Late Evaluation of Silent Cerebral Ischemia Detected by Diffusion-Weighted MR Imaging after Filter-Protected Carotid Artery Stenting

BACKGROUND AND PURPOSE: Postoperative diffusion-weighted MR imaging (DWI) often discloses new lesions after carotid artery stent placement (CAS), most of them asymptomatic. Our aim was to investigate the fate of these silent ischemic lesions. MATERIALS AND METHODS: We prospectively studied 110 patients undergoing protected transfemoral CAS, 98 of whom underwent DWI before and after the intervention. Patients in whom DWI disclosed silent postoperative lesions also had delayed MR imaging. Preoperative, postoperative, and delayed scans were compared. RESULTS: Of the 92 patients without postoperative symptoms, DWI disclosed 33 new silent ischemic lesions in 14 patients (15.2%), 13 of whom (30 lesions) underwent delayed MR imaging after a mean follow-up of 6.2 months. In 8 of these 13 patients (61%), MR imaging disclosed 12 persistent lesions (12/30, 40%). The reversibility rate depended significantly on the location (cortical versus subcortical) and size (0–5 versus 5–10 mm) of the lesions ( P χ 2 test). CONCLUSIONS: Because many silent ischemic lesions seen on postoperative DWI after CAS reverse within months, the extent of permanent CAS-related cerebral damage may be overestimated

Reliability and resilience of wastewater networks

The wastewater network is a critical infrastructure in a community and damages or disruption due to a hazard event implicate consequences in the economic security, public health and wellness of the community. Therefore, using an index to evaluate the vulnerability and the functionality of the system is essential for designers and utility managers for the design, operation and protection of wastewater network. In this paper, a functionality index for the wastewater network has been proposed that is the product of three different indices: (i) the number of users still connected to the system, (ii) the quality of sewer discharge into the water body after the treatment, in term of two pollutants, biochemical oxygen demand and total suspended solids, and (iii) the presence of leaks into the network. Seaside, a small city in Oregon, in the West cost of USA has been selected as case of study using an earthquake scenario and a restoration plan. The results show the critical elements of the networks that under the observed operating conditions would not be able to present reliable performances. Using the proposed indices in a decision support tool for governmental agencies could give guidelines for the restoration of elements that have more weight in the functionality of the system

Light-emitting textiles: Device architectures, working principles, and applications

E-textiles represent an emerging technology aiming toward the development of fabric with augmented functionalities, enabling the integration of displays, sensors, and other electronic components into textiles. Healthcare, protective clothing, fashion, and sports are a few examples application areas of e-textiles. Light-emitting textiles can have different applications: Sensing, fashion, visual communication, light therapy, etc. Light emission can be integrated with textiles in different ways: Fabricating light-emitting fibers and planar light-emitting textiles or employing side-emitting polymer optical fibers (POFs) coupled with light-emitting diodes (LEDs). Different kinds of technology have been investigated: Alternating current electroluminescent devices (ACELs), inorganic and organic LEDs, and light-emitting electrochemical cells (LECs). The different device working principles and architectures are discussed in this review, highlighting the most relevant aspects and the possible approaches for their integration with textiles. Regarding POFs, the methodology to obtain side emissions and the critical aspects for their integration into textiles are discussed in this review. The main applications of light-emitting fabrics are illustrated, demonstrating that LEDs, alone or coupled with POFs, represent the most robust technology. On the other hand, OLEDs (Organic LEDs) are very promising for the future of light-emitting fabrics, but some issues still need to be addressed

Seismic Damage Assessment of a Virtual Large Scale City Model

Recent social developments and economic transformation have changed the engineering design approach from building design level towards community design level (city, region, country). The latter approach involves modeling of interconnections between different systems (buildings, transportation, water network, etc.) rather than designing the buildings individually. Thus, new analysis tools are expected to be developed to simulate the complex response of a community subsequently to disasters. The need of such rational tools is the object of this research work. Two different numerical approaches to simulate the response of a large-scale built envi-ronment after a seismic scenario are explored by developing multipurpose numerical codes. A district of a vir-tual city is considered as a case study and the level of damage for built environment is estimated. This work could be the first step for further urban loss analysis, e.g. through agent-based models that could be updated online with the proposed simulation

Modulating Thermal Properties of Polymers through Crystal Engineering

Crystal engineering has exclusively focused on the development of advanced materials based on small organic molecules. We now demonstrate how the cocrystallization of a polymer yields a material with significantly enhanced thermal stability but equivalent mechanical flexibility. Isomorphous replacement of one of the cocrystal components enables the formation of solid solutions with melting points that can be readily fine-tuned over a usefully wide temperature range. The results of this study credibly extend the scope of crystal engineering and cocrystallization from small molecules to polymers

Modulating Thermal Properties of Polymers through Crystal Engineering

Crystal engineering has exclusively focused on the development of advanced materials based on small organic molecules. We now demonstrate how the cocrystallization of a polymer yields a material with significantly enhanced thermal stability but equivalent mechanical flexibility. Isomorphous replacement of one of the cocrystal components enables the formation of solid solutions with melting points that can be readily fine-tuned over a usefully wide temperature range. The results of this study credibly extend the scope of crystal engineering and cocrystallization from small molecules to polymers

Discharge FGF23 level predicts one year outcome in patients admitted with acute heart failure

Background: Patients with acute heart failure (AHF) show high levels of fibroblast growth factor-23 (FGF23) on admission. We examined if plasma FGF23 changes during an episode of AHF, and if FGF23 holds prognostic significance in this setting. Methods: Consecutive AHF patients were enrolled. Blood samples were collected on admission and at discharge. Patients were then followed for all-cause death or HF hospitalization. Results: Patients (n = 125; median age 76 years [interquartile interval 71–83], 63% men, left ventricular ejection fraction 35% [25%–56%]) had median admission FGF23 70 ng/L (47–100), N-terminal pro-B-type natriuretic peptide (NT-proBNP) 5844 ng/L (2,503-10,468), high-sensitivity troponin T (hs-TnT) 40 ng/L (25–72), and soluble suppression of tumorigenesis-2 (sST2) 26 ng/mL (17–37). While other biomarkers decreased, FGF23 increased by 15% from admission to discharge (p = 0.033), with a significant correlation with percent changes in estimated glomerular filtration rate (rho = 0.306, p = 0.001). Over a 12-month follow-up, 64 patients (51%) experienced the endpoint. They were more often men, older, with higher systolic pulmonary artery pressure (sPAP), higher NT-proBNP, hs-TnT and discharge FGF23. The best FGF23 cut-off at discharge from receiver operating characteristics analysis was 78 ng/L. Both discharge FGF23 and the 78 ng/L cut-off independently predicted outcome in models including gender, sPAP, age, and 1) admission NT-proBNP, 2) discharge NT-proBNP, 3) admission NT-proBNP and hs-TnT, 4) discharge NT-proBNP and hs-TnT. The 78 ng/L cut-off also refined risk reclassification. Conclusions: During an AHF episode, FGF23 increases from admission to discharge, and patients with higher discharge FGF23 have a higher risk of worse outcome

Pre-surgery supportive and goal-oriented strategies are associated with lower post-surgery perceived distress in women diagnosed with breast cancer

Background: Psycho-oncology literature pointed out that individual health outcomes may depend on patients’ propensity to adopt approach or, conversely, avoidant coping strategies. Nevertheless, coping factors associated with postoperative distress remain unclear, unfolding the lack of tailored procedures to help breast cancer patients manage the psychological burden of scheduled surgery. In view of this, the present study aimed at investigating: 1. pre-/post-surgery distress variations occurring among women diagnosed with breast cancer; 2. the predictivity of approach and avoidant coping strategies and factors in affecting post-surgery perceived distress. Methods: N = 150 patients (mean age = 59.37; SD = ± 13.23) scheduled for breast cancer surgery were administered a screening protocol consisting of the Distress Thermometer (DT) and the Brief-COPE. The DT was used to monitor patients’ distress levels before and after surgery (± 7 days), whereas the Brief-COPE was adopted only preoperatively to evaluate patients’ coping responses to the forthcoming surgical intervention. Non-parametric tests allowed for the detection of pre-/post-surgery variations in patients’ perceived distress. Factor analysis involved the extraction and rotation of principal components derived from the Brief-COPE strategies. The predictivity of such coping factors was investigated through multiple regression (Backward Elimination). Results: The Wilcoxon Signed-Rank Test yielded a significant variation in DT mean scores (TW = -5,68 < -zα/2 = -1,96; p <.001) indicative of lower perceived distress following surgery. The four coping factors extracted and Varimax-rotated were, respectively: 1. cognitive processing (i.e., planning + acceptance + active coping + positive reframing); 2. support provision (i.e., instrumental + emotional support); 3. emotion-oriented detachment (i.e., self-blame + behavioral disengagement + humor + denial); 4. goal-oriented detachment (i.e., self-distraction). Among these factors, support provision (B =.458; β = −.174; t = − 2.03; p =.045), encompassing two approach coping strategies, and goal-oriented detachment (B =.446; β = −.176; t = − 2.06; p =.042), consisting of one avoidant strategy, were strongly related to post-surgery distress reduction. Conclusion: The present investigation revealed that the pre-surgery adoption of supportive and goal-oriented strategies led to postoperative distress reduction among breast cancer patients. These findings highlight the importance of timely psychosocial screening and proactive interventions in order to improve patients’ recovery and prognosis

Involvement of the genicular branches in cystic adventitial disease of the popliteal artery as a possible marker of unfavourable early clinical outcome: a case report

<p>Abstract</p> <p>Introduction</p> <p>Cystic adventitial disease of the popliteal artery is a rare cause of non-atheromatous claudication. It usually requires surgery to improve the distance walked by patients.</p> <p>Case presentation</p> <p>We report the case of a 44-year-old Caucasian man with unilateral symptomatic popliteal cysts extending to his genicular branches and associated with multilevel stenosis of his anterior tibial artery. A surgical evacuation of the cysts successfully restored his arterial patency and led to an objective haemodynamic improvement but was associated with early recurrence of symptoms.</p> <p>Conclusion</p> <p>We suggest that the involvement of the genicular branches in cystic adventitial disease of the popliteal artery is a possible indicator of extensive adventitial degeneration and unfavourable clinical prognosis.</p