Randomised trial of excimer laser angioplasty versus balloon angioplasty for treatment of obstructive coronary artery disease

BACKGROUND: Excimer laser coronary angioplasty is reported to give excellent procedural results for treatment of complex coronary lesions, but this method has not been compared with balloon angioplasty in a randomised trial. METHODS: Patients (n = 308) with stable angina and coronary lesions longer than 10 mm on visual assessment were included. 151 patients (158 lesions) were assigned randomly to laser angioplasty and 157 (167 lesions) to balloon angioplasty. The primary clinical endpoints were death, myocardial infarction, coronary bypass surgery, or repeat coronary angioplasty of the randomised segment during 6 months of follow-up. The primary angiographic endpoint was the minimal lumen diameter at follow-up in relation to the baseline value (net gain), as determined by quantitative coronary angiography. FINDINGS: Laser angioplasty was followed by balloon angioplasty in 98% of procedures. The angiographic success rate was 80% in patients treated with laser angioplasty compared with 79% in patients treated with balloon angioplasty. There were no deaths. Myocardial infarction, coronary bypass surgery, and repeat angioplasty occurred in 4.6%, 10.6%, and 21.2%, respectively, of the patients in the laser angioplasty group compared with 5.7%, 10.8%, and 18.5% of the balloon angioplasty group. Net mean (SD) gain in minimal lumen diameter was 0.40 (0.69) mm in patients treated with laser angioplasty and 0.48 (0.66) mm in those treated with balloon angioplasty (p = 0.34). The restenosis rate (> 50% diameter stenosis) was 51.6% in the laser angioplasty group versus 41.3% in the balloon angioplasty group (p = 0.13). INTERPRETATION: Excimer laser angioplasty followed by balloon angioplasty provides no benefit additional to balloon angioplasty alone with respect to the initial and long-term clinical and angiographic outcome in the treatment of obstructive coronary artery diseas

Community compensation in the context of Carbon Capture and Storage: Current debates and practices

Societal opposition has the potential to slow down the implementation of Carbon Capture and Storage (CCS). One of the difficulties is that the perceived benefits associated with a CCS facility for local communities tend to be low compared to its perceived burdens. As is the case for other low carbon technologies, community compensation (or community benefits) has been suggested as a way to restore this perceived imbalance. A diverse literature has looked into the role of community compensation across various land uses and research fields. Synthesis is limited, while at the same time, the provision of community compensation in practice is moving from an ad hoc to a more institutionalized approach. Therefore, it is important to take stock of the literature. This paper provides a review of the community compensation literature in the form of four debates, drawing together environmental social science research on different low carbon technologies (e.g. CCS, renewable energy). In addition, current practices in community compensation for four European countries are discussed. The two parts of this paper are brought together in a set of lessons for the provision of community compensation for future CCS projects; in turn, suggestions for further research are made to address remaining knowledge gaps

NewsReader:Recording history from daily news streams

The European project NewsReader develops technology to process daily news streams in 4 languages, extracting what happened, when, where and who was involved. NewsReader does not just read a single newspaper but massive amounts of news coming from thousands of sources. It compares the results across sources to complement information and determine where they disagree. Further-more, it merges news of today with previous news, creating a long-term history rather than separate events. The result is stored in a KnowledgeStore, that cumulates information over time, producing an extremely large knowledge graph that is visualized using new tech-niques to provide more comprehensive access. We present the first version of the system and the results of processing first batches of data

Innovatie in de publieke sector; goede instrumenten zijn (slechts) het halve werk

Dit hoofdstuk gaat over innovatie in de publieke sector, gericht op verbetering van de efficiëntie en kwaliteit van de dienstverlening, resulterend in betere prestaties. De innovaties die centraal staan, betreffen flexibeler inzet van personeel om extra inhuur te beperken, het stroomlijnen van werkprocessen om doorlooptijden en wachttijden te verkorten en het betrekken van de klantbeleving om processen beter op de klanten te kunnen afstemmen. In een project met de gemeente Lelystad hebben we onderzocht of we deze innovaties konden realiseren met instrumenten die TNO oorspronkelijk ontwikkelde voor toepassing in productieomgevingen en de private markt: de Flextool, LeanPlus en de Customer Journey. De bedoeling was deze instrumenten zodanig toepasbaar te maken, dat de dienstverlening in de publieke sector er aantoonbaar mee kan worden verbeterd. Daarnaast hebben we naar het innovatieproces als zodanig gekeken om in kaart te kunnen brengen waaraan het proces moet voldoen om de instrumenten zo goed mogelijk te benutten. De inzichten over het verbeteren van efficiëntie die het project met de gemeente Lelystad heeft opgeleverd, zijn interessant voor managers, leidinggevenden en consultants die processen in een publieke omgeving willen vernieuwen en verbeteren

On the Organisation of Translation—An Inter- and Transdisciplinary Approach to Developing Design Options for CO<inf>2</inf> Storage Monitoring Systems

Interdisciplinary and transdisciplinary collaboration has become a common practice in technology development projects. Rarely, however, the integration (and translation) of knowledge from different disciplines and different societal contexts is reported in detail. In this article, we address this gap and present the inter- and transdisciplinary technology development in the international research project “DigiMon—Digital Monitoring of CO2 Storage Projects” that aims to develop a human-centered monitoring system. Based on interviews, surveys and stakeholder workshops in Norway, Greece, Germany and The Netherlands, we identify characteristics of CO2 storage monitoring systems that reflect the concerns and expectations of publics and stakeholders. We document the translation of social scientific findings into technical expertise for the design of a monitoring system. We discuss how the interdisciplinary and transdisciplinary process has affected the technology development. In outlining how this process was set up, carried out and validated, we are able to show a viable route for the meaningful incorporation of heterogeneous knowledge in complex energy infrastructures. Furthermore, we discuss the features of the project organization that made this comprehensive process possible. Thus, our results contribute to inter- and transdisciplinary research organization in general and to the development of methods for monitoring CO2 storage in particular.publishedVersio

NewsReader: Recording history from daily news streams

The European project NewsReader develops technology to process daily news streams in 4 languages, extracting what happened, when, where and who was involved. NewsReader does not just read a single newspaper but massive amounts of news coming from thousands of sources. It compares the results across sources to complement information and determine where they disagree. Furthermore, it merges news of today with previous news, creating a long-term history rather than separate events. The result is stored in a KnowledgeStore, that cumulates information over time, producing an extremely large knowledge graph that is visualized using new techniques to provide more comprehensive access. We present the first version of the system and the results of processing first batches of data

Coronary Flow Assessment Using Accelerated 4D Flow MRI With Respiratory Motion Correction

Magnetic resonance imaging (MRI) can potentially be used for non-invasive screening of patients with stable angina pectoris to identify probable obstructive coronary artery disease. MRI-based coronary blood flow quantification has to date only been performed in a 2D fashion, limiting its clinical applicability. In this study, we propose a framework for coronary blood flow quantification using accelerated 4D flow MRI with respiratory motion correction and compressed sensing image reconstruction. We investigate its feasibility and repeatability in healthy subjects at rest. Fourteen healthy subjects received 8 times-accelerated 4D flow MRI covering the left coronary artery (LCA) with an isotropic spatial resolution of 1.0 mm3. Respiratory motion correction was performed based on 1) lung-liver navigator signal, 2) real-time monitoring of foot-head motion of the liver and LCA by a separate acquisition, and 3) rigid image registration to correct for anterior-posterior motion. Time-averaged diastolic LCA flow was determined, as well as time-averaged diastolic maximal velocity (VMAX) and diastolic peak velocity (VPEAK). 2D flow MRI scans of the LCA were acquired for reference. Scan-rescan repeatability and agreement between 4D flow MRI and 2D flow MRI were assessed in terms of concordance correlation coefficient (CCC) and coefficient of variation (CV). The protocol resulted in good visibility of the LCA in 11 out of 14 subjects (six female, five male, aged 28 ± 4 years). The other 3 subjects were excluded from analysis. Time-averaged diastolic LCA flow measured by 4D flow MRI was 1.30 ± 0.39 ml/s and demonstrated good scan-rescan repeatability (CCC/CV = 0.79/20.4%). Time-averaged diastolic VMAX (17.2 ± 3.0 cm/s) and diastolic VPEAK (24.4 ± 6.5 cm/s) demonstrated moderate repeatability (CCC/CV = 0.52/19.0% and 0.68/23.0%, respectively). 4D flow- and 2D flow-based diastolic LCA flow agreed well (CCC/CV = 0.75/20.1%). Agreement between 4D flow MRI and 2D flow MRI was moderate for both diastolic VMAX and VPEAK (CCC/CV = 0.68/20.3% and 0.53/27.0%, respectively). In conclusion, the proposed framework of accelerated 4D flow MRI equipped with respiratory motion correction and compressed sensing image reconstruction enables repeatable diastolic LCA flow quantification that agrees well with 2D flow MRI