97,651 research outputs found
Charities’ new non-financial reporting requirements: preparers’ insights
The purpose of this paper is to obtain insights from preparers on the new Performance Report requirements for New Zealand charities, in particular the non-financial information included in the ‘Entity Information’ section and the ‘Statement of Service Performance’ for Tier 3 and 4 charities. Semi-structured interviews were conducted with 11 interviewees, each involved with governance and reporting of one or more Tier 3 or Tier 4 charities. These interviews were analysed in terms of accountability and legitimacy objectives, which motivated the regulators to introduce the new reporting regime. Key findings are summarised under three themes. Manageability relates to perceptions and suggestions regarding implementation of the new requirements. Scepticism concerns some doubts raised by interviewees regarding the motivations for performance reports and the extent to which they will be used. Effects include concerns about potentially losing good charities and volunteers due to new requirements making their work ‘too hard’, although increased focus on outcomes creates the potential for continuous improvement. The subjectivity that is inherent in thematic analysis is acknowledged and also that multiple themes may sometimes be present in the sentences and paragraphs analysed. We acknowledge too that early viewpoints may change over time. Themes identified may assist regulators, professional bodies and support groups to respond to the views of preparers. Findings will also be of interest to parties in other jurisdictions who are considering the implementation of similar initiatives. This paper provides early insights on new reporting requirements entailing significant changes for New Zealand charities for financial periods beginning on or after April 2015. The focus is on small charities (97% of all New Zealand charities) and key aspects of the Performance Report: Entity information and the Statement of Service Performance.fals
A New 3-D automated computational method to evaluate in-stent neointimal hyperplasia in in-vivo intravascular optical coherence tomography pullbacks
Abstract. Detection of stent struts imaged in vivo by optical coherence
tomography (OCT) after percutaneous coronary interventions (PCI) and
quantification of in-stent neointimal hyperplasia (NIH) are important.
In this paper, we present a new computational method to facilitate the
physician in this endeavor to assess and compare new (drug-eluting)
stents. We developed a new algorithm for stent strut detection and utilized
splines to reconstruct the lumen and stent boundaries which provide
automatic measurements of NIH thickness, lumen and stent area. Our
original approach is based on the detection of stent struts unique characteristics:
bright reflection and shadow behind. Furthermore, we present
for the first time to our knowledge a rotation correction method applied
across OCT cross-section images for 3D reconstruction and visualization
of reconstructed lumen and stent boundaries for further analysis in
the longitudinal dimension of the coronary artery. Our experiments over
OCT cross-sections taken from 7 patients presenting varying degrees of
NIH after PCI illustrate a good agreement between the computer method
and expert evaluations: Bland-Altmann analysis revealed a mean difference
for lumen cross-section area of 0.11 ± 0.70mm2 and for the stent
cross-section area of 0.10 ± 1.28mm2
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Accuracy of Length of Virtual Stents in Treatment of Intracranial Wide-Necked Aneurysms.
Background and purposePrecise stent deployment is important for successful treatment of intracranial aneurysms by stent-assisted coiling (SAC). We evaluated the accuracy of virtual stents generated using commercial stent planning software by comparing the length of virtual and actually deployed intracranial laser cut stents on three-dimensional digital subtraction angiography (3D-DSA) images.MethodsWe retrospectively analyzed the data of 75 consecutive cases of intracranial wide-necked aneurysms treated with the SAC technique using laser cut stents. Based on 3D-DSA images acquired by C-arm CT, stent sizing and placement were intraoperatively simulated by a commercial software application. The difference in length of the stents was estimated by measuring proximal discrepancies between the end points of the virtual and actually deployed stents on fused pre-procedural and post-procedural 3D-DSA images. Discrepancies between distal stent end points were manually minimized. The Kruskal-Wallis test was applied to test whether stent location, type, and length had an effect on difference in length between virtual and real stent.ResultsThe median difference in length between virtual and real stents was 1.58 mm with interquartile range 1.12-2.12 mm. There was no evidence for an effect of stent location (p = 0.23), stent type (p = 0.33), or stent length (p = 0.53) on difference in length between virtual and real stents.ConclusionsStent planning software allows 3D simulation of laser cut stents overlain on 3D-DSA images of vessels and may thus be useful for stent selection and deployment of laser cut stents during stent-assisted coiling of intracranial aneurysms
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Effect of stent position on flow characteristics in a cerebral aneurysm
The position of an intracranial stent in relation to the ostium of a cerebral aneurysm can
significantly affect the blood flow characteristics through the ostium and inside the aneurysm.
An idealised cerebral artery and aneurysm were simulated with a pulsatile flow. Simulation
results show that the effect on mass inflow between two stent positions is about 20%
whereas the difference in the porosity effect of the pattern at these two positions is around
3%. The remainder may be attributed to differences in flow velocity profile across the stent
into the aneurysm. The implications for clinical practice are an important consideration as the
surgeon may place the stent in any position between the two investigated and hence this will
lead to markedly different stent performance. Therefore, computational tools that take into
account the variability of stent placement will be valuable for assisting surgical planning
Stent implant follow-up in intravascular optical coherence tomography images
The objectives of this article are (i) to
utilize computer methods in detection of stent struts
imaged in vivo by optical coherence tomography
(OCT) during percutaneous coronary interventions
(PCI); (ii) to provide measurements for the assessment
and monitoring of in-stent restenosis by OCT post PCI.
Thirty-nine OCT cross-sections from seven pullbacks
from seven patients presenting varying degrees of
neointimal hyperplasia (NIH) are selected, and stent
struts are detected. Stent and lumen boundaries are
reconstructed and one experienced observer analyzed
the strut detection, the lumen and stent area measurements,
as well as the NIH thickness in comparison to
manual tracing using the reviewing software provided
by the OCT manufacturer (LightLab Imaging, MA,
USA). Very good agreements were found between
the computer methods and the expert evaluations
for lumen cross-section area (mean difference =
0.11 ± 0.70 mm2; r2 = 0.98, P\ 0.0001) and the
stent cross-section area (mean difference = 0.10 ±
1.28 mm2; r2 = 0.85, P value\ 0.0001). The average
number of detected struts was 10.4 ± 2.9 per crosssection
when the expert identified 10.5 ± 2.8
(r2 = 0.78, P value\0.0001). For the given patient
dataset: lumen cross-sectional area was on the average
(6.05 ± 1.87 mm2), stent cross-sectional area was
(6.26 ± 1.63 mm2), maximum angle between struts
was on the average (85.96 ± 54.23), maximum,
average, and minimum distance between the stent
and the lumen were (0.18 ± 0.13 mm), (0.08 ±
0.06 mm), and (0.01 ± 0.02 mm), respectively, and
stent eccentricity was (0.80 ± 0.08). Low variability
between the expert and automatic method was
observed in the computations of the most important
parameters assessing the degree of neointimal tissue
growth in stents imaged by OCT pullbacks. After
further extensive validation, the presented methods
might offer a robust automated tool that will improve
the evaluation and follow-up monitoring of in-stent
restenosis in patients
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Combination of high-resolution cone beam computed tomography and metal artefact reduction software: a new image fusion technique for evaluating intracranial stent apposition after aneurysm treatment.
We introduce a new imaging technique to improve visualisation of stent apposition after endovascular treatment of brain aneurysms employing high-resolution cone beam CT and three-dimensional digital subtraction angiography. After performing a stent-assisted coil embolisation of brain aneurysm, the image datasets were processed with a metal artefact reduction software followed by the automated image fusion programmes. Two patients who underwent aneurysm coiling using a Neuroform stent were evaluated. The reconstructed 3D images showed a detailed structure of the stent struts and identified malappositions of the deployed stents. Case 1 showed good apposition on the outer curvature side of the carotid siphon, while the inner curvature side showed prominent malapposition. Case 2, with multiple aneurysms, showed good apposition on both outer and inner curvature sides, although inward prolapse of the struts was observed. This new imaging technique may help evaluate stent apposition after the endovascular aneurysm treatment
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