Publications

Purpose: Wall shear stress (WSS) estimated in models reconstructed from intravascular imaging and 3-dimensional-quantitative coronary angiography (3D-QCA) data provides important prognostic information and enables identification of high-risk lesions. However, these analyses are time-consuming and require expertise, limiting WSS adoption in clinical practice. Recently, a novel software has been developed for real-time computation of time-averaged WSS (TAWSS) and multidirectional WSS distribution. This study aims to examine its inter-corelab reproducibility. Methods: Sixty lesions (20 coronary bifurcations) with a borderline negative fractional flow reserve were processed using the CAAS Workstation WSS prototype to estimate WSS and multi-directional WSS values. Analysis was performed by two corelabs and their estimations for the WSS in 3mm segments across each reconstructed vessel were extracted and compared. Results: In total 700 segments (256 located in bifurcated vessels) were included in the analysis. A high intra-class correlation was noted for all the 3D-QCA and TAWSS metrics between the estimations of the two corelabs irrespective of the presence (range: 0.90-0.92) or absence (range: 0.89-0.90) of a coronary bifurcation, while the ICC was good-moderate for the multidirectional WSS (range: 0.72-0.86). Lesion level analysis demonstrated a high agreement of the two corelabls for detecting lesions exposed to an unfavourable haemodynamic environment (WSS >8.24Pa, κ=0.77) that had a high-risk morphology (area stenosis >61.3%, κ=0.71) and were prone to progress and cause events. Conclusion: The CAAS Workstation WSS enables reproducible 3D-QCA reconstruction and computation of WSS metrics. Further research is needed to explore its value in detecting high-risk lesions.

In hydrating Portland cements, more than one of the AFm family of calcium aluminates may exist. Depending on the amount of carbonate and sulfate present in the cement, the most common phase to precipitate is monosulfate, monocarbonate and/or hemicarbonate. It has been reported in the literature that hemicarbonate often appears in measurements such as XRD but not predicted to form/equilibrate in thermodynamic models. With the ongoing use of commercial cements such as CEM I and CEM II containing more and more limestone, it is important to understand which hydrate solids physically precipitate and numerically predict over time. Using 27 cement samples with three w/c ratios analysed at 1, 3 and 28 days, this paper shows that although hemicarbonate was observed in a hydrating commercial Portland cement, as well as being predicted based on its carbonate (CO2/Al2O3) and sulfate (SO3/Al2O3) ratios, thermodynamic analysis did not predict it to equilibrate and form as a solid hydrate. Regardless of the w/c ratio, thermodynamic analysis did predict hemicarbonate to form for calcite contents < 2 wt.%. It appears that the dominant stability of monocarbonate in thermodynamic models leads to it precipitating and remaining as a persistent phase.

No abstract is provided for this article.

Abstract In the framework of the revision of Eurocode 3 Part 1‐1, several amendments have been proposed and accepted in order to improve the rules for the resistance to member buckling. For clarification, a flow‐chart connecting the global analysis (1st or 2nd order), the imperfections and the type of verification has been implemented for ease of use. Since the publication of the standard in 2005, many research projects have been carried out across Europe on this topic and their results have contributed to provide appropriate answers to problems identified in practice. Therefore, the revised code provides new design rules for stability. Important works of calibration have been performed in these different projects to derive appropriate values of the partial factor on the resistance side. For example, a new formulation for lateral torsional buckling has been introduced for the calculation of the reduction factor. The consequence is a reduction of the discrepancy between the results obtained by these new methods and those from experimental or numerical tests. In order to extend the scope of Eurocode 3 Part 1‐1, additional methods have been implemented in an annex to cover the stability of members with mono‐symmetric cross‐section under compression axial force, biaxial bending, with or without torsion. The format of the resistance criteria remains similar to the format of the current interaction formulae so that the designers can easily identify the evolution of the rules. This paper presents in a systematic way the new implementations in prEN 1993‐1‐1.

1. In common with human bronchial epithelial cells, pulmonary A549 cells release prostaglandin (PG) E(2) in response to pro-inflammatory cytokines. We have therefore used these cells to examine the effect of the selective mitogen activated protein (MAP) kinase inhibitors; PD098059, a mitogen activated and extracellular regulated kinase kinase (MEK) 1 inhibitor, UO126, a dual MEK1 & MEK2 inhibitor, and SB203580, a p38 MAP kinase inhibitor in the IL-1beta-dependent release of PGE(2). 2. Following IL-1beta treatment the extracellular regulated kinases (ERKs) and the p38 MAP kinases were rapidly phosphorylated. 3. PD09059, UO126 and SB203580 prevented IL-1beta-induced PGE(2) release at doses that correlated closely with published IC(50) values. Small or partial effects at the relevant doses were observed on induction of cyclo-oxygenase (COX) activity or COX-2 protein suggesting that the primary effects were at the level of arachidonate availability. 4. Neither PD098059 nor SB203580 showed any effect on IL-1beta-induced arachidonate release. We therefore speculate that the MEK1/ERK and p38 kinase cascades play a role in the functional coupling of arachidonate release to COX-2. 5. In contrast, UO126 was highly effective at inhibiting IL-1beta-dependent arachidonate release, implicating MEK2 in the activation of the PLA(2) that is involved in IL-1beta-dependent PGE(2) release. 6. We conclude that the MEK1, MEK2 and p38 MAP kinase inhibitors, PD098059, UO126 and SB203580, are highly potent in respect of inflammatory PG release. Finally, we conclude that these inhibitors act via mechanistically distinct processes, which may have anti-inflammatory benefits.

A 50-year-old male with diagnosis of acute type A aortic dissection underwent surgical repair. Immediately after surgery the patient had transient ECG changes, a raise in serum cardiac markers and physical signs of heart failure.Physical examination, electrocardiography, echocardiography (transthoracic and transoesophageal), coronary angiography, intravascular ultrasound.Type A aortic dissection.Surgical repair, coronary angiography, percutaneous coronary intervention.

The Academic Research Consortium (ARC) and the Standardized Data Collection for Cardiovascular Trials Initiative have recently published updated clinical and angiographic endpoint definitions for percutaneous coronary intervention trials. The aim of this document is to provide practical guidance to facilitate and harmonize the implementation of those definitions in randomized trials or registries, as well as to foster consistency among independent adjudication committees. The authors compared the ARC-2 and Standardized Data Collection for Cardiovascular Trials Initiative definitions to identify areas of consistency, complex scenarios, and definitions in need of further standardization. Furthermore, the authors compared the fourth universal definition of myocardial infarction with the ARC-2 definition of myocardial infarction. The Society for Cardiovascular Angiography and Interventions definition of periprocedural myocardial infarction was also compared with the ARC-2 definition and the fourth universal definition of myocardial infarction. An in-depth assessment was done for each individual clinical endpoint to guide clinical investigators on reporting and classifying clinical adverse events. Finally, the authors propose standard streamlined data capture templates for reporting and adjudicating death, myocardial infarction, stroke, revascularization, stent or scaffold thrombosis, and bleeding.

No abstract is provided for this article.

First generation drug-eluting stents have considerably reduced in-stent restenosis and broadened the applications of percutaneous coronary interventions for the treatment of coronary artery disease. The polymer is an integral part of drug-eluting stents in that, it controls the release of an antiproliferative drug. The main safety concern of first generation drug-eluting stents with permanent polymers—stent thrombosis—has been caused by local hypersensitivity, delayed vessel healing, and endothelial dysfunction. This has prompted the development of newer generation drug-eluting stents with biodegradable polymers or even polymer-free drug-eluting stents. Recent clinical trials have shown the safety and efficacy of drug-eluting stents with biodegradable polymer, with proven reductions in very late stent thrombosis as compared to first generation drug-eluting stents. However, the concept of using a permanent metallic prosthesis implies major drawbacks, such as the presence of a foreign material within the native coronary artery that causes vascular inflammation and neoatherosclerosis, and also impedes the restoration of the vasomotor function of the stented segment. Bioresorbable scaffolds have been introduced to overcome these limitations, since they provide temporary scaffolding and then disappear, liberating the treated vessel from its cage. This update article presents the current status of these new technologies and highlights their future perspectives in interventional cardiology.