Terms Of Success Rate Research Articles

Energy Efficient Ant Colony System for Packet Routing in Wireless Sensor Network

Routing packets in Wireless Sensor Network (WSN) is challenging due to the distribution of sensor nodes with different ability. Inefficient routing may lead to higher failure rate, higher latency and higher energy consumption. One of the common approaches to solve this problem is by using bio-inspired routing algorithms due to their abilities to adapt with dynamic environment. This paper proposed an improved ant colony system for packing routing in WSN that focuses on exploration and exploitation techniques. In the proposed routing algorithm, the best path to be used for packet transmission will be determined by considering the remaining energy of each sensor node to reduce the hotspot problem. Local pheromone update and global pheromone update are used with the aim to prevent imbalanced energy depletion of sensor nodes and to balance the packet distribution. The proposed routing algorithm was validated against several bio-inspired routing algorithms in medium and large sized networks. The results suggested that it has outperformed in terms of success rate, packet loss rate, latency and energy efficiency.

Compare the Outcomes of Laparotomy Versus Laparostomy Tube in Neonates Presented with Pneumoperitoneum

Objective: The purpose of this study is to compare the outcomes of laparotomy versuslaparostomy tube in neonates presented with pneumoperitoneum. Study Design: Retrospective study Place and Duration: Children Hospital, Pakistan Institute of Medical Sciences PIMS Islamabad. Jan 2021-Dec 2021 Methods: There were 130 neonates of both genders were presented in this study. All the included neonates had pneumoperitoneum and admitted for surgery of abdomen. Detailed demographics of enrolled cases were recorded after taking informed written consent. Patients were equally divided in two groups. Group A received laparotomy among 65 patients and group B received laparostomy tube (conservative management) among 65 patients. Outcomes among both groups were assessed and compared in terms of efficacy, hospital stay, complications and pain score by visual analog score. Results: Majority of the neonates were males 78 (60%) and 52 (40%) neonates were females. Most common symptom was abdominal and scrotal distension, followed by vomiting, cyanosis, respiratory distress and tachypnea.Efficacy of group B was found among 55 (84.6%) cases, 6 cases required laparotomy and 4 patients were died because of sepsis. Hospital stay was lower in group B 3.9±10.74 days as compared to group A 6.2±11.41 days. Post-operative lower pain score was observed in group B 0.9±1.66 as compared to group A 4.2± 2.53. Complications were also higher in group A found in 10 (15.4%) cases as compared to group B in 4 (6.2%) cases. Conclusion: We concluded in this study that use of laparostomy tube among neonates with pneumoperitoneum was equally affective and useful in terms of success rate while hospital stay, and complications were lower as compared to laparotomy group. Keywords: Pneumoperitoneum, Hospital stay, Laparotomy, Laparostomy tube, Complications, Pain Score

Management of periprosthetic joint infection of shoulder arthroplasty: Single-stage versus two-stage protocols. A systematic review and meta-analysis of the literature.

The treatment of shoulder prosthetic joint infections (PJIs) requiring removal of the prosthesis is not well defined. This article aims to systematically review and compare the results of the literature in single-stage and two-stage protocols in the treatment of shoulder PJI. An in-depth search on PubMed/Scopus/Web of Science databases and cross-referencing search was carried out concerning the articles reporting detailed data on the topic. A total of 486 shoulder PJIs were included: 137 treated with single-stage and 349 with two-stage procedure. A similar distribution between early and not-early infections (19.1% vs 80.9%) was found between the two groups. The overall rate of success in terms of PJI eradication was significantly higher in the single-stage group (95.6% vs 85.7%, p < 0.001). The non-infection-related complications rate was 13.8% in the single-stage group and 37.6% in the two-stage group (p < 0.001), the non-infection-related revision rate was 8% and 18.9%, respectively (p = 0.005). The single-phase protocol showed a higher success rate in eradicating the infection and a lower complication rate. However, the low number of patients included, the low quality of the articles, the lack of data on clinical severity and bacteriological virulence suggest caution in conclusions.

Acceptability of the COVID-19 contact-tracing app – Does culture matter?

During the pandemic, several countries deployed contact-tracing apps in order to contain or reduce the community spread of COVID-19. However, the success rate in terms of acceptance and use of these apps was reportedly low. Using information gathered from citizens across four European countries and the United States of America, this study explores the role of national culture in relation to the acceptance of these apps.Using partial least squares structural equation modelling (PLS-SEM), an analysis was undertaken of 3595 records from a cross-country survey dataset that is in the public domain and can be obtained from the Centre for Open Science (Study 1). This analysis was followed by another survey comprising 910 respondents (Study 2). The research model was then validated by using a qualitative approach and undertaking interviews with 51 participants from four countries (Study 3). The results confirmed the moderating role of national culture on the acceptability of the contact-tracing apps in relation to power-distance, masculinity, individualism, long-term orientation and indulgence in the pre-deployment phase (Study 1). There were, however, no significant differences in acceptability of the apps between countries in relation to uncertainty avoidance; and none of the hypotheses in Study 2 was supported.The study concludes that national culture is significant in terms of the acceptance of COVID-19 apps only during the pre-deployment phase; therefore attention is required with pertinence to pre-deployment strategies. Recommendations regarding how governments and public health institutions can increase the acceptability of contact-tracing apps have been highlighted.

A Fast Local Search Algorithm for the Latin Square Completion Problem

The Latin square completion (LSC) problem is an important NP-complete problem with numerous applications. Given its theoretical and practical importance, several algorithms are designed for solving the LSC problem. In this work, to further improve the performance, a fast local search algorithm is developed based on three main ideas. Firstly, a reduction reasoning technique is used to reduce the scale of search space. Secondly, we propose a novel conflict value selection heuristic, which considers the history conflicting information of vertices as a selection criterion when more than one vertex have equal values on the primary scoring function. Thirdly, during the search phase, we record previous history search information and then make use of these information to restart the candidate solution. Experimental results show that our proposed algorithm significantly outperforms the state-of-the-art heuristic algorithms on almost all instances in terms of success rate and run time.

Trans-gastric and trans-abdominal percutaneous drainage of acute peripancreatic fluid infected collections: A retrospective analysis

BackgroundAcute pancreatitis is one of the most common gastrointestinal diseases. Approximately 20% of the patients develop peripancreatic collections. Step-up management it's now the best approach with less rate of morbidity and mortality compared with open or minimally invasive surgery. Percutaneous management could reach a success rate between 50 and 76%. Our study shows the outcomes of trans-gastric versus transabdominal percutaneous drainage in cases of acute peripancreatic fluid infected collections in the absence of interventionist endoscopy. MethodsA retrospective review of a prospectively collected database was conducted. All the patients older than 18 years old that underwent percutaneous drainage between January 2010–December 2021 were included. Analysis and description of outcomes such as mortality, complications, and avoidance of surgical procedures was performed. Results18 patients underwent percutaneous drainage. 66.67% of patients were male. Mean age was 52.55 ± 22.06 years. Mean weight was 74.43 ± 15.25 kg. Mean size of peripancreatic collections 118.4 ± 49.12 mm. Wall-off necrosis was present in 33.33%. Trans-gastric approach was performed in 50% of the cases, the rest was trans-abdominal. No mortality was evidenced after 30 days of follow up. After trans-gastric percutaneous drainage, all patients avoided surgical open or laparoscopic procedure. ConclusionStandardized step-up approach shows increased rates of success in percutaneous drainage of peripancreatic collections. Our case series shows a high rate of success in terms of avoidance any surgical procedure with no mortality after trans-abdominal and trans-gastric percutaneous drainage. Nevertheless, further prospective studies with higher sample size are needed.

Design of an Integrated Platform for Active Debris Removal

In research concerning active debris removal, scholars have proposed dozens of schemes for removing debris. However, every scheme has both advantages and disadvantages, and no scheme possesses an overwhelming advantage. This paper proposes an integrated platform scheme which integrates multiple capture and deorbit technologies, such as a tethered net, harpoon, and robotic arm, to improve the success rate in terms of the active removal of debris of different shapes and different sizes. The design of the mechanisms of the integrated platform is presented in detail.

Randomized comparison between perineural dexamethasone and combined perineural dexamethasone-dexmedetomidine for ultrasound-guided infraclavicular block

BackgroundThis randomized trial compared perineural dexamethasone with combined perineural dexamethasone-dexmedetomidine for ultrasound-guided infraclavicular block. We hypothesized that the combination of perineural adjuvants would result in a longer motor block.MethodsFifty patients...

Development of a Vision-Guided Shared-Control System for Assistive Robotic Manipulators.

Assistive robotic manipulators (ARMs) provide a potential solution to mitigating the difficulties and lost independence associated with manipulation deficits in individuals with upper-limb impairments. However, achieving efficient control of an ARM can be a challenge due to the multiple degrees of freedom (DoFs) of an ARM that need to be controlled. This study describes the development of a vision-guided shared-control (VGS) system and how it is applied to a multi-step drinking task. The VGS control allows the user to control the gross motion of the ARM via teleoperation and commands the ARM to autonomously perform fine manipulation. A bench-top test of the autonomous actions showed that success rates for different subtasks ranged from 80% to 100%. An evaluation with three test pilots showed that the overall task performance, in terms of success rate, task completion time, and joystick mode-switch frequency, was better with VGS than with teleoperation. Similar trends were observed with a case participant with a spinal cord injury. While his performance was better and he perceived a smaller workload with VGS, his perceived usability for VGS and teleoperation was similar. More work is needed to further improve and test VGS on participants with disabilities.

Interspinous process device versus conventional decompression for lumbar spinal stenosis: 5-year results of a randomized controlled trial.

Interspinous process distraction devices (IPDs) can be implanted to treat patients with intermittent neurogenic claudication (INC) due to lumbar spinal stenosis. Short-term results provided evidence that the outcomes of IPD implantation were comparable to those of decompressive surgery, although the reoperation rate was higher in patients who received an IPD. This study focuses on the long-term results. Patients with INC and spinal stenosis at 1 or 2 levels randomly underwent either decompression or IPD implantation. Patients were blinded to the allocated treatment. The primary outcome was the Zurich Claudication Questionnaire (ZCQ) score at 5-year follow-up. Repeated measurement analysis was applied to compare outcomes over time. In total, 159 patients were included and randomly underwent treatment: 80 patients were randomly assigned to undergo IPD implantation, and 79 underwent spinal bony decompression. At 5 years, the success rates in terms of ZCQ score were similar (68% of patients who underwent IPD implantation had a successful recovery vs 56% of those who underwent bony decompression, p = 0.422). The reoperation rate at 2 years after surgery was substantial in the IPD group (29%), but no reoperations were performed thereafter. Long-term visual analog scale score for back pain was lower in the IPD group than the bony decompression group (p = 0.02). IPD implantation is a more expensive alternative to decompressive surgery for INC but has comparable functional outcome during follow-up. The risk of reoperation due to absence of recovery is substantial in the first 2 years after IPD implantation, but if surgery is successful this positive effect remains throughout long-term follow-up. The IPD group had less back pain during long-term follow-up, but the clinical relevance of this finding is debatable.

Treatment of long bone infection by a biodegradable bone cement releasing antibiotics in human.

Repair of methicillin-resistant Staphylococcal (MRSA) chronic osteomyelitis and resulting bone defect is one of the major challenges in orthopaedics. Previous study has shown the effectiveness of antibiotic loaded biodegradable composite bone cement with in vitro tests and in the treatment of experimental osteomyelitis. The cement is composed of poly(lactide-co-glycolide) encapsulated antibiotic-biphasic calcium phosphate granule complex and additive antibiotic powder in gypsum binder. In this study, the cement was studied further to evaluate its in vitro biological properties (cytocompatibility, platelet activation), anti-infective, and bone regenerative potential in comparison to poly(methyl methacrylate) (PMMA) cement and parenteral therapy in 43 patients (age 5-57years) with chronic MRSA osteomyelitis by analyzing the results of histopathology, radiographs, magnetic resonance imaging, scanning electron microscopy, and serum drug concentrations for 1year. The composite cement showed superior cytocompatibility and coagulant activity compared to PMMA cement. Moreover, the results of different postoperative clinical and radiological examinations also proved the supremacy of composite cement over the other treatment modalities in terms of success rate, faster sepsis control and bone regeneration. Low serum antibiotic concentrations and normal serum calcium levels indicate that the calcium-rich composite cement is safe for application in human. Therefore, we conclude that the composite bone cement is a promising candidate for the treatment of chronic osteomyelitis.

Amniopatch as an active treatment of spontaneous previable rupture of membranes

Objective To assess the use of amniopatch – intraamniotic application of maternal platelets and cryoprecipitate, in patients after spontaneous previable rupture of membranes (sPPPROM) in terms of its effect on the course and outcome of pregnancy in the largest cohort so far. Since the amniopatch is currently used only to treat patients with iatrogenic preterm rupture of membranes, aim of this study was to find out, if amniopatch could be also used in case of sPPPROM as a safe alternative to currently used expectant management and to compare the results with published data on expectant management. Methods The study included 53 patients with single-fetal pregnancy after sPPPROM who underwent amniopatch as an experimental method in the years 2008–2019. Authors evaluated individual characteristics for the whole group as well as a subgroup of live-born neonates who survived to discharge and abortions/live-born infants who did not survive to discharge. Results The mean time of sPPPROM was 19 + 3 gestational week (gw) and of amniopatch performance 22 + 0 gw. Across the group, the miscarriage rate was 33.96%, survival rate 66.03%, mortality rate after delivery 8.57%, survival rate to discharge 60.37%. The mean time of latency period was 5 + 3 gw in the total group, 7 + 1 gw in the group of live births who survived to discharge. We did not find any maternal/fetal complications related directly to amniopatch procedure. Conclusion Amniopatch is a safe treatment alternative in patients with sPPPROM who require an active approach. It is associated with high percentage of a success rate in terms of duration of pregnancy and neonatal survival. In order to elucidate the possible mechanism of amniopatch effect in sPPPROM despite failure of complete sealing of membrane defect, authors give novel hypothesis of antimicrobial effect of amniopatch based on literature data.

CT-guided microwave ablation of osteoid osteoma: Long-term outcome in 28 patients

The purpose of this study was to assess the long-term efficacy of CT-guided microwave ablation (MWA) in the treatment of osteoid osteoma. Secondary objectives were to assess early outcome and side-effects of MWA. Twenty-eight consecutive patients (18 men, 10 women) with a median age of 19.5 years (IQR: 16, 25.5) with a total of 28 non-spinal osteoid osteoma treated by CT-guided MWA were retrospectively included. The ablations were performed with a median power and duration of 60 Watt and 1 min 30 s, respectively. Pain referred to osteoid osteoma was assessed at predefined time points using a 0-10 numeric rating scale. At one month, contrast-enhanced follow-up MRI was performed to evaluate the nidus vascularization and the volume of necrosis induced by MWA. Clinical success was defined by the absence of osteoid osteoma-related pain, and technical success was defined by the presence of necrosis of the nidus on the one-month post-MWA MRI. Long term success rate was 93% (26/28) after a follow-up of 55.5 months (IQR: 25.75, 74.5) and technical success rate was 96 % (25/26). One late failure was observed after a patient had been declared cured at one month but the formal proof of a late recurrence of osteoid osteoma could not be brought. Three minor complications were reported including mild reversible superficial radial nerve injury with a skin burn (grade 2) in one patient and moderate skin burn only in two patients. Our results suggest that CT-guided MWA is an effective option for a minimally-invasive treatment of osteoid osteoma with a low rate of complication and no late recurrence.

Trends in endotracheal intubation for patients with COVID-19 by emergency physicians.

Emergency physicians perform endotracheal intubations for patients with COVID-19. However, the trends in the intubation for COVID-19 patients in terms of success rate, complications, personal protective equipment (PPE) information, barrier enclosure use, and its transition have not been established. We conducted a retrospective study of COVID-19 cases that required tracheal intubation at four hospitals in the Tokyo metropolitan area between January 2020 and August 2021. The overall intubation success rate, operator experience, and infection control methods were investigated. We then compared the early and late phases of the pandemic for a period of 8 months each. A total of 211 cases met the inclusion criteria, and 133 were eligible for analysis. The intubation success rate increased from 85% to 94% from early to late phase, although the percentage of intubations performed by emergency medicine residents increased significantly in the late phase (p = 0.03). The percentage of light PPE use significantly increased from 65% to 91% from early to late phase (p < 0.01), whereas the percentage of barrier enclosure use significantly decreased from 26% to 0% (p < 0.01). Furthermore, the infection prevention methods during intubation became more simplified from early to late phase.

Satellite replacement and task reallocation for multiple-payload fractionated Earth observation mission

This paper studies the sustainability of an Earth observation mission that utilizes a multiple-payload fractionated system consisting of twelve eight-unit CubeSats, with respect to the CubeSat failures. It proposes practical approaches to the CubeSat replacement, deorbiting and orbit insertion maneuvering, as well as task reallocation. The performance and failure analyses, using Monte-Carlo simulations, suggest that by having a maximum of four reserved CubeSats in orbit the impact of CubeSat failures on the mission can be notably lessoned. It can also lower the total number of required launches for the entire mission lifetime. A maneuvering sequence that can set a new CubeSat on a precise trajectory to reach its designated orbital position is formulated, and it is shown that the total ΔV required for correcting the initial orbit deviation can be significantly reduced by taking benefit from the J2 perturbation. A deorbiting analysis proves that each failed CubeSat can be safely removed from the orbit if equipped with a stand-alone drag sail unit. A dynamic approach is proposed toward the reallocation of the tasks of the failed CubeSats to the operational ones, using a combinatorial auction-based real-time algorithm, and its performance is studied, in terms of success rate, optimal utilization and CPU time, under different circumstances with respect to the use of reserved CubeSats, partial or complete reallocation, and task redundancy.

Dynamics-Aware Metric Embedding: Metric Learning in a Latent Space for Visual Planning

In this letter, we consider vision-based control tasks of which the desired goals are given as target images. The problems are often addressed by an autonomous agent which optimizes a trajectory to minimize a manually designed cost function. However, it is challenging to design a suitable cost function for each goal by hand, especially, when the current and the goal states of the system are only described by visual observations. In order to tackle this issue, we propose a method called dynamics-aware metric embedding (DAME), which generates cost functions in a self-supervised manner to help the agent plan the controls to accomplish the desired goals. The proposed method learns a metric function that reflects how easy to find a path connecting two states considering the dynamics of the system. To learn the metric between states, we utilize a measure named probabilistic reachability, which is computed using the probability of reaching from one state to the other state via random walk. We evaluate the proposed method in several vision-based control tasks, including both various simulation benchmarks and real-world table-top manipulation tasks, and observe that DAME outperforms other baseline algorithms by over <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><tex-math notation="LaTeX">$\mathbf {\text{30}\%}$</tex-math></inline-formula> in the terms of success rate.

PokeRRT: Poking as a Skill and Failure Recovery Tactic for Planar Non-Prehensile Manipulation

In this work, we introduce <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">PokeRRT</i> , a novel motion planning algorithm that demonstrates poking as an effective non-prehensile manipulation skill to enable fast manipulation of objects and increase the size of a robot’s reachable workspace. We showcase poking as a failure recovery tactic used synergistically with pick-and-place for resiliency in cases where pick-and-place initially fails or is unachievable. Our experiments demonstrate the efficiency of the proposed framework in planning object trajectories using poking manipulation in uncluttered and cluttered environments. In addition to quantitatively and qualitatively demonstrating the adaptability of <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">PokeRRT</i> to different scenarios in both simulation and real-world settings, our results show the advantages of poking over pushing and grasping in terms of success rate and task time.

Cinematheraphy dalam Islam

Cinematherapy is one of various techniques in therapy, but in this paper the researcher tries to combine cinematherapy techniques and the use of Islamic films in cinematherapy techniques. This study has a purpose, namely, to analyze the development of cinematherapy to help clients, and the lack of specific references that discuss cinematherapy in a religious context. Therefore, this research is here to try to contribute in the academic and social sciences in terms of counseling guidance so that it can contribute to the development of cinematherapy in Islam. The method used in this research is library research from the findings of journals that specifically discuss cinematherapy problems, namely 16 journals obtained through geoogle schoolar, garuda journals, sinta journals, and various searches found. The results of the study found that the cinematherapy technique has a high success rate in terms of general scientific fields but specifically the use of cinematherapy in Islam to overcome client problems has not been found. Therefore, researchers are trying to present Islamic values ​​in cinematherapy techniques as a form of scientific development in the form of cinematherapy as techniques and methods in overcoming client problems Keywords: therapy, film, cinematherapy, islam

Safety and efficacy of retrograde intrarenal surgery in primary and residual renal calculi in children

Minimal invasive approach is the current standard of care in the management of pediatric renal calculi. Current guidelines are clear with extra corporal shock wave lithotripsy (ESWL) and percutaneous nephrolithotomy (PCNL) for stone size less than and greater than 20mm respectively. Although retrograde intrarenal surgery (RIRS) is well established in adults but literature on its role, safety and efficacy in children is sparsely available. To share our experience of RIRS and its outcome in a pediatric population in both primary and residual calculi of size less than 20mm. We retrospectively analysed data of children who underwent RIRS for either primary or residual renal calculi from January 2017 to January 2021. Children less than 5 years underwent passive ureteric dilatation with stenting preoperatively. A7.5 Fr flexible ureteroscope with an access sheath was used in all cases while performing RIRS. All the patients had a stent left in situ at the end of the procedure. Data including stone burden, number of sittings, operative time, stone-free rate (SFR) and grade of post procedural complications were analysed with appropriate statistical methods. A total of 20 patients were included in this study. The median age at presentation was 9 years ranging from 9 months to 18 years. Eight patients (40%) presented with primary renal calculi and underwent RIRS directly while the rest of the 12 (60%) had residual calculi following other procedures like SWL, PCNL before undergoing RIRS. Seven patients (35%) had congenital renal anomalies. The mean stone size and operating time (OR) was 12.6±3.2mm 84.5±7.2min respectively. The post-procedural complications were seen in 4 (20%) patients in the form of Grade-1 modified Clavein classification in 3 and Grade 2 in 1 patient. The 100% stone-free rate was achieved in 80% of the cases after first attempt. In the present series, RIRS was effective in both the types of stones (primary and residual) less than 20mm in size, showing 100% stone free rate with maximum of two attempts. Choosing age based optimised passive ureteric dilation led to injury free access for RIRS. Overall complications remained with in low grades and are comparable to current literature. Limitations of the study include small cohort, retrospective study and the need of three anaesthesia procedures in children under 5 years of age. RIRS is safe and effective in children with a renal stone(s) less than 20mm and it has a high success rate in term of achieving stone free status in both primary and residual calculi.

Efficacy and Safety of Zero-Fluoroscopy Approach during Catheter Ablation of Accessory Pathway.

Background: Catheter ablation (CA) is a safe and efficient treatment in patients with an atrioventricular accessory pathway (AP). Electroanatomical mapping (EAM) systems are useful during CA of AP, especially for reducing fluoroscopy. There are limited data about the feasibility of CA procedures performed with the use of the EAM system entirely without fluoroscopy in adults with AP. The aim of the study is to assess the feasibility, efficacy and safety of CA with the use of EAM without fluoroscopy, compared to CA with EAM and fluoroscopy in patients with AP. Methods: The study included 83 consecutive patients (age 38.25 ± 15.8 years), who were subjected to CA for AP. In 40 patients CA was performed with the use of EAM without fluoroscopy (EAM group), and in 43 patients CA was performed with EAM and fluoroscopy (control group). Baseline characteristics, procedure parameters and complications were obtained from the medical records. Data on permanent success rate was obtained after the mean follow-up time of 1 year. Primary outcomes were acute procedural success rate, long term success rate at 1-year follow-up and complications. Secondary outcomes were the procedure time and number of applications. Results: There were no statistically significant differences in baseline characteristics between the groups, except for the AP locations. Right-sided AP was more common in the EAM group, while left-sided AP was more common in the control group (p = 0.007 and p = 0.004, respectively). Acute procedural success was achieved in 38 patients (95.0%) in the EAM group and in 39 patients (90.7%) in the control group (p = 0.449). Long term success rate was achieved in 36 patients (90.0%) in the EAM group and in 36 (83.7%) patients in the control group (p = 0.399). There was one minor complication in the form of RBBB in the EAM group (p = 0.138). The mean procedure time was shorter in the EAM group compared to the control group (93.0 ± 58.3 min vs. 127.6 ± 57.5 min; p = 0.009). Conclusions: CA of both right-sided and left-sided AP completely guided by EAM without the use of fluoroscopy is feasible, safe and effective.