bluuebunny/crossref_metadata_2025 huggingface dataset:
Age: “A Natural Anesthetic” in Pain Perception during the Transrectal Ultrasound-Guided Prostate Biopsy Procedure
Authors: Dell'atti Lucio , Borea Pier Andrea , Russo Gian Rosario
Published: November 2011

Introduction

The purpose of this study was to evaluate how the age factor might influence the tolerance biopsy examination, and then choose the modality of a local or general anesthetic technique.

Materials and Methods

This study evaluated 248 consecutive patients undergoing transrectal ultrasound-guided prostate biopsy for the first time. Each patient was treated under local anesthesia with lidocaine spray (10gr/100ml). Patients were divided into two groups according to age: Group A) 112 with age range ≤65 years, Group B) 136 with age range >65 years. Our first aim was to obtain a schedule of 14 biopsy samples in both groups. After the procedure each patient was given a verbal numeric pain scale (VNS), which was designed with 0 representing absence of pain and 10 the maximum pain they perceived in life.

Results

The average pain assessed with VNS was around 4.2 (2–8) and 2.8 (0–6) for the patients in Group A and Group B, respectively. The two groups appeared to be homogeneous in terms of pain perception regarding PSA value and gland volume, and appeared to have different pain scores with regard to age. In fact, the first group of patients, with the same anesthetic technique used, perceived more intense pain sensations related to acute biopsy.

Conclusions

In conclusion, we can say that a local anesthetic in clinical practice in the course of prostate biopsy is more sensitive if performed in a person aged 65 years.
Resolving the Three‐Dimensional Microstructure of Polymer Electrolyte Fuel Cell Electrodes using Nanometer‐Scale X‐ray Computed Tomography
Authors: Epting William K. , Gelb Jeff , Litster Shawn
Published: November 2011

The electrodes of a polymer electrolyte fuel cell (PEFC) are composite porous layers consisting of carbon and platinum nanoparticles and a polymer electrolyte binder. The proper composition and arrangement of these materials for fast reactant transport and high electrochemical activity is crucial to achieving high performance, long lifetimes, and low costs. Here, the microstructure of a PEFC electrode using nanometer‐scale X‐ray computed tomography (nano‐CT) with a resolution of 50 nm is investigated. The nano‐CT instrument obtains this resolution for the low‐atomic‐number catalyst support and binder using a combination of a Fresnel zone plate objective and Zernike phase contrast imaging. High‐resolution, non‐destructive imaging of the three‐dimensional (3D) microstructures provides important new information on the size and form of the catalyst particle agglomerates and pore spaces. Transmission electron microscopy (TEM) and mercury intrusion porosimetry (MIP) is applied to evaluate the limits of the resolution and to verify the 3D reconstructions. The computational reconstructions and size distributions obtained with nano‐CT can be used for evaluating electrode preparation, performing pore‐scale simulations, and extracting effective morphological parameters for large‐scale computational models.
Highly Conductive and Transparent PEDOT:PSS Films with a Fluorosurfactant for Stretchable and Flexible Transparent Electrodes
Authors: Vosgueritchian Michael , Lipomi Darren J. , Bao Zhenan
Published: November 2011

Highly conductive and transparent poly‐(3,4‐ethylenedioxythiophene):poly(styrenesulfonic acid) (PEDOT:PSS) films, incorporating a fluorosurfactant as an additive, have been prepared for stretchable and transparent electrodes. The fluorosurfactant‐treated PEDOT:PSS films show a 35% improvement in sheet resistance (Rs) compared to untreated films. In addition, the fluorosurfactant renders PEDOT:PSS solutions amenable for deposition on hydrophobic surfaces, including pre‐deposited, annealed films of PEDOT:PSS (enabling the deposition of thick, highly conductive, multilayer films) and stretchable poly(dimethylsiloxane) (PDMS) substrates (enabling stretchable electronics). Four‐layer PEDOT:PSS films have an Rs of 46 Ω per square with 82% transmittance (at 550 nm). These films, deposited on a pre‐strained PDMS substrate and buckled, are shown to be reversibly stretchable, with no change to Rs, during the course of over 5000 cycles of 0 to 10% strain. Using the multilayer PEDOT:PSS films as anodes, indium tin oxide (ITO)‐free organic photovoltaics are prepared and shown to have power conversion efficiencies comparable to that of devices with ITO as the anode. These results show that these highly conductive PEDOT:PSS films can not only be used as transparent electrodes in novel devices (where ITO cannot be used), such as stretchable OPVs, but also have the potential to replace ITO in conventional devices.
Boron Subphthalocyanine Chloride as an Electron Acceptor for High‐Voltage Fullerene‐Free Organic Photovoltaics
Authors: Beaumont Nicola , Cho Sang Wan , Sullivan Paul , Newby David , Smith Kevin E. , Jones Tim. S.
Published: November 2011

High‐efficiency fullerene‐free single‐heterojunction (SHJ) organic photovoltaic (OPV) cells consisting of tetracene (Tc) as a typical donor material and boron subphthalocyanine chloride (SubPc) as an acceptor material are reported. Cells containing SubPc as a direct replacement for C60 exhibit an ∼60% improvement in open circuit voltage (Voc) achieving a maximum Voc of 1.24 V, which is amongst the highest values acheived to date for SHJ devices. This resulted in an overall improvement of ∼60% in power conversion efficiency from 1.8%, for Tc/C60 cells, to 2.9% for Tc/SubPc. The OPV device results are complemented by soft X–ray photoelectron spectroscopy (PES) measurements of the interfacial energetics of both systems. The results demonstrate that SubPc shows considerable promise as an electron acceptor material for future cell designs.
Interspecies difference in placement of developing teeth and its relationship with cross‐sectional geometry of the mandibular symphysis in four primate species including modern humans
Authors: Fukase Hitoshi
Published: November 2011

The form of the anthropoid mandibular symphysis has recently been addressed in association with spatial requirements for the forming anterior teeth. To evaluate potential relationships between the symphyseal shape and teeth further, the growth patterns of the symphyseal region and the positioning of the tooth crypts were examined using CT data, comparing four primate species (modern humans, chimpanzees, Japanese monkeys, and hamadryas baboons) with varied symphyseal curvature and tooth size. First, results showed that interspecies differences in overall mandibular shape including symphyseal inclination and bicanine width are consistently expressed throughout postnatal ontogeny, although local symphyseal configurations related to the superior transverse torus (STT) tended to change considerably during growth in chimpanzees. Second, the four species were found to exhibit differentiated formation positions of the incisor and canine crypts. In particular, I2 developed between I1 and C in humans with a broad bicanine space and small teeth, whereas it was positioned posterior to I1 and above C in the cercopithecines with an extremely narrow bicanine space. In chimpanzees, despite the large bicanine width, I1 and I2 grew with a large antero‐posterior overlap owing to their large size. These results indicate that the dental positioning is determined in concert with the size balance of the available mandibular space and forming teeth. Finally, the positions/contours of I2 crypt were shown to correspond strongly with the STT across the taxa. This suggests that interspecies differences in symphyseal shape should be interpreted partially by the species‐specific positional relationships of the developing anterior teeth. Am J Phys Anthropol 147:217–226, 2012. © 2011 Wiley Periodicals, Inc.
Cell therapy for neonatal hypoxia–ischemia and cerebral palsy
Authors: Bennet Laura , Tan Sidhartha , Van den Heuij Lotte , Derrick Matthew , Groenendaal Floris , van Bel Frank , Juul Sandra , Back Stephen A. , Northington Frances , Robertson Nicola J. , Mallard Carina , Gunn Alistair Jan
Published: November 2011

Perinatal hypoxic–ischemic brain injury remains a major cause of cerebral palsy. Although therapeutic hypothermia is now established to improve recovery from hypoxia–ischemia (HI) at term, many infants continue to survive with disability, and hypothermia has not yet been tested in preterm infants. There is increasing evidence from in vitro and in vivo preclinical studies that stem/progenitor cells may have multiple beneficial effects on outcome after hypoxic–ischemic injury. Stem/progenitor cells have shown great promise in animal studies in decreasing neurological impairment; however, the mechanisms of action of stem cells, and the optimal type, dose, and method of administration remain surprisingly unclear, and some studies have found no benefit. Although cell‐based interventions after completion of the majority of secondary cell death appear to have potential to improve functional outcome for neonates after HI, further rigorous testing in translational animal models is required before randomized controlled trials should be considered. ANN NEUROL 2012;
FXN methylation predicts expression and clinical outcome in Friedreich ataxia
Authors: Evans‐Galea Marguerite V. , Carrodus Nissa , Rowley Simone M. , Corben Louise A. , Tai Geneieve , Saffery Richard , Galati John C. , Wong Nicholas C. , Craig Jeffrey M. , Lynch David R. , Regner Sean R. , Brocht Alicia F. D. , Perlman Susan L. , Bushara Khalaf O. , Gomez Christopher M. , Wilmot George R. , Li Lingli , Varley Elizabeth , Delatycki Martin B. , Sarsero Joseph P.
Published: November 2011

Objective:

Friedreich ataxia (FA) is the most common ataxia and results from an expanded GAA repeat in the first intron of FXN. This leads to epigenetic modifications and reduced frataxin. We investigated the relationships between genetic, epigenetic, and clinical parameters in a large case–control study of FA.

Methods:

Clinical data and samples were obtained from individuals with FA during annual visits to our dedicated FA clinic. GAA expansions were evaluated by polymerase chain reaction (PCR) and restriction endonuclease digest. DNA methylation was measured using bisulfite‐based EpiTYPER MassARRAY (Sequenom, San Diego, CA). FXN expression was determined using real‐time reverse transcriptase PCR. Significant correlations between the different parameters were examined using the nonparametric Spearman rank correlation coefficient, as well as univariate and multivariate regression modeling.

Results:

Characteristic DNA methylation was identified upstream and downstream of the expansion, and validated in an independent FA cohort. Univariate and multivariate analyses showed significant inverse correlations between upstream methylation and FXN expression, and variation in downstream methylation and age of onset. FXN expression also inversely correlated with the Friedreich Ataxia Rating Scale score, an indicator of disease severity.

Interpretation:

These novel findings provide compelling evidence for the link between the GAA expansion, the DNA methylation profile, FXN expression, and clinical outcome in FA. Epigenetic profiling of FXN could be used to gain greater insight into disease onset and progression, but also as a biomarker to learn more about specific treatment responses and pharmacological mechanism(s). This work also highlights the potential for developing therapies aimed at increasing frataxin levels to treat this debilitating disease. ANN NEUROL 2012;
Comparative effectiveness and implementation research: Directions for Neurology
Authors: Vickrey Barbara G. , Hirtz Deborah , Waddy Salina , Cheng Eric M. , Johnston S. Claiborne
Published: November 2011

There is an enormous unmet need for knowledge about how new insights from discovery and translational research can yield measurable, population‐level improvements in health and reduction in mortality among those having or at risk for neurological disease. Once several, well‐conducted randomized controlled trials establish the efficacy of a given therapy, implementation research can generate new knowledge about barriers to uptake of the therapy into widespread clinical care, and what strategies are effective in overcoming those barriers and in addressing health disparities. Comparative effectiveness research aims to elucidate the relative value (including clinical benefit, clinical harms, and/or costs) of alternative efficacious management approaches to a neurological disorder, generally through direct comparisons, and may include comparisons of methodologies for implementation. Congress has recently appropriated resources and established an institute to prioritize funding for such research. Neurologists and neuroscientists should understand the scope and objectives of comparative effectiveness and implementation research, their range of methodological approaches (formal literature syntheses, randomized trials, observational studies, modeling), and existing research resources (centers for literature synthesis, registries, practice networks) relevant to research for neurological conditions, to close the well‐documented evidence‐to‐practice gap. Future directions include building this research resource capacity, producing scientists trained to conduct rigorous comparative effectiveness and implementation research, and embracing innovative strategies to set research priorities in these areas. Ann Neurol 2012;71:732–742
A novel X‐linked disorder with developmental delay and autistic features
Authors: Kaya Namik , Colak Dilek , Albakheet Albandary , Al‐Owain Mohammad , Abu‐Dheim Nada , Al‐Younes Banan , Al‐Zahrani Jawaher , Mukaddes Nahit M. , Dervent Aysin , Al‐Dosari Naji , Al‐Odaib Ali , Kayaalp Inci V. , Al‐Sayed Moeenaladin , Al‐Hassnan Zuhair , Nester Michael J. , Al‐Dosari Mohammad , Al‐Dhalaan Hesham , Chedrawi Aziza , Gunoz Hulya , Karakas Bedri , Sakati Nadia , Alkuraya Fowzan S. , Gascon Generaso G. , Ozand Pinar T.
Published: November 2011

Objective:

Genomic duplications that lead to autism and other human diseases are interesting pathological lesions since the underlying mechanism almost certainly involves dosage sensitive genes. We aim to understand a novel genomic disorder with profound phenotypic consequences, most notably global developmental delay, autism, psychosis, and anorexia nervosa.

Methods:

We evaluated the affected individuals, all maternally related, using childhood autism rating scale (CARS) and Vineland Adaptive scales, magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) brain, electroencephalography (EEG), electromyography (EMG), muscle biopsy, high‐resolution molecular karyotype arrays, Giemsa banding (G‐banding) and fluorescent in situ hybridization (FISH) experiments, mitochondrial DNA (mtDNA) sequencing, X‐chromosome inactivation study, global gene expression analysis on Epstein‐Barr virus (EBV)‐transformed lymphoblasts, and quantitative reverse‐transcription polymerase chain reaction (qRT‐PCR).

Results:

We have identified a novel Xq12–q13.3 duplication in an extended family. Clinically normal mothers were completely skewed in favor of the normal chromosome X. Global transcriptional profiling of affected individuals and controls revealed significant alterations of genes and pathways in a pattern consistent with previous microarray studies of autism spectrum disorder patients. Moreover, expression analysis revealed copy number–dependent increased messenger RNA (mRNA) levels in affected patients compared to control individuals. A subset of differentially expressed genes was validated using qRT‐PCR.

Interpretation:

Xq12–q13.3 duplication is a novel global developmental delay and autism‐predisposing chromosomal aberration; pathogenesis of which may be mediated by increased dosage of genes contained in the duplication, including NLGN3, OPHN1, AR, EFNB1, TAF1, GJB1, and MED12. ANN NEUROL 2012
Rare variants in the CYP27B1 gene are associated with multiple sclerosis
Authors: Ramagopalan Sreeram V. , Dyment David A. , Cader M. Zameel , Morrison Katie M. , Disanto Giulio , Morahan Julia M. , Berlanga‐Taylor Antonio J. , Handel Adam , De Luca Gabriele C. , Sadovnick A. Dessa , Lepage Pierre , Montpetit Alexandre , Ebers George C.
Published: November 2011

Objective:

Multiple sclerosis (MS) is a complex neurological disease. Genetic linkage analysis and genotyping of candidate genes in families with 4 or more affected individuals more heavily loaded for susceptibility genes has not fully explained familial disease clustering.

Methods:

We performed whole exome sequencing to further understand the heightened prevalence of MS in these families.

Results:

Forty‐three individuals with MS (1 from each family) were sequenced to find rare variants in candidate MS susceptibility genes. On average, >58,000 variants were identified in each individual. A rare variant in the CYP27B1 gene causing complete loss of gene function was identified in 1 individual. Homozygosity for this mutation results in vitamin D‐dependent rickets I (VDDR1), whereas heterozygosity results in lower calcitriol levels. This variant showed significant heterozygous association in 3,046 parent‐affected child trios (p = 1 × 10−5). Further genotyping in >12,500 individuals showed that other rare loss of function CYP27B1 variants also conferred significant risk of MS, Peto odds ratio = 4.7 (95% confidence interval, 2.3–9.4; p = 5 × 10−7). Four known VDDR1 mutations were identified, all overtransmitted. Heterozygous parents transmitted these alleles to MS offspring 35 of 35× (p = 3 × 10−9).

Interpretation:

A causative role for CYP27B1 in MS is supported; the mutations identified are known to alter function having been shown in vivo to result in rickets when 2 copies are present. CYP27B1 encodes the vitamin D‐activating 1‐alpha hydroxylase enzyme, and thus a role for vitamin D in MS pathogenesis is strongly implicated. ANN NEUROL 2011;70:881–886
Durch N‐heterocyclische Carbene katalysierte Dominoreaktionen
Authors: Grossmann André , Enders Dieter
Published: November 2011

Während sich die organokatalytischen Dominoreaktionen (auch Organokaskadenkatalysen genannt) im letzten Jahrzehnt zu einem wichtigen Hilfsmittel in der Synthesechemie entwickelt haben, fand die Anwendung von N‐heterocyclischen Carbenen (NHCs) als Katalysatoren in Dominoreaktionen erst in den letzten drei Jahren zunehmend Beachtung. Unter Berücksichtigung der besonderen Aktivierungsmodi der Substrate durch die NHC‐Katalysatoren ist eine Unterscheidung zwischen einer einzelnen chemischen Transformation und einer sequenziellen Eintopfreaktion schwierig. Das Ziel dieses Kurzaufsatzes besteht darin, die Domino‐, Kaskaden‐ und Tandemkatalyse in Gegenwart von NHC‐Katalysatoren kritisch zu betrachten und jüngste Publikationen auf diesem Gebiet vorzustellen.
Transition‐Metal‐Catalyzed Denitrogenative Transannulation: Converting Triazoles into Other Heterocyclic Systems
Authors: Chattopadhyay Buddhadeb , Gevorgyan Vladimir
Published: November 2011

Transition metal catalyzed denitrogenative transannulation of a triazole ring has recently received considerable attention as a new concept for the construction of diverse nitrogen‐containing heterocyclic cores. This method allows a single‐step synthesis of complex nitrogen heterocycles from easily available and cheap triazole precursors. In this Minireview, recent progress of the transition metal catalyzed denitrogenative transannulation of a triazole ring, which was discovered in 2007, is discussed.
Quantitative determination of bioactive alkaloids lysergol and chanoclavine in Ipomoea muricata by reversed‐phase high‐performance liquid chromatography
Authors: Maurya Anupam , Verma Ram Kishore , Srivastava Santosh Kumar
Published: November 2011

A rapid, simple, sensitive, gradient and reproducible, reverse‐phase high‐performance liquid chromatographic method was developed for the quantitative estimation of bioactive alkaloids, lysergol and chanoclavine in the seeds of Ipomoea muricata. The clavine alkaloid, lysergol, is a bioenhancer for the drugs and nutrients. The samples were analyzed by reverse‐phase chromatography on a Waters spherisorb ODS2 column (250 × 4.6 mm, i.d., 10 µm) using binary gradient elution with acetonitrile and 0.01 m phosphate buffer (NaH2PO4) containing 0.1% glacial acetic acid at a flow rate of 0.8 mL/min, a column temperature of 25 °C and UV detection at λ 254 nm. The limits of detection (LOD) and quantitation (LOQ) were 0.035 and 0.106 µg/mL for lysergol and 0.039 and 0.118 µg/mL for chanoclavine, respectively. Standard curves were linear in the range of 2–10 µg/mL (r > 99) for both analytes. Good results were achieved with respect to repeatability (RSD < 2%) and recovery (99.20–102.0). The method was validated for linearity, accuracy repeatability, LOQ and LOD. The method is simple, accurate and precise, and may be recommended for routine quality control analysis of I. muricata seed extracts containing these two clavine alkaloids (1, 2) as bioactive principles of the herb. Copyright © 2011 John Wiley & Sons, Ltd.
Beliefs Contributing to HIV‐related Stigma in African and Afro‐Caribbean Communities in the Netherlands
Authors: Stutterheim Sarah E. , Bos Arjan E. R. , van Kesteren Nicole M. C. , Shiripinda Iris , Pryor John B. , de Bruin Marijn , Schaalma Herman P.
Published: November 2011

Thirty years after the first diagnosis, people living with HIV (PLWH) around the world continue to report stigmatizing experiences. In this study, beliefs contributing to HIV‐related stigma in African and Afro‐Caribbean diaspora communities and their cultural context were explored through semi‐structured interviews with HIV‐positive (N = 42) and HIV‐negative (N = 52) African, Antillean and Surinamese diaspora community members in the Netherlands. Beliefs that HIV is highly contagious, that HIV is a very severe disease, and that PLWH are personally responsible for acquiring their HIV infection were found to contribute to HIV‐related stigma, as did the belief that PLWH are HIV‐positive because they engaged in norm‐violating behaviour such as promiscuity, commercial sex work, and, for Afro‐Caribbean diaspora, also homosexuality. These beliefs were found to be exacerbated and perpetuated by cultural taboos on talking about HIV and sexuality. HIV‐related stigma reduction interventions should focus on changing these beliefs and breaking cultural taboos on HIV and sexuality in a manner that is participatory and consistent with the current theory and empirical findings. Copyright © 2011 John Wiley & Sons, Ltd.
How valuable is a well‐crafted design and name brand?: Recognition and willingness to pay
Authors: Kristensen Tore , Gabrielsen Gorm , Zaichkowsky Judith Lynne
Published: November 2011

Preferences for similarly designed consumer products, evaluated blind and branded and also with and without prices, were tested in a consumer setting. The consumer's perceptual experience led to preference of the well‐crafted high‐priced option. This preference was enhanced by priming consumers with background information about the brand, perhaps causing the subjects to guess which choice was the well‐known brand before evaluation. Preferences for that choice increased again when brand names were visible during evaluation. When actual prices were added to the evaluations, preferences for the well‐known brand were very robust to high prices, indicating the strength of the brand name. Using the least preferred option and the lowest price as an anchor, the consumers' price threshold to pay for the preferred design and the brand name was computed. Attempts to explain and predict individual differences of choices using measures of inherent design acumen, prior experience, and purchasing behavior were largely unsuccessful. Copyright © 2011 John Wiley & Sons, Ltd.
The XIENCE nano™ everolimus eluting coronary stent system for the treatment of small coronary arteries: The SPIRIT small vessel trial
Authors: Cannon Louis A. , Simon Daniel I. , Kereiakes Dean , Jones Jennifer , Mehran Roxana , Kusano Hajime , Zhang Zhen , Lombardi William , James Fleischhauer F. , Costa Marco A.
Published: November 2011

Objectives: The SPIRIT Small Vessel (SV) was designed to evaluate the safety and effectiveness of the 2.25‐mm XIENCE V everolimus eluting coronary stent system (EECSS), known as the XIENCE nano EECSS, in subjects with SVs and ischemic heart disease. Background: The core sizes of XIENCE V EECSS are associated with low rates of restenosis and thrombosis in the general population, but the XIENCE nano EECSS has not been tested in the United States. Methods: This prospective, single‐arm, open‐label study was conducted at 33 centers and in 150 patients in the United States. The primary endpoint was the target lesion failure (TLF) rate at 1 year, required to meet the prespecified performance goal (PG) of 20.4%, derived from historical data. Results: The mean patient age was 63 years, 38% were women, 39.2% were diabetic, 49.3% had multivessel disease, and the reference vessel diameter was 2.13 ± 0.23 mm. The 1‐year TLF rate was 8.1% in with an upper limit of the one‐sided 95% confidence interval of 13.0%, which met the PG of 20.4% (P < 0.0001). At 1 year, the rate of cardiac death was 1.5%, the target vessel myocardial infarction rate was 1.5%, and clinically indicated target lesion revascularization rate was 5.1%. The 8‐month angiographic in‐stent late loss was 0.2 ± 0.4 mm, respectively. The 1‐year academic research consortium defined definite/probable stent thrombosis rate was 1.5%. Conclusions: Based on the 1‐year clinical and 8‐month angiographic SPIRIT SV data, the XIENCE nano EECSS is considered safe and effective in the treatment of SVs. © 2011 Wiley Periodicals, Inc.
Retrograde fractional flow reserve and recanalization of a chronic total occlusion of a saphenous venous graft
Authors: Singla Sandeep , Uretsky Barry F. , Sachdeva Rajesh
Published: November 2011

Chronic total occlusion (CTO) of the coronary artery represents a difficult group of lesions for percutaneous interventions. Conventionally, antegrade approach has been used to open these lesions, but recent literature provides evidence for the utility of retrograde approach in cases where initial antegrade approach is either not feasible or fails to recanalize the target vessel. This report illustrates retrograde CTO recanalization of saphenous vein graft (SVG) with fractional flow reserve utilization to determine ischemia in the territory of occluded SVG. © 2012 Wiley Periodicals, Inc.
The prognostic role of mitral regurgitation after primary percutaneous coronary intervention for acute ST‐Elevation myocardial infarction
Authors: Uddin Ahmed M. , Henry Timothy D. , Hodges James S. , Haq Zeeshan , Pedersen Wesley R. , Harris Kevin M.
Published: November 2011

Objectives: The aim of this study was to elucidate the prognostic significance of mitral regurgitation (MR) after primary percutaneous coronary intervention (PCI) for acute ST‐elevation myocardial infarction (STEMI). Background: MR has prognostic implications after myocardial infarction (MI). However, for STEMI patients receiving primary PCI, the influence of MR on long‐term (3–5 years) outcome is unknown. Methods: We examined 888 STEMI patients receiving primary PCI enrolled in a prospective database at a regional STEMI center, who had an echocardiogram within 72 hr following successful primary PCI. MR was graded by color Doppler as none/trace vs. mild vs. moderate/severe. Mean ± SD follow‐up was 3.1 ± 1.4 years. Results: For patients with none/trace (n = 469), mild (n = 325), and moderate/severe (n = 94) MR, mortality at 3 years was 8.1%, 13.6%, and 25.7% and at 5 years was 12.7%, 18.3%, and 33.5%, respectively (P < 0.0001, log‐rank test). Patients with moderate/severe MR tended to be older (P < 0.0001) with lower ejection fraction (P < 0.0001) and were less likely to have had an anterior MI (P < 0.001). Independent predictors of mortality included age, creatinine, and heart rate. Conclusions: Following primary PCI for STEMI, echocardiographic detected MR in the first 72 hr following PCI stratifies mortality risk. However, when accounting for age, MR is not an independent predictor of mortality. © 2011 Wiley Periodicals, Inc.
Use of intraprocedural CT imaging to guide alcohol septal ablation of hypertrophic cardiomyopathy in the cardiac catheterization laboratory
Authors: Krishnaswamy Amar , Tuzcu E. Murat , Kapadia Samir R.
Published: November 2011

Alcohol septal ablation (ASA) is a common treatment for hypertrophic cardiomyopathy. The success of the procedure is dependent on targeting a small dose of alcohol to the appropriate septal perforator in order to cause a myocardial infarction in the septum at the point of mitral valve contact. Typically, this is identified by injecting echocardiographic contrast into a septal vessel and using echocardiography to confirm that the area of septal–systolic anterior motion contact is highlighted. Rotational angiography using the C‐arm in the catheterization laboratory acquires a 3‐dimensional “CT‐like” image, and has shown promise in providing anatomic guidance in coronary and structural heart disease interventions. We demonstrate here a novel application of intraprocedural CT imaging to localize the region of interest for ASA in the catheterization laboratory. © 2012 Wiley Periodicals, Inc.
Clinical outcome following transcatheter aortic valve implantation in patients with impaired left ventricular systolic function
Authors: van der Boon Robert M. , Nuis Rutger‐Jan , Van Mieghem Nicolas M. , Benitez Luis M. , van Geuns Robert‐Jan , Galema Tjebbe W. , van Domburg Ron T. , Geleijnse Marcel L. , Dager Antonio , de Jaegere Peter P.
Published: November 2011

Objectives: To determine the prevalence of impaired left ventricular (LV) systolic function and its impact on the in‐hospital and long‐term outcome in patients who underwent Transcatheter Aortic Valve Implantation (TAVI). Background: Although impaired LV function may be considered a contra‐indication for aortic valve replacement, the hemodynamic characteristics of transcatheter valves may offer procedural and long‐term clinical benefit in such patients. Methods: 230 consecutive patients underwent TAVI with the Medtronic‐CoreValve System. Impaired LV function was defined by a Left Ventricular Ejection Fraction (LVEF) ≤ 35% (European Multicenter Study on Operative Risk Stratification and Long‐term Outcome in patients with Low‐Flow/Low‐Gradient Aortic Stenosis). Study endpoints were selected and defined according to the Valve Academic Research Consortium recommendations. Results: Compared with patients with a LVEF > 35% (n = 197), those with LVEF ≤ 35% (n = 33) were more often male (78.8 % vs. 46.7%, P < 0.001), more symptomatic (NYHA class III or IV, 97.0% vs. 77.2%, P = 0.008) and had a higher prevalence of prior coronary artery disease (63.6% vs. 43.1%, P = 0.029). The Logistic EuroSCORE was 14.8% and 22.8, respectively (P = 0.012). No difference was observed between the two groups in in‐hospital or 30‐day mortality (3.0% vs. 9.6%, P = 0.21), the Combined Safety Endpoint at 30 days (24.2% and 24.4%, P = 0.99) and survival free from readmission at one year (69.2% and 69.7%, P = 0.85). After adjustment, LVEF ≤ 35% was not associated with an increased risk of 30‐day mortality, in‐hospital complications and survival free from readmission at follow‐up. Conclusion: The immediate and long‐term outcome after TAVI did not differ between patients with an impaired and preserved LVEF. LVEF ≤ 35% did not predict adverse immediate and long‐term outcome. These findings suggest that TAVI should not be withheld in selected patients with impaired LV function. © 2011 Wiley Periodicals, Inc.
Anatomic features of the left main coronary artery and factors associated with its bifurcation angle: A 3‐dimensional quantitative coronary angiographic study
Authors: Rubinshtein Ronen , Lerman Amir , Spoon Daniel B. , Rihal Charanjit S.
Published: November 2011

Objective: To assess the anatomic characteristics of the left main coronary artery (LM), and the relation between anatomic and clinical factors and the LM bifurcation angle (BA) using a novel, three dimensional quantitative coronary angiography (3D QCA) software. Background: Percutaneous intervention of the LM is a therapeutic option in selected patients with coronary artery disease (CAD). The anatomic features of the LM and its BA are determinants of procedural success and clinical outcome. However, those features and the factors that may affect the LM BA have not been fully described. Methods: The LM anatomy was evaluated from angiograms of 203 patients (age = 66 ± 11 years, 31% female) with and without LM CAD using 3D QCA analysis (IC‐PRO, Paieon, Israel). LM size as well as the proximal BA (between LM and LCX) and the distal BA (between left anterior descending coronary artery (LAD) and left circumflex coronary artery (LCX)) were measured in end‐diastole. Angiographic and clinical findings were also recorded. Results: 133/203 patients (65%) had no LM CAD. 3D QCA analysis demonstrated significant variability in the anatomy of the normal LM, including the LM branch vessels (LAD, LCX) diameter, and the LM BA. Among the 70 patients with LM CAD, 44 had distal LM disease. Importantly, patients with distal LM CAD had narrower proximal BA and a wider distal BA. Multivariate analysis (adjusted for clinical and anatomic variables) identified female sex (P = 0.02), trifurcation anatomy (P = 0.009), age > 75 years (P = 0.0009), and LM length > 12 mm (P = 0.001) as independent associates of the proximal BA. Independent associates of the distal BA were: trifurcation anatomy (P = 0.001), LM length > 12 mm (P < 0.0001), age > 75 years (P = 0.004), and a history of coronary bypass surgery (P = 0.04). Conclusions: The current study demonstrates significant variability in the anatomy of the LM. The LM BA differs between patients with and without distal LM CAD, and both anatomic and clinical factors may affect the LM BA. Our findings also emphasize the possible usefulness of 3D QCA in the assessment of the LM. © 2012 Wiley Periodicals, Inc.
Retrograde transpedal stenting of the tibioperoneal trunk in critical limb ischemia
Authors: Ruzsa Zoltán , Pintér László , Kolvenbach Ralf
Published: November 2011

Management of critical limb ischemia (CLI) requires a combined treatment approach: optimal medical therapy and revascularization procedures are both essential for favorable outcome. With the development of endovascular interventions these new modalities took the primary role in limb revascularization, especially in CLI patients, where the culprit lesion is often located below the knee (BTK) level, making the surgical procedure unfeasible. In our present case report, we demonstrate a successful percutaneous recanalization of a surgically non‐treatable tibioperoneal trunk occlusion. The procedure was performed with dual access from anterograde and retrograde transpedal approach, and modified “V stenting” technique was used. We describe feasibility of bail out stenting using retrograde posterior tibial artery access after failed retrograde guidewire externalization. Our report discusses the feasibility, safety, and efficacy of the retrograde approach applying 4F compatible devices. © 2012 Wiley Periodicals, Inc.
Use of four MitraClip devices in a patient with ischemic cardiomyopathy and mitral regurgitation
Authors: Kische Stephan , Nienaber Christoph , Ince Hüseyin
Published: November 2011

Severe mitral regurgitation (MR) as a consequence of underlying left ventricular dysfunction substantially contributes to morbidity and mortality. A variety of percutaneous treatment options for mitral valve repair have been developed; however, most of these techniques are still at an early stage of clinical evaluation. Today, percutaneous edge‐to‐edge mitral valve repair using the MitraClip® system is the only endovascular approach that demonstrated noninferiority when compared with standard surgical repair in a randomized trial. However, a considerable number of patients with functional MR will present with extensive annulus dilatation and minimal vertical leaflet coaptation that potentially preclude them from this beneficial technology for anatomical reasons. In this report, we portray a 72‐year‐old man presenting with end‐stage systolic heart failure and severe functional MR as a consequence of long‐standing coronary artery disease. Recently, his clinical course was complicated by intractable hemodynamic instability and recurrent pulmonary edema. High predicted mortality and progressive physical decay rendered this moribund patient a candidate for salvage percutaneous mitral valve repair. During the endovascular procedure, a central systolic coaptation gap of 7 mm proved to be too wide for adequate simultaneous grasping of both leaflets. Consideration was given to an alternative approach by means of our novel “zipping technique.” Through the trans‐septal route, medial to lateral approximation of the tethered leaflets was successfully achieved by intentional deployment of four MitraClip® devices. With the first in‐human application of four mechanical implants, a profound reduction of MR grade has been accomplished by the creation of a lateral neo‐orifice with apparent acute clinical success. However, it needs to be determined whether successful application of the zipping technique leads to sustained reverse ventricular remodeling and will translate into an improved long‐term prognosis. © 2012 Wiley Periodicals, Inc.
Elective percutaneous intervention for intracranial atherosclerotic stenoses by interventional cardiologists
Authors: Badawi Ramy A. , White Christopher J. , Collins Tyrone J. , Jenkins J. Stephen , Reilly John P. , Grise Mark A. , McMullan Paul W. , Ramee Stephen R.
Published: November 2011

Background: Current “best” medical therapy with anti‐platelet and/or anti‐thrombotic agents for symptomatic atherosclerotic intracranial (IC) disease is associated with high recurrence. IC catheter‐based therapy (CBT) using balloon angioplasty with or without stent placement is an option for patients who have failed medical therapy. We sought to examine the outcomes of CBT for patients with symptomatic IC arterial disease managed by experienced interventional cardiologists. Methods: We retrospectively studied 89 consecutive symptomatic patients with 99 significant (≥70% diameter) IC arterial stenoses who underwent CBT. CBT was performed by experienced interventional cardiologists with the consultative support of a neurovascular team. The primary endpoint was stroke and vascular death. Results: Procedure success was achieved in 96/99 (97%) lesions and percent diameter stenosis was reduced from 91% ± 7.5% preprocedure to 19% ± 15% postprocedure (P < 0.001). The rate of in‐hospital periprocedural stroke and all death was 3%. The primary endpoint of stroke and vascular death rate at 1 year was 5.7% (5/88) and at 2 years was 13.5% (11/81). The 2‐year all‐cause mortality was 11.3% (10/88). Conclusions: For patients with symptomatic IC arterial stenosis who have failed medical therapy or are considered very high risk for stroke, CBT performed by experienced interventional cardiologists is safe and offers both high procedural success rates and excellent clinical outcomes at 1 year. CBT is an attractive option for this high‐risk patient population considering the expected 12–15% rate of recurrent stroke at 1 year. © 2012 Wiley Periodicals, Inc.
Comparison of the efficacy and safety of paclitaxel‐eluting coroflex please stents and paclitaxel‐eluting stents in patients with coronary artery disease: A randomized PIPA trial
Authors: Kim Hyun‐Sook , Park Seung‐Jung , Park Duk‐Woo , Park Seong‐Wook , Cheong Sang‐Sig , Lee Sang‐Gon , Cho Byung‐Ryul , Lee Seung‐Wook , Lee Nae‐Hee , Lee Keun ,   for the PIPA Study Investigators
Published: November 2011

Objectives: To compare the safety and efficacy of the new Coroflex™ Please stents with conventional Taxus™ Liberte stents in patients with coronary artery lesions. Background: The Coroflex™ Please stent is a new version of paclitaxel‐eluting stent, and observational cohort studies have reported similar angiographic and clinical outcomes as with the first‐generation stents. However, it has not been directly compared with the early generation paclitaxel‐eluting stents in a multicenter, prospective, and randomized study. Methods: We randomly assigned 319 patients to receive Coroflex™ Please stents (159 patients; 198 lesions) or Taxus™ Liberte stents (160 patients; 232 lesions). The primary end point was angiographic in‐segment late luminal loss at 9 months. Results: Most baseline clinical and angiographic characteristics were similar between these two groups. The Coroflex™ Please and Taxus™ Liberte stents showed similar in‐segment late loss (0.40 ± 0.53 mm vs. 0.39 ± 0.52 mm, P = 0.98) and rates of in‐segment binary restenosis (22.2% vs. 18.8%, P = 0.48) at 9 months. After clinical follow‐up for 12 months, the two groups had similar rates of death (1.3% vs. 1.3%, P > 0.99), myocardial infarction (3.8% vs. 7.5%, P = 0.22), stent thrombosis (2.5% vs. 1.9%, P = 0.72), and target‐lesion revascularization (7.5% vs. 7.5%, P = 0.99). Conclusions: The Coroflex™ Please stent resulted in similar angiographic and clinical outcomes as the Taxus™ Liberte stent in patients with coronary artery lesions. © 2012 Wiley Periodicals, Inc.
One + One‐Dimensional Modeling of Monolithic Catalytic Converters
Authors: Depcik C. , Srinivasan A.
Published: November 2011

The inclusion of a washcoat model into monolithic catalyst simulations in order to create a one + one‐dimensional framework using a minimum number of parameters is reviewed. All assumptions and numerical methods are presented while ensuring the prevention of excessive temperature excursions. Parametric studies illustrate the influence of model parameters (porosity, wall thickness, pore diameter) on the conversion of carbon monoxide during a light‐off experiment using a uniform washcoat. Moreover, simulating a layered washcoat of dissimilar catalytic materials demonstrates a significant influence on conversion characteristics depending on the order of the layers. As a result, employing a washcoat requires careful consideration of the advection of the gas, the reactions occurring in each catalytic material, material layering, the diffusion properties of the different species, and the characteristics of the washcoat.
CFD Prediction of the Critical Agitation Speed for Complete Dispersion in Liquid‐Liquid Stirred Reactors
Authors: Cheng D. , Cheng J. , Yong Y. , Yang C. , Mao Z.‐S.
Published: November 2011

A computational fluid dynamics (CFD) model is adopted to simulate the turbulent immiscible liquid‐liquid flow in a stirred vessel based on a two‐fluid model with a k‐ϵ‐AP turbulence model. An improved inner‐outer iterative procedure is adopted to deal with the impeller rotation in a fully baffled stirred tank. Different drag formulations are examined, and the effect of the droplet size on both the dispersed phase holdup distribution and the velocity field is analyzed. Two different numerical criteria are tested for determining the critical impeller speed for complete dispersion. The simulated critical impeller speeds are generally in good agreement with the correlations in the literature when the fixed droplet size is properly selected. This demonstrates that the modeling approach and the numerical criteria proposed in this work are promising for predicting the dispersion characteristics in liquid‐liquid stirred tanks.
Heat Exchanger Network Integration Considering Flow Exergy Loss
Authors: Jiang N. , Li L.
Published: November 2011

This work describes a systematic procedure to integrate a heat exchanger network (HEN) considering heat and flow exergy consumptions. The flow exergy consumption by the HEN is calculated by means of pressure drop correlation and stepwise optimization. Case studies reveal that the flow exergy loss changes the two‐way trade‐off between the operating cost and the capital cost in the traditional method. The introduction of heat exergy loss adds the weight of energy cost by considering both the external utility consumption and internal heat exergy loss in the HEN, which benefits heat recovery and energy conservation at the cost of more area and investment. In contrast, the flow exergy loss shifts the balance to the capital cost by adding the cost relating to area in terms of flow frictional dissipation.
Development of Al2O3 Film on Diatomite for Treating Wastewater Containing Anionic Polyacrylamide
Authors: Zhang Y. , Zhang C. , Zhang Y. , Zhang G. , Liu S. , Xu Z.
Published: November 2011

To efficiently treat anionic polyacrylamide (APAM) with a linear structure in wastewater, an Al2O3 film on the surface of diatomite was prepared via the hydrolysis reaction of AlCl3. The Al2O3‐coated diatomite was characterized by FT‐IR, XRD, and SEM. The results show that the Al2O3 film can be coated on diatomite. The resulting Al2O3‐coated diatomite was utilized to treat wastewater (pH = 7) that contained APAM of 60 mg L–1 and suspended solids of 90 mg L–1. Results show that after wastewater was treated using Al2O3‐coated diatomite, the content of APAM and suspended solids in the filtrate can meet the standard for wastewater recycling. Therefore, Al2O3‐coated diatomite can be used in treating wastewater containing APAM.
Partially Acetylated Sugarcane Bagasse for Wicking Oil from Contaminated Wetlands
Authors: Chung S. , Suidan M. T. , Venosa A. D.
Published: November 2011

Sugarcane bagasse was partially acetylated to enhance its oil‐wicking ability in saturated environments while holding moisture for hydrocarbon biodegradation. The water sorption capacity of raw bagasse was reduced fourfold after treatment, which indicated considerably increased hydrophobicity but not a limited capability to hold moisture for hydrocarbon biodegradation. Characterization results by Fourier transform infrared (FT‐IR), scanning electron microscopy (SEM), X‐ray diffraction (XRD), and surface area analyzer suggested that treated bagasse exhibited enhanced hydrophobicity and surface area. Oil wicking test results indicate that treated bagasse is more effective in wicking oil from highly saturated environments than raw bagasse and suggest that application of this material in remediation of oil spills in highly saturated wetlands is promising.
From {Bi22O26} to Chiral Ligand‐Protected {Bi38O45}‐Based Bismuth Oxido Clusters
Authors: Mansfeld Dirk , Miersch Linda , Rüffer Tobias , Schaarschmidt Dieter , Lang Heinrich , Böhle Tony , Troff Ralf W. , Schalley Christoph A. , Müller Jens , Mehring Michael
Published: November 2011

The reaction of [Bi22O26(OSiMe2tBu)14] (1) in THF with salicylic acid gave [Bi22O24(HSal)14] (2) first, which was converted into [Bi38O45(HSal)22(OH)2(DMSO)16.5] ⋅DMSO⋅H2O (3⋅DMSO⋅H2O) after dissolution and crystallization from DMSO. Single‐crystal X‐ray diffraction analysis and ESI mass spectrometry associated with infrared multi‐photon dissociation (IRMPD) tandem MS experiments confirm the formation of the large and quite stable bismuth oxido cluster 3. The reaction of compound 2 with the butoxycarbonyl(BOC)‐protected amino acids phenylalanine and valine (BOC‐PheOH and BOC‐ValOH), respectively, resulted in the formation of chiral [Bi38O45(BOC‐AA)22(OH)2] (AA=deprotonated amino acid), as shown by a combination of different analytical techniques such as elemental analysis, dynamic light scattering, circular dichroism spectroscopy, and ESI mass spectrometry.