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Background and PurposeData on safety and efficacy of periprocedural use of heparin are limited during treatment of acute ischemic stroke patients with anterior circulation tandem occlusion. This study aimed to investigate the impact of heparin use during endovascular therapy of anterior circulation tandem occlusions on the functional and safety outcomes.
MethodsA retrospective analysis of the multicenter observational TITAN registry was performed. Patients with anterior circulation tandem occlusion and treated with endovascular therapy (EVT) were included, with or without extracranial carotid intervention. We divided patients into two groups based on periprocedural heparin use (heparin vs. non-heparin). The dose of intravenous unfractionated heparin ranged from 1500 to 2500 I.U. Primary study endpoint was 90-day Modified Rankin Scale (mRS). Secondary study endpoint included angiographic and safety endpoints such as hemorrhagic complications. A propensity-score-matched analysis was performed.
ResultsAmong 369 patients, heparin was used in 68 patients (18.4%). In the propensity-score-matched cohort, favorable outcome (mRS 0–2) occurred in 51.3% in heparin group and 58.0% in non-heparin group (matched OR, 0.76; 95% CI, 0.32–1.78; P = 0.52). Similar result was found in propensity-score-adjusted cohort (adjusted OR, 0.72; 95%CI, 0.39–1.32; P = 0.28). Likewise, there was no difference in the rate of successful reperfusion (mTICI 2b-3) (propensity-score-adjusted OR, 1.03; 95%CI, 0.50–2.09; P = 0.93) neither in safety endpoints between the two groups.
ConclusionsPeriprocedural heparin use during EVT of anterior circulation tandem occlusions was not associated with better functional, angiographic or safety outcomes. These findings are applicable for low doses of heparin, and further studies are warranted.
[en] The low-level effluent treatment plant (LLETP) treats effluent contaminated with radionuclides at concentration or activities greater than clearance levels, as established by the regulatory body. This study concerns the development of a new operational procedure for the treatment of low-level liquid radioactive waste containing alpha and gamma type effluents. Treatment of effluents will be by a flocculation-coagulation method, also known as chemical precipitation process. Therefore, a jar test will be used to simulate the flocculation-coagulation process and to determine the right amount of treatment chemicals that should be used. Analyses of the effluents before and after treatment were also done to measure success. Parameters used for this analysis were pH, temperature, conductivity, total dissolved solids, suspended solids, Chemical Oxygen Demand (COD), Biochemical Oxygen Demand (BOD) and activity. (author)
[en] Each system runs with the aim of achieving organisational objectives through the management system. However, even though it has been anticipated in various ways through various kinds of safety engineering approaches, incidents and even severe accidents are still possible to be happen. Management systems with their derivative documents like standard operating procedures are prepared to keep the system operating under normal conditions. However, such management system tools are sometimes cannot be applied in an emergency condition which requires a beyond ordinary action. That action is becoming the scope of resilience engineering in the effort to restore the system into normal conditions and/or to avoid more severe accidents. This article explaining the concepts of resilience engineering, how this concept should be applied together with the management system through the spectrum leadership approach as an effort to anticipate events that possibly can lead to severe accidents. This study shows that the resilience engineering, system management and spectrum leadership are very close correlated and have to be owned by all levels of personnel in the high-risk installation organization. (author)
[en] Stevia rebaudiana has recently gained the attention of food industry as one of the natural sweeteners. The sweet flavor is contributed by the glycosides compound included stevioside, rebaudiosides A to F, rubusoside, steviolmonoside, steviolbioside, and dulcoside A. Among these glycosides, the rebaudioside A and stevioside are 70% of the total glycosides in stevia. Therefore, they were used as stevia chemical markers in this study. The aim of the work reported here was to develop the extraction method of stevia using Hot Water Extraction (HWE) technique. In this paper, the extraction, precipitation and separation processes involved in HWE techniques for stevia were studied and developed. The glycosides yield from each processes were analyzed by High Performance Liquid Chromatography (HPLC). Approximately 283.5 mg purified glycosides contained of rebaudioside A and stevioside was quantified by High Performance Liquid Chromatography (HPLC) in HWE. Therefore, from the obtained results suggest the HWE is an efficient technique for stevia extraction. (author)
[en] Instability in uniform motion flows occurs when continues waves take over dynamic waves. In those cases primary uniform motion of the flow looses its stability and waves appear on free surface of the flow. The issue of prediction of waves occurrence on free surface are discussed in the paper. The calculations are made for both, cohesive debris flows (non Newtonian liquid) and water flows (Newtonian liquid) in order to control and secure stability of ecological situation in the bed and surrounding medium of water flow. (author)
[en] With the development in field of industry and medicine, new machines and techniques are being launched. Moreover, the complexity of the techniques is associated to an increasing risk of incident. Especially, a small error in radiotherapy can lead to a serious patient-related incident, risk management is necessary in radiotherapy in order to reduce the risk of incident. However, in field of radiotherapy, there are no legally binding clauses for risk management and there is an absence of risk management systems at an institutional level. Therefore, we analyzed institutional status of risk management, reporting & classification systems, and risk assessment & analysis in 31 countries. For risk management and reporting systems, 65% of countries investigated had legislation or regulations; however, only 35% of countries used classification systems. It was found that 43% more countries had legislation for risk management in health care than those for radiotherapy; 19% more countries had reporting systems for health care than those for radiotherapy. For classification systems, 60% more countries had legislation, recommendation, and guidelines in the field of radiotherapy than those for health care. Recently, international institutes have published several reports for risk management and patient safety in radiotherapy, owing to which, countries adopting risk management for radiotherapy will gradually increase. Before adopting risk management in Korea, we should precisely understand the procedures and functions of risk management, in order to increase efficiency of risk management because classification & reporting system and risk assessment & analysis are connected organically, and institutional management is needed for high quality of risk management in Korea.
[en] A Large Sample Neutron Activation Analysis (LSNAA) facility has been developed at the TRIGA-Annular Core Pulsed Reactor (ACPR) operated by the Institute for Nuclear Research in Pitesti, Romania. The central irradiation cavity of the ACPR core can accommodate a large irradiation device. The ACPR neutron flux characteristics are well known and spectrum adjustment techniques have been successfully applied to enhance the thermal neutrons weight in the central irradiation cavity. An analysis methodology was developed by using the MCNP code to estimate counting efficiency and correction factors for the major perturbing phenomena. Test experiments, comparison with classical instrumental neutron activation analysis results (INAA) and international inter-comparison exercise have been performed to validate the new methodology. Finally an uncertainty evaluation based on the complexity of whole experimental process is presented. (author).