Endovascular Recanalization and Carotid Stenting: The New Approach to Restore Cerebral Perfusion during Aortic Dissection.

A type A aortic dissection (TAAD) is a dangerous condition requiring emergency surgery. Due to the similarity of the symptoms of cerebral malperfusion in TAAD and the signs of ischemic stroke, a differential diagnosis of these diseases is not always available. Patients with TAAD after cerebral malperfusion can have a neurological deficit. Thrombolysis is performed in this case. It can worsen the patient's condition and increase the risk of mortality and disability. The aim of the study is to evaluate the new approach to restoring cerebral perfusion during aortic dissection. This approach includes endovascular recanalization and carotid stenting. METHODS: Two clinical cases of TAAD complicated by cerebral malperfusion are described. The first patient is 73 years old and was admitted as planned to perform transcatheter aortic valve implantation (TAVI) for grade III aortic stenosis. The patient underwent transcatheter aortic valve implantation (TAVI) on the second day after admission. The second patient is 60 years old and was hospitalized by an ambulance with strong hypertension and ischemia. The surgical correction of aortic dissection was postponed until the neurological status assessment in both patients. RESULTS: The surgery to correct the aorta dissection was deemed inappropriate. The carotid arteries have been reanalyzed, and cerebral perfusion has been restored in a short time in both patients. CONCLUSION: Acute bilateral internal carotid occlusion is a potentially fatal TAAD outcome. Emergency endovascular recanalization and carotid stenting may be considered one of the few ways to restore cerebral perfusion.

Bio-Derived Furanic Compounds with Natural Metabolism: New Sustainable Possibilities for Selective Organic Synthesis.

Biomass-derived C6-furanic compounds have become the cornerstone of sustainable technologies. The key feature of this field of chemistry is the involvement of the natural process only in the first step, i.e., the production of biomass by photosynthesis. Biomass-to-HMF (5-hydroxymethylfurfural) conversion and further transformations are carried out externally with the involvement of processes with poor environmental factors (E-factors) and the generation of chemical wastes. Due to widespread interest, the chemical conversion of biomass to furanic platform chemicals and related transformations are thoroughly studied and well-reviewed in the current literature. In contrast, a novel opportunity is based on an alternative approach to consider the synthesis of C6-furanics inside living cells using natural metabolism, as well as further transformations to a variety of functionalized products. In the present article, we review naturally occurring substances containing C6-furanic cores and focus on the diversity of C6-furanic derivatives, occurrence, properties and synthesis. From the practical point of view, organic synthesis involving natural metabolism is advantageous in terms of sustainability (sunlight-driven as the only energy source) and green nature (no eco-persisted chemical wastes).

Regulation of the Concentration Heterogeneity and Thermal Expansion Coefficient in the Metastable Invar FeNi31.1 Alloy.

Mössbauer spectroscopy and electron microscopy study of the active redistribution of Ni atoms during the process of polymorphous transformation α→γ in the metastable FeNi31.1 alloy revealed that slow heating (at the rate of 0.2 K/min) results in the depletion of the initial α-phase with a beneficiation of developing disperse γ-phase plates according to the equilibrium diagram. A regulation possibility of the concentration heterogeneity and austenite thermal expansion coefficient resulted from the polymorphous transformation α→γ was shown. Comparison with data of FeNi35 alloy irradiation by high-energy electrons responsible for the variation of atomic distribution and thermal expansion coefficient (owing to the spinodal decomposition) was performed.

Mechanosynthesis of High-Nitrogen Steels Strengthened by Secondary Titanium Nitrides.

The solid-phase mechanical synthesis of high-nitrogen ferritic and austenitic steel composites in the course of mechanical activation in a ball mill is studied by the method of Mössbauer spectroscopy and electron microscopy. For mechanical alloying, mixtures of iron alloys doped with transition metals (Ni, Cr, Mn, and Ti) and nitrides with low stability to deformation (CrN and Mn2N) were used. The correlation between the phase-concentration composition of the mechanically synthesized samples and the heat of formation of transition metal nitrides, which are part of the initial metal mixtures, is investigated. It is established that the use of titanium as an alloying additive of the Fe component of the mixture accelerates the processes of dissolution of primary nitrides and allows the transference of chromium and manganese to the position of substitution in the metallic solid solution. In addition, the titanium additive entails the formation of secondary nitrides with stabilizing the nanostructure of the mechanically synthesized samples.

Atom-economic Approach to the Synthesis of α-(Hetero)aryl-substituted Furan Derivatives from Biomass.

An atom-economic ring construction approach to the synthesis of α-(hetero)arylfurans based on renewable furanic platform chemicals has been developed. Corresponding compounds have been prepared in good to excellent yields via [2+2+2] and [4+2] cycloaddition reactions using metal-catalyzed or photoredox protocols. Easily available HMF-based 2-hydroxymethyl-5-ethynylfuran and 2-hydroxymethyl-5-cyanofuran were used as starting materials. A synthetic route with an improved carbon economy factor has been implemented to achieve sustainability aim. The possible application of arylfurans as molecular conductors has been investigated by DFT calculations, which revealed excellent charge transfer properties. As a future perspective, integration of biomass processing strategy into manufacturing of molecular electronics was pointed out to achieve the aim of sustainability.

Senescence-Associated Secretory Phenotype of Cardiovascular System Cells and Inflammaging: Perspectives of Peptide Regulation.

A senescence-associated secretory phenotype (SASP) and a mild inflammatory response characteristic of senescent cells (inflammaging) form the conditions for the development of cardiovascular diseases: atherosclerosis, coronary heart disease, and myocardial infarction. The purpose of the review is to analyze the pool of signaling molecules that form SASP and inflammaging in cells of the cardiovascular system and to search for targets for the action of vasoprotective peptides. The SASP of cells of the cardiovascular system is characterized by a change in the synthesis of anti-proliferative proteins (p16, p19, p21, p38, p53), cytokines characteristic of inflammaging (IL-1α,ß, IL-4, IL-6, IL-8, IL-18, TNFα, TGFß1, NF-κB, MCP), matrix metalloproteinases, adhesion molecules, and sirtuins. It has been established that peptides are physiological regulators of body functions. Vasoprotective polypeptides (liraglutide, atrial natriuretic peptide, mimetics of relaxin, Ucn1, and adropin), KED tripeptide, and AEDR tetrapeptide regulate the synthesis of molecules involved in inflammaging and SASP-forming cells of the cardiovascular system. This indicates the prospects for the development of drugs based on peptides for the treatment of age-associated cardiovascular pathology.

Critical Redistribution of Nitrogen in the Austenitic Cr-Mn Steel under Severe Plastic Deformation.

A narrow temperature range of changes in the mechanism and kinetics of structural-phase transformations during mechanical alloying under deformation in rotating Bridgman anvils was determined by the methods of Mössbauer spectroscopy, electron microscopy, and mechanical tests in the high-nitrogen chromium-manganese steel FeMn22Cr18N0.83. The experimentally established temperature region is characterized by a change in the direction of nitrogen redistribution-from an increase in the N content in the metal matrix during cold deformation to a decrease with an increase in the temperature and degree of severe plastic deformation. The change in the direction of nitrogen redistribution is due to the acceleration of the decomposition of a nitrogen-supersaturated solid solution of austenite with the formation of secondary nanocrystalline nitrides. The presence of a transition region for the mechanism of structural-phase transitions is manifested in the abnormal behavior of the mechanical properties of steel.

The Role of Working Memory in Dual-Target Visual Search.

Visual search (VS) for multiple targets is especially error prone. One of these errors is called subsequent search misses (SSM) and represents a decrease in accuracy at detecting a second target after a first target has been found. One of the possible explanations of SSM errors is working memory (WM) resource depletion. Three experiments investigated the role of WM in SSM errors using a dual task paradigm. The first experiment investigated the role of object WM using a classical color change detection task. In the second and the third experiments, a modified change detection task was applied, using shape as the relevant feature. The results of our study revealed no effect of additional WM task on second target detection in dual-target VS. To this end, SSM errors are not related to WM resource depletion. On the contrary, WM task performance was violated by dual-target VS as compared to single-target VS, when the targets in VS task were defined by the same feature used in the WM task.

Coronary revascularization in the elderly with stable angina.

A proportion of elderly with coronary artery disease is rapidly growing. They have more severe coronary artery disease, therefore, derive more benefit from revascularization and have a greater need for it. The elderly is a heterogeneous group, but compared to the younger cohort, the choice of the optimal revascularization method is much more complicated among them. In recent decades, results has improved dramatically both in surgery and percutaneous coronary intervention (PCI), even in very old persons. Despite the lack of evidence in elderly, it is obvious, that coronary artery bypass surgery (CABG) has a more pronounced effect on long-term survival in price of more strokes, while PCI is certainly less invasive. Age itself is not a criterion for the selection of treatment strategy, but the elderly are often more interested in quality of life and personal independence instead of longevity. This article discusses the factors that influence the choice of the revascularization method in the elderly with stable angina and presents a complex algorithm for making an individual risk-benefit profile. As a consequence the features of CABG and PCI in elderly patients are exposed. Emphasis is centered on the frailty and non-medical factors, including psychosocial, as essential components in making the decision of what strategy to choose. Good communication with the patients and giving them unbiased information is encouraged.