Percutaneous balloon aortic valvuloplasty in the era of transcatheter aortic valve implantation: a narrative review

The role of percutaneous balloon aortic valvuloplasty (BAV) in the management of severe symptomatic aortic stenosis has come under the spotlight following the development of the transcatheter aortic valve implantation (TAVI) technique. Previous indications for BAV were limited to symptom palliation and as a bridge to definitive therapy for patients undergoing conventional surgical aortic valve replacement (AVR). In the TAVI era, BAV may also be undertaken to assess the ‘therapeutic response’ of a reduction in aortic gradient in borderline patients often with multiple comorbidities, to assess symptomatic improvement prior to consideration of definitive TAVI intervention. This narrative review aims to update the reader on the current indications and practical techniques involved in undertaking a BAV procedure. In addition, a summary of the haemodynamic and clinical outcomes, as well as the frequently encountered procedural complications is presented for BAV procedures conducted during both the pre-TAVI and post-TAVI era

The Giant Chalukou Porphyry Mo Deposit, Northeast China: The Product of a Short-Lived, High Flux Mineralizing Event

Whether giant porphyry ore deposits are the products of single, short-lived magmatic-hydrothermal events or multiple events over a prolonged interval is a topic of considerable debate. Previous studies, however, have all been devoted to porphyry Cu and Cu-Mo deposits. In this paper, we report high-precision isotope dilution-negative-thermal ionization mass spectrometric (ID-N-TIMS) molybdenite Re-Os ages for the newly discovered, world-class Chalukou porphyry Mo deposit (reserves of 2.46 Mt @ 0.087 wt % Mo) in NE China. Samples were selected based on a careful evaluation of the relative timing of the different vein types (i.e., A, B, and D veins), thereby ensuring that the suite of samples analyzed could be used to reliably determine the age and duration of mineralization. The molybdenite Re-Os geochronology reveals that hydrothermal activity at Chalukou involved two magmatic-hydrothermal events spanning an interval of 6.92 ± 0.16 m.y. The first event (153.96 ± 0.08/0.63/0.79 Ma, molybdenite ID-N-TIMS Re-Os age) was associated with the emplacement of a granite porphyry dated at 152.1 ± 2.2 Ma (zircon laser ablation-inductively coupled plasma-microscopic [LA-ICP-MS] U-Pb ages), and led to only minor Mo mineralization, accounting for 90%) was deposited in less than 650 kyr, between 147.67 ± 0.10/0.60/0.76 and 147.04 ± 0.12/0.72/0.86 Ma (molybdenite ID-N-TIMS Re-Os ages), coincident with the emplacement of a fine-grained porphyry at 148.1 ± 2.6 Ma (zircon LA-ICP-MS U-Pb ages). The high-precision Re-Os age determinations presented here show, contrary to the finding of a number of studies of porphyry Cu and Cu-Mo systems, that the giant Chalukou porphyry Mo deposit primarily formed in a single, short-lived (<650 kyr) hydrothermal event, suggesting that this may also have been the case for other giant porphyry Mo deposits

Almanac 2012: cell therapy in cardiovascular disease. The national society journals present selected research that has driven recent advances in clinical cardiology.

Brz prijelaz iz laboratorija do bolesničke postelje koji se dogodio kod primjene regenerativne medicine u kardiologiji doveo je do uzbudljivih novih napredaka u našem razumijevanju nekih od osnovnih mehanizama ljudske biologije. Prva generacija stanica, koja je korištena u prvoj i drugoj fazi kliničkih ispitivanja (uglavnom mononuklearne matične stanice koštane srži), sada ulazi u treću fazu kliničkih ispitivanja, čiji je cilj proizvesti terapeutik koji se temelji na terapiji stanicama te bi mogao utjecati na ishod liječenja bolesti srca. Terapija stanicama prve generacije je bila usmjerena na praćenje sigurnosti primjene, kao i prikaz djelovanja te terapije, što je objavljeno u brojnim meta-analizama. Zahvaljujući dosadašnjem stečenom znanju, napredujemo prema sljedećoj generaciji stanica – stanice dobivene inženjeringom – koje su razvijene tako da daju fenotip koji će još više poboljšati proces obnavljanja/spašavanja miokarda. Ovaj pregledni članak donosi pregled najnovijih temeljnih znanstvenih istraživanja koja bi uskoro mogla biti primijenjena na ljudima te rezultata najnovijih kliničkih studija.The rapid translation from bench to bedside that has been seen in the application of regenerative medicine to cardiology has led to exciting new advances in our understanding of some of the fundamental mechanisms related to human biology. The first generation of cells used in phase I-II trials (mainly bone marrow mononuclear cells) are now entering phase III clinical trials with the goal of producing a cell based therapeutic that can change the outcome of cardiac disease. First generation cell therapy appears to have addressed safety concerns as well as showing \u27activity\u27 in numerous published meta- analyses. With the knowledge gained to date, the field is moving towards the next generation of cells-the \u27engineered\u27 cell-that have been developed to display a phenotype that will further enhance the myocardial repair/salvage process. This almanac review covers the latest basic research that may soon have application to humans as well as the results of the latest clinical trials

Noninflammatory Changes of Microglia Are Sufficient to Cause Epilepsy.

Microglia are well known to play a critical role in maintaining brain homeostasis. However, their role in epileptogenesis has yet to be determined. Here, we demonstrate that elevated mTOR signaling in mouse microglia leads to phenotypic changes, including an amoeboid-like morphology, increased proliferation, and robust phagocytosis activity, but without a significant induction of pro-inflammatory cytokines. We further provide evidence that these noninflammatory changes in microglia disrupt homeostasis of the CNS, leading to reduced synapse density, marked microglial infiltration into hippocampal pyramidal layers, moderate neuronal degeneration, and massive proliferation of astrocytes. Moreover, the mice thus affected develop severe early-onset spontaneous recurrent seizures (SRSs). Therefore, we have revealed an epileptogenic mechanism that is independent of the microglial inflammatory response. Our data suggest that microglia could be an opportune target for epilepsy prevention

Rapid prediction of wall shear stress in stenosed coronary arteries based on deep learning

There is increasing evidence that coronary artery wall shear stress (WSS) measurement provides useful prognostic information that allows prediction of adverse cardiovascular events. Computational Fluid Dynamics (CFD) has been extensively used in research to measure vessel physiology and examine the role of the local haemodynamic forces on the evolution of atherosclerosis. Nonetheless, CFD modelling remains computationally expensive and time-consuming, making its direct use in clinical practice inconvenient. A number of studies have investigated the use of deep learning (DL) approaches for fast WSS prediction. However, in these reports, patient data were limited and most of them used synthetic data generation methods for developing the training set. In this paper, we implement 2 approaches for synthetic data generation and combine their output with real patient data in order to train a DL model with a U-net architecture for prediction of WSS in the coronary arteries. The model achieved 6.03% Normalised Mean Absolute Error (NMAE) with inference taking only 0.35 s; making this solution time-efficient and clinically relevant