Search

Introduction: Carotid artery stenting (CAS) through transradial access (TRA) is emerging as an alternative to carotid endarterectomy. However, the current evidence base is limited, mainly comprising single-center studies. Objective: This systematic review and meta-analysis aim to assess the safety and effectiveness of TRA for CAS, providing evidence to support clinical decisions. Methods: We conducted searches on PUBMED, Cochrane Library, Embase, and Web of Science databases, including studies on TRA for CAS. Studies with fewer than 20 patients, non-primary outcomes, and non-full-text articles were excluded. Results: We analyzed 14 studies involving 1,166 patients who underwent CAS via TRA. Procedural success rate was high in 13 studies, with a 95% rate (95% CI; 92%–98%). Crossover to TFA access was observed in 12 studies at 6% (95% CI: 3%–9%). Transradial access failure was reported in four studies, with a rate of 0% (95% CI: 0%–0%). Cannulation failure resulted in a rate of 4% (95% CI: 2%–7%). Asymptomatic radial artery occlusion (ARAO) occurred at a rate of 2% based on eight studies (95% CI: 0%–5%). Forearm hematoma was reported in 10 studies, with an occurrence of 1% (95% CI: 0%–2%). Cerebral vascular attacks (CAV) within 30 days were assessed in 13 studies, indicating a 2% occurrence (95% CI: 1%–2%). Conclusion: The findings suggest that TRA for CAS yields promising outcomes with high success rates and low complication rates. Further research should focus on randomized controlled trials and long-term outcomes to validate and extend findings. [ABSTRACT FROM AUTHOR]

Wood constitutes a unique and valuable material that has been used from ancient times until nowadays in a wide variety of applications, in which the surface quality of wood often constitutes a critical factor. In this study, the influence of different wood areas and therefore, of different anatomical characteristic areas of chestnut wood (Castanea sativa Mill.) on the surface quality, was thoroughly studied, in terms of surface roughness. Five different chestnut tree trunks were harvested, from which five different disks were obtained corresponding to five different trunk heights. Surface roughness was measured on these disks on the transverse, radial, and tangential planes, on the areas of sapwood and heartwood, measuring the roughness in each point both vertically and in parallel to the wood grain. The results revealed that the examined roughness indexes (Ra, Rz, Rq) follow a parallel path to one another. In the case of all surfaces (transverse, radial, tangential) of the disks examined, when the measurement was implemented perpendicularly to the wood grain, a significantly higher roughness was recorded, compared to the wood grain measurements being implemented in parallel with the wood grain. Significant differences between heartwood and sapwood roughness were not demonstrated, although sapwood often appeared to exhibit a higher surface roughness than heartwood sites. Among the roughness values of the three different surfaces, the highest roughness in the vertical-to-wood-grain measurements was recorded by tangential surfaces, with slightly lower values on the transverse surfaces and the lowest roughness on radial surfaces. Meanwhile, for the measurements in parallel with the wood grain, the transverse surfaces presented significantly higher roughness values compared to the tangential and radial surfaces. Significant roughness differences were not detected among the surfaces at different trunk heights. Although, significant differences in roughness were recorded among different trees, it was observed that all the studied trees align with the identified and described within-tree trends. [ABSTRACT FROM AUTHOR]

Purpose Mechanical thrombectomy (MT) is the standard of care for acute ischemic stroke (AIS) due to large vessel occlusion (LVO). The choice of a transradial approach (TRA) for anterior circulation LVOs is still debatable; the use of a specific tricoaxial system could help mitigate numerous issues related to transradial MT. Materials and Methods From November 2022 to November 2023, 22 patients underwent TRA-MT for anterior circulation LVOs, both as first-line and rescue from transfemoral approach (TFA) failure, with the same triaxial setup consisting of a 7F introducer sheath, 7F guide catheter, and aspiration catheters ranging from 5.5F to 5F in relation to the occlusion site. Choice of thrombectomy technique was at operator discretion. Patients’ demographic data, clinical presentation, treatment details, complications, rate of crossover to TFA, successful revascularization (modified thrombolysis in cerebral infarction [mTICI] score ≥2b), and good clinical outcome at 3 months (modified Rankin scale [mRS] 0-2) were reported. Results Of 20 patients selected, 10 (50%) had occlusion of M1 segment of middle cerebral artery (MCA), 6 (30%) of internal carotid artery (ICA) terminus, and 4 (20%) with M2 MCA occlusions; 12/20 (60%) were right-sided occlusions and 8/20 (40%) were left-sided. The mean National Institutes of Health Stroke Scale score was 9.25 at admission. Successful revascularization to mTICI 2b-3 was achieved in 18/20 patients (90%). Intracranial complications were reported in 2 (10%) patients. Rate of radial artery occlusion at 24 hours was 10,6%; no access-site haemorrhagic complications were reported. Symptomatic intracranial hemorrhage occurred in 2 (10%) patients. mRS score 0-2 at 3 months was 50%. Conclusion The high technical effectiveness and good safety profile of this specific tricoaxial setup for TRA-MT in AIS, even for large proximal LVOs, could constitute a viable alternative to TFA-MT in selected cases.

Background: Cervical esophageal reconstruction is vital to improve the quality of life in cancer surgery patients. Microsurgery is crucial in providing vascularized tissue for defect repair, particularly in secondary cases with a higher risk of failure due to larger defects and damage from previous surgery and radiotherapy. The purpose of this study was to describe the clinical characteristics of a series of patients who underwent secondary repair of esophageal defects and provide practical information for the management and treatment of such cases based on the authors' experience and the literature review. Methods: We retrospectively reviewed the electronic medical records of the Plastic Surgery Clinic at the University of Trieste to identify cases of patients who underwent secondary esophageal microsurgical reconstructions following oncological surgery. Patient demographics, the etiology of esophageal defects, previous surgical history, and preoperative assessments were collected from medical records. Surgical techniques utilized for reconstruction, such as pedicled flaps or free tissue transfers, were documented along with intraoperative information. Postoperative outcomes, including complications, graft viability, and functional outcomes, were evaluated during follow-up. Results: We treated 13 cases of secondary esophageal reconstructions between 2011 and 2022. Most commonly, Antero-Lateral Thigh (ALT) flaps were used in 10 cases, while 2 cases employed a radial forearm flap (RFF), and 1 case employed a chimeric parascapular flap. No flap failures occurred during a median 50-month follow-up. One ALT flap patient experienced postop stricture but maintained swallowing ability. A single tracheoesophageal fistula occurred in an RFF patient with a history of radiotherapy and complete lymph node dissection. Conclusions: Cervical esophageal reconstruction significantly impacts patients' quality of life by restoring oral feeding and phonation. When local flaps fall short, microsurgical reconstruction with intestinal flaps is valuable but is burdened by limitations. For challenging secondary cases, ALT or RFF flaps emerge as safer options due to their robust pedicles, yielding low complication rates and positive functional outcomes. [ABSTRACT FROM AUTHOR]

Transradial Access (TRA) is the suggested method when performing coronary procedures. TRA has several advantages over the transfemoral approach, but also some restrictions. The present study compared the efficacy and safety of the traditional proximal transradial approach (pTRA) with a newer technique known as the distal transradial approach (dTRA) for performing a coronary angiography (CAG) and percutaneous coronary intervention (PCI). Patients (n = 700) were placed into one of two categories (dTRA or pTRA) based on a random technique. The primary endpoint was RAO at follow-up. The secondary endpoints included the time required for sheath insertion, the rate of successful sheath insertion, rate of successful completion of CAG and PCI, total procedure time, total fluoroscopy time, total radiation dose, total contrast volume used, pain perception (visual analog scale 0–10), and hemostasis duration. dTRA patients had more skin punctures, failed punctures, failed wiring, overlap of access sites, sheath insertion time, and pain evaluation scale, while the pTRA group had more hemostasis time and first-time cannulation. RAO and pseudoaneurysm (PseA) were lower in the dTRA group. In this randomized study, dTRA had lower RAO and PseA than pTRA. However, multicenter, larger-patient trials are needed to provide definitive evidence. [ABSTRACT FROM AUTHOR]

Systemic systolic (SAP) and mean (MAP) arterial pressure monitoring is the cornerstone in hemodynamic management of the cardiac surgical patient, and the radial artery is the most common site of catheter placement. The present study compared 3 different arterial line procedures. It is hypothesized that a 20-G 12.7- cm catheter inserted into the radial artery will be equal to a 20-G 12.7- cm angiocath placed in the brachial artery, and superior to a 20-G 5.00 cm angiocath placed in the radial artery. A prospective randomized control study was performed. Single academic university hospital. Adult patients ≥18 years old undergoing nonemergent cardiac surgery using cardiopulmonary bypass (CPB). After approval by the Rhode Island Hospital institutional review board, a randomized prospective control study to evaluate 3 different peripheral intraarterial catheter systems was performed: (1) Radial Short (RS): 20-G 5- cm catheter; (2) Radial Long (RL): 20-G 12- cm catheter; and (3) Brachial Long (BL): 20-G 12- cm catheter. Gradients between central aortic and peripheral catheters (CA-P) were compared and analyzed before CPB and 2 and 10 minutes after separation from CPB. The placement of femoral arterial lines and administration of vasoactive medications were recorded. After exclusions, 67 BL, 61 RL, and 66 RS patients were compared. Before CPB, CA-P SAP and MAP gradients were not significant among the 3 groups. Two minutes after CPB, the CA-P SAP gradient was significant for the RS group (p = 0.005) and insignificant for BL (p = 0.47) and RL (p = 0.39). Two-group analysis revealed that CA-P SAP gradients are similar between BL and RL (p = 0.84), both of which were superior to RS (p = 0.02 and p = 0.04, respectively). At 10 minutes after CPB, the CA-P SAP gradient for RS remained significant (p = 0.004) and similar to the gradient at 2 minutes. The CA-P SAP gradients increased from 2 to 10 minutes for BL (p = 0.13) and RL (p = 0.06). Two minutes after CPB, the CA-P MAP gradients were significant for the BL (p = 0.003), RL (p < 0.0001), and RS (p < 0.0001) groups. Two-group analysis revealed that the CA-P MAP gradients were lower for the BL group compared with the RL (p = 0.054) and RS (p< 0.05) groups. Ten minutes after CPB, the CA-P MAP gradients in the RL and RS groups remained significant (p < 0.0001) and both greater than the BL group (p = 0.002). A femoral arterial line was placed more frequently in the RS group (8/66 = 12.1%) than in the RL group (3/61 = 4.9%) and the BL group (2/67 = 3.0%). Vasopressin was administered significantly more frequently in the RS group. Regarding CA-P SAP gradients, the RL group performed equally to the BL group, both being superior to RS. Regarding CA-P MAP gradients, BL was superior to RL and RS. Clinically, femoral line placement and vasopressin administration were fewer for the BL and RL groups when compared with the RS group. This study demonstrated the benefits of a long (12.7 cm) 20- G angiocath placed in the radial artery. [ABSTRACT FROM AUTHOR]

Background: There are several methods developed for the treatment of high-level peripheral nerve injury (HLPNI) in the upper extremity. However, it causes significant loss of motor functions and sensory defects for the patients, and it is a challenging topic for surgeons. The purpose of our study is to analyze patient characteristics and long-term results of early and late repair of the HLPNI in the upper extremity. Patients and Methods: Patients who were operated from January 2016 to January 2022 due to HLPNI in the upper extremity are included. The characteristics of the patients, which are gender, age, affected nerve, time frame from the injury to operation time, mechanism of injury, whether nerve grafts are used during surgery, and mean follow-up time, are evaluated. Long-term functional results are assessed according to the British Medical Research Council scale during follow-up examinations. Results: The study included 24 patients, and the majority were male (79.1%). Sixteen patients were injured with sharp objects (66.6%). 41.6% of the patients are operated within 72 h after admission to the emergency room, whereas 58.4% of them are operated on after the outpatient clinic admission. The mean motor and sensory results of the patients who operated within the first 72 h after injury were M3S3+. The mean motor and sensory results of the patients who were operated on 72 h-1 month after the injury were M3S3, and for the patients who were operated on 1-5 months after the injury, the mean motor and sensory result was M2S2. The results of the injuries due to sharp objects were M3S3, whereas it was M2S2 for the patients who have been injured due to blunt trauma or firearms. Results of the patients under 20 years old were M3S3+; it was M3S2+ for the 20-50-year-old patients, whereas it was M2S2 for the patients older than 50 years old. Conclusion: Early repair is suggested for the HLPNI in the upper extremity, and gross motor function of the upper extremity is regained better, especially in young patients. Nerve graft necessity should be considered for the late repair. Early repair and secondary nerve repair with nerve graft are not always disappointing for the patient and the surgeon. [ABSTRACT FROM AUTHOR]

The energy sector faces a pressing need for significant transformation to curb CO2 emissions. For instance, Czechia and Germany have taken steps to phase out fossil thermal power plants by 2038, opting instead for a greater reliance on variable renewable energy sources like wind and solar power. Nonetheless, thermal power plants will still have roles, too. While the conventional multistage axial turbine design has been predominant in large-scale power plants for the past century, it is unsuitable for small-scale decentralized projects due to complexity and cost. To address this, the study investigates less common turbine types, which were discarded as they demonstrated lower efficiency. One design is the Elektra turbine, characterized by its velocity compounded radial re-entry configuration. The Elektra turbine combines the advantages of volumetric expanders (the low rotational speed requirement) with the advantages of a turbine (no rubbing seals, no lubrication in the working fluid, wear is almost completely avoided). Thus, the research goal of the authors is the implementation of a 10 kW-class ORC turbine driving a cost-effective off-the-shelf 3000 rpm generator. The paper introduces the concept of the Elektra turbine in comparison to other turbines and proposes this approach for an ORC working fluid. In the second part, the 1D design and 3D–CFD optimization of the 7 kW Elektra turbine working with Hexamethyldisiloxane (MM) is performed. Finally, CFD efficiency characteristics of various versions of the Elektra are presented and critically discussed regarding the originally defined design approach. The unsteady CFD calculation of the final Elektra version showed 46% total-to-static isentropic efficiency. [ABSTRACT FROM AUTHOR]

Purpose: Mechanical thrombectomy (MT) is the standard of care for acute ischemic stroke (AIS) due to large vessel occlusion (LVO). The choice of a transradial approach (TRA) for anterior circulation LVOs is still debatable; the use of a specific tricoaxial system could help mitigate numerous issues related to transradial MT. Materials and Methods: From November 2022 to November 2023, 22 patients underwent TRA-MT for anterior circulation LVOs, both as first-line and rescue from transfemoral approach (TFA) failure, with the same triaxial setup consisting of a 7F introducer sheath, 7F guide catheter, and aspiration catheters ranging from 5.5F to 5F in relation to the occlusion site. Choice of thrombectomy technique was at operator discretion. Patients' demographic data, clinical presentation, treatment details, complications, rate of crossover to TFA, successful revascularization (modified thrombolysis in cerebral infarction [mTICI] score =2b), and good clinical outcome at 3 months (modified Rankin scale [mRS] 0-2) were reported. Results: Of 20 patients selected, 10 (50%) had occlusion of M1 segment of middle cerebral artery (MCA), 6 (30%) of internal carotid artery (ICA) terminus, and 4 (20%) with M2 MCA occlusions; 12/20 (60%) were right-sided occlusions and 8/20 (40%) were left-sided. The mean National Institutes of Health Stroke Scale score was 9.25 at admission. Successful revascularization to mTICI 2b-3 was achieved in 18/20 patients (90%). Intracranial complications were reported in 2 (10%) patients. Rate of radial artery occlusion at 24 hours was 10,6%; no access-site haemorrhagic complications were reported. Symptomatic intracranial hemorrhage occurred in 2 (10%) patients. mRS score 0-2 at 3 months was 50%. Conclusion: The high technical effectiveness and good safety profile of this specific tricoaxial setup for TRA-MT in AIS, even for large proximal LVOs, could constitute a viable alternative to TFA-MT in selected cases. [ABSTRACT FROM AUTHOR]

Background: There are several methods developed for the treatment of high-level peripheral nerve injury (HLPNI) in the upper extremity. However, it causes significant loss of motor functions and sensory defects for the patients, and it is a challenging topic for surgeons. The purpose of our study is to analyze patient characteristics and long-term results of early and late repair of the HLPNI in the upper extremity. Patients and Methods: Patients who were operated from January 2016 to January 2022 due to HLPNI in the upper extremity are included. The characteristics of the patients, which are gender, age, affected nerve, time frame from the injury to operation time, mechanism of injury, whether nerve grafts are used during surgery, and mean follow-up time, are evaluated. Long-term functional results are assessed according to the British Medical Research Council scale during follow-up examinations. Results: The study included 24 patients, and the majority were male (79.1%). Sixteen patients were injured with sharp objects (66.6%). 41.6% of the patients are operated within 72 h after admission to the emergency room, whereas 58.4% of them are operated on after the outpatient clinic admission. The mean motor and sensory results of the patients who operated within the first 72 h after injury were M3S3+. The mean motor and sensory results of the patients who were operated on 72 h–1 month after the injury were M3S3, and for the patients who were operated on 1–5 months after the injury, the mean motor and sensory result was M2S2. The results of the injuries due to sharp objects were M3S3, whereas it was M2S2 for the patients who have been injured due to blunt trauma or firearms. Results of the patients under 20 years old were M3S3+; it was M3S2+ for the 20–50-year-old patients, whereas it was M2S2 for the patients older than 50 years old. Conclusion: Early repair is suggested for the HLPNI in the upper extremity, and gross motor function of the upper extremity is regained better, especially in young patients. Nerve graft necessity should be considered for the late repair. Early repair and secondary nerve repair with nerve graft are not always disappointing for the patient and the surgeon.

Purpose: DTI characterizes tissue microstructure and provides proxy measures of nerve health. Echo‐planar imaging is a popular method of acquiring DTI but is susceptible to various artifacts (e.g., susceptibility, motion, and eddy currents), which may be ameliorated via preprocessing. There are many pipelines available but limited data comparing their performance, which provides the rationale for this study. Methods: DTI was acquired from the upper limb of heathy volunteers at 3T in blip‐up and blip‐down directions. Data were independently corrected using (i) FSL's TOPUP & eddy, (ii) FSL's TOPUP, (iii) DSI Studio, and (iv) TORTOISE. DTI metrics were extracted from the median, radial, and ulnar nerves and compared (between pipelines) using mixed‐effects linear regression. The geometric similarity of corrected b = 0 images and the slice matched T1‐weighted (T1w) images were computed using the Sörenson‐Dice coefficient. Results: Without preprocessing, the similarity coefficient of the blip‐up and blip‐down datasets to the T1w was 0·80 and 0·79, respectively. Preprocessing improved the geometric similarity by 1% with no difference between pipelines. Compared to TOPUP & eddy, DSI Studio and TORTOISE generated 2% and 6% lower estimates of fractional anisotropy, and 6% and 13% higher estimates of radial diffusivity, respectively. Estimates of anisotropy from TOPUP & eddy versus TOPUP were not different but TOPUP reduced radial diffusivity by 3%. The agreement of DTI metrics between pipelines was poor. Conclusions: Preprocessing DTI from the upper limb improves geometric similarity but the choice of the pipeline introduces clinically important variability in diffusion parameter estimates from peripheral nerves. [ABSTRACT FROM AUTHOR]

Background: The formation of abscesses with necrosis within large, striated muscles leads to pyomyositis, a condition relatively rarely encountered outside the tropics. Intravenous drug users and other immunocompromised individuals are predisposed toward this infection, which may occur due to local or haematogenous spread of infection to skeletal muscles previously damaged by trauma, exercise, or rhabdomyolysis. Methods: We report a young male intravenous drug user with rhabdomyolysis due to use of a synthetic opioid, in whom disseminated pyomyositis was detected following evaluation for sciatic and radial neuropathies and Horner's syndrome and review available reports of peripheral nerve dysfunction in the setting of this uncommon infection. We searched online databases to identify all published reports on adult patients with pyomyositis complicated by peripheral nerve dysfunction. Conclusions: Peripheral nerve dysfunction may rarely occur via local spread of infection or compression from abscesses. [ABSTRACT FROM AUTHOR]

Injuries to the biceps reflection pulley lead to instability of the long head of the biceps tendon (LHBT). However, conventional magnetic resonance (MR) imaging (MRI) has low diagnostic accuracy for LHBT and pulley lesions. Here, we investigated the usefulness of novel biceps-radial MRI for evaluating LHBT and pulley lesions. Biceps-radial MR images of 84 patients (84 shoulders) were prospectively analyzed. The biceps-radial MRI protocol includes sequences acquired in radial planes perpendicular to the LHBT in the shoulder joint. All patients underwent shoulder arthroscopy, and the intraoperative LHBT and pulley lesion findings were compared to the preoperative evaluations. The diagnostic accuracies of the biceps-radial MR images and conventional MR images were determined. A normal LHBT was observed in 30 (31.6%) patients, partial tears in 43 (52.6%), and complete tears in 11 (15.8%). Normal LHBT stability was present in 54 (61.4%) patients, subluxation in 24 (31.6%), and dislocation in 6 (7.0%). The biceps-radial MR (kappa coefficient: 0.94) and conventional MR (kappa coefficient: 0.68) images accurately identified LHBT tears. The biceps-radial MR images excellently agreed with the arthroscopic findings (kappa coefficient: 0.91), whereas the conventional MR images poorly agreed (kappa coefficient: 0.17) regarding LHBT instability. A normal medial wall of the pulley was observed in 26 (31.0%) patients, partial tears in 30 (35.7%), and complete tears in 28 (33.3%). A normal lateral wall of the pulley was observed in 30 (35.7%) patients, partial tears in 21 (25.0%), and complete tears in 33 (39.3%). The biceps-radial MR images excellently agreed with the arthroscopic findings (kappa coefficient: 0.89), whereas the conventional MR images moderately agreed (kappa coefficient: 0.50) regarding medial pulley lesions. The biceps-radial MR images excellently agreed with the arthroscopic findings (kappa coefficient: 0.95) and the conventional MR images moderately agreed (kappa coefficient: 0.56) regarding lateral pulley lesions. Biceps-radial MRI allows for tracking of the LHBT and pulley from the supraglenoid tuberosity to the bicipital groove in the glenohumeral joint and accurate evaluations of LHBT and pulley lesions. [ABSTRACT FROM AUTHOR]

Hereditary neuropathy with liability pressure palsies (HNPP) is usually caused by compression and is an episodic, painless, recurrent hereditary neuropathy with focal motor and sensory involvement. It begins in adolescence and young adulthood. The most commonly affected nerves in HNPP are the ulnar, peroneal, radial, and median nerves. In this article, we present a 31-year-old female patient with a previously undescribed case of HNPP, which presented with wrist drop due to the trapping of the radial nerve in the spiral groove after the crow position in yoga. [ABSTRACT FROM AUTHOR]

Wood constitutes a unique and valuable material that has been used from ancient times until nowadays in a wide variety of applications, in which the surface quality of wood often constitutes a critical factor. In this study, the influence of different wood areas and therefore, of different anatomical characteristic areas of chestnut wood (Castanea sativa Mill.) on the surface quality, was thoroughly studied, in terms of surface roughness. Five different chestnut tree trunks were harvested, from which five different disks were obtained corresponding to five different trunk heights. Surface roughness was measured on these disks on the transverse, radial, and tangential planes, on the areas of sapwood and heartwood, measuring the roughness in each point both vertically and in parallel to the wood grain. The results revealed that the examined roughness indexes (Ra, Rz, Rq) follow a parallel path to one another. In the case of all surfaces (transverse, radial, tangential) of the disks examined, when the measurement was implemented perpendicularly to the wood grain, a significantly higher roughness was recorded, compared to the wood grain measurements being implemented in parallel with the wood grain. Significant differences between heartwood and sapwood roughness were not demonstrated, although sapwood often appeared to exhibit a higher surface roughness than heartwood sites. Among the roughness values of the three different surfaces, the highest roughness in the vertical-to-wood-grain measurements was recorded by tangential surfaces, with slightly lower values on the transverse surfaces and the lowest roughness on radial surfaces. Meanwhile, for the measurements in parallel with the wood grain, the transverse surfaces presented significantly higher roughness values compared to the tangential and radial surfaces. Significant roughness differences were not detected among the surfaces at different trunk heights. Although, significant differences in roughness were recorded among different trees, it was observed that all the studied trees align with the identified and described within-tree trends.

Purpose: To present the validation of a new Flexible Ultra‐Short Echo time (FUSE) pulse sequence using a short‐T2 phantom. Methods: FUSE was developed to include a range of RF excitation pulses, trajectories, dimensionalities, and long‐T2 suppression techniques, enabling real‐time interchangeability of acquisition parameters. Additionally, we developed an improved 3D deblurring algorithm to correct for off‐resonance artifacts. Several experiments were conducted to validate the efficacy of FUSE, by comparing different approaches for off‐resonance artifact correction, variations in RF pulse and trajectory combinations, and long‐T2 suppression techniques. All scans were performed on a 3 T system using an in‐house short‐T2 phantom. The evaluation of results included qualitative comparisons and quantitative assessments of the SNR and contrast‐to‐noise ratio. Results: Using the capabilities of FUSE, we demonstrated that we could combine a shorter readout duration with our improved deblurring algorithm to effectively reduce off‐resonance artifacts. Among the different RF and trajectory combinations, the spiral trajectory with the regular half‐inc pulse achieves the highest SNRs. The dual‐echo subtraction technique delivers better short‐T2 contrast and superior suppression of water and agar signals, whereas the off‐resonance saturation method successfully suppresses water and lipid signals simultaneously. Conclusion: In this work, we have validated the use of our new FUSE sequence using a short T2 phantom, demonstrating that multiple UTE acquisitions can be achieved within a single sequence. This new sequence may be useful for acquiring improved UTE images and the development of UTE imaging protocols. [ABSTRACT FROM AUTHOR]

In this paper, we propose an acoustic black hole radial elastic metamaterial (AREM). Through the study of its dispersion relations, it is found that, compared with the conventional elastic metamaterial, the AREM gathers energy at the tip of the black hole cell, which can trigger the local resonance (LR) effect and couples with the Bragg scattering (BS) effect, thus opening the very low-frequency strong attenuation broadband. The influence of the structural parameters of the AREM on the bandgap (BG) characteristics is further explored, and the bandwidth can be modulated in the frequency range of 0–1300 Hz by varying the truncation thickness and power exponent of the acoustic black hole (ABH) structure. Finally, by analyzing the transmission spectrum and displacement field, it is found that the total bandwidth of the flexural BG is better than that of the conventional radial elastic metamaterial, and the wave attenuation capability is improved by more than 110%. It is also discovered that the BG characteristics of the longitudinal BG are also better than those of the conventional radial elastic metamaterial, and the total bandwidth of the longitudinal BG is superior to that of the conventional radial elastic metamaterial, with the wave attenuation capability improved by more than 56%. The research findings may have applications in engineering fields such as ultra-low-frequency vibration reduction. [ABSTRACT FROM AUTHOR]

To develop an arterial spin labeling (ASL) perfusion imaging method with balanced steady-state free precession (bSSFP) readout and radial sampling for improved SNR and robustness to motion and off-resonance effects. An ASL perfusion imaging method was developed with pseudo-continuous arterial spin labeling (pCASL) and bSSFP readout. Three-dimensional (3D) k -space data were collected in segmented acquisitions following a stack-of-stars sampling trajectory. Multiple phase-cycling technique was utilized to improve the robustness to off-resonance effects. Parallel imaging with sparsity-constrained image reconstruction was used to accelerate imaging or increase the spatial coverage. ASL with bSSFP readout showed higher spatial and temporal SNRs of the gray matter perfusion signal compared to those from spoiled gradient-recalled acquisition (SPGR). Cartesian and radial sampling schemes showed similar spatial and temporal SNRs, regardless of the imaging readout. In case of severe B 0 inhomogeneity, single-RF phase incremented bSSFP acquisitions showed banding artifacts. These artifacts were significantly reduced when multiple phase-cycling technique (N = 4) was employed. The perfusion-weighted images obtained by the Cartesian sampling scheme showed respiratory motion-related artifacts when a high segmentation number was used. The perfusion-weighted images obtained by the radial sampling scheme did not show these artifacts. Whole brain perfusion imaging was feasible in 1.15 min or 4.6 min for cases without and with phase-cycling (N = 4), respectively, using the proposed method with parallel imaging. The developed method allows non-invasive perfusion imaging of the whole-brain with relatively high SNR and robustness to motion and off-resonance effects in a practically feasible imaging time. [ABSTRACT FROM AUTHOR]

Objective: To study the anatomy and biometry of the radial artery and to report the implications of this study for daily practice in Cardiac Surgery. Method: Radial arteries from 45 human cadavers (28 males and 17 females, average age 79.2 (92) fixed in 10% formalin were dissected. The proximal and distal internal calibers and lengths of these radial arteries were measured. Results: Our results showed the presence of a single radial artery variation in 2.3% of the entire sample (1.1% of the 90 dissected upper limbs). The distance between the epicondyle and the emergence of the radial artery was 32.4 (6.67) mm in men and 30.7 (9.00) mm in women, with an average of 31.8 (7.58) mm. For the right upper limb, the mean proximal internal caliber of the radial artery was 3.16 (0.56) mm and its mean distal internal caliber was 2.62 (0.66) mm. For the left upper limb, the mean proximal internal caliber of the radial artery was 3.17 (0.59) mm and its mean distal internal caliber was 2.64 (0.68) mm. The mean length of the left radial artery was 197.0 (17) mm. The mean length of the right radial artery was 201.0 (33) mm. Conclusion: It is very important to be aware of the possible anatomical variation of the radial artery. Despite its rarity, this knowledge may ensure a better safety and reliability of the harvesting technique for use as a graft. [ABSTRACT FROM AUTHOR]

This report discusses the biometry and microscopic features of Crataegus azarolus wood fibers. A Crataegus azarolus tree was selected and cut from the gardens of Neka city (Mazandaran province). At a breast height, 2.5 m and 3.5 m height, three 5 cm thick disks were prepared and in the transverse direction, the test samples were cut and evaluated sequentially 2 x 2 cm long by 3 cm long from the pith to the bark. The anatomical properties of C. azarolus wood were studied using a light microscope. Wood anatomical features of C. azarolus are as follows: diffuse-porous with multiple vessel grouping in the radial direction (in most cases), homogenous rays, simple perforation plates, alternate intervessel pits, and the average length of vessel elements shorter than 350 microns. There was a significant difference in the fiber length, fiber diameter, fiber lumen diameter, and fiber wall thickness, both in the transverse direction and in the longitudinal direction of the Crataegus azarolus tree stem. The biometric properties of the fibers increased from the pith to the bark. The average fiber length, fiber diameter, fiber lumen diameter, and cell wall thickness of the fibers were 0.78 mm, 22.53 µm, 18.6 µm, and 4.5 µm, respectively.

The energy sector faces a pressing need for significant transformation to curb CO2 emissions. For instance, Czechia and Germany have taken steps to phase out fossil thermal power plants by 2038, opting instead for a greater reliance on variable renewable energy sources like wind and solar power. Nonetheless, thermal power plants will still have roles, too. While the conventional multistage axial turbine design has been predominant in large-scale power plants for the past century, it is unsuitable for small-scale decentralized projects due to complexity and cost. To address this, the study investigates less common turbine types, which were discarded as they demonstrated lower efficiency. One design is the Elektra turbine, characterized by its velocity compounded radial re-entry configuration. The Elektra turbine combines the advantages of volumetric expanders (the low rotational speed requirement) with the advantages of a turbine (no rubbing seals, no lubrication in the working fluid, wear is almost completely avoided). Thus, the research goal of the authors is the implementation of a 10 kW-class ORC turbine driving a cost-effective off-the-shelf 3000 rpm generator. The paper introduces the concept of the Elektra turbine in comparison to other turbines and proposes this approach for an ORC working fluid. In the second part, the 1D design and 3D–CFD optimization of the 7 kW Elektra turbine working with Hexamethyldisiloxane (MM) is performed. Finally, CFD efficiency characteristics of various versions of the Elektra are presented and critically discussed regarding the originally defined design approach. The unsteady CFD calculation of the final Elektra version showed 46% total-to-static isentropic efficiency.

Purpose: Multi-echo Stack-of-stars (SoS) radial k-space trajectories with golden angle ordering are becoming popular for free-breathing abdominal Dixon imaging and proton density fat fraction (PDFF) mapping. Gradient chain imperfections including eddy currents and system delays are known to affect the image quality of radial imaging and to confound the estimation of PDFF mapping. This work proposes a retrospective trajectory correction method based on a simple gradient modulation transfer function (GMTF) measurement to predict and correct gradient chain induced k-space trajectory errors.Methods: The GMTF was measured using the standard hardware of a 3 Tesla scanner on a phantom using the thin slice method and was applied to a 3D radial SoS Dixon imaging sequence. The impact of the GMTF-based correction on image reconstruction and PDFF quantification was investigated using numerical simulations and validated on experimental phantom data as well as on in vivo leg and liver data of healthy volunteers.Results: Correcting the k-space trajectories with the measured GMTF during image reconstruction reduced PDFF quantification errors for phantom and in vivo acquisitions. A Bland-Altman comparison of the measured PDFF phantom and reference data confirmed that the GMTF correction narrowed down the limits of agreement (LoA) from 1.3% ± 8.1% (uncorrected) to 1.9% ± 5.4% (GMTF-corrected) over the full PDFF range (0%–100%) and from −0.26% ± 2.8% (uncorrected) to 0.12% ± 1.5% (GMTF-corrected) within the 0%–50% PDFF range. Liver PDFF estimation was improved by reducing the standard deviation of the mean liver PDFF and the bias of the mean liver PDFF for all subjects.Conclusion: The proposed GMTF-based k-space trajectory correction is a fast alternative method for avoiding PDFF quantitation errors caused by gradient-system induced k-space trajectory errors in 3D radial multi-echo gradient-echo acquisitions.

The numerical results from the modeling of liquid crystals dispersed in aqueous solutions in the form of axially symmetric droplets, with the aim of helping to facilitate the development of liquid crystal biosensors, were obtained. We developed a transient two-dimensional nonlinear model obtained via torque balance that incorporates Frank's elastic free energy. In order to perform parametric studies, we defined the scaled parameters based on the surface viscosity and the homeotropic anchoring energy at the droplet interface. To evaluate the performance of the biosensor, the average angle and characteristic time were defined as performance criteria. Using these results, we studied the bulk reorientation of liquid crystal droplets in aqueous solutions caused by biomolecular interaction. Furthermore, we examined how surface viscosity affects the performance of a biosensor in the case of weak planar anchoring. The droplet interface ordering was modeled using the Euler–Lagrange equation. The droplets' equilibrium was determined by minimizing their total distortion energy based on the interaction between their surface and bulk elastic energy. Two factors that contributed to the biosensor performance were homeotropic strength and surface viscosity. This highlights the importance of controlling the surface and physicochemical properties to achieve the desired liquid crystal orientation. In addition, our results provide insight into the role that surface viscosity plays in controlling radial configuration. [ABSTRACT FROM AUTHOR]

This report discusses the biometry and microscopic features of Crataegus azarolus wood fibers. A Crataegus azarolus tree was selected and cut from the gardens of Neka city (Mazandaran province). At a breast height, 2.5 m and 3.5 m height, three 5 cm thick disks were prepared and in the transverse direction, the test samples were cut and evaluated sequentially 2 x 2 cm long by 3 cm long from the pith to the bark. The anatomical properties of C. azarolus wood were studied using a light microscope. Wood anatomical features of C. azarolus are as follows: diffuse-porous with multiple vessel grouping in the radial direction (in most cases), homogenous rays, simple perforation plates, alternate intervessel pits, and the average length of vessel elements shorter than 350 microns. There was a significant difference in the fiber length, fiber diameter, fiber lumen diameter, and fiber wall thickness, both in the transverse direction and in the longitudinal direction of the Crataegus azarolus tree stem. The biometric properties of the fibers increased from the pith to the bark. The average fiber length, fiber diameter, fiber lumen diameter, and cell wall thickness of the fibers were 0.78 mm, 22.53 µm, 18.6 µm, and 4.5 µm, respectively. [ABSTRACT FROM AUTHOR]

Computer Numerical Control (CNC) machines are increasingly popular in the production of furniture and wood products, because they combine high processing quality with short production time. The effective use of CNC machines depends on the processing parameters, which also affects the quality of the processed surface. The aim of this study was to determine the effect of feed rate, cutting direction, and grain direction on the surface roughness of various types of wood. Three European wood species (oak, beech, fir) were cut with a spindle speed of 16,000 rpm and two different feed rates (5,000 and 10,000 mm/min) using end mill tools on the CNC machine. The milling was performed in two cutting directions (radial and tangential) and two grain orientations (0° and 90°). An analysis of variance (ANOVA) was performed to evaluate the impact of the cutting parameters. The surface roughness measurements were taken, and two surface roughness parameters (Ra and Rz) were measured to determine the surface quality of the wood. According to the results of this study, the lowest surface roughness values, milling with the same processing parameters, occurred for oak wood, while the highest values occurred for fir. [ABSTRACT FROM AUTHOR]

One method to deal with the problem of soft soil is to accelerate consolidation by preloading and prefabricating a vertical drain (PVD). Consolidation analysis was based on a one-dimensional theory that required PVD as an equivalent circular well. Further studies on a simple approximate for consolidated soil were represented by equivalent permeability coefficients, kve. The equivalent conductivity coefficient is influenced by the soil and PVD permeability coefficients. The formulation of kve based on the influence area in cylindrical has been applied to a lot of construction projects. According to the comparative analysis of the classical consolidation theory, it is considered that the diameter of the circle is less representative. This study proposed a simple formulation of kve based on the elliptical assumption of influence area. The kve was derived based on an equal average degree of consolidation in one dimension, which applied the elliptical coordinate for degree of consolidation in the radial direction. The formulation is based on an elliptical cross-section and a cylindrical coordinate formulation. The validation of this formula is conducted with numerical calculations using 2D FEM. The results show that the consolidation time in the elliptical discharge area is shorter than that in the circular discharge area. [ABSTRACT FROM AUTHOR]

In this paper, the benefits of an offshore wind transmission backbone grid for the east coast of the United States are discussed. It is explained why this is a more structured approach than a traditional radial grid where each wind farm project has its own export cable connection onshore. In this study, it was revealed that following an individualistic approach that Europe has followed so far in the wind offshore transmission, strategically, is more costly and time-consuming, including long-lasting permission processes. However, States by following a more collectivistic approach and by working synergistically towards implementing a backbone grid, it may be possible to reduce costs and save time. [ABSTRACT FROM AUTHOR]

Background and Aims: Short axis, out of plane (SAOOP) and long axis, in-plane (LAIP) are two approaches employed under ultrasound-guided radial arterial cannulation. Dynamic needle tip positioning (DNTP) is a recently introduced approach which integrates the features of both. Methods: A total of 114 adult patients from American Society of Anaesthesiologists (ASA) I-IV were studied in this hospital-based cross-sectional study after getting Institutional Ethical approval, CTRI registration and prior written informed consent. The primary objective was to compare the success rates among LAIP and DNTP techniques. The radial arterial diameter and its depth were correlated to the success rates in both. Statistical analysis was done using SPSS version 23.0. Results: Success rates were similar in both (P value-0.094). Ultrasonographic location time (in seconds) was shorter in DNTP (4.351 ± 0.9727) compared to LAIP (7.140 ± 1.0763) (P value-0.0001). The mean overall diameter and depth of radial artery (in mm) were found to be 2.36 ± 0.02 and 2.51 ± 0.12, respectively. Pearson's correlation coefficient between cannulation time and diameter was found to be -0.602 (P value-0.0001) and with depth of the radial artery was 0.034 (P value 0.723). Conclusion: The success rates were similar in both techniques. Ultrasonographic location time of the radial artery was more in LAIP although cannulation time was similar in both. Cannulation time decreased with an increase in the diameter of radial artery but was unaffected by the depth of the radial artery.

Abstract The Teleostei class has the most species of the fishes. Members of this group have pectoral fins, enabling refined movements in the water. Although teleosts live in a diverse set of environments, the skeletal pattern of pectoral fins in teleosts is considered to show little morphological variability. Here, in order to elucidate variations in pectoral fin skeletons and to identify their evolutionary processes, we compared the pectoral fin skeletons from 27 species of teleosts. We identified several variations and a diversity of pectoral fin skeletal patterns within some teleost groups. Taken together with previous reports on teleost skeletons, our findings reveal that in the course of teleost evolution, there are a mixture of conserved and non-conserved components in the pectoral fin skeletons of teleosts, and that teleosts may have experienced the variation and conservation of the number and shape of the proximal radials, the loss of the mesocoracoid, and the change in the distal radial-fin ray relationship.

Copyright of Acta Materiae Compositae Sinica is the property of Acta Materiea Compositae Sinica Editorial Department and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: Various treatment methods for senile primary sarcopenia have been developed, but all of them are restrictedly used in clinical practice due to their limitations. Therefore, it is necessary to find a safe treatment with good patient compliance. OBJECTIVE: To explore the clinical effect of radial extracorporeal shockwave therapy combined with resistance exercise on senile primary sarcopenia. METHODS: Forty elderly patients with primary sarcopenia admitted in the First Affiliated Hospital of Jinzhou Medical University from February to August 2021 were collected and randomly divided into control group and treatment group with 20 cases in each group. Both two groups were subjected to resistance exercise. The treatment group was treated with radial extracorporeal shockwave therapy based on resistance exercise. Skeletal muscle index, walking speed, knee extension muscle strength, thigh circumference, and serum insulin growth factor-1 level were recorded before treatment and after 4 weeks and 8 weeks of treatment. All data were statistically analyzed. RESULTS AND CONCLUSION: Significant differences were found in skeletal muscle index, walking speed, knee extensor strength, thigh circumference and serum insulin growth factor-1 level in both control and treatment groups at different time points (P < 0.05). After 4 and 8 weeks of treatment, knee extensor strength and serum insulin growth factor-1 level were significantly better in the treatment group than the control group (P < 0.05). After 8 weeks of treatment, the circumference of the thigh was significantly improved in the treatment group compared with the control group (P < 0.05). These findings indicate that compared with resistance training alone, radial extracorporeal shockwave therapy combined with resistance training can better promote the recovery of muscle quality and function and delay the occurrence and development of senile primary sarcopenia. [ABSTRACT FROM AUTHOR]

Background and Aims: Short axis, out of plane (SAOOP) and long axis, in-plane (LAIP) are two approaches employed under ultrasound-guided radial arterial cannulation. Dynamic needle tip positioning (DNTP) is a recently introduced approach which integrates the features of both. Methods: A total of 114 adult patients from American Society of Anaesthesiologists (ASA) I-IV were studied in this hospital-based cross-sectional study after getting Institutional Ethical approval, CTRI registration and prior written informed consent. The primary objective was to compare the success rates among LAIP and DNTP techniques. The radial arterial diameter and its depth were correlated to the success rates in both. Statistical analysis was done using SPSS version 23.0. Results: Success rates were similar in both (P value-0.094). Ultrasonographic location time (in seconds) was shorter in DNTP (4.351 ± 0.9727) compared to LAIP (7.140 ± 1.0763) (P value-0.0001). The mean overall diameter and depth of radial artery (in mm) were found to be 2.36 ± 0.02 and 2.51 ± 0.12, respectively. Pearson's correlation coefficient between cannulation time and diameter was found to be -0.602 (P value-0.0001) and with depth of the radial artery was 0.034 (P value 0.723). Conclusion: The success rates were similar in both techniques. Ultrasonographic location time of the radial artery was more in LAIP although cannulation time was similar in both. Cannulation time decreased with an increase in the diameter of radial artery but was unaffected by the depth of the radial artery. [ABSTRACT FROM AUTHOR]

To verify whether transradial (TRA) compared to transfemoral (TFA) cardiac catheterization reduces the risk of periprocedural stroke (PS). We reviewed (CRD42021277918) published real-world cohorts reporting the incidence of PS within 3 days following diagnostic or interventional catheterization. Meta-analyses and meta-regressions of odds ratios (OR) performed using the DerSimonian and Laird method were checked for publication bias (Egger test) and adjusted for false-positive results (study sequential analysis SSA). The pooled incidence of PS from 2,188,047 catheterizations (14 cohorts), was 193 (105 to 355) per 100,000. Meta-analyses of adjusted estimates (OR = 0.66 (0.49 to 0.89); p = 0.007; I2 = 90%), unadjusted estimates (OR = 0.63 (0.51 to 0.77; I2 = 74%; p = 0.000)), and a sub-group of prospective cohorts (OR = 0.67 (0.48 to 0.94; p = 0.022; I2 = 16%)) had a lower risk of PS in TRA (without indication of publication bias). SSA confirmed the pooled sample size was sufficient to support these conclusions. Meta-regression decreased the unexplained heterogeneity but did not identify any independent predictor of PS nor any effect modifier. Periprocedural stroke remains a rare and hard-to-predict adverse event associated with cardiac catheterization. TRA is associated with a 20% to 30% lower risk of PS in real-world/common practice settings. Future studies are unlikely to change our conclusion. [ABSTRACT FROM AUTHOR]

Background: Although Extracorporeal Shock Wave Therapy (ESWT) is a widely used treatment option in patellar tendinopathy (PT), treatment protocols are not clearly defined. There is no consensus on the type of shock wave or the energy level, number of shocks, pressure, and frequency values. For this reason, this study will, on the one hand, aim to contribute to the confusion of whether ESWT is effective in the treatment of PT and, on the other hand, try to define the most effective ESWT protocol in the treatment of PT, rather than choosing one at random. Methods: Eighty-six patients with PT randomised to 'Controlled Unfocused/Radial' ESWT (r-ESWT), 'Large-Focused' ESWT (f-ESWT) and sham ESWT (s-ESWT) groups and the data of seventy-eight patients who could reach the last control were evaluated statistically. The patients received the ESWT application once a week for a total of three sessions. Patients were evaluated with Visual Analog Scale (VAS) and Victorian Institute of Sports Assessment-Patella (VISA-P) scores just before the treatment (baseline), one day after the end of treatment (week 3), one month after the end of treatment (week 7) and three months after the end of treatment (week 15). Results: VAS and VISA-P scores have significantly improved at 3th, 7th, and 15th weeks in the r-ESWT group (p<0.05) and at 7th, and 15th weeks in the f-ESWT group (p<0.05). In terms of baseline-3th week, baseline-7th week and baseline-15th week differences of VAS and VISA-P scores, r- ESWT was superior to f-ESWT (p<0.05). Conclusions: Although both r-ESWT and f- ESWT were effective in the treatment of PT according to the results of this study, the efficacy of r-ESWT was superior to f-ESWT. [ABSTRACT FROM AUTHOR]

The purpose of the current study was to develop a deep learning technique called Golden‐angle RAdial Sparse Parallel Network (GRASPnet) for fast reconstruction of dynamic contrast‐enhanced 4D MRI acquired with golden‐angle radial k‐space trajectories. GRASPnet operates in the image‐time space and does not use explicit data consistency to minimize the reconstruction time. Three different network architectures were developed: (1) GRASPnet‐2D: 2D convolutional kernels (x,y) and coil and contrast dimensions collapsed into a single combined dimension; (2) GRASPnet‐3D: 3D kernels (x,y,t); and (3) GRASPnet‐2D + time: two 3D kernels to first exploit spatial correlations (x,y,1) followed by temporal correlations (1,1,t). The networks were trained using iterative GRASP reconstruction as the reference. Free‐breathing 3D abdominal imaging with contrast injection was performed on 33 patients with liver lesions using a T1‐weighted golden‐angle stack‐of‐stars pulse sequence. Ten datasets were used for testing. The three GRASPnet architectures were compared with iterative GRASP results using quantitative and qualitative analysis, including impressions from two body radiologists. The three GRASPnet techniques reduced the reconstruction time to about 13 s with similar results with respect to iterative GRASP. Among the GRASPnet techniques, GRASPnet‐2D + time compared favorably in the quantitative analysis. Spatiotemporal deep learning enables reconstruction of dynamic 4D contrast‐enhanced images in a few seconds, which would facilitate translation to clinical practice of compressed sensing methods that are currently limited by long reconstruction times. [ABSTRACT FROM AUTHOR]

Application of quantitative dynamic contrast-enhanced (DCE) MRI in mouse models of abdominal cancer is challenging due to the effects of RF inhomogeneity, image corruption from rapid respiratory motion and the need for high spatial and temporal resolutions. Here we demonstrate a DCE protocol optimized for such applications. The method consists of three acquisitions: (1) actual flip-angle B1 mapping, (2) variable flip-angle T1 mapping and (3) acquisition of the DCE series using a motion-robust radial strategy with k-space weighted image contrast (KWIC) reconstruction. All three acquisitions employ spoiled radial imaging with stack-of-stars sampling (SoS) and golden-angle increments between the views. This scheme is shown to minimize artifacts due to respiratory motion while simultaneously facilitating view-sharing image reconstruction for the dynamic series. The method is demonstrated in a genetically engineered mouse model of pancreatic ductal adenocarcinoma and yielded mean perfusion parameters of Ktrans = 0.23 ± 0.14 min−1 and ve = 0.31 ± 0.17 (n = 22) over a wide range of tumor sizes. The SoS-sampled DCE method is shown to produce artifact-free images with good SNR leading to robust estimation of DCE parameters.