Endovascular thrombectomy with or without intravenous thrombolysis for anterior circulation large vessel occlusion in the Imperial College London Thrombectomy Registry

Background and purpose. Mechanical thrombectomy (MT) is the standard of care for eligible patients with a large vessel occlusion (LVO) acute ischemic stroke. Among patients undergoing MT there has been uncertainty regarding the role of intravenous thrombolysis (IVT) and previous trials have yielded conflicting results regarding clinical outcomes. We aim to investigate clinical, reperfusion outcomes and safety of MT with or without IVT for ischemic stroke due to anterior circulation LVO. Materials and Methods. This observational, prospective, single-centre study included consecutive patients with acute LVO ischemic stroke of the anterior circulation. The primary outcomes were the rate of in-hospital mortality, symptomatic intracranial haemorrhage and functional independence (mRS 0–2 at 90 days). Results. We enrolled a total of 577 consecutive patients: 161 (27.9%) were treated with MT alone while 416 (72.1%) underwent IVT and MT. Patients with MT who were treated with IVT had lower rates of in-hospital mortality (p = 0.037), higher TICI reperfusion grades (p = 0.007), similar rates of symptomatic intracranial haemorrhage (p = 0.317) and a higher percentage of functional independence mRS (0–2) at 90 days (p = 0.022). Bridging IVT with MT compared to MT alone was independently associated with a favorable post-intervention TICI score (>2b) (OR, 1.716; 95% CI, 1.076–2.735, p = 0.023). Conclusions. Our findings suggest that combined treatment with MT and IVT is safe and results in increased reperfusion rates as compared to MT alone

Unsolved questions and preferred solution about living will.

Background: Ethical problems about end-of-life medicine include a variety of issues approached in different ways by physicians and, more recently, special emphasis to this kind of ethical issues and possible answers has done by Italian National Ethical Committee in the issue named “Deep and continuous palliative sedation in the imminence of Death” (January, 2016). The debate is very critical in Intensive Care Units and Cancer Wards, where health care professionals face-off with terminally-ill patients is an outright routine; the Authors investigated their medical knowledge and ethical perception about patient critical and terminal condition to discuss the most relevant conclusions. Material: In the Sicilian province of Palermo, physicians working in Intensive Care and Oncology fields were been given a questionnaire that takes inspiration from the Ethicatt Questionnaire-Doctor. The authors reported the results obtained, by selecting and analyzing the most involved questions about living wills. Results: Generally, the respondents showed a great sensibility on this topic. Overall agreement on the living will was observed, as past surveys, but also a new conception. Euthanasia remains not very popular, attitude in line with other countries. Opinions and aptitudes of relatives have minor importance towards patient’s wishes, that are in some cases in first place. Conclusion: Explicit positive answer towards dilemmas about living wills lifts the veil and reveals how these ones would represent a very useful tool for health care professionals in this study. It is also plausible that, if doctors had available an advance directive (living will) document, they would follow it, overcoming any contingent ethical objections

Observing Brownian motion in vibration-fluidized granular matter

At the beginning of last century, Gerlach and Lehrer observed the rotational Brownian motion of a very fine wire immersed in an equilibrium environment, a gas. This simple experiment eventually permitted the full development of one of the most important ideas of equilibrium statistical mechanics: the very complicated many-particle problem of a large number of molecules colliding with the wire, can be represented by two macroscopic parameters only, namely viscosity and the temperature. Can this idea, mathematically developed in the so-called Langevin model and the fluctuation-dissipation theorem be used to describe systems that are far from equilibrium? Here we address the question and reproduce the Gerlach and Lehrer experiment in an archetype non-equilibrium system, by immersing a sensitive torsion oscillator in a granular system of millimetre-size grains, fluidized by strong external vibrations. The vibro-fluidized granular medium is a driven environment, with continuous injection and dissipation of energy, and the immersed oscillator can be seen as analogous to an elastically bound Brownian particle. We show, by measuring the noise and the susceptibility, that the experiment can be treated, in first approximation, with the same formalism as in the equilibrium case, giving experimental access to a ''granular viscosity'' and an ''effective temperature'', however anisotropic and inhomogeneous, and yielding the surprising result that the vibro-fluidized granular matter behaves as a ''thermal'' bath satisfying a fluctuation-dissipation relation

A kinetic study of the basic hydrolysis of 2-phenylethyl nitrite in the presence of borate buffer and β-cyclodextrin

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Wo3 and ionic liquids: A synergic pair for pollutant gas sensing and desulfurization

This review deals with the notable results obtained by the synergy between ionic liquids (ILs) and WO3 in the field of pollutant gas sensing and sulfur removal pretreatment of fuels. Starting from the known characteristics of tungsten trioxide as catalytic material, many authors have proposed the use of ionic liquids in order to both direct WO3 production towards controllable nanostructures (nanorods, nanospheres, etc.) and to modify the metal oxide structure (incorporating ILs) in order to increase the gas adsorption ability and, thus, the catalytic efficiency. Moreover, ionic liquids are able to highly disperse WO3 in composites, thus enhancing the contact surface and the catalytic ability of WO3 in both hydrodesulfurization (HDS) and oxidative desulfurization (ODS) of liquid fuels. In particular, the use of ILs in composite synthesis can direct the hydrogenation process (HDS) towards sulfur compounds rather than towards olefins, thus preserving the octane number of the fuel while highly reducing the sulfur content and, thus, the possibility of air pollution with sulfur oxides. A similar performance enhancement was obtained in ODS, where the high dispersion of WO3 (due to the use of ILs during the synthesis) allows for noteworthy results at very low temperatures (50◦ C)

Polarization and high resolution parametric spectral analisys applied to the seismic signals recorded on the Marsili submarine volcano

The Ocean Bottom Seismometer with Hydrophone deployed by the Gibilmanna OBS Lab (CNT-INGV) from the 12th to the 21st July 2006 on the flat top of the Marsili submarine volcano (790m of depth) recorded more than 1000 seismic events. By comparing them with the ones recorded in other volcanic areas and described in literature (Wassermann, 2002; McNutt, 2002; Díaz et al., 2007), we grouped these events in three categories: 817 VTB (Volcanic-Tectonic type B) events, 159 HF (High Frequency) events and 53 SDE’s (Short Duration Event). Small-magnitude VTB swarms, with frequency band between 2 and 6 Hz and mean time length of about 30 seconds, were almost all recorded in the first 7 days, while in the last 2 days, OBS recorded HF events with frequency band over 40 Hz and few minutes of length. Signals with similar frequency and time domain features are associated, to hydrothermal activity (Ohminato, 2006). The SDE waveform, characterized by a monochromatic signal with a slowly decaying envelope, is generated by oscillations of a resonant body excited by magmatic or hydrothermal activity (Chouet, 1996). We applied, to all the signals dataset, polarization and high resolution parametric spectral analysis. This kind of study allowed to mark the VTB events as multi P-phase events with shallow sources placed in a narrow azimuthal window as regards the OBS/H position. The seismogenetic volume is probably located in the North-East sector of the Marsili building. The high resolution parametric spectral analysis of the SDE signals allowed to find with high accuracy their dominant complex frequencies (!=f+ig). Plotting them in the complex frequencies plane we identified two distinct clusters with middle complex frequencies f=7.8s^−1, g=-0.35s^−1 and f=7.5s^−1, g=-0.47s^−1 respectively. These two clusters are probably linked two different seismogenetic volumes