Antegrade coeliac axis reconstruction for Chronic Mesenteric Ischaemia : a case series

The management of chronic mesenteric ischaemia remains a compelling challenge for many vascular surgeons. Over the past four decades, several reports have demonstrated encouraging results following revascularisation of the splanchnic arteries. To this date, due to limited numbers, there have been no randomized trials on which we can base our current practise. In this series, we have demonstrated the benefits of a left thoracoabdominal approach for performing an antegrade bypass graft to the coeliac axis, in patients with severe mesenteric angina. Its low complication rate and excellent aortic vessel exposure make it a procedure of choice in expert centres.peer-reviewe

Association of coronary vessel characteristics with outcome in patients with percutaneous coronary interventions with incomplete revascularization

© 2017 American Medical Association. All rights reserved. IMPORTANCE Many studies have compared outcomes for incomplete revascularization (IR) among patients undergoing percutaneous coronary interventions (PCI), but little is known about whether outcomes are related to the nature of the IR. OBJECTIVE To determine whether some coronary vessel characteristics are associated with worse outcomes in patients with PCI with IR. DESIGN, SETTING, AND PARTICIPANTS New York\u27s PCI registrywas used to examine mortality (median follow-up, 3.4 years) as a function of the number of vessels that were incompletely revascularized, the stenosis in those vessels, and whether the proximal left anterior descending artery was incompletely revascularized after controlling for other factors associated with mortality for patients with and without ST-elevationmyocardial infarction (STEMI). This was a multicenter study (all nonfederal PCI hospitals in New York State) that included 41 639 New York residents with multivessel coronary artery disease undergoing PCI in New York State between January 1, 2010, and December 31, 2012. EXPOSURES Percutaneous coronary interventions, with complete and incomplete revascularization. MAIN OUTCOMES AND MEASURES Medium-term mortality. RESULTS For patients with STEMI, the mean age was 62.8 years; 26.2%were women, 11.9% were Hispanic, and 81.5%were white. For other patients, the mean age was 66.6 years, 29.1%were women, 11.3%were Hispanic, and 79.1%were white. Incomplete revascularization was very common (78%among patients with STEMI and 71%among other patients). Patients with IR in a vessel with at least 90% stenosis were at higher risk than other patients with IR. This was not significant among patients with STEMI (17.18%vs 12.86%; adjusted hazard ratio [AHR], 1.16; 95%CI, 0.99-1.37) and significant among patients without STEMI (17.71% vs 12.96%; AHR, 1.15; 95%CI, 1.07-1.24). Similarly, patients with IR in 2 or more vessels had higher mortality than patients with completely revascularization and higher mortality than other patients with IR among patients with STEMI (20.37%vs 14.39%; AHR, 1.35; 95%CI, 1.15-1.59) and among patients without STEMI (20.10% vs 12.86%; AHR, 1.17; 95% CI, 1.09-1.59). Patients with proximal left anterior descending artery vessel IR had higher mortality than other patients with IR (20.09% vs 14.67%; AHR, 1.31; 95%CI, 1.04-1.64 for patients with STEMI and 20.78%vs 15.62%; AHR, 1.11; 95%CI, 1.01-1.23 for patients without STEMI). More than 20%of all PCI patients had IR of 2 or more vessels and more than 30% had IR with more than 90% stenosis. CONCLUSIONS AND RELEVANCE Patients with IR are at higher risk of mortality if they have IR with at least 90% stenosis, IR in 2 or more vessels, or proximal left anterior descending IR

Light scattering from an isotropic layer between uniaxial crystals

We develop a model for the reflection and transmission of plane waves by an isotropic layer sandwiched between two uniaxial crystals of arbitrary orientation. In the laboratory frame, reflection and transmission coefficients corresponding to the principal polarization directions in each crystal are given explicitly in terms of the c-axis and propagation directions. The solution is found by first deriving explicit expressions for reflection and transmission amplitude coefficients for waves propagating from an arbitrarily oriented uniaxial anisotropic material into an isotropic material. By combining these results with Lekner's (1991) earlier treatment of waves propagating from isotropic media to anisotropic media and employing a matrix method we determine a solution to the general form of the multiple reflection case. The example system of a wetted interface between two ice crystals is used to contextualize the results.Comment: 18 pages, 9 figures,updated with changes made to published versio

Photoproduction of eta mesons from the neutron: cross sections and double polarization observable E

Photoproduction of $\eta$ mesons from neutrons} \abstract{Results from measurements of the photoproduction of $\eta$ mesons from quasifree protons and neutrons are summarized. The experiments were performed with the CBELSA/TAPS detector at the electron accelerator ELSA in Bonn using the $\eta\to3\pi^{0}\to6\gamma$ decay. A liquid deuterium target was used for the measurement of total cross sections and angular distributions. The results confirm earlier measurements from Bonn and the MAMI facility in Mainz about the existence of a narrow structure in the excitation function of $\gamma n\rightarrow n\eta$. The current angular distributions show a forward-backward asymmetry, which was previously not seen, but was predicted by model calculations including an additional narrow $P_{11}$ state. Furthermore, data obtained with a longitudinally polarized, deuterated butanol target and a circularly polarized photon beam were analyzed to determine the double polarization observable $E$. Both data sets together were also used to extract the helicity dependent cross sections $\sigma_{1/2}$ and $\sigma_{3/2}$. The narrow structure in the excitation function of $\gamma n\rightarrow n\eta$ appears associated with the helicity-1/2 component of the reaction

Research Diary: A Tool for Scaffolding

Diaries have long been seen as tools for reflection in learning languages, and learning about teaching. Despite this recognition of the importance of narratives in diary writing, little attention has been paid to the role of research diaries in the process of learning about research, and learning how to be a researcher. During the author\u27s own research into the construction of teaching knowledge by pre-service trainees, she became aware that her research diary was scaffolding her own construction of research knowledge. In this article the author discusses the role of a research diary based on a socio-cultural theory of learning. The diary acts as the expert other in the scaffolding of research knowledge by the novice researcher. The discussion of the nature of the scaffolding and the role of diary writing draws on examples from the author\u27s research diary written during her doctoral studies

Photoproduction of π0\pi^0-pairs off protons and off neutrons

Total cross sections, angular distributions, and invariant-mass distributions have been measured for the photoproduction of $\pi^0\pi^0$ pairs off free protons and off nucleons bound in the deuteron. The experiments were performed at the MAMI accelerator facility in Mainz using the Glasgow photon tagging spectrometer and the Crystal Ball/TAPS detector. The accelerator delivered electron beams of 1508 and 1557~MeV, which produced bremsstrahlung in thin radiator foils. The tagged photon beam covered energies up to 1400~MeV. The data from the free proton target are in good agreement with previous measurements and were only used to test the analysis procedures. The results for differential cross sections (angular distributions and invariant-mass distributions) for free and quasi-free protons are almost identical in shape, but differ in absolute magnitude up to 15\%. Thus, moderate final-state interaction effects are present. The data for quasi-free neutrons are similar to the proton data in the second resonance region (final state invariant masses up to $\approx$1550~MeV), where both reactions are dominated by the $N(1520)3/2^-\rightarrow \Delta(1232)3/2^+\pi$ decay. At higher energies, angular and invariant-mass distributions are different. A simple analysis of the shapes of the invariant-mass distributions in the third resonance region is consistent with strong contributions of an $N^{\star}\rightarrow N\sigma$ decay for the proton, while the reaction is dominated by a sequential decay via a $\Delta\pi$ intermediate state for the neutron. The data are compared to predictions from the Two-Pion-MAID model and the Bonn-Gatchina coupled channel analysis.Comment: accepted for publication in Eur. Phys. J.

Photoproduction of π0-pairs off protons and off neutrons

Total cross sections, angular distributions, and invariant-mass distributions have been measured for the photoproduction of π0π0 pairs off free protons and off nucleons bound in the deuteron. The experiments were performed at the MAMI accelerator facility in Mainz using the Glasgow photon tagging spectrometer and the Crystal Ball/TAPS detector. The accelerator delivered electron beams of 1508 and 1557MeV, which produced bremsstrahlung in thin radiator foils. The tagged photon beam covered energies up to 1400MeV. The data from the free proton target are in good agreement with previous measurements and were only used to test the analysis procedures. The results for differential cross sections (angular distributions and invariant-mass distributions) for free and quasi-free protons are almost identical in shape, but differ in absolute magnitude up to 15%. Thus, moderate final-state interaction effects are present. The data for quasi-free neutrons are similar to the proton data in the second resonance region (final-state invariant masses up to ≈1550 MeV), where both reactions are dominated by the N(1520)3/2−→Δ(1232)3/2+π decay. At higher energies, angular and invariant-mass distributions are different. A simple analysis of the shapes of the invariant-mass distributions in the third resonance region is consistent with strong contributions of an N⋆→Nσ decay for the proton, while the reaction is dominated by a sequential decay via a Δπ intermediate state for the neutron. The data are compared to predictions from the Two-Pion-MAID model and the Bonn-Gatchina coupled-channel analysis

Helicity-dependent cross sections and double-polarization observable E in η photoproduction from quasifree protons and neutrons

Precise helicity-dependent cross sections and the double-polarization observable E were measured for η photoproduction from quasifree protons and neutrons bound in the deuteron. The η → 2γ and η → 3π0 → 6γ decay modes were used to optimize the statistical quality of the data and to estimate systematic uncertainties. The measurement used the A2 detector setup at the tagged photon beam of the electron accelerator MAMI in Mainz. A longitudinally polarized deuterated butanol target was used in combination with a circularly polarized photon beam from bremsstrahlung of a longitudinally polarized electron beam. The reaction products were detected with the electromagnetic calorimeters Crystal Ball and TAPS, which covered 98% of the full solid angle. The results show that the narrow structure observed earlier in the unpolarized excitation function of η photoproduction off the neutron appears only in reactions with antiparallel photon and nucleon spin (σ1/2). It is absent for reactions with parallel spin orientation (σ3/2) and thus very probably related to partial waves with total spin 1/2. The behavior of the angular distributions of the helicity-dependent cross sections was analyzed by fitting them with Legendre polynomials. The results are in good agreement with a model from the Bonn-Gatchina group, which uses an interference of P11 and S11 partial waves to explain the narrow structure