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coronary stent, tiny metal devices inserted into narrowed arteries to keep them open, saving millions of lives annually by treating coronary artery disease (CAD),

60,663 次观看 • 1 年前 •via X (Twitter)

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PHOTON COUNTING CT AND A NEW CONCEPT OF NORMAL CORONARY ARTERIES For more than 2 decades we have been performing Cardiac CT with constant improvements in all parameters (spatial, temporal and contrast resolution). The improvements were progressive in certain fields and steep in other (e.g.: the introduction of Dual Source CT that completely changed the range of temporal resolution achievable basically overnight and still is the most important source of flexibility in Cardiac CT scanning after almost 20 years). Spatial resolution instead was improved in a slow and progressive way until the test EID CT generations that achieved a spatial resolution of 250 microns. This allowed us to assess a coronary artery tree and define it as normal when no apprentice changes were visibile up to that value. But we know that the normal thickness of coronary artery walls is quite below that threshold. It is more in the range of 80-200 microns. Therefore, the very early changes in coronary artery wall thickness could not be picked up by EID CT technology. With the introduction of PCCT we can constantly achieve 100 microns spatial resolution which means that we work extol in range in which coronary artery disease starts. It also means that we don't see any thickening of the the coronary artery walls we have a much higher specificity and reliability. This concept is a transformative one because it allows us to shift earlier and earlier the beginning of atherosclerosis in our patients and think even more precisely in terms of cardiovascular prevention and monitoring. Movie: example of normal coronary artery tree with PCCT. A new era is coming into practice and it is the age of Photon Counting CT which pushes this boundaries further away. PCCT is a NEW Imaging Modality. PCCT is changing the game, the field, the language, the priorities and in the end it will change the entire infrastructure of diagnostic medicine. PS: note that PCCT images have to be reduced in resolution when uploaded in social media. #CardiacImaging #MedicalInnovation #StentAssessment #Radiology #PCCT #photoncounting #QuantumHD #CT #computedtomography #yesCCT #coronaryarterydisease #ischemia #naeotomalpha #Peak #Pro #Prime #speed #cardiac #highresolution #siemenshealthinners #CardiacCT #PhotonCountingCT #MedicalImaging #HeartHealth #CardiovascularInnovation #Radiology #AIInMedicine

Dr. Filippo Cademartiri

63,147 次观看 • 1 年前

🫀 Seeing Truly Normal Coronary Arteries Dual Source PCCT + High Iodine = Confidence of Exclusion In coronary CTA, detecting plaque matters. But confidently proving absence of plaque is even more powerful. A truly normal coronary artery should not look “probably normal.” It should look sharp, smooth, motion-free, and perfectly opacified. That level of certainty comes from the combination of: - Photon-Counting CT (PCCT) - High spatial/temporal/contrast resolution - High iodine concentration contrast (400 mg I/mL) 🧠 Why this combination matters Subtle abnormalities can be masked by: - Motion blur - Noise - Partial volume effects - Insufficient intraluminal enhancement Sometimes what we call “normal” is simply underpowered imaging. ⚡ What changes with PCCT + 400 mg I/mL Ultra-high spatial resolution - Clear intima–lumen interface - Distal vessels sharply defined High temporal resolution - Minimal motion artifacts - True coronary borders, even at higher HR High iodine concentration (400 mg I/mL) - Stronger intraluminal signal - Higher contrast-to-noise ratio - Uniform, stable lumen opacification - Subtle wall irregularities no longer hide in low signal Spectral capability - Cleaner iodine–tissue separation - Greater confidence in excluding non-calcified plaque When arteries are truly normal, they appear: ✔️ Smooth ✔️ Thin-walled ✔️ Motion-free ✔️ Intensely and uniformly opacified Not “likely fine.” But objectively pristine. In coronary CTA, technology is not only about finding disease. It’s about confidently saying: There is none. From uncertainty to reassurance. From suspicion to precision. That’s the strength of PCCT with high-iodine coronary imaging. ⚡🫀 #PhotonCountingCT #PCCT #CoronaryCTA #HighIodine #400mgIodine #HighTemporalResolution #UltraHighResolution #CardiacCT #PreventiveCardiology #yesCCT

Dr. Filippo Cademartiri

12,529 次观看 • 7 个月前

As tensions escalate in Bangladesh, Gaushala broken into in Tripura, 10 gauvansh rescued from the Indo-Bangladesh border stolen from Dhyan Foundation's Debipur Gaushala As tensions escalate in #Bangladesh whose international border is merely 2 kms away, 2100 gauvansh rescued by #BSF jawans from the border rehabbed in Gaushalas in the region, face increased threats to their lives and property from Bangladeshi mafia and their local goons in the inhospitable regions of #Tripura... But permissions to shift them to Dhyan's safer, well-equipped Gaushala in #Jharkhand have been held up by senior officials for months. Not just that, even funds sanctioned by the गृहमंत्री कार्यालय, HMO India itself to move the gauvansh to safer territory have been held up! This is despite repeated attacks and thefts on the Gaushalas and due intimation to BSF IG Tripura on the same, time & again. We fear some officials are involved in this, otherwise why will permissions to shift them to safer territory be held up? Instead, rescued gauvansh are handed over to fake Gaushalas, which openly admit to disposing of them. ...Now where are the cattle which were handed over to the fake Gaushalas? There have been continuous efforts to force this organization Dhyan Foundation to backstep so smuggling can continue, with holding up of permissions being yet another attempt. However, this time it has put 2100 innocent gauvansh's lives at open risk of attack from Bangladeshi mafia goons. CMO Tripura | Sepahijala District Police

Gau Gyan Foundation

31,256 次观看 • 2 年前

I will never forget the first time I walked into St Peter's Basilica... None of it is painted. Everything overhead that appears to be a fresco is a mosaic: millions of small glass tiles, cut and set into place by hand. Michelangelo pierced the drum with sixteen windows, and beneath them runs a band of text, black on gold: TU ES PETRUS ET SUPER HANC PETRAM AEDIFICABO ECCLESIAM MEAM. "You are Peter, and upon this rock I will build my church." From the floor it reads like an ordinary inscription but each of those letters is two metres tall... Above the windows the dome divides into sixteen segments, and within them six tiers of figures rise in rings: the popes buried in the basilica, then Christ, the Virgin Mary, St John the Baptist and the Apostles, then angels carrying the instruments of the Passion, then the faces of cherubim and seraphim. Above all of them, a blue sky scattered with gold stars, and at the summit, in the lantern, God the Father. The man who designed it, Giuseppe Cesari, was a painter. Between 1603 and 1612 he produced sixty-five life-size cartoons setting out the whole scheme, and every one of them was then translated into glass by mosaicists. The reason is actually pretty unglamorous. The basilica was damp, and candle smoke and incense from centuries of liturgy were eating the pictures alive. So the Vatican began converting the building into glass, dome by dome, and from the end of the 1600s the painted altarpieces too, one at a time. By the basilica's own reckoning, around ten thousand square metres of mosaic. The workshop that did all of this is still open: twelve artists work in the Vatican Mosaic Studio today, cutting tesserae by hand in nearly 28,000 shades and fixing them with a linseed-oil stucco whose recipe has been in use for four centuries. Earlier this year its director, Paolo Di Buono, described the work: "We have the idea that we are working for something that is almost eternal."

James Lucas

73,288 次观看 • 2 个月前

Rare Anglo-Saxon Treasures Unearthed In a remarkable discovery that has thrilled archaeologists and history enthusiasts alike, two metal detectorists have uncovered a pair of exquisite gold and garnet artifacts from the Anglo-Saxon period in southwestern England’s Wiltshire county. Dating back approximately 1,400 years to the 7th century AD, the finds include a stunning gold and garnet raven’s head and an intricately designed gold band or ring. The discovery was made on January 8, 2025, during a metal detecting rally organized by the 9th Region Metal Detecting Group in West Wiltshire. Paul Gould, one of the detectorists, first spotted a flattened gold band inlaid with triangular garnets and studded with tiny gold beads, which he initially mistook for a simple metal object. Shortly afterward, his detecting partner, Chris Phillips, unearthed the star of the show: a decorative raven’s head crafted from gold, featuring a striking garnet eye encircled by white enamel and intricate filigree work outlining the “feathers” with garnets set on a waffle-pattern foil backing. The raven head, weighing around 60 grams as estimated, showcases the advanced metalworking techniques of the era, with tiny gold spheres adding to its detailed plumage. These artifacts are believed to be part of elite jewelry or ceremonial objects, reflecting the high status of their original owners during the Anglo-Saxon period. Ravens held significant symbolic meaning in Germanic and Norse mythology, often associated with wisdom, warfare, darkness, and death, which adds a layer of cultural intrigue to the find. The use of garnets, a popular gemstone in Anglo-Saxon jewelry from the 6th to 8th centuries, further ties these pieces to the artistic traditions of the time. Phillips described the moment of discovery as overwhelming: “It’s unbelievable — I’m a bit emotional.” The finds have been declared treasure under the UK’s Treasure Act, and experts from the British Museum are evaluating them for potential acquisition, highlighting their national significance. #metaldetecting #metaldetectinguk #metaldetectingfinds #detectorists This discovery underscores the valuable role that amateur metal detectorists play in uncovering Britain’s rich archaeological heritage, often in collaboration with professional archaeologists. Similar finds, such as those from the Staffordshire Hoard, have previously revealed the opulence and artistry of Anglo-Saxon England. As analysis continues, these Wiltshire treasures promise to offer new insights into the social and cultural dynamics of 7th-century Britain.

Metal Detectives Group

129,397 次观看 • 8 个月前

Kalgukjju, our pride, our precious girls, and our happiness—keep soaring even higher. 🕊️ Please always remain the people we are so proud of: kind-hearted, loving, humble, and respectful. Keep being the ones who always give your very best on every stage, who never stop learning, growing, and shining in your own beautiful way. You will always be our pride because of your strength, your sincerity, and your passion. To Eomma and Mamah, thank you for bringing these two beautiful girls into the world. Thank you for raising them into strong, compassionate, and inspiring women. Thank you for teaching them kindness, humility, and warmth that they share with everyone around them. Thank you for raising two incredible daughters who have become a source of comfort, hope, and inspiration for so many people. To our beloved Kalgukjju, thank you for working so hard. Thank you for never giving up, and thank you for choosing to keep chasing your dreams. You may never fully realize how much you mean to us, but your smiles, laughter, dedication, and genuine hearts give us strength every single day. We hope your journey is always filled with happiness, good health, love, and people who truly cherish you. May every dream you hold close come true, one by one. Keep flying higher, shining brighter, and becoming the amazing women you are meant to be. Our sweet Kalgukjju, thank you for coming into our lives. We will always be here, cheering for you, believing in you, and loving you—today, tomorrow, and always. You will forever be our pride, our comfort, and one of the brightest reasons we smile. We love you endlessly. 🤍🕊️ #HEARTS2HEARTS #CARMEN #카르멘 #JUUN #주은

carmjnspace

34,124 次观看 • 2 个月前

Physiology of PEEP Alveolar Recruitment and Stabilization Recruitment: PEEP opens collapsed alveoli, increasing the surface area for gas exchange. Stabilization: By maintaining alveoli open, PEEP prevents the cyclic opening and closing of alveoli, reducing shear stress and the risk of ventilator-induced lung injury (VILI). Improvement in Oxygenation V/Q Matching: PEEP improves ventilation-perfusion matching by redirecting blood flow to well-ventilated alveoli, reducing intrapulmonary shunting. Redistribution of Edema: In conditions like ARDS, PEEP can redistribute alveolar edema, improving compliance and gas exchange. Effects on Compliance Static Compliance: PEEP can increase static compliance by recruiting alveoli, but excessive PEEP may overdistended alveoli, decreasing compliance. Dynamic Compliance: PEEP may also affect dynamic compliance by altering airway resistance. Hemodynamic Implications Venous Return: Increased intrathoracic pressure reduces venous return, potentially decreasing cardiac output. Afterload: PEEP may increase left ventricular afterload by increasing transpulmonary pressure. Right Ventricular Function: High PEEP may cause right ventricular dilation and dysfunction, especially in the presence of pulmonary hypertension. Effects on Intracranial Pressure (ICP) PEEP may increase ICP by reducing venous outflow from the brain, a critical consideration in neurocritical care. Clinical Application and Monitoring ARDS: PEEP/FiO2 Tables: Utilizing evidence-based tables to titrate PEEP based on FiO2 requirements. Recruitment Maneuvers: Often used in conjunction with PEEP to assess recruitability. Monitoring with Esophageal Manometry: To assess transpulmonary pressure and individualize PEEP settings. Obstructive Lung Disease: Careful application of PEEP to prevent air trapping and intrinsic PEEP (auto-PEEP). Heart Failure and Fluid Status: Echocardiographic Monitoring: To assess the impact of PEEP on cardiac function and filling pressures. Pulmonary Artery Catheterization: May be used to monitor the effects of PEEP on pulmonary artery pressures and cardiac output. Protective Lung Ventilation in Surgery: Utilizing PEEP to prevent atelectasis and postoperative pulmonary complications. Weaning Process Gradual Reduction: Monitoring respiratory mechanics, work of breathing, and gas exchange. Spontaneous Breathing Trials (SBT): Assessing the ability to tolerate lower PEEP levels. Conclusion PEEP is a complex and vital component of mechanical ventilation, with multifaceted effects on respiratory mechanics, gas exchange, hemodynamics, and even neurodynamics. Its application requires a nuanced understanding of underlying pathophysiology, continuous monitoring with advanced tools, and individualized titration to optimize patient outcomes. The integration of PEEP into a comprehensive respiratory care strategy exemplifies the complexity and precision required in critical care medicine.

𝗥𝗲𝘀𝘂𝘀𝗠𝗲𝗱

84,714 次观看 • 3 年前

Big win for open-source LLMs! DeepSeek V4 Pro holds the top open-weights score on SWE-bench Verified, in the GPT-5.5 range. GLM 5.2 leads the open-weight intelligence index and sits near the closed frontier on long-horizon coding. But this leaderboard number is a weak proxy for real performance. It comes from one task set, run through one harness, served at one precision. The same weights can even score differently across providers, since many hosts quantize activations to fp8 and drift the model off its reference weights. Real performance is determined based on whether a model can read a repo, make coordinated edits across files, run the tests, and recover when one breaks. By that measure, the top open models hold up, but only inside the right harness. The teams that actually put DeepSeek V4 into production pipelines as a frontier substitute got there through the harness they built around the model, not by picking a stronger model. If you want to see this in practice, Cline (64k+ stars) has actually built that harness around open models, tuned so they run at production quality. And it's tuned so that these LLMs can run at production quality, with plan and act modes, checkpoints, and terminal feedback. ClinePass is the new access layer on top of it. It runs a curated set of those models inside Cline, narrowed to the ones tested for coding-agent use, with 2 to 5x the standard rate limits and no separate provider accounts, keys, or billing to track. The video below shows the setup, and I worked with the team to put this together. It runs alongside custom keys and local models as well, not in place of them.

Avi Chawla

44,124 次观看 • 3 个月前