[Choice of an alternative access in failed endovascular intervention through the right radial artery]. / Vybor al'ternativnogo dostupa pri neudache éndovaskuliarnogo vmeshatel'stva cherez pravuiu radial'nuiu arteriiu.

The transradial access has deservedly become the 'gold standard' while performing various X-ray endovascular interventions both diagnostic and therapeutic ones. However, along with all its advantages, it is not without disadvantages. These difficulties for the most part are related to peculiarities of the anatomy of upper-limb arteries. It is exactly complex anatomy that is the most common cause of complications and compelled change of the access while using the right radial artery. The purpose of our study was to examine the symmetry of complex anatomy of upper-limb arteries in order to choose an optimal and safe way of conversion of the access in case of forced refusal from the right radial access. For this reason there was developed an open multicentre registry acronymized as COMPAAS (COMPlex Anatomy of Arteries and Symmetry). During the work of this Registry from February to December 2018, correspondents of the study became 35 colleagues from 23 clinics of 11 cities of Russia. The working group analysed a total of 127 patients presenting with 157 variants of complex anatomy of lower limb arteries: high bifurcation of the radial artery (84), complete loop or tortuosity (66), and compartmental calcification of brachial arteries (7). The anatomy of arteries on the opposite upper extremity was studied based on angiographic findings. The most frequent variant (84 cases) of complex anatomy was high bifurcation of the radial artery at the level of the a. brachialis (20.9% of cases), with the origin of the brachial artery at the level of the a. axillaris being revealed half as often (9.9%). The maximum percentage of symmetry was observed in the group of patients presenting with compartmental calcification of upper-limb arteries (85.7%). Complete loop or marked (more than 100°) tortuosity of arteries on both arms was revealed in 54% of cases. Besides, in 25% of cases, tortuosity was combined with the high origin of the radial artery. It is noteworthy that none of the 127 patients appeared to have complex anatomy on the a. ulnaris. When revealing pronounced calcification of arteries of the forearm or a combination of high bifurcation with tortuosity, it seems feasible to decide upon conversion of the access to the femoral one (a. femoralis) or ulnar (a. ulnaris). In isolated high bifurcation on the right, effective conversion to the contralateral (left) radial approach is possible in not less than 75% of cases.

Resonant metasurfaces at oblique incidence: interplay of order and disorder.

Understanding the impact of order and disorder is of fundamental importance to perceive and to appreciate the functionality of modern photonic metasurfaces. Metasurfaces with disordered and amorphous inner arrangements promise to mitigate problems that arise for their counterparts with strictly periodic lattices of elementary unit cells such as, e.g., spatial dispersion, and allows the use of fabrication techniques that are suitable for large scale and cheap fabrication of metasurfaces. In this study, we analytically, numerically and experimentally investigate metasurfaces with different lattice arrangements and uncover the influence of lattice disorder on their electromagnetic properties. The considered metasurfaces are composed of metal-dielectric-metal elements that sustain both electric and magnetic resonances. Emphasis is placed on understanding the effect of the transition of the lattice symmetry from a periodic to an amorphous state and on studying oblique illumination. For this scenario, we develop a powerful analytical model that yields, for the first time, an adequate description of the scattering properties of amorphous metasurfaces, paving the way for their integration into future applications.

Teenage pregnancy and motherhood.

In a random sample of British-born women from a deprived inner London borough who were expecting their first baby, 31% were teenagers at the time they gave birth. The teenage mothers were compared with a group of older women randomly selected from the sample and both groups were followed up for 6 1/2 years after the birth. The teenage mothers were more likely to have had a deprived background and to have experienced material disadvantage. Despite this, they and their children did as well as the older women on a wide variety of measures of physical and mental health. A comparison of the teenagers with another sample of women who did poorly (those who had been brought up in care) suggests that the lack of an adverse result amongst the teenagers was at least in part due to support from the womens' own mothers.

Childhood separation experiences and psycho-social status in primiparous women: preliminary findings.

In a group of British-born primiparous women, admission of a separation experience from parents in childhood was found to be associated with unmarried status, teenage pregnancy, having had psychiatric treatment, housing problems and a high score on a 'Malaise' inventory. Within the separated group the unmarried and teenage status were associated only with separations occurring in the context of a disrupted childhood, but were not related to the age of the separations. The Malaise score, however, was raised both for disrupted separations and for those occurring below the age of 5. It is noted that the factors associated with the separation in the mothers are those which have been found to be more common in the mothers of children with behaviour disorders.