ACR Appropriateness Criteria ® Cerebrovascular Disease Salmela, Michael B; Mortazavi, Shabnam; Jagadeesan, Bharathi D ...
Journal of the American College of Radiology,
05/2017, Letnik:
14, Številka:
5S
Journal Article
Recenzirano
Odprti dostop
Diseases of the cerebral vasculature represent a heterogeneous group of ischemic and hemorrhagic etiologies, which often manifest clinically as an acute neurologic deficit also known as stroke or ...less commonly with symptoms such as headache or seizures. Stroke is the fourth leading cause of death and is a leading cause of serious long-term disability in the United States. Eighty-seven percent of strokes are ischemic, 10% are due to intracerebral hemorrhage, and 3% are secondary to subarachnoid hemorrhage. The past two decades have seen significant developments in the screening, diagnosis, and treatment of ischemic and hemorrhagic causes of stroke with advancements in CT and MRI technology and novel treatment devices and techniques. Multiple different imaging modalities can be used in the evaluation of cerebrovascular disease. The different imaging modalities all have their own niches and their own advantages and disadvantages in the evaluation of cerebrovascular disease. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
Type 2 diabetes mellitus (T2DM) is a global epidemic. According to international guidelines, the management protocol of T2DM includes lowering of blood glucose, along with preventing disease-related ...complications and maintaining optimal quality of life. Further, the guidelines recommend the use of a patient-centric approaches for the management of T2DM; however, Asian population is underrepresented in landmark cardiovascular outcome trials (CVOTs). There are several guidelines available today for the diagnosis and management of T2DM, and hence there is much confusion among practitioners about which guidelines to follow. A group of thirty international clinical experts comprising of endocrinologists, diabetologists and cardiologist from South Asia, Middle East and Africa met at New Delhi, India on February 8 and 9, 2020 and developed an international expert opinion statements via a structured modified Delphi method on the glucodynamic properties of OADs and the glucocratic treatment approach for the management of T2DM. In this modified Delphi consensus report, we document the glucodynamic properties of Modern SUs in terms of glucoconfidence, glucosafety, and gluconomics. According to glucodynamics theory, an ideal antidiabetic drug should be efficacious, safe, and affordable. Modern SUs as a class of OADs that have demonstrated optimal glucodynamics in terms of glucoconfidence, glucosafety, and gluconomics. Hence, modern SUs are most suitable second line drug after metformin for developing countries. Based on the current evidence, we recommend a glucocratic approach for the treatment of T2DM, where an individualized treatment plan with phenotype, lifestyle, environmental, social, and cultural factors should be considered for persons with T2DM in the South Asian, Middle Eastern and African regions.
A series of CoCrFeNiCux (x = 0, 0.2, 0.4, 0.6, 0.8, 1.0) high entropy alloys (HEA) were prepared using arc melting technique and the effect of Cu on microstructure evolution and wear was studied both ...at room and high temperature. Microstructure reveals two phases, namely, CoCrFeNi and pure Cu. Wear rate at room temperature (RT) as well as at elevated temperatures (ET) decreases with increase in Cu content. However, wear resistance is found to be more at ET than RT. This is attributed to the self-lubricating behaviour of Cu at elevated temperature.
Display omitted
Composite thin films of polyaniline-ruthenium oxide (PANI-RuO
2
) are prepared by a chemical bath deposition (CBD) method. The prepared thin films are characterized by X-ray diffraction (XRD), ...Fourier transform infrared (FT-IR) and FT-Raman spectroscopy. XRD patterns reveal the amorphous nature of the composite thin films. FT-IR and FT-Raman spectroscopy confirm PANI-RuO
2
composite formation. Cyclic voltammetry, galvanostatic charge-discharge and impedance analysis are carried out in order to investigate the applicability of the composite electrode as a supercapacitor. The PANI-RuO
2
composite electrode demonstrate the maximum specific capacitance of 830 F g
−1
. The specific energy and specific power of the PANI-RuO
2
composite electrode are 216 W h kg
−1
and 4.16 kW kg
−1
, respectively. The observed specific capacitance is the best yet reported for a PANI-RuO
2
composite supercapacitor in H
2
SO
4
electrolyte. Moreover, the composite electrode shows enhanced cycling stability. These results demonstrate the potential of developing the PANI-RuO
2
composite electrode material for high-performance supercapacitors.
Polyaniline-ruthenium oxide (PANI-RuO
2
) composite thin films prepared by a chemical bath deposition (CBD) method for supercapacitor application.
Undoped and Ga doped ZnO thin films (1% GZO, 3% GZO and 5% GZO) were grown on
c-Al
2O
3 substrates using the 1, 3 and 5
at. wt.% Ga doped ZnO targets by pulsed laser deposition. X-ray diffraction ...studies revealed that highly
c-axis oriented, single phase, undoped and Ga doped ZnO thin films with wurtzite structure were deposited. Micro-Raman scattering analysis showed that Ga doping introduces defects in the host lattice. The E
2
High mode of ZnO in Ga doped ZnO thin film was observed to shift to higher wavenumber indicating the presence of residual compressive stress. Appearance of the normally Raman inactive B
1 modes (B
1
Low, 2B
1
Low and B
1
High) due to breaking of local translational symmetry, also indicated that defects were introduced into the host lattice due to Ga incorporation. Band gap of the Ga doped ZnO thin films was observed to shift to higher energy with the increase in doping concentration and is explicated by the Burstein-Moss effect. Electrical resistivity measurements of the undoped and GZO thin films in the temperature range 50 to 300
K revealed the metal to semiconductor transition for 3 and 5% GZO thin films.
An effective environmentally friendly procedure has been proposed for the synthesis of novel bioactive 2-amino-4
H
-chromene derivatives by one-pot three-component condensation of aromatic aldehydes, ...malononitrile, and cyclohexane-1,3-dione using tetrabutylammonium hydrogen sulfate (TBAHS) as a catalyst under reflux conditions. The product structure was confirmed by IR,
1
H and
13
C NMR, and mass spectroscopic techniques. Simple workup procedure, excellent yields, and short reaction times are the most attractive benefits of the proposed multicomponent approach.
An experiment was conducted to study the anti-Mullerian hormone (AMH) concentration, antral follicle count (AFC) and progesterone (P4) concentration during estrous cycle in Murrah buffaloes. Seven ...animals of 5–10 years were selected for the study. All the animals were synchronized as per the ovsync protocol and the pair of ovary of each animal was scanned by ultrasonography on 0, 3rd, 7th, 11th, 14th, 17th and 21st day of estrous cycle. Blood was collected on the same day to evaluate serum AMH and P4 concentration. The nonsignificant difference was observed in antral follicle count of 3–5 mm, 5–8 mm and total follicles count (> 3 mm), whereas, significantly lower mean values of >8 mm of antral follicles were recorded on the day of estrus (0.14 ±0.14) as compared to 3rd, 7th, 11th, 14th, 17th and 21st day of estrous cycle. The significant individual variation was recorded in average mean of 3 - 5 mm and total antral follicle count (>3 mm). However, the difference for 5 - 8 mm and >8 mm was nonsignificant. The positive correlation of low and high antral follicle count was observed in the present study. Two animals of low antral follicle count remained non pregnant and two animals showed 3 follicular waves during estrous cycle. The nonsignificant difference was recorded in AMH concentration during estrous cycle, whereas, individual variation in AMH concentration differ significantly. The progesterone concentration showed significant increase and decrease in values according to the stages of estrous cycle.
The present work describes the occurrence of thermo-acoustic instability inside a horizontal Rijke tube and its suppression using an open loop active control technique. The Rijke tube is provided ...with a co-axial pre-mixed gas burner as the source of heat, which could be placed at any desired position. Radial injection of air (less than 3% of the total mass flow) through micro-jets into the flame is used as a control technique to suppress the thermo-acoustic instability. The rise in heat content inside the Rijke tube, estimated from the temperature mapping, clearly shows reduction in the heat loss as a result of complete suppression of the thermo-acoustic instability. However, the stability achieved passively by means of a slight shift in the burner position does not result in any change in the heat content. There is a visible change in the appearance of the burner flame when the above two methods are used to suppress the thermo-acoustic instability. The flame is seen to significantly shrink in length and spread radially when the control technique was applied. The flame dynamics is believed to determine the heat loss and hence the heat content inside the Rijke tube.
Large-scale deployment of photovoltaic modules is required to power our renewable energy future. Kesterite, Cu2ZnSn(S, Se)4, is a p-type semiconductor absorber layer with a tunable bandgap consisting ...of earth abundant elements, and is seen as a potential 'drop-in' replacement to Cu(In,Ga)Se2 in thin film solar cells. Currently, the record light-to-electrical power conversion efficiency (PCE) of kesterite-based devices is 12.6%, for which the absorber layer has been solution-processed. This efficiency must be increased if kesterite technology is to help power the future. Therefore two questions arise: what is the best way to synthesize the film? And how to improve the device efficiency? Here, we focus on the first question from a solution-based synthesis perspective. The main strategy is to mix all the elements together initially and coat them on a surface, followed by annealing in a reactive chalcogen atmosphere to react, grow grains and sinter the film. The main difference between the methods presented here is how easily the solvent, ligands, and anions are removed. Impurities impair the ability to achieve high performance (>∼10% PCE) in kesterite devices. Hydrazine routes offer the least impurities, but have environmental and safety concerns associated with hydrazine. Aprotic and protic based molecular inks are environmentally friendlier and less toxic, but they require the removal of organic and halogen species associated with the solvent and precursors, which is challenging but possible. Nanoparticle routes consisting of kesterite (or binary chalcogenides) particles require the removal of stabilizing ligands from their surfaces. Electrodeposited layers contain few impurities but are sometimes difficult to make compositionally uniform over large areas, and for metal deposited layers, they have to go through several solid-state reaction steps to form kesterite. Hence, each method has distinct advantages and disadvantages. We review the state-of-the art of each and provide perspective on the different strategies.
The coupling between pressure fluctuations and heat release variations during the combustion process is responsible for occurrence of thermo-acoustic instability. These instabilities will cause many ...adverse effects in power-producing devices. To control thermo-acoustic instabilities, its characterization is essential for design and implementation of control technique. The characterization of thermo-acoustic instabilities can be done using pressure amplitude and its frequency. In this study, the authors have presented two different approaches for thermo-acoustic instability characterization. In the first approach, the wall pressure measurements were taken at eleven locations, along the longitudinal directions, using differential pressure transducer. In the second approach, acoustic pressure outside the Rijke tube is measured. To check the consistency in the results, measurements are taken at different equivalence ratios and total mass flow rates. The result shows that the sound pressure level is higher in case of wall pressure measurement as compared to acoustic measurement outside the Rijke tube. The peak frequency is similar in both the cases, over a wide range of equivalence ratios and total flow rates. The captured standing wave pattern is similar to third mode of instabilities, but it was affected by the pulling force due to use of suction pump at the other end of Rijke tube. The suggested approaches can be effectively used to design the control techniques for suppression of thermo-acoustic instabilities. The acoustic pressure measured outside the Rijke tube is able to give the exact frequency of thermo-acoustic instabilities and also free from disruptions of flow. The exact prediction of mode of instability is essential, to identify location for mounting the pressure transducer on the wall of combustor, which was the major drawback of wall pressure measurements. The study further concluded that the intensity of thermo-acoustic instability is dependent on equivalence ratio.
PDF
