Simulating Drug-Eluting Stents: Progress Made and the Way Forward

Drug-eluting stents have significantly improved the treatment of coronary artery disease. Compared with their bare metal predecessors, they offer reduced rates of restenosis and thus represent the current gold standard in percutaneous coronary interventions. Drug-eluting stents have been around for over a decade, and while progress is continually being made, they are not suitable in all patients and lesion types. Furthermore there are still real concerns over incomplete healing and late stent thrombosis. In this paper, some modelling approaches are reviewed and the future of modelling and simulation in this field is discussed

A polymer coated cicaprost-eluting stent increases neointima formation and impairs vessel function in the rabbit iliac artery

Drug-eluting stents have been successful in reducing in-stent restenosis but are not suitable for all lesion types and have been implicated in causing late stent thrombosis due to incomplete regeneration of the endothelial cell layer. In this study we implanted stents coated with cicaprost, a prostacyclin analogue with a long plasma half-life and antiproliferative effects on vascular smooth muscle cells, into the iliac arteries of rabbits. At 28-day follow-up we compared neointima formation within the stented vessels and vascular function in adjacent vessels, to assess if cicaprost could reduce restenosis without impairing vessel function. Arteries implanted with cicaprost eluting stents had significantly more neointima compared to bare metal stents. In adjacent segments of artery, endothelium-dependent relaxation was impaired by the cicaprost-eluting stent but vasodilation to an endothelium-independent vasodilator was maintained. We conclude that the presence of the polymer and sub-optimal release of cicaprost from the stent may be responsible for the increased neointma and impaired functional recovery of the endothelium observed. Further experiments should be aimed at optimising release of cicaprost and exploring different stent polymer coatings

The Purdue University Get Away Special II (PUGAS II)

The Purdue University Get Away Special Project (PUGAS) is a student-run organization dedicated to preparing payloads for flight on NASA's space shuttle. The first such payload (PUGAS I) flew on Challenger in 1983. The second payload (PUGAS II) should be ready by the end of 1988 and will include three experiments. The first experiment will involve the production of tin metal foam under microgravity conditions. The second experiment will focus on the desorption of water from carbon-epoxy composite materials. The third experiment will use a solid polymeric material to detect radiation in space

Parallel development and characterisation of an anti-oxidant stent coating and an in vitro biological model for qualitative assessment

Restenosis is a major cause of coronary artery stent failure and is linked to vascular endothelium damage with resultant oxidative and inflammatory stress. Drug eluting stents (DES) have failed to eliminate this risk; particularly for diabetic patients. Here, we have assessed the potential therapeutic effects of a novel antioxidant stent coating using (i) a common chemical assay, DPPH (2,2-diphenyl-1-picrylhydrazyl) and (ii) superoxide scavenging ability using NBT (nitroblue tetrazolium) reduction and have identified high antioxidant potential that is not dependent on drug incorporation within the coating. To assess the biological effect of this novel antioxidant coating, we have initially used human umbilical vein endothelial cells (HUVECs) treated with pro-inflammatory cytokines to mimic the inflammation stress encountered post-stent placement. Pro-inflammatory signalling was assessed by measuring phospho-P65 (pP65) expression using quantitative western blotting and oxidative stress assessed by measuring reactive oxygen species (ROS) generation using DCFDA. In addition, we have specifically examined expression and activation (via oxidation) of an enzyme called Ca2+/Calmodulin-dependent protein kinase II-delta (CaMKIIδ) that is known to be a central component of vascular pathology during acute and chronic inflammation and oxidative stress. HUVECs were stimulated with pro-inflammatory cytokines, Tissue Necrotic Factor alpha (TNFα) and Interleukin 1-beta (IL-1β). Stimulation with IL-1β (10 ng/ml) for 1h resulted in the highest overall level of P65 phosphorylation (7.80 ± 1.41 (fold increase ± S.E.M. in pP65 expression in IL-1β -stimulated cells c.f. unstimulated controls, n=4, p<0.05). Conversely, stimulation with TNFα (10 ng/ml) for 6h led to the highest overall increase in ROS (5.02 ± 0.54, fold-stimulation ± S.E.M. in ROS in TNFα -stimulated cells c.f. unstimulated controls, n=3, p<0.05). We have shown that CaMKIIδ is highly expressed in HUVECs and that stimulation with IL-1β (10 ng/ml) for 3h significantly induced CaMKII oxidation (1.56 ± 0.06 (fold-increase ± S.E.M. in oxCaMKII in IL-1β stimulated cells c.f. unstimulated controls, n=4, p<0.05). Preventing the oxidation-induced activation of CaMKII may present a therapeutic mechanism by which antioxidant stents can improve endothelial recovery and future work will examine the reduction or reversal of this effect in the presence of our novel stent coating. In conclusion, we have developed a novel anti-oxidant stent coating and established an in vitro system to test biological activity. This approach will now be applied to more physiologically relevant cell types before examining the novel coating’s efficacy

Cultural Resources Survey for the Riverside Drive Improvements Project, City of Fort Worth, Tarrant County, Texas

This report documents the substantive findings and management recommendations of a cultural resources survey conducted by Integrated Environmental Solutions, LLC (IES) for the proposed Riverside Drive improvements project. The proposed project pertains to the improvement of Riverside Drive from Golden Triangle Boulevard to Keller Hicks Road, in the City of Fort Worth, Tarrant County, Texas. As the project will require compliance with Section 404 of the Clean Water Act through the use of a Nationwide Permit from the U.S. Army Corps of Engineers (USACE), portions of the project will be subjected to the provisions of the National Historic Preservation Act (NHPA) of 1966, as amended. Additionally, as the City of Fort Worth is a political subdivision of the State of Texas, the project is subject to the provisions of the Antiquities Code of Texas (ACT). The goal of this survey was to locate cultural resources that could be adversely affected by the proposed development, and to provide an evaluation of the eligibility potential of each identified resource for listing in the National Register of Historic Places (NRHP) or for designation as a State Antiquities Landmark (SAL). This cultural resources survey was conducted on 30 July 2019. All work conformed to 13 Texas Administrative Code 26, which outlines the regulations for implementing the ACT, and was conducted under Antiquities Permit No. 8972. During the survey, no cultural resources were encountered within the APE. No artifacts were collected as part of this survey. All project-related records and field data will be temporarily stored at the IES McKinney office and permanently curated at the Center for Archeological Research at The University of Texas at San Antonio. No further cultural resources investigation or evaluation of the APE is recommended. However, if any cultural resources are encountered during construction, the operators should stop construction activities in the vicinity of the inadvertent discovery, and immediately contact the project cultural resources consultant to initiate coordination with the USACE and Texas Historical Commission (THC) prior to resuming construction activities

When I Grow Up...Education Works - Career Exposure Program

https://digitalcommons.pcom.edu/bridging_gaps2015/1000/thumbnail.jp

Archeological Survey for the Port of Victoria U.S. Army Corp of Engineers Easement Disposal, Port of Victoria, Victoria County, Texas

This report documents the substantive findings and management recommendations of an archeological survey conducted by Integrated Environmental Solutions, LLC (IES) in preparation for an easement disposal by the U.S. Army Corps of Engineers (USACE) Galveston District (SWG) within property owned by the Port of Victoria (POV), in Victoria County, Texas. An archeological survey was requested by the USACE as part of the overall National Environmental Policy Act (NEPA) Categorical Exclusion documentation process, which subsequently required compliance with Section 106 of the National Historic Preservation Act (NHPA). Additionally, as the POV is a political subdivision of the State of Texas, the project is subject to the provisions of the Antiquities Code of Texas (ACT). Although no ground disturbing activities are included in this undertaking, the POV seeks to conduct coordination with the Texas Historical Commission (THC) for the easement disposal areas to facilitate future development of the property. To satisfy USACE-SWG and THC requirements for the easement disposal, IES conducted an archeological inventory of the easement disposal tracts. The proposed easement disposal tracts are located adjacent to the Pickering Basin near the northern terminus of the Victoria Barge Canal, in southern Victoria County, Texas. The project area or Area of Potential Effects (APE) encompasses the proposed easement disposal area, consisting of five tracts totaling 193.34 acres (ac). The goal of this survey was to locate archeological sites that could be adversely affected by the proposed and anticipated development, and to provide an evaluation of the eligibility potential of each identified resource for listing in the National Register of Historic Places (NRHP) or for designation as a State Antiquities Landmark (SAL). This survey was conducted between 09 and 13 September 2019. All work conformed to 36 Code of Federal Regulations 800.4 and 13 Texas Administrative Code 26, which outlines the regulations for implementing Section 106 of the NHPA and the ACT, respectively, and was conducted under Antiquities Permit No. 9048. During this survey, backhoe trenching was conducted within a 78-ac portion of the APE. Pedestrian transect survey and systematic shovel testing was conducted within a 12-ac portion of the APE. The remaining 103.34-ac portion of the APE has experienced extensive previous disturbance due to the construction, operation, and maintenance of the Victoria Barge Canal and its associated facilities. No archeological sites were encountered within the APE during this survey. No artifacts were collected during this survey. All project-related records will be temporarily stored at the IES McKinney office and permanently curated at the Museum of the Coastal Bend in Victoria, Texas. No further archeological investigation or evaluation of the APE is recommended. However, if any archeological resources are encountered during construction, the operators should stop construction activities, and immediately contact the project environmental representative to initiate coordination with the USACE-SWG Regulatory Archeologist and the THC prior to resuming any construction activities in the vicinity of the inadvertent discovery

Cultural Resources Survey of the Sparks Drive Valley Storage Project, City of Cleburne, Johnson County, Texas

This report documents the substantive findings and management recommendations of a cultural resources survey conducted by Integrated Environmental Solutions, LLC (IES) for the Sparks Drive Valley Storage Project in the City of Cleburne, Johnson County, Texas. The project area or Area of Potential Effects (APE) encompasses approximately 14 acres (ac). As the project will require compliance with Section 404 of the Clean Water Act through the use of a Nationwide Permit from the U.S. Army Corps of Engineers (USACE), portions of the project will be subjected to the provisions of the National Historic Preservation Act (NHPA) of 1966, as amended. Additionally, the City of Cleburne is a political subdivision of the State of Texas. Therefore, the project is also subject to the provisions of the Antiquities Code of Texas (ACT). The goal of this survey was to locate, identify, and document any cultural resources, which included architectural and archeological resources, that could be adversely affected by the proposed development, and to provide an evaluation of the eligibility potential of each identified resource for listing in the National Register of Historic Places (NRHP) or for designation as a State Antiquities Landmark (SAL). This cultural resources survey was conducted on 01 August 2019. All work conformed to 13 Texas Administrative Code 26, which outlines the regulations for implementing the ACT, and was conducted under Antiquities Permit No. 8993. During the survey, no cultural resources were documented within the 14-ac APE. No artifacts were collected during this survey. All field and project-related records will be temporarily stored at the IES McKinney office and permanently curated at the Center for Archaeological Research at The University of Texas at San Antonio. Based on the results of this survey, no additional cultural resources investigations or evaluation of the APE is recommended. It is the recommendation of IES that the State Historic Preservation Officer, represented by the Texas Historical Commission, concur with these findings. However, if any cultural resources are encountered during construction, the operators should cease work immediately in that area and contact the project cultural resources consultant to initiate coordination with the THC and USACE prior to resuming any construction activities in the vicinity of the inadvertent discovery

Human Granulocytic Ehrlichiosis Complicating Early Pregnancy

Background. The goal of this case is to review the zoonotic infection, human granulocytic ehrlichiosis, presenting with pyrexia. Case. A 22-year-old multigravid female presented to the emergency department with a painful skin rash, high fever, and severe myalgias. The patient underwent a diagnostic evaluation for zoonotic infections due to her geographical and seasonal risk factors. Treatment of human granulocytic ehrlichiosis was successful though the patient spontaneously aborted presumably due to the severity of the acute illness. Conclusion. Treatment of human granulocytic ehrlichiosis in pregnancy presents unique challenges. Management of pyrexia during pregnancy is limited to external cooling in the setting of thrombocytopenia and elevated aminotransferases. Extensive counseling regarding teratogenic potential of medications allows the patient to weigh the pros and cons of treatment