A randomised comparison of novolimus-eluting and zotarolimus-eluting coronary stents: 9-month follow-up results of the EXCELLA II study

Novolimus, a macrocyclic lactone with anti-proliferative properties, has a similar efficacy to currently available agents; however it requires a lower dose, and less polymer, and is therefore conceivably safer.

Copper filtration in pediatric digital X-ray imaging: its impact on image quality and dose

The effect of copper (Cu) filtration on image quality and dose in different digital X-ray systems was investigated. Two computed radiography systems and one digital radiography detector were used. Three different polymethylmethacrylate blocks simulated the pediatric body. The effect of Cu filters of 0.1, 0.2, and 0.3 mm thickness on the entrance surface dose (ESD) and the corresponding effective doses (EDs) were measured at tube voltages of 60, 66, and 73 kV. Image quality was evaluated in a contrast-detail phantom with an automated analyzer software. Cu filters of 0.1, 0.2, and 0.3 mm thickness decreased the ESD by 25-32%, 32-39%, and 40-44%, respectively, the ranges depending on the respective tube voltages. There was no consistent decline in image quality due to increasing Cu filtration. The estimated ED of anterior-posterior (AP) chest projections was reduced by up to 23%. No relevant reduction in the ED was noted in AP radiographs of the abdomen and pelvis or in posterior-anterior radiographs of the chest. Cu filtration reduces the ESD, but generally does not reduce the effective dose. Cu filters can help protect radiosensitive superficial organs, such as the mammary glands in AP chest projections.

Carotid plaque and intima-media thickness and the incidence of ischemic events in patients with atherosclerotic vascular disease

We aimed to evaluate whether carotid intima-media thickness (CIMT) or the presence of plaque can confer additional predictive value of future cardiovascular (CV) ischemic events in patients with pre-existing atherosclerotic vascular disease. We identified 2317 patients enrolled in the REduction of Atherothrombosis for Continued Health (REACH) registry who had atherosclerotic vascular disease and baseline CIMT measurements. The entire range of CIMT was divided into quartiles and the fourth quartile (? 1.5 mm) was defined as carotid plaque. Mean ± standard deviation baseline CIMT was 1.31 ± 0.65 mm. Associated CV ischemic events and vascular-related hospitalizations were evaluated over a 2-year follow-up. There was a positive increase in adjusted hazard ratios (HRs) for all-cause mortality (p = 0.04 for trend) and the quadruple endpoint (CV death, myocardial infarction (MI), stroke, hospitalization for CV events) with increasing quartiles of CIMT (p = 0.0008 for trend), which was mainly driven by the fourth quartile (carotid plaque). HRs for all-cause mortality, CV death, CV death/MI/stroke and the quadruple endpoint comparing the highest (carotid plaque) with the lowest CIMT quartile were 2.09 (95% CI, 1.07-4.10; p = 0.03); 2.49 (1.10-5.67; p = 0.03); 1.71 (1.10-2.67; p = 0.02); and 1.73 (1.31-2.27; p = 0.0001). In conclusion, our analyses suggest that the presence of carotid plaque, rather than the thickness of intima-media, appears to be associated with increased risk of CV morbidity and mortality, but confirmation of these findings in other population and prospective studies is required.

Stereoscope

Wheatstone’s stereoscope placed two mirrors on either side that were mounted at a right angle in order to view the two dissimilar drawings presented (Hankins 148). There are two identical monocular tubes that allow each eye to view the images (Hankins 148). Each eye views the image it was intended to see. The two eyes see slightly different images through this binocular vision (Hankins 148). The combination of the two images creates this illusion of depth and solidarity through their superimposition (Hankins 154). In order to view these images, the eyes were covered from all external light (Clay 152). The stereoscope was first seen as a philosophical toy along with other inventions such as the zoetrope, providing entertainment as well as scientific insight (Hankins 148). The stereoscope above is more similar to the “Holmes Stereoscope”, which transformed Wheatstone’s stereoscope into a handheld version that could be put on a stand (Hawkins 155). He replaced the retina of the eye with a sensitive plate; therefore, the lenses acted as the eyes (Silverman 738). In the video, an embellishment adorns the bottom of the stand that holds up the binocular lens and the images. The lenses are in a wooden frame that has an attached stand that holds the slides of images. There also is a knob on the side of the device that can adjust the lens on the two monocular tubes (Bokander 485).

Media reform and development in Bosnia: An interorganizational account of the Media Issues Group

This manuscript focuses on development assistance players’ efforts to cooperate, coordinate and collaborate on projects of mutual interest. I target the case of the cross-sectoral and international Media Issues Group designed to reform and develop the media sector in Bosnia and Herzegovina. I identify and categorize variables that influenced interorganizational relationships to summarize lessons learned and potentially inform similar interventions. This work suggests that cooperation, coordination and collaboration are constrained by contextual, strategic and procedural variables. Through participant narrative based on observation and interviews, this work clarifies the nuances within these three sets of variables for potential extrapolation to other settings. Perhaps more importantly, it provides lessons learned that can inform future international community interventions in market development activities.

Parallel vector processing of multidimensional orthogonal transforms for digital signal processing applications

The performance of the parallel vector implementation of the one- and two-dimensional orthogonal transforms is evaluated. The orthogonal transforms are computed using actual or modified fast Fourier transform (FFT) kernels. The factors considered in comparing the speed-up of these vectorized digital signal processing algorithms are discussed and it is shown that the traditional way of comparing th execution speed of digital signal processing algorithms by the ratios of the number of multiplications and additions is no longer effective for vector implementation; the structure of the algorithm must also be considered as a factor when comparing the execution speed of vectorized digital signal processing algorithms. Simulation results on the Cray X/MP with the following orthogonal transforms are presented: discrete Fourier transform (DFT), discrete cosine transform (DCT), discrete sine transform (DST), discrete Hartley transform (DHT), discrete Walsh transform (DWHT), and discrete Hadamard transform (DHDT). A comparison between the DHT and the fast Hartley transform is also included.(34 refs)

The three year follow-up of the randomised "all-comers" trial of a biodegradable polymer biolimus-eluting stent versus permanent polymer sirolimus-eluting stent (LEADERS)

Aims: The current study reports clinical outcomes at three year follow-up of the LEADERS clinical trial which was the first all-comers trial comparing a new generation biodegradable polymer biolimus drug-eluting stent (BES) with the first generation permanent polymer sirolimus-eluting stent (SES). Methods and results: One thousand seven hundred and seven patients were randomised to unrestricted use of BES (n=857) or SES (n=850) in an all-comers population. Three year follow-up was available in 95% of the patients, 812 treated with BES and 809 treated with SES. At three years, BES remains non-inferior to SES for the primary endpoint of major adverse cardiac events (composite of cardiac death, myocardial infarction (MI), or clinically-indicated target vessel revascularisation (CI-TVR) (BES 15.7% versus SES 19%; HR 0.82 CI 0.65-1.03; p=0.09). The MACE Kaplan Meier event curves increasingly diverge with the difference in events increasing from 1.4% to 2.4% and 3.3% at 1, 2 and 3 years, respectively in favour of BES. The rate of cardiac death was non-significantly lower 4.2% versus 5.2% (HR=0.81 CI 0.52-1.26; p=0.34) and the rate of myocardial infarction was equivalent 7.2% versus 7.1% (HR 1.01 CI 0.70-1.44; p=0.97) for BES versus SES, respectively. Thus BES was non-inferior to SES in all the safety endpoints. Clinically-indicated TVR occurred in 9.4% of BES treated patients versus 11.1% of SES treated patients (HR 0.84 CI 0.62-1.13; p=0.25). Rates of definite stent thrombosis were 2.2% for BES and 2.9% for SES (HR 0.78 CI 0.43-1.43; p=0.43), with the event rate increase of 0.2% from one to three years for BES and 0.9% for SES. For patients presenting with ST-elevation myocardial infarction BES was superior to SES in reducing MACE. Conclusions: The findings of the three year follow-up support the claim that the biodegradable polymer biolimus-eluting stent has equivalent safety and efficacy to permanent polymer sirolimus-eluting stent in an all-comers patient population. Its performance is superior in some subpopulations such as in ST-elevation MI patients and event rates for BES are overall lower than for SES with a trend toward increasing divergence of outcomes over three years. - See more at: http://www.pcronline.com/eurointervention/42nd_issue/125/#sthash.E5HhMQ4a.dpuf

Implantation of the biodegradable polymer biolimus-eluting stent in patients with high SYNTAX score is associated with decreased cardiac mortality compared to a permanent polymer sirolimus-eluting stent: two year follow-up results from the "all-comers" LEADERS trial

Background: The SYNTAX score (SXscore) has been shown to be an effective predictor of clinical outcomes in patients undergoing percutaneous coronary intervention (PCI). Methods and results: The SXscore was prospectively collected in 1,397 of the 1,707 patients enrolled in the “all-comers” LEADERS trial (patients post-surgical revascularisation were excluded). Post hoc analysis was performed by stratifying clinical outcomes at two-year follow-up, according to one of three SXscore tertiles: SXlow ≤8 (n=464), 816 (n=461). At two-year follow-up the rate of major adverse cardiovascular events was 18.4%, 12.0% and 9.4% in the SXhigh, SXmid, and SXlow tertile, respectively (HR 1.45; CI 1.21-1.74; p<0.01). There was a significantly higher rate of cardiac death in patients in the highest SXscore tertile (7% SXhigh versus 2.4% SXmid versus 1.8% SXlow; HR 2.22; CI 1.5-3.27; p<0.001). Within the SXhigh tertile the rate of cardiac death was significantly lower in patients treated with the biolimus-eluting stent compared with the sirolimus-eluting stent (4.7% versus 9.6%, HR 0.48; CI 0.23-0.99; p=0.046). Conclusions: The SXscore when applied to an “all-comers” patient population allows for prospective risk stratification of patients undergoing PCI up to two years follow-up. In addition, the SXscore appears to separate the performance of devices in high risk patient groups.

Organic Interfaces; or, How Human Beings Augment Their Digital Devices

It is a central premise of the advertising campaigns for nearly all digital communication devices that buying them augments the user: they give us a larger, better memory; make us more “creative” and “productive”; and/or empower us to access whatever information we desire from wherever we happen to be. This study is about how recent popular cinema represents the failure of these technological devices to inspire the enchantment that they once did and opens the question of what is causing this failure. Using examples from the James Bond films, the essay analyzes the ways in which human users are frequently represented as the media connecting and augmenting digital devices and NOT the reverse. It makes use of the debates about the ways in which our subjectivity is itself a networked phenomenon and the extended mind debate from the philosophy of mind. It will prove (1) that this represents an important counter-narrative to the technophilic optimism about augmentation that pervades contemporary advertising, consumer culture, and educational debates; and (2) that this particular discourse of augmentation is really about technological advances and not advances in human capacity.

Gender Differences in Emotional Responses to Hooking Up

The present research looked to explore the relationship between the emotional responses of college students to different hooking up behaviors. Seven hundred and nine undergraduates participated in a web-based survey that included a demographic questionnaire, SDS, PANAS, AUDIT, and a measure of hooking up. This measure examined the frequency with which they participated in eight different types of hooking up varying by degree of familiarity to their hook partner and whether or not the hook up was coital or non-coital, as well as their emotional responses to the behavior and their perception of the emotional responses of their partner. Results showed that both menand women experienced more positive emotional responses to hooking up behaviors than negative emotional responses. Men experienced significantly more positive emotional responses to hook up behaviors than did women. Women experienced significantly more negative emotional responses for hook ups that were coital with strangers than did men, while men experienced more positive emotional responses for hook ups that were coital with strangers, coital with acquaintances, and coital with partners that were previous romantic partners than did women. Men also experienced more positive emotional responses for hook ups that were non-coital with strangers and non-coital withacquaintances. Men tended to rate their partner’s positive emotional responses higher than what women reported experiencing, particularly for hook ups with less familiar partners. Women’s ratings of their partner’s negative emotional responses were lower than what men actually reported experiencing. The data collected provide several opportunities for future analyses to be conducted and this research will add to the relatively small body of literature on hooking up.

Time-lapse microscopy and classification of 2D human mesenchymal stem cells based on cell shape picks up myogenic from osteogenic and adipogenic differentiation

Current methods to characterize mesenchymal stem cells (MSCs) are limited to CD marker expression, plastic adherence and their ability to differentiate into adipogenic, osteogenic and chondrogenic precursors. It seems evident that stem cells undergoing differentiation should differ in many aspects, such as morphology and possibly also behaviour; however, such a correlation has not yet been exploited for fate prediction of MSCs. Primary human MSCs from bone marrow were expanded and pelleted to form high-density cultures and were then randomly divided into four groups to differentiate into adipogenic, osteogenic chondrogenic and myogenic progenitor cells. The cells were expanded as heterogeneous and tracked with time-lapse microscopy to record cell shape, using phase-contrast microscopy. The cells were segmented using a custom-made image-processing pipeline. Seven morphological features were extracted for each of the segmented cells. Statistical analysis was performed on the seven-dimensional feature vectors, using a tree-like classification method. Differentiation of cells was monitored with key marker genes and histology. Cells in differentiation media were expressing the key genes for each of the three pathways after 21 days, i.e. adipogenic, osteogenic and chondrogenic, which was also confirmed by histological staining. Time-lapse microscopy data were obtained and contained new evidence that two cell shape features, eccentricity and filopodia (= 'fingers') are highly informative to classify myogenic differentiation from all others. However, no robust classifiers could be identified for the other cell differentiation paths. The results suggest that non-invasive automated time-lapse microscopy could potentially be used to predict the stem cell fate of hMSCs for clinical application, based on morphology for earlier time-points. The classification is challenged by cell density, proliferation and possible unknown donor-specific factors, which affect the performance of morphology-based approaches. Copyright © 2012 John Wiley & Sons, Ltd.

Classification of acute and delayed contrast media-induced reactions: proposal of a three-step system

Physicians and scientists use a broad spectrum of terms to classify contrast media (CM)-induced adverse reactions. In particular, the designation of hypersensitivity reactions is quite varied. Consequently, comparisons of different papers dealing with this subject are difficult or even impossible. Moreover, general descriptions may lead to problems in understanding reactions in patients with a history of adverse CM-reactions, and in efficiently managing these patients. Therefore, the goal of this paper is to suggest an easy system to clearly classify these reactions. The proposed three-step systems (3SS) is built up as follows: step 1 exactly describes the clinical features, including their severity; step 2 categorizes the time point of the onset (immediate or nonimmediate); and step 3 generally classifies the reaction (hypersensitivity or nonhypersensitivity reaction). The 3SS may facilitate better understanding of the clinical manifestations of adverse CM reactions and may support the prevention of these reactions on the basis of personalized medicine approaches.

The Evolution of Media Coverage of Historical Sports Controversies

This thesis will cover sports controversies throughout the 20th Century in the context of the media’s newspaper coverage of the events. The 1919 Black Sox Scandal, the debate over American participation in the 1936 Olympics, and Muhammad Ali’s conversion to the Nation of Islam, standing as a notorious public figure, and conscientious objection to the Vietnam War will represent the three sports controversies. The media’s adherence to cultural norms is clear in all three cases. The consistent devotion to the cultural and racial atmosphere of their respective eras was constant and helped to perpetuate accepted, mainstream cultural attitudes. Cultural and racial norms were followed in the coverage of the three discussed controversies. The anti-Semitism and racially intolerant sentiments in America during great waves of immigration in the early 1900s allowed for journalists to freely vilify Jews as corrupters of baseball and the ballplayers who were rumored to have thrown the 1919 World Series. The white ballplayers were supported in the press, who protected their own and blamed outsiders. Jim Crow and the Americanization movement forced African American and Jewish newspapers to limit their journalistic bias on both sides of the debate over American participation in the 1936 Berlin Olympics. The white, mainstream press was void of bias as the spirit of isolationism in America triumphed over journalist’s leanings in the Olympic debate. The racial tension created by the Civil Rights movement of the 1960s created an atmosphere that allowed mainstream journalists to heap endless criticism on Muhammad Ali as he gained fame. By portraying him as a villain of society as both a religious radical and traitor to America, journalists created a common enemy in the minds of white America. In all three cases, a pattern of journalists expressing the state of cultural and racial norms of the era is present and significant.

Scale Up of PLA Nanoparticle Synthesis by Solvent Displacement and Functionalization of the Particles with a Silica Shell for Targeted Drug Delivery Applications

Biodegradable polymer nanoparticles have the properties necessary to address many of the issues associated with current drug delivery techniques including targeted and controlled delivery. A novel drug delivery vehicle is proposed consisting of a poly(lactic acid) nanoparticle core, with a functionalized, mesoporous silica shell. In this study, the production of PLA nanoparticles is investigated using solvent displacement in both a batch and continuous manner, and the effects of various system parameters are examined. Using Pluronic F-127 as the stabilization agent throughout the study, PLA nanoparticles are produced through solvent displacement with diameters ranging from 200 to 250 nm using two different methods: dropwise addition and in an impinging jet mixer. The impinging jet mixer allows for easy scale-up of particle production. The concentration of surfactant and volume of quench solution is found to have minimal impact on particle diameter; however, the concentration of PLA is found to significantly impact the diameter mean and polydispersity. In addition, the stability of the PLA nanoparticles is observed to increase as residual THF is evaporated. Lastly, the isolated PLA nanoparticles are coated with a silica shell using the Stöber Process. It is found that functionalizing the silica with a phosphonic silane in the presence of excess Pluronic F-127 decreases coalescence of the particles during the coating process. Future work should be conducted to fine-tune the PLA nanoparticle synthesis process by understanding the effect of other system parameters and in synthesizing mesoporous silica shells.