Activity

In our study the proximal balloon-guided catheter and the distal filter protection device as protection devices during the carotid stenting didn’t show significant differences regarding complications related to the system.

In our study the proximal balloon-guided catheter and the distal filter protection device as protection devices during the carotid stenting didn’t show significant differences regarding complications related to the system.

We aimed to correlate the presence or absence of embolic debris in filter-type embolic protection devices (EPD), which are frequently used during carotid artery stenting (CAS), with possible risk factors and ultrasonographic plaque features.

Eighty patients, who underwent CAS using a filter-type EPD in the period between July 2016 and March 2019, were included in our study. The modified Gray-Weale classification (mGWC) subtypes obtained in the pre-procedural ultrasonographic examinations were recorded. In addition, other patient-related risk factors considered to be related to a distal embolism were recorded. After the procedure the filters were evaluated to detect and examine embolic debris in the pathology clinic. The presence and features of embolic debris in the filters were recorded.

In the examinations performed after CAS, embolic debris was macroscopically and microscopically detected in 22 (27%) and 34 (42.5%) of the filter-type EPDs, respectively. A significant correlation was found between the change in the mGWC category of stenotic plaques from type 5 to type 1 and the presence of embolic debris in the filter (p < 0.05). Furthermore, a significant relationship was found between stenotic segment length and the presence of embolic debris in the filter (p < 0.05). The presence of embolic debris was not statistically significantly related to predisposing risk factors for atherosclerosis (p > 0.05).

During CAS, the likelihood of the presence of embolic debris in the EPDs increases as mGWC categories change from type 5 to type 1 and as the length of the stenotic segment increases.

During CAS, the likelihood of the presence of embolic debris in the EPDs increases as mGWC categories change from type 5 to type 1 and as the length of the stenotic segment increases.Reversible adhesion provides robotic systems with unique capabilities, including wall climbing and walking underwater, and yet the control of adhesion continues to pose a challenge. Directional adhesives have begun to address this limitation by providing adhesion when loaded in one direction and releasing easily when loaded in the opposite direction. However, previous work has focused on directional adhesives for dry environments. In this work, we sought to address this need for directional adhesives for use in a wet environment by tuning the morphology of suction discs to achieve anisotropic adhesion. We developed a suction disc that exhibited significant directional preference in attachment and detachment without requiring active control. The suction discs exhibited morphological computation-that is, they were programmed based on their geometry and material properties to detach under specific angles of loading. We investigated two design parameters-disc symmetry and slits within the disc margin-as mechanisms to yield anisotropic adhesion, and through experimental characterizations, we determined that an asymmetric suction disc most consistently provided directional adhesion. We performed a parametric sweep of material stiffness to optimize for directional adhesion and found that the material composition of the suction disc demonstrated the ability to override the effect of body asymmetry on achieving anisotropic adhesion. We modeled the stress distributions within the different suction disc symmetries using finite element analysis, yielding insights into the differences in contact pressures between the variants. We experimentally demonstrated the utility of the suction discs in a simulated walking gait using linear actuators as one potential application of the directional suction disc.Many baked products, except for bread, (i.e., cakes, cookies, laminated pastries, and so on) generally contain high levels of fat in their formulas and they require different bakery fats that impart product-specific quality characteristics through their functionalities. Even though, fat is crucial for baked product quality, strategies have been developed to replace fat in their formulas as high fat intake is associated with chronic diseases such as obesity, diabetes, and cardiovascular heart diseases. Besides, the solid bakery fats contain trans- and saturated fats, and their consumption has been shown to increase total and low-density lipoprotein cholesterol levels and to constitute a risk factor for cardiovascular diseases when consumed at elevated levels. Therefore, the aim of this review was to provide a detailed summary of the functionality of lipids/fats (endogenous lipids, surfactants, shortening) in different baked products, the rheological behavior of bakery fats and their contribution to baked product quality, the impact of different types of fat replacers (carbohydrate-, protein-, lipid-based) on dough/batter rheology, and on the quality characteristics of the resulting reduced-fat baked products.Sepsis is the major culprit of death among critically ill patients who are hospitalized in intensive care units (ICUs). Although sepsis-related mortality is steadily declining year-by-year due to the continuous understanding of the pathophysiological mechanism on sepsis and improvement of the bundle treatment, sepsis-associated hospitalization is rising worldwide. Surviving Sepsis Campaign (SSC) guidelines are continuously updating, while their content is extremely complex and comprehensive for a precisely implementation in clinical practice. As a consequence, a standardized step-by-step approach for the diagnosis and treatment of sepsis is particularly important. In the present study, we proposed a standardized step-by-step approach for the diagnosis and treatment of sepsis using our daily clinical experience and the latest researches, which is close to clinical practice and is easy to implement. The proposed approach may assist clinicians to more effectively diagnose and treat septic patients and avoid the emergence of adverse clinical outcomes.

A survival gap between weaning from venoarterial-extracorporeal membrane oxygenation (VA-ECMO) and the hospital discharge has been consistently reported. The aim of this study is to investigate the clinical features of patients who underwent successful VA-ECMO decannulation at our institution and to identify the major contributors responsible for adverse outcomes.

We retrospectively reviewed all patients supported with VA-ECMO in our institution between January 2013 and June 2020. find more Only patients that survived VA-ECMO and underwent successful decannulation were included and dichotomized based on survival to hospital discharge non-survivors versus survivors. The primary study outcome was the cause of death after successful VA-ECMO decannulation.

Of the 262 adult patients who underwent VA-ECMO decannulation, 72 (27.5%) patients did not survive to hospital discharge. Non-survivors were older (62 vs. 54 years, p < 0.001) and suffering from many pre-existing comorbidities. Pneumonia and sepsis were the mostt survive to hospital discharge due to end-stage heart failure, infections or neurological injury. The first 8 post-decannulation days were recognized as a critical period where thorough strategies to prevent acquired infections and cautious support of end-organ function should be warranted. Future large-scale trials are needed to confirm our results.Chronotype is the attitude of subjects to carry out their daily activities mainly in the morning (“lark”) or in the evening (“owl”). The intermediate chronotype is located between these two categories. It has been demonstrated that chronotype can influence the incidence, course and response to treatments of tumors. In particular patients diagnosed with gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) and evening chronotype are characterized by unhealthy lifestyle, obesity, metabolic syndrome, a worsen cardiometabolic profile, a poor prognosis with a progressive disease and the development of metastasis. In addition, evening chronotype has been associated with sleep disturbances, which in turn have been related to tumor development and progression of tumors. There is a strict connection between sleep disturbances and NENs because of the hyperactivation of proangiogenic factors that caused aberrant neoangiogenesis. A nutritional tailored approach could represent a tool to align subjects with evening chronotype to physiological biological rhythms based on the properties of some macro and micronutrients of being substrate for melatonin synthesis. Thus, we aimed to provide an overview on the association of chronotype categories and sleep disturbances with NENs and to provide nutritional advices to manage subjects with NENs and these disturbances of circadian rhythm.Varicella-zoster virus (VZV) is the etiologic agent of varicella (chickenpox) and herpes zoster (shingles) infections commonly involving skin, mucous membranes, and less frequently the central nervous system. Traditional methods for the laboratory diagnosis of these infections are time-consuming, labor-intensive, and often insensitive. As such, these tests are being replaced by more sensitive and rapid molecular methods. This study evaluated the performance of two different molecular assays, the Simplexa VZV Direct and Simplexa VZV Swab Direct, to detect VZV DNA in cerebrospinal fluid (CSF) and lesion-swab specimens, respectively. The Simplexa VZV Direct and Simplexa VZV Swab Direct assays were compared against individual composite reference methods that varied depending on the sample cohort examined. A total of 883 CSF and 452 cutaneous and mucocutaneous prospective, retrospective, and contrived specimens were evaluated in this multicenter study. The results of this study showed that the Simplexa assays demonstrated near perfect agreement (k = 0.98) compared to the composite reference methods for the detection of VZV in CSF and lesion swab specimens. A further comparison between the standard of care molecular assays employed at the site of specimen collection and the Simplexa assays demonstrated excellent agreement (k = 1.0). The Simplexa assays offer rapid and reliable alternatives for the detection of VZV in certain clinical specimens without the need for nucleic acid extraction.Translesion synthesis (TLS) by specialized DNA polymerases (Pols) is an evolutionarily conserved mechanism for tolerating replication-blocking DNA lesions. Using the Escherichia coli dinB-encoded Pol IV as a model to understand how TLS is coordinated with the actions of the high-fidelity Pol III replicase, we previously described a novel Pol IV mutant containing a threonine 120-to-proline mutation (Pol IV-T120P) that failed to exchange places with Pol III at the replication fork in vitro as part of a Pol III-Pol IV switch. This in vitro defect correlated with the inability of Pol IV-T120P to support TLS in vivo, suggesting Pol IV gains access to the DNA, at least in part, via a Pol III-Pol IV switch. Interaction of Pol IV with the β sliding clamp and the single-stranded DNA binding protein (SSB) significantly stimulates Pol IV replication and facilitates its access to the DNA. In this work, we demonstrate that Pol IV interacts physically with Pol III. We further show that Pol IV-T120P interacts normally with the β clamp, but is impaired in interactions with the α catalytic and εθ proofreading subunits of Pol III, as well as SSB.