Patient Safety in Interventional Radiology: A CIRSE IR Checklist

Interventional radiology (IR) is an invasive speciality with the potential for complications as with other invasive specialities. The World Health Organization (WHO) produced a surgical safety checklist to decrease the morbidity and mortality associated with surgery. The Cardiovascular and Interventional Society of Europe (CIRSE) set up a task force to produce a checklist for IR. Use of the checklist will, we hope, reduce the incidence of complications after IR procedures. It has been modified from the WHO surgical safety checklist and the RAD PASS from Holland

B-mode polarization forecasts for GreenPol

We present tensor-to-scalar ratio forecasts for GreenPol, a hypothetical ground-based B-mode experiment aiming to survey the cleanest regions of the Northern Galactic hemisphere at five frequencies between 10 and 44 GHz. Its primary science goal would be to measure large-scale CMB polarization fluctuations at multipoles $\ell \lesssim 500$, and thereby constrain the primordial tensor-to-scalar ratio. The observations for the suggested experiment would take place at the Summit Station (72deg N, 38deg W) on Greenland, at an altitude of 3216 meters above sea level. In this paper we simulate various experimental setups, and derive limits on the tensor-to-scalar ratio after CMB component separation using a Bayesian component separation implementation called Commander. When combining the proposed experiment with Planck HFI observations for constraining polarized thermal dust emission, we find a projected limit of r<0.02 at 95 % confidence for the baseline configuration. This limit is very robust with respect to a range of important experimental parameters, including sky coverage, detector weighting, foreground priors etc. Overall, GreenPol would have the possibility to provide deep CMB polarization measurements of the Northern Galactic hemisphere at low frequencies.Comment: 10 pages, 8 figures. To be submitted to A&

European Multicenter Study for the Evaluation of a Dual-Layer Flow-Diverting Stent for Treatment of Wide-Neck Intracranial Aneurysms: The European Flow-Redirection Intraluminal Device Study

BACKGROUND AND PURPOSE: Endoluminal reconstruction with flow-diverting stents represents a widely accepted technique for the treatment of complex intracranial aneurysms. This European registry study analyzed the initial experience of 15 neurovascular centers with the Flow-Redirection Intraluminal Device (FRED) system. MATERIALS AND METHODS: Consecutive patients with intracranial aneurysms treated with the FRED between February 2012 and March 2015 were retrospectively reviewed. Complications and adverse events, transient and permanent morbidity, mortality, and occlusion rates were evaluated. RESULTS: During the defined study period, 579 aneurysms in 531 patients (median age, 54 years;range, 13-86 years) were treated with the FRED. Seven percent of patients were treated in the acute phase (3 days) of aneurysm rupture. The median aneurysm size was 7.6 mm (range, 1-36.6 mm), and the median neck size 4.5 mm (range, 1-30 mm). Angiographic follow-up of >3 months was available for 516 (89.1%) aneurysms. There was progressive occlusion witnessed with time, with complete occlusion in 18 (20%) aneurysms followed for up to 90 14 days, 141 (82.5%) for 180 +/- 20 days, 116 (91.3%) for 1 year +/- 24 days, and 122 (95.3%) aneurysms followed for >1 year. Transient and permanent morbidity occurred in 3.2% and 0.8% of procedures, respectively. The overall mortality rate was 1.5%. CONCLUSIONS: This retrospective study in real-world patients demonstrated the safety and efficacy of the FRED for the treatment of intracranial aneurysms. In most cases, treatment with a single FRED resulted in complete angiographic occlusion at 1 year

Transitioning towards a Sustainable Wellbeing Economy— Implications for Rural–Urban Relations

This article focuses on the question of how a shift from a narrow economic perspective to a wider sustainable wellbeing focus in regional development strategies and actions might change rural–urban relations. A brief review of relevant research and discourses about economic develop-ment models provides the foundation for the analysis. The review leads to the development of an analytical framework that puts the notion of sustainable wellbeing at its center. The criteria included in the analytical framework are then used to assess the current situation, challenges and perceived ways forward based on data and analyses from 11 European regions. The focus of the analysis is on different expressions of a sustainable wellbeing economy, and aspects of territorial development that are consistent with the basic features of a wellbeing economy are identified. Development dy-namics and tensions between different development goals and resource uses, strategies and actions that are in favor of sustainable wellbeing goals, and conditions for a more mutually beneficial rural–urban relationship are discussed. The article concludes with the implications for local government, and governance and policy frameworks. Reference is made to current high-level strategic policy frameworks and the European Green Deal

Stenting and interventional radiology for obstructive jaundice in patients with unresectable biliary tract carcinomas

Together with biliary drainage, which is an appropriate procedure for unresectable biliary cancer, biliary stent placement is used to improve symptoms associated with jaundice. Owing to investigations comparing percutaneous transhepatic biliary drainage (PTBD), surgical drainage, and endoscopic drainage, many types of stents are now available that can be placed endoscopically. The stents used are classified roughly as plastic stents and metal stents. Compared with plastic stents, metal stents are of large diameter, and have long-term patency (although they are expensive). For this reason, the use of metal stents is preferred for patients who are expected to survive for more than 6 months, whereas for patients who are likely to survive for less than 6 months, the use of plastic stents is not considered to be improper. Obstruction in a metal stent is caused by a tumor that grows within the stent through the mesh interstices. To overcome such problems, a covered metal stent was developed, and these stents are now used in patients with malignant distal biliary obstruction. However, this type of stent has been reported to have several shortcomings, such as being associated with the development of acute cholecystitis and stent migration. In spite of these shortcomings, evidence is expected to demonstrate its superiority over other types of stent

Planck 2015 results: XXV. Diffuse low-frequency Galactic foregrounds

We discuss the Galactic foreground emission between 20 and 100 GHz based on observations by Planck and WMAP. The total intensity in this part of the spectrum is dominated by free-free and spinning dust emission, whereas the polarized intensity is dominated by synchrotron emission. The Commander component-separation tool has been used to separate the various astrophysical processes in total intensity. Comparison with radio recombination line templates verifies the recovery of the free-free emission along the Galactic plane. Comparison of the high-latitude H\u3b1 emission with our free-free map shows residuals that correlate with dust optical depth, consistent with a fraction (\ue2\u2030 30%) of H\u3b1 having been scattered by high-latitude dust. We highlight a number of diffuse spinning dust morphological features at high latitude. There is substantial spatial variation in the spinning dust spectrum, with the emission peak (in I\u3bd) ranging from below 20 GHz to more than 50 GHz. There is a strong tendency for the spinning dust component near many prominent H ii regions to have a higher peak frequency, suggesting that this increase in peak frequency is associated with dust in the photo-dissociation regions around the nebulae. The emissivity of spinning dust in these diffuse regions is of the same order as previous detections in the literature. Over the entire sky, the Commander solution finds more anomalous microwave emission (AME) than the WMAP component maps, at the expense of synchrotron and free-free emission. This can be explained by the difficulty in separating multiple broadband components with a limited number of frequency maps. Future surveys, particularly at 5-20 GHz, will greatly improve the separation by constraining the synchrotron spectrum. We combine Planck and WMAP data to make the highest signal-to-noise ratio maps yet of the intensity of the all-sky polarized synchrotron emission at frequencies above a few GHz. Most of the high-latitude polarized emission is associated with distinct large-scale loops and spurs, and we re-discuss their structure. We argue that nearly all the emission at 40deg &gt; l &gt;-90deg is part of the Loop I structure, and show that the emission extends much further in to the southern Galactic hemisphere than previously recognised, giving Loop I an ovoid rather than circular outline. However, it does not continue as far as the "Fermi bubble/microwave haze", making it less probable that these are part of the same structure. We identify a number of new faint features in the polarized sky, including a dearth of polarized synchrotron emission directly correlated with a narrow, roughly 20deg long filament seen in H\u3b1 at high Galactic latitude. Finally, we look for evidence of polarized AME, however many AME regions are significantly contaminated by polarized synchrotron emission, and we find a 2\u3c3 upper limit of 1.6% in the Perseus region