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To investigate the different impact of optical coherence tomography (OCT)-derived vulnerable plaque features on future adverse events (AEs) according to the biological sex.The prospective multicenter CLIMA study (ClinicalTrials.gov: NCT02883088) enrolled 1003 patients with OCT plaque analysis of non-treated coronary plaques located in the proximal left anterior descending artery. Sex-specific differences in plaque composition and vulnerable features were described. We investigated the incidence of AEs, including cardiac death, any myocardial infarction and target vessel revascularization at 1-year.Among 1003 patients, 24.6% were women. Women were older and more frequently affected by chronic kidney disease. Dyslipidemia, prior MI and smoking habit were more common in men. At OCT analysis, women had shorter plaque length (p 0.001), ticker fibrous cap (p = 0.001), smaller maximum lipid arc (p = 0.019), lower macrophage infiltration (p 0.001) and intra-plaque layered tissue (p = 0.007). During follow-up, 65 AEs were registered. The presence of a thin fibrous cap and a large macrophage infiltration ( 67°) predicted AEs in both sexes. The presence of macrophages (HR 3.38, p = 0.018) and a small minimum lumen area (HR 4.97, p = 0.002) were associated with AEs in women but not in men, while a large lipid arc ( 180°) was associated with AEs in men (HR 2.56, p = 0.003) but not in women.This subanalysis of the CLIMA study investigated for the first-time sex-specific OCT features of plaque vulnerability associated with AEs. Local inflammation was associated with AEs in women and a large lipid arc was predictive in men. OCT may help develop sex-specific risk stratification strategies.

Aims The aim of this study was to assess the morphological characteristics and prognostic implications of the optical coherence tomography (OCT)-derived lipid core burden index (LCBI). Methods and results OCT-LCBI was assessed in 1003 patients with 1-year follow-up from the CLIMA multicentre registry using a validated software able to automatically obtain a maximum OCT-LCBI in 4 mm (maxOCT-LCBI4mm). Primary composite clinical endpoint included cardiac death, myocardial infarction, and target-vessel revascularization. A secondary analysis using clinical outcomes of CLIMA study was performed. Patients with a maxOCT-LCBI4mm ≥ 400 showed higher prevalence of fibrous cap thickness (FCT) 180° (OR 3.93, 95%CI 2.97–5.21; P < 0.001), minimum lumen area Conclusions A high maxOCT-LCBI4mm was related to poor outcome and vulnerable plaque features. This study represents a step further in the automated assessment of the coronary plaque risk profile.

In this study, we used a compact, high-resolution, and MRI-compatible PET camera (VersaPET) to assess the feasibility of measuring the image-derived input function (IDIF) from arteries in the leg with the ultimate goal of enabling fully quantitative PET brain imaging without blood sampling. We used this approach in five (18)F-FDG PET/MRI brain studies in which the input function was also acquired using the gold standard of serial arterial blood sampling. After accounting for partial volume, dispersion, and calibration effects, we compared the metabolic rates of glucose (MRglu) quantified from VersaPET IDIFs in 80 brain regions to those using the gold standard and achieved a bias and variability of 0.97) against the gold standard across regions. The results of this preliminary study are promising and support further studies to optimize methods, validate in a larger cohort, and extend to the modeling of other radiotracers.

The present investigation aims to study the interaction between systemic and intra-plaque inflammation in predicting cardiac events. We investigated C-reactive protein (CRP) levels as well as plaque inflammation with optical coherence tomography (OCT)-detected macrophages in the CLIMA study. 689 patients had admission CRP serum values reported, and high CRP values were defined as ≥ 2 mg/dl. The main study endpoint was a composite of cardiac death, myocardial infarction, and/or target vessel revascularization at 1-year follow-up. At multivariate Cox regression analysis, a large (hazard ratio [HR] 2.27, 95% confidence interval [CI] 1.2-4.3; p = 0.013) and superficial (HR 2.78, 95%CI 1.5-5.1; p = 0.001) macrophage arc was predicted of the main composite endpoint in patients with high CRP levels. Patients with large/superficial macrophage accumulation and low CRP levels were not at higher risk of adverse events. The presence of high CRP levels and large/superficial macrophage accumulation at OCT analysis identified patients at higher risk of clinical events.

Optical coherence tomography (OCT) is a high-resolution imaging modality that provides a precise evaluation of coronary anatomy. However, the presence of severe coronary lesions can prevent the required adequate distal contrast flushing resultting in inadequate blood clearance and poor image quality or complete blood shadowing of the underlying vessel wall.The aim of this prospective study was to evaluate the feasibility and safety of a novel "double injection technique" (DIT) to overcome the limitations of the conventional technique (CT) in patients with severely stenotic lesions.Twenty-three patients with severe angiographic lesions were sequentially imaged before intervention with OCT with the CT and then with DIT. A total of 5125 OCT frames were carefully matched and analyzed by an independent central core lab. A semiquantitative image quality score was used to grade the number of quadrants (0-4) with vessel wall visualization.Optimal OCT visualization (Grades 3-4) significantly improved by the DIT (68% vs. 38% of frames, p 0.001). The DIT also improved the mean score (3.1 ± 0.6 vs. 2.0 ± 0.8; p 0.05; mean improvement of 1.1 ± 0.5 per patient). There were no complications associated with the DIT.The DIT significantly improved preintervention image quality of OCT in severe coronary lesions.

BACKGROUND Navigated augmented reality (AR) through a head-mounted display (HMD) may lead to accurate glenoid component placement in reverse shoulder arthroplasty (RSA). The purpose of this study is to evaluate the deviation between planned, intra- and postoperative inclination, retroversion, entry point, depth and rotation of the glenoid component placement assisted by a navigated AR through HMD during RSA. METHODS Both shoulders of six fresh frozen human cadavers, free from fractures or other bony pathologies, were used. Preoperative computed tomography (CT) scans were used for the three-dimensional (3D) planning. The glenoid component placement was assisted using a navigated AR system through a HMD in all specimens. Intraoperative inclination, retroversion, depth and rotation were measured by the system. A postoperative CT scan was performed. The pre- and postoperative 3D CT scan reconstructions were superimposed to calculate the deviation between planned and postoperative inclination, retroversion, entry point, depth and rotation of the glenoid component placement. Additionally, a comparison between intra- and postoperative values was calculated. Outliers were defined as >10° inclination, >10° retroversion, >3 mm entry point. RESULTS The registration algorithm of the scapulae prior to the procedure was correctly completed for all cases. The deviations between planned and postoperative values were 1.0 ± 0.7° for inclination, 1.8 ± 1.3° for retroversion, 1.1± 0.4mm for entry point, 0.7 ± 0.6mm for depth, and 1.7 ± 1.6° for rotation. The deviation between intra- and postoperative values were 0.9±0.8° for inclination, 1.2±1.1° for retroversion, 0.6±0.5mm for depth, and 0.3±0.2° for rotation. There were no outliers between planned and postoperative parameters. CONCLUSION In this study, the use of a navigated AR system through a HMD for RSA led to low deviation between planned and postoperative values and between intra- and postoperative parameters.

Aims New onset atrial fibrillation (NOAF) is associated with worse clinical outcomes after acute coronary syndrome (ACS). Identification of patients at risk of NOAF remains challenging, and various clinical scores of varying complexities have been proposed to predict incident AF. We tested the value of the simple C2HEST score for predicting NOAF in patients with ACS. Methods We studied patients from the prospective ongoing multicenter REALE-ACS registry of patients with ACS. NOAF was the primary endpoint of the study. The C2HEST score was calculated as coronary artery disease or chronic obstructive pulmonary disease (1 point each), hypertension (1 point), elderly (age ≥75 years, 2 points), systolic heart failure (2 points), thyroid disease (1 point). We also tested the mC2HEST score. Results We enrolled 555 patients (mean age 65.6±13.3 years; 22.9% women), of which 45 (8.1%) developed NOAF. Patients with NOAF were older (p3 was associated with NOAF occurrence (odds ratio 4.33, 95% confidence interval 2.19-8.59, p Conclusion The simple C2HEST score may be a useful tool to identify patients at higher risk of developing NOAF after presentation with ACS.

Background Several environmental and seasonal factors are thought to be crucial in the risk of acute coronary syndromes (ACS), including temperature, latitude, longitude, atmospheric air pressure, wind velocity and circadian period. However differences in coronary plaque composition according to season variation is still poorly understood. Purpose Our study aims to analyse the characteristics of non-culprit coronary plaques in patients undergoing optical coherence tomography evaluation (OCT) evaluation of the left anterior descending artery. Methods We included 1848 non-culprit coronary plaques from 1003 patients of the CLIMA registry. The season of OCT pullback acquisition was collected for each patient. Results Overall, median age was 66 years (56-74), with 24.6% of women and 53.4% of ACS. At patient-level analysis, patients admitted in summer were less frequently affected by hypertension (59.8% vs 69.4% in autumn, 68.5% in winter and 72% in spring; p=0.027) and chronic kidney disease (14.8% vs 15.9% in autumn, 10.3% in winter and 19.4% in spring; p=0.037) in. At lesion-level analysis, similar values of fibrous cap thickness, maximum lipid arc, length of plaques and presence of macrophages were observed (Table 1). Summer plaques had a smaller minimum lumen area than spring plaques (5.7±3.1 vs 5.1±239; p=0.044) and also a less frequent superficial macrophage infiltration (23% vs 36.1% in autumn, 30.5% in winter and 30.6% in spring; p=0.030) and presence of cholesterol crystals (16.7% vs 23.8% in autumn, 28.4% in winter and 22.1% in spring; p=0.037 than three other season). Table 1 Conclusions Coronary plaques during summer had less local sign of inflammation such superficial macrophage infiltration and cholesterol crystals. Further studies are needed to confirm these results and investigate clinical implications.

Coronary artery atherosclerosis is a constantly evolving disease. Over the years, new drug therapies have been shown to reduce adverse cardiovascular events and improve the survival of patients with coronary artery disease. New intracoronary imaging modalities, including intravascular ultrasound, optical coherence tomography, and near-infrared spectroscopy, have been introduced to detect the anatomic changes which follow an effective lipid-lowering therapy in human coronary plaques. Particularly, the use of optical coherence tomography made it possible to evaluate plaque composition and showed how an intensive lipid-lowering therapy can stabilize atherosclerosis by improving vulnerable plaque features. Future non-invasive applications are required for large-scale use of these findings.

Background Several environmental and seasonal factors are thought to be crucial in the risk of acute coronary syndromes (ACS), including temperature, latitude, longitude, atmospheric air pressure, wind velocity and circadian period. However differences in coronary plaque composition according to season variation is still poorly understood. Purpose. Our study aims to analyse the characteristics of non–culprit coronary plaques in patients undergoing optical coherence tomography evaluation (OCT) evaluation of the left anterior descending artery. Methods We included 1848 non–culprit coronary plaques from 1003 patients of the CLIMA registry. The season of OCT pullback acquisition was collected for each patient. Results Overall, median age was 66 years (56–74), with 24.6% of women and 53.4% of ACS. At patient–level analysis, patients admitted in summer were less frequently affected by hypertension (59.8% vs 69.4% in autumn, 68.5% in winter and 72% in spring; p=0.027) and chronic kidney disease (14.8% vs 15.9% in autumn, 10.3% in winter and 19.4% in spring; p=0.037) in. At lesion–level analysis, similar values of fibrous cap thickness, maximum lipid arc, length of plaques and presence of macrophages were observed (Table 1). Summer plaques had a smaller minimum lumen area than spring plaques (5.7±3.1 vs 5.1±239; p=0.044) and also a less frequent superficial macrophage infiltration (23% vs 36.1% in autumn, 30.5% in winter and 30.6% in spring; p=0.030) and presence of cholesterol crystals (16.7% vs 23.8% in autumn, 28.4% in winter and 22.1% in spring; p=0.037 than three other season). Conclusions Coronary plaques during summer had less local sign of inflammation such superficial macrophage infiltration and cholesterol crystals. Further studies are needed to confirm these results and investigate clinical implications.

The search for subclinical atherosclerosis is carried out in several arterial districts using ultrasonography and computed tomography (CT). Coronary calcium assessed by computerized tomography (calcium score) is a well-validated marker of atherosclerosis and able to correlate with the extent of coronary artery disease and the risk of cardiovascular events. The evaluation of carotid atherosclerosis by ultrasonography is a technically simple and low-cost solution. However, the literature does not provide a sufficient number of evidence to clarify the clinical impact of carotid atherosclerosis and in particular the risk of developing cardiac events. According to the researchers of the Progression of Early Subclinical Atherosclerosis (PESA) study, subclinical atherosclerosis research should preferably be carried out in the femoral district, which is more easily affected by atherosclerosis. Pending the data from the PESA study, which will better clarify the role of ultrasound applied in non-coronary districts, the coronary calcifications seems to be a reasonable solution. It is possible that in the future imaging techniques (CT-PET) capable of studying the extent and functional status of coronary atherosclerosis will further improve the identification of the risk of cardiovascular events.

Aortic stenosis is a highly prevalent cardiac valvular disease in adult population and increases with age. After symptoms onset in severe aortic stenosis, the prognosis begins to decline; however, new studies demonstrate an increased risk of death in patients with moderate disease. Although majority of patients with severe aortic stenosis are treated electively with surgical or transcatheter aortic valve replacement, not all patients are candidates for the interventions. Balloon aortic valvuloplasty can be used successfully as a bridge to definitive treatment or as palliative therapy in patients who are not candidates for either procedure. In this paper, we discuss and justify the current indications and contraindications for balloon aortic valvuloplasty. Additionally, the step-by-step procedure technique and most frequent complications are described. Moreover, we presented the safety and feasibility of balloon aortic valvuloplasty in 33 consecutive patients on a waiting list for transcatheter aortic valve replacement at 3 expert Italian centers during the first and second waves of COVID-19, when clinical priorities focused on hospitalized patients with pneumonia. The procedural success in this cohort of patients was achieved in 31 patients (94%). Out of the 33 patients enrolled, 15 underwent TAVR within 5±2 months from the valvuloplasty, and at 6-month follow-up a total of 2 patients died for end-stage heart failure.

Pathogenic variants in the leucine-rich repeat kinase 2 (LRRK2) gene have been identified that increase the risk for developing Parkinson's disease in a dominantly inherited fashion. These pathogenic variants, of which G2019S is the most common, cause abnormally high kinase activity, and compounds that inhibit this activity are being pursued as potentially disease-modifying therapeutics. Because LRRK2 regulates important cellular processes, developing inhibitors that can selectively target the pathogenic variant while sparing normal LRRK2 activity could offer potential advantages in heterozygous carriers. We conducted a high-throughput screen and identified a single selective compound that preferentially inhibited G2019S-LRRK2. Optimization of this scaffold led to a series of novel, potent, and highly selective G2019S-LRRK2 inhibitors.

Background The distal radial approach was recently introduced with the hope to improve patients' comfort, particularly during left wrist access and maybe to reduce the rate of complications (mainly radial artery occlusion). However up to now, little is known about the real incidence and type of complications related to this access site. Case presentation We report the case of a left distal radial pseudoaneurysm complicating a successful percutaneous recanalization of a right coronary artery chronic total occlusion with bilateral wrist approach (right radial artery retrograde and left distal radial artery antegrade). This complication was successfully resolved by percutaneous thrombin injection. Conclusion Our case proves that dTRA is not free from conventional vascular complications and this should be considered during the planning of the best strategy for our patients.

Background Bioresorbable scaffold (BRS) have the aim to combine short-term radial force by vessel scaffold (which should dissolve after few months), with drug eluting capability. It has been hypothesized that complete resorption would result in restoration of vasomotion, reduction in angina and reduction of restenosis. Case presentation We report a case of 7 years angiographic follow up after DESolve Novolimus eluting Bioresorbable Coronary Scaffold System implantation. Conclusion The invasive control showed persistence of scaffold patency and evidence of restored vascular motility by the growing in vessel diameter at QCA control after nitrates administration.

Background Percutaneous Coronary Interventions (PCI) of chronic total occlusions (CTOs) represent one of the most complex procedure in the whole spectrum of PCI. In the last years the success rate of CTO-PCI has improved because of the evolution in materials and in CTO-techniques. For most CTO operators, the choice of the vascular access has been driven by the desire to achieve a high success-rate. The trans-femoral access allows the use of larger caliber guide catheters with increased passive support and may help to achieve a better procedural success. Recently, the use of bi-radial approach has gained popularity, supported by evidence of non-inferiority versus the bifemoral/radial-femoral approach. At present, very limited data are available concerning the use of trans-ulnar access for this complex setting of PCI. Case presentation In the present manuscript, we describe in detail a case series of patients undergoing CTO PCI, with limited options in vascular access and resolved with trans-ulnar approach. Conclusions Our case series shows the safety and feasibility of transulnar approach in CTO-PCI.

In recent years, Transcatheter Aortic Valve Replacement (TAVR) has become a treatment option in patients with severe aortic stenosis at most levels of surgical risk.1,2 To date, few data are availa...

The recently proposed MUonE experiment at CERN aims at providing a novel determination of the leading order hadronic contribution to the muon anomalous magnetic moment through the study of elastic muon-electron scattering at relatively small momentum transfer. The anticipated accuracy of the order of 10ppm demands for high-precision prediction in radiative corrections to the $μe$ scattering as well as for robust quantitative estimates of all possible background processes. In this letter, the contribution due to the emission of a neutral pion through the process $μe \to μe π^0$ is studied and its numerical impact is discussed in different phase space configurations by means of the upgraded Monte Carlo event generator MESMER. In fact, single $π^0$ production could be a source of reducible background for the measurement of the QED running coupling constant at MUonE and it could be also an important background for possible New Physics searches at MUonE involving $2 \to 3$ processes, in phase space regions complementary to the ones characteristic of the elastic $μe$ scattering., 9 pages, 11 figures

Since its ability to precisely characterized atherosclerotic plaque phenotypes, to tailor stent implantation, as well as to guide both complex percutaneous coronary interventions (PCI) and invasive diagnostic work-ups (e.g., spontaneous coronary dissections or myocardial infarction with non-obstructive arteries), the adoption of optical coherence tomography (OCT) was raised in the past decades in order to provide complementary information to the traditional angiography and to overcome its limitations. However, the impact of OCT on daily clinical practice is currently modest, firstly because of the lack of both standardized algorithms of PCI guidance and data from prospective clinical trials. Therefore, the aim of our narrative review is to provide a comprehensive overview of the basic OCT interpretation, to summarize the evidence supporting the OCT guidance procedures and applications, to discuss its current limitations, and to highlight the knowledge gaps that need to be filled with more robust evidence.

Aims Plaque vulnerability features are associated with major coronary events and poor outcomes. However, routinary and reproducible manual assessment of plaque vulnerability features at optical coherence tomography (OCT) is still challenging. We recently developed and validated an OCT-derived automated approach that can identify the intra-plaque lipid core burden index (LCBI). Our aim was to investigate the association between the automated detection of OCT-derived LCBI and clinical events. Methods and results We conducted a post hoc analysis of the CLIMA study, a large prospective observational, multicentre registry recruiting all consecutive patients undergoing assessment of the proximal left anterior descending artery (LAD) segment by OCT in the context of clinically indicated coronary angiography. The automated detection of maximum LCBI was carried out in 4 mm of intervention-naïve proximal LAD segment (maxLCBI4mm) by using the validated software. The mean and median value of LCBI in all study population (n = 1003) was 407.6 and 411.1, respectively. Patients with higher LCBI (≥400) were more frequently male (P = 0.016) and affected by insulin-dependent diabetes mellitus (0.046). Furthermore, they showed more frequently at OCT analysis the vulnerable plaque characteristics investigated in the CLIMA study (Table 1). At Cox regression analysis, a maxLCBI4mm ≥400 predicted at 1 year both a hard endpoint of cardiac death and target-vessel myocardial infarction [hazard ratio (HR): 2.56, 95% confidence interval (CI): 1.2–5.3, P 0.011], as well as a composite endpoint of cardiac death, any myocardial infarction and target vessel revascularization (HR: 1.87, 95% CI: 1.1–3.1, P = 0.011). Conclusions In our study, the automated detection of LCBI at OCT was feasible and related to poorer clinical outcome at 1-year follow-up.

Background Near infrared spectroscopy – intravascular ultrasound (NIRS-IVUS) imaging can provide a fully automated estimation of lipid burden, providing a two-dimensional spread-out plot, the Lipid Core Burden Index (LCBI), which has been associated with higher incidence of cardiac events. Optical coherence tomography (OCT) can identify lipid component with high accuracy and it is therefore potentially capable of measuring its longitudinal extension in a dedicated two-dimensional LCBI spread-out plot. Purpose The present study has been designed to validate a novel automated approach to assess OCT images, able of providing a dedicated LCBI spread-out plot plus other features of plaque vulnerability. Methods We compared the results obtained with a novel automated OCT alghorithm, developed utilising a convolutional neural network, with those obtained with conventional (manual) OCT and with NIRS-IVUS in a consecutive series of 40 patients with coronary artery disease. We tested and validated our new OCT algorithm to calculate the lipid core longitudinal extension in a dedicated two-dimensional LCBI spread-out plot. In each coronary plaque, the following measurements were obtained with NIRS-IVUS: 1) minimum lumen area (MLA), 2) vessel area at MLA site, 3) plaque burden (%) at MLA site, 4) NIRS-defined lipid pool arch and 5) maximum LCBI measurement within a 4 mm length. The following OCT features were obtained: 1) the MLA cross section, 2) the minimum fibrous cap thickness (FCT) in presence of lipid components and measured as the average of three measurements obtained in the same cross-section and 3) maximum LCBI within a 4 mm length. Results Three lesions groups were identified according to the studied lesions: 1) culprit lesions in patients with acute coronary syndrome (ACS, n=16), 2) non-culprit lesions in patients with ACS (n=12) and 3) lesions in patients with stable angina (n=12). OCT conventional assessment showed for the culprit ACS plaques a trend for a larger lipid arc and a significant thinner FCT (p=0.028). Consistently, NIRS-IVUS showed for culprit ACS plaques a more complex anatomy. A strong trend for increased maximum LPBI in 4mm segments was found in the culprit ACS group, regardless of the adopted imaging modality, either NIRS-IVUS or automated OCT (p=0.184 and p=0.066, respectively, figure 1). A fair correlation was obtained for the maximum 4 mm LCBI measured by NIRS-IVUS and automated OCT (r=0.75). The sensitivity and specificity of automated OCT to detect significant LCBI, applying a validated 400 cut off were 90.5 and 84.2 respectively. Conclusions We developed an automated approach, comparable to NIRS, to assess OCT images that can provide a dedicated lipid plaque spread-out plot to address plaque vulnerability. The automated OCT software can promote and improve OCT clinical applications for the identification of patients at risk of hard events. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): CLI - Centro Lotta all'Infarto Spread-out plot by IVUS-NIRS and OCT

The recently proposed MUonE experiment at CERN aims at providing a novel determination of the leading order hadronic contribution to the muon anomalous magnetic moment through the study of elastic muon-electron scattering at relatively small momentum transfer. The anticipated accuracy of the order of 10ppm demands for high-precision prediction in radiative corrections to the $\mu e$ scattering as well as for robust quantitative estimates of all possible background processes. In this letter, the contribution due to the emission of a neutral pion through the process $\mu e \to \mu e \pi^0$ is studied and its numerical impact is discussed in different phase space configurations by means of the upgraded Monte Carlo event generator MESMER. In fact, single $\pi^0$ production could be a source of reducible background for the measurement of the QED running coupling constant at MUonE and it could be also an important background for possible New Physics searches at MUonE involving $2 \to 3$ processes, in phase space regions complementary to the ones characteristic of the elastic $\mu e$ scattering., Comment: 9 pages, 11 figures

We describe a method for fragmenting, in-situ, surface-adsorbed and immobilized DNAs on polymethylmethacrylate(PMMA)-coated silicon substrates using microfluidic delivery of the cutting enzyme DNase I. Soft lithography is used to produce polydimethylsiloxane (PDMS) gratings which form microfluidic channels for delivery of the enzyme. Bovine serum albumin (BSA) is used to reduce DNase I adsorption to the walls of the microchannels and enable diffusion of the cutting enzyme to a distance of 10mm. Due to the DNAs being immobilized, the fragment order is maintained on the surface. Possible methods of preserving the order for application to sequencing are discussed.

OBJECTIVES Aim of this study is to prospectively assess the feasibility of the "Minimalistic Hybrid Approach" (MHA) algorithm for chronic total occlusion (CTO) percutaneous coronary intervention (PCI). BACKGROUND We recently described the MHA, with focus on the classic hybrid strategies (antegrade wire escalation [AWE] or retrograde wire escalation [RWE], antegrade dissection-re-entry [ADR] or retrograde dissection-re-entry [RDR]), and also on access site (favoring "wrist" approach: radial, ulnar, and distal radial), introducer French size (favoring 6 French catheters) and nonroutine initial use of dual injection. METHODS The MHA was prospectively attempted in 56 consecutive CTO PCI in 54 patients. Technical success was defined as the achievement of TIMI 3 antegrade flow with residual stenosis

Aim: Chronic total occlusions (CTO) in patients with history of coronary artery bypass graft (CABG) show more advanced and complex atherosclerotic pathology. Aim of our study is to compare outcomes in patients undergoing CTO percutaneous coronary intervention (PCI) with previous CABG versus those without in the REgistry of Crossboss and Hybrid procedures in FrAnce the NetheRlands, BelGium and UnitEd Kingdom (RECHARGE). Methods & results: The RECHARGE cohort (1,252 patients) was divided in two groups according to the presence of previous CABG (217) or not. We also focused, in the post-CABG group, on a comparison between CTO in previously grafted vessels versus non-grafted vessels. The CTO complexity scores were higher and the success rate (71.9% vs. 88.7%, p

Chronic total occlusions (CTO) in patients with history of coronary artery bypass graft (CABG) show more advanced and complex atherosclerotic pathology. Aim of our study is to compare outcomes in patients undergoing CTO percutaneous coronary intervention (PCI) with previous CABG versus those without in the REgistry of Crossboss and Hybrid procedures in FrAnce the NetheRlands, BelGium and UnitEd Kingdom (RECHARGE).The RECHARGE cohort (1,252 patients) was divided in two groups according to the presence of previous CABG (217) or not. We also focused, in the post-CABG group, on a comparison between CTO in previously grafted vessels versus non-grafted vessels. The CTO complexity scores were higher and the success rate (71.9% vs. 88.7%, p .001) was lower in the CABG group, this difference was driven by higher failure rates in high-complexity-score CTO. The rate of in-hospital complications was similar. In the post-CABG group, the procedural success of CTO located in previously grafted vessels versus those in vessels not previously grafted, was comparably suboptimal (73.1% vs. 68%, p = .47).Patients undergoing CTO PCI with prior CABG have a higher prevalence of comorbidities and more complex lesion characteristics. In the post-CABG population the success rate was significantly lower, particularly in high CTO complexity scores, though complication rates were comparable. In the post-CABG population, the CTO success rate was independent of the presence of a previous graft on the CTO vessel.

Heart failure (HF) is a health issue diffused worldwide, both in developed and developing countries. In the last years, the improvement in medical therapy, resynchronization therapy with implantable cardioverter defibrillators, mechanical circulation support with left ventricular assist devices have improved the prognosis of patients with HF and reduced ejection fraction (EF). In this review, we aim to describe a spectrum of newest devices for the treatment of chronic HF by means of left ventricular (LV) remodeling, renal decongestion, and neuromodulation. The most diffused cause of HF is the coronary disease; in fact, ischemic insults to the heart have complex effects on myocytes and myocardial extracellular matrix. The broad result of these modifications is reflected in variations of LV shape, volume, and efficiency. At present a lot of devices with the purpose of reducing ventricular remodeling are available. In patients with chronic HF and acute decompensation, renal decongestion could also be an important goal to achieve. A rise in central venous pressure and consequently increased renal venous pressure determines pressure raises leading to reductions in renal blood flow, glomerular filtration rate (GFR), urine output, and sodium excretion. An additional mechanism involved in the progression of HF is the increase in sympathetic activation. Recent experiments aiming at increasing the parasympathetic tone by vagal nerve stimulation to normalize the autonomic imbalance have been performed. We will focus on describing these devices, their main procedural characteristics, patient eligibility, procedural results, and clinical outcomes.

BACKGROUND: Hybrid positron emission tomography (PET)-magnetic resonance imaging (MRI) systems have been taken in use as new clinical diagnostic tools including detection and therapy planning of cancer. To reduce the amount of contrast agents injected in patients while fully benefitting both modalities, dual-modality probes are required.MATERIAL AND METHODS: This study was first aimed at developing a hybrid PET-MRI probe by labeling superparamagnetic iron oxide nanoparticles (SPIONs) with 64Cu using a fast and chelator-free conjugation method, and second, to demonstrate the ability of the agent to target sentinel lymph nodes (SLNs) in vivo using simultaneous PET-MRI imaging.RESULTS: High labeling efficiency of 97% produced within 10-15 min was demonstrated at room temperature. 64Cu-SPIONs were chemically stable in mouse serum for 24 h and after intradermal injection in the hind paw of C57BL/6J mice, demonstrated specific accumulation in the SLN. Simultaneous PET-MRI clearly demonstrated visualization of 64Cu-SPIONs, in dynamic and static imaging sequences up to 24 h after administration.CONCLUSION: The use of a single hybrid probe and simultaneous hybrid imaging provides an efficient, complementary integration of quantitation and is expected to improve preoperative planning and intraoperative guidance of cancer treatments. (Less)

Despite more than a century of research, the origin of the Insular Celtic double system of verbal inflection is still debated. In this paper, we defend the thesis that the set of absolute endings originated by the agglutination of a subject clitic to the verb form. This clitic marked the declarative (vs. relative) use of verbs, since its distribution was complementary to that of the relative marker *yo. The present indicative as well as the preterite (in both the absolute and conjunct inflection) of one strong verb (berid‘bring’) and one weak verb (lécid‘leave’) are reconstructed according to this theory. For compound verb forms, the clitic ~ *yoalternation can be posited as well. The cases in which the distribution of initial mutations on the verb stem after preverbs does not follow the diachronic phonological rules of Old Irish (that is, there is no lenition after preverbs originally ending in a vowel) are accounted for from a synchronic standpoint. This “anomalous” behaviour can be explained by positing that a functionally relevant (morphological) system of mutations had replaced the previous phonology-based system.

The goal of this study is to examine whether participation in high school research apprenticeships increases pursuit of degrees and careers in science, and to explore other apprenticeship benefits. Students who participated in a research apprenticeship were surveyed about its influence on their undergraduate, graduate, and professional decisions. A control group who attended the same high schools, had similar grade point averages, and graduated with the apprenticeship participants was also surveyed. It was found that a significantly higher fraction of the apprenticeship group majored in Science, Math, Engineering, and Technology (STEM) fields, pursued careers in STEM disciplines, and found the experience to strategically influence their job performance.

A sensitive and straightforward method for discriminating between surface-adsorbed double-stranded DNA (dsDNA) and single-stranded DNA (ssDNA), based on analysis of the fluorescence emission spectra of DNAs dyed with the metachromatic dye acridine orange, has been developed. Since the degree of discrimination between dsDNA and ssDNA is dependent on dye-base ratio (as has been shown in early studies of DNAs in solution), a specific, reproducible protocol for obtaining good ss-ds discrimination was needed. We studied the emission spectra for DNAs dyed in-situ on two different surfaces, polymethylmethacrylate and poly-l-lysine, using acridine orange solutions of varying concentrations in either 2-(N-morpholino)ethanesulfonic acid (MES) or Tris-Borate EDTA (TBE) buffers. The method should prove useful in characterizing the efficacy of denaturing techniques applied to surface-adsorbed DNAs in preparation for hybridization, replication and transcription experiments on stretched and aligned DNAs.

More than 50 high school students each year learn how to conduct science research at the Garcia Summer Scholars Program at Stony Brook University through hands-on, inquiry-based methods. Started in 1998, the program has already provided hundreds of students from diverse backgrounds a unique opportunity for outstanding scientific performance and achievement. In this paper, we present a brief overview of how the program operates as well as several case studies that display the effect of the Garcia Program on student accomplishment. The evidence provided demonstrates that the Garcia Program has had an overwhelmingly positive effect on its many student participants, regardless of their background or socio-economic status.

For the evaluation of the expression level of each miRNA was used the Ct (threshold cycle) method quantification. The threshold cycle (Ct) is defined as the PCR cycle at which the fluorescent signal of the reporter dye crosses an arbitrarily placed threshold. This method allows to quantify the absolute expression of each miRNAs in each sample analyzed and then to calculate the different expression of each miRNA in sample versus the controls.

A total of 99 patients has been enrolled to study circulating microRNAs, as diagnostic biomarkers, in patients with chronic stable coronary artery disease (CAD) and with acute myocardial infarction (AMI). For each patient, we have collected 10 mL of whole blood. All the samples have been processed maintaining the same conditions and timing. The samples with hemolysis and clots have been excluded from the study.

The qRT-PCR expression analyses were performed on all the recruited patients (61 CAD, 38 AMI_T0 and 11 AMI_T1 patients respectively). Since the absence of a universally recognized miRNA with housekeeping properties, we have analyzed the amplification curve of 84 circulating microRNAs using the Human Serum & Plasma miScript miRNA PCR Array (MIHS-106ZA, QIAGEN).