bluuebunny/crossref_metadata_2025 huggingface dataset:
O-024 A Cost-Effectiveness Analysis of Mechanical Thrombectomy for Acute Ischaemic Stroke in the Stent-Retriever ERA
Authors: Kass-Hout T , Kass-Hout O , Sun C , Gupta R , Nogueira R
Published: July 2013

Background and purpose

Early Reperfusion is critical for favourable outcomes in ischaemic stroke (AIS). Stent-Retrievers lead to faster and more complete reperfusion than previous technologies. Our aim is to compare the cost-effectiveness of Stent-Retrievers (the Solitaire™ FR device and the Trevo™ Pro Retrieval System) to the previous mechanical thrombectomy devices.

Methods

Retrospective review of a prospective collected database of endovascularly treated large vessel AIS in a large academic centre. Data from all consecutive patients who underwent treatment with Merci, Penumbra, intracranial stenting, or Stent-Retrievers from January 2012 through November 2012 were analysed. Baseline characteristics including age, gender, baseline NIHSS, and co-morbidities were analysed. The primary outcomes measures was the total procedural cost (using device list price). Other outcome measures included the rates of successful near-complete or complete recanalisation (TICI 2b-3) and good outcomes (90-day mRS 0–2) as well as the length of stay at the hospital, and the critical care unit. Univariate analysis was performed to identify any differences between the Stent-Retriever (SR) and the Non Stent-Retriever (NSR) groups. Logistic regression analysis was performed to define factors associated with a “high cost procedure” (defined as a cost above the median procedural cost for the overall cohort).

Results

After excluding the patients that underwent concomitant extra-cranial stenting (n=22) or received Intra-Arterial t-PA only (n=6), the entire cohort included 150 patients. There were no significant differences in terms of baseline characteristics between the SR group (n= 85) and the NSR group (n=65). The total cost of the reperfusion procedure was significantly higher in the SR group compared to the NSR ($13,419 vs $9,308, p <0.001). We were unable to demonstrate a statistical significant difference in the rates of TICI 2b-3 reperfusion (81 % vs 74% respectively, p= 0.337) or the length of stay (11.1 ± 9.1 days vs 12.8 ± 9.6 days respectively, p=0.260) amongst the SR and the NSR patients./ Notably, the devices procedural cost alone for the SR and NSR treatments comprised 44% and 31% of the national mechanical thrombectomy DRG (MS-DRG 024 = $30,197), respectively.

Conclusion

The procedural costs of mechanical thrombectomy for AIS are increasing and account for the bulk of hospitalisation reimbursement. The impact of these expenditures in the long-term sustainability of stroke centres deserves greater consideration. While is likely that the SR technology results in higher rates of optimal reperfusion, better clinical outcomes, and shorter lengths of stay, larger studies are needed to prove its cost-effectiveness.

Disclosures

T. Kass-Hout: None. O. Kass-Hout: None. C. Sun: None. R. Gupta: None. R. Nogueira: None.
P-004 Retreatment and Rebleed Rates of Coiled Aneurysms with Respect to the Raymond-Roy Scale, a Meta Analysis
Authors: Darflinger R , Urdaneta A , Chao K , Feng L
Published: July 2013

Introduction

We tend to use the Raymond-Roy scale for aneurysm occlusion although its significance in terms of long term durability and outcome has not been established. Although there is a tendency of higher recurrence after initial aneurysm coiling with higher grades, the retreatment rates and rebleed rates are less understood. We conducted a meta-analysis to study the retreatment and rebleed rates after initial aneurysm coiling.

Method

We performed a meta-analysis utilising publications in pubmed for cerebral aneurysm coiling retreatment and rebleed. We then analysed papers with data that provided initial aneurysm coiling results using the Raymond-Roy system or some variation. We selected data with at least 1 year follow up. Given staged treatment, we defined retreatment as occurring greater than 3 month to exclude intentionally incomplete treatment. Rebleed was defined as greater than 1 month to exclude periprocedural complications.

Results

Initial angiographic results after aneurysm coiling utilising Raymond-Roy scale: grade 1 - 53%, grade 2 - 34%, grade 3 - 13%. For those aneurysms with initial grade 1 occlusion, there was 11% recurrence, 5% retreatment, and <1% rebleed. For those aneurysms with initial grade 2 neck remnant, there was 16% recurrence, 4% retreatment, and <1% rebleed. For those aneurysm with initial grade 3 residual aneurysm, there was 18% recurrence, 11% retreatment, and <1% rebleed. Although there was a difference in aneurysm recurrence after initial treatment, grade 1 and 2 demonstrated no significant difference in retreatment and rebleed.

Conclusion

The Raymond-Roy scale provides predictive value for recurrence but less predictive value for retreatment and rebleed of cerebral aneurysms after coiling. Furthermore, grade 1 and 2 coiled aneurysms may not have any impact on clinical outcome given similar rates of retreatment and rebleed.

Disclosures

R. Darflinger: None. A. Urdaneta: None. K. Chao: None. L. Feng: None.
P-007 Flow Diversion versus Traditional Aneurysm Embolisation Strategies: Analysis of Fluoroscopy and Procedure Times
Authors: Chalouhi N , McMahon J , Moukarzel L , Starke R , Jabbour P , Dumont A , Tjoumakaris S , Rosenwasser R , Gonzalez L
Published: July 2013

Background and Purpose

Flow diverters are increasingly used for treatment of complex intracranial aneurysms. The goal of this study was to compare the Pipeline Embolisation Device (PED) and traditional embolisation strategies in terms of fluoroscopy and procedure time.

Methods

Fluoroscopy and procedure times in minutes were retrospectively analysed and compared between 127 patients treated with PED, 86 patients treated with single-stage SAC, and 16 patients treated with Onyx HD 500 at our institution. A multivariate logistic regression analysis was performed to determine independent predictors of fluoroscopy and procedure time.

Results

The 3 groups were comparable with respect to patient age, gender, and ruptured/ unruptured aneurysm status. Aneurysms treated with PED were significantly larger than stent-coiled aneurysms and aneurysm location distribution differed significantly between the 3 groups. Mean fluoroscopy time was significantly increased in the SAC (55 ± 31 min, p>0.001) and Onyx HD 500 (91 ± 36 min, p>0.001) groups relative to PED (34 ± 23 min). Likewise, mean procedure time was significantly longer in SAC (155 ± 50 min, p>0.001) and Onyx HD 500 patients (176 ± 65 min, p>0.001) compared to PED (131 ± 36 min). Mean fluoroscopy and procedure times remained significantly longer in SAC and Onyx HD 500 patients compared with those who underwent placement of more than 1 PED. In multivariate analysis, SAC/Onyx HD 500 vs PED independently predicted both longer procedure and fluoroscopy times.

Conclusion

PED treatment requires significantly shorter fluoroscopy and procedure times compared with SAC and Onyx HD 500. The results of this study may be used by advocates of flow diverters as an additional argument for using this treatment modality to treat intracranial aneurysms.

Disclosures

N. Chalouhi: None. J. McMahon: None. L. Moukarzel: None. R. Starke: None. P. Jabbour: None. A. Dumont: None. S. Tjoumakaris: None. R. Rosenwasser: None. L. Gonzalez: None.
P-012 Endovascular Management of Inoperable Meningioma
Authors: Yakes W
Published: July 2013

Purpose

To determine the efficacy of ethanol embolisation of single and multiple meningiomas in poor surgical candidates and in recurrent lesions.

Materials and Methods

11 patients (8 female, 3 male; mean age 52 yrs) underwent clinical, MR, and arteriographic evaluations. In patients who had post-surgical recurrence and/or were poor operative risks, ethanol embolisation was offered as an alternative procedure. Two patients that had multiple meningiomas related to Von Recklinghausen’s Neurofibromatosis Type II were offered endovascular ethanol treatments as multiple surgical craniotomies with excision were not possible.

Results

All patients underwent ethanol embolisation of single and multiple pedicles supplying the tumour. Four patients suffered complications (1 patient minor late SAH without sequelae, 2 patients transient 6th nerve palsy, 1 patient transient worsening for 2 weeks of his aphasia). MR and CT demonstrated significant necrosis and shrinkage of the tumours at long-term follow-up (range: 6–72 mos; mean: 30 mos).

Conclusion

Ethanol, being a liquid agent, penetrates to the capillary level causing necrosis and exclusion of collateral flow. This leads to tumour necrosis and shrinkage. Taking advantage of the slow-growing, non-metastasising characteristics and increased vascularity of this tumour, ethanol is an attractive alternative therapy that is minimally invasive. This treatment can be offered in selected poor surgical patients and in patients who developed post-operative recurrence. This procedure is efficacious in highly vascular tumours and in poorly vascularised meningiomas that are not possible to treat by endovascular approaches.

Disclosures

W. Yakes: None.
E-010 Prolonged Neurologic Deterioration Following Acetazolamide Testing in the Acute Phase Following Ischaemic Stroke
Authors: Tawk R , Eidelman B , Hanel R , Meschia J , Barrett K
Published: July 2013

Background

Acetazolamide induces cerebral vasodilatation and may be used to measure cerebrovascular reserve in patients with cerebral arteriopathy. While acetazolamide is known to induce transient neurologic deficits as a result of “steal phenomenon,” prolonged deficits have rarely been described.

Methods

Retrospective, single-centre case review from 2011 to 2012.

Results

We describe 3 patients ages 41, 60 and 65 years (2 women; 1 man) who developed prolonged neurological deterioration following administration of acetazolamide in the acute phase following presentation for evaluation of cerebrovascular reserve. Two patients presented with hemispheric ischaemic symptoms; one presented with headache and parietal convexity subarachnoid haemorrhage.

One patient had extensive intracranial vascular disease consistent with a moyamoya-like syndrome with left middle cerebral artery (MCA) occlusion and severe left supraclinoid internal carotid artery (ICA) stenosis.

Another had 50% left MCA stenosis as well as > 70% stenosis of the left ICA. She failed medical therapy, L CAS, L MCA angioplasty, and left EC-IC bypass. A third patient had occlusion of the right ICA and severe left ICA stenosis. In every case, acetazolamide challenge was carried out in the acute phase following presentation. All three patients developed significant prolonged worsening of neurologic deficits following the administration of acetazolamide (1 g). Patients received aggressive intravenous hydration. Two of the patients regained pre-acetazolamide neurological status within 18 hours. The third patient recovered several days after emergency left carotid artery stenting. Imaging studies (CT in 2 cases; MRI in 1) did not reveal interval haemorrhage or additional ischaemic changes in any case.

Conclusion

Administration of acetazolamide has the potential to induce decline in neurological function after administration in the acute phase and may be persistent for several hours or days. A steal phenomenon is a possible mechanism. The combination of severe extracranial and intracranial vascular disease may predispose to prolonged deficits and may be a contraindication to diagnostic use of acetazolamide.

Disclosures

R. Tawk: None. B. Eidelman: None. R. Hanel: None. J. Meschia: None. K. Barrett: None.
E-020 The Effectiveness and Safety of Dexmedetomidine during Coil Embolisation for Intracranial Aneurysm
Authors: Chang C , Jung Y , Choi B
Published: July 2013

Introduction/Purpose

The general goals of anaesthetic management during endovascular procedure involve haemodynamic control to minimise the risk of aneurysm re-rupture, to protect the brain against ischaemic injury and to keep the patient motionless to optimise the quality of the images used to perform the endovascular procedure: hence, general anaesthesia with endotracheal intubation is often preferred for these procedures at most centres. But general anaesthesia is not available in all hospital and in all situations. At the authors’ institution, coil embolisation of the intracranial aneurysm is performed under monitored anaesthesia using dexmedetomidine. To determine the feasibility and safety of this approach, the author has reviewed our clinical experience.

Methods

Retrospectively analysis of prospectively collected data at single neurovascular institution was performed during July 2012 to November 2012. We performed more than 50cases using this method. In these cases, we analysed 12cases, their procedure time is more than 1hour for statistical significance.

To measure the haemodynamic and respiratory impact of the drug to the patients, vital signs of the patients were checked every 10 minutes throughout the procedures. Systolic blood pressure (sBP), diastolic blood pressure (dBP), mean arterial blood pressure (mABP), heart rate (HR), respiratory rate (RR) and peripheral oxygen saturation (SpO2) were recorded at each time point as follow; preoperative baseline, at anaesthesia start, after every 10 minute until the end of procedures. Depth of sedation was measured by Ramsay sedation scale and frequency of the repeated roadmap caused by the patient head movement during the endovascular procedure.

Results

All procedures were completed without procedure related complications. Obliteration of the intracranial aneurysm was performed in all cases. With dexmedetomidine induced monitored anaesthesia, vital signs (sBP, dBP, and mABP, HH, RR and SpO2) of the patients were not changed during the procedure. Haemodynamic and respiratory parameters did not showed any statistical significance (P value > 0.05). Adequate sedation for endovascular procedure was achieved. Mean Ramsay sedation scale was 3.67 ± 1.61 (2 to 6). Repeated roadmap due to patient’s factor was occurred in only one case. The drug dose for adequate sedation for endovascular procedure was 0.65 ± 0.12 mcg/kg/hr without loading doses.

Conclusion

Embolisation of the intracranial aneurysms with dexmedetomidine anaesthesia appeared to be safe and feasible. Differently with other drugs, there was no systemic side effects such as hypotensio, bradycardia and respiratory depressions. In you need endovascular surgery for intracranial aneurysm; general anaesthesia is the first choice to be selected. But local anaesthesia with dexmedetomidine should be considered as alternative, when it is not suitable .

Disclosures

C. Chang: None. Y. Jung: None. B. Choi: None.
E-028 Intracranial Stenting without Angioplasty for Cerebral Aneurysms with Adjacent Vessel Stenoses
Authors: Toth G , Elgabaly M , Bain M , Hui F , Hussain M
Published: July 2013

Introduction

Intracranial stenting is currently not routinely recommended for intracranial stenotic disease based on recent clinical trial results. However, wide-necked cerebral aneurysms with adjacent vascular stenoses may require stent placement to assist with coil embolisation. The safety and efficacy of this approach have not been well studied.

Objective

We report the outcomes of intracranial stent placement and coiling in patients with wide-necked intracranial aneurysms and associated vessel stenosis.

Methods

Report of 2 cases with relevant neuroimaging and literature review

Results

The first female patient presented with dizziness and vertigo, and was found to have an unruptured wide-necked basilar apex aneurysm involving both posterior cerebral artery origins. In addition, there was significant atherosclerotic narrowing of the distal basilar artery, just proximal to the aneurysm. The second female patient initially presented with subarachnoid haemorrhage from a ruptured broad-based posterior communicating artery aneurysm, which was first coil embolised, but later showed recurrence requiring re-treatment. This patient also had moderate adjacent parent vessel stenosis. After a 5-day pretreatment with aspirin and clopidogrel, endovascular coiling was performed with Neuroform stent (Boston Scientific, Fremont, CA) assistance in both cases. The vascular reconstruction device covered the stenotic vessel segments. No balloon angioplasty was performed. We encountered no periprocedural complications. Both patents remained clinically asymptomatic with 6-month follow-up angiograms demonstrating stable aneurysm occlusion and improved vascular stenoses.

Conclusion

Stent assisted coiling may be a feasible option for wide-necked intracranial aneurysm with associated pre-existing vascular stenoses. In our cases, Neuroform stent placement across the stenotic area was safe without in-stent stenosis, thromboembolism, ischaemia or other adverse event. These results are promising, but a larger cohort is needed to assess long-term outcome.

Disclosures

G. Toth: None. M. Elgabaly: None. M. Bain: None. F. Hui: None. M. Hussain: None.
E-031 Versatile Fill Coils: Initial Experience as Framing coil for Oblong Aneurysms
Authors: Osanai T , Bain M , Hui F
Published: July 2013

Introduction

Oblong aneurysms, with dimensions of 2:1 or greater aspect ratios, are typically coiled with framing coils with helix diameter of aneurysm (l+w)/2, thus a 6 x 3 mm aneurysm might be framed with a 4–5 mm coil. The introduction of the versatile fill coil which has two separate coil elements - loops and longer wave segments - allows another approach to framing oblong or snow-man shaped aneurysms.

Methods

The endovascular database at a single institution was reviewed to assess aneurysms coiled with versatile fill coils as a framing coil yielding 3 consecutive patients in non-spherical, oblong aneurysms. The results were reviewed and demographic and outcome information collected and summarised.

Results

3 patients (1 man and 2 women) were treated with VFC coils, 1 with balloon assistance and 0 with stent assistance. All cases were diagnosis as ruptured aneurysm which located in Anterior communicate artery. There were no complications immediately post procedurally, with 1 case of intraprocedural catheter induced vasospasm which resolved with calcium channel blockers. Complete occlusion was achieved in all cases. There were no recurrent and re-bleeding during follow up periods.

Conclusion

The VFC coil may offer an alternative to spherical framing coils in oblong aneurysms, as the coil structure offers elements that conform to the short axis diameter of the aneurysms, with wave elements that displace the loop elements, peripheralising along the aneurysm length. Further experience would be necessary to confirm these clinical impressions.

Disclosures

T. Osanai: None. M. Bain: None. F. Hui: 2; C; Microvention.
E-033 Single Session, Single Pedicle Injections in the Treatment of Brain Arteriovenous Malformations
Authors: Durst C , Evans A
Published: July 2013

Background and Purpose

Cure rates using traditional open surgical techniques decrease and risks increase as arteriovenous malformations (AVMs) increase in size, develop deep venous drainage, or encroach upon areas of eloquence. Using a percutaneous transluminal approach, Onyx may be used to cure AVMs in a single treatment session offering an alternative to open surgery.

Materials and Methods

Twelve patients underwent Onyx embolisation of an AVM using a novel technique, termed the plug then push, in which a well-formed plug is formed around the treatment catheter prior to injecting the Onyx. The plug mitigates the risk of backflow and catheter entrapment, thereby allowing the user to inject higher volumes of Onyx at higher injection rates.

All patients were followed clinically throughout the immediate post-operative course. Requests were made to return for 2 month, 12 month, and 24 month follow up imaging.

Results

Using the plug then push technique, it was possible to inject an average of 8.8 mL of Onyx into the AVM, significantly more than using traditional techniques (p=0.049). The faster injection rate and need for only a single treatment session reduced treatment time by over 50% (p < 0.001). Angiographic cures were achieved in 83% of patients. There were three complications related to the procedure. Two resulted in permanent morbidity and one resulted in temporary dysarthria. There was a 12% recurrence rate with 1 patient demonstrating a recurrence at 24 months after initially appearing cured in follow-up.

Conclusion

The plug then push technique allows for a more rapid injection of contrast due to the formation of a well controlled plug prior to treatment, mitigating the risk for backflow of Onyx and entrapment of the catheter. As such, complete obliteration of an AVM can be expected in at least 83% of cases after a single session, resulting in an approximate 50% reduction in total procedural time.

Long term results from this study and the literature suggests that 6–12 months of follow-up imaging may be insufficient to declare a permanent angiographic cure. We suggest that a “cure” should not be declared until at least the 2 year follow-up demonstrates no residual or recurrent AVM.

Disclosures

C. Durst: None. A. Evans: 1; C; The For the Love of Molly Foundation.
E-037 Initial Multi-Centre Experience with the Penumbra PC 400 Detachable Coil in aneurysms 10 mm or greater
Authors: Chaudry I , Frei D , Baxter B , Patel A , Huddle D , Loy D , Moyle H , Polykarpou M , Patel A , Turner R , Turk A
Published: July 2013

Background

Aneurysm coil technology has changed considerably since the introduction of the GDC coil. We evaluated our initial clinical experience with a novel 0.020 Penumbra PC 400 coil to determine device safety and acute performance.

Materials and Methods

Between 2/2011 and 9/2012, 143 aneurysms were coiled with Penumbra PC 400 coils at four high volume centres. Of these, 40 aneurysms had a maximum diameter of 10 mm or greater. Average aneurysm size in this cohort was 13 mm with 20% of aneurysms being ophthalmic in location, 22% other ICA (cavernous, superior hypophyseal or dorsal wall), 17% in ACOM region, 12.5% PCOM, 15% Basilar, 7.5% vertebral and 5% in the MCA. 18% of the cases were treated with balloon assisted coiling, 33% were stent assisted coiling, and 3% utilised both balloons and stents. 30% of the cases achieved an initial Raymond Scale of 1, 25% achieved a Raymond scale of 2, and 45% were Raymond Scale of 3. Half (20) of this patient cohort have angiographic follow up at the time of this abstract. Based on the same/better/worse scale there is a strong trend towards improved angiographic outcomes at 6 months and one year. Eleven had improved, 6 remained unchanged and 2 worsened, none have required retreatment. We experienced a 5% clinically significant procedural complication rate, which include an aneurysm perforation in a 21 mm right dorsal wall ICA aneurysm that presented as a grade 4 Hunt and Hess SAH who expired and a temporal lobe infarct secondary to distal coil migration during treatment of an 18 mm paraophthalmic aneurysm in a grade 4 Hunt and Hess SAH patient that expired from SAH sequellae. We continue to use the coils and accrue follow up and will update results at time of the meeting.

Discussion

The new Penumbra PC 400 coils are a unique 0.020 coil that appears to be safe and effective in treating large aneurysms.

Disclosures

I. Chaudry: 2; C; Penumbra, Microvention, Covidien. D. Frei: None. B. Baxter: None. A. Patel: None. D. Huddle: None. D. Loy: None. H. Moyle: None. M. Polykarpou: None. A. Patel: None. R. Turner: None. A. Turk: 1; C; Penumbra.
NAGY–SOPER SUBTRACTION: A REVIEW
Authors: ROBENS TANIA
Published: July 2013

In this review, we present a review on an alternative NLO subtraction scheme, based on the splitting kernels of an improved parton shower that promises to facilitate the inclusion of higher-order corrections into Monte Carlo event generators. We give expressions for the scheme for massless emitters, and point to work on the extension for massive cases. As an example, we show results for the C parameter of the process e+e-→3 jets at NLO which have recently been published as a verification of this scheme. We equally provide analytic expressions for integrated counterterms that have not been presented in previous work, and comment on the possibility of analytic approximations for the remaining numerical integrals.
COHOMOLOGY RING OF THE BRST OPERATOR ASSOCIATED TO THE SUM OF TWO PURE SPINORS
Authors: MIKHAILOV ANDREI , SCHWARZ ALBERT , XU RENJUN
Published: July 2013

In the study of the Type II superstring, it is useful to consider the BRST complex associated to the sum of two pure spinors. The cohomology of this complex is an infinite-dimensional vector space. It is also a finite-dimensional algebra over the algebra of functions of a single pure spinor. In this paper we study the multiplicative structure.
EXPLOSIVE BEHAVIOR IN A LOG-NORMAL INTEREST RATE MODEL
Authors: PIRJOL DAN
Published: July 2013

We consider an interest rate model with log-normally distributed rates in the terminal measure in discrete time. Such models are used in financial practice as parametric versions of the Markov functional model, or as approximations to the log-normal Libor market model. We show that the model has two distinct regimes, at low and high volatilities, with different qualitative behavior. The two regimes are separated by a sharp transition, which is similar to a phase transition in condensed matter physics. We study the behavior of the model in the large volatility phase, and discuss the implications of the phase transition for the pricing of interest rates derivatives. In the large volatility phase, certain expectation values and convexity adjustments have an explosive behavior. For sufficiently low volatilities the caplet smile is log-normal to a very good approximation, while in the large volatility phase the model develops a non-trivial caplet skew. The phenomenon discussed here imposes thus an upper limit on the volatilities for which the model behaves as intended.
LCT-WAVELET BASED ALGORITHMS FOR DATA COMPRESSION
Authors: AVERBUCH AMIR Z. , ZHELUDEV VALERY A. , GUTTMANN MOSHE , KOSLOFF DAN D.
Published: July 2013

We present an algorithm that compresses two-dimensional data, which are piece-wise smooth in one direction and have oscillatory events in the other direction. Fine texture, seismic, hyper-spectral and fingerprints have this mixed structure. The transform part of the compression process is an algorithm that combines the application of the wavelet transform in one direction with the local cosine transform (LCT) in the other direction. This is why it is called hybrid compression. The quantization and the entropy coding parts in the compression process were taken from SPIHT codec but it can also be taken from any multiresolution based codec such as EZW. To efficiently apply the SPIHT codec to a mixed coefficients array, reordering of the LCT coefficients takes place. When oscillating events are present in different directions as in fingerprints or when the image comprises of a fine texture, a 2D LCT with coefficients reordering is applied. These algorithms outperform algorithms that are solely based on the the application of 2D wavelet transforms to each direction with either SPIHT or EZW coding including JPEG2000 compression standard. The proposed algorithms retain fine oscillating events including texture even at a low bitrate. Its compression capabilities are also demonstrated on multimedia images that have a fine texture. The wavelet part in the mixed transform of the hybrid algorithm utilizes the Butterworth wavelet transforms library that outperforms the 9/7 biorthogonal wavelet transform.
DYNAMICAL PROPERTIES OF MULTI-PHOTON INTERACTION BETWEEN A CAVITY FIELD AND A SINGLE-QUBIT
Authors: KADRY HEBA , ZAKARIA NORDIN , CHEONG LEE YEN , ABDEL-ATY MAHMOUD
Published: July 2013

We study the dynamical properties of a cavity field coupling to a Cooper pair box (CPB). We assumed that the CPB is prepared initially in a mixed state with a coherent state for the field. By solving the time-dependent equations using the evolution operator, it shows that mean numbers of Cooper pairs is affected by the detuning. The mean number of Cooper pairs is further enhanced by the multi-photon processes in commonly used cavity field.
QPSO‐Based Adaptive DNA Computing Algorithm
Authors: Karakose Mehmet , Cigdem Ugur
Published: July 2013

DNA (deoxyribonucleic acid) computing that is a new computation model based on DNA molecules for information storage has been increasingly used for optimization and data analysis in recent years. However, DNA computing algorithm has some limitations in terms of convergence speed, adaptability, and effectiveness. In this paper, a new approach for improvement of DNA computing is proposed. This new approach aims to perform DNA computing algorithm with adaptive parameters towards the desired goal using quantum‐behaved particle swarm optimization (QPSO). Some contributions provided by the proposed QPSO based on adaptive DNA computing algorithm are as follows: (1) parameters of population size, crossover rate, maximum number of operations, enzyme and virus mutation rate, and fitness function of DNA computing algorithm are simultaneously tuned for adaptive process, (2) adaptive algorithm is performed using QPSO algorithm for goal‐driven progress, faster operation, and flexibility in data, and (3) numerical realization of DNA computing algorithm with proposed approach is implemented in system identification. Two experiments with different systems were carried out to evaluate the performance of the proposed approach with comparative results. Experimental results obtained with Matlab and FPGA demonstrate ability to provide effective optimization, considerable convergence speed, and high accuracy according to DNA computing algorithm.
Panax Quinquefolius Saponin of Stem and Leaf Attenuates Intermittent High Glucose-Induced Oxidative Stress Injury in Cultured Human Umbilical Vein Endothelial Cells via PI3K/Akt/GSK-3βPathway
Authors: Wang Jingshang , Yin Huijun , Huang Ye , Guo Chunyu , Xia Chengdong , Liu Qian , Zhang Lu
Published: July 2013

Panax quinquefolius saponin of stem and leaf (PQS), the effective parts of American ginseng, is widely used in China as a folk medicine for diabetes and cardiovascular diseases treatment. In our previous studies, we have demonstrated that PQS could improve the endothelial function of type II diabetes mellitus (T2DM) rats with high glucose fluctuation. In the present study, we investigated the protective effects of PQS against intermittent high glucose-induced oxidative damage on human umbilical vein endothelial cells (HUVECs) and the role of phosphatidylinositol 3-kinase kinase (PI3K)/Akt/GSK-3βpathway involved. Our results suggested that exposure of HUVECs to a high glucose concentration for 8 days showed a great decrease in cell viability accompanied by marked MDA content increase and SOD activity decrease. Moreover, high glucose significantly reduced the phosphorylation of Akt and GSK-3β. More importantly, these effects were even more evident in intermittent high glucose condition. PQS treatment significantly attenuated intermittent high glucose-induced oxidative damage on HUVECs and meanwhile increased cell viability and phosphorylation of Akt and GSK-3βof HUVECs. Interestingly, all these reverse effects of PQS on intermittent high glucose-cultured HUVECs were inhibited by PI3K inhibitor LY294002. These findings suggest that PQS attenuates intermittent-high-glucose-induced oxidative stress injury in HUVECs by PI3K/Akt/GSK-3βpathway.
Improving the Collaboration between Main Contractors and Subcontractors within Traditional Construction Procurement
Authors: Akintan Obafemi A. , Morledge Roy
Published: July 2013

The inability of subcontractors/specialist contractors to contribute meaningfully to the construction process under the traditional construction procurement hampers the possibilities of improving value on projects and their integration with the rest of the supply chain. In particular, the main contractors and subcontractors in traditional construction procurement projects pursue their self-interests to such an extent that collaborative working has been impossible to achieve. In this research, qualitative and quantitative approaches were used to collect data to explore the problems at the root of the main contractor-subcontractor relationship. Intending to derive innovative ideas to reinvent the delivery process of traditional construction procurement, the principles of integrated project delivery (IPD) and the last planner system (LPS) were studied to seek useful ideas that can be employed to improve collaboration between main contractors and subcontractors. A high point of contention is the debate on the managerial competence of subcontractors; nevertheless, hope is expressed at the possibility of improving collaboration between the main contractor and subcontractor within traditional construction procurement work environment.
The Pharmacological Options in the Treatment of Eating Disorders
Authors: Milano W. , De Rosa M. , Milano L. , Riccio A. , Sanseverino B. , Capasso A.
Published: July 2013

The eating disorders (DCA) are complex systemic diseases with high social impact, which tend to become chronic with significant medical and psychiatric comorbidities. The literature data showed that there is good evidence to suggest the use of SSRIs, particularly at high doses of fluoxetine, in the treatment of BN reducing both the crisis of binge that the phenomena compensates and reducing the episodes of binge in patients with BED in the short term. Also, the topiramate (an AED) showed a good effectiveness in reducing the frequency and magnitude of episodes of binge with body weight reduction, both in the BN that is in the therapy of BED. To date, modest data support the use of low doses of second-generation antipsychotics in an attempt to reduce the creation of polarized weight and body shapes, the obsessive component, and anxiety in patients with AN. Data in the literature on long-term drug treatment of eating disorders are still very modest. It is essential to remember that the pharmacotherapy has, however, a remarkable efficacy in treating psychiatric disorders that occur in comorbidity with eating disorders, such as mood disorders, anxiety, insomnia, and obsessive-compulsive personality disorders and behavior.
Inflammation and Immune Response in COPD: Where Do We Stand?
Authors: Rovina Nikoletta , Koutsoukou Antonia , Koulouris Nikolaos G.
Published: July 2013

Increasing evidence indicates that chronic inflammatory and immune responses play key roles in the development and progression of COPD. Recent data provide evidence for a role in the NLRP3 inflammasome in the airway inflammation observed in COPD. Cigarette smoke activates innate immune cells by triggering pattern recognition receptors (PRRs) to release “danger signal”. These signals act as ligands to Toll-like receptors (TLRs), triggering the production of cytokines and inducing innate inflammation. In smokers who develop COPD there appears to be a specific pattern of inflammation in the airways and parenchyma as a result of both innate and adaptive immune responses, with the predominance of CD8+ and CD4+ cells, and in the more severe disease, with the presence of lymphoid follicles containing B lymphocytes and T cells. Furthermore, viral and bacterial infections interfere with the chronic inflammation seen in stable COPD and exacerbations via pathogen-associated molecular patterns (PAMPs). Finally, autoimmunity is another novel aspect that may play a critical role in the pathogenesis of COPD. This review is un update of the currently discussed roles of inflammatory and immune responses in the pathogenesis of COPD.
Prone Position Ventilation Used during a Transfer as a Bridge to Ecmo Therapy in Hantavirus-Induced Severe Cardiopulmonary Syndrome
Authors: Cornejo R. , Ugalde D. , Llanos O. , Bisbal P. , De la Barrera L. , Romero C. , Neira R. , González Roberto , Gajardo J.
Published: July 2013

Background. Transport of critically ill patients is a complex issue. We present a case using prone positioning as a bridge to extracorporeal membrane oxygenation (ECMO), performed by a critical retrieval team from a university hospital.Case Report. A 28-year-old male developed fever, progressive respiratory failure, and shock. He was admitted to ICU from a public hospital, and mechanical ventilation was begun, but clinical response was not adequate. ECMO was deemed necessary due to severe respiratory failure and severe shock. A critical retrieval team of our center was assembled to attempt transfer. Prone positioning was employed to stabilize and transfer the patient, after risk-benefit assessment. Once in our hospital, ECMO was useful to resolve shock and pulmonary edema secondary to Hantavirus cardiopulmonary syndrome. Finally, he was discharged with normal functioning.Conclusion. This case exemplifies the relevance of a retrieval team and bridge therapy. Prone positioning improves oxygenation and is safe to perform as transport if performed by a trained team as in this case. Preparation and organization is necessary to improve outcomes, using teams and organized networks. Catastrophic respiratory failure and shock should not be contraindications to transferring patients, but it must be done with an experienced team.
Beyond Virtual Replicas: 3D Modeling and Maltese Prehistoric Architecture
Authors: Stanco Filippo , Tanasi Davide
Published: July 2013

In the past decade, computer graphics have become strategic for the development of projects aimed at the interpretation of archaeological evidence and the dissemination of scientific results to the public. Among all the solutions available, the use of 3D models is particularly relevant for the reconstruction of poorly preserved sites and monuments destroyed by natural causes or human actions. These digital replicas are, at the same time, a virtual environment that can be used as a tool for the interpretative hypotheses of archaeologists and as an effective medium for a visual description of the cultural heritage. In this paper, the innovative methodology and aims and outcomes of a virtual reconstruction of the Borg in-Nadur megalithic temple, carried out by Archeomatica Project of the University of Catania, are offered as a case study for a virtual archaeology of prehistoric Malta.
Suspended Particulates Concentration (PM10) under Unstable Atmospheric Conditions over Subtropical Urban Area (Qena, Egypt)
Authors: Adam M. El-Nouby
Published: July 2013

The main purpose of this study is to evaluate the suspended particulates (PM10) in the atmosphere under unstable atmospheric conditions. The variation of PM10was investigated and primary statistics were employed. The results show that, the PM10concentrations values ranged from 6.00 to 646.74 μg m−3. The average value of PM10is equal to 114.32 μg m−3. The high values were recorded in April and May (155.17 μg m−3and 171.82 μg m−3, respectively) and the low values were noted in February and December (73.86 μg m−3and 74.05 μg m−3, respectively). The average value of PM10of the hot season (125.35 × 10−6 g m−3) was higher than its value for the cold season (89.27 μg m−3). In addition, the effect of weather elements (air temperature, humidity and wind) on the concentration of PM10was determined. The multiple R between PM10and these elements ranged from 0.05 to 0.47 and its value increased to reach 0.73 for the monthly average of the database used. Finally, the PM10concentrations were grouped depending on their associated atmospheric stability class. These average values were equal to 122.80 ± 9 μg m−3(highly unstable or convective), 109.37 ± 12 μg m−3(moderately unstable) and 104.42 ± 15 μg m−3(slightly unstable).
Heterozygous Alterations ofTNFRSF13B/TACIin Tonsillar Hypertrophy and Sarcoidosis
Authors: Speletas Matthaios , Salzer Ulrich , Florou Zoe , Petinaki Efthimia , Daniil Zoe , Bardaka Fotini , Gourgoulianis Konstantinos I. , Skoulakis Charalampos , Germenis Anastasios E.
Published: July 2013

TNFRSF13B/TACIdefects have been associated with CVID pathogenesis and/or phenotype, especially the development of benign lymphoproliferation and autoimmunity. Our purpose was to investigate the role ofTNFRSF13B/TACIdefects in the pathogenesis of two common lymphoproliferative disorders, namely, sarcoidosis and tonsillar hypertrophy (TH). 105 patients (71 with sarcoidosis and 34 with TH, including 19 without infectious causative and 15 due toHaemophilus influenzae) were analyzed forTNFRSF13B/TACIdefects. Two out of 19 TH patients without infectious cause (10.5%) and 2 patients with sarcoidosis (2.8%) displayed rareTNFRSF13B/TACIdefects (I87N, L69TfsX12, E36L, and R202H, resp.). Both mutations identified in TH patients have been assessed as deleterious for protein function, while the patient with the R202H mutation and sarcoidosis exhibited also sIgG4D. Our study further supports the notion thatTNFRSF13B/TACIdefects alone do not result in CVID but may be also found frequently in distinct clinical phenotypes, including benign lymphoproliferation and IgG subclass deficiencies.
Salivary Glands Proteins Expression ofAnopheles dirusA Fed onPlasmodium vivax-andPlasmodium falciparum-Infected Human Blood
Authors: Cotama Saowanee , Dekumyoy Paron , Samung Yudthana , Lek-Uthai Usa
Published: July 2013

Mosquitoes are able to adapt to feed on blood by the salivary glands which created a protein that works against the haemostasis process. This study aims to investigate the salivary glands proteins expression of 50 adult femaleAn. dirusA mosquitoes, a main vector of malaria in Thailand, each group with an age of 5 days which were artificial membrane fed on sugar, normal blood, blood infected withP. vivax, and blood infected withP. falciparum. Then mosquito salivary gland proteins were analyzed by SDS-PAGE on days 0, 1, 2, 3, and 4 after feeding. The findings revealed that the major salivary glands proteins had molecular weights of 62, 58, 43, 36, 33, 30, and 18 kDa. One protein band of approximately 13 kDa was found in normal blood and blood infected withP. vivaxfed on day 0. A stronger protein band, 65 kDa, was expressed from the salivary glands of mosquitoes fed withP. vivax- orP. falciparum-infected blood on only day 0, but none on days 1 to 4. The study shows that salivary glands proteins expression ofAn. dirusmay affect the malaria parasite life cycle and the ability of mosquitoes to transmit malaria parasites in post-24-hour disappearance observation.
The Role of the Immune System in Huntington’s Disease
Authors: Ellrichmann Gisa , Reick Christiane , Saft Carsten , Linker Ralf A.
Published: July 2013

Huntington’s disease (HD) is characterized by a progressive course of disease until death 15–20 years after the first symptoms occur and is caused by a mutation with expanded CAG repeats in the huntingtin (htt) protein. Mutant htt (mhtt) in the striatum is assumed to be the main reason for neurodegeneration. Knowledge about pathophysiology has rapidly improved discussing influences of excitotoxicity, mitochondrial damage, free radicals, and inflammatory mechanisms. Both innate and adaptive immune systems may play an important role in HD. Activation of microglia with expression of proinflammatory cytokines, impaired migration of macrophages, and deposition of complement factors in the striatum indicate an activation of the innate immune system. As part of the adaptive immune system, dendritic cells (DCs) prime T-cell responses secreting inflammatory mediators. In HD, DCs may contain mhtt which brings the adaptive immune system into the focus of interest. These data underline an increasing interest in the peripheral immune system for pathomechanisms of HD. It is still unclear if neuroinflammation is a reactive process or if there is an active influence on disease progression. Further understanding the influence of inflammation in HD using mouse models may open various avenues for promising therapeutic approaches aiming at slowing disease progression or forestalling onset of disease.
A.C. Conductivity Investigations on Layered Na2-x-yLixKyTi3O7 Ceramics
Authors: Singh Rakesh , Shripal
Published: July 2013

Frequency and temperature dependence of a.c. electrical conductivity of layered mixed ionic alkali trititanates, Na1.89Li0.10K0.01Ti3O7, Na1.88Li0.10K0.02Ti3O7, Na1.86Li0.10K0.04Ti3O7, and Na1.85Li0.10K0.05Ti3O7, have been investigated over a wide temperature 350 K ≤T≥ 725 K and frequency 10 kHz to 1 MHz range. For this, Arrhenius plots are used for a.c. electrical conductivity of these compounds. The obtained conductivity plots have been divided into four distinct regions and discussed the relevant theory. According to slop variation, the conduction mechanisms occurring are different in different temperature regions. At lower temperatures, the hopping electron disorders the surroundings by moving to its neighboring Ti atoms from their equilibrium positions, causing structural defect in the polycrystalline network named small polaron. At higher temperatures, associated/unassociated interlayer ionic conduction occurs along with the alkali ions hopping through the interlayer space and electron hopping (small polaron) conduction through Ti–Ti chains in these layered polar alkali titanates.
Green Synthesis of Hydroxyethyl Cellulose-Stabilized Silver Nanoparticles
Authors: El-Sheikh M. A. , El-Rafie S. M. , Abdel-Halim E. S. , El-Rafie M. H.
Published: July 2013

Green synthesis aims to minimize the use of unsafe reactants and maximize the efficiency of synthesis process. These could be achieved by using environmentally compassionate polymers and nontoxic chemicals. Hydroxyethyl cellulose (HEC), an ecofriendly polymer, was used as both reducing and stabilizing agents in the synthesis of stable silver nanoparticles, while silver nitrate was used as a precursor and water as a solvent. The formation of silver nanoparticles was assessed by monitoring UV-vis spectra of the silver colloidal solution. The size of the nanoparticles was measured using transmission electron microscope (TEM). Reaction kinetics was followed by measuring the absorbance of silver colloidal solution at different time intervals. Optimum reaction conditions revealed that the highest absorbance was obtained using HEC : AgNO3of 1.5 : 0.17 (g/100 cm3) at 70°C for 120 min at pH 12. The Ag0nanoparticles colloidal solution so obtained (1000 ppm) were found stable in aqueous solution over a period of six months at room temperature (°C). The sizes of these nanoparticles were found in the range of 11–60 nm after six months of storing. FTIR spectra confirmed the interaction of both the aldehyde and OH groups in the synthesis and stabilization of silver nanoparticles.