Treatment of Truncal Incompetence and Varicose Veins with a Single Administration of a New Polidocanol Endovenous Microfoam Preparation Improves Symptoms and Appearance

ObjectiveThis multicenter, parallel group study was designed to determine if a single administration of ≤15 mL of pharmaceutical-grade polidocanol endovenous microfoam (PEM, now approved in the United States as Varithena [polidocanol injectable foam], BTG International Ltd.) could alleviate symptoms and improve appearance of varicose veins in a typical population of patients with moderate to very severe symptoms of superficial venous incompetence and visible varicosities of the great saphenous vein (GSV) system.MethodsThe primary endpoint was patient-reported venous symptom improvement measured by change from baseline to Week 8 in 7-day average VVSymQ score. Co-secondary endpoints measured improvement in appearance of visible varicose veins from baseline to Week 8, as measured by the Independent Photography Review–Visible Varicose Veins (IPR-V3) and Patient Self-assessment of Visible Varicose Veins (PA-V3) scores. Patients were randomized to five groups: PEM 0.125% (control), 0.5%, 1%, 2%, or placebo. Adverse events (AEs) were recorded at each study visit. Tertiary endpoints measured duplex ultrasound response, changes in venous clinical severity score, and the modified Venous Insufficiency Epidemiological and Economic Study–Quality of Life/Symptoms.ResultsAt Week 8, VVSymQ scores for the pooled PEM group (0.5% + 1% + 2%; p < .0001) and individual dose concentrations (p < .001) were significantly superior to placebo. Mean changes from baseline to Week 8 in IPR-V3 and PA-V3 scores were significantly greater for pooled PEM than for placebo (p < .0001). Most AEs were mild and resolved without sequelae. No pulmonary emboli were reported.ConclusionsThis study demonstrated that a single administration of up to 15 mL of PEM is a safe, effective, and convenient treatment for the symptoms of superficial venous incompetence and the appearance of visible varicosities of the GSV system. Doses of 0.5%, 1%, and 2% PEM appear to have an acceptable risk-benefit ratio

On the compact operators case of the Bishop-Phelps-Bollobás property for numerical radius

The authors would like to thank Bill Johnson for kindly answering several inquiries.We study the Bishop–Phelps–Bollobás property for numerical radius restricted to the case of compact operators (BPBp-nu for compact operators in short). We show that C0(L) spaces have the BPBp-nu for compact operators for every Hausdorff topological locally compact space L. To this end, on the one hand, we provide some techniques allowing to pass the BPBp-nu for compact operators from subspaces to the whole space and, on the other hand, we prove some strong approximation property of C0(L) spaces and their duals. Besides, we also show that real Hilbert spaces and isometric preduals of ℓ1 have the BPBp-nu for compact operators

Modeling and visualizing object-oriented programs with Codecharts

Software design, development and evolution commonly require programmers to model design decisions, visualize implemented programs, and detect conflicts between design and implementation. However, common design notations rarely reconcile theoretical concerns for rigor and minimality with the practical concerns for abstraction, scalability and automated verifiability. The language of Codecharts was designed to overcome these challenges by narrowing its scope to visual specifications that articulate automatically-verifiable statements about the structure and organization of object-oriented programs. The tokens in its visual vocabulary stand for the building-blocks of object-oriented design, such as inheritance class hierarchies, sets of dynamically-bound methods, and their correlations. The formalism was tailored for those pragmatic concerns which arise from modeling class libraries and design patterns, and for visualizing programs of any size at any level of abstraction. We describe design verification, a process of proving or refuting that a Java program (i.e. its native code) conforms to the Codechart specifying it. We also describe a toolkit which supports modeling and visualization with Codecharts, as well as a fully-automated design verification tool. We conclude with empirical results which suggest gains in both speed and accuracy when using Codecharts in software design, development and evolution