Risk Of Radiation Exposure Research Articles

Investigation of aerosol generation through laser cleaning of various surfaces and optimization of mist & spray scavenging

To ensure the safe and effective decommissioning of the Fukushima Daiichi Nuclear Power Plant (NPP), it is crucial to investigate the behavior of radioactive aerosols generated during the laser decontamination of radiation hot spots and laser cutting of fuel debris. Understanding the generation and dispersion patterns of these aerosols is of utmost importance for the proper planning and execution of decommissioning activities. This study focuses on the performance evaluation of high-power continuous wave (CW) fiber lasers for cleaning surfaces composed of carbon steel, stainless steel, and concrete. The effective confinement and scavenging of radioactive aerosols are critical in minimizing the risk of radiation exposure during decommissioning processes. Test samples, made of carbon steel (CS), stainless steel (SS), and concrete, coated with ZrO2, CeO2, and CsI, were subjected to laser decontamination using a class-4 fiber laser within the UTARTS (University of Tokyo Aerosol Removal Test with Sprays) facility. The aerosol particles generated during the laser decontamination process were confined and captured utilizing a spray and mist system. The study proposes the utilization of a combined spray and mist technique, which has demonstrated high efficiency in scavenging aerosols generated through laser irradiation. This research contributes to the broader goal of promoting best practices and innovative solutions in the field of nuclear decommissioning, thereby safeguarding the environment and human health.

Diagnostic Accuracy of Bedside Lung Ultrasound in Detecting Traumatic Pneumothorax by Novice Physicians in the Emergency Department of a Tertiary Care Hospital of Nepal.

Traumatic pneumothorax is a life-threatening condition requiring vigilant clinical assessment and urgent management. Lung ultrasound (LUS) is considered to be a safer, rapid, and accurate modality for the early diagnosis of traumatic pneumothorax. The principle objective of this study was to evaluate the diagnostic accuracy of bedside LUS performed by trained novice physicians in the diagnosis of traumatic pneumothorax as compared to supine chest X-rays (CXRs) and/or computed tomography (CT) scans and/or air leak during needle/tube thoracostomy as composite standard. It is a prospective, cross-sectional, single-blinded study using a nonprobability quota sampling technique. A total of 96 patients presenting to the emergency department (ED) with polytrauma and chest injuries within a period of twelve months were included. The diagnostic accuracy of bedside LUS performed by trained novice physicians was calculated in terms of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) and compared with the composite standard. The sensitivity of LUS in diagnosing traumatic pneumothorax as compared to the composite standard was 100% (95% confidence interval (CI): 59.05%-100.00%), whereas its specificity was 97.75% (95% CI: 92.12%-99.73%). Similarly, the PPV and NPV of LUS were 77.7% (95% CI: 39.99%-97.19%) and 100% (95% CI: 95.85%-100.00%), respectively. The results of the study showed that the application of LUS in detecting traumatic pneumothorax had similar diagnostic accuracy as supine CXR. Bedside LUS is widely available, portable, and inexpensive. It also has the capability of real-time imaging and can be repeated as necessary with less risk of radiation exposure. Therefore, physicians working in tertiary and rural health institutions must be trained adequately in order to uplift the clinical utility of LUS for the timely and cost-effective detection of traumatic pneumothorax.

Exploring marine algae-derived phycocyanin nanoparticles as a safe and effective adjuvant for sunscreen systems

BackgroundUV radiation (UV) exposure risks skin damage and cancer due to DNA damage and oxidative stress. Synthetic chemical sunscreens that protect against UV radiation can have health and environmental concerns. This study explores phycocyanin (PC), a marine algae-derived natural photoprotective compound, and its crosslinked nanoparticles (PCNP) as safe and effective adjuvants for sunscreen systems.MethodsPCNP was synthesized via genipin-crosslinking. PC and PCNP biocompatibility were assessed on mouse embryonic fibroblast cells. ABTS evaluated antioxidant activity, and the UV absorption capacity of PC and PCNP were analyzed. PCNP skin permeability was tested in vitro and in vivo. Gel formulations with PCNP were examined for UV absorption effects.ResultsPCNP showed good biocompatibility, maintaining cell viability above 90% across concentrations. Both PC and PCNP demonstrated concentration-dependent antioxidant activity, efficiently scavenging free radicals. PCNP exhibited enhanced UV absorption in the UVB range compared to PC alone. Skin permeation studies displayed limited PCNP penetration through skin layers. In vivo, absorption assessments indicated PCNP localized mainly in the stratum corneum. PCNP-containing gels displayed improved UV absorption compared to gels without PCNP.ConclusionThis study showcases PCNP’s potential as a natural and safe adjuvant for sunscreen with enhanced UV protection capabilities. PCNP preserved antioxidant activity, displayed limited skin penetration, and enhanced UV absorption. The findings suggest PCNP’s promise as a viable alternative to synthetic sunscreen agents, delivering effective photoprotection while minimizing health and environmental concerns.

Progress in the Application of Lung Ultrasound for the Evaluation of Neonates with Respiratory Distress Syndrome.

Neonatal respiratory distress syndrome (NRDS) is a common critical disease in neonates. Early diagnosis and timely treatment are crucial. Historically, X-ray imaging was the primary method for diagnosing NRDS. However, this method carries radiation exposure risks, making it unsuitable for dynamic lung condition monitoring. In addition, neonates who are critically ill require bedside imaging, but diagnostic delays are often unavoidable due to equipment transportation and positioning limitations. These challenges have been resolved with the introduction of lung ultrasound (LUS) in neonatal intensive care. The diagnostic efficacy and specificity of LUS for NRDS is superior to that of X-ray. The non-invasive, dynamic, and real-time benefits of LUS also allow for real-time monitoring of lung changes throughout treatment for NRDS, yielding important insights for guiding therapy. In this paper, we examine the ultrasonographic characteristics of NRDS and the recent progress in the application of ultrasound in the diagnosis and treatment of NRDS while aiming to promote wider adoption of this method.

Assessment Awareness and Knowledge of Apron to Protect Radiographer During Radiographic Examination

Aims: Empowering radiation workers with enhanced awareness and knowledge to effectively manage and minimise the risk of radiation exposure. The aim was to determine the level of awareness and knowledge of radiographers about aprons as personal protective equipment from radiation exposure during radiographic examinations. Methodology: The research study employed a research method that involved 26 respondents who were radiographers. The objective of the study was to assess the level of awareness and knowledge regarding the apron. This assessment was done by analysing the results of both pre-test and post-test examinations, then statistical analysis was carried out using a paired sample t-test to determine the increase in awareness and knowledge after providing learning and practical materials with a p-value < 0.05. Results: The research results showed that the awareness and knowledge of aprons had an average pre-test percentage score of 50% before providing material and practice on aprons, whereas after providing material and practice on aprons, the average post-test percentage value increased by 95%. Furthermore, the results of the paired sample t-test showed that there was an increase in radiographers' awareness and knowledge about aprons with a p-value <0.001. Conclusion: Assessing the awareness and knowledge of radiographers through the distribution of questionnaires is an initial means of identifying areas for improvement within the radiology department. This allows for the implementation of training programs or courses aimed at enhancing awareness and understanding of aprons and the significance of radiation protection in the field of diagnostic radiology.

Concrete corrosion in nuclear power plants and other nuclear installations and its mitigation techniques: a review

Abstract Nuclear power plants (NPPs) have been affected by various failures through corrosion which causes economic losses, increased chance of the radiation exposure and environmental risk. One of the major durability issues in reinforced concrete is the corrosion of reinforcement which significantly reduces the life of reinforced concrete. Considering the increasing demand for longer service lives of NPPs, and the high cost involved in building and maintaining it, adequate preventive measures should be followed to minimize the corrosion. This review majorly discusses about the mechanism of corrosion of steel in NPP structures with emphasis on the mechanisms relevant to NPPs, possible reasons for the concrete corrosion as well as potential failure happening in NPPs. The majors reason for the concrete corrosion in nuclear power plants are mainly corrosive external and internal environment, thermal and mechanical stress, moisture content, microorganisms and stray electrical currents. The corrosion of NPPs may result in loss of structural integrity and leakage of radioactive material. The review also discusses about various corrosion prevention and protection techniques against concrete corrosion and concludes with an overview of present methods and possible future perspectives used to enhance the efficiency of concrete corrosion mitigation methods with focus of NPPs.

Bladder stone in pregnancy: a rare encounter

Bladder stones are rare and account for approximately 5.0% of all urinary tract stones. The presence of bladder stones places the pregnancy at risk for adverse outcomes including recurrent urinary tract infections, preterm labour, and obstructed labour. Prompt and accurate diagnosis requires a high degree of suspicion and judicious use of diagnostic imaging given the higher risks of radiation exposure. Treatment ranges from conservative to more invasive approaches. Thus, management needs to be individualized to the patient with careful consideration of the potential adverse effects. We report a case of bladder stone in mid-pregnancy that was treated by open cystolithotomy.

Quality assurance of lead aprons for radiation protection.

Radiation protection is essential to minimize the harmful effects of ionizing radiation. Lead equivalent apron is one of the common protective devices to reduce the occupational risk of radiation exposure. The aim of the study is to analyse the percentage attenuation of 0.5mm lead equivalent apron. Twenty aprons were used for calculating the percentage of attenuation. The computed tomography (CT) phantom was placed on the radiography and CT table at 1 m from the X-ray tube. The readings were taken from the phantom using a detector at 1-m distance with and without lead equivalent aprons. The readings were tabulated and analysed. The mean percentage attenuation of 0.5mm lead equivalent apron is 95.66±0.61 in radiography (100kVp), 95.64±0.57 in CT (130kVp), respectively. The percentage attenuation of lead equivalent aprons is permissible comparing with the literature.

BRAIN DEATH IN PREGNANCY: A SYSTEMATIC REVIEW

Background: Brain death is a rare event in pregnancy. A recent case series estimated the prevalence of pregnancy among brain dead patients at 2.5. The care of a brain-dead pregnant women focuses on optimizing maternal recovery, considering fetal health impacts, and interventions for maternal support, including medication, radiation exposure, and preterm labor risks. The aim: This study aims to investigate brain death in pregnancy. Methods: By comparing itself to the standards set by the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020, this study was able to show that it met all of the requirements. So, the experts were able to make sure that the study was as up-to-date as it was possible to be. For this search approach, publications that came out between 2013 and 2023 were taken into account. Several different online reference sources, like Pubmed and ScienceDirect, were used to do this. It was decided not to take into account review pieces, works that had already been published, or works that were only half done. Results: In the PubMed database, the results of our search brought up 17 articles, whereas the results of our search on ScienceDirect brought up 11 articles. The results of the search conducted by title screening yielded a total 12 articles for PubMed and 6 articles for ScienceDirect. We compiled a total of 12 papers, 7 of which came from PubMed and 5 of which came from ScienceDirect. We excluded 2 review articles, 3 duplicate articles, 1 article having ineligible subject, and 1 discussion article. In the end, we included five research that met the criteria. Conclusion: In this review, 80 of neonates were born alive. Somatic support of the brain-dead pregnant woman was perfomed to maximize perinatal outcomes. And during gestation, obstetricians must closely monitored fetal development.

M3S-Net: multi-modality multi-branch multi-self-attention network with structure-promoting loss for low-dose PET/CT enhancement.

Objective.PET (Positron Emission Tomography) inherently involves radiotracer injections and long scanning time, which raises concerns about the risk of radiation exposure and patient comfort. Reductions in radiotracer dosage and acquisition time can lower the potential risk and improve patient comfort, respectively, but both will also reduce photon counts and hence degrade the image quality. Therefore, it is of interest to improve the quality of low-dose PET images.Approach.A supervised multi-modality deep learning model, named M3S-Net, was proposed to generate standard-dose PET images (60 s per bed position) from low-dose ones (10 s per bed position) and the corresponding CT images. Specifically, we designed a multi-branch convolutional neural network with multi-self-attention mechanisms, which first extracted features from PET and CT images in two separate branches and then fused the features to generate the final generated PET images. Moreover, a novel multi-modality structure-promoting term was proposed in the loss function to learn the anatomical information contained in CT images.Main results.We conducted extensive numerical experiments on real clinical data collected from local hospitals. Compared with state-of-the-art methods, the proposed M3S-Net not only achieved higher objective metrics and better generated tumors, but also performed better in preserving edges and suppressing noise and artifacts.Significance.The experimental results of quantitative metrics and qualitative displays demonstrate that the proposed M3S-Net can generate high-quality PET images from low-dose ones, which are competable to standard-dose PET images. This is valuable in reducing PET acquisition time and has potential applications in dynamic PET imaging.

Immunoglobulin High Throughput Sequencing (Ig-HTS) Minimal Residual Disease (MRD) Analysis is an Effective Surveillance Tool in Patients With Mantle Cell Lymphoma

IntroductionMantle cell lymphoma (MCL) accounts for 4% to 6% of B-cell non-Hodgkin lymphoma with historically poor outcomes. With the advent of intensive first-line, targeted, and cellular therapies, outcomes have improved, and initial remission can be 8 to 10 years or longer. As patients experience longer remissions, this raises the question of the optimal surveillance modality. Peripheral blood minimal residual disease (MRD) analysis offers a potential alternative to surveillance imaging that is sensitive, less costly, and eliminates the risk of radiation exposure. Materials and MethodsThe clonoSEQ assay (Adaptive Biotechnologies) is an FDA-cleared commercially available Ig-HTS MRD assay with a sensitivity of 1 cell in 1,000,000. We performed a retrospective analysis of 34 patients from 2015 to 2021, who underwent MRD testing after achieving remission with first-line therapy. ResultsWith a median follow-up of 6.5 years, 10-year progression free survival (PFS) was 60% and 10-year overall survival was 92% of the entire cohort. Among 12 patients who sustained a radiographic relapse, peripheral blood became MRD+ either at or prior to the time of relapse in 11 patients (92%). The first MRD+ test had a lead time of 0 to 24 months (median 34 days) prior to radiographic relapse. Only 1 patient had a MRD− result while being found to have progressive disease on imaging. Among 22 patients who sustained continuous clinical remission, 21 have remained MRD−. Several patients were able to enjoy 2 to 4-year intervals without surveillance imaging. ConclusionsOur data suggest that the clonoSEQ MRD assay is an effective surveillance tool for MCL patients following first-line therapy and is predictive of relapse prior to imaging.

Optimization of Radiation Exposure when Examining Patients with Pathology of the Craniovertebral Region

The diagnostics are based on the principle of obtaining informative and high-quality images with minimal radiation exposure using radiation diagnostic methods: traditional radiography, multislice and cone-beam computed tomography.When conducting X-ray examinations, the main factors in reducing the risk of radiation exposure are the use of highly sensitive digital diagnostic image receivers, minimal exposure time, and a minimum number of images per examination. A lower current value and high anode voltage values, a minimum focal spot size, the placement of the tube as far as possible from the patient and the image receiver as close to the patient as possible, collimation of the radiation beam, and preference for a low radiation dose rate mode are also factors in reducing the risk of radiation exposure.Imaging of the craniovertebral region using cone beam computed tomography offers the opportunity to evaluate the bone structure of the region in detail, with an equal or less effective dose to the patient.

Radiation exposure and cancer risk of pediatric head CT scans: Impact of age and scanning parameters

Computed tomography (CT) is a widely utilized imaging technique in various medical applications due to the advanced technology that allows the diagnosis of diseases efficiently. The aims of this study were (1) to assess the radiation dose and the probability of cancer incidence for pediatric head CT scans, and (2) to analyze the influence of age and other scanning parameters on radiation dose. A total of 224 pediatric patients, ranging in age from newborn to 18 years, were collected from three main hospitals in Saudi Arabia. The patient data were divided into four age groups: Group 1 (0 to < 1 year old), Group 2 (1 to < 5 years old), Group 3 (5 to < 10 years old), and Group 4 (10 to < 18 years old). Initially, descriptive statistics were conducted for the values of volume CT dose index (CTDIvol), dose-length product (DLP), effective dose, and probability of lifetime cancer risk. This was followed by applying the Kruskal-Wallis H and the Mann-Whitney U tests to investigate the influence of age and other scanning parameters, namely tube voltage, slice thickness, and the use of automatic tube current modulation (ATCM), on radiation dose. It has been found that as the age of patients increased, there was a corresponding increase in CTDIvol and DLP values and a decrease in effective doses and lifetime cancer risk. The patient's age accounted for 33.4% and 34.9% of the variations in CTDIvol and DLP, respectively, while tube voltage (kVp) settings accounted for 25.8% and 24.9%, respectively. There was an increase of 22.3% in CTDIvol reported for patients scanned with a slice thickness of 2 mm compared to those scanned at 2.5 mm, and a 2.2% dose increase between slice thicknesses of 2.5 mm and 5 mm. Radiation doses in the surveyed hospitals fall within acceptable limits. Further studies in Saudi Arabia should focus on evaluating patient doses based on the actual sizes, which determine radiation doses for pediatric CT imaging more accurately.

Patient and physician radiation exposure during minimally invasive lumbar decompression: A prospective assessment of X-ray exposure risks.

Minimally invasive lumbar decompression (mild®) is becoming a popular procedure for treating lumbar spinal stenosis (LSS) secondary to hypertrophic ligamentum flavum (LF). The mild® procedure is commonly performed under live fluoroscopic guidance and carries a risk of radiation exposure to the patient and healthcare. One physician performed mild® on 41 patients at the Cleveland Clinic Department of Pain Management from October 2019 to December 2021, while wearing a radiation exposure monitor (Mirion Technologies). Mean fluoroscopy time, mean exposure per case, and mean exposure per unilateral level decompressed were the primary outcomes measured. The secondary outcome was to provide a comparison of radiation exposure during similar fluoroscopically guided procedures. Mean patient fluoroscopy exposure time was 2.1 min ±0.9 (range: 1.1-5.6) fluoroscopy time per unilateral level decompressed. The mean patient radiation skin exposure from mild® was 1.1 ± 0.9 mGym2, and the mean total dose was 142.3 ± 108.6 mGy per procedure. On average, the physician was exposed to an average deep tissue exposure of 4.1 ± 3.2 mRem, 2.9 ± 2.2 mRem estimated eye exposure, and 14.7 ± 11.0 mRem shallow tissue exposure per unilateral level decompressed. An individual physician would exceed the annual exposure limit of 5 Rem after approximately 610 mild® procedures per year. This study is an attempt to quantify the radiation exposure to the physician and patient during the mild® procedure. Compared with other fluoroscopically guided pain management procedures, patient and physician radiation exposure during mild® was low.

Krisis Lingkungan Dan Implikasinya Terhadap Keamanan Manusia

The current environmental crisis has emerged as one of the most significant global issues, with the disposal of nuclear waste into the oceans garnering international attention. With the increasing production of nuclear waste from nuclear activities, such as nuclear power generation and nuclear use in industries, there arises a need to understand the environmental impact and threats to human safety associated with these actions. The disposal of nuclear waste can jeopardize marine ecosystems and biodiversity, creating contamination in seawater and marine organisms that can persist for decades to centuries. The risk of radiation exposure to humans through the consumption of contaminated seafood escalates, leading to potential serious health issues, including the risk of cancer. In this context, stringent policies and regulations in the management of nuclear waste and international cooperation are imperative. This research underscores the importance of identifying hazards arising from the disposal of nuclear waste into the open sea. Efforts to reduce and manage nuclear waste must be intensified through strict supervision by nuclear and environmental regulatory bodies. The disposal of nuclear waste can have serious impacts on the environment and human health by polluting seawater and marine organisms. Therefore, urgent actions are required to protect marine ecosystems, maintain ecological balance, and safeguard fisheries resources and biodiversity.

MPVF: 4D Medical Image Inpainting by Multi-Pyramid Voxel Flows.

Generatinga detailed 4D medical image usually accompanies with prolonged examination time and increased radiation exposure risk. Modern deep learning solutions have exploited interpolation mechanisms to generate a complete 4D image with fewer 3D volumes. However, existing solutions focus more on 2D-slice information, thus missing the changes on the z-axis. This article tackles the 4D cardiac and lung image interpolation problem by synthesizing 3D volumes directly. Although heart and lung only account for a fraction of chest, they constantly undergo periodical motions of varying magnitudes in contrast to the rest of the chest volume, which is more stationary. This poses big challenges to existing models. In order to handle various magnitudes of motions, we propose a Multi-Pyramid Voxel Flows (MPVF) model that takes multiple multi-scale voxel flows into account. This renders our generation network rich information during interpolation, both globally and regionally. Focusing on periodic medical imaging, MPVF takes the maximal and the minimal phases of an organ motion cycle as inputs and can restore a 3D volume at any time point in between. MPVF is featured by a Bilateral Voxel Flow (BVF) module for generating multi-pyramid voxel flows in an unsupervised manner and a Pyramid Fusion (PyFu) module for fusing multiple pyramids of 3D volumes. The model is validated to outperform the state-of-the-art model in several indices with significantly less synthesis time.

Lamb waves evaluation in CFRP plates with laser shock wave technique

Lamb waves, which are guided waves propagating along the surface of a thin plate structure, have been investigated to remotely perform nondestructive testing for aircraft or infrastructures made of carbon fiber reinforced plastic (CFRP) plates. CFRP plates are prone to internal damage such as delamination, which does not occur in metallic materials. Although nondestructive methods such as X-ray, flash thermography, etc. have been investigated in several studies, they may have some disadvantages such as risks of radiation exposure or limitation in terms of size of the structures to be tested for the former, and heat diffusion for the latter. Laser thermoelasticity can generate Lamb waves remotely and nondestructively. However, the generated Lamb waves have a small amplitude; therefore, hundreds of measurements must be averaged to achieve a sufficient signal-to-noise ratio. For these reasons, it has not yet been demonstrated as possible to detect damage in large CFRP structures within a short time using nondestructive, remote-controlled methods. As a first step towards performing nondestructive tests in CFRP plates, this paper demonstrates the generation of A0 mode Lamb waves in the experimental plate samples using laser-induced plasma (LIP) shock waves. The validity of the proposed system is verified by comparing the phase velocities of Lamb waves in the CFRP plates with three different layups obtained with the proposed system, with the theoretical values obtained analytically. This system can generate vibrations in CFRP plates in frequency ranges of a few hundred kHz and allow to determine the phase velocity of the experimental Lamb waves up to approximately 100 kHz.

Abstract 13876: Women Face Unique Obstacles During Pediatric Cardiology Fellowship Training

Background: There are persistent disparities in career advancement for women physicians in pediatric cardiology. We sought to explore differences by gender in fellowship experience, as these may set the foundation for long-term gender inequity. Aims: To describe and compare fellowship experiences, career aspirations and family obligations of men and women in pediatric cardiology training. Methods: We performed a national survey of pediatric cardiology fellows examining mentorship, scholarly and DEI work, clinical experiences, career intentions and family commitments. Descriptive analyses were performed. Results: A total of 176 responses were included in the analysis (men=74, women=102). Most fellows were white (69%) and aged 30-34 years old (68%). Men and women reported similar mentorship, scholarly and clinical experiences, and influential factors in their decision to pursue subspecialty training. More women plan to pursue advanced imaging training (42% vs. 24%, p=0.04), to have administrative responsibilities (27% vs. 14%, p=0.06), and to work part time during their career (28% vs. 5.6%, p=0.001). Men reported greater interest in teaching (93% vs. 83%, p=0.04). While similar proportions of men and women were married, the spouses of women were more likely to be employed (91% vs. 71%, p=0.002). Among fellows with children, more women than men planned for additional children (75% vs. 25%, p=0.0004). Among fellows without children, more men than women planned for additional children (93% vs. 74%, p=0.01). Women were more likely to report delay in childbearing due to training (71% vs. 40%, p=0.0002), that childbearing decisions were influenced by the risk of radiation exposure (22% vs. 0%, p&lt;.0001), and the use of assistive reproductive technologies (11% vs. 1%, p=0.01). Conclusion(s): Women and men in pediatric cardiology fellowship have similar training experiences and career aspirations yet differ in their plans to raise families. Women face unique obstacles to childbearing and child raising during training. Motherhood in pediatric cardiology may be a vulnerable period during career development and advancement.

Abstract 12595: Vascular and Cardiac Ultrasound as the Primary Imaging Tool to Safely Deliver Pacing Leads While Implanting Single Chamber Cardiac Implantable Electronic Devices. RADICAI USE Investigators

Introduction: Conventional Cardiac implantable electronic devices (CIEDs) implantation requires fluoroscopy. Risks involved with implantation include pneumothorax, lead dislodgement, and perforation of the right ventricular wall. In addition, there are long-term risks of malignancy associated with prolonged and repeated use of radiation over the decades of operators’ employment and mechanical injuries related to heavy personal protection equipment. To reduce these risks, we aimed to study the utilization and safety of ultrasound (US) for the entire procedure to implant single-chamber devices. Methods: The RADICAI USE study (Reduction or Elimination of Radiation Use in Single Chamber Cardiac Devices using ultrasound) is a prospective, single-arm and multi-operator case series enrolled patients awaiting a single-chamber CIED. A fluoroscopic cut-off time of 20 seconds was used to define the success (Group A) or failure (Group B) of using the US for the entire implant duration. Patients were followed up at 1 week, 1 month and 1-year post-implant. Results: The study enrolled 63 patients, with 50 pacemakers and 13 ICDs, a mean age of 79.5 ± 13.8 years (95% CI = 76.1 - 82.9), and a mean weight of 74.1 ± 14.6 (95% CI = 70.5 - 77.7). Overall, 53 (84.1%) CIEDs were successfully implanted with a radiation time of less than 20 seconds (Group A). Fluoroscopic over 20 seconds was required due to poor echocardiographic windows, challenging access, or anatomy. No iatrogenic new or worsening of tricuspid regurgitation was noted. The mean procedure time including US setup time was 65.2 ± 20.2 (95% CI = 60.2 -70.2) minutes. Fluoroscopic time was significantly reduced in Group A compared to Group B (5.8 ± 4.5s vs 109.5 ± 92.9s, p = 0.004). Follow-up showed no device-related complications, with only two patients requiring lead revisions due to poor sensitivity, one unrelated to US use and another probably related. Conclusions: US-guided implantation of single-chamber CIEDs is feasible and safe, reducing the need for fluoroscopic guided implantation and subsequent risks of higher radiation exposure. Further studies are required to evaluate the cost-effectiveness and to explore fluoroscopic-free single-chamber CIED implantations using the US.

High-precision and high-efficiency measurement method of accelerator tunnel control network based on total station angle observation

Given the importance of accelerator devices, major developed and emerging countries around the world have invested substantial human and material resources into the development, construction, and operation of more advanced large-scale accelerator devices. High-precision and high-efficiency alignment of the control network is crucial for the stable operation of accelerators. This study proposes a method for measuring tunnel control networks using total station angle observation. By taking advantage of the high precision of angle observation with a total station, we use the measured results of the designed and deployed control points measured by the laser tracker to simulate the total station angle observations, combined with some length scale values in the control network measured by the laser range finder. With the angle observations and several known distances, the point coordinates can be calculated by angle intersection methods. Only angle observations are used from total stations, while different length scale reference conditions are added to constrain the control network. This is done by calculating the point accuracy of the China Spallation Neutron Source circular accelerator. The overall plane point accuracy can reach 66 μm. By using this method, personnel will spend less time on the site and are at lower risk of radiation exposure, for example by automating measurements at night. This method can be used at nighttime for measurements, avoiding the need for daytime work and shielding employees from severe radiation exposure. By employing this method, efficiency can be increased twice. For on-site measurement, it enables monitoring and automated measurement during operation, as well as providing reference for the installation and measurement of tunnel control networks for large scale accelerators such as the Circular Electron Positron Collider.