryProgram Title: FUMILIM v3Program Files doi:http://dx.doi.org/10.17632/xphc8ctxr3.2Licensing provisions: GPLv3Programming language: Fortran-90Journal reference of previous version: Comput. Phys. Comm. 209 (2016) 199Does the new version supersede the previous version?: Yes.Reasons for the new version: To extend the class of solvable tasks, fixing a number of bugs.Summary of revisions:•A number of new intrinsic and extrinsic programs are added to the package.•Now the program can work 2-column experimental data arrays.•The program call has changed because the dimension of experimental points is now determined automatically.•User’s interface is improved.•A number of subsidiary programs is included to facilitate the creation of a file of initial parameter values for multi-set tasks.Nature of problem: To minimize χ2-functional.Solution method: Least square method.

A simple sonographic finding is associated with a successful vacuum application: the fetal occiput or forehead sign

Intrapartum ultrasound scanning has been proposed as an ancillary tool in the decision-making process of instrumental vaginal delivery. The purpose of this study was to evaluate the correlation between the sonographic visualization with a transperineal scan of the fetal occiput or forehead distal to the pubic symphysis with anterior or posterior presentation, respectively (fetal occiput or forehead sign), and the outcome of a vacuum delivery. We conducted a retrospective cohort study of patients who underwent a vacuum application in our hospital from 2011-2017, excluding outlet applications. In each case, a preliminary transperineal scan was performed to confirm fetal presentation and position and to demonstrate the presence or absence of the fetal occiput or forehead sign. The head direction, angle of progression, and the head perineum distance were also noted. The primary outcome measure was the success of the vacuum. The secondary outcome measures included fetal complications and perineal lacerations. A total of 196 consecutive patients were enrolled in the study. The occiput or forehead sign was present in 150 and was associated with a successful vaginal extraction in all cases. Of the 46 cases without the sign, 5 babies (10.8%) were delivered by cesarean section after a failed vacuum (P=.0006). The occiput or forehead sign was also associated with fewer grade 3-4 perineal lacerations (10.7% vs 35.7%; P=.0005) and cephalohematomas, although the difference was not statistically significant (1.4% vs 4.3%). There was a good correlation between the occiput or forehead sign and the other sonographic methods that previously had been proposed to predict a successful vacuum extraction, such as head direction, angle of progression, and head perineum distance. In our hands, the fetal occiput or forehead sign was associated strongly with successful vacuum application and with a very low rate of maternal and fetal complications.

AIUM Practice Parameter for the Performance of Point-of-Care Ultrasound Examinations.

AIUM Practice Parameter for the Performance of Point-of-Care Ultrasound Examinations.