Ongoing Geometric Remodeling of the Parent Artery After Flow-Diverter Stent Reconstruction in Cerebral Aneurysms: The Device Design Matters

Objective Configuration changes of the parent artery (PA) after flow-diverter (FD) stent reconstruction, caused by the bending force of the device, may have an additional role in aneurysm occlusion as a result of the secondary alteration of intra-aneurysmal hemodynamics related to the geometry alteration of the vessel. To determine the degree of PA deformation and aneurysm occlusion rates after deployment of 2 different types of FD. Methods Patients treated with 2 different designs of cobalt-chromium braid (48 and 64 wire braid) structure FD were subject to analysis. Vascular angle changes at the level of the reconstructed segment immediately after FD deployment and at 1 year follow-up were measured and the potential relationship with aneurysmal occlusion rate was analyzed. Results Forty-two patients harboring 48 aneurysms were included in the present study. The aneurysms were divided into side wall (85.4%) and bifurcation types (14.6%). Twenty-six aneurysms were treated using the Pipeline FD (48 wire braid; 54.2%) and 22 using the Evolve FD (64 wire braid; 45.8%). Of the 48 aneurysms, 42 (87.5%) met the primary end point of complete occlusion at 12 months. The median postdeployment angle change was 7.04°± 4.59° for the Pipeline and 5.05°± 2.49° for the Evolve, whereas the median 12 months follow-up angle change was 15.49°± 10.99° and 10.01°± 8.83°, respectively. PA angle changes were significantly higher in the bifurcation group compared with the side wall group both during procedure and at 12 months follow-up. Angle change had a statistically nonsignificant association with complete aneurysm occlusion. Conclusions PA deformation starts immediately after deployment and remodeling continues for 1 year after. Aneurysms located in the vessel bifurcation were more prone to PA straightening after FD deployment than were side wall aneurysms. Furthermore, Pipeline seemed to be more prone to inducing vascular deformation, compared with Evolve

Single antiplatelet regimen in flow diverter treatment of cerebral aneurysms: The drug matters. A systematic review and meta-analysis

BACKGROUND Hemorrhagic and thromboembolic complications (TECs) are the main concerns in the endovascular treatment of intracranial aneurysms using flow diverter devices (FDs). The clinical demand for single antiplatelet therapy (SAPT) is increasing especially with the development of devices with lower thrombogenicity profile. However, the safety of SAPT is not well established. OBJECTIVE To analyze the safety and efficacy of SAPT in terms of ischemic and hemorrhagic complications in patients undergoing FDs treatment for cerebral aneurysms. METHODS A systematic literature search and meta-analysis were conducted in PubMed, Ovid MEDLINE, Ovid Embase, and Web of Science from January 2010 until October 2022. Twelve articles which reported SAPT and data on hemorrhagic, TECs, and mortality following FDs treatment were included. RESULTS Overall, the 12 studies involved 237 patients with 295 aneurysms. Five investigated the safety and efficacy of SAPT in 202 unruptured aneurysms. Six studies focused on 57 ruptured aneurysms. One study included both ruptured and unruptured aneurysms. Among the 237 patients, prasugrel was most often used as SAPT in 168 cases (70.9%), followed by aspirin in 42 (17.7%) patients, and by ticagrelor in 27 (11.4%). Overall, the hemorrhagic complication rate was 0.1% (95% CI 0% to 1.8%). The TEC rate was 7.6% (95% CI 1.7% to 16.1%). In the subgroup analysis, the TEC rates of prasugrel monotherapy of 2.4% (95% CI 0% to 9.3%) and ticagrelor monotherapy of 4.2% (95% CI 0.1% to 21.1%) were lower than of aspirin monotherapy 20.2% (95% CI 5.9% to 38.6%). The overall mortality rate was 1.3% (95% CI 0% to 6.1%). CONCLUSION According to the available data, SAPT regimen in patients undergoing FDs treatment for cerebral aneurysms has an acceptable safety profile, especially with the use of ADP-receptor antagonists

Non-Thermal Plasma Activation of Gold-Based Catalysts for Low-Temperature Water-Gas Shift Catalysis

Acknowledgements The UK Catalysis Hub is kindly thanked for resources and support provided via our membership of the UK Catalysis Hub Consortium and funded by EPSRC (Portfolio Grants EP/K014706/2, EP/K014668/1, EP/K014854/1, EP/K014714/1, and EP/I019693/1). Open access data can be found via the University of Manchester research portal. We are grateful to Helen Daly (Queen's University Belfast) for discussion, to Fabio de Rosa (Queen's University Belfast) for the thermodynamic equilibrium calculations (obtained using the Convergence tool of Aspen Plus 8.0) and to Emma Gibson (Harwell Research Complex) for the BET measurements. JJ Delgado is grateful to Ramon y Cajal program and the Ce-NanoSurPhases project grant from MINECO.Peer reviewedPostprintPostprintPublisher PD

Managing active pharmaceutical ingredient raw material variability during twin-screw blend feeding

Continuous powder feeding is a critical step in continuous manufacturing of solid dosage forms, as this unit operation should ensure the mass flow consistency at the desired powder feed rate to guarantee the process throughput and final product consistency. In this study, twin-screw feeding of a pharmaceutical formulation (i.e., blend) existing of a highly dosed very poorly flowing active pharmaceutical ingredient (API) leading to insufficient feeding capacity was investigated. Furthermore, the API showed very high batch-to-batch variability in raw material properties dominating the formulation blend properties. Formulation changes were evaluated to improve the flowability of the blends and to mitigate the impact of API batch-to-batch variability on the twin-screw feeding. Herewith, feeding evaluation tests and an extensive material characterization of the reformulated blends were performed to assess the impact of the formulation changes upon continuous twin-screw feeding. The transfer of the glidant from extra-granular to intra-granular phase allowed to improve the flowability of the blends. A sufficient feeding capacity for the downstream process and a mitigation of the impact of batch-to-batch variability of the API upon twin-screw feeding of the blends could be achieved. No effect of the formulation or of the API properties on the feeding stability was observed. The material characterization of the blends allowed identifying the material attributes which were critical for continuous twin-screw feeding (i.e., bulk density, mass charge and powder cohesiveness)

Summing Feynman diagrams in the worldline formalism

The worldline formalism shares with string theory the property that it allows one to write down master integrals that effectively combine the contributions of many Feynman diagrams. While at the one-loop level these diagrams differ only by the position of the external legs along a fixed line or loop, at multiloop they generally involve different topologies. Here we summarize various efforts that have been made over the years to exploit this property in a computationally meaningful way. As a first example, we show how to generalize the Landau-Khalatnikov-Fradkin formula for the non-perturbative gauge transformation of the fermion propagator in QED to the general 2n - point case by pure manipulations at the path-integral level. At the parameter-integral level, we show how to integrate out individual photons in the low-energy expansion, and then sketch a recently introduced general framework for the analytical evaluation of such worldline integrals involving a reduction to quantum mechanics on the circle and the relation between inverse derivatives and Bernoulli polynomials

Motional sidebands and direct measurement of the cooling rate in the resonance fluorescence of a single trapped ion

Resonance fluorescence of a single trapped ion is spectrally analyzed using a heterodyne technique. Motional sidebands due to the oscillation of the ion in the harmonic trap potential are observed in the fluorescence spectrum. From the width of the sidebands the cooling rate is obtained and found to be in agreement with the theoretical prediction.Comment: 4 pages, 4 figures. Final version after minor changes, 1 figure replaced; to be published in PRL, July 10, 200

Thermal Bremsstrahlung photons probing the nuclear caloric curve

Hard-photon (E$_{\gamma}>$ 30 MeV) emission from second-chance nucleon-nucleon Bremsstrahlung collisions in intermediate energy heavy-ion reactions is studied employing a realistic thermal model. Photon spectra and yields measured in several nucleus-nucleus reactions are consistent with an emission from hot nuclear systems with temperatures $T\approx$ 4 - 7 MeV. The corresponding caloric curve in the region of excitation energies $\epsilon^\star\approx$ 3{\it A} - 8{\it A} MeV shows lower values of $T$ than those expected for a Fermi fluid.Comment: 13 pages, 3 figures. To appear in Physics Letters

The role of sociocultural perspectives in eating disorder treatment: A study of health professionals

Eating disorders are now often approached as biopsychosocial problems, because they are widely recognised as multifactorial in origin. However, it has been suggested that there is a substantial and unwarranted imbalance within this biopsychosocial framework, with the ‘social’ aspects of the equation relegated to secondary or facilitating factors within treatment contexts. Drawing on data from 12 qualitative interviews with health professionals in a UK region, this article examines the extent to which sociocultural perspectives on eating disorders are valued and explored in eating disorder treatment, with a particular focus on the relationship between eating disorders and gender. As girls/women are widely acknowledged to be disproportionately affected by eating problems, the article draws on feminist perspectives on eating disorders to explore whether the relationships between cultural constructions of femininity and experiences of body/eating distress are actively addressed within treatment. The study reveals high levels of inconsistency in this regard, as while some participants see such issues as central to treatment, others have ‘never really considered’ them before. In addition, the study examines the potential limitations of how such sociocultural issues are conceptualised and addressed, as well as why they might be marginalised in the current climate of evidence-based eating disorder treatment. The article then considers the implications of the findings for thinking about feminist perspectives on eating disorders – and the significance of gender in treatment – at the level of both research and practice