Cerebral Angiography Can Demonstrate Changes in Collateral Flow During Induced Hypertension

AbstractA 52-year-old woman with a large left-hemispheric stroke was transferred to our hospital for possible endovascular treatment. The patient underwent a cerebral angiogram at 7 hours after symptom onset with intent to treat and was found to have occlusion of the proximal M1-segment of the left middle cerebral artery (MCA). At that time it was felt that this was a high-risk patient for mechanical clot retrieval and it was decided to treat her with induced hypertension. The diagnostic catheter was left in place in the left internal carotid artery (ICA) and hypertension was induced in the angiography suite by means of an infusion of neosynephrine. Ten minutes after the goal blood pressure levels had been reached, a repeat left ICA injection was performed, which demonstrated more extensive collateralization of the MCA territory from anterior cerebral artery branches. Mean transit times (MTT) for the left ICA circulation improved from 9.5 seconds prior to induced hypertension to 6.0 seconds. The neosynephrine infusion was continued for a total of 24 hours and the patient showed neurological improvement. We suggest that induced hypertension led to the improved collateralization to the left MCA as evidenced by the improved MTT and augmentation of leptomeningeal collaterals, which in turn led to the patient's clinical improvement

Finding 2-Edge and 2-Vertex Strongly Connected Components in Quadratic Time

We present faster algorithms for computing the 2-edge and 2-vertex strongly connected components of a directed graph, which are straightforward generalizations of strongly connected components. While in undirected graphs the 2-edge and 2-vertex connected components can be found in linear time, in directed graphs only rather simple $O(m n)$-time algorithms were known. We use a hierarchical sparsification technique to obtain algorithms that run in time $O(n^2)$. For 2-edge strongly connected components our algorithm gives the first running time improvement in 20 years. Additionally we present an $O(m^2 / \log{n})$-time algorithm for 2-edge strongly connected components, and thus improve over the $O(m n)$ running time also when $m = O(n)$. Our approach extends to k-edge and k-vertex strongly connected components for any constant k with a running time of $O(n^2 \log^2 n)$ for edges and $O(n^3)$ for vertices

CO2 wettability of caprocks: Implications for structural storage capacity and containment security

© 2015. American Geophysical Union. All Rights Reserved. Structural trapping, the most important CO2 geostorage mechanism during the first decades of a sequestration project, hinges on the traditional assumption that the caprock is strongly water wet. However, this assumption has not yet been verified; and it is indeed not generally true as we demonstrate here. Instead, caprock can be weakly water wet or intermediate wet at typical storage conditions; and water wettability decreases with increasing pressure or temperature. Consequently, a lower storage capacity can be inferred for structural trapping in such cases

Simulation of propofol anaesthesia for intracranial decompression using brain hypothermia treatment

<p>Abstract</p> <p>Background</p> <p>Although propofol is commonly used for general anaesthesia of normothermic patients in clinical practice, little information is available in the literature regarding the use of propofol anaesthesia for intracranial decompression using brain hypothermia treatment. A novel propofol anaesthesia scheme is proposed that should promote such clinical application and improve understanding of the principles of using propofol anaesthesia for hypothermic intracranial decompression.</p> <p>Methods</p> <p>Theoretical analysis was carried out using a previously-developed integrative model of the thermoregulatory, hemodynamic and pharmacokinetic subsystems. Propofol kinetics is described using a framework similar to that of this model and combined with the thermoregulation subsystem through the pharmacodynamic relationship between the blood propofol concentration and the thermoregulatory threshold. A propofol anaesthesia scheme for hypothermic intracranial decompression was simulated using the integrative model.</p> <p>Results</p> <p>Compared to the empirical anaesthesia scheme, the proposed anaesthesia scheme can reduce the required propofol dosage by more than 18%.</p> <p>Conclusion</p> <p>The integrative model of the thermoregulatory, hemodynamic and pharmacokinetic subsystems is effective in analyzing the use of propofol anaesthesia for hypothermic intracranial decompression. This propofol infusion scheme appears to be more appropriate for clinical application than the empirical one.</p

Dependence of quartz wettability on fluid density

Wettability is one of the most important parameters in multiphase flow through porous rocks. However, experimental measurements or theoretical predictions are difficult and open to large uncertainty. In this work we demonstrate that gas densities (which are much simpler to determine than wettability and typically well known) correlate remarkably well with wettability. This insight can significantly improve wettability predictions, thus derisking subsurface operations (e.g., CO2 geostorage or hydrocarbon recovery), and significantly enhance fundamental understanding of natural geological processes

Residual trapping of supercritical CO2 in oil-wet sandstone

Residual trapping, a key CO2 geo-storage mechanism during the first decades of a sequestration project, immobilizes micrometre sized CO2 bubbles in the pore network of the rock. This mechanism has been proven to work in clean sandstones and carbonates; however, this mechanism has not been proven for the economically most important storage sites into which CO2 will be initially injected at industrial scale, namely oil reservoirs. The key difference is that oil reservoirs are typically oil-wet or intermediate-wet, and it is clear that associated pore-scale capillary forces are different. And this difference in capillary forces clearly reduces the capillary trapping capacity (residual trapping) as we demonstrate here. For an oil-wet rock (water contact angle θ = 130°) residual CO2 saturation SCO2,r (≈8%) was approximately halved when compared to a strongly water-wet rock (θ = 0°; SCO2,r ≈ 15%). Consequently, residual trapping is less efficient in oil-wet reservoirs

Mature Peripheral RPE Cells Have an Intrinsic Capacity to Proliferate; A Potential Regulatory Mechanism for Age-Related Cell Loss

Mammalian peripheral retinal pigmented epithelium (RPE) cells proliferate throughout life, while central cells are senescent. It is thought that some peripheral cells migrate centrally to correct age-related central RPE loss.We ask whether this proliferative capacity is intrinsic to such cells and whether cells located centrally produce diffusible signals imposing senescence upon the former once migrated. We also ask whether there are regional differences in expression patterns of key genes involved in these features between the centre and the periphery in vivo and in vitro. Low density RPE cultures obtained from adult mice revealed significantly greater levels of proliferation when derived from peripheral compared to central tissue, but this significance declined with increasing culture density. Further, exposure to centrally conditioned media had no influence on proliferation in peripheral RPE cell cultures at the concentrations examined. Central cells expressed significantly higher levels of E-Cadherin revealing a tighter cell adhesion than in the peripheral regions. Fluorescence-labelled staining for E-Cadherin, F-actin and ZO-1 in vivo revealed different patterns with significantly increased expression on central RPE cells than those in the periphery or differences in junctional morphology. A range of other genes were investigated both in vivo and in vitro associated with RPE proliferation in order to identify gene expression differences between the centre and the periphery. Specifically, the cell cycle inhibitor p27(Kip1) was significantly elevated in central senescent regions in vivo and mTOR, associated with RPE cell senescence, was significantly elevated in the centre in comparison to the periphery.These data show that the proliferative capacity of peripheral RPE cells is intrinsic and cell-autonomous in adult mice. These differences between centre and periphery are reflected in distinct patterns in junctional markers. The regional proliferation differences may be inversely dependent to cell-cell contact

A study on torsional vibration attenuation in automotive drivetrains using absorbers with smooth and non-smooth nonlinearities

The automotive industry is predominantly driven by legislations on stringent emissions. This has led to the introduction of downsized engines, incorporating turbocharging to maintain output power. As downsized engines have higher combustion pressures, the resulting torsional oscillations (engine order vibrations) are of broadband nature with an increasing severity, which affect noise and vibration response of the drive train system. Palliative devices, such as clutch pre-dampers and dual mass flywheel have been used to mitigate the effect of transmitted engine torsional oscillations. Nevertheless, the effectiveness of these palliative measures is confined to a narrow band of response frequencies. The nonlinear targeted energy transfer is a promising approach to study vibration mitigation within a broader range of frequencies, using nonlinear vibration absorbers (or nonlinear energy sinks – NESs). These devices would either redistribute vibration energy within the modal space of the primary structure, thus dissipating the vibrational energy more efficiently through structural damping, or passively absorb and locally dissipate a part of this energy (in a nearly irreversible manner) from the primary structure. The absence of a linear resonance frequency of an NES, enables its broadband operation (in contrast to the narrowband operation of current linear tuned mass dampers). Parametric studies are reported to determine the effectiveness of various smooth or non-smooth nonlinear stiffness characteristics of such absorbers. A reduced drivetrain model, incorporating single and multiple absorber attachments is used and comparison of the predictions to numerical integrations proves its efficacy

Brain ageing in schizophrenia: evidence from 26 international cohorts via the ENIGMA Schizophrenia consortium

Schizophrenia (SZ) is associated with an increased risk of life-long cognitive impairments, age-related chronic disease, and premature mortality. We investigated evidence for advanced brain ageing in adult SZ patients, and whether this was associated with clinical characteristics in a prospective meta-analytic study conducted by the ENIGMA Schizophrenia Working Group. The study included data from 26 cohorts worldwide, with a total of 2803 SZ patients (mean age 34.2 years; range 18-72 years; 67% male) and 2598 healthy controls (mean age 33.8 years, range 18-73 years, 55% male). Brain-predicted age was individually estimated using a model trained on independent data based on 68 measures of cortical thickness and surface area, 7 subcortical volumes, lateral ventricular volumes and total intracranial volume, all derived from T1-weighted brain magnetic resonance imaging (MRI) scans. Deviations from a healthy brain ageing trajectory were assessed by the difference between brain-predicted age and chronological age (brain-predicted age difference [brain-PAD]). On average, SZ patients showed a higher brain-PAD of +3.55 years (95% CI: 2.91, 4.19; I$^{2}$ = 57.53%) compared to controls, after adjusting for age, sex and site (Cohen's d = 0.48). Among SZ patients, brain-PAD was not associated with specific clinical characteristics (age of onset, duration of illness, symptom severity, or antipsychotic use and dose). This large-scale collaborative study suggests advanced structural brain ageing in SZ. Longitudinal studies of SZ and a range of mental and somatic health outcomes will help to further evaluate the clinical implications of increased brain-PAD and its ability to be influenced by interventions