Frozen elephant trunk: Assets and liabilities of a challenging technique

The development of the frozen elephant trunk (FET) technique for a simplified treatment of complex lesions of the thoracic aorta originated as an evolution of the classic elephant trunk technique, described for the first time by Borst et al .[1] in 1983. Novel technologies and standardization of the surgical approach produced a progressive improvement of early and late outcomes. Most of the time and for specific indications, FET procedure allows physicians to treat lesions involving extensive portions of the thoracic aorta in one single step. Spinal cord injury remains one of the main complications of this procedure, even though spinal protection strategies have led to better results. We hereby report our opinions and recommendations based on our experience started in 2007

Survival and reoperation in acute aortic syndromes - a single-centre experience of 912 patients

OBJECTIVES: Acute aortic syndromes are associated with poor outcomes, despite diagnostic and therapeutic advances. We analysed trends in volumes and outcomes from 2000 to 2021. METHODS: The study population includes 494 type A acute aortic syndromes (TAAAS) (54.2%) and 418 type B acute aortic syndromes (TBAAS) (45.8%). Primary outcomes were in-hospital mortality, long-term survival and freedom from aortic reoperation. RESULTS: Regardless the type of acute aortic syndrome, patient volumes increased over time. Patients with TBAAS were older, more likely to have comorbid conditions and previous cardiac surgery (P < 0.001), while cerebrovascular accidents were more frequent in TAAAS (P < 0.05). Among TAAAS, 143 (28.9%) required total arch and 351 (71.1%) hemiarch replacement. TBAAS management was medical therapy in 182 (43.5%), endovascular in 198 (47.4%) and surgical in 38 (9.1%) cases. Overall in-hospital mortality was 14.6% [18.2% in TAAAS (95% confidence interval (CI) 14.4-21.2%) vs 10.7% in TBAAS (95% CI 7.8%-13.7%); P = 0.0027]. After propensity score adjustment, in-hospital mortality exhibited a significantly decreasing trend from 2000 to 2021 (P < 0.001) in TAAAS and TBAAS. 1-, 5- and 10-year survival was 74.2%, 62.2% and 45.5% in TAAAS and 75.4%, 60.7% and 41.0% in TBAAS (P = 0.975), with no differences among treatment strategies. The adjusted cumulative reoperation risk at 10 years was more than two-fold in TBAAS versus TAAAS (9.5% vs 20.5%, hazard ratio (HR) = 2.30, 95% I 1.31-4.04). CONCLUSIONS: In the last decades, better patient triage and surgical/endovascular techniques led to substantial improvements in the management of acute aortic syndrome, with reduction in early mortality and reoperation rate. However, long-term mortality is still >50%

Pregnancy outcome after loop electrosurgical excision procedure for cervical intraepithelial neoplasia

To determine pregnancy outcomes among women who underwent loop electrosurgical excision procedure (LEEP)

GTI-space : the space of generalized topological indices

A new extension of the generalized topological indices (GTI) approach is carried out torepresent 'simple' and 'composite' topological indices (TIs) in an unified way. Thisapproach defines a GTI-space from which both simple and composite TIs represent particular subspaces. Accordingly, simple TIs such as Wiener, Balaban, Zagreb, Harary and Randićconnectivity indices are expressed by means of the same GTI representation introduced for composite TIs such as hyper-Wiener, molecular topological index (MTI), Gutman index andreverse MTI. Using GTI-space approach we easily identify mathematical relations between some composite and simple indices, such as the relationship between hyper-Wiener and Wiener index and the relation between MTI and first Zagreb index. The relation of the GTI space with the sub-structural cluster expansion of property/activity is also analysed and some routes for the applications of this approach to QSPR/QSAR are also given

Search for low energy neutrinos in correlation with the 8 events observed by the EXPLORER and NAUTILUS detectors in 2001

We report on a search for low-energy neutrino (antineutrino) bursts in correlation with the 8 time coincident events observed by the gravitational waves detectors EXPLORER and NAUTILUS (GWD) during the year 2001. The search, conducted with the LVD detector (INFN Gran Sasso National Laboratory, Italy), has considered several neutrino reactions, corresponding to different neutrino species, and a wide range of time intervals around the (GWD) observed events. No evidence for statistically significant correlated signals in LVD has been found. Assuming two different origins for neutrino emission, the cooling of a neutron star from a core-collapse supernova or from coalescing neutron stars and the accretion of shocked matter, and taking into account neutrino oscillations, we derive limits to the total energy emitted in neutrinos and to the amount of accreting mass, respectively.Comment: Accepted for publication in Astronomy and Astrophysic

A simulation tool for MRPC telescopes of the EEE project

The Extreme Energy Events (EEE) Project is mainly devoted to the study of the secondary cosmic ray radiation by using muon tracker telescopes made of three Multigap Resistive Plate Chambers (MRPC) each. The experiment consists of a telescope network mainly distributed across Italy, hosted in different building structures pertaining to high schools, universities and research centers. Therefore, the possibility to take into account the effects of these structures on collected data is important for the large physics programme of the project. A simulation tool, based on GEANT4 and using GEMC framework, has been implemented to take into account the muon interaction with EEE telescopes and to estimate the effects on data of the structures surrounding the experimental apparata.A dedicated event generator producing realistic muon distributions, detailed geometry and microscopic behavior of MRPCs have been included to produce experimental-like data. The comparison between simulated and experimental data, and the estimation of detector resolutions is here presented and discussed

Initial operation of the International Gravitational Event Collaboration

The International Gravitational Event Collaboration, IGEC, is a coordinated effort by research groups operating gravitational wave detectors working towards the detection of millisecond bursts of gravitational waves. Here we report on the current IGEC resonant bar observatory, its data analysis procedures, the main properties of the first exchanged data set. Even though the available data set is not complete, in the years 1997 and 1998 up to four detectors were operating simultaneously. Preliminary results are mentioned.Comment: 8 pages, 2 figures, 3 tables; Proceeding of the GWDAW'99. Submitted to the International Journal of Modern Physic

Procedure for short-lived particle detection in the OPERA experiment and its application to charm decays

The OPERA experiment, designed to perform the first observation of $\nu_\mu \rightarrow \nu_\tau$ oscillations in appearance mode through the detection of the $\tau$ leptons produced in $\nu_\tau$ charged current interactions, has collected data from 2008 to 2012. In the present paper, the procedure developed to detect $\tau$ particle decays, occurring over distances of the order of 1 mm from the neutrino interaction point, is described in detail. The results of its application to the search for charmed hadrons are then presented as a validation of the methods for $\nu_\tau$ appearance detection

The instrumented magnets for the OPERA experiment: construction and commissioning

The design and construction of the 990-ton gapless iron magnets for the OPERA experiment represent a major challenge from the point of view of mechanics, electric and heat engineering. Two of such magnets have been built in a deep underground hall of the Gran Sasso laboratories between 2003 and 2006 and they have been switched on for the first time in March 2006. In this paper we discuss the construction and characterization of these devices. First experience with the CNGS beam are also reported. © 2007 Elsevier B.V. All rights reserved