Prior retrospective and case-control studies have shown that the use of general anesthesia (GA) during endovascular therapy (EVT) for acute ischemic stroke with large vessel occlusion (AIS-LVO) was ...independently associated with poor clinical outcomes compared with cases performed under conscious sedation (CS). Conversely, recent small randomized clinical trials (RCT) demonstrated a trend toward better outcome in cases performed under GA.
We submitted an online survey to 193 Society of Vascular Interventional Neurology and 78 American Association of Neurological Surgeons and Congress of Neurological Surgeons - Cerebrovascular Section neuroendovascular practitioners. Questions were aimed at understanding the current state of anesthesia practice during EVT, and to determine if there is clinical equipoise for a large multicenter RCT comparing GA versus CS during EVT.
Between March and May of 2017, we received 116 (43%) responses. Anesthesiologists were responsible for managing 96% of the GA cases as compared to only 51% of the CS cases (
< 0.0001). Notable 56% of providers reported performing less than a quarter of their cases under GA. Only 7% performed all cases under GA compared with 17% who used solely CS (
= 0.048). More than half of respondents thought a new RCT was necessary, of whom 61% were interested in participating. Among interested responders, 59% were located in centers with 3 or more neurointerventionalists.
The significant variation among neuroendovascular providers, added with the lack of consensus among recent trials and meta-analyses, demonstrate clinical equipoise for further studies to explore the effects of anesthesia during EVT in AIS-LVO.
Automatic vehicle record-keeping systems have varied applications such as security for car parking facilities, tracking vehicle location and monitoring vehicular traffic. In this paper, we propose a ...system for vehicle authentication, book-keeping and tracking. The proposed system implements Automatic License Plate Recognition (ALPR) with Convolution Neural Network (CNN) followed by a Gated Recurrent Unit (GRU), which recognizes vehicles and automatically authenticates them with the records on a database to provide information about the vehicle. On the request of the vehicle owner, the system can send vehicle location data through SMS (Short Message Service) notification to the vehicle owner by using a GSM module. Tradition ALPR Systems employ Image Segmentation followed by individual character classification. In this work, we have used a sequence modeling technique that does not require image segmentation. It achieved a character recognition accuracy of 98% and a complete license plate character recognition accuracy of 88%, when trained on a modest data set consisting of 400 images of different fonts.
Abstract only Background: Prior studies have suggested that unruptured cerebral aneurysm (CA) treatments have spread from high-volume centers into lower-volume centers in the past decade, coinciding ...with the increase of endovascular coiling (EC) relative to surgical clipping (SC). Our understanding of outcomes from CA treatments by hospital treatment volumes is lacking. Methods: Using administrative data on all discharges from hospitals in New York (2005-2014) and Florida (2005-2015), we identified patients with treatments for unruptured CAs. Good outcome was defined as discharge home without intracerebral hemorrhage (ICH) and poor outcome as discharge to SNF or death. A composite weighted index of risk factors was calculated using the Charlson Comorbidity Index (CCI). Logistic regression adjusted for age, sex, smoking, diabetes and CCI were performed. Results are provided as median IQR or OR 95% CI. Results: Among 14,064 patients with treated unruptured CAs, median age was 58 49 - 66 and 75% were female. EC was performed in 9,417 (67%), and increased over time (56% vs. 74%, 2006 vs. 2014). Annual treatments increased over the study period, with 1125 CAs treated in 2006 versus 1517 in 2014, whereas the number of treating hospitals did not (66 vs. 64, 2006 vs. 2014). In adjusted logistic regression, there was no difference in likelihood of a good outcome over time (OR 0.94 0.86 - 1.03, 2012-2015 vs. 2005 - 2008). The likelihood of good outcome increased with annual hospital treatment volume ( Figure 1a ). This relationship was maintained for patients treated with SC and EC (ORs 1.7 1.33 - 2.2 and 3.2 2.5 -4.1). The likelihood of poor outcome conversely decreased consistently with increasing annual treatment volume ( Figure 1b ). Conclusion: In this large cohort study, we did not observe an increase in the number of hospitals performing CA treatments. However, for patients treated with both SC and EC, treatment at higher-volume centers was associated with improved outcomes.
We present a measurement of the flux of neutrino-induced upgoing muons (<E
ν
>∼ 100 GeV) using the MACRO detector. The ratio of the number of observed to expected events integrated over all zenith ...angles is 0.74 ±0.036 (stat) ±0.046 (systematic) ±0.13 (theoretical). The observed zenith distribution for −1.0≤cos
θ≤−0.1 does not fit well with the no oscillation expectation, giving a maximum probability for
χ
2 of 0.1%. The acceptance of the detector has been extensively studied using downgoing muons, independent analyses and Monte Carlo simulations. The other systematic uncertainties cannot be the source of the discrepancies between the data and expectations.
We have investigated whether the observed number of events and the shape of the zenith distribution can be explained by a neutrino oscillation hypothesis. Fitting either the flux or zenith distribution independently yields mixing parameters of sin
22
θ=1.0 and
Δm
2 of a few times 10
−3 eV
2. However, the observed zenith distribution does not fit well with any expectations, giving a maximum probability for
χ
2 of 5% for the best oscillation hypothesis, and the combined probability for the shape and number of events is 17%. We conclude that these data favor a neutrino oscillation hypothesis, but with unexplained structure in the zenith distribution not easily explained by either the statistics or systematics of the experiment.
The PHOBOS detector at RHIC Back, B.B; Baker, M.D; Barton, D.S ...
Nuclear instruments & methods in physics research. Section A, Accelerators, spectrometers, detectors and associated equipment,
03/2003, Letnik:
499, Številka:
2
Journal Article
Recenzirano
This manuscript contains a detailed description of the PHOBOS experiment as it is configured for the Year 2001 running period. It is capable of detecting charged particles over the full solid angle ...using a multiplicity detector and measuring identified charged particles near mid-rapidity in two spectrometer arms with opposite magnetic fields. Both of these components utilize silicon pad detectors for charged particle detection. The minimization of material between the collision vertex and the first layers of silicon detectors allows for the detection of charged particles with very low transverse momenta, which is a unique feature of the PHOBOS experiment. Additional detectors include a time-of-flight wall which extends the particle identification range for one spectrometer arm, as well as sets of scintillator paddle and Cherenkov detector arrays for event triggering and centrality selection.
In this letter we present the results of the search for massive magnetic monopoles in the penetrating cosmic ray radiation using the various subdetectors of the MACRO apparatus, during the period ...1989–1995. Flux limits are given for the
β =
v
c
range 4 × 10
−5 < β < 1; for 10
−4 < β < 10
−1 the limits are below the Parker bound, ∼ 10
−15 cm
−2s
−1sr
−1.
PDF
