The Mechanical Properties of Fresh and Cryopreserved Arterial Homografts

AbstractObjectives to assess the effect of cryopreservation on the elasticity and compliance of arterial allografts. Materials and methods iliofemoral segments of arteries and veins harvested from multiorgan donors were divided into two groups: fresh–control, tested for 24 hours after harvesting, and cryopreserved in liquid nitrogen after pretreatment with 20% dimethylsulphoxide and stored for an average time of 22 days. Vessel wall elastic properties were evaluated from the stress–strain relationship in a specially designed test cell fixed to the Instron Universal Testing Machine. Results the elastic modulus of the artery control group (1.54±0.33 MPa, n=20) was not significantly different from the cryopreserved group (1.69±0.61 MPa, n=15). Similarly, values for unfrozen veins (3.11±0.65 MPa, n=47) were not significantly different from those of frozen samples (2.71±0.85 MPa, n=38). Control compliance (6.86±1.79×10−5%/Pa, for arteries; 3.84±0.81×10−5%/Pa, for veins) was similar to that of the cryopreserved group (6.66±1.80×10−5%/Pa, for arteries; 4.16±1.21×10−5%/Pa, for veins). Conclusions cryopreservation maintains the important elastic properties of arterial and venous allografts during average storage time of 22 days

Second asymptomatic carotid surgery trial (ACST-2): a randomised comparison of carotid artery stenting versus carotid endarterectomy

Background: Among asymptomatic patients with severe carotid artery stenosis but no recent stroke or transient cerebral ischaemia, either carotid artery stenting (CAS) or carotid endarterectomy (CEA) can restore patency and reduce long-term stroke risks. However, from recent national registry data, each option causes about 1% procedural risk of disabling stroke or death. Comparison of their long-term protective effects requires large-scale randomised evidence. Methods: ACST-2 is an international multicentre randomised trial of CAS versus CEA among asymptomatic patients with severe stenosis thought to require intervention, interpreted with all other relevant trials. Patients were eligible if they had severe unilateral or bilateral carotid artery stenosis and both doctor and patient agreed that a carotid procedure should be undertaken, but they were substantially uncertain which one to choose. Patients were randomly allocated to CAS or CEA and followed up at 1 month and then annually, for a mean 5 years. Procedural events were those within 30 days of the intervention. Intention-to-treat analyses are provided. Analyses including procedural hazards use tabular methods. Analyses and meta-analyses of non-procedural strokes use Kaplan-Meier and log-rank methods. The trial is registered with the ISRCTN registry, ISRCTN21144362. Findings: Between Jan 15, 2008, and Dec 31, 2020, 3625 patients in 130 centres were randomly allocated, 1811 to CAS and 1814 to CEA, with good compliance, good medical therapy and a mean 5 years of follow-up. Overall, 1% had disabling stroke or death procedurally (15 allocated to CAS and 18 to CEA) and 2% had non-disabling procedural stroke (48 allocated to CAS and 29 to CEA). Kaplan-Meier estimates of 5-year non-procedural stroke were 2·5% in each group for fatal or disabling stroke, and 5·3% with CAS versus 4·5% with CEA for any stroke (rate ratio [RR] 1·16, 95% CI 0·86–1·57; p=0·33). Combining RRs for any non-procedural stroke in all CAS versus CEA trials, the RR was similar in symptomatic and asymptomatic patients (overall RR 1·11, 95% CI 0·91–1·32; p=0·21). Interpretation: Serious complications are similarly uncommon after competent CAS and CEA, and the long-term effects of these two carotid artery procedures on fatal or disabling stroke are comparable. Funding: UK Medical Research Council and Health Technology Assessment Programme

Session 17 Ecophysiology

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The market for open source: An intelligent virtual open source marketplace

This paper describes the MARKOS (the MARKet for Open Source) European Project, a FP7-ICT-2011-8 STREP project, which aims to realize a service and an interactive application providing an integrated view on the open source projects available on the web, focusing on functional, structural, and licenses aspects of software source code. MARKOS involves 7 partners from 5 countries, including industries, universities, and research institutions. MARKOS differs from other services available on the Web - which often provide textual-based code search - in that it provides the possibility to browse the code structure at a high level of abstraction, in order to facilitate the understanding of the software from a technical point of view. Also, it highlights relationships between software components released by different projects, giving an integrated view of the available Open Source software at a global scale. Last, but not least, MARKOS is able to highlight potential legal issues due to license incompatibilities, providing explanations for these issues and supporting developers in the search for alternative solutions to their problems. MARKOS will involve end users in order to allow to practice its results in scenarios coming from industrial and Open Source communities