Successful true cavity pathfinding with balloon assisted CTO with bifurcation lesions: Two case reports.

BACKGROUND: Coronary artery disease is a prevalent global cardiovascular ailment, with percutaneous coronary intervention (PCI) standing out as a crucial method for relieving symptoms and enhancing the quality of life in patients with coronary heart disease. However, the presence of concurrent chronic total occlusion (CTO) and bifurcation lesions within coronary arteries elevates the complexity and treatment risks, especially when the entry point of the CTO is ambiguous. OBJECTIVE: This study aims to present an innovative approach for treating CTO complicated with bifurcation lesions, focusing on true cavity pathfinding assisted by a balloon. METHODS: Two cases of CTO patients with concomitant bifurcation lesions are described. One case involves CTO of the left anterior descending artery) combined with anterior non-angle trigeminal lesions, while the other entails CTO of the posterior left artery combined with posterior angle trigeminal lesions. True lumen identification using a balloon and subsequent opening of the CTO blood vessel were performed in both cases. RESULTS: In both cases, the true lumen was successfully located with the assistance of a balloon, leading to the successful opening of the CTO blood vessel. This approach not only simplified the procedure but also reduced procedural difficulty and associated risks of complications compared to traditional guide wire operations. CONCLUSION: The application of true cavity pathfinding assisted by a balloon offers a novel and effective strategy for managing CTO complicated with bifurcation lesions. The method simplifies the procedure, decreases procedural difficulty, and lowers the risk of complications associated with guide wire operations. However, further studies and long-term follow-up data are warranted to validate the reliability and long-term efficacy of this innovative approach.

A Single-Center Study Using IVUS to Guide Rotational Atherectomy for Chronic Renal Disease's Calcified Coronary Artery.

Objective: To assess the effectiveness and safety of an IVUS-guided rotational atherectomy (RA) percutaneous coronary intervention (PCI) in chronic renal patients with complex coronary calcification who are at risk for contrast-related acute kidney injury (AKI). Methods: From October 2018 to October 2021, 48 patients with chronic renal disease who were receiving PCI with RA at the General Hospital of NingXia Medical University were informed for data collection for this research. They were randomly assigned to the IVUS-guided RA group and the Standard RA group, which did not use IVUS. According to a clinical expert consensus document on rotational atherectomy in China, both PCI procedures were performed. The intravascular ultrasound (IVUS) results from the study group were used to describe the morphology of the lesion and to guide the selection of burrs, balloons, and stents. IVUS and angiography were used to evaluate the outcome in the end. IVUS-guided RA PCI and Standard RA PCI groups' effects and results were contrasted. Results: There were no appreciable differences in the clinical baseline characteristics between the IVUS-guided RA PCI group and the Standard RA PCI group. The average estimated glomerular filtration rate (eGFR) of two groups was (81.42 ± 20.22 vs 82.34 ± 22.19) mL/min/1.73 m2. Most of them (45.8% vs 54.2%) was in stage 60-90 mL/min/1.73m2. When compared to the standard RA PCI group, RA in IVUS-Guided group was more performed electively (87.5% vs 58.3%; p = 0.02). The IVUS-guided RA PCI group was associated with shorter fluoroscopy time (20.6 ± 8.4 vs 36 ± 22; p<0.01) and less contrast amount (32 ±16 vs 184 ±116mL; p<0.01) than Standard-RA group. Five patients in the Standard RA PCI group developed contrast-induced nephropathy, which was 5 times than the IVUS-guided RA PCI group (20.8% VS 4.1%; p=0.19). Conclusion: In chronic renal patients with complex coronary calcification, an IVUS-guided RA PCI technique is effective and safe. It can also lower the volume of contrast and perhaps the incidence of contrast-related AKI.

Spectral and Temporal Envelope Cues for Human and Automatic Speech Recognition in Noise.

Acoustic features of speech include various spectral and temporal cues. It is known that temporal envelope plays a critical role for speech recognition by human listeners, while automated speech recognition (ASR) heavily relies on spectral analysis. This study compared sentence-recognition scores of humans and an ASR software, Dragon, when spectral and temporal-envelope cues were manipulated in background noise. Temporal fine structure of meaningful sentences was reduced by noise or tone vocoders. Three types of background noise were introduced: a white noise, a time-reversed multi-talker noise, and a fake-formant noise. Spectral information was manipulated by changing the number of frequency channels. With a 20-dB signal-to-noise ratio (SNR) and four vocoding channels, white noise had a stronger disruptive effect than the fake-formant noise. The same observation with 22 channels was made when SNR was lowered to 0 dB. In contrast, ASR was unable to function with four vocoding channels even with a 20-dB SNR. Its performance was least affected by white noise and most affected by the fake-formant noise. Increasing the number of channels, which improved the spectral resolution, generated non-monotonic behaviors for the ASR with white noise but not with colored noise. The ASR also showed highly improved performance with tone vocoders. It is possible that fake-formant noise affected the software's performance by disrupting spectral cues, whereas white noise affected performance by compromising speech segmentation. Overall, these results suggest that human listeners and ASR utilize different listening strategies in noise.

Magnetic-responsive switchable emulsions based on Fe3O4@SiO2-NH2 nanoparticles.

Magnetic-responsive switchable emulsions, which are stabilized by 3-aminopropyltriethoxy silane coated nanoparticles, have been developed in this study. The emulsions show excellent stability for dozens of days and more importantly perform complete demulsification on demand in several minutes. This study provides a facile and possible manipulation strategy to re-disperse the components, re-produce the stable emulsions, and re-trigger the demulsification performance without long-lasting effects.

A pH and salt dually responsive emulsion in the presence of amphiphilic macromolecules.

A pH and salt dually responsive emulsion has been designed on the basis of a novel amphiphilic macromolecule. It was found that the water separation of an oil-in-water emulsion reached up to ∼60% after standing for 10 min at low pH. 2-(Diethylamino)ethyl methacrylate (DEA) residues were found to induce the macromolecules to protonate and to be hydrophilic at pH values between 2 and 6, resulting in dewetting from oil droplet surfaces in water. Besides, the macromolecules form aggregates with different structures at the water/oil interface, depending on the pH value or salt concentration of the emulsion system, enabling the system to be demulsified in response to the pH or salt stimulus. The experimental results also showed that with the addition of aluminium chloride at 100 mg L-1, the water separation was about 70% after 20 min. A possible mechanism with respect to demulsifying was proposed on the basis of an "ion bridge" among sodium acrylate (SA) residues, inducing the macromolecules to "cross-link" and become insoluble, and leading to oil/water separation. Furthermore, at a fixed pH of 5, addition of salt to the aqueous dispersion increased the degree of oil-water interfacial activity and batch emulsions were significantly unstable to coalesce at a low salinity of 25-50 mg L-1. This finding presents a new manipulation on emulsion stability and potential applications in the fields of oil recovery, wastewater treatment, sludge removal, and so on.

[Composition of NOM in raw water of Danjiangkou Reservoir of South-to-North Water Diversion Project and comparison of efficacy of enhanced coagulation].

The best enhanced coagulation conditions for the raw water of Danjiangkou Reservoir of South-to-North Water Diversion Project and the molecular weights as well as hydrophobicity composition of Natural organic matter (NOM) in the water were investigated in this study. The results showed that the NOM in the raw water of Danjiangkou Reservoir of South-to-North Water Diversion Project was mainly composed of the fraction with a molecular weight of < 1 000 and transphilic components. Dissolved organic carbon (DOC, 39.98%) and UV254 (39.10%) were the major components. And the fraction with a molecular weight of < 1 000 had the highest contents of THMFP and N-DBPFP. In the raw water of Danjiangkou Reservoir, the sum of transphilic and hydrophobic fractions was up to 80%, and the hydrophobic fraction was the minimum contributor of the NOM, but the THMFP of the hydrophobic fraction had the highest percentage. And when the raw water of Danjiangkou Reservoir was treated using polymeric ferric sulfate (PFS, 4 mg x L(-1)) and poly-acrylamide (PAM, 0.4 mg x L(-1)) , the optimal removal rates of turbidity, DOC, UV254 and THMFP were 76.33%, 25.57%, 37.78% and 23.16%, respectively. The results of this paper can provide theoretical and technological basis for upgrading of the process and operation optimization of original drinking water treatment plants in the intake area of South-to-North Water Diversion Project.

Comparison of Saline-Irrigated Catheter vs. Temperature-Controlled Catheter for Renal Denervation in a Canine Model.

BACKGROUND: The effectiveness of catheter-based renal denervation (RDN) remains controversial. Although the reasons for this have not yet been elucidated, ineffective denervation appears to be an important factor. The present study aimed to investigate the difference in RDN between a saline-irrigated catheter (SIC) and a temperature-controlled catheter (TCC). METHODS: Dogs (n = 6) from the Kunming province in Chinese were ablated; the SIC was introduced into the right renal artery, while the TCC was introduced into the left renal artery. After 6 months, histopathology and renal angiography were performed, and the change in neural density was evaluated using morphometric software. The average values of heart rate (HR), blood pressure (BP), and catecholamine metabolites were assessed at baseline and follow-up. RESULTS: Histopathology showed nerve demyelination and denaturation, as well as interstitial hyperplasia, although these changes were more pronounced when the SIC was used. The change in neural density was greater and ablation was deeper when the SIC was used. Intimal hyperplasia was greater when the TCC was used, whereas medial hyperplasia was greater when the SIC was used. A trend toward a decrease in HR, BP, metanephrine, and normetanephrine between baseline and follow-up was observed. CONCLUSIONS: Our findings suggest that SIC ablation results in more extensive neural degeneration, deeper penetration, and less extensive intimal hyperplasia than TCC ablation for RDN.