Restenosis after directional coronary atherectomy: Differences between primary atheromatoes and restenosls lesions and influence of subintimal tissue resection

AbstractRates of restenosis were evaluated in 70 patients (74 lesions) after successful directional coronary atherectomy. The extent of vascular tissue resection was correlated with restenosis rates for coronary (n = 59) and vein bypass graft (n = 15) lesions.After 6 months, the overall restenosis rate was 50% (37 of 74 lesions); it was 42% (15 of 36 lesions) when intima alone was resected, 50% (7 of 14 lesions) when media was resected and 63% (15 of 24 lesions) when adventitia was resected. Subintimal tissue resection increased the restenosis rate for vein grafts (43% with intimal resection versus 100% with subintimal resection, p = 0.01) but not for coronary arteries (50% versus 48%). There was no overall difference in restenosis rates after atherectomy between primary lesions and restenosis lesions that occurred after balloon angioplasty (46% versus 54%). Among postballoon angioplasty restenosis lesions, a higher rate of restenosis after atherectomy was found with subintimal than with intimal resection (78% versus 32%, p = 0.01).Tissues from patients undergoing a second atherectomy for restenosis after initial atherectomy (n = 8) demonstrated neointimal hyperplasia that appeared histotogically identical to restenotic tissue developing after balloon angioplasty (n = 37).These data suggest that the cellular response to directional coronary atherectomy is characterized by neointimal proliferation similar to that which may develop after balloon angioplasty. The extent of fibrous hyperplasia appears to be related to the depth of tissue resection in vein graft lesions and coronary artery restenosis lesions that occur after balloon angioplasty but not in primary atheromatous coronary artery lesions

Temporal resolution of a pre-maximum halt in a Classical Nova: V5589 Sgr observed with STEREO HI-1B

Classical novae show a rapid rise in optical brightness over a few hours. Until recently the rise phase, particularly the phenomenon of a pre-maximum halt, was observed sporadically. Solar observation satellites observing Coronal Mass Ejections enable us to observe the pre-maximum phase in un- precedented temporal resolution. We present observations of V5589 Sgr with STEREO HI-1B at a cadence of 40 min, the highest to date. We temporally resolve a pre-maximum halt for the first time, with two examples each rising over 40 min then declining within 80 min. Comparison with a grid of outburst models suggests this double peak, and the overall rise timescale, are consistent with a white dwarf mass, central temperature and accretion rate close to 1.0 M⊙, 5 × 107 K and 10−10 M⊙ yr−1 respectively. The modelling formally predicts mass loss onset at JD 2456038.2391±0.0139, 12 hrs before optical maximum. The model assumes a main–sequence donor. Observational evidence is for a subgiant companion; meaning the accretion rate is under–estimated. Post–maximum we see erratic variations commonly associated with much slower novae. Estimating the decline rate difficult, but we place the time to decline two magnitudes as 2.1 < t2(days) < 3.9 making V5589 Sgr a “very fast” nova. The brightest point defines “day 0” as JD 2456038.8224±0.0139, although at this high cadence the meaning of the observed maximum becomes difficult to define. We suggest that such erratic variability normally goes undetected in faster novae due to the low cadence of typical observations; implying erratic behaviour is not necessarily related to the rate of decline

Economic Growth and the Diffusion of Clean Technologies: Explaining Environmental Kuznets Curves

Production often causes pollution as a by-product. Once environmental degradation becomes too severe, regulation is introduced by which society forces the economy to make a transition to cleaner production processes. We model this transition as a change in general purpose technology" and investigate how it interferes with economic growth driven by quality-improvements. The model gives an explanation for the inverted U-shaped pollution-income relation found in empirical research for many pollutants (Environmental Kuznets Curve). We provide an analytical foundation for the claim that the rise and decline of pollution can be explained by policy-induced technology shifts and intrasectoral changes

The Science Performance of JWST as Characterized in Commissioning

This paper characterizes the actual science performance of the James Webb Space Telescope (JWST), as determined from the six month commissioning period. We summarize the performance of the spacecraft, telescope, science instruments, and ground system, with an emphasis on differences from pre-launch expectations. Commissioning has made clear that JWST is fully capable of achieving the discoveries for which it was built. Moreover, almost across the board, the science performance of JWST is better than expected; in most cases, JWST will go deeper faster than expected. The telescope and instrument suite have demonstrated the sensitivity, stability, image quality, and spectral range that are necessary to transform our understanding of the cosmos through observations spanning from near-earth asteroids to the most distant galaxies.Comment: 5th version as accepted to PASP; 31 pages, 18 figures; https://iopscience.iop.org/article/10.1088/1538-3873/acb29

The James Webb Space Telescope Mission

Twenty-six years ago a small committee report, building on earlier studies, expounded a compelling and poetic vision for the future of astronomy, calling for an infrared-optimized space telescope with an aperture of at least $4m$. With the support of their governments in the US, Europe, and Canada, 20,000 people realized that vision as the $6.5m$ James Webb Space Telescope. A generation of astronomers will celebrate their accomplishments for the life of the mission, potentially as long as 20 years, and beyond. This report and the scientific discoveries that follow are extended thank-you notes to the 20,000 team members. The telescope is working perfectly, with much better image quality than expected. In this and accompanying papers, we give a brief history, describe the observatory, outline its objectives and current observing program, and discuss the inventions and people who made it possible. We cite detailed reports on the design and the measured performance on orbit.Comment: Accepted by PASP for the special issue on The James Webb Space Telescope Overview, 29 pages, 4 figure