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X-ray radiography offers the ability to noninvasively inspect the internal structure and material composition of objects. Dual-energy radiography allows material discrimination but is limited in quantitative material measurements due to the broad nature of the interrogating x-ray spectrum. Spectral radiography detectors provide an observation of not just the number of x rays that are transmitted through a sample but also the spectrum. Here, experimental validations of a method to use spectral x-ray radiography to accurately quantify the uranium mass in a powder are presented. An accurate system response model was developed, which includes a model of the incident x-ray source spectrum and a pixel-wise detector response that describes how the transmitted x rays were observed. Further, a calibration to account for the effect of partial x-ray attenuation was developed. The method is demonstrated to be capable of estimating the uranium mass in a variety of uranium oxide powders to a bias of − 0.01 ± 0.62 %. [ABSTRACT FROM AUTHOR]

Background: Ocular foreign bodies (OFBs) are a relatively common occurrence in ocular injuries, and a severe risk factor for vision disorders. They are notoriously challenging to identify and localize precisely to allow surgical removal, even with the most recent technological advancements. Purpose: To compare the efficiency of different imaging methods in detecting and localizing OFBs. Methods: We conducted a retrospective analysis of the medical records of patients with OFBs, detected by ultrasound biomicroscopy (UBM) and confirmed during surgery. Patients who presented to our medical center between January 2016 and January 2022 and also underwent computed tomography (CT), X ray, and/or ocular B‐scan ultrasonography (B‐scans) were selected. Results: This study included 134 patients with a history of ocular trauma and OFBs (mean age: 47.25 years, range: 8–78). The mean time interval from injury to UBM examination was 36.31 months (range: 0.2–120 months). Most OFBs were metallic (51.82%) or plant‐based (25.37%); 22.39% of them were located in the sclera, 26.87% in the anterior chamber, and 23.88% in the ciliary body and iris. OFBs ranged in size from 0.10 to 6.67 mm (mean: 1.15 ± 1.10 mm). B‐scans identified OFBs in 37 of the 119 patients examined (31.09%); CT in 52 of 84 patients (61.90%); and radiography in 29 of 50 patients (58.00%). Univariate and multivariate analyses determined that both CT and radiography showed low detection rates for plant‐based versus non‐plant‐based OFBs (CT: p < 0.001; radiography: p = 0.007), small particles (<1.00 mm vs. >1.00 mm; CT: p = 0.001, radiography: p = 0.024), and with eyeball wall locations (vs. intraocular; CT: p < 0.001, radiography: p = 0.021). Similarly, B‐scans were less efficient for plant‐based and eyeball wall‐located OFBs (both p = 0.001), whereas the difference based on dimensions was not significant (p = 0.118). Conclusions: CT, radiography, and B‐scans showed lower detection rates for plant‐based, small, and eyeball wall‐located OFBs. Our findings strongly suggest that UBM could be a more adequate imaging modality when such OFBs are suspected. [ABSTRACT FROM AUTHOR]

High-resolution imaging of Cu/low-k on-chip interconnect stacks in advanced microelectronic products is demonstrated using full-field transmission X-ray microscopy (TXM). The comparison of two lens-based laboratory X-ray microscopes that are operated at two different photon energies, 8.0 keV and 9.2 keV, shows a contrast enhancement for imaging of copper nanostructures embedded in insulating organosilicate glass of a factor of 5 if 9.2 keV photons are used. Photons with this energy (Ga-Kα radiation) are generated from a Ga-containing target of a laboratory X-ray source applying the liquid-metal-jet technology. The 5 times higher contrast compared to the use of Cu-Kα radiation (8.0 keV photon energy) from a rotating anode X-ray source is caused by the fact that the energy of the Ga-Kα emission line is slightly higher than that of the Cu-K absorption edge (9.0 keV photon energy). The use of Ga-Kα radiation is of particular advantage for imaging of copper interconnects with dimensions from several 100 nm down to several 10 nm in a Cu/SiO2 or Cu/low-k backend-of-line stack. Physical failure analysis and reliability engineering in the semiconductor industry will benefit from high-contrast X-ray images of sub-μm copper structures in microchips. [ABSTRACT FROM AUTHOR]

The Medical Radiation Practice Board of Australia (MRPBA) minimum competency framework requires all Australian radiographers to identify significant pathology in radiological images and take appropriate action to alert these urgent findings and ensure patient safety. Despite professional bodies endorsing the provision of preliminary image evaluations (PIE) in written format, radiographer image interpretation often remains inconsistent, informal, or undocumented. The purpose of this narrative review was to assess the literature to determine if PIE in the form of written radiographer comments is of value to the Australian healthcare system. A structured search was completed using four health research databases: CINAHL, Medline, Scopus and Web of Science. Studies have suggested that there is a contextual need for commenting due to increased imaging service pressures, radiologist shortages and subsequent reporting delays. Radiographers appear well placed and willing to provide accurate initial input with evidence that this would be valued and appreciated within the multidisciplinary team. Radiographer commenting has also been shown to reduce diagnostic and communicative errors with the potential to improve patient management. Finally, it was shown that participation in image interpretation practices can enhance recruitment, retention and job satisfaction among radiographers. Therefore, the current literature supports implementation of radiographer commenting within the Australian healthcare system. [ABSTRACT FROM AUTHOR]

Spectral properties of the high-temperature plasma obtained by exposing a nickel layer to a source of high-power X-ray radiation (a power of 6–10 TW with a duration of 7–10 ns) based on a Z-pinch, formed during implosion of tungsten multi-wire arrays at the Angara-5-1 facility, are studied. In this case, the Z‑pinch radiation heats the target and turns it into the hot plasma, and the same radiation probes the target plasma to determine the spectral dependence of the transmission of this plasma. An original scheme is proposed for measuring the incident, transmitted and self-emission of a target simultaneously in one experiment in the frame mode using a grazing incidence diffraction spectrograph. Using laser shadow imaging, experimental data are obtained on the velocity of the plasma expansion on the irradiated and back sides of the target, which reached 100 km/s. Targets made of thin Ni layers deposited on a mylar film are studied. An irradiation-induced multiple increase in the transmission of the target plasma in the EUV range is observed compared to the transmittance of the target in the cold state. The dependence of the absorption spectrum of the plasma and the accompanying self-radiation of the target on the power and shape of the heating pulse is studied. The measurement results are compared with numerical calculations performed using the RALEF-2D two-dimensional radiation code, which has been repeatedly used previously to simulate similar experiments. The shape of the spectral dependence of the transmission in the experiment and calculation is similar in the range of ∼30–200 Å, but the model plasma transmission (∼0.8–0.9) is higher than that obtained using a spectrograph and X-ray multi-frame photography (∼0.5–0.6). [ABSTRACT FROM AUTHOR]

Purpose To evaluate whether the image quality of chest radiographs obtained using a camera-type portable X-ray device is appropriate for clinical practice by comparing them with traditional mobile digital X-ray devices. Materials and Methods Eighty-six patients who visited our emergency department and underwent endotracheal intubation, central venous catheterization, or nasogastric tube insertion were included in the study. Two radiologists scored images captured with traditional mobile devices before insertion and those captured with camera-type devices after insertion. Identification of the inserted instruments was evaluated on a 5-point scale, and the overall image quality was evaluated on a total of 20 points scale. Results The identification score of the instruments was 4.67 ± 0.71. The overall image quality score was 19.70 ± 0.72 and 15.02 ± 3.31 (p < 0.001) for the mobile and camera-type devices, respectively. The scores of the camera-type device were significantly lower than those of the mobile device in terms of the detailed items of respiratory motion artifacts, trachea and bronchus, pulmonary vessels, posterior cardiac blood vessels, thoracic intervertebral disc space, subdiaphragmatic vessels, and diaphragm (p = 0.013 for the item of diaphragm, p < 0.001 for the other detailed items). Conclusion Although caution is required for general diagnostic purposes as image quality degrades, a camera-type device can be used to evaluate the inserted instruments in chest radiographs. [ABSTRACT FROM AUTHOR]

The emergency of esophageal button batteries is recognized. Foreign bodies in the ear or nose are treated as comparatively nonemergent. We present the case of a child who presented with suspected pen-nib in the nostril to highlight the importance of investigation and intervention in unwitnessed nasal foreign body and review the literature regarding X-rays in these cases. Fifteen papers were identified as per search parameters; 3 papers recommend the use of plain radiographs for nasal foreign bodies. We propose that in unwitnessed pediatric nasal foreign body insertion, a facial X-ray should be considered, especially if suspecting a metallic foreign body. [ABSTRACT FROM AUTHOR]

Industrial radiography is a pivotal non-destructive testing (NDT) method that ensures quality and safety in a wide range of industrial sectors. Conventional human-based approaches, however, are prone to challenges in defect detection accuracy and efficiency, primarily due to the high inspection demand from manufacturing industries with high production throughput. To solve this challenge, numerous computer-based alternatives have been developed, including Automated Defect Recognition (ADR) using deep learning algorithms. At the core of training, these algorithms demand large volumes of data that should be representative of real-world cases. However, the availability of digital X-ray radiography data for open research is limited by non-disclosure contractual terms in the industry. This study presents a pipeline that is capable of modeling synthetic images based on statistical information acquired from X-ray intensity distribution from real digital X-ray radiography images. Through meticulous analysis of the intensity distribution in digital X-ray images, the unique statistical patterns associated with the exposure conditions used during image acquisition, type of component, thickness variations, beam divergence, anode heel effect, etc., are extracted. The realized synthetic images were utilized to train deep learning models, yielding an impressive model performance with a mean intersection over union (IoU) of 0.93 and a mean dice coefficient of 0.96 on real unseen digital X-ray radiography images. This methodology is scalable and adaptable, making it suitable for diverse industrial applications. [ABSTRACT FROM AUTHOR]

Introduction: Concepts are cornerstones in science, and their determination is a prerequisite for understanding their substance and meaning. Radiography as a concept is not straightforward nor simple to understand, and there are different interpretations depending on the scientific perspective. To develop truthful knowledge of radiography from the perspective of the discipline, a determination of the subject and substance of radiography is required and thereby is a precursor for theory development. The aim of this study was to investigate the etymological and semantic meaning of radiography from the radiography science perspective. Methods: An etymological and semantic analysis has been applied according to Koort and Eriksson's theoretical model. Dictionaries published between 2004 and 2021 were used. Results: The findings show that etymologically, radiography is formed by compounding the words 'radio' and 'graphy', originating historically from Latin and Greek. The semantic analysis revealed that the substance of radiography consisted of four characteristics that are the basic substance of radiography. The characteristics were X‐ray and radiation, human beings—opaque objects, process including an act and art and images. Conclusion: This study clarifies the substance and meaning of radiography as a subject from the perspective of radiography science. The subject and substance consisted of the four basic characteristics that all are vital and required to understand the concept of radiography. The characteristics revealed that radiography science is based on scientific knowledge and carrier of properties of meaning that provide a fundamental understanding of radiography science. Implications for Practice: Investigating the subject, substance and meaning of radiography as a concept can become the base for further theoretical, contextual and practical understanding and support in the development of theory in radiography science. [ABSTRACT FROM AUTHOR]

The development of a sample environment for in situ x-ray characterization during metal Electron Beam Powder Bed Fusion (PBF-EB), called MiniMelt, is presented. The design considerations, the features of the equipment, and its implementation at the synchrotron facility PETRA III at Deutsches Elektronen-Synchrotron, Hamburg, Germany, are described. The equipment is based on the commercially available Freemelt ONE PBF-EB system but has been customized with a unique process chamber to enable real-time synchrotron measurements during the additive manufacturing process. Furthermore, a new unconfined powder bed design to replicate the conditions of the full-scale PBF-EB process is introduced. The first radiography (15 kHz) and diffraction (1 kHz) measurements of PBF-EB with a hot-work tool steel and a Ni-base superalloy, as well as bulk metal melting with the CMSX-4 alloy, using the sample environment are presented. MiniMelt enables time-resolved investigations of the dynamic phenomena taking place during multi-layer PBF-EB, facilitating process understanding and development of advanced process strategies and materials for PBF-EB. [ABSTRACT FROM AUTHOR]

Background: Hemophilia is associated with an increased risk of developing osteoporosis and osteopenia. The aim of the study was to interpret the usefulness of fractal analysis of the trabecular bone of the mandible (FD) and selected radiomorphic indices (the antegonial index (AI) and Klemetti index (KI)) to assess the risk of reduced bone mineral density (BMD) in patients with hemophilia A/B. Methods: The study group consisted of 50 patients with type A/B hemophilia. The control group consisted of 25 males without congenital bleeding disorders. The patients had a panoramic radiograph taken with the same X-ray machine (Vistapano S, Durr Dental, Bietigheim-Bissingen, Germany). The AudaXCeph software (Audax d.o.o., Ljubljana, Slovenia) was used to evaluate the AI index, and the ImageJ, software with a specially prepared script, was used to evaluate the FD. The mandibular cortex was assessed distal to the mental foramen using the Klemetti index. Results: There were no statistically significant differences between the AI, KI and FD values between the study group and the control group. Conclusions: This study indicated the lack of usefulness of AI, KI and fractal analysis in identifying patients with hemophilia at risk of reduced bone mass. [ABSTRACT FROM AUTHOR]

Purpose: Given the growing demand for intraoperative imaging, there is increased concern for radiation dose for orthopaedic surgical staff. This study sought to determine the distribution of scatter radiation from fluoroscopic imaging in the orthopaedic surgical environment, with particular emphasis on the positions of personnel and the type of orthopaedic surgery performed. Methods: A radiation survey detector was deployed at various angles and distances around an anthropomorphic phantom. The scatter dose rate in microsieverts per hour (µSv/h) was recorded using consistent exposure parameters for five common surgical procedures. A C-arm unit produced radiation for the hip arthroscopy, hip replacement and knee simulations, whilst a mini C-arm unit produced fluoroscopy for the foot and hand simulations. Results: Readings were tabulated, and coloured heatmaps were generated from scatter measurements for each of the five procedures. Positions corresponding to the typical location of the surgical staff (surgeon, surgical assistant, anaesthetist, instrument (scrub) nurse, circulation (scout) nurse and anaesthetic nurse) were superimposed on heatmaps. The surgeon's proximity to the radiation source meant this position experienced the greatest amount of radiation in all five surgical procedures. Mini C-arm doses were considered low in all procedures for positions, with and without lead protection. Conclusion: This investigation demonstrated the distribution of scattered radiation dose experienced at different positions within the orthopaedic surgical theatre. It reinforces the importance of staff increasing their distance from the primary beam where possible, reducing exposure time and increasing shielding with lead protection. [ABSTRACT FROM AUTHOR]

Pulsed x-rays are crucial for various applications such as radiography, biological effects, and the system-generated electromagnetic pulse effect. X rays with a higher dose rate and a higher total dose can generate more significant radiation effects and more effective radiography. However, most pulsed sub-100 keV x-ray systems with high dose rates operate in the single pulse mode with limited total dose, and most repetitive pulsed x-ray systems have a low dose rate. This paper develops a compact high-current repetitive pulsed x-ray system with a low-impedance diode to generate high dose rate pulsed x-rays with an average energy below 100 keV. A diode with a double-ring cathode is designed and tested to produce uniform pulsed x-rays. In order to investigate the x-ray intensity and the pulse number of repetitions for different anode thicknesses, five typical thicknesses are tested. The experimental results show that this system can operate stably at a repetitive rate of 0.2 Hz with a peak voltage of about 200 kV and a peak current of about 100 kA. The dose rate is about 2.4 × 105 Gy(LiF)/s, and the average x-ray energy is about 55 keV with the 40 µm thick tantalum anode. The x-ray uniformity is better than 2:1 over the measuring plane. [ABSTRACT FROM AUTHOR]

Background: To show the femoral neck better in hip lateral view of X-ray, we design a modified hip lateral view and then investigate the value in femoral neck fractures. Methods: CT images of 10 normal hip joints for 3D reconstruction were selected, the Mimics Medical 21.0 was used, and rotating the proximal femur was to find the most suitable angle for showing the femoral neck well, designed the modified lateral view according to this angle. We collected 35 healthy cases and 35 femoral neck fractures as the normal and fracture group. And two groups were all taken hip anteroposterior view, cross-table lateral view and modified lateral view, which were analyzed by two radiologists to score the anatomical structures of the articular surface, femoral head, head neck junction, femoral neck, basal region and intertrochanteric region. Friedman test was used to analyze the score of femoral neck at different angles. T test and Wilcoxon signed-rank test were to compare inter-groups. Results: The modified lateral view was designed as follows: The subjects were supine, with the sagittal axis biased toward the healthy side at an angle of approximately 20° to the long axis of the examination table, the hip joint flexed at 45°, the lower extremity abducted at 40°, the centerline inclined 45° toward the head and the centerline aligned with the center of the groin. The modified lateral view showed the femoral head, head neck junction and femoral neck more clearly than the cross-table lateral view, but the cross-table lateral view showed the femoral neck basal and intertrochanteric region better. In addition, the time of taking the modified lateral view was significantly less than the cross-table lateral view (normal group: 0.789 min ± 0.223 vs 0.623 min ± 0.207, P < 0.001; fracture group: 1.131 min ± 0.362 vs 0.946 min ± 0.390, P < 0.001). Conclusions: The modified lateral view can obtain a standard sagittal image of femoral neck, which can show the dislocation and angulation of the sagittal femoral neck fracture clearly, and improve the accuracy of diagnosis. And it is more convenient and easier for patients to cooperate, which is worthy promoting and applying in clinical work. [ABSTRACT FROM AUTHOR]

A non-functional printed circuit board assembly was developed using ULTIboard and a simple computational transport model was created for use with the Monte Carlo software MCNP. EBT3 film radiography was used to compare with Monte Carlo simulation to validate the board representation. The computational transport model was then revised to include connection pins, solder balls, highly attenuating internal structures, and copper trace distribution. Results from the revised model were compared to the EBT3 films to observe improvements to dose profiles. It was found that this method was useful in verifying the placement of components, as the dose profiles were observed to follow the same trends. The experiment was then repeated using XRQA2 films to achieve the same level of contrast with 1% the dose of EBT3 films. It was found that high contrast may be achieved using these films to identify major issues with the model geometry, at a cost of dose profile accuracy. A second validation method was applied to the model using 37 CaF 2 thermoluminescent dosimeters (TLDs). TLD measurements were compared with the simplified and complex transport models to identify the features that have the greatest impact on simulation accuracy. The TLD calibration to CaF 2 was found to be accurate within 5.6%, while calibration to dose in Si was found to be accurate within 4.7%. It was observed that the accurate representation of solder balls and proper modeling of highly attenuating internal structures had the greatest impact on simulation accuracy. [ABSTRACT FROM AUTHOR]

Objectives: To compare the visibility of anatomical structures and overall quality of the attenuation images obtained with a dark-field X-ray radiography prototype with those from a commercial radiography system. Methods: Each of the 65 patients recruited for this study obtained a thorax radiograph at the prototype and a reference radiograph at the commercial system. Five radiologists independently assessed the visibility of anatomical structures, the level of motion artifacts, and the overall image quality of all attenuation images on a five-point scale, with 5 points being the highest rating. The average scores were compared between the two image types. The differences were evaluated using an area under the curve (AUC) based z-test with a significance level of p ≤ 0.05. To assess the variability among the images, the distributions of the average scores per image were compared between the systems. Results: The overall image quality was rated high for both devices, 4.2 for the prototype and 4.6 for the commercial system. The rating scores varied only slightly between both image types, especially for structures relevant to lung assessment, where the images from the commercial system were graded slightly higher. The differences were statistically significant for all criteria except for the bronchial structures, the cardiophrenic recess, and the carina. Conclusions: The attenuation images acquired with the prototype were assigned a high diagnostic quality despite a lower resolution and the presence of motion artifacts. Thus, the attenuation-based radiographs from the prototype can be used for diagnosis, eliminating the need for an additional conventional radiograph. Key Points: • Despite a low tube voltage (70 kVp) and comparably long acquisition time, the attenuation images from the dark-field chest radiography system achieved diagnostic quality for lung assessment. • Commercial chest radiographs obtained a mean rating score regarding their diagnostic quality of 4.6 out of 5, and the grating-based images had a slightly lower mean rating score of 4.2 out of 5. • The difference in rating scores for anatomical structures relevant to lung assessment is below 5%. [ABSTRACT FROM AUTHOR]

Objectives: To report a case of ingested wire bristle embedded within the extrinsic musculature of the tongue requiring a transcervical approach for removal and to provide a revised algorithm for the management of ingested wire bristles. Methods: The clinical record of 1 patient who ingested a grill brush wire bristle was reviewed. A literature review was also conducted to refine a treatment algorithm for managing ingested wire bristles. Results: We present a case of a 53-year-old male who accidentally ingested a grill brush wire bristle. After multiple unsuccessful endoscopic attempts at removal, the wire bristle migrated deep into the extrinsic musculature of the tongue, necessitating a transcervical approach for adequate visualization and retrieval. Conclusions: This is the first case reported of a wire bristle migrating deep into the tongue musculature that was successfully removed via a transcervical approach. Our proposed algorithm provides a comprehensive approach to the management of ingested wire bristles, specifically in cases where endoscopic retrieval is not feasible. [ABSTRACT FROM AUTHOR]

The objective of this study was twofold. (1) To investigate the predictive characteristics of transvaginal ultrasonography for hysteroscopy necessity in Essure removal surgery. (2) To investigate the additional predictive value of a preoperative pelvic radiograph to transvaginal ultrasonography for hysteroscopy necessity. Retrospective cohort study, performed in an academic and a non-academic teaching hospital in the Netherlands. 71 women who underwent Essure removal surgery with a perioperative hysteroscopy and who had a preoperative pelvic X-ray and transvaginal ultrasound were included. Four experts first predicted hysteroscopy necessity based on transvaginal ultrasound description and secondly based on transvaginal ultrasound combined with the preoperative pelvic radiograph. Sensitivity, specificity, positive predictive value and negative predictive value of the predictive tests were calculated. Based on transvaginal ultrasound, the mean predictive characteristics for experts were: sensitivity 89.7% (range 66.7%–100%), specificity 37.4% (range 17.6%–67.7%), positive predictive value 18.8% (range 13.2%–29.5%) and negative predictive value 95.1% (range 86.1%–100%). After adding the pelvic radiograph to the transvaginal ultrasound descriptions, the results were: sensitivity 66.7% (range 53.3%–80%), specificity 72.6% (range 56%–97.3%), positive predictive value 23% (range 14.3%–26.9%) and negative predictive value 94.1 % (range 90.3%–98.4%). For three experts sensitivity decreased after adding the pelvic radiograph. For all experts specificity increased. It is difficult to preoperatively decide if the fourth marker of the Essure outer coil can be excised during hysteroscopy. The addition of pelvic radiography to transvaginal ultrasound is not beneficial. It is recommended to perform a hysteroscopy during Essure removal surgery. [ABSTRACT FROM AUTHOR]

Dynamic chest radiography (DCR) is a real-time sequential high-resolution digital X-ray imaging system of the thorax in motion over the respiratory cycle, utilising pulsed image exposure and a larger field of view than fluoroscopy coupled with a low radiation dose, where post-acquisition image processing by computer algorithm automatically characterises the motion of thoracic structures. We conducted a systematic review of the literature and found 29 relevant publications describing its use in humans including the assessment of diaphragm and chest wall motion, measurement of pulmonary ventilation and perfusion, and the assessment of airway narrowing. Work is ongoing in several other areas including assessment of diaphragmatic paralysis. We assess the findings, methodology and limitations of DCR, and we discuss the current and future roles of this promising medical imaging technology. Critical relevance statement Dynamic chest radiography provides a wealth of clinical information, but further research is required to identify its clinical niche. Key points: Dynamic chest radiography (DCR) captures high-resolution moving images of the thorax. The ionising radiation dose of DCR is low. DCR can image the diaphragm, chest wall, ventilation and perfusion. Most papers on DCR are small, with heterogeneity in study design or outcome. Large, multicentre studies with similar outcomes and healthy controls are desirable. [ABSTRACT FROM AUTHOR]

One challenge in using X-ray imaging for post-process inspection of aluminum alloys fusion welded with conventional filler wires (e.g., 4xxx, 5xxx) is the negligible contrast between the fusion zone and base metal, which hinders measurement of important weld characteristics such as weld penetration. The current study outlines the development of novel filler wires that are based on commercial 4xxx (Al-Si) wires, but include additions of Ce to create grayscale contrast in X-ray imaging. Four custom Al-Si-Ce filler wires were fabricated by casting and extrusion, and were used for fusion welding of AA6061 plates. X-ray computed tomography of the lap joints with the Al-Si-Ce filler wires showed enhanced contrast between the fusion zone and the base metal enabling superior quantitative inspection. Microstructure analysis revealed that the increased X-ray contrast was due to Ce-containing precipitate particles within the fusion zone, which were identified to be τ1-Ce(AlxSi1-x)2 and τ4-Al2CeSi2. Hardness and other mechanical tests indicate a slight increase in mechanical properties with increasing Si and Ce content in the filler wire. It is concluded that the addition of relatively small amounts of Ce to conventional Al-Si filler wires is an effective method for creating the needed fusion zone contrast for measurement of weld penetration by X-ray imaging. [ABSTRACT FROM AUTHOR]

Anteroposterior (AP) and lateral shoulder projections are routinely performed as part of a post‐reduction shoulder x‐ray series in the emergency department (ED). Research has shown that these projections alone are insufficient to demonstrate post‐dislocation injuries, particularly Hill‐Sachs and Bankart lesions. These concomitant pathologies are best demonstrated on axial shoulder projections but are difficult to obtain in trauma patients with limited range of motion. The diagnostic quality and the pathology demonstrated by different projections is crucial so that doctors and other ED staff can triage patients appropriately, radiologists can report on the presence or absence of post‐dislocation shoulder injuries, and the orthopaedic team can plan for follow‐up or treatment. Different modified axial views were reported to improve the post‐dislocation pathology sensitivity in the shoulder series. However, all of these shoulder axial views require patient movement. The modified trauma axial (MTA) is an alternative projection that is suitable for trauma patients that does not depend on patient movement. This paper presents several cases where the MTA shoulder projection had clinical importance when used as part of the post‐reduction shoulder series in the ED or radiology department. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to comparatively evaluate the learning outcomes achieved by first‐year radiography students educated with either virtual reality (VR) simulation training or physical simulation training. The implementation of VR has been proposed to enhance learning in radiography students and provide a more effective and efficient approach to simulation. However, the learning outcomes achieved with this approach have not been widely investigated. Methods: Through stratified randomisation, 188 radiography students were allocated to one of two matched groups: a VR group (using Virtual Medical Coaching's Radiography simulation) and a physical simulation group (using Philips' X‐ray equipment). Both groups were taught 31 radiography views over one 25‐week semester. Both groups were assessed in an Objective Structured Clinical Examination (OSCE), using actors as patients in a physical X‐ray environment. Assessment was conducted by assigning objective count scores for five assessment criteria. Results: The VR group achieved shorter OSCE duration and fewer errors in moving equipment and patient positioning: these results were statistically significant (P < 0.00). There was no significant difference in the frequency of errors in radiographic exposure setting between the VR and the physical simulation group. The current findings concur with the limited number of published studies concerning VR simulation in radiography. Conclusions: The results of this study demonstrated superior effectiveness and efficiency in the VR group. This provides preliminary evidence to introduce VR simulation in the host institution and provide evidence that it may be possible to replace the use of physical simulation across other years of the degree. Further research investigating these possibilities is warranted. [ABSTRACT FROM AUTHOR]

The black shales of the Middle Triassic Botneheia Formation in Svalbard are known for their fossil richness with abundant ichthyosaur remains and beds of the bivalve Daonella. Vertebrate remains from the Muen Mountain on Edgeøya are shown to have exceptional X-ray contrast due to a combination of sulphide and sulphate permineralisation and pseudomorphing. Radiography imaging of a previously described specimen, PMO 219.250, revealed new and spectacular details such as more carpals, teeth, and skull sutures. Teeth and skull characters are taxonomically significant. supporting the referral of PMO 219.250 to Phalarodon and further suggesting an affinity to P. atavus. Three sulphur phases were identified, with the sulphide sphalerite (ZnS) being the highest temperature phase, followed by the sulphate baryte (BaSO4), and the sulphide pyrite (FeS2). Sulphate permineralisation is also seen in specimens from the Upper Jurassic on Svalbard. We suggest that sulphur-rich fluids have flowed and dissolved barium from the shales and deposited the sphalerite and baryte, and that this could be linked to the Cretaceous HALIP. The Jurassic specimens are only permineralised by baryte, while the Triassic specimens have also been permineralised, but mainly pseudomorphed by baryte with crystals of sphalerite. Lithology differences appear to have controlled the compaction of the Triassic specimens, while the Jurassic specimens have retained their three-dimensional shape due to the baryte emplacement relatively earlier in their depositional history. Although soft tissues are not preserved, the excellent X-ray contrast in the Middle Triassic specimens is reminiscent of pyritised fossil sites such as the Hunsrück Slate (Devonian), Beecher's Trilobite Bed (Ordovician), and the La Voulte-sur-Rhône marls (Jurassic). [ABSTRACT FROM AUTHOR]

X-ray scatter in planar radiography degrades the contrast resolution of the image, thus reducing its diagnostic utility. Antiscatter grids partially block scattered photons at the cost of increasing the dose delivered by two- to four-fold and posing geometrical restrictions that hinder their use for other acquisition settings, such as portable radiography. The few software-based approaches investigated for planar radiography mainly estimate the scatter map from a low-frequency version of the image. We present a novel method for scatter correction in planar imaging based on direct patient measurements. Samples from the shadowed regions of an additional partially obstructed projection acquired with a beam stopper placed between the X-ray source and the patient are used to estimate the scatter map. Evaluation with simulated and real data showed an increase in contrast resolution for both lung and spine and recovery of ground truth values superior to those of three recently proposed methods. Our method avoids the biases of post-processing methods and yields results similar to those for an antiscatter grid while removing geometrical restrictions at around half the radiation dose. It can be used in unconventional imaging techniques, such as portable radiography, where training datasets needed for deep-learning approaches would be very difficult to obtain. [ABSTRACT FROM AUTHOR]

A common issue with X-ray examinations (XE) is the erroneous quality classification of the XE, implying that the process needs to be repeated, thus delaying the diagnostic assessment of the XE and increasing the amount of radiation the patient receives. The authors propose a system for automatic quality classification of XE based on convolutional neural networks (CNN) that would simplify this process and significantly decrease erroneous quality classification. The data used for CNN training consist of 4000 knee images obtained via radiography procedure (KXE) in total, with 2000 KXE labeled as acceptable and 2000 as unacceptable. Additionally, half of the KXE belonging to each label are right knees and left knees. Due to the sensitivity to image orientation of some CNNs, three approaches are discussed: (1) Left-right-knee (LRK) classifies XE based just on their label, without taking into consideration their orientation; (2) Orientation discriminator (OD) for the left knee (LK) and right knee (RK) analyses images based on their orientation and inserts them into two separate models regarding orientation; (3) Orientation discriminator combined with knee XRs flipped to the left or right (OD-LFK)/OD-RFK trains the models with all images being horizontally flipped to the same orientation and uses the aforementioned OD to determine whether the image needs to be flipped or not. All the approaches are tested with five CNNs (AlexNet, ResNet50, ResNet101, ResNet152, and Xception), with grid search and k-fold cross-validation. The best results are achieved using the OD-RFK hybrid approach with the Xception network architecture as the classifier and ResNet152 as the OD, with an average AUC of 0.97 (±0.01). [ABSTRACT FROM AUTHOR]

Transport properties of high energy density matter affect the evolution of many systems, ranging from the geodynamo in the Earth's core, to hydrodynamic instability growth in inertial confinement fusion capsules. Large uncertainties of these properties are present in the warm dense matter regime where both plasma models and condensed matter models become invalid. To overcome this limit, we devise an experimental platform based on x-ray differential heating and time-resolved refraction-enhanced radiography coupled to a deep neural network. We retrieve the first measurement of thermal conductivity of CH and Be in the warm dense matter regime and compare our measurement with the most commonly adopted models. The discrepancies observed are related to the estimation of a correction term from electron-electron collisions. The results necessitate improvement of transport models in the warm dense matter regime and could impact the understanding of the implosion performance for inertial confinement fusion. Thermal transport in high-energy-density matter is key to understand systems as the geodynamic in the Earth's core or the hydrodynamic instability in inertial confinement fusion capsules. The authors measure the thermal conductivity of warm dense CH and Be by coupling x-ray differential heating and time-resolved refraction-enhanced radiography. [ABSTRACT FROM AUTHOR]

Objective: To determine which radiographic measures used to define the severity of hip dysplasia are associated with hip joint translation and to investigate relationships between position, body mass index, and joint translation. Materials and methods: This is a cross-sectional retrospective study evaluating 10 validated radiographic measures of dysplasia on weight-bearing AP pelvis and supine 45-degree bilateral Dunn radiographs of 93 young adults with symptomatic hip dysplasia presenting to a single academic institution between October 2016 and May 2019. We determined the difference between standing and supine measurements for each hip and the correlation of each measure with the patient's body mass index. Results: Femoral head extrusion index was 2.49% lower on supine X-ray (p = 0.0020). Patients with higher body mass index had higher center gap distance (p = 0.0274), femoral head extrusion (p = 0.0170), and femoral head lateralization (p = 0.0028) when standing. They also had higher Tönnis angle (pstanding = 0.0076, psupine = 0.0121) and lower lateral center–edge angle (pstanding = 0.0196, psupine = 0.0410) in both positions. The difference in femoral head lateralization between standing and supine positions increased with higher body mass index (p = 0.0081). Conclusion: Translation of the hip joint with position change is demonstrated by decreased femoral head extrusion index on supine X-ray. Patients with higher body mass index had more dysplastic hips, as measured by five of six radiographic outcomes of dysplasia, and experienced more translation with weight-bearing, reflected by increased femoral head lateralization. [ABSTRACT FROM AUTHOR]

A scheme is considered and the parameters of a multipulse X-ray source for obtaining images of the compressed state of a primary laser thermonuclear target are determined. As an example of a source, we consider the characteristic radiation of an iron secondary target with focusing on it of several picosecond laser pulses of subrelativistic intensity The proposed technique makes it possible to determine the relative large-scale inhomogeneity of the energy release of laser beams that irradiated the thermonuclear target, based on the results of X-ray diffraction of a compressed thermonuclear target, and to estimate the decrease in the neutron yield caused by the asymmetry of the compressed target. [ABSTRACT FROM AUTHOR]

Background: EOSedge™* (EOS Imaging, Paris, France) is an X-ray imaging system using automatic exposure control (AEC) with tube current modulation, in order to optimize dose deposition in patients. Purpose: This study aims at characterizing EOSedge organ dose deposition in comparison to a digital radiography (DR) system and the previous EOS system (EOS-1st generation), in relation to their respective image quality levels. Method: Organ doses were measured in an anthropomorphic female adult phantom and a 5-year-old pediatric phantom using optically stimulated luminescence (OSL) dosimeters, which were carefully calibrated within the studied energy range. Organ doses were recorded on the EOSedge and the Fuji Visionary DRF (Fujifilm Medical Systems U.S.A., Inc, Lexington, MA). The resulting effective doses were compared to the EOS-1st-generation values present in the literature. Image quality assessment was carried out on end-user images. Quantitative image quality metrics were computed for all tested modalities on a quality assurance phantom. Qualitative assessment of EOSedge image quality was based on anthropomorphic phantom acquisitions against the EOS-1st-generation system, and on clinical images against the tested DR system. Results: For a full-spine exam, and on the female adult phantom (respectively, the pediatric phantom), an effective dose of 92 Sv (respectively, 32 Sv) was obtained on EOSedge, and 572 Sv (respectively, 179 Sv) on the DR system; these values were compared to effective dose values of 290 Sv (respectively, 200 Sv) from the literature on EOS-1st generation, leading to an effective dose reduction factor of 6 with respect to the DR system, and of 3-6 with respect to EOS-1st generation. EOSedge provides the best compromise between contrast-to-noise ratio (CNR) and dose, with more consistent CNR values than the other tested modalities, in a range of attenuation from 10 to 40 cm of poly(methyl methacrylate) (PMMA). Within this range, EOSedge is also comparable to DR for 10 and 20 cm of PMMA, and better than DR for 30 and 40 cm of PMMA, both in terms of spatial resolution and low-contrast detection. The anatomical landmarks of interest in the follow-up of spinal deformities can be detected in all tested modalities. Conclusion: Results showed that EOSedge provides significant dose reduction factors for full spine imaging in both adults and children compared to the other tested modalities, without compromising image quality. We believe that this work could help raise awareness on the capabilities of modern X-ray systems, when equipped with appropriate AEC strategies, to perform ultra-low-dose, long-axis images. [ABSTRACT FROM AUTHOR]

In many inertial confinement fusion (ICF) experiments, the neutron yield and other parameters cannot be completely accounted for with one and two dimensional models. This discrepancy suggests that there are three dimensional effects that may be significant. Sources of these effects include defects in the shells and defects in shell interfaces, the fill tube of the capsule, and the joint feature in double shell targets. Due to their ability to penetrate materials, x rays are used to capture the internal structure of objects. Methods such as computational tomography use x-ray radiographs from hundreds of projections, in order to reconstruct a three dimensional model of the object. In experimental environments, such as the National Ignition Facility and Omega-60, the availability of these views is scarce, and in many cases only consists of a single line of sight. Mathematical reconstruction of a 3D object from sparse views is an ill-posed inverse problem. These types of problems are typically solved by utilizing prior information. Neural networks have been used for the task of 3D reconstruction as they are capable of encoding and leveraging this prior information. We utilize half a dozen, different convolutional neural networks to produce different 3D representations of ICF implosions from the experimental data. Deep supervision is utilized to train a neural network to produce high-resolution reconstructions. These representations are used to track 3D features of the capsules, such as the ablator, inner shell, and the joint between shell hemispheres. Machine learning, supplemented by different priors, is a promising method for 3D reconstructions in ICF and x-ray radiography, in general. [ABSTRACT FROM AUTHOR]

An x-ray Fresnel diffractive radiography platform was designed for use at the National Ignition Facility. It will enable measurements of micron-scale changes in the density gradients across an interface between isochorically heated warm dense matter materials, the evolution of which is driven primarily through thermal conductivity and mutual diffusion. We use 4.75 keV Ti K-shell x-ray emission to heat a 1000 μm diameter plastic cylinder, with a central 30 μm diameter channel filled with liquid D2, up to 8 eV. This leads to a cylindrical implosion of the liquid D2 column, compressing it to ∼2.3 g/cm3. After pressure equilibration, the location of the D2/plastic interface remains steady for several nanoseconds, which enables us to track density gradient changes across the material interface with high precision. For radiography, we use Cu He-α x rays at 8.3 keV. Using a slit aperture of only 1 μm width increases the spatial coherence of the source, giving rise to significant diffraction features in the radiography signal, in addition to the refraction enhancement, which further increases its sensitivity to density scale length changes at the D2/plastic interface. [ABSTRACT FROM AUTHOR]

Because of noise interference, improper exposure, and the over thickness of human tissues, the detailed information of DR (digital radiography) images can be masked, including unclear edges and reduced contrast. An image-enhancement algorithm based on wavelet multiscale decomposition is proposed to address the shortcomings of existing single-scale image-enhancement algorithms. The proposed algorithm is based on Shannon–Cosine wavelets by taking advantage of the interpolation, smoothness, tight support, and normalization properties. Next a multiscale interpolation wavelet operator is constructed to divide the image into several sub-images from high frequency to low frequency, and to perform different multi-scale wavelet transforms on the detailed image of each channel. So that the most subtle and diagnostically useful information in the image can be effectively enhanced. Moreover, the image will not be over-enhanced and combined with the high contrast sensitivity of the human eye's visual system in smooth regions, different attenuation coefficients are used for different regions to achieve the purpose of suppressing noise while enhancing details. The results obtained by some simulations show that this method can effectively eliminate the noise in the DR image, and the enhanced DR image detail information is clearer than before while having high effectiveness and robustness. [ABSTRACT FROM AUTHOR]

Neutron/x-ray combined radiography can integrate the merits of x-ray and neutron radiography and have an enhanced non-destructive detecting capability compared to single neutron or x-ray radiography. In this work, magnifying neutron/x-ray combined radiography along the same line of sight was performed at the Shenguang (SG) laser facility for the first time. Based on ∼ 0.1 mm point-like backlight sources of neutrons and x rays, structural defects on the order of ∼0.2 mm within polyethylene and Fe were observed in neutron and x-ray radiography, respectively. In addition, the spatial resolution obtained was 0.68 ∼ 2.05 mm in the object position for neutron radiography and ∼0.14 mm for x-ray radiography. This indicated that the combined radiography system arranged along the same line of sight at the SG laser facility possessed the ability to inspect structural defects within both low-Z and high-Z materials simultaneously, with relatively high spatial resolution. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To present an optimized examination model by analyzing the risk of disease and image quality according to the combination of the ion chamber of automatic exposure control (AEC) with digital radiography (DR). METHODS: The X-ray quality was analyzed by first calculating the percentage average error (PAE) of DR. After that, when using AEC, the combination of the ion chambers was the same as the left and centre and right, right and centre, left and centre, centre, right, and left, for a total of six. Accordingly, the entrance surface dose (ESD), risk of disease, and image quality were evaluated. ESD was obtained by attaching a semiconductor dosimeter to the L4 level of the lumbar spine, and then irradiating X-rays to dosimeter centre through average and standard deviation of radiation dose. The calculated ESD was input into the PCXMC 2.0 programme to evaluate disease risk caused by radiation. Meanwhile, image quality according to chamber combination was quantified as the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) through Image J. RESULTS: X-ray quality of DR used in the experiment was within the normal range of±10. ESD of six ion chamber combinations was 1.363mGy, 0.964mGy, 0.946mGy, 0.866mGy, 0.748mGy, 0.726mGy for lumbar anteroposterior (AP), and the lumbar lateral values were 1.126mGy, 0.209mGy, 0.830mGy, 0.662mGy, 0.111mGy, and 0.250mGy, respectively. Meanwhile, disease risk analyzed through PCXMC 2.0 was bone marrow, colon, liver, lung, stomach, urinary and other tissue cancer, and disease risk showed a tendency to increase in proportion to ESD. SNR and CNR recorded the lowest values when three chambers were combined and did not show proportionality with dose, while showed the highest values when two chambers were combined. CONCLUSION: In this study, combination of three ion chambers showed the highest disease risk and lowest image quality. Using one ion chamber showed the lowest disease risk, but lower image quality than two ion chambers. Therefore, if considering all above factors, combination of two ion chambers can optimally maintain the disease risk and image quality. Thus, it is considered an optimal X-ray examination parameter. [ABSTRACT FROM AUTHOR]

Summary: Background: Different locations of x‐ray beam centring on the equine distal limb for lateromedial and dorsopalmar radiographs of the equine digit may affect clinically relevant radiographic measurements. Objectives: To evaluate the effects of two different locations of x‐ray beam centring on lateromedial and dorsopalmar radiographic measurements of the equine digit and to assess intra‐ and inter‐observer variability of measurements. Study design: Prospective, observational and method comparison. Methods: Comparisons were made of nine measurements on orthogonal radiographs acquired from 24 unshod equine feet at two locations of x‐ray beam centring: coronary band and hoof–ground interface. Radiographic measurements were obtained by three observers of varied equine veterinary experience and made in triplicate by a board‐certified veterinary radiologist. Results: Radiographs acquired with x‐ray beam centred at the coronary band and hoof–ground interface produced differences in the mean measurements of palmar angle, defined as the angle created by the palmar processes of the distal phalanx relative to the ground surface, on the lateromedial projection (p = 0.002), and medial (p < 0.001) and lateral (p < 0.001) sole thickness on the dorsopalmar projection. There was less variability of palmar angle (p = 0.039) and more superimposition of the palmar processes (p < 0.001) with the x‐ray beam centred at the hoof–ground interface. Main limitations: The study population was homogeneous and only included horses without outwardly visible abnormalities of the foot. Anatomic measurements were not used for comparison due to the nonterminal nature of the study. Conclusions: Centring the x‐ray beam at the hoof–ground interface produces more repeatable and smaller radiographic measurements of palmar angle and sole thickness when compared to centring the x‐ray beam centred at the coronary band. The distal phalangeal palmar processes are more superimposed with the more distal x‐ray beam centring. The strong inter‐ and intraobserver variability support the use of these nine radiographic measurements by practitioners of all levels of experience. [ABSTRACT FROM AUTHOR]

Objectives: To demonstrate the utility of routine intraoperative plain film imaging in optimizing outcomes in cochlear implantation.Introduction: Evolving surgical techniques, programming, and electrode arrays have all improved performance outcomes in cochlear implantation. Yet despite decreasing complication rates, electrode misplacement remains a common occurrence. Utilization of intraoperative confirmational tools (radiologic, electrophysiologic) remains unstandardized despite the acknowledged importance of proper electrode positioning. The purpose of this article is to illustrate the use and benefits of intraoperative X-ray (IOXR) in four cases, particularly in cases of normal electrophysiologic testing.Methods: Four cases performed by an experienced CI surgeon are discussed where electrode malposition was only detected through X-ray. Literature review was performed on the use of intraoperative imaging, focusing on plain film radiography.Results: Case 1-3 describe examples of resistance-free electrode insertion in patients with normal pre-operative imaging. Intraoperative impedances and neural response telemetry (NRT) were normal. However, IOXR ultimately revealed tip fold-over prompting array repositioning. Case 4 describes an elective replacement of a soft-failing device. Resistance was encountered during array insertion, with IOXR demonstrating incomplete insertion compared with prior imaging. Positioning was revised to achieve pre-revision insertion depth, demonstrating the utility of prior IOXR in revision cases. Literature review of IOXR is discussed.Conclusion: Appropriate placement of the electrode is paramount to successful CI outcomes. These cases illustrate IOXR as a safe, effective method to ensure optimal placement even in cases of normal electrophysiologic testing, supporting its routine use even by the most seasoned surgeons. [ABSTRACT FROM AUTHOR]

A platform has been developed to study laser-direct-drive energy coupling at the National Ignition Facility (NIF) using a plastic sphere target irradiated in a polar-direct-drive geometry to launch a spherically converging shock wave. To diagnose this system evolution, eight NIF laser beams are directed onto a curved Cu foil to generate Heα line emission at a photon energy of 8.4 keV. These x rays are collected by a 100-ps gated x-ray imager in the opposing port to produce temporally gated radiographs. The platform is capable of acquiring images during and after the laser drive launches the shock wave. A backlighter profile is fit to the radiographs, and the resulting transmission images are Abel inverted to infer radial density profiles of the shock front and to track its temporal evolution. The measurements provide experimental shock trajectories and radial density profiles that are compared to 2D radiation-hydrodynamic simulations using cross-beam energy transfer and nonlocal heat-transport models. [ABSTRACT FROM AUTHOR]

Flash x-ray (FXR) systems are used for dynamic radiography. Depending on the speed of the object, these systems typically require a very short pulse duration (∼25 ns) for image acquisition without motion blur. The conventional Marx generators with zigzag discharge paths result in higher inductance; hence, they do not meet the requirement of shorter pulse duration (30–40 ns) and low impedance (40–60 Ω) simultaneously. A coaxial Marx generator has been designed and developed, which is capable of generating 500 kV peak voltages and 10 kA peak current within a 40 ns pulse duration. The CST simulation of the coaxial Marx generator has been carried out to validate the design parameters. The FXR electron beam diode is powered by this Marx generator. Experiments were carried out to measure the x-ray parameters like pulse width, source size, x-ray energy spectrum, penetration depth, and cone angle. The maximum measured x-ray dose was 62 mR at 1 m distance from the source window. The x-ray radiograph demonstrates a penetration depth of 32 mm in steel kept at 2.5 m distance from the source for 500 kV diode voltages. [ABSTRACT FROM AUTHOR]

An editorial is presented on the controversy over X-Ray Technology and the increased radiation doses for black Americans in 1968. It expresses the view that assumptions about biologic differences between Black and White people affected the theory and practice of medicine in the United States. An overview of the Racist theories that motivated unethical experiments on Black Americans is presented.

X-ray radiography is a technique frequently used to diagnose convergent high-energy-density (HED) systems, such as inertial confinement fusion implosion, and provides unique information that is not available through self-emission measurements. We investigate the scope and limits of that information using a radiography simulation combined with the Bayesian inference workflow. The accuracy of density reconstruction from simulated radiographs of spherical implosions driven with 27 kJ laser energy is assessed, including the increase or decrease in accuracy due to the addition of Lagrangian marker layers, Poisson noise, and improved prior information. This work is the first to present the full uncertainty distributions inferred from radiography analysis in HED systems and demonstrates the importance of constructing the full posterior probability density, as opposed to a point estimate, due to the modal structure of the likelihood surface introduced by typical experimental noise sources. This general methodology can be used both for robust analysis of radiographic data and for an improved design of radiography experiments by modeling the full experimental system. [ABSTRACT FROM AUTHOR]

Background Overcrowding of paediatric emergency departments (EDs) is a worldwide issue, where improving the quality of care is a priority. The main objective of this study was to determine the effect of triage nurse–initiated X-ray radiography on length of stay in paediatric emergency admissions. Methods This retrospective, monocentric, descriptive study was performed in two successive 3-month periods: a pre-protocol ('before') period from 3 February to 3 May 2020 and a protocol ('after') period from 4 May to 2 August 2020, when patients underwent nurse-initiated X-ray radiography. The study involved all patients who were aged ≥3 years, valid, non-hyperalgic, accompanied by their parents and consulting at the paediatric ED for a simple closed distal trauma, involving a single limb segment or joint. Results A total of 695 patients were included, 298 in the first period and 397 in the second period. The median length of stay in the paediatric ED was significantly shorter during the second period (119 min [80, 165] vs. 80 min [60, 105], P  < 0.001), i.e. a median reduction time of 39 min or 33% (effect size = − 0.68, 95% confidence interval [−0.84 to −0.53]). Triage nurse requests were judged 'adequate and sufficient' in 95.2% of cases, with only 2.0% of instances deemed 'unnecessary' by the medical team. In 2.8% of cases, 'another X-ray' was required to support diagnosis. Conclusions The application of a triage nurse X-ray protocol significantly reduced the length of stay in a paediatric ED. The quality of patient management remained unchanged, and nurse requests were relevant. [ABSTRACT FROM AUTHOR]

Predisposing factors for CAM-type femoroacetabular impingement (FAI) include acetabular protrusion and retroversion; however, nothing is known regarding development in dysplastic hips. The purpose of this study was to determine the correlation between CAM-type FAI and developmental dysplastic hips diagnosed using X-ray and rotational computed tomography. In this retrospective study, 52 symptomatic hips were included, with a mean age of 28.8 ± 7.6 years. The inclusion criteria consisted of consecutive patients who suffered from symptomatic dysplastic or borderline dysplastic hips and underwent a clinical examination, conventional radiographs and rotational computed tomography. Demographics, standard measurements and the rotational alignments were recorded and analyzed between the CAM and nonCAM groups. Among the 52 patients, 19 presented with CAM impingement, whereas, in 33 patients, no signs of CAM impingement were noticed. For demographics, no significant differences between the two groups were identified. On conventional radiography, the acetabular hip index as well as the CE angle for the development of CAM impingement were significantly different compared to the nonCAM group with a CE angle of 21.0° ± 5.4° vs. 23.7° ± 5.8° (p = 0.050) and an acetabular hip index of 25.6 ± 5.7 vs. 21.9 ± 7.3 (p = 0.031), respectively. Furthermore, a crossing over sign was observed to be more common in the nonCAM group, which is contradictory to the current literature. For rotational alignment, no significant differences were observed. In dysplastic hips, the CAM-type FAI correlated to a lower CE angle and a higher acetabular hip index. In contrast to the current literature, no significant correlations to the torsional alignment or to crossing over signs were observed. [ABSTRACT FROM AUTHOR]

If we had the technology to detect nuclear materials remotely it could help deter smuggling and make it easier to monitor international nuclear agreements. Several recent breakthroughs, if followed up with continued research and funding, could deliver on this promise. They include technological advances in x-ray and neutron radiography; a method that measures how plasma breaks down when exposed to a radioactive source; and developments in antineutrino detection. While all require more development and testing, they are important steps as the global need for ways to detect nuclear materials grows. [ABSTRACT FROM PUBLISHER]

Background: There is widespread variation in the optimal procedure for correction of severe hallux valgus deformity defined as hallux valgus angle (HVA) (≥40°) and/or 1-2 intermetatarsal angle (IMA) (≥20°). There is limited evidence investigating the clinical or radiological outcomes following treatment of severe hallux valgus deformity with third-generation minimally invasive chevron and Akin osteotomies (MICA).Methods: This was a prospective observational single surgeon series of consecutive patients who underwent primary third-generation MICA with screw fixation for severe hallux valgus. The primary outcome was a validated patient reported outcome measure (PROM), the Manchester-Oxford Foot Questionnaire (MOXFQ), assessed minimum 2 years following MICA. Secondary outcomes were radiographic deformity correction (assessed 6 weeks post-operatively), complication rates and other quality of life PROMs (EQ-5D and Visual Analogue Pain Scale).Results: Between September 2014 and November 2018, 106 consecutive feet (n = 78 patients; 73 female, 5 male) met the inclusion criteria. Prospectively collected pre-operative and 2 year PROM MOXFQ data was available for 86 feet (81.1%). At two years following surgery, the MOXFQ score significantly improved for the Pain, Walking and Standing and Social Interaction domains from 39.2 to 7.5, 38.2 to 5.9 and 48.6 to 5.5, respectively (p < 0.001). Pre- and 6 week post-operative radiographic data was available for all 106 feet. Mean IMA improved from 18.2° to 6.3° (p < 0.001) whilst mean HVA improved from 45.3° to 10.9° (p < 0.001). The complication rate was 18.8% and the screw removal rate was 5.6%.Conclusion: This study has demonstrated third-generation MICA for the treatment of severe hallux valgus deformity enables substantial deformity correction and is associated with significant improvements in clinical PROMs 2 years following surgery. [ABSTRACT FROM AUTHOR]