Notes

Economic sustainability tricks of open public major medical care centres in the Republic involving Srpska, Bosnia and also Herzegovina.
Recanalization after cerebral ischemia. Acute ischemic stroke (AIS) management is based on stroke unit admission and arterial recanalization. Recanalization therapies include the endovascular approach (also called mechanical thrombectomy) and intravenous (IV) alteplase (i.e. thrombolysis). In the setting of AIS consecutive to large vessel occlusion of the anterior circulation (i.e. internal carotid and/or middle cerebral arteries), IV alteplase is associated to endovascular approach. IV alteplase alone being devoted to AIS without large vessel occlusion. The therapeutic window is of 4h30 for IV alteplase administration and 6 hours for endovascular approach. Using MRI and perfusion brain imaging, the therapeutic window may be individualized and extended up to 24 hours. Although this extended time window is an opportunity to treat more patients, the rapidity of recanalization remains critical, as it is a major predictor of clinical outcome, emphasizing the need to reduce, as much as possible, treatment delays.Acute stroke imaging. Imaging, within the first 24 hours of stroke, supports its clinical diagnosis and allows a careful patient selection for treatment. It excludes hemorrhage and stroke mimics, provides an estimate of potentially salvageable brain tissue, locates and characterizes the intra-arterial thrombus before treatment decision in acute ischaemic stroke. In cerebral hemorrhage, it plays a pivotal role in establishing the diagnosis and identifying causes and complications. We outline the role of neuroimaging applied to patients presenting with acute stroke within the first 24 hours.Prehospital management of acute stroke patients. In France, prehospital management of patients with suspected acute stroke relies on emergency medical communication centers (Samu), which provides first-line telephone assessment and dispatches the most appropriate emergency vehicle. Such tasks are not straightforward because many clinical symptoms may correspond to stroke and alternative diagnoses - stroke mimics - are common. It is crucial to reduce both prehospital and hospital delays in patients eligible for reperfusion therapies, namely intravenous thrombolysis and/or mechanical thrombectomy. Because mechanical thrombectomy only applies to patients with acute ischemic stroke and large-vessel occlusion, prehospital triage is important. However, clinical prediction of large-vessel occlusion is difficult and whether a specific patient should be sent to the nearest primary stroke center (drip and ship paradigm) or a comprehensive stroke center with thrombectomy capability (mothership paradigm) remains uncertain. Prehospital notification of the hospital-based stroke teams by the emergency medical system crews is crucial in reducing delays to achieve reperfusion.When to think early about a stroke and what to do ? Rapid recognition of stroke symptoms leads to early treatment and improved clinical outcomes, with direct impact on stroke survival and functional outcome. The typical clinical presentation of a stroke consists of a sudden onset of a focal neurological deficit of maximum intensity at onset. Typical warning symptoms, that have been promoted in public awareness campaigns, are the sudden unilateral numbness or weakness of face, arm, or leg, especially on one side of the body, speech difficulty and visual trouble. It may also happen that a stroke has an unusual clinical presentation, 'false negatives' are called 'stroke chameleons', because the clinical presentation suggests another disorder. The call of the emergency number (number 15 in France) is the first thing to do in case of stroke symptom recognition. Stroke code allows to stroke management anticipation and significantly reduces the delays for early treatment.Towards a new derogation from medical confidentiality in the event of immediate danger? In the relationship between the patient and the healthcare professional, medical confidentiality is an essential principle. Liraglutide in vitro However, there are exceptions, all provided for by law. In recent years, the question has arisen of whether to add to these derogations when the patient poses a significant risk to a third party, or even when the patient himself is at risk. A bill in the process of being voted on tends to lift secrecy to protect the victim of domestic violence. The implementation of such a mandatory exemption will never be easy for the doctor concerned.New in radiotherapy of solid tumors. The new irradiation techniques integrate the latest technological developments in medical imaging and computer science, dosimetry, and linacs into the treatment procedure. They raise new hopes for the treatment of solid tumor pathologies. Three techniques seem particularly promising intensity modulated radiotherapy, respiratory gating radiotherapy, and stereotactic radiotherapy. The emergence of artificial intelligence, and particularly its applications in the field of imaging, opens up a new field of research. The purpose of these different innovations is to achieve very high precision radiotherapy, which makes it possible to better adapt the radiation fields to the tumor and thus protect the critical organs.The executive nurse director role is complex and there is significant variation in the expectations and responsibilities placed on it. The main function of the role is to deliver the nursing agenda and ensure that safety and quality remain the focus of the executive board. However, it is unclear what evidence exists regarding the challenges and opportunities experienced by executive nurse directors. This scoping review, undertaken as part of the Stronger Study, explores the literature published from 2009 onwards on the challenges and opportunities affecting executive nurse directors' ability to deliver the nursing agenda in the UK. Findings from the review suggest that the importance attached to the executive nurse director role is not matched by the amount of research available. Strengthening the executive nurse director role requires a stronger evidence base and an awareness of the benefits of the role.
Ultrafast fiber lasers are an attractive alternative to bulk lasers for nonlinear optical microscopy for their compactness and low cost. The high relative intensity noise (RIN) of these lasers poses a challenge for pump-probe measurements such as transient absorption and stimulated Raman scattering, along with modalities that provide label-free contrast from the vibrational and electronic structure of molecules.

Digital adaptive filtering was applied to determine the applicability for canceling laser RIN in a transient absorption microscope with an ultrafast fiber laser source.

Digitized signals from the transmitted probe and reference photodetectors were fed to an adaptive filter in MATLAB, running in a noise canceling configuration. This result was then fed to a software lock-in algorithm to demodulate the pump-probe signal. Images were built up one line scan at a time with a 3.5-kHz resonant scanner, with 100  ×   averaging. The imaging target was Bi4Ge3O12, which exhibits nondegenerate two-photon absorption at the pump/probe wavelengths used (530-nm pump and 490-nm probe).
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