Background and Purpose—
Accurate assessment of the risk of hemorrhage could help to improve patient selection for thrombolytic therapy and reduce hemorrhagic complications, especially for patients with longer or uncertain time after symptom onset. This study sought to define characteristics of hemodynamic magnetic resonance imaging (MRI), which best predict hemorrhage.
Methods—
Bolus contrast and diffusion MRI were performed before intravenous tissue plasminogen activator (tPA) therapy in 20 patients presenting with acute stroke symptoms within the first 6 hours after symptom onset. Hemorrhage was assessed on follow-up MRI (n=15) and computed tomography (n=5) scans.
Results—
Of the 20 patients studied, 5 had detectable hemorrhage on follow-up scans. Blood volume maps demonstrated virtually no signal within much of the hemorrhagic region, indicating contrast did not arrive by the end of the imaging series (80 seconds). Within the hemodynamically abnormal region, a threshold of at least 126 voxels with blood volume <5% of contralateral normal gray matter separated hemorrhagic patients from nonhemorrhagic with a sensitivity of 100% and a specificity of 73% (
P
<0.01). All subjects with hemorrhage were at least partially reperfused after thrombolysis, whereas most false-positives did not reperfuse (
P
<0.05). The number of low blood volume voxels within individual patients correlated with the number of voxels with apparent diffusion coefficient values <550×10
−6
mm
2
/s (
P
<0.019), another previously proposed predictor of hemorrhage.
Conclusions—
Extremely low or completely absent contrast arrival may indicate tissue-at-risk for hemorrhage before tPA treatment and thus may aid in risk–benefit assessments. Occurrence of hemorrhage within at-risk areas may depend on tissue reperfusion.
The comparative analysis of two options for investment and construction projects, with partial robotization of production and traditional work organization was conducted on the criterion of time and cost minimizing the of construction. The use of two robot types was considered, a bricklayer and a plasterer robot. As a comparison result of main quantitative indicators of construction organization plan, it was found that the use of robots reduced the duration of construction, expenditures and labor costs. Lack of fatiguability, lunch breaks, smoke breaks, conversations, illnesses, as well as round-the-clock operation, the absence of malicious intents, no theft and, therefore, procedural violations, composition disorders, etc., allows to look at the introduction prospect of construction robots with optimism.
The article presents an assessment of the activities of the construction company from the Tyumen city. An important stage in developing an effective strategy of the company is strategic analysis, which should give a real assessment of own resources and capabilities in relation to the state (and needs) of the external environment in which the firm operates. On the basis of this analysis, rational choice of strategies from a possible set of options should occur. The conducted SWOT- analysis has allowed to formulate the potential directions, capable to make financial indicators of the construction company much better.
The paper proposes the use of the integrated logistic approach, application of the cross-functional logistic coordination and integration in managing processes of the distribution center that promotes both to minimization of expenses and enhancing the effective functioning of the distribution center in the supply chain. The SMED analysis of logistic processes and Value Stream Mapping make it possible to identify inefficient operations and to reduce the duration of a logistics cycle. The researches of processes conducted by the author with the use of the logistic tools allowed revealing the reserves and making recommendations on how to enhance the effectiveness of the regional distribution center.
Each company seeks to find new resources to maintain the leading position in the market. One of such resources is the personnel development system, which allows maximizing and increasing the labor potential of the company's employees. Personnel development system is one of the main components of personnel management activities, which contributes to the formation of a team with high abilities and strong motivation to fulfill the tasks facing the company. Development and training of personnel helps to match the level of professional competence of employees to the requirements of the developing market.
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