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Vascular interventionalists continue to expand the scope and breadth of endovascular procedures that we offer to our patients. However, we often have to overcome various anatomical and technical challenges to deliver an endovascul...
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Vascular interventionalists continue to expand the scope and breadth of endovascular procedures that we offer to our patients. However, we often have to overcome various anatomical and technical challenges to deliver an endovascular device. This article should give the modern interventionalist an array of technical tips and tricks to enable them to overcome various challenging anatomical features such as vessel tortuosity, vascular calcifications, and increasing abdominal pannus. We also hope to elucidate alternative accesses such as radial access, pedal access, popliteal access, and direct stent access as well as direct aortic access. Ever since Sven Ivar Seldinger discovered the concept of needle in, wire in, needle out, and catheter in, interventional radiologists have been using this technique to gain access to various areas in the human body to perform diagnostic angiography. Subsequently, Charles Dotter showcased to the world of medicine that a remote percutaneous vascular access can enable us to perform elegant minimally invasive endovascular procedures without a scalpel. For the past 50 years vascular interventional physicians have been able to push the envelope and have developed solutions for dealing with challenging vascular anatomy. We are performing far more complex interventions and often require the deliver)/ of devices as large as 26 French in size. Some challenging factors such as small-caliber vessels, vessel tortuosity, calcified vessels, and abdominal pannus are hurdles all clinical interventionalists face. The purpose of this article is to specifically provide a few tips and tricks to overcome challenging anatomies and complex conditions regarding endovascular interventions.
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This study presents a methodology for appraising accessibility in rural areas considering both settlement areas and farmlands, taking into account stakeholders' perceptions about accessibility to desired services/facilities. It is...
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This study presents a methodology for appraising accessibility in rural areas considering both settlement areas and farmlands, taking into account stakeholders' perceptions about accessibility to desired services/facilities. It is motivated by the fact that farmlands, unvaryingly, are the origins or destinations of a significant number of regular trips (passengers and goods) related to agricultural activities, and are, thus, important for accessibility studies in rural areas. A region-level accessibility index has been constructed for the study, which has then been applied to Jalangi block in India. The demonstrative application provides insights into the block's accessibility scenario based on stakeholders' perception. The suggested methodology is replicable to other similar areas with suitable calibrations. Thus, it may complement the existing approaches for rural accessibility planning in general and the Indian scenario in particular. The scope for further studies has been identified.
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Introduction: The aim of this study was to determine and compare the difference in the volume of dentin and enamel removed (DER) to prepare 3 different access cavities and to propose a standardization of the access cavities accord...
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Introduction: The aim of this study was to determine and compare the difference in the volume of dentin and enamel removed (DER) to prepare 3 different access cavities and to propose a standardization of the access cavities according to their volume of DER. Methods: One hundred twenty maxillary and mandibular molars and premolars were assigned to 3 subgroups for each tooth type (n = 10): the traditional endodontic cavity (TEC) group; the conservative endodontic cavity (CEC) group with partial unroofing and convergent walls; and the ultraconservative endodontic cavity (UEC) group, preserving most part of the pulp chamber roof and the occlusal surface. The sliced image data of cone-beam computed tomographic images before and after access cavity preparation were exported as Digital Imaging and Communications in Medicine files and imported into the MeVisLab framework system (MeVis Research, Bremen, Germany). After segmentation, the volumes of coronal dentin and enamel were measured, and the difference in the percentage of volume of DER for endodontic access cavity preparation was calculated. The data were subjected to statistical analyses (analysis of variance) with a level of significance set at P < .05. Results: The percentage of volume of DER was less than 6% for the UEC group, up to 15% for the CEC group, and more than 15% for the TEC group, with a statistically significant difference among all groups in all of the tooth types analyzed (P < .05). Conclusions: The present study showed significantly different percentages of volume of DER among the groups analyzed (ie, UEC < CEC < TEC). A standardization of access cavity preparation was proposed according to the percentage of volume of DER.
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Digital access to banking and financial systems is no longer merely a way to augment physical transactions or experiences. It is now the primary way that consumers interact with banking and financial services. As a result, it is e...
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Digital access to banking and financial systems is no longer merely a way to augment physical transactions or experiences. It is now the primary way that consumers interact with banking and financial services. As a result, it is essential and equitable that full digital access to these services be provided for people with disabilities. Building on a recently published survey that investigated the accessibility issues within banking and financial systems for blind users, this evaluation of 100 banking and financial websites in the USA provides a current analysis of the broader state of banking and finance website accessibility for people with disabilities. The results of our research not only document these current findings as an accessibility baseline for banking and finance websites but also reveal common problems and strategies that may benefit the banking and finance industries.
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The increasing traffic congestion and pollution in cities is seriously threatening the livability and development of urban areas. As a result, the growing importance of transit accessibility is attracting considerable attention am...
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The increasing traffic congestion and pollution in cities is seriously threatening the livability and development of urban areas. As a result, the growing importance of transit accessibility is attracting considerable attention among researchers in transport planning, urban geography and sustainable development. To help solve these increasingly serious issues, public transport studies related to transit network design, transit system evaluation, land use, and transport planning in cities require accurate transit accessibility measurements. The past three decades have seen a burgeoning body of research on transit accessibility, and numerous models have been developed to measure transit accessibility for different purposes. This comprehensive review explores the existing transit accessibility models and highlights their practical advantages and drawbacks from different perspectives to help researchers and transport planners employ the most suitable models to counter mounting traffic threats. Accordingly, this review seeks to answer the following questions. What are the major challenges in developing transit accessibility models? What are the potential research directions to address these challenges? Why have different researchers developed different models for measuring transit accessibility in cities? How important is it to estimate travel impedance or attractiveness of opportunities accurately? Finally, what are the important criteria for developing future transit accessibility models? To deliver its outcomes and answer these questions, this paper reviews transit accessibility models under three main categories: system accessibility, system-facilitated accessibility and access to destinations.
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The role of electricity in human development is well established as being key to improved qualie) , of life, safer environments, greater communication and connectivity, better educational services, and increased economic opportuni...
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The role of electricity in human development is well established as being key to improved qualie) , of life, safer environments, greater communication and connectivity, better educational services, and increased economic opportunities. Despite it having such a fundamental role, nearly one billion people across the world are deprived of electricity access, and many more suffer with poor and limited access. Limited definitions of electricity access have led to improper measurement and monitoring and inadequate management, resulting in poor targeting of efforts by governments, enterprises, and investors. This in turn has adversely affected the pace of improvement. Based on a survey of the literature and policy discourse on the subject in recent years, the authors argue that multidimensional, multi-tier, multi-locale energy access can help not just to better define, but also to better monitor and manage electricity-access provision. While the multidimensional approach to energy access has been featured in the literature lately, no attention has been paid to the integration of this approach into planning and action. In this regard, we are proposing that an end-user-centric approach helps guide planning, execution, course correction, and operations, to achieve universal energy access while keeping the objective of overall human development at its core.
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This paper examines Open Access (OA) self archiving policies of different Open Access Repositories (OARs) affiliated to COAR (Confederation of Open Access Repositories) as partner institutes. The process of scrutiny includes three...
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This paper examines Open Access (OA) self archiving policies of different Open Access Repositories (OARs) affiliated to COAR (Confederation of Open Access Repositories) as partner institutes. The process of scrutiny includes three major activities – selection of databases to consult; comparison and evaluation of Open Access policies of repositories listed in the selected databases and attached to COAR group; and critical examination of available self archiving policies of these OA repositories against a set of selected criteria. The above steps lead to reporting the following results: key findings have been identified and highlighted; common practices have been analyzed in relation to the focus of this paper; and a best practice benchmark has been suggested for popularizing and strengthening OARs as national research systems. This paper may help administrators, funding agencies, policy makers and professional librarians in devising institute-specific self archiving policies for their own organizations.
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Accessible websites are a necessity for everyone, especially for people with disabilities. However, this is an objective that has not been achieved yet and requires initiatives that continue guiding the way towards an increasingly...
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Accessible websites are a necessity for everyone, especially for people with disabilities. However, this is an objective that has not been achieved yet and requires initiatives that continue guiding the way towards an increasingly inclusive web and lowering accessibility barriers. One of the first steps in this regard is to identify the accessibility level of a particular website, and for this purpose, a set of automatic tools and manual instruments have been developed. These tools allow calculating an accessibility level from the expert's perspective and from the website's source code using as a reference the accessibility guidelines defined by the W3C. The authors state that evaluating accessibility with just one of these methods is not enough, so therefore its integration is required. This article presents a tool called Accessibility Evaluation Tool, which allows and facilitates the integration of the accessibility evaluation delivered by an automatic validator with the manual evaluation of elements by experts.
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Securing stable vascular access is an important clinical skill for the anaesthesiologist. Sick children, complex surgeries, chronic illnesses, multiple hospitalisations, and prolonged treatments can make vascular access challengin...
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Securing stable vascular access is an important clinical skill for the anaesthesiologist. Sick children, complex surgeries, chronic illnesses, multiple hospitalisations, and prolonged treatments can make vascular access challenging. A search was done in the English language literature using the keywords “paediatric,” “vascular access,” “venous access,” and “techniques” or “complications” in Pubmed, Embase, and Google scholar databases. Articles were screened and appropriate content was included. Intraosseous access is a lifesaving technique that can be performed even in hypovolaemic patients rapidly. Transillumination and near-infrared light improve visualisation of superficial veins in difficult access. Ultrasonography has become the standard of care in selecting the vessel, size of catheter, guide placement, and prevent complications. Fluoroscopy is used during insertion of long-term vascular access devices. This article reviews the various routes of access, their indications, most appropriate site, securing techniques, advantages, disadvantages, and complications associated with vascular access in children.
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