Insight into the Cycling Behaviour of Metal Anodes, Enabled by X-ray Tomography and Mathematical Modelling

This work tackles the methodological challenge of rationalizing symmetric-cell cycling data from a materials-science perspective, through experiment replication, mathematical modelling, and tomographic imaging. Specifically, we address Zn electrode cycling in alkaline electrolyte with and without adding tetrabutylammonium bromide (TBAB). This additive is known from literature, but its practical impact is jeopardized by lack of in-depth understanding of its behaviour. Electrochemical testing was carried out at practically relevant current densities and the effect of variations of operating conditions was taken into account. The physical chemistry underlying cell potential profiles, has been modelled mathematically, accounting for: electrokinetics, mass-transport, electrode shape change and passivation. In particular, we disclosed an unexpected joint effect of TBAB and current density on passivation time: tomography allowed to rationalise this behaviour in terms of precipitate morphology

The ACEF score: a simple but powerful predictor of short-term mortality in patients with ST-elevation myocardial infarction

Background: several clinical risk scores are available for the risk stratification of patients with ST-elevation myocardial infarction (STEMI), such as the CADILLAC, GRACE, PAMI, TIMI, and Zwolle, but all are complex to use and there is uncertainty on the best one. The age-creatinine-ejection fraction (ACEF) score, has been recently proven effective and proficient as a risk score in cardiac surgery despite its user-friendliness. We thus aimed to compare the performance of the ACEF score in comparison to the other available risk scores in patient with STEMI. Methods: subjects with STEMI undergoing primary percutaneous coronary intervention at our Institution from 2001 to 2009 were enrolled. The primary end-point was in-hospital all-cause death, whereas long-term all-cause death, long-term cardiac death were appraised as secondary outcomes. ACEF, CADILLAC, GRACE, PAMI, TIMI, and Zwolle risk scores were compared with receiver-operating characteristics (ROC) curves with areas under the curve (AUC), and binary multivariable logistic regression analysis with odds ratios (OR), plus 95% confidence intervals

Status report of a systematic investigation on low-dose ionizing radiation effects in mammalian cells

In the last 15 years a growing interest in the biological effects induced by low doses of ionizing radiation has arisen in the scientific community, due to an increasing number of experimental evidences showing a plethora of non-linear effects occurring after low-dose irradiations. In particular, hyper-radiosensitivity and induced radioresistance (HRS/IRR) have been reported after exposure to low- and high-LET radiation, in human (normal and tumoural) and other mammalian cells in vitro. In this framework, Chinese hamster V79 cells, human primary fibroblasts (HFFF2) and murine embryonic fibroblasts (MEFs) were irradiated with broadbeams of protons in the dose range 0.1–5.0Gy and at 1 Gy/min dose-rate. Cellular response has been evaluated in terms of cell survival, micronuclei induction, chromosomal aberrations and telomere length alterations. For comparison purpose, the same end-points were studied after X/γ-rays irradiation

Percutaneous pericardiocentesis for pericardial effusion: predictors of mortality and outcomes

Pericardial effusion can dangerously precipitate patient’s hemodynamic stability and requires prompt intervention in case of tamponade. We investigated potential predictors of in-hospital mortality, a composite outcome of in-hospital mortality, pericardiocentesis-related complications, and the need for emergency cardiac surgery and all-cause mortality in patients undergoing percutaneous pericardiocentesis. This is an observational, retrospective, single-center study on patients undergoing percutaneous pericardiocentesis (2010–2019). We enrolled 81 consecutive patients. Median age was 71.4 years (interquartile range [IQR] 58.1–78.1 years) and 51 (63%) were male. Most of the pericardiocentesis were performed in an urgency setting (76.5%) for cardiac tamponade (77.8%). The most common etiology was idiopathic (33.3%) followed by neoplastic (22.2%). In-hospital mortality was 14.8% while mortality during follow-up (mean 17.1 months) was 44.4%. Only hemodynamic instability (i.e., cardiogenic shock, hypotension refractory to fluid challenge therapy and inotropes) was associated with in-hospital mortality at the univariate analysis (odds ratio [OR] 7.2; 95% confidence interval [CI] 1.76–29.4). Non-neoplastic/non-idiopathic etiology and hemodynamic instability were associated with the composite outcome of in-hospital mortality, need for emergency cardiac surgery, or pericardiocentesis-related complications (OR 5.75, 95% CI 1.65–20.01, and OR 5.81, 95% CI 2.11–15.97, respectively). Multivariate Cox regression analysis adjusted for possible confounding variables (age, coronary artery disease, and hemodynamic instability) showed that neoplastic etiology was independently associated with medium-term mortality (hazard ratio [HR] 4.05, 95% CI 1.45–11.36). In a real-world population treated with pericardiocentesis for pericardial effusion, in-hospital adverse outcomes and medium-term mortality are consistent, in particular for patients presenting with hemodynamic instability or neoplastic pericardial effusion

Randomized clinical trial on short-time compression with Kaolin-filled pad: a new strategy to avoid early bleeding and subacute radial artery occlusion after percutaneous coronary intervention.

BACKGROUND: Despite the increasing use of transradial techniques for cardiac percutaneous procedures, none of the strategies commonly utilized for hemostasis has been able to reduce the occurrence of radial artery occlusion (RAO). The aim of this study was to evaluate the occurrence of 24-hour RAO and the rate of bleeding of a novel hemostatic device for radial closure after percutaneous interventions, in adjunct to short-time compression.METHODS: Once the radial access was obtained, patients were randomized to 3 different strategies of radial closure: a short compression with the QuikClot® Interventional™ pad (Z-Medica Corporation, Wallingford, CT, USA) (15 minutes, group 1), a short compression (15 minutes, group 2), and a conventional prolonged compression (2 hours, group 3) both without QuikClot® utilization.RESULTS: Fifty patients in group 1, 20 in group 2, and 50 in group 3 were enrolled. The three groups were homogenous for baseline and procedural characteristics. None of patients in group 1 developed RAO, 1 (5%) occurred in group 2, and 5 (10%) in group 3 (P = 0.05). Active bleeding after compression removal occurred in 10 patients (20%) in group 1, 18 (90%) in group 2, and 1 (2%) in group 3 (P < 0.001). Among patients in group 1, at univariate analysis, the predictors of acute bleeding resulted in chronic therapy with clopidogrel (Odds Ratio 28.78, 95% Confidence Intervals 4.79-172.82, P < 0.001) and high levels of activated clotting time (ACT) at the time of sheath removal (OR 1.02, 95% CI 1.00-1.03, P = 0.009). At ROC analysis, the cutoff value of ACT for the risk of bleeding with a sensitivity of 80% and specificity of 75% was 287 seconds.CONCLUSIONS: Early sheet removal and short-time compression with QuikClot® Interventional™ can reduce the rate of RAO after diagnostic or interventional procedures especially in patients not on double antiplatelet therapy

Preface

Not abstract available

Quantitative flow ratio-based outcomes in patients undergoing transcatheter aortic valve implantation quaestio study

Background: Coronary artery disease (CAD) is common in patients with aortic valve stenosis (AS) ranging from 60% to 80%. The clinical and prognostic role of coronary artery lesions in patients undergoing Transcatheter Aortic Valve Implantation (TAVI) remains unclear. The aim of the present observational study was to estimate long-term clinical outcomes by Quantitative Flow Ratio (QFR) characterization of CAD in a well-represented cohort of patients affected by severe AS treated by TAVI. Methods: A total of 439 invasive coronary angiographies of patients deemed eligible for TAVI by local Heart Teams with symptomatic severe AS were retrospectively screened for QFR analysis. The primary endpoint of the study was all-cause mortality. The secondary endpoint was a composite of cardiovascular mortality, stroke/transient ischemic attack (TIA), acute myocardial infarction (AMI), and any hospitalization after TAVI. Results: After exclusion of patients with no follow-up data, coronary angiography not feasible for QFR analysis and previous surgical myocardial revascularization (CABG) 48/239 (20.1%) patients had a QFR value lower or equal to 0.80 (QFR + value), while the remaining 191/239 (79.9%) did not present any vessel with a QFR positive value. In the adjusted Cox regression analysis, patients with positive QFR were independently associated with an increased risk of all-casual mortality (Model 1, HR 3.47, 95% CI, 2.35−5.12; Model 2, HR 5.01, 95% CI, 3.17−7.90). In the adjusted covariate analysis, QFR+ involving LAD (37/48, 77,1%) was associated with the higher risk of the composite outcome compared to patients without any positive value of QFR or non-LAD QFR positive value (11/48, 22.9%). Conclusions: Pre-TAVI QFR analysis can be used for a safe, simple, wireless functional assessment of CAD. QFR permits to identify patients at high risk of cardiovascular mortality or MACE, and it could be considered by local Heart Teams