Vena Cava Filters: Toward Optimal Strategies for Filter Retrieval and Patients' Follow-Up.

Mortality rates associated with venous thromboembolism (VTE) are high. Inferior vena cava filters (IVCFs) have been frequently placed for these patients as part of their treatment, albeit the paucity of data showing their ultimate efficacy and potential risk of complications. Issues regarding long-term filter dwell time are accounted for in society guidelines. This topic has led to an FDA mandate for filter retrieved as soon as protection from pulmonary embolism is no longer needed. However, even though most are retrievable, some were inadvertently left as permanent, which carries an incremental lifetime risk to the patient. In the past decade, attempts have aimed to determine the optimal time interval during which filter needs to be removed. In addition, distinct strategies have been implemented to boost retrieval rates. This review discusses current conflicts in indications, the not uncommon complications, the rationale and need for timely retrieval, and different quality improvement strategies to fulfill this aim

Novel nanorod precipitate formation in neodymium and titanium codoped bismuth ferrite

The discovery of unusual nanorod precipitates in bismuth ferrite doped with Nd and Ti is reported. The atomic structure and chemistry of the nanorods are determined using a combination of high angle annular dark field imaging, electron energy loss spectroscopy, and density functional calculations. It is found that the structure of the BiFeO3 matrix is strongly modified adjacent to the precipitates; the readiness of BiFeO3 to adopt different structural allotropes in turn explains why such a large axial ratio, uncommon in precipitates, is stabilized. In addition, a correlation is found between the alignment of the rods and the orientation of ferroelastic domains in the matrix, which is consistent with the system's attempt to minimize its internal strain. Density functional calculations indicate a finite density of electronic states at the Fermi energy within the rods, suggesting enhanced electrical conductivity along the rod axes, and motivating future investigations of nanorod functionalities

Pulmonary angioplasty: A step further in the continuously changing landscape of chronic thromboembolic pulmonary hypertension management.

Chronic thromboembolic pulmonary hypertension (CTEPH) is a potentially fatal and frequently undiagnosed form of pulmonary hypertension (PH), classified within group 4 by the World Health Organization (WHO). It is a type of precapillary PH, which uncommonly develops as a peculiar sequel of acute pulmonary embolism due to the partial resolution of the mechanically obstructing thrombus with a coexisting inflammatory response from pulmonary vessels. CTEPH is one of the potentially treatable forms of PH whose current standard of care is surgical pulmonary endarterectomy. Medical therapy with few drugs in non-operable disease is approved and has shown improvement in patients' hemodynamic condition and functional ability. Recently, balloon pulmonary angioplasty (BPA) has shown promising results as a treatment option for technically inoperable patients, those with unacceptable risk-to-benefit ratio and in a case of residual PH after endarterectomy. Lack of meticulous CTEPH screening programs in post-pulmonary embolism patients leading to underdiagnosis of this condition, complex operability assessment, and diversity in BPA techniques among different institutions are still the issues that need to be addressed. In this paper, we review the recent achievements in the management of non-operable CTEPH, their outcome and safety, based on available data

Insights into pelvic venous disorders.

Pelvic venous disorders (PeVD), sometimes referred to as pelvic congestion syndrome (PCS), widely impact affected patients-mainly young women's quality of life, causing puzzling, uncomfortable symptoms sometimes requiring months or years to get an explanation, while simply remaining undiagnosed in other cases. Because pelvic pain is a non-specific symptom, an appropriate diagnosis requires a careful patient workup, including a correlation between history and non-invasive imaging. Invasive imaging is frequently required to confirm the diagnosis and plan treatment. Current therapeutic approaches principally rely on minimally invasive techniques delivered through endovascular access. However, while comprehensive descriptive classifications such as the symptoms-varices-pathophysiology (SVP) classification exist, universally accepted guidelines regarding therapy to apply for each SVP category are still lacking. This review strongly focuses on PeVD imaging and discusses available therapeutic approaches with regard to pathophysiological mechanisms. It proposes a new classification scheme assisting clinical decision-making about endovascular management to help standardize the link between imaging findings and treatment

The effect of substrate clamping on the paraelectric to antiferroelectric phase transition in Nd-doped BiFeO₃ thin films

Thin films were deposited on Pt/Ti/SiO₂/Si substrates using pulsed laser deposition from a target with a composition (Bi₀.₈₂₅Nd₀.₁₇₅Fe₀.₉₇Ti₀.₀₃O₃) with 5 mol% excess Bi₂O₃ within the antiferroelectric (AFE) region of the NdFeO₃-BiFeO₃ phase diagram. However, Raman spectroscopy and transmission electron microscopy (TEM) revealed that films consisted of a mosaic microstructure in which (AFE), ferroelectric (FE) and paraelectric (PE) phases coexisted. Variation in the spatial distribution of Nd is typically greater in bulk ceramics than in thin films and therefore, the absence of single phase AFE cannot be attributed to local changes in composition. Instead, it is proposed that clamping due to mismatch in thermal expansion coefficient with the substrate suppresses the large volume change associated with the PE-FE and PE-AFE transition in bulk and its absence in the thin film prevents an avalanche-like transition throughout grains, which in bulk sustains single phase AFE, irrespective of local deviations in the Nd concentration

Agricultural land conversion in Northwest Iran

Agricultural Land Conversion (ALC) has been introduced as one of the most important factors affecting ecosystem. This type of conversion has led to several challenges in agricultural development and human life. Monitoring ALC plays a crucial role when dealing with such challenges. The main objective of this study was to monitor the trend of ALC in the Qazvin province located in Northwest Iran from 1990 to 2010 using remote sensing data. The results showed that 44,845 ha of agricultural lands (3.03% of the total agricultural lands of the province) were converted to non-agricultural lands, of which, 32,033 and 10,243 ha (2.16% and 0.69% of total agricultural lands of the province), were respectively transformed to saline lands and urban areas and infrastructures. Our projection for 2030 shows that among other uses, the conversion of agricultural lands to the saline lands and urban areas and infrastructures will stay most likely. However, the conversion probability for irrigated and orchard lands to urban areas and infrastructures will be more than the saline lands while the conversion probability for dry and rangelands to the saline lands will be more than urban areas and infrastructures

Local stabilisation of polar order at charged antiphase boundaries in antiferroelectric (Bi_0.85Nd_0.15)(Ti_0.1Fe_0.9)O₃

Observation of an unusual, negatively-charged antiphase boundary in (Bi<sub>0.85</sub>Nd<sub>0.15</sub>)(Ti<sub>0.1</sub>Fe<sub>0.9</sub>)O<sub>3</sub> is reported. Aberration corrected scanning transmission electron microscopy is used to establish the full three dimensional structure of this boundary including O-ion positions to ~ ± 10 pm. The charged antiphase boundary stabilises tetragonally distorted regions with a strong polar ordering to either side of the boundary, with a characteristic length scale determined by the excess charge trapped at the boundary. Far away from the boundary the crystal relaxes into the well-known Nd-stabilised antiferroelectric phase

Structured team-oriented program to follow patients after vena cava filter placement: a step forward in improving quality for filter retrieval.

To reduce inferior vena cava filter (IVCF) related complications, retrieval is recommended whenever possible. Nevertheless, IVCF retrieval rates remain lower than expected, likely due to insufficient follow-up after placement. We evaluated the value of a structured program designed to follow patients by the interventional radiology team up to 5 months after IVCF placement. We prospectively enrolled 366 consecutive patients (mean age 64 ± 17 years; 201 men and 165 women) who benefited from IVCF between March 2015 and February 2020. The program consisted of advising the patient and clinicians to consider IVCF retrieval as soon as possible (standard workflow) and systematically planning an additional follow-up visit at 5-month. Clinical and technical eligibility, as well as technical success for retrieval (TSR) were evaluated. At 5-months, 38 (10.4%) patients were lost to follow-up, and 47 (12.8%) had died. Among survivors, the overall retrieval rate was 58%. The retrieval rates were 83% and 97% for the clinically eligible and technically eligible patients for retrieval, respectively. The 5-month visit enabled 89 additional retrievals (47.8%) compared to the standard workflow. No significant difference was seen in TSR before and after 5 months (p = 0.95). Improved patient tracking with a dedicated IVCF program results in an effective process to identify suitable patients for retrieval and drastically improves retrieval rates in eligible patients. Involving interventionalists in the process improved IVCF patient management