World Federation for Interventional Stroke Treatment (WIST) multispecialty training guidelines for endovascular stroke intervention

IntroductionToday, endovascular treatment (EVT) is the therapy of choice for strokes due to acute large vessel occlusion, irrespective of prior thrombolysis. This necessitates fast, coordinated multi-specialty collaboration. Currently, in most countries, the number of physicians and centres with expertise in EVT is limited. Thus, only a small proportion of eligible patients receive this potentially life-saving therapy, often after significant delays. Hence, there is an unmet need to train a sufficient number of physicians and centres in acute stroke intervention in order to allow widespread and timely access to EVT.AimTo provide multi-specialty training guidelines for competency, accreditation and certification of centres and physicians in EVT for acute large vessel occlusion strokes.Material and methodsThe World Federation for Interventional Stroke Treatment (WIST) consists of experts in the field of endovascular stroke treatment. This interdisciplinary working group developed competency – rather than time-based – guidelines for operator training, taking into consideration trainees' previous skillsets and experience. Existing training concepts from mostly single specialty organizations were analysed and incorporated.ResultsThe WIST establishes an individualized approach to acquiring clinical knowledge and procedural skills to meet the competency requirements for certification of interventionalists of various disciplines and stroke centres in EVT. WIST guidelines encourage acquisition of skills using innovative training methods such as structured supervised high-fidelity simulation and procedural performance on human perfused cadaveric models.ConclusionsWIST multispecialty guidelines outline competency and quality standards for physicians and centres to perform safe and effective EVT. The role of quality control and quality assurance is highlighted

On weighted estimates of solutions of nonlinear elliptic problems

summary:The paper is devoted to the estimate \vert u(x,k)\vert\leq K\vert k\vert\left\{\mathop cap\nolimits_{p,w}(F)\frac{\rho^p}{w(B(x,\rho))}\right\} ^{\frac1{p-1}}, 2\ for a solution of a degenerate nonlinear elliptic equation in a domain ${B(x_0,1)\setminus F}$, $F\subset B(x_0,d)=\{x\in\Bbb R^n |x_0-x|<d\}$, $d<\frac12$, under the boundary-value conditions $u(x,k)=k$ for $x\in\partial F$, $u(x,k)=0$ for $x\in\partial B(x_0,1)$ and where $0<\rho\leq\mathop dist(x,F)$, $w(x)$ is a weighted function from some Muckenhoupt class, and $\mathop cap_{p,w}(F)$, $w(B(x,\rho))$ are weighted capacity and measure of the corresponding sets

Photonics of <i>Viburnum opulus</i> L. Extracts in Microemulsions with Oxygen and Gold Nanoparticles

In this paper, the optical properties of viburnum extract flavonoids in the visible region of the spectrum were investigated and their use as a potential photosensitizer of singlet oxygen for photodynamic therapy was evaluated. The presence of long-lived excited states in the extract molecules was established by spectral methods and time-resolved spectroscopy methods and the dependences of the absorption capacity and luminescence intensity of the extract molecules on the concentrations of oxygen and ablative nanoparticles of the gold in the reverse micelles of AOT (sodium dioctyl sulfosuccinate) were established. The plasmonic enhancement of the luminescence of the extract molecules and the processes of their complexation with oxygen were also established. Furthermore, the rate constants of the processes of conversion of exciting energy in complexes were determined

Polyphasic characterization of the thermotolerant cyanobacterium Desertifilum sp. strain IPPAS B-1220

A cyanobacterial strain from Lake Shar-Nuur, a freshwater lake in Mongolia, was isolated and characterized by a polyphasic approach. According to the 16S ribosomal RNA gene sequence, this strain (IPPAS B-1220) belongs to a newly described genus Desertifilum. In general, strains of Desertifilum maintain their genetic stability, as seen from the analysis of the 16S rRNA gene and 16S-23S rRNA internal transcribed spacer sequences from strains collected at distant locations. The newly discovered strain is characterized by an unusual fatty acid composition (16:1Δ7 and 16:2Δ7,10). Analysis of its draft genomic sequence reveals the presence of six genes for the acyl-lipid desaturases: two Δ9-desaturases, desC1 and desC2; two Δ12-desaturases, desA1 and desA2; one desaturase of unknown specificity, desX; and one gene for the bacillary-type desaturase, desG, which supposedly encodes an ω9-desaturase. A scheme for a fatty acid desaturation pathway that describes the biosynthesis of 16:1Δ7 and 16:2Δ7,10 fatty acids in Desertifilum is proposed

Identifying Performance Descriptors in CO2CO_2 Hydrogenation over Iron‐based Catalysts Promoted with Alkali Metals

Alkali metal promoters have been widely employed for preparation of heterogeneous catalysts used in many industrially important reactions. However, the fundamentals of their effects are usually difficult to access. Herein, we unravel mechanistic and kinetic aspects of the role of alkali metals in CO$_2$ hydrogenation over Fe-based catalysts through the state-of-the-art characterization techniques, spatially resolved steady-state and transient kinetic analyses. The promoters affect electronic properties of iron in iron carbides. These carbide characteristics determine catalyst ability to activate H$_2$ , CO and CO$_2$. The Allen scale electronegativity of alkali metal promoter was successfully correlated with the rates of CO$_2$ hydrogenation to higher hydrocarbons and CH$_4$ as well as with the rate constants of individual steps of CO or CO$_2$ activation . The derived knowledge can be valuable for designing and preparation of catalysts applied in other reactions where such promoters are also used

Identifying Performance Descriptors in CO2 Hydrogenation over Iron‐based Catalysts Promoted with Alkali Metals

Alkali metal promoters have been widely employed for preparation of heterogeneous catalysts used in many industrially important reactions. However, the fundamentals of their effects are usually difficult to access. Herein, we unravel mechanistic and kinetic aspects of the role of alkali metals in CO(2) hydrogenation over Fe‐based catalysts through state‐of‐the‐art characterization techniques, spatially resolved steady‐state and transient kinetic analyses. The promoters affect electronic properties of iron in iron carbides. These carbide characteristics determine catalyst ability to activate H(2), CO and CO(2). The Allen scale electronegativity of alkali metal promoter was successfully correlated with the rates of CO(2) hydrogenation to higher hydrocarbons and CH(4) as well as with the rate constants of individual steps of CO or CO(2) activation. The derived knowledge can be valuable for designing and preparing catalysts applied in other reactions where such promoters are also used

Endovascular Treatment of Acute Ischemic Stroke With the Penumbra System in Routine Practice: COMPLETE Registry Results

The purpose of the COMPLETE (International Acute Ischemic Stroke Registry With the Penumbra System Aspiration Including the 3D Revascularization Device) registry was to evaluate the generalizability of the safety and efficacy of the Penumbra System (Penumbra, Inc, Alameda) in a real-world setting. COMPLETE was a global, prospective, postmarket, multicenter registry. Patients with large vessel occlusion-acute ischemic stroke who underwent mechanical thrombectomy using the Penumbra System with or without the 3D Revascularization Device as frontline approach were enrolled at 42 centers (29 United States, 13 Europe) from July 2018 to October 2019. Primary efficacy end points were successful postprocedure angiographic revascularization (modified Thrombolysis in Cerebral Infarction ≥2b) and 90-day functional outcome (modified Rankin Scale score 0-2). The primary safety end point was 90-day all-cause mortality. An imaging core lab determined modified Thrombolysis in Cerebral Infarction scores, Alberta Stroke Program Early CT Scores, clot location, and occurrence of intracranial hemorrhage at 24 hours. Independent medical reviewers adjudicated safety end points. Six hundred fifty patients were enrolled (median age 70 years, 54.0% female, 49.2% given intravenous recombinant tissue-type plasminogen activator before thrombectomy). Rate of modified Thrombolysis in Cerebral Infarction 2b to 3 postprocedure was 87.8% (95% CI, 85.3%-90.4%). First pass and postprocedure rates of modified Thrombolysis in Cerebral Infarction 2c to 3 were 41.5% and 66.2%, respectively. At 90 days, 55.8% (95% CI, 51.9%-59.7%) had modified Rankin Scale score 0 to 2, and all-cause mortality was 15.5% (95% CI, 12.8%-18.3%). Using Penumbra System for frontline mechanical thrombectomy treatment of patients with large vessel occlusion-acute ischemic stroke in a real-world setting was associated with angiographic, clinical, and safety outcomes that were comparable to prior randomized clinical trials with stringent site and operator selection criteria. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03464565