Search

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

We report the case of a 64-year-old male who died suddenly short after his admission to hospital because of strong chest pain and before any clinical diagnosis was established. His medical history included coronary disease with coronary by-pass surgery at the age of 40 years old, uncontrolled hypertension, diabetes mellitus, and elevated levels of cholesterol. The autopsy revealed quite a rare case of Stanford A aortic dissection with extension to the common and internal carotid arteries; the subclavian, axillary, brachial, and radial arteries; three coronary arteries; the superior mesenteric artery; and the iliac arteries. There was no histological evidence of aortitis or connective tissue disease. The death did not result from the rupture of the aortic dissection, but from myocardial ischemia due to coronary occlusion in combination with hemodynamic disturbance from stress caused by the extended aortic dissection. [ABSTRACT FROM AUTHOR]

Although the classical treatments listed in the guidelines for osteoarthritis are widely used, the majority of patients do not fully recover from their pain. It is a fact that new treatment methods are needed both to relieve pain and restore deteriorated joint function. No study has been found to date that evaluated the efficacy of ESWT in hip OA. This pilot trial is the first in the literature to investigate the comparative effects of the two ESWT types (f-ESWT and r-ESWT) in the treatment of hip OA. Briefly, 148 patients were randomly distributed into the three ESWT groups: focused (f-ESWT), radial (r-ESWT), and sham (s-ESWT). Patients were assessed with the Visual Analog Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores just before the treatment (0 week), just after the treatment (4th week), and 1 month after completion of the treatment (8th week). VAS and all WOMAC scores were significantly reduced at follow-up points (4th and 8th weeks) in both the f-ESWT and r-ESWT groups compared with baseline (0 week) (for all, p < 0.001). Statistical comparisons between the f-ESWT and r-ESWT groups showed that f-ESWT was superior to r-ESWT for the decrease in VAS and WOMAC scores from baseline to the 4th and 8th weeks (p < 0.001 or p < 0.002). Both r-ESWT and f-ESWT were found to have significant treatment efficacy compared with s-ESWT. However, f-ESWT produced a superior improvement in follow-up parameters compared to r-ESWT. [ABSTRACT FROM AUTHOR]

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

Background The effectiveness of vascular closure devices (VCDs) to reduce bleeding after transfemoral percutaneous coronary intervention remains unsettled. Methods and Results Participants in the REGULATE‐PCI (Effect of the REG1 anticoagulation system versus bivalirudin on outcomes after percutaneous coronary intervention) trial who underwent transfemoral percutaneous coronary intervention with VCD implantation were compared with those who underwent manual compression. The primary effectiveness end point was type 2, 3, or 5 Bleeding Academic Research Consortium access site bleeding at day 3. Univariate and multivariate analyses were adjusted by the inverse probability weighting method using propensity score. Time to hemostasis and time to ambulation were compared between groups. Of the 1580 patients who underwent transfemoral percutaneous coronary intervention, 1004 (63.5%) underwent VCD implantation and 576 (36.5%) had manual compression. The primary effectiveness end point occurred in 64 (6.4%) participants in the VCD group and in 38 (6.6%) participants in the manual compression group (inverse probability weighting–adjusted odds ratio, 1.02 [95% CI, 0.77–1.36]; P=0.89). There were statistically significant 2‐way interactions between VCD use and female sex, chronic kidney disease, and use of high‐potency P2Y12 inhibition (ticagrelor or prasugrel) (P

In this article, a novel radial–axial (RA) flux switching permanent magnet generator (FSPMG) is introduced. In contrast to other RA flux machines, a major advantage of this generator is its implementation only by the use of conventional nonoriented electrical steel sheets, even though the flux linkage of the novel RA-FSPMG has a 3-D path. Besides that, it benefits from the flux concentration strategy and a passive rotor. A concrete foundation of the novel RA-FSPMG is provided, in which, the 3D-Flux path is described, working principles are discussed, and power-sizing equation is derived. No-load characteristics and the full-load performance of an optimized RA-FSPMG are investigated in contrast to an optimized double stator radial FSPMG and an optimized double stator axial FSPMG with similar volume, number of permanent magnets (PMs), and electrical loading. The results show the competitiveness of the novel RA-FSPMG, in particular, in the output power and the required copper mass. Furthermore, the PM demagnetization possibility and the rotor axial pull force of the optimized RA-FSPMG are investigated, in detail. All discussions are supported by the 3-D finite element analysis and experimental results. [ABSTRACT FROM AUTHOR]

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

Due to the reach of the MP catheter compared to other preshaped catheters used for RCA cannulation, it can commonly cannulate and perform angiography on high and anterior right coronary arteries from the radial approach as well. While the original description of performing a left heart catheterization with the MP catheter was described from the femoral approach, the MP is also viable as a single catheter technique to perform left heart catheterization and coronary angiography from the radial approach as well. Keywords: angiography; imaging; multipurpose catheter; radial EN angiography imaging multipurpose catheter radial 1123 1127 5 12/01/22 20221101 NES 221101 INTRODUCTION It is an honor to contribute to a tribute to my friend Richard Conti, a true pioneer in Cardiology, and in his earlier years a denizen of the Cath Lab. [Extracted from the article]

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

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

Discusión en la conducta de patología del nervio radial.

Taking the main bearing of a diesel engine as the study object， the lubrication state analysis model of the main bearing is established by taking the roughness and elastic deformation of the main bearing surface into account， and the influence of the radial profile of the main bearing on the lubrication state is analyzed. The results show that， compared with the calculated results without considering the radial journal profile， when the influence of the radial journal profile is taken into account， the minimum oil film thickness of the main bearing increases by 25.95%， the maximum oil film pressure decreases by 17.69%， the mean friction power loss decreases by 6.14% and the inclination of the spindle neck is improved. With the increase of journal roughness， the minimum oil film thickness increases， the maximum oil film pressure almost invariably， and the mean friction power loss increases.

Floods in a watershed area are caused by reduced water recharge due to changes in land use, increasing their discharge volume. Benanain watershed is an extensive area with many tributaries. Watershed morphometrics provides initial information about the hydrological behavior and the hydrograph shape of flooding in these areas. Furthermore, rainfall-runoff modeling uses as a unit to approach the hydrological values of the flooding process. This study determines the physical characteristics of the Benanain watershed based on curve number (CN) values, land cover, peak discharge, and peak time. It was conducted on the Benanain watershed with 29 sub-watersheds covering 3,181.521 km2. Data were collected on the rainfall experienced for 13 years from 1996 to 2008 and analyzed using the Log Pearson Type III method, while the HEC HMS model was used for flood discharge analysis. HEC-HMS model must calibrate by adjusting the model parameter values until the model results match historical data such as initial abstraction, lag time, recession, baseflow values, and curve number. The results show that the curve number values range from 56.55 - 73.90, comprising secondary dryland forest and shrubs. Moreover, the rock lithology in the Benanain watershed is dominated by scaly clay and other rock blocks. This means the area has low to very low permeability, which affects the volume of runoff. The return period of a 1000-year flood discharge obtained a peak of 5,794.50 m3/s, with a peak time of ± 14 hours. Morphometry of the Temef watershed with large catchment, radial shape pattern, an average of steep slope river, and meandering affects the peak of flood discharge hydrograph and the peak time of the flood.

The vascular cambium is the main lateral meristem responsible for the secondary growth of trees. There are a number of explicit and implicit assumptions behind this statement which allow questions to be raised about the mechanism underlying the radial growth of trees. Based on the hypothesis of the diurnal strains of plant organs, it is anticipated that the process of radial growth can be understood as an adaptation to the cyclically changing mechanical stress in the radial direction generated by the phloem during the 24 h day cycle. This qualitative hypothesis treats cambium as a tissue subjected to nighttime stretching and daytime compression in the radial direction. The proposed osmo-mechanical hypothesis of the radial growth of vascular cambium links the daily change in water status and the considerable daily strains in the xylem and phloem with the radial net expansion of a tree trunk. We highlight transpiration as a major factor influencing the secondary growth of woody plants. Thus, we indirectly relate all the biotic (e.g., insect infestation, fungi infections, injuries, shadowing, intra- and interspecies competition, parasitism, symbiosis, etc.) and abiotic (e.g., humidity, water availability, wind, injuries, shadowing, day length in a vegetative season, altitude, temperature, insolation, etc.) processes influencing transpiration with radial growth. In the proposed hypothesis, we also infer that differences in the strains in phloem and xylem are the direct source of tensile stress, tensile stress relaxation, compressive stress, and compressive stress relaxation in the vascular cambium. This sequence appears to be crucial in understanding both the process of the radial growth of trees and the formation of differential wood patterns, within the same genotype as well as in different genotypes. It also provides arguments for the discussion on the mechanisms regulating processes in the vascular cambium. It points out the important role of the variable mechanical stresses in the radial, circumferential, and axial directions and their interference in the development of this lateral meristem. Thus, this hypothesis supports the concept of the epigenetic and systemic regulation of intrinsic wood patterns and tree forms by environmental factors. The hypothesis is focused exclusively on broadleaved trees and symplastic growth. This limitation of the scope is due to a concern for clarity. In this form, the hypothesis provides an alternative explanation for a pure process of radial growth and paves the way for a better interpretation of such phenomena as earlywood and latewood formation. At the same time, this approach to the vascular cambium provides answers to many questions related to the generation of the mechanical conditions necessary for the occurrence of intrusive growth between tangential cell walls; this is of fundamental importance for fusiform initials readjustment, vessel element and fibre formation, ring-porous wood formation, etc.

Background: Fast and accurate T1ρ mapping in myocardium is still a major challenge, particularly in small animal models. The complex sequence design owing to electrocardiogram and respiratory gating leads to quantification errors in in vivo experiments, due to variations of the T1ρ relaxation pathway. In this study, we present an improved quantification method for T1ρ using a newly derived formalism of a T1ρ* relaxation pathway. Methods: The new signal equation was derived by solving a recursion problem for spin-lock prepared fast gradient echo readouts. Based on Bloch simulations, we compared quantification errors using the common monoexponential model and our corrected model. The method was validated in phantom experiments and tested in vivo for myocardial T1ρ mapping in mice. Here, the impact of the breath dependent spin recovery time Trec on the quantification results was examined in detail. Results: Simulations indicate that a correction is necessary, since systematically underestimated values are measured under in vivo conditions. In the phantom study, the mean quantification error could be reduced from − 7.4% to − 0.97%. In vivo, a correlation of uncorrected T1ρ with the respiratory cycle was observed. Using the newly derived correction method, this correlation was significantly reduced from r = 0.708 (p < 0.001) to r = 0.204 and the standard deviation of left ventricular T1ρ values in different animals was reduced by at least 39%. Conclusion: The suggested quantification formalism enables fast and precise myocardial T1ρ quantification for small animals during free breathing and can improve the comparability of study results. Our new technique offers a reasonable tool for assessing myocardial diseases, since pathologies that cause a change in heart or breathing rates do not lead to systematic misinterpretations. Besides, the derived signal equation can be used for sequence optimization or for subsequent correction of prior study results. [ABSTRACT FROM AUTHOR]

Introduction: Radial arterial access is one of the main ways to perform left heart catheterization and coronary angiography in different clinical settings, due to its lower rate of local complications and similar clinical results to when using the femoral access. Objective: To determine the incidence of complications of radial access in interventional cardiology procedures of a hemodynamic service, as well as the impact on functionality and predictive factors for presentation. Methodology: Prospective observational cohort-type study in patients undergoing radial access coronary angiography in a university hospital with collection of demographic, clinical and ultrasound data prior to the procedure and 24 hours after it; The statistical model of logistic regression was applied to evaluate the association between the variables and the complications. Results: 100 patients were obtained, 62% men, with a mean age of 64 years, 69% had arterial hypertension, 38% diabetes mellitus, 35% dyslipidemia, 2% peripheral arterial disease, and 10% chronic kidney disease. The reason for coronary angiography was non-STsegment elevation acute coronary syndrome (NSTE-ACS) 65%, ST-segment elevation myocardial infarction (STEMI) 28%, pre-surgical 6%, and chronic coronary syndrome 1%. A 6 Fr introducer was used in all of them. 13% complications were documented, the most common being arterial occlusion and hematoma. Only one had implications for the functionality of the hand after a complication. After multivariate regression, height (<1.65 m) and dynamometry (<25 pounds) were found as predictive factors by area under the curve analysis using the Youden index. Conclusion: The present cohort had an incidence of complications detected by ultrasound of 13%, although none of these had direct clinical implications and only one reported alteration in functionality. Height less than 1.65 m and dynamometry less than 25 pounds were found as predictive factors. [ABSTRACT FROM AUTHOR]

PurposeDevelop self-gated MRI for distinct heartbeat morphologies in subjects with arrhythmias.MethodsGolden angle radial data was obtained in seven sinus and eight arrhythmias subjects. An image-based cardiac navigator was derived from single-shot images, distinct beat types were identified, and images were reconstructed for repeated morphologies. Image sharpness, contrast, and volume variation were quantified and compared with self-gated MRI. Images were scored for image quality and artifacts. Hemodynamic parameters were computed for each distinct beat morphology in bigeminy and trigeminy subjects and for sinus beats in patients with infrequent premature ventricular contractions.ResultsImages of distinct beat types were reconstructed except for two patients with infrequent premature ventricular contractions. Image contrast and sharpness were similar to sinus self-gated images (contrast = 0.45 ± 0.13 and 0.43 ± 0.15; sharpness = 0.21 ± 0.11 and 0.20 ± 0.05). Visual scoring was highest in self-gated images (4.1 ± 0.3) compared with real-time (3.9 ± 0.4) and ECG-gated cine (3.4 ± 1.5). ECG-gated cine had less artifacts than self-gating (2.3 ± 0.7 and 2.1 ± 0.2), but was affected by misgating in two subjects. Among arrhythmia subjects, post-extrasystole/sinus (58.1 ± 8.6 mL) and interrupted sinus (61.4 ± 5.9 mL) stroke volume was higher than extrasystole (32.0 ± 16.5 mL; P

OBJECTIVE To assess the effects of topical application of undiluted heterologous serum on time to corneal reepithelialization in dogs with superficial chronic corneal epithelial defects (SCCEDs). DESIGN Multicenter, randomized, double-masked, controlled clinical trial. ANIMALS 41 client-owned dogs. PROCEDURES After collection of baseline clinical and historical data, dogs were randomly assigned to receive topically applied undiluted heterologous serum (n = 22) or isotonic saline (0.9% NaCl) solution (19) along with tobramycin and atropine. Epithelial debridement (at all visits) and grid keratotomy (at visits 2, 3, and 4) of SCCEDs were performed. Ophthalmic examination including fluorescein application was performed once weekly for 4 weeks or until corneal reepithelialization. Clinicians and owners were masked to treatment group. RESULTS No differences in baseline data were detected between treatment groups. No difficulties with medication administration, noncompliance, or adverse reactions were noted. All SCCEDs in both groups healed by 4 weeks after treatment began. Median time to reepithelialization (2 weeks) was not significantly different between serum-treated and placebo-treated eyes. Irrespective of treatment group, median time to reepithelialization was not significantly different for Boxers versus non-Boxer breeds. Direct correlations were detected between time to reepithelialization and vascularization score at study entry, vascularization score at time of reepithelialization, and ulcer area at study entry in both groups. Time to reepithelialization was not correlated with age, sex, or duration of signs in either group. CONCLUSIONS AND CLINICAL RELEVANCE Topical application of undiluted heterologous serum was well tolerated by dogs with SCCEDs but, as an adjunct to standard treatment, did not reduce time to corneal reepithelialization.

Teaching Point: Extramedullary acute myeloid leukemia tumor belongs to the differential diagnosis when a tumor develops in a patient with a history of leukemia, and magnetic resonance imaging is of diagnostic value by demonstrating iso-intensity and hyperintensity compared to skeletal muscle respectively on T1- and T2-weighted images and homogeneous contrast enhancement.

Abstract Purpose Wall shear stress (WSS) and pulse wave velocity (PWV) are important parameters to characterize blood flow in the vessel wall. Their quantification with flow-sensitive phase-contrast (PC) cardiovascular magnetic resonance (CMR), however, is time-consuming. Furthermore, the measurement of WSS requires high spatial resolution, whereas high temporal resolution is necessary for PWV measurements. For these reasons, PWV and WSS are challenging to measure in one CMR session, making it difficult to directly compare these parameters. By using a retrospective approach with a flexible reconstruction framework, we here aimed to simultaneously assess both PWV and WSS in the murine aortic arch from the same 4D flow measurement. Methods Flow was measured in the aortic arch of 18-week-old wildtype (n = 5) and ApoE−/− mice (n = 5) with a self-navigated radial 4D-PC-CMR sequence. Retrospective data analysis was used to reconstruct the same dataset either at low spatial and high temporal resolution (PWV analysis) or high spatial and low temporal resolution (WSS analysis). To assess WSS, the aortic lumen was labeled by semi-automatically segmenting the reconstruction with high spatial resolution. WSS was determined from the spatial velocity gradients at the lumen surface. For calculation of the PWV, segmentation data was interpolated along the temporal dimension. Subsequently, PWV was quantified from the through-plane flow data using the multiple-points transit-time method. Reconstructions with varying frame rates and spatial resolutions were performed to investigate the influence of spatiotemporal resolution on the PWV and WSS quantification. Results 4D flow measurements were conducted in an acquisition time of only 35 min. Increased peak flow and peak WSS values and lower errors in PWV estimation were observed in the reconstructions with high temporal resolution. Aortic PWV was significantly increased in ApoE−/− mice compared to the control group (1.7 ± 0.2 versus 2.6 ± 0.2 m/s, p

We report the case of a 64-year-old male who died suddenly short after his admission to hospital because of strong chest pain and before any clinical diagnosis was established. His medical history included coronary disease with coronary by-pass surgery at the age of 40 years old, uncontrolled hypertension, diabetes mellitus, and elevated levels of cholesterol. The autopsy revealed quite a rare case of Stanford A aortic dissection with extension to the common and internal carotid arteries; the subclavian, axillary, brachial, and radial arteries; three coronary arteries; the superior mesenteric artery; and the iliac arteries. There was no histological evidence of aortitis or connective tissue disease. The death did not result from the rupture of the aortic dissection, but from myocardial ischemia due to coronary occlusion in combination with hemodynamic disturbance from stress caused by the extended aortic dissection.

Background: While Balloon Guide Catheters (BGC) have been shown to increase the rate of reperfusion during mechanical thrombectomy (MT), its implementation with transfemoral approach is at times limited due to unfavorable vascular anatomy. Objective: to determine safety, feasibility and performance of the transradial use of 8 F BGC Flowgate 2 during mechanical thrombectomy procedures in patients with unfavorable vascular anatomies (type 3 or bovine arch) Material/Methods: We performed a retrospective cohort study of consecutive transradial mechanical thrombectomies performed with BGC Flowgate 2 between January and December 2019. Patient demographics, procedural and radiographic metrics, and clinical data were analyzed. Results: 20 (8.7%) out of 230 overall thrombectomy procedures underwent transradial approach using an 8 F BGC Flowgate. 2 Successful approach was achieved in 17/20 cases, and in 3 cases radial was switched to femoral, after failure. TICI 2 C/3 was achieved in 18 cases (90%), followed by TICI 2 b and 2a in 1 (5%) case respectively. The average number of passes was 1.8. The average radial puncture-to-first pass time was 22 min. Radial vasospasm was observed in 3/20 cases. The Flowgate 2 was found kinked in 4/20 cases (20%), all of them during right internal carotid procedures. There were no postprocedural complications at puncture site, as hematoma, pseudoaneurysm or local ischemic events Conclusion: The use of 8 F Balloon Guide Catheter during MT via transradial approach might represent an alternative in selected cases with unfavorable vascular anatomies. Its use in right ICA catheterizations was associated with a high rate of catheter kinking. [ABSTRACT FROM AUTHOR]

Objective: To determine the relative efficacy of intravenous heparin as compared to intra-arterial heparin used during transradial coronary angiography for the prevention of radial artery occlusion. Study Design: Comparative cross-sectional study. Place and Duration of Study: Study was conducted at the Department of Cardiology, AFIC/NIHD Rawalpindi, Pakistan, from Jul 2019 to Dec 2019. Methodology: A total number of 144 patients were considered for the study using the consecutive sampling technique who were undergoing diagnostic coronary angiography. Patients were divided into the intra-arterial group (n=72) who received 50 IU/kg of unfractionated heparin (maximal dose 5,000 U) intra-arterially, and an intravenous group (n=72) received the similar dose through intravenous route. All patients were administered 100 mcg of nitroglycerin to minimize radial artery spasm. Coronary Angiography was performedusing a 6F introducer sheath and diagnostic catheters. Early radial artery occlusion (RAO) at 24 hours after the procedure was detected by performing the plethysmographic (reverse Barbeau’s) and doppler USG evaluation. Chronic RAO was assessed 30 days after the procedure by performing the same tests. Data was collected through a predesigned proforma and analyzed using SPSS 23. A p-value of less than 0.05 was considered as significant. Results: Early RAO was found in 4 (5.6%) of the patients from the intra-arterial groupand 5 (6.9%) of the intravenous group. The difference was found to be statistically insignificant (p-value 0.731). Chronic RAO was observed in 3 (4.4%) of the intra-arterial group as compared to 4 (6%) of the intravenous group. This difference was also statistically insignificant (p-value 0.683) for chronic RAO. Conclusion: Intra-arterial and intravenous heparin administration providedsimilar efficacy to prevent RAO.

Abstract Background Computed tomography angiography (CTA) or contrast-enhanced (CE) cardiovascular magnetic resonance angiography (CMRA) is often obtained in patients with atrial fibrillation undergoing evaluation prior to pulmonary vein (PV) isolation. Drawbacks of CTA include radiation exposure and potential risks from iodinated contrast agent administration. Free-breathing 3D balanced steady-state free precession (bSSFP) Non-contrast CMRA is a potential imaging option, but vascular detail can be suboptimal due to ghost artifacts and blurring that tend to occur with a Cartesian k-space trajectory or, in some cases, inconsistent respiratory gating. We therefore explored the potential utility of both breath-holding and free-breathing non-contrast CMRA, using radial k-space trajectories that are known to be less sensitive to flow and motion artifacts than Cartesian. Main body Free-breathing 3D Cartesian and radial stack-of-stars acquisitions were compared in 6 healthy subjects. In addition, 27 patients underwent CTA and non-contrast CMRA for PV mapping. Three radial CMR acquisition strategies were tested: (1) breath-hold (BH) 2D radial bSSFP (BH-2D); (2) breath-hold, multiple thin-slab 3D stack-of-stars bSSFP (BH-SOS); and (3) navigator-gated free-breathing (FB) 3D stack-of-star bSSFP using a spatially non-selective RF excitation (FB-NS-SOS). A non-rigid registration algorithm was used to compensate for variations in breath-hold depth. In healthy subjects, image quality and vessel sharpness using a free-breathing 3D SOS acquisition was significantly better than free-breathing (FB) Cartesian 3D. In patients, diagnostic image quality was obtained using all three radial CMRA techniques, with BH-SOS and FB-NS-SOS outperforming BH-2D. There was overall good correlation for PV maximal diameter between BH-2D and CTA (ICC = 0.87/0.83 for the two readers), excellent correlation between BH-SOS and CTA (ICC = 0.90/0.91), and good to excellent correlation between FB-NS-SOS and CTA (ICC = 0.87/0.94). For PV area, there was overall good correlation between BH-2D and CTA (ICC = 0.79/0.83), good to excellent correlation between BH-SOS and CTA (ICC = 0.88/0.91) and excellent correlation between FB-NS-SOS and CTA (ICC = 0.90/0.95). CNR was significantly higher with BH-SOS (mean = 11.04) by comparison to BH-2D (mean = 6.02; P = 0.007) and FB-NS-SOS (mean = 5.29; P = 0.002). Conclusion Our results suggest that a free-breathing stack-of-stars bSSFP technique is advantageous in providing accurate depiction of PV anatomy and ostial measurements without significant degradation from off-resonance artifacts, and with better image quality than Cartesian 3D. For patients in whom respiratory gating is unsuccessful, a breath-hold thin-slab stack-of-stars technique with retrospective motion correction may be a useful alternative.

We performed a prospective observational study of 215 patients (58 ± 11 years) and compared the outcomes of ultrasound guided ulnar (n = 98, 45.6%) vs. radial (n = 117, 54.4%) cardiac catheterization and percutaneous coronary intervention (PCI) in patients selected by an ultrasound based algorithm. Primary endpoints included the number of access attempts and conversion to femoral access. Secondary endpoints included all-cause mortality, cardiac mortality, myocardial infarction, stroke, repeat revascularization, stent thrombosis, in-stent restenosis, and access site complications.No significant difference was found in the primary endpoints between radial or ulnar. Ulnar access showed no significant hematomas. Therefore, ulnar PCI is a feasible alternative.

Background: Transradial access for neurointerventional procedures was adopted and modified from cardiovascular intervention and is increasingly established as a safe and effective alternative to transfemoral catheterization. As social media influences public opinion on medical treatment, this study analyzes Twitter conversations to elucidate social media's depiction of transradial access as a neurointerventional tool. Materials and methods: Twitter hashtags #RadialFirst and #RadialForNeuro were evaluated using a mixed-method analysis of quantitative social media metrics and qualitative thematic analysis. Results: Between January 2015 and April 2020, 104,146 tweets from 141 countries employed the hashtag #RadialFirst (2015 (1); 2016 (0); 2017 (22,804); 2018 (33,074); 2019 (38,352); 2020 (9,915 January-April)). These generated 226,909,374 impressions and were retweeted 80,120 times by 13,707 users. Media was present in 62.5% of tweets (e.g. wrist image, angiographic runs) but only 14.5% had a reference article. Physicians authored 70.8% of tweets; interventional cardiologists accounted for 83% of top 100 influencers. #RadialForNeuro is more nascent (6 posts in 2019; 323 posts January–April 2020), with 392,662 impressions, and 254 retweets by 177 users; physicians authored 35.6%. Compared to #RadialFirst, #RadialforNeuro tweets were more likely to include media (76%), less likely to include citations (9.7%), and more likely to discuss complications and troubleshooting techniques. Conclusion: Twitter activity regarding transradial access permits information dissemination and discussion on approach benefits and challenges. However, many posts arise from non-physician sources and lack links to peer-reviewed publication. The public should be mindful that tweets may reflect opinions, rather than experience or scientific evidence. [ABSTRACT FROM AUTHOR]

Abstract Background The aim of this study was to determine the radiographic, second-look, and functional outcomes after arthroscopic side-to-side repair for complete radial posterior lateral meniscus root tears (PLMRTs). Methods Patients who underwent arthroscopic side-to-side repair for complete radial PLMRTs were identified. Clinical assessment consisted of symptoms (locking, catching, giving way and effusion), examinations of joint-line tenderness and McMurray test, and subjective scores of International Knee Documentation Committee (IKDC), Lysholm, and Tegner. In addition, postoperative MRI scan and second-look arthroscopy were performed to assess the healing status of the repaired meniscus. Results Twenty-nine patients met the inclusion criteria. The mean age was 25.41 years. The mean follow-up period was 26.68 months. During the follow-up, none of the patients had symptoms of meniscal retear, lateral joint-line tenderness or a positive McMurray test. The postoperative subjective scores of IKDC, Lysholm, and Tegner improved significantly compared to the preoperative values (P = 0.01). Postoperative MRI scan showed that 28/29 (96.6%) patients achieved meniscus healing. Twenty-two patients underwent second-look arthroscopy, among whom 19 (86.4%) patients showed complete meniscus healing and 3 (13.6%) patients showed partial healing. Conclusion Arthroscopic side-to-side repair was a valuable surgical repair technique for complete radial PLMRTs, which leaded to significant improvements in both objective and subjective functional outcomes with a high rate of meniscus healing. Level of evidence Level IV, case series.

Recent trends in neuroendovascular surgery have seen a rise in alternative access utilization. Social media feeds such as #RadialFirst or #RadialForNeuro are the beacons of a growing movement among more and more endovascular neurosurgeons, as they venture away from the traditional femoral access gravitating toward radial access. We have previously shown our distal radial access technique utilizing the snuffbox to be a reliable means of endovascular access and in addition to traditional ventral radial access provides access to the entire cerebrum. Stroke thrombectomy often encounters reticence from those who prefer transfemoral access over the radial access. Thrombectomy has been performed radially in a few series and only once previously in a case report of distal radial access for thrombectomy. Hesitance to adopt radial access for mechanical thrombectomy is often related to perceived increased access times and a lack of suitable balloon guide catheters for radial techniques. Here, we present one of the first descriptions of a distal transradial access with balloon guide flow arrest for stentriever thrombectomy.