Evaluation of a New Balloon Catheter for Difficult Calcified Lesions in Infrainguinal Arterial Disease: Outcome of a Multicenter Registry

The purpose of this study was to assess the technical performance and immediate procedure outcome of a new balloon catheter in the treatment of calcified lesions in infrainguinal arterial disease. Seventy-five patients with infrainguinal arterial disease were prospectively entered into the registry. The catheter (ReeKross Clearstream, Ireland) is a 5- to 6-Fr balloon catheter with a rigid shaft intended for enhanced pushability. Only technical procedural outcome was recorded. Treated calcified lesions (range: 5–30 cm), assessed angiographically, were located in the superficial femoral, popliteal, and crural arteries. In 67 patients the lesion was an occlusion. Guidewire passage occurred subintimally in 68 patients. In 24 patients a standard balloon catheter was chosen as first treatment catheter: 5 failed to cross the lesion, 8 balloons ruptured, and in 11 patients there was an inadequate dilatation result. In only one of the five patients did subsequent use of the ReeKross catheter also fail in lesion crossing. The ReeKross was successful as secondary catheter in the other 23 cases. In 50 patients the ReeKross was used as primary catheter. In total the ReeKross crossed the lesions in 74 patients. After passage and dilatation with this catheter in 73 patients (1 failed true-lumen reentry), 19 had >30% residual lesions, of which 11 were not treated and 8 were successfully stented. No ReeKross balloons ruptured. We conclude that in the treatment of difficult calcified lesions in arterial stenotic or occlusive disease, the choice of a high-pushability angioplasty catheter, with more calcification-resistant balloon characteristics, like the ReeKross, warrants consideration

Low Liver Enzymes and Risk of Dementia: The Atherosclerosis Risk in Communities (ARIC) Study

Background: Low levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in the low physiologic range, surrogate markers for reduced liver metabolic function, are associated with cerebral hypometabolism, impairment in neurotransmitter production and synaptic maintenance, and a higher prevalence of dementia. It is unknown whether a prospective association exists between low liver enzyme levels and incident dementia. Objective: To determine whether low levels of ALT and AST are associated with higher risk of incident dementia. Methods: Plasma ALT and AST were measured on 10,100 study participants (mean age 63.2 years, 55% female, 22% black) in 1996-1998. Dementia was ascertained from comprehensive neuropsychological assessments, annual contact, and medical record surveillance. Cox proportional hazards regression was used to estimate the association. Results: During a median follow-up of 18.3 years (maximum 21.9 years), 1,857 individuals developed dementia. Adjusted for demographic factors, incidence rates of dementia were higher at the lower levels of ALT and AST. Compared to the second quintile, ALT values <10th percentile were associated with a higher risk of dementia (hazard ratio [HR] 1.34, 95% CI 1.08-1.65). The corresponding HR was 1.22 (0.99-1.51) for AST. Conclusion: Plasma aminotransferases <10th percentile of the physiologic range at mid-life, particularly ALT, were associated with greater long-term risk of dementia, advocating for attention to the putative role of hepatic function in the pathogenesis of dementia

Slepton Flavor Nonuniversality, the Muon EDM and its Proposed sensitive Search at Brookhaven

We analyze the electric dipole moment of the electron ($d_e$), of the neutron ($d_n$) and of the muon ($d_{\mu}$) using the cancellation mechanism in the presence of nonuniversalities of the soft breaking parameters. It is shown that the nonuniversalities in the slepton sector produce a strong violation of the scaling relation $d_{\mu}/d_e\simeq m_{\mu}/m_e$ in the cancellation region. An analysis of $d_e, d_n$ and $d_{\mu}$ under the constraints of the current experimental limits on $d_e$ and $d_n$ and under the constraints of the recent Brookhaven result on $g_{\mu}-2$ shows that in the non-scaling region $d_{\mu}$ can be as large as ($10^{-24}-10^{-23}$)ecm and thus within reach of the recently proposed Brookhaven experiment for a sensitive search for $d_{\mu}$ at the level of $10^{-24}$ ecm.Comment: 24 pages, Latex, including 5 figures with additional reference

Lipoprotein-Associated Phospholipase A2 and High-Sensitivity C-Reactive Protein Improve the Stratification of Ischemic Stroke Risk in the Atherosclerosis Risk in Communities (ARIC) Study

Inflammation plays a critical role in the development of vascular disease, and increased levels of the inflammatory biomarkers, lipoprotein-associated phospholipase A2 (Lp-PLA2), and high-sensitivity C-reactive protein (hs-CRP) have been shown to be associated with an increased risk for ischemic stroke

Update of the Pompe variant database for the prediction of clinical phenotypes: Novel disease-associated variants, common sequence variants, and results from newborn screening

Pompe disease is an inherited disorder caused by disease-associated variants in the acid α-glucosidase gene (GAA). The Pompe disease GAA variant database (http://www.pompevariantdatabase.nl) is a curated, open-source, disease-specific database, and lists disease-associated GAA variants, in silico predictions, and clinical phenotypes reported until 2016. Here, we provide an update to include 226 disease-associated variants that were published until 2020. We also listed 148 common GAA sequence variants that do not cause Pompe disease. GAA variants with unknown severity that were identified only in newborn screening programs were listed as a new feature to indicate the reason why phenotypes were still unknown. Expression studies were performed for common missense variants to predict their severity. The updated Pompe disease GAA variant database now includes 648 disease-associated variants, 26 variants from newborn screening, and 237 variants with unknown severity. Regular updates of the Pompe disease GAA variant database will be required to improve genetic counseling and the study of genotype–phenotype relationships

The quest for the solar g modes

Solar gravity modes (or g modes) -- oscillations of the solar interior for which buoyancy acts as the restoring force -- have the potential to provide unprecedented inference on the structure and dynamics of the solar core, inference that is not possible with the well observed acoustic modes (or p modes). The high amplitude of the g-mode eigenfunctions in the core and the evanesence of the modes in the convection zone make the modes particularly sensitive to the physical and dynamical conditions in the core. Owing to the existence of the convection zone, the g modes have very low amplitudes at photospheric levels, which makes the modes extremely hard to detect. In this paper, we review the current state of play regarding attempts to detect g modes. We review the theory of g modes, including theoretical estimation of the g-mode frequencies, amplitudes and damping rates. Then we go on to discuss the techniques that have been used to try to detect g modes. We review results in the literature, and finish by looking to the future, and the potential advances that can be made -- from both data and data-analysis perspectives -- to give unambiguous detections of individual g modes. The review ends by concluding that, at the time of writing, there is indeed a consensus amongst the authors that there is currently no undisputed detection of solar g modes.Comment: 71 pages, 18 figures, accepted by Astronomy and Astrophysics Revie

Concepts and Applications of AquaCrop: The FAO Crop Water Productivity Model

Predicting attainable yield under water-limiting conditions is an important goal in arid, semi-arid and drought-prone environments. To address this task, FAO has developed a model, AquaCrop, which simulates attainable yields of the major herbaceous crops in response to water. Compared to other models, AquaCrop has a significantly smaller number of parameters and attempts to strike a balance between simplicity, accuracy, and robustness. Root zone water content is simulated by keeping track of incoming and outgoing water fluxes. Instead of leaf area index, AquaCrop uses canopy ground cover. Canopy expansion, stomatal conductance, canopy senescence, and harvest index are the key physiological processes which respond to water stress. Low and high temperature stresses on pollination and harvestable yield are considered, as is cold temperature stress on biomass production. Evapotranspiration is simulated separately as crop transpiration and soil evaporation and the daily transpiration is used to calculate the biomass gain via the normalized biomass water productivity. The normalization is for atmospheric evaporative demand and carbon dioxide concentration, to make the model applicable to diverse locations and seasons, including future climate scenarios. AquaCrop accommodates fertility levels and water management systems, including rainfed, supplemental, deficit, and full irrigation. Simulations are routinely in thermal time, but can be carried out in calendar time. Future versions will incorporate salt balance and capillary raise. AquaCrop is aimed at users in extension services, consulting firms, governmental agencies, NGOs, farmers associations and irrigation districts, as well as economists and policy analysts in need of crop models for planning and assessing water needs and use of projects and regions