Mechanisms to explain the poor results of carotid artery stenting (CAS) in symptomatic patients to date and options to improve CAS outcomes

BackgroundCarotid artery stenting (CAS) is considered by many as an alternative to carotid endarterectomy (CEA) for the management of carotid artery stenosis. However, recent trials demonstrated inferior results for CAS in symptomatic patients compared with CEA. We reviewed the literature to evaluate the appropriateness of CAS for symptomatic carotid artery stenosis and to determine the pathogenetic mechanism(s) associated with stroke following the treatment of such lesions. Based on this, we propose steps to improve the results of CAS for the treatment of symptomatic carotid stenosis.MethodsPubMed/Medline was searched up to March 25, 2010 for studies investigating the efficacy of CAS for the management of symptomatic carotid stenosis. Search terms used were “carotid artery stenting,” “symptomatic carotid artery stenosis,” “carotid endarterectomy,” “stroke,” “recurrent carotid stenosis,” and “long-term results” in various combinations.ResultsCurrent data suggest that CAS is not equivalent to CEA for the treatment of symptomatic carotid stenosis. Differences in carotid plaque morphology and a higher incidence of microemboli and cerebrovascular events during and after CAS compared with CEA may account for these inferior results.ConclusionsCurrently, most symptomatic patients are inappropriate candidates for CAS. Improved CAS technology referable to stent design and embolic protection strategies may alter this conclusion in the future

Lepton Flavor Violation: Constraints from exotic muon to electron conversion

The exotic neutrinoless $\mu^- - e^-$ nuclear conversion is studied within the conventional extensions of the standard model as well as in the minimal supersymmetric (SUSY) models with and without R-parity conservation. The dependence of the $\mu^- - e^-$ conversion rates on the nucleon and nuclear structure is consistently taken into account. Using our calculated transition matrix elements and the available experimental data on the branching ratio $R_{\mu e^-}$ for $^{48}$Ti and $^{208}$Pb as well as the expected experimental sensitivity for $^{27}$Al employed as a target in the planned at Brookhaven $\mu^--e^-$ conversion (MECO) experiment, we extract very severe constraints for the flavor violation parameters. We especially emphasize on the constraints resulting for SUSY R-parity violating parameters.Comment: 14 pages, 2 figures. Based on the Invited talk given by T.S. Kosmas at the International Conference on Non-Accelerator New Physics(NANP'99), Dubna, Russia, 199

The Impact of Lower Extremity Venous Ulcers due to Chronic Venous Insufficiency on Quality of Life

Lower extremity venous ulcers comprise a complex medical and social issue. The conservative and/or surgical management of venous ulcers is often inadequate. In addition, the psychosocial aspect of the disease is often overlooked and most often undertreated. Common symptoms such as pain, low self-esteem and patient isolation are usually not recognized and therefore not adequately managed

Cold Dark Matter in SUSY Theories. The Role of Nuclear Form Factors and the Folding with the LSP Velocity

The momentum transfer dependence of the total cross section for elastic scattering of cold dark matter candidates, i.e. lightest supersymmetric particle (LSP), with nuclei is examined. The presented calculations of the event rates refer to a number of representative nuclear targets throughout the periodic table and have been obtained in a relatively wide phenomenologically allowed SUSY parameter space. For the coherent cross sections it is shown that, since the momentum transfer can be quite big for large mass of the LSP and heavy nuclei even though the energy transfer is small ($\le 100 KeV$), the total cross section can in such instances be reduced by a factor of about five. For the spin induced cross section of odd-A nuclear targets, as is the case of $^{207}Pb$ studied in this work, we found that the reduction is less pronounced, since the high multipoles tend to enhance the cross section as the momentum transfer increases (for LSP $mass < 200 GeV$) and partially cancell the momentum retardation. The effect of the Earth's revolution around the sun on these event rates is also studied by folding with a Maxwellian LSP-velocity distribution which is consistent with its density in the halos. We thus found that the convoluted event rates do not appreciably change compared to those obtained with an average velocity. The event rates increase with A and, in the SUSY parameter space considered, they can reach values up to 140 $y^{-1}Kg^{-1}$ for Pb. The modulation effect, however, was found to be small (less than $\pm 5$).Comment: 23 LATEX pages, 4 Tables, 3 PostScript Figures included. Phys. Rev. D, to be publishe

ROTATIONAL-DYNAMICS OF SOLID C-70 - A NEUTRON-SCATTERING STUDY

PMID: 10011126PMID: 10011126 This work at the University of Sussex at supported by the Science and Engineering Research Council, U.K.PMID: 10011126 This work at the University of Sussex at supported by the Science and Engineering Research Council, U.K.PMID: 10011126 This work at the University of Sussex at supported by the Science and Engineering Research Council, U.K.We report the results of neutron-diffraction and low-energy neutron-inelastic-scattering experiments on high-purity solid C-70 between 10 and 640 K. Thermal hysteresis effects are found to accompany structural changes both on cooling and on heating. The observed diffuse scattering intensity does not change with temperature. At 10 K broad librational peaks are observed at 1.82(16) meV [full width at half maximum=1.8(5) meV]. The peaks soften and broaden further with increasing temperature. At and above room temperature, they collapse into a single quasielastic line. At 300 K, the diffusive reorientational motion appears to be somewhat anisotropic, becoming less so with increasing temperature. An isotropic rotational diffusion model, in which the motions of adjacent molecules are uncorrelated, describes well the results at 525 K. The temperature dependence of the rotational diffusion constants is consistent with a thermally activated process having an activation energy of 32(7) meV.This work at the University of Sussex at supported by the Science and Engineering Research Council, U.K

Modulation effect in the differential rate for Supersymmetric Dark Matter detection

The modulation effect in the direct detection of supersymmetric Cold Dark Matter (CDM) particles is investigated. It is shown that, while normally the modulation effect in the total event rate is small, $\leq 5$, in some special cases it becomes much larger. It also becomes more pronounced in the differential event rate. It may thus be exploited to discriminate against background.Comment: 17 LATEX pages, 4 Tables, 4 PostScript Figures included. Phys. Rev. D, to be publishe

Coherent pion production in neutrino nucleus collision in the 1 GeV region

We calculate cross sections for coherent pion production in nuclei induced by neutrinos and antineutrinos of the electron and muon type. The analogies and differences between this process and the related ones of coherent pion production induced by photons, or the (p,n) and $(^3 He, t)$ reactions are discussed. The process is one of the several ones occurring for intermediate energy neutrinos, to be considered when detecting atmospheric neutrinos. For this purpose the results shown here can be easily extrapolated to other energies and other nuclei.Comment: 13 pages, LaTex, 8 post-script figures available at [email protected]

U(1) textures and Lepton Flavor Violation

U(1) family symmetries have led to successful predictions of the fermion mass spectrum and the mixing angles of the hadronic sector. In the context of the supersymmetric unified theories, they further imply a non-trivial mass structure for the scalar partners, giving rise to new sources of flavor violation. In the present work, lepton flavor non-conserving processes are examined in the context of the minimal supersymmetric standard model augmented by a U(1)-family symmetry. We calculate the mixing effects on the \mu-> e\gamma and \tau -> \mu\gamma rare decays. All supersymmetric scalar masses involved in the processes are determined at low energies using two loop renormalization group analysis and threshold corrections. Further, various novel effects are considered and found to have important impact on the branching ratios. Thus, a rather interesting result is that when the see-saw mechanism is applied in the (12 X 12)-sneutrino mass matrix, the mixing effects of the Dirac matrix in the effective light sneutrino sector are canceled at first order. In this class of models and for the case that soft term mixing is already present at the GUT scale, tau -> \mu \gamma decays are mostly expected to arise at rates significantly smaller than the current experimental limits. On the other hand, the \mu \ra e \gamma rare decays impose important bounds on the model parameters, particularly on the supersymmetric scalar mass spectrum. In the absence of soft term mixing at high energies, the predicted branching ratios for rare decays are, as expected, well below the experimental bounds.Comment: 24p, 10 figures, version to appear in Phys. Rev.

Searching for Supersymmetric Dark Matter - The Directional Rate and the Modulation Effect Due to Caustic Rings

The detection of the theoretically expected dark matter is central to particle physics and cosmology. Current fashionable supersymmetric models provide a natural dark matter candidate which is the lightest supersymmetric particle (LSP). The allowed parameter space of such models combined with fairly well understood physics (quark substructure of the nucleon and nuclear structure) permit the evaluation of the event rate for LSP-nucleus elastic scattering. The thus obtained event rates, which sensitively depend on the allowed parameter space parameters, are usually very low or even undetectable. So, for background reduction, one would like to exploit two nice features of the reaction, the directional rate, which depends on the sun's direction of motion and the modulation effect, i.e. the dependence of the event rate on the earth's annual motion. In the present paper we study these phenomena in a specific class of non isothermal models, which take into account the late in-fall of dark matter into our galaxy, producing flows of caustic rings. We find that the modulation effect arising from such models is smaller than that found previously with isothermal symmetric velocity distributions and much smaller compared to that obtained using a realistic asymmetric distribution with enhanced dispersion in the galactocentric direction.Comment: 31 LATEX pages, 2 tables and 1 figure included. Accepted for publication in Physical Review