Early vein bypass thrombectomy is associated with an increased risk of graft related stenoses

Objectives:To assess the risk of graft stenoses following early thrombectomy of peripheral vein bypasses.Design:Prospective study of 371 vein bypasses performed at the Vascular Service, Rigshospitalet, Copenhagen from January 1991 through December 1992.Materials and methods:Thirty-six vein bypasses reopened by thrombectomy within 30 days postoperatively (group I) and 335 bypasses not subjected to early thrombectomy (group II) were studied by ultrasound duplex scanning 3, 6, 9, 12, 18, 24, 36 and 48 months postoperatively. A localised increase in the peak systolic velocity of 250% or more was considered an indicator for significant stenosis.Results:In the perioperative period nine (2%) patients died, 30 (8%) bypasses occluded and 14 (4%) patients were lost to follow-up. Among the 318 patients remaining at risk at 1 month graft stenoses were identified in 39% (9/23) in group I compared to 17% (51/295) in group II, p = 0.03. Late bypass revisions were required in 35% (8/23) in group I as opposed to 9% (28/295) in group II, p = 0.004. Despite this high number of revisional procedures the 12-months secondary bypass patency was lower in recanalised grafts (38% vs. 82%, p < 0.00001).Conclusion:Early vein bypass thrombectomy is associated with a two-fold increased risk of graft related stenoses and a reduced secondary bypass patency

Carotid Endarterectomy after Intravenous Thrombolysis for Acute Cerebral Ischaemic Attack: Is It Safe?

ObjectivesIntravenous thrombolysis (IVT) has proven effective in the treatment of acute cerebral ischaemic attack in selected cases. In the presence of a carotid artery stenosis, such patients may be candidates for carotid endarterectomy (CEA). Few studies have been made on the safety of CEA performed after IVT.DesignThis was a retrospective study. Data including 30 days' follow-up were obtained from medical records and from a vascular registry.MaterialsA consecutive series of 306 patients were operated on for symptomatic carotid artery stenosis during a 5-year period. Among these, 22 (7%) patients had been treated with IVT for an acute cerebral ischaemic attack prior to CEA and 284 (93%) patients had CEA only.MethodsIVT as well as CEA was performed following established guidelines. CEA was performed in median 11 days (25 and 75% percentiles: 7–13 days) after the neurological index event in patients having undergone IVT and 12 days (25 and 75% percentiles: 8–21 days) in patients undergoing CEA only.ResultsThe 30 days' stroke and death rate was 0% (95% confidence interval (CI): 0–15%) in patients who had IVT before CEA and 2.4% (95% CI: 0.9–4.7%) in patients who underwent CEA only.ConclusionOur experience indicates that CEA performed after IVT for acute cerebral ischaemic attack is safe, confirming existing but sparse publications. However, our series is small and our study possesses a number of limitations. Thus, our results cannot necessarily be transferred to other units, who instead should perform similar studies, preferably together

Phase Behavior of Type-II Superconductors with Quenched Point Pinning Disorder: A Phenomenological Proposal

A general phenomenology for phase behaviour in the mixed phase of type-II superconductors with weak point pinning disorder is outlined. We propose that the ``Bragg glass'' phase generically transforms via two separate thermodynamic phase transitions into a disordered liquid on increasing the temperature. The first transition is into a glassy phase, topologically disordered at the largest length scales; current evidence suggests that it lacks the long-ranged phase correlations expected of a ``vortex glass''. This phase has a significant degree of short-ranged translational order, unlike the disordered liquid, but no quasi-long range order, in contrast to the Bragg glass. This glassy phase, which we call a ``multi-domain glass'', is confined to a narrow sliver at intermediate fields, but broadens out both for much larger and much smaller field values. The multi-domain glass may be a ``hexatic glass''; alternatively, its glassy properties may originate in the replica symmetry breaking envisaged in recent theories of the structural glass transition. Estimates for translational correlation lengths in the multi-domain glass indicate that they can be far larger than the interline spacing for weak disorder, suggesting a plausible mechanism by which signals of a two-step transition can be obscured. Calculations of the Bragg glass-multi-domain glass and the multi-domain glass-disordered liquid phase boundaries are presented and compared to experimental data. We argue that these proposals provide a unified picture of the available experimental data on both high-T$_c$ and low-T$_c$ materials, simulations and current theoretical understanding.Comment: 70 pages, 9 postscript figures, modified title and minor changes in published versio

The performance of the jet trigger for the ATLAS detector during 2011 data taking

The performance of the jet trigger for the ATLAS detector at the LHC during the 2011 data taking period is described. During 2011 the LHC provided proton–proton collisions with a centre-of-mass energy of 7 TeV and heavy ion collisions with a 2.76 TeV per nucleon–nucleon collision energy. The ATLAS trigger is a three level system designed to reduce the rate of events from the 40 MHz nominal maximum bunch crossing rate to the approximate 400 Hz which can be written to offline storage. The ATLAS jet trigger is the primary means for the online selection of events containing jets. Events are accepted by the trigger if they contain one or more jets above some transverse energy threshold. During 2011 data taking the jet trigger was fully efficient for jets with transverse energy above 25 GeV for triggers seeded randomly at Level 1. For triggers which require a jet to be identified at each of the three trigger levels, full efficiency is reached for offline jets with transverse energy above 60 GeV. Jets reconstructed in the final trigger level and corresponding to offline jets with transverse energy greater than 60 GeV, are reconstructed with a resolution in transverse energy with respect to offline jets, of better than 4 % in the central region and better than 2.5 % in the forward direction

Geographical and temporal distribution of SARS-CoV-2 clades in the WHO European Region, January to June 2020

We show the distribution of SARS-CoV-2 genetic clades over time and between countries and outline potential genomic surveillance objectives. We applied three available genomic nomenclature systems for SARS-CoV-2 to all sequence data from the WHO European Region available during the COVID-19 pandemic until 10 July 2020. We highlight the importance of real-time sequencing and data dissemination in a pandemic situation. We provide a comparison of the nomenclatures and lay a foundation for future European genomic surveillance of SARS-CoV-2.Peer reviewe

New Blood Pressure-Associated Loci Identified in Meta-Analyses of 475,000 Individuals

Background - Genome-wide association studies have recently identified &gt;400 loci that harbor DNA sequence variants that influence blood pressure (BP). Our earlier studies identified and validated 56 single nucleotide variants (SNVs) associated with BP from meta-analyses of exome chip genotype data. An additional 100 variants yielded suggestive evidence of association. Methods and Results - Here, we augment the sample with 140 886 European individuals from the UK Biobank, in whom 77 of the 100 suggestive SNVs were available for association analysis with systolic BP or diastolic BP or pulse pressure. We performed 2 meta-analyses, one in individuals of European, South Asian, African, and Hispanic descent (pan-ancestry, ≈475 000), and the other in the subset of individuals of European descent (≈423 000). Twenty-one SNVs were genome-wide significant (P&lt;5×10-8) for BP, of which 4 are new BP loci: rs9678851 (missense, SLC4A1AP), rs7437940 (AFAP1), rs13303 (missense, STAB1), and rs1055144 (7p15.2). In addition, we identified a potentially independent novel BP-associated SNV, rs3416322 (missense, SYNPO2L) at a known locus, uncorrelated with the previously reported SNVs. Two SNVs are associated with expression levels of nearby genes, and SNVs at 3 loci are associated with other traits. One SNV with a minor allele frequency &lt;0.01, (rs3025380 at DBH) was genome-wide significant. Conclusions - We report 4 novel loci associated with BP regulation, and 1 independent variant at an established BP locus. This analysis highlights several candidate genes with variation that alter protein function or gene expression for potential follow-up

Search for long-lived neutral particles in pp collisions at s√=13 TeV that decay into displaced hadronic jets in the ATLAS calorimeter

This paper describes a search for pairs of neutral, long-lived particles decaying in the ATLAS calorimeter. Long-lived particles occur in many extensions to the Standard Model and may elude searches for new promptly decaying particles. The analysis considers neutral, long-lived scalars with masses between 5 and 400 GeV, produced from decays of heavy bosons with masses between 125 and 1000 GeV, where the long-lived scalars decay into Standard Model fermions. The analysis uses either 10.8 fb−1 or 33.0 fb−1 of data (depending on the trigger) recorded in 2016 at the LHC with the ATLAS detector in proton–proton collisions at a centre-of-mass energy of 13 TeV. No significant excess is observed, and limits are reported on the production cross section times branching ratio as a function of the proper decay length of the long-lived particles