Enterprise risk management for automation in correctional facilities with pandemic and other stressors.

Real-time tracking of tool and equipment inventories is a critical function of many organizations and sectors. For prisons and correctional facilities, tracking and monitoring of assets such as cookware, hardware, keys, janitorial equipment, vocational/technical specialty tools, etc., is essential for safety, security, trust, efficiency, education, etc. The performance of automated systems for this purpose can be diminished by a variety of emergent and future sociotechnical factors alone and in combination. This article introduces a methodology for contractor evaluation and selection in acquisition of innovative asset management systems, with an emphasis on evolving system requirements under uncertainty. The methodology features a scenario-based preferences analysis of emergent and future conditions that are disruptive to the performance of the asset-control system. The conditions are across technologies, operating environments, regulations, workforce behaviors, offender behaviors, prices and markets, organizations, cyber threats, etc. The methodology addresses the influence and interaction of the conditions to disrupt system priorities. Examples include: (i) infectious disease disrupting priorities among requirements and (ii)  radio-frequency identification (RFID) and wireless-technology innovations disrupting priorities among stakeholders. The combinations of conditions that most and least matter for the system acquisition are characterized. The methodology constitutes a risk register for monitoring sources of risk to project performance, schedule, and cost throughout the system lifecycle. The results will be of interest to both practitioners and scholars engaged in systems acquisition as the pandemic interacts with other factors to affect risk, uncertainty, and resilience of organizational missions and operations.

Appendiceal Intussusception Mimicking Cecal Mass and Fecal Matter: A Report of Two Rare Cases.

Intussusception of the appendix is a relatively rare event that is usually asymptomatic but can present similar to other acute and chronic abdominal conditions. We present two separate cases of suspected appendiceal intussusception mimicking cecal masses. The authors also present a cursory review of the limited number of literatures available concerning this entity to help the radiologist avoid misdiagnosis and potentially unnecessary invasive intervention.

Prevalence of thoracic spine lesions masquerading as cauda equina syndrome: yield of a novel magnetic resonance imaging protocol.

Our objective was to describe the yield of actionable thoracic spine lesions for a novel magnetic resonance imaging (MRI) protocol including evaluation of the thoracic spine among patients presenting to the Emergency Department (ED) with symptoms consistent with epidural compression syndrome. Our ED and Department of Radiology together designed a novel rapid MRI protocol entailing 3D volumetric T2 weighted sequences through both the thoracic and lumbar spine obtained in the sagittal plane to assess for both lumbar and thoracic spine lesions. We recorded study outcomes for all patients undergoing this protocol or conventional lumbar MRI during May 2014-May 2015 to determine the prevalence of actionable thoracic spine lesions. We defined an actionable thoracic lesion as any pathology requiring treatment (e.g., medication, admission, surgery) not otherwise indicated on the basis of lumbar spine findings. During the study period, 112 of 124 (90.3%) of ED patients undergoing MRI evaluation for epidural compression syndrome underwent the novel protocol. The remaining patients underwent evaluation of the lumbar spine using only a conventional MRI protocol. Of the 112 patients undergoing the novel protocol, 6 (5.4%) patients had thoracic spine lesions indicating therapy not otherwise indicated by lumbar spine findings. The etiologies of these six lesions were: neoplasms (2), de-myelination (2), compression fracture (1), and degeneration due to pernicious anemia (1). Emergency providers should strongly consider the routine use of MRI protocols including thoracic spine evaluation in patients presenting to the ED with symptoms consistent with epidural compression syndrome.

Percutaneous Stent-Graft Repair of Anastomotic Pseudoaneurysms following Vascular Bypass Procedures: A Report of Two Cases.

Anastomotic pseudoaneurysms are common entities following vascular bypass procedures and, if left untreated, serious complications such as thromboses, infection, and rupture can frequently occur. Therefore, attempts to employ various methods of repair have been utilized in treating anastomotic pseudoaneurysms to maximize operational success and future risk reduction. Herein, the authors report two cases of anastomotic pseudoaneurysms which were repaired percutaneously utilizing a combination of strategies such as careful preoperational image planning, multiple commercially available devices, and secondary embolization techniques.

Rare pulmonary infarction after superior epigastric artery chemoembolization of unresectable hepatocellular carcinoma.

Nontarget organ complications are a rare, yet serious side effect of transarterial chemoembolization (TACE) procedures. We describe a case of a patient with unresectable hepatocellular carcinoma who subsequently developed right-lower-lobar pulmonary infarction approximately three weeks after receiving TACE, owing to an abnormal vascular connection between the superior epigastric artery and the distal right pulmonary artery. Our case stresses the importance of pre-operative planning and imaging to familiarize oneself with variations in vascular anatomy and to recognize symptoms associated with even the rarest complication associated with TACE procedures, so as to initiate treatment and improve patient outcome.