Percentage Of Occlusion Research Articles

Hemodynamic changes of arteriovenous malformation and endovascular embolization.

Objective: To analyze the hemodynamic changes caused by arteriovenous malformation (AVM) and AVM embolization through a meta-analysis of the existing literature. Method: Search for relevant studies on PubMed/Medline until November 7, 2023, and further screen the bibliographies of relevant studies to ensure comprehensive search. According to the PRISMA guidelines, manuscripts were selected to provide local hemodynamic information on AVM arterial feeders and drainage veins. Result: A total of 13 studies were included in the final analysis. The diameter of the supplying artery (y = 0.002x + 2.24, R2 = 0.99) and flow velocity (y = 0.09x + 54.55, R2 = 0.92) had a positive linear relationship with cerebral blood flow. The pressure difference through the small AVM nidus was higher than that in the large AVM, with values of (y = -12.23x + 101.39, R2 = 0.96). There was a negative linear correlation between the sessions of AVM embolization and blood flow (1 session: y = -150.7x + 564.97, R2 = 0.98 and 4 sessions: y = -118.81x + 750.07, R2 = 0.99). There was a positive linear relationship between the increase in arterial pressure, peri-AVM parenchymal perfusion, and the percentage of occlusion in the medium-sized AVMs. However, this correlation was a nonlinear relationship between elevated arterial pressure, peri-AVM parenchymal perfusion, and the percentage of large AVM occlusion. Conclusion: The hemodynamic changes of AVM (in the feeding arteries, compartments of AVM, and draining veins) follow a linear relationship. The impact of embolization on hemodynamics in medium and small AVMs follows a linear relationship. The impact of embolization of large AVMs on hemodynamics follows a nonlinear relationship.

Development of an image binarization software tool for net occlusion estimations

Marine biofouling poses a set of challenges to the salmon aquaculture industry, where an accumulation of biota on pens can lead to significant net mesh occlusion. This can reduce flow rates, risking oxygen depletion. The industry currently manages this challenge through regular cleaning of nets, with sporadic manual visual estimations of net occlusion an important but time-consuming task. This study developed a simple automated desktop application to more regularly and more robustly quantify pen net occlusion caused by biofouling. This software application pre-processes and binarizes images collected from cameras currently used by the industry into water and non-water pixels. The percentage of net occlusion is then calculated from the binary image. Accurate binarization of representative images was achieved by training a deep learning network on images collected in situ. The resulting network attained a validation accuracy of 96.4 % and a mean test accuracy of 93.5 %. From the test images, 98.3 % of pixels annotated as non-water and 88.8 % of pixels annotated as water were correctly classified by the network. This automated tool has the capacity to better inform industry and create a more efficient cleaning framework based on the needs of individual pens, based on data that can be more readily obtained as compared to manual net inspections.

Pattern of eye disease among obese population in Erbil city, Iraq

Background and objective: Obesity is a multifactorial disease. It is a multifactorial pathology that can be related to an altered nutritional behaviour or secondary to genetic, hypothalamic, iatrogenic or endocrine diseases. Obesity and visual acuity are negatively correlated, obesity may be linked to dysfunction of the mechanical and vascular components of the eye. The aim of the study is to find out the impact of obesity on eye health and the pattern of eye disease. Methods: Across-sectional study was conducted in the Ophthalmology Department/ Erbil Teaching Hospital during the period from 1st of August 2021 to 31st of March 2022. A simple random sampling method was adopted, and a total of 300 participants with an age of more than 18 years old were enrolled. Results: The percentage of cataract, glaucoma, age-related maculopathy, papilloedema, keratoconus, and retinal vein occlusion was higher in the case group than in the control group. Obesity is a significant risk factor for cataracts, age-related maculopathy, and papilloedema, while it was insignificant regarding keratoconus and retinal vein occlusion. The mean of internal ocular pressure and central corneal thickness was higher in the case group compared to the control group. Conclusion: The prevalence of ocular disease was higher among the obese population than in those with normal weight. Obesity is a significant risk factor for ocular disease. Age and gender represented additional risk factors in some of the ocular diseases in obese people.

LSTM-QDCNN: long short-term memory and quantum dilated convolutional neural network enabled occlusion percentage prediction

ABSTRACT Occlusion detection is vital in longer video sequences of real-time scenarios, as deformable objects generally occlude themselves or be occluded by exterior objects eventually. Occlusion can affect accuracy of the entire model significantly, because optical flow may reveal random attributes in occluded as well as neighbourhood areas. Occlusion is a challenging issue in real-world visual object tracking. Several techniques learn imprecise appearance of target while it becomes occluded by another object in the scene. Occlusion is a complicated issue that causes target loss in tracking procedure. Here, long short-term memory fused quantum dilated convolutional neural network (LSTM-QDCNN) is presented for occlusion percentage prediction. Initially, video frames are extracted from considered input video. The extracted frame is pre-processed by adaptive fuzzy filtering, and object localisation is accomplished by employing sparse fuzzy c-means with local optimal oriented pattern feature. Thereafter, occlusion category detection is conducted by deep Q-network. Lastly, occlusion percentage prediction is done by utilising LSTM-QDCNN. Additionally, LSTM-QDCNN is designed by merging deep LSTM (DLSTM) with quantum dilated convolutional neural network (QDCNN). Furthermore LSTM-QDCNN achieved maximum multiple-object tracking precision of 0.892 and minimum tracking distance of 3.714. In addition, LSTM-QDCNN achieved tracking number about 18.

Abstract TP127: Pretreatment CT Collateral Parameters Predict Good Outcomes in Successfully Recanalized Middle Cerebral Artery Distal Medium Vessel Occlusions

Background/Purpose: Distal medium vessel occlusions (DMVOs) account for a large percentage of vessel occlusions resulting in acute ischemic stroke (AIS) with disabling symptoms. We aim to assess whether pretreatment CTP collateral status (CS) parameters can serve as imaging biomarkers for good clinical outcomes prediction in successfully recanalized middle cerebral artery (MCA) DMVOs. Methods: We performed a retrospective analysis of consecutive patients with AIS secondary to primary MCA-DMVOs who were successfully recanalized by mechanical thrombectomy (MT) defined as modified thrombolysis in cerebral infarction (mTICI) 2b, 2c, or 3. We evaluated the association between CBV index and HIR independently with good clinical outcomes (modified Rankin score 0-2) using Spearman rank correlation, logistic regression, and ROC analyses. Results: From 8/22/2018 to 10/18/2022, 60 consecutive patients met our inclusion criteria (mean age 71.2 +- 13.9 years old [mean+-SD], 35 female). CBV index (r = -0.693, p < 0.001) and HIR (0.687, p < 0.001) strongly correlated with 90 day mRS. A CBV index >= 0.7 ((OR 2.27 [6.94 - 21.23], p = 0.001)) and lower likelihood of prior stroke (0.13 [0.33 - 0.86]), p = 0.024) were independently associated with good outcomes.ROC analysis demonstrated good performance of CBV Index in predicting good 90 day mRS (AUC 0.73, p = 0.003) with a threshold of 0.7 for optimal sensitivity (71% [52.0-85.8%]) and specificity (76% [54.9 - 90.6%]). HIR also demonstrated strong performance in predicting good 90 day mRS (AUC 0.77, p = 0.001) with a threshold of 0.3 for optimal sensitivity (64.5% [45.4-80.8%]) and specificity (76.0% [54.9 - 90.6%]). Conclusion: A CBV index ≥ 0.7 may be independently associated with good clinical outcomes in our cohort of AIS caused by MCA-DMVOs that were successfully treated with MT. An HIR < 0.3 is also associated with good clinical outcomes. This is the first study of which we are aware to identify a CBV index threshold for MCA-DMVOs.

Effects of ethephon on heartwood formation and related physiological indices of Dalbergia odorifera T. Chen

IntroductionDalbergia odorifera T. Chen, known as fragrant rosewood, is a rare and endangered tree species. Studies have shown that plant growth regulators can effectively promote heartwood formation. This study aimed to investigate the effects of ethephon (ETH) on heartwood formation and the influence of ethephon and hydrogen peroxide (H2O2) on the physiological characteristics in D. odorifera.MethodsD. odorifera branches underwent treatment with 2.5% plant growth regulators, including ETH, jasmonic acid (JA), salicylic acid (SA), abscisic acid (ABA), H2O2, and inhibitors such as ascorbic acid (AsA) to inhibit H2O2 synthesis, and (S) -trans 2-amino-4 - (2-aminoethoxy) -3-butene (AVG) to inhibit ethylene synthesis. After a 14-day period, we conducted an analysis to evaluate the impact of these plant growth regulators on elongation distance, vessel occlusion percentage, and trans-nerol content. Additionally, the effects of ETH and H2O2 on endogenous plant hormones, H2O2 content, soluble protein content, and enzyme activity were investigated within 0-48 h of treatment.ResultsAfter treatment with ETH for 14 days, the extension distance of the heartwood material was 15 cm, while the trans-nerolol content was 15 times that of the ABA group. ETH and H2O2 promoted endogenous ethylene synthesis; Ethylene content peaked at 6 and 18 h. The peak ethylene content in the ETH group was 68.07%, 12.89%, and 20.87% higher than the initial value of the H2O2 group and ddH2O group, respectively, and 29.64% higher than that in the AVG group. The soluble protein content and activity of related enzymes were significantly increased following ETH treatment.DiscussionETH exhibited the most impact on heartwood formation while not hindering tree growth. This treatment effectively triggered the production of endogenous ethylene in plants and enhanced the activity of essential enzymes involved in heartwood formation. These findings serve as a valuable reference for future investigations into heartwood formation.

Midterm results of atherectomy as an adjunct to endovascular intervention in a population with chronic limb-threatening ischemia.

The use of atherectomy in peripheral vascular intervention remains controversial. To review our experience with atherectomy as an adjunct to endovascular revascularization in a successive group of patients with chronic limb-threatening ischemia (CLTI). Consecutive patients with CLTI treated in a high-volume vascular center between 12/01/2019 and 12/31/2021 were reviewed. Follow-up data were abstracted from office and hospital records. Endpoints were death, all amputation, major amputation and target lesion revascularization (TLR). Secondary endpoints were relief of ischemic rest pain and healing of wounds. During the study period 405 patients (447 limbs) underwent an endovascular procedure. Mean age was 77 ±11.7 years. Of the 447 limbs treated, 123 (27.5%) were Rutherford 4, 284 (63.5%) Rutherford 5 and 40 (8.9%) Rutherford 6. 1190 lesions (2.66 ±1.02 lesion per limb) underwent treatment, with 56.3% located in the femoral-popliteal distribution and 681 (57.2%) being total occlusion. During follow-up to 24 months, there were 76 deaths (18.8%) and 18 major amputations (4%). Surgical bypass was performed in 2% of cases. Estimated two-year amputation and major amputation-free survival probability was 88.4% and 94.5%, respectively. Estimated two-year TLR-free probability was 55%. Atherectomy facilitated treatment of patients with CLTI. These patients were elderly, with limited life expectancy and had multiple lesions per extremity with a high percentage of long occlusions and tibial disease. While TLR-free probability at 2 years was 55%, the overall amputation rate was low. This approach resulted in excellent limb salvage in a high-risk patient group with limited life expectancy and advanced disease.

Pretreatment CTP Collateral Parameters Predict Good Outcomes in Successfully Recanalized Middle Cerebral Artery Distal Medium Vessel Occlusions.

Distal medium vessel occlusions (DMVOs) account for alarge percentage of vessel occlusions resulting in acute ischemic stroke (AIS) with disabling symptoms. We aim to assess whether pretreatment quantitative CTP collateral status (CS) parameters can serve as imaging biomarkers for good clinical outcomes prediction in successfully recanalized middle cerebral artery (MCA) DMVOs. We performed aretrospective analysis of consecutive patients with AIS secondary to primary MCA-DMVOs who were successfully recanalized by mechanical thrombectomy (MT) defined as modified thrombolysis in cerebral infarction (mTICI) 2b, 2c, or 3. We evaluated the association between the CBV index and HIR independently with good clinical outcomes (modified Rankin score0-2) using Spearman rank correlation, logistic regression, and ROC analyses. From 22 August 2018 to 18 October 2022 8/22/2018 to 10/18/2022, 60consecutive patients met our inclusion criteria (mean age 71.2 ± 13.9 years old [mean ± SD], 35female). The CBV index (r = -0.693, p < 0.001) and HIR (0.687, p < 0.001) strongly correlated with 90-day mRS. ACBV index ≥ 0.7 (odds ratio, OR, 2.27, range 6.94-21.23 [OR] 2.27 [6.94-21.23], p = 0.001)) and lower likelihood of prior stroke (0.13 [0.33-0.86]), p = 0.024)) were independently associated with good outcomes. The ROC analysis demonstrated good performance of the CBV index in predicting good 90-day mRS (AUC 0.73, p = 0.003) with athreshold of 0.7for optimal sensitivity (71% [52.0-85.8%]) and specificity (76% [54.9-90.6%]). The HIR also demonstrated adequate performance in predicting good 90-day mRS (AUC 0.77, p = 0.001) with athreshold of 0.3for optimal sensitivity (64.5% [45.4-80.8%]) and specificity (76.0% [54.9-90.6%]). ACBV index ≥ 0.7may be independently associated with good clinical outcomes in our cohort of AIS caused by MCA-DMVOs that were successfully treated with MT. Furthermore, a HIR < 0.3 is also associated with good clinical outcomes. This is the first study of which we are aware to identify aCBV index threshold for MCA-DMVOs.

Targeted delivery of therapeutic agents in a healthy and stenosed patient-specific carotid artery using an external magnetic field

In Magnetic Drug Targeting (MDT), an alternative and highly efficient technique to traditional drug delivery methods, therapeutic agents labeled with magnetic particles are transported to a target region using an external magnetic field. A high concentration of agents in the target tissue and their non-dispersion in the body increases treatment efficiency. In this study, targeted delivery of endothelial cells containing magnetic particles in a healthy and stenosed patient-specific carotid artery was studied. The Eulerian-Lagrangian approach was adapted to track the motion of particles and solve fluid equations. The effect of many internal parameters such as plaque morphology (occlusion percentage and the chord length of stenosis) and external parameters such as the strength and the position of the magnetic source, injection time, and the mass of magnetic particles inside each cell on the capture efficiency (CE) of cells was investigated. Results reveal that increasing the mass of magnetic particles in each cell and magnetic field strength enhances the capture efficiency of cells in the target region. Also, shifting the magnetic source location from position 1 (before the carotid sinus) to position 3 (after the carotid sinus) can increase and decrease the number of absorbed cells in the target region and CCA, respectively, both of which are desirable. Investigation of the injection time shows that the CE of cells when injecting in the systole and diastole is approximately the same as their CE when injected in a whole cardiac cycle. For a stenosed carotid artery, the percentage of occlusion is directly related to the CE of cells in the target region. Also, the chord length of stenosis has a direct and inverse relationship with the number of absorbed cells on the plaque surface and in the target region, respectively. Therefore, magnetic particles with higher magnetism or stronger magnetic fields are recommended for the stenosed carotid artery with a more severe occlusion percentage or a longer chord length.

Efficiency of Various Tubular Occlusion Agents in Human Dentin after In-Office Tooth Bleaching.

The aim of this laboratory study was to investigate and compare the impact of five desensitizing techniques as a treatment fortooth sensitivity on the exposed dentin after an in-office tooth bleaching procedure. Thirty intact human molars were collected for this investigation. The specimens were obtained by transversely cutting 2.5 mm of the crowns, leading to exposure of the dentin. The specimens were cleaned in an ultrasonic bath and treated initially with EDTA gel 15% for 4 min and then with Opalescence Boost bleaching gel (40% H2O2) for two sets of 20 min. Then, the samples were randomly divided into six groups (n = 5) and received one of the following treatments: Group 1 (no treatment-control group), Group 2 (Emofluor gel-0.4% SnF2), Group 3 (MI Paste-CPP-ACPF), Group 4 (BioMinF paste-calcium phospho-fluoro-silicate), Group 5 (air-abrasion with ProSylc-Bioglass 45S5), and Group 6 (Er,Cr:YSGG laser). Subsequently, each sample was observed utilizing scanning electron microscopy (SEM) in order to detect the rate of occlusion of dentin tubules. SEM-EDS analysis revealed no occlusion of the dentin tubules in the control group, while Groups 2, 4, and 5 presented high effectiveness (>95% percentage of occluded tubules), and Groups 3 and 6 presented lower values (21.6 and 26.8%, respectively). It was concluded that althoughall the tested groups presented higher percentages of occlusion of the dentinal tubules compared to the control group, there were differences in effectiveness among them. The most effective treatments were the daily use of BioMinF paste and SnF2-containing gel, as well as air-abrasion with ProSylc powder.

Investigating the Impact of Different Partial Overlap Levels on the Perception of Visual Variables for Categorical Data

The overlap of visual items in data visualization techniques is a known problem aggravated by data volume and available visual space issues. Several methods have been applied to mitigate occlusion in data visualizations, such as random jitter, transparency, layout reconfiguration, focus+context techniques, etc. This paper aims to present a comparative study of the reading of visual variables values with partial overlap. The study focuses on categorical data representations varying the percentage limits of partial overlap and the number of distinct values for each visual variable: hue, lightness, saturation, shape, text, orientation, and texture. A computational application generated random scenarios for a unique visual pattern target to perform location tasks. Each scenario involved presentation of the visual items in a grid layout with 160 elements (10 × 16), each visual variable had from three to five distinct values encoded, and the partial overlap percentages applied, represented by a gray square in the center of each grid element, were 0% (control), 50%, 60%, and 70%. Similar to the preliminary tests, the tests conducted in this study involved 48 participants organized into four groups, with 126 tasks per participant, and the application captured the response and time for each task performed. The results analysis indicated that the hue, lightness, and shape visual variables were robust to high percentages of occlusion and gradual increase in encoded visual values. The text visual variable showed promising results for accuracy, and the resolution time was a little higher than for the last visual variables mentioned. In contrast, the texture visual variable presented lower accuracy to high levels of occlusion and more different visual encoding values. Finally, the orientation and saturation visual variables exhibited the highest error and worst perfomance rates during the tests.

Endovascular embolisation as minimally-invasive treatment for spinal dural arteriovenous fistulas - evaluation of long-term results.

Spinal dural arteriovenous fistulas (sDAVF) are rare spinal cord lesions formed between a radicular artery and medullary vein leading to venous hypertension resulting in neurological impairment. Endovascular embolisation is a minimally-invasive method aiming to interrupt the shunt between the artery and vein. We report our experience with sDAVF treated endovascularly. Clinical and procedural data of 16 consecutive patients diagnosed with sDAVF was reviewed. Pre- and post-operative neurological condition was evaluated using both the Aminoff and Logue disability scale and the VAS scale. Rates of complete occlusions, technical difficulties, and procedural complications were noted. Four of the patients were female and 12 were male; mean age was 62.4 years. Mean interval between symptom onset and treatment was 13.3 months. Complete occlusion was achieved in 88% (14/16 patients). Significant or moderate clinical improvement in long-term follow-up was observed in eight patients (50%). Recurrence was observed in two cases (13%). While endovascular methods are being refined and thus achieving an increasing percentage of successful occlusions, patients should be closely monitored since this condition is recurrent and the clinical consequences of myelopathy can persist despite complete occlusion of the shunt.

Optimal Blood Flow Restriction Occlusion Pressure for Shoulder Muscle Recruitment With Upper Extremity Exercise

Background: As blood flow restriction (BFR) utilization continues to rise, it is crucial to define optimal parameters for use. Currently unknown are the effects of occlusion level during BFR on muscle activity in the proximal shoulder. Purpose/Hypothesis: The purpose of this study was to compare electromyographic amplitude (EMGa) of shoulder musculature during exercise using limb occlusion percentages (LOPs). The authors hypothesized that EMGa would increase concurrently with occlusion. Study Design: Controlled laboratory study. Methods: α Fifteen healthy adults were recruited and underwent 4 experimental sessions, performing 3 common rotator cuff exercises at low intensity (20% maximal strength) to failure in the following order: cable external rotation (ER), cable internal rotation (IR), and dumbbell scaption. Exercises were completed at a different occlusion pressure (0%, 25%, 50%, and 75% LOP— order randomized) applied at the proximal arm. EMGa was recorded from shoulder musculature proximal to the occlusion site and averaged across 5-repetition intervals and overall for the first 30 repetitions. An analysis of variance repeated on occlusion pressure followed by a Bonferroni post hoc test was used to compare EMGa, repetitions to fatigue, and ratings of discomfort (visual analog scale [VAS], 0-10) between occlusion pressures. The type 1 error was set at α = .05 for all analyses. Results: Significant effects of the occlusion level on shoulder muscle EMGa were observed for all exercises (P < .05) with diminishing returns above 50% LOP (overall). For ER, elevations in EMGa were observed at ≥50% LOP for the anterior deltoid, middle deltoid, infraspinatus, and trapezius compared with 0% LOP (P < .05). For IR, elevations in EMGa were observed at ≥25% LOP for the anterior deltoid and trapezius compared with 0% LOP (P < .05). For the teres minor, a significant elevation in EMGa occurred at 75% LOP compared with 0%, 25%, and 50% LOP (P < .05). A decrease in EMGa was observed at ≥50% LOP compared with 0% LOP for the posterior deltoid (P < .05). For scaption, an increase in EMGa was observed at ≥25% LOP for the infraspinatus and teres minor muscles, at 75% LOP for the posterior deltoid, and at ≥50% LOP for the trapezius compared with 0% LOP (P < .05). Decreases in repetitions to failure relative to 0% LOP were observed at 75% LOP for ER (0%: 47 ± 5; 75%: 40 ± 2; P = .034), IR (0%: 82 ± 10; 75%: 64 ± 5; P = .017), and scaption (0%: 85 ± 9; 75%: 64 ± 6; P < .001). A significant linear increase in discomfort was observed for all exercises with increasing occlusion pressures (VAS: 0-10, 0% → 75% LOP; ER: 2.2 ± 0.4 → 7.2 ± 0.3; IR: 1.3 ± 0.2 → 6.1 ± 0.6; scaption: 1.3 ± 0.4 → 6.1 ± 0.4; P < .01). Conclusion: There are several differences in muscle activation about the shoulder based on exercise and occlusion when utilizing BFR. Increasing the percentage of limb occlusion leads to heightened EMGa with diminished returns past 50% LOP when considering muscle activation, discomfort, and achievable exercise volume. Clinical Relevance: These findings may be used to refine upper extremity BFR guidelines.

Aneurysm Treatment with Woven EndoBridge-17: Angiographic and Clinical Results at 12 Months from a Retrospective, 2-Center Series.

This retrospective, 2-center study investigated the feasibility, safety, and efficacy at 12-month follow-up of the treatment of ruptured, unruptured, and recurrent intracranial aneurysms using the latest generation of the Woven EndoBridge (WEB) device, the WEB-17 system. Aneurysms treated with WEB-17 were extracted from the databases of 2 neurovascular centers. Patients, aneurysm characteristics, complications, and clinical and anatomic results were analyzed. From February 2017 to May 2021, two hundred twelve patients with 233 aneurysms (181/233, 77.7%, unruptured-recurrent, and 52/233, 22.3%, ruptured) were included. High treatment feasibility (95.3%) was reported and was similar in ruptured aneurysms (94.2%) and unruptured-recurrent aneurysms (95.6%) (P = .71) and in typical (95.4%) and atypical (94.7%) locations (P = .70), but it was lower in aneurysms with an angle between the parent artery and main aneurysm axis of ≥45° (90.2%) compared with those with an angle of <45° (97.1%) (P = .03). Global mortality and morbidity were 1.9% and 3.8% at 1 month, respectively, and 4.4% and 1.9% at 12 months, respectively. One-month morbidity (P = .02) and mortality (P = .003) were higher in the ruptured group (10.0% and 8.0%, respectively) compared with unruptured-recurrent group (1.9% and 0.0%, respectively). Overall adequate occlusion (complete occlusion and neck remnant) was 86.3%. The percentage of adequate occlusion was higher (P = .05) in the unruptured-recurrent group (88.5%) compared with the ruptured group (77.5%). The WEB-17 system showed high feasibility for ruptured and unruptured aneurysms, typical and atypical locations, and some aneurysms with an angle of ≥45°. As the most recent generation device, the WEB-17 also demonstrates high safety and good efficacy.

In vitro evaluation of remineralizing agents on dentinal tubule occlusion: A scanning electron microscopic study.

Over the years, numerous treatment modalities have been researched for the management of dentinal hypersensitivity. A recent remineralizing agent containing a phase of amorphous calcium phosphate combined with fluoride has shown the ability to rapidly convert into biomimetic hydroxyapatite. This potential can be utilized in occluding the dentinal tubules for the treatment of hypersensitivity. The present study aims to compare the effectiveness of biomimetic hydroxyapatite-based tooth mousse and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) tooth mousse as desensitizing agents on dentinal tubule occlusion. The in vitro study design involved 30 prepared dentin specimens that were divided into three groups: Group A: negative control, Group B: CPP-ACP tooth mousse (GC tooth mousse™), and Group C: fluoride-doped amorphous calcium phosphate (F-ACP) tooth mousse (Curasept Biosmalto Denti Sensibili Tooth Mousse). The specimens were observed under a scanning electron microscope (SEM) and an attached energy-dispersive X-ray (EDX) spectroscopy apparatus after 1 week. The data were analyzed using Kruskal-Wallis test and post hoc Mann-Whitney test for intragroup and intergroup analysis, respectively. The SEM analysis of the F-ACP group showed statistically greater percentage of tubule occlusion (40.21%) compared to the CPP-ACP group (38.15%). EDX analysis of both F-ACP and CPP-ACP groups revealed calcium, phosphorus, carbon, oxygen, and silica with an additional fluoride element in the F-ACP group. In the present study, both remineralizing agents were able to occlude the dentinal tubules. Among the two, the F-ACP tooth mousse showed greater tubule occlusion, and therefore, appears promising as an upcoming remineralizing agent in the management of dentinal hypersensitivity.

The Efficacy and Durability of Three Desensitising Agents for Management of Hypersensitive Teeth: An In Vitro Study

Introduction: Dentine hypersensitivity (DH) is a brief and acute pain produced when dentine is subjected to various stimuli. The treatment for DH has been classified by mode of delivery as at- home and in-office therapy. It was proven that desensitising agents have the capacity for occluding dentinal tubules. The purpose of this study was to evaluate the efficacy and durability of desensitising agents for management of DH. Methods: Twelve non-carious extracted human permanent premolars were sectioned into dentine layer. The dentine disc specimens were divided into four groups. Each group were applied with 8% arginine-calcium toothpaste, 0.24% sodium fluoride toothpaste, 5% potassium nitrate toothpaste and distilled water respectively. Scanning Electron Microscope (SEM) is used to evaluate the magnitude changes of dentinal tubules post treatment with the desensitising toothpastes in terms of the efficacy and durability at day one, week one and week three after application. The data will be analyzed by analysis of variance (ANOVA) using the Statistical Package for the Social Sciences (SPSS) software (version 19.0). Results: All toothpastes demonstrated significant dentinal tubule occlusions. However, 8% arginine-calcium toothpaste showed the greatest percentage of occlusion at day one followed by potassium nitrate toothpaste and sodium fluoride toothpaste. After three weeks, 8% arginine-calcium toothpaste remained the greatest percentage of dentinal tubules occlusion Conclusion: The result revealed that 8% arginine-calcium toothpaste is the most efficient and has longer durability among the other toothpaste. Therefore, with this finding it could help the patient for selection of desensitising toothpaste in managing the DH.

Influence of different postballoon expansion procedures: A finite element analysis.

Postballoon expansion is considered as an appropriate procedure for adequate stent expansion for coronary bifurcation lesions. Two postballoon expansion procedures are currently recommended: proximal optimization technique (POT)/side/POT and POT/kiss/POT. However, the effects of the two postballoon expansion treatments are different. There is a lack of biomechanical study to quantify the difference. It is recognized that biomechanical factors influence the occurrence of Major Cardiovascular Adverse Events (MACE), which includes recurrent angina pectoris, acute myocardial infarction and coronary heart disease death. The current paper evaluated the two postexpansion strategies and quantified biomechanical parameters to provide a basis for clinical decisions. Based on the CT angiography (CTA) data of a patient diagnosed with coronary bifurcation lesions, a personalized coronary bifurcation lesion model was constructed, and the surgical procedure after two expansions was simulated. The POT/side/POT and POT/kiss/POT expansion procedures were analyzed from the perspective of biomechanics through finite element analysis. The biomechanics factors, including the percentage of stent malapposition and stent occlusion at the side branch (SB) opening, the stent ellipse index of proximal main vessel (PMV) segment, the minimum lumen area of the stent vessel segment and the stress distribution of the vessel wall, were used to quantify clinician concerns about factors affecting patient outcomes. The factors include stent adhesion, SB open stent occlusion, poor stent deformation, patency effect of vessel stenosis, and vessel wall damage. Both postexpansion procedures were successfully simulated. The malapposition rate during POT/side/POT was larger (1.2%vs. 0.42%) and stent occlusion at the SB opening from the cross-section perpendicular to the SB opening after the POT/side/POT procedure was 0.20%, compared with 0.00% after POT/kiss/POT. POT/kiss/POT produced a larger PMV segment stent ellipse index. Minimum lumen area after POT/side/POT was 5.6 mm2 and after POT/kiss/POT 5.9 mm2 . POT/kiss/POT produces an effect of greater vascular stress than POT/side/POT. Numerical simulations provide a quantitative analysis to inform clinicians of the differences between preoperative planning and surgical procedures. Biomechanical analysis of the differences between the two postexpansion strategies found that the POT/kiss/POT procedure resulted in better stent fit, less occlusion of the SB open stent and better vascular patency but also resulted in poor stent deformation and caused greater vessel wall stress. The current study informs rationales for clinical understanding of postexpansion strategies.

What is the most effective method to treat indirect carotid-cavernous fistula?

To review the most relevant treatment options for indirect carotid-cavernous fistulas (iCCF), cohorts of 20 patients or more published after 2000 were analyzed. Clinical and radiological outcomes, as well as embolization techniques and material, had to be clarified in the study to be considered. Statistical analysis was based on calculating the relative percentage of therapeutic methods or embolic material, followed by calculating parametric and nonparametric correlations. Some 22 studies and 1550 patients were included. Transvenous embolization (TVE) was used in 53% of the patients and was strongly associated with coiling (rw = 0.66, p = 0.0.0012; rs = 0.53, p = 0.0138), transarterial embolization (TAE) was preferred in 11% of the patients and was strongly linked to liquid embolics (rw = 0.44, p = 0.0434;rs = 0.64, p = 0.0018). A combination of TAE and TVE treatment was used in 7% and a combination of embolic materials in 13% of the patients. None of the endovascular techniques or embolization materials showed significant superiority over the others in clinical outcome and obliteration rate. Radiosurgery in 22% and mechanical compression in 5% of patients showed a lower obliteration rate (rw = - 0.48, p = 0.0254; rs = - 0.45, p = 0.0371). The clinical outcomes were comparable to endovascular treatment (EVT). The remaining 2% of the patients were treated by open surgery or a combination of EVT and radiosurgery. Transvenous coiling is the preferred EVT method for iCCF. However, comparable results may be accomplished with TAE using liquid. Radiosurgery may achieve a lower percentage of fistula occlusion, but the clinical results are equal to EVT.

Croatian study on COVID-19-positive stroke patients during the second wave of the pandemic

To investigate stroke characteristics in patients with concomitant coronavirus disease 2019 (COVID-19) infection in Croatia during the second wave of the COVID-19 pandemic. This retrospective study investigated the characteristics of two groups of ischemic stroke patients: those who developed COVID-19 infection before stroke and those who developed the infection during the hospital stay after stroke onset. Stroke etiology was classified according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification. We analyzed data from 255 stroke patients from 12 Croatian hospitals. The two groups of ischemic stroke patients differed in stroke etiology (P=0.038). Patients with COVID-19 infection before stroke had fewer cardioembolic strokes (46% vs 29.1%), more cryptogenic strokes (32.5% vs 14.3%), and more strokes in multiple vascular territories (12.4% vs 1.8%). The percentage of large-vessel occlusions was high in both groups (49.6% and 44.4%). Median modified Rankin Scale score on discharge was 4 in both groups. Mortality was 36.4% in the group with stroke after COVID-19 and 33.3% in the group with COVID-19 after stroke. Ischemic stroke after COVID-19 differs in etiology from ischemic stroke complicated by COVID-19 infection. Both patient groups are characterized by severe disability and high mortality. Raising the awareness of prehospital stroke and optimization of clinical workflow are important if we want to improve the stroke outcomes by acute recanalization techniques.

Uncertainty quantification of a thrombosis model considering the clotting assay PFA-100®.

Mathematical models of thrombosis are currently used to study clinical scenarios of pathological thrombus formation. As these models become more complex to predict thrombus formation dynamics high computational cost must be alleviated and inherent uncertainties must be assessed. Evaluating model uncertainties allows to increase the confidence in model predictions and identify avenues of improvement for both thrombosis modeling and anti-platelet therapies. In this work, an uncertainty quantification analysis of a multi-constituent thrombosis model is performed considering a common assay for platelet function (PFA-100®). The analysis is facilitated thanks to time-evolving polynomial chaos expansions used as a parametric surrogate for the full thrombosis model considering two quantities of interest; namely, thrombus volume and occlusion percentage. The surrogate is thoroughly validated and provides a straightforward access to a global sensitivity analysis via computation of Sobol' coefficients. Six out of 15 parameters linked to thrombus consitution, vWF activity, and platelet adhesion dynamics were found to be most influential in the simulation variability considering only individual effects; while parameter interactions are highlighted when considering the total Sobol' indices. The influential parameters are related to thrombus constitution, vWF activity, and platelet to platelet adhesion dynamics. The surrogate model allowed to predict realistic PFA-100® closure times of 300,000 virtual cases that followed the trends observed in clinical data. The current methodology could be used including common anti-platelet therapies to identify scenarios that preserve the hematological balance.