Intensive care unit patients' experiences of receiving music therapy sessions during invasive procedures: A qualitative phenomenological study.

BACKGROUND: Excessive noise in intensive care units poses a significant challenge, impacting both patients and staff by elevating stress, disrupting recovery, and impeding effective communication among healthcare professionals. Despite the World Health Organization recommending noise levels below 35 dB, alarms in these units often surpass these limits, contributing to consistently high noise levels. OBJECTIVES: The aim of this study is to explore intensive care unit patients' experiences with music therapy sessions during invasive procedures. METHODS: This study was conducted using a qualitative hermeneutic phenomenological methodology grounded in Heideggerian philosophy. Interventions were conducted with a music therapist, and 14 in-depth interviews were collected. Reflexive inductive thematic analysis was performed. RESULTS/FINDINGS: From the thematic analysis extracted from the 14 personal interviews, three themes were described that represent the bulk of the experiences and emotions of the study participants following the completion of the music therapy sessions. The most noteworthy results are described in the following, organised according to each theme: (i) music therapy against noise, sounds, and light; (ii) music therapy in the face of invasive tests and techniques; and (iii) music therapy as a strategy and tool. CONCLUSIONS: Music therapy has significant potential to enhance the quality of life for patients in the intensive care unit. Music therapy can promote relaxation, reduce stress and anxiety, alleviate pain and discomfort, and improve emotional and physical wellbeing during patients' stay and invasive procedures.

Anomaly Detection for Power Quality Analysis Using Smart Metering Systems.

The problem of Power Quality analysis is becoming crucial to ensuring the proper functioning of complex systems and big plants. In this regard, it is essential to rapidly detect anomalies in voltage and current signals to ensure a prompt response and maximize the system's availability with the minimum maintenance cost. In this paper, anomaly detection algorithms based on machine learning, such as One Class Support Vector Machine (OCSVM), Isolation Forest (IF), and Angle-Based Outlier Detection (ABOD), are used as a first tool for rapid and effective clustering of the measured voltage and current signals directly on-line on the sensing unit. If the proposed anomaly detection algorithm detects an anomaly, further investigations using suitable classification algorithms are required. The main advantage of the proposed solution is the ability to rapidly and efficiently detect different types of anomalies with low computational complexity, allowing the implementation of the algorithm directly on the sensor node used for signal acquisition. A suitable experimental platform has been established to evaluate the advantages of the proposed method. All the different models were tested using a consistent set of hyperparameters and an output dataset generated from the principal component analysis technique. The best results achieved included models reaching 100% recall and a 92% F1 score.

Impact of double stent retriever configuration on first-pass effect in stroke: a multicenter study.

BACKGROUND: Efficient recanalization of occluded cerebral arteries is crucial in the treatment of acute ischemic stroke. Double stent retrievers have shown the potential to enhance the rates of recanalization on the first pass. This study aims to evaluate the efficacy and safety of the double stent retriever technique and the predictors of achieving first-pass effect in patients with acute ischemic stroke. METHODS: This prospective multicenter study involved 209 patients from 16 comprehensive stroke centers in Spain. Patients with occlusions in the anterior circulation were treated using the Aperio Hybrid double stent retriever. The study examined various deployment techniques, including simultaneous and sequential deployment and stent configurations, comparing the Y-shaped and parallel configurations. RESULTS: The double stent retriever technique achieved a first-pass effect in 72.7% of cases and a final successful recanalization rate of 99.5%. The Y-shaped configuration was significantly associated with higher recanalization rates on the first pass (OR 2.59, 95% CI 1.18 to 5.68, P=0.02). Procedural complications were mild to moderate in 6.7% and severe in 1.5% of cases, with symptomatic intracranial hemorrhage occurring in 3.3% of patients. At 3 months follow-up, 57.2% of patients achieved a good clinical outcome, with a mortality rate of 15.1%. CONCLUSION: The findings support the efficacy of the double stent retriever technique, particularly the Y-shaped configuration, in achieving high recanalization rates on the first pass with an acceptable safety profile. This technique may offer clinical benefits for future acute ischemic stroke treatment protocols.

Probing the Influence of Alkyne Substitution on the Electronic and Magnetic Properties of Diindeno[1,2-b;1',2'-i]anthracenes.

To further the ability to manipulate the properties of open-shell molecules, logical and incremental modifications to molecular structure are key steps that provide fine-tuning of established diradicaloid scaffolds. We report the synthesis of an electronically "pure" diradicaloid based on a 2,6-anthroquinoidal core where the once necessary ethynyl "wings" are removed. Through the simplification of the overall electronic structure, the singlet-triplet energy gap increases by 0.3-0.4 kcal mol-1 in the reported diradicaloids while avoiding significant disruption to their optoelectronic properties.

Targeted proteomics addresses selectivity and complexity of protein degradation by autophagy.

Macroautophagy/autophagy is a constitutively active catabolic lysosomal degradation pathway, often found dysregulated in human diseases. It is often considered to act in a cytoprotective manner and is commonly upregulated in cells undergoing stress. Its initiation is regulated at the protein level and does not require de novo protein synthesis. Historically, autophagy has been regarded as nonselective; however, it is now clear that different stimuli can lead to the selective degradation of cellular components via selective autophagy receptors (SARs). Due to its selective nature and the existence of multiple degradation pathways potentially acting in concert, monitoring of autophagy flux, i.e. selective autophagy-dependent protein degradation, should address this complexity. Here, we introduce a targeted proteomics approach monitoring abundance changes of 37 autophagy-related proteins covering process-relevant proteins such as the initiation complex and the Atg8-family protein lipidation machinery, as well as most known SARs. We show that proteins involved in autophagosome biogenesis are upregulated and spared from degradation under autophagy-inducing conditions in contrast to SARs, in a cell-line dependent manner. Classical bulk stimuli such as nutrient starvation mainly induce degradation of ubiquitin-dependent soluble SARs and not of ubiquitin-independent, membrane-bound SARs. In contrast, treatment with the iron chelator deferiprone leads to the degradation of ubiquitin-dependent and -independent SARs linked to mitophagy and reticulophagy/ER-phagy. Our approach is automatable and supports large-scale screening assays paving the way to (pre)clinical applications and monitoring of specific autophagy flux.Abbreviation: AMBRA1: autophagy and beclin 1 regulator 1; ATG: autophagy related; BafA1: bafilomycin A1; BNIP1: BCL2 interacting protein 1; BNIP3: BCL2 interacting protein 3; BNIP3L/NIX: BCL2 interacting protein 3-like; CALCOCO2/NDP52: calcium binding and coiled-coil domain 2; CCPG1: cell cycle progression 1; CV: coefficients of variations; CCCP: carbonyl cyanide m-chlorophenyl hydrazone; DFP: deferiprone; ER: endoplasmic reticulum; FKBP8: FKBP prolyl isomerase 8; GABARAPL: GABA type A receptor associated protein like; LC: liquid chromatography; LOD: limit of detection; LOQ: limit of quantification; MAP1LC3: microtubule associated protein 1 light chain 3; MS: mass spectrometry; NCOA4: nuclear receptor coactivator 4; NBR1: NBR1 autophagy cargo receptor; NUFIP1: nuclear FMR1 interacting protein 1; OPTN: optineurin; PHB2: prohibitin 2; PNPLA2/ATGL: patatin like phospholipase domain containing 2; POI: protein of interest; PTM: posttranslational modification; PRM: parallel reaction monitoring; RB1CC1/FIP200: RB1 inducible coiled-coil 1; RETREG1/FAM134B: reticulophagy regulator 1; RPS6KB1: ribosomal protein S6 kinase B1; RTN3: reticulon 3; SARs: selective autophagy receptors; SQSTM1/p62: sequestosome 1; STBD1: starch binding domain 1; TAX1BP1: Tax1 binding protein 1; TFEB: transcription factor EB; TNIP1: TNFAIP3 interacting protein 1; TOLLIP: toll interacting protein; ULK1: unc-51 like autophagy activating kinase 1; WBP2: WW domain binding protein 2; WDFY3/Alfy: WD repeat and FYVE domain containing 3; WIPI2: WD repeat domain, phosphoinositide interacting 2.

Development of Seizures Following Traumatic Brain Injury: A Retrospective Study.

Objectives: The multifaceted impact of Traumatic brain injury (TBI) encompasses complex healthcare costs and diverse health complications, including the emergence of Post-Traumatic Seizures (PTS). In this study, our goal was to discern and elucidate the incidence and risk factors implicated in the pathogenesis of PTS. We hypothesize that the development of PTS following TBI varies based on the type and severity of TBI. Methods: Our study leveraged the Nationwide Inpatient Sample (NIS) to review primary TBI cases spanning 2016-2020 in the United States. Admissions featuring the concurrent development of seizures during the admission were queried. The demographic variables, concomitant diagnoses, TBI subtypes, hospital charges, hospital length of stay (LOS), and mortality were analyzed. Results: The aggregate profile of TBI patients delineated a mean age of 61.75 (±23.8) years, a male preponderance (60%), and a predominantly White demographic (71%). Intriguingly, patients who encountered PTS showcased extended LOS (7.5 ± 9.99 vs. 6.87 ± 10.98 days, p < 0.001). Paradoxically, PTS exhibited a reduced overall in-hospital mortality (6% vs. 8.1%, p < 0.001). Notably, among various TBI subtypes, traumatic subdural hematoma (SDH) emerged as a predictive factor for heightened seizure development (OR 1.38 [1.32-1.43], p < 0.001). Conclusions: This rigorous investigation employing an extensive national database unveils a 4.95% incidence of PTS, with SDH accentuating odds of seizure risk by OR: 1.38 ([1.32-1.43], p < 0.001). The paradoxical correlation between lower mortality and PTS is expected to be multifactorial and necessitates further exploration. Early seizure prophylaxis, prompt monitoring, and equitable healthcare provision remain pivotal avenues for curbing seizure incidence and comprehending intricate mortality trends.

Enhancing systematic reviews: An in-depth analysis on the impact of active learning parameter combinations for biomedical abstract screening.

Systematic Review (SR) are foundational to influencing policies and decision-making in healthcare and beyond. SRs thoroughly synthesise primary research on a specific topic while maintaining reproducibility and transparency. However, the rigorous nature of SRs introduces two main challenges: significant time involved and the continuously growing literature, resulting in potential data omission, making most SRs become outmoded even before they are published. As a solution, AI techniques have been leveraged to simplify the SR process, especially the abstract screening phase. Active learning (AL) has emerged as a preferred method among these AI techniques, allowing interactive learning through human input. Several AL software have been proposed for abstract screening. Despite its prowess, how the various parameters involved in AL influence the software's efficacy is still unclear. This research seeks to demystify this by exploring how different AL strategies, such as initial training set, query strategies etc. impact SR automation. Experimental evaluations were conducted on five complex medical SR datasets, and the GLM model was used to interpret the findings statistically. Some AL variables, such as the feature extractor, initial training size, and classifiers, showed notable observations and practical conclusions were drawn within the context of SR and beyond where AL is deployed.

Gaze Behaviors, Estimated Quiet Eye Characteristics, and Decision Making of Nonexpert Assistant Referees Judging Offside Events in Soccer.

The study analyzed the gaze behavior and decision-making performance of 20 soccer assistant referees while judging offside events. Specifically, gaze behaviors, gaze entropy, and estimated quiet eye (eQE; defined as the last fixation prior to the attacker's ball pass) characteristics (i.e., location, onset, offset, and duration) were analyzed in relation to decision-making accuracy. Although a significant number of fixations were observed on the offside line, the highest viewing time corresponded to the ball carrier. The gaze behavior indicated a high distribution of fixations, as evidenced by high stationary gaze entropy (>90%). The assistant referees also distinguished offside from onside positions above chance. However, they displayed nonprolonged eQE on the offside line. As a result, no significant relationships were found between the eQE characteristics and decision-making accuracy. The study concludes that the absence of more functional gaze behaviors, specifically with longer eQE focused on the offside line, impaired the decision-making accuracy of nonexpert assistant referees in soccer.

Fast and quantitative mitophagy assessment by flow cytometry using the mito-QC reporter.

Mitochondrial quality control is finely tuned by mitophagy, the selective degradation of mitochondria through autophagy, and mitochondrial biogenesis. Removal of damaged mitochondria is essential to preserve cellular bioenergetics and prevent detrimental events such as sustained mitoROS production, pro-apoptotic cytochrome c release or mtDNA leakage. The array of tools available to study mitophagy is very limited but in constant development. Almost a decade ago, we developed a method to assess mitophagy flux using MitoTracker Deep Red in combination with lysosomal inhibitors. Now, using the novel tandem-fluorescence reporter mito-QC (mCherry-GFP-FIS1101-152) that allows to differentiate between healthy mitochondria (mCherry+GFP+) and mitolysosomes (mCherry+GFP-), we have developed a robust and quantitative method to assess mitophagy by flow cytometry. This approach has been validated in ARPE-19 cells using PINK1/Parkin-dependent (CCCP) and PINK1/Parkin-independent (DFP) positive controls and complementary techniques. Furthermore, we show that the mito-QC reporter can be multiplexed, especially if using spectral flow cytometry, to simultaneously study other cellular parameters such as viability or ROS production. Using this technique, we evaluated and characterized two prospective mitophagy inducers and further dissected their mechanism of action. Finally, using mito-QC reporter mice, we developed a protocol to measure mitophagy levels in the retina ex vivo. This novel methodology will propel mitophagy research forward and accelerate the discovery of novel mitophagy modulators.

Perceptual-Cognitive Skills of Basketball Referees: On-The-Court Visual Search Behavior.

Perceptual-cognitive skills are crucial in successfully managing information and decision-making in sports, particularly in high-pressure environments. We examined 16 basketball referees' on-the-court visual search behavior by comparing referees of different experience levels (experienced, n = 8; and novice, n = 8) and different court positions. Participants' visual search behavior was analyzed during 20 live gameplay situations using eye-tracking technology. Dependent variables were the number of eye fixations, mean fixation time, and total fixation time on selected areas of interest; and independent variables were the referees' experience and visual angles (lead and trail referee positions). Experienced referees exhibited significantly lower total fixation time than novice referees (p = .009). Referees in the trail position showed more fixations of shorter duration and a greater focus on the basket than those in the lead position. Our findings suggest that the visual search behavior of basketball referees varies with their court position and experience. These data provide valuable insights into referees' complex visual search patterns in the real-game context, and they highlight the importance of considering viewing angle and experience in future research.

In-line rate encrypted links using pre-shared post-quantum keys and DPUs.

The development of quantum computers poses a risk to the cryptographic algorithms utilized by current public key infrastructure (PKI). High performance computing (HPC), inter- and intra-datacenter communications, and governmental communications are particularly vulnerable to security attacks by quantum computers. In response, there are on-going efforts on implementing post-quantum cryptography (PQC) despite the considerable overhead involved in processing PQC encrypted data packets in comparison with their classical counterparts. This work aims to help with the transition to quantum resistant cryptographic schemes by means of providing a thorough experimental performance comparison of the four algorithms selected by the National Institute of Standards and Technology (NIST) for standardization when implemented in a data processing unit (DPU). The experiments are conducted at line-rate, demonstrating for the first time operation at almost 100 Gbit/s and hence suitability for high-capacity data center environments.

Six and twelve-month respiratory outcomes in a cohort of severe and critical COVID-19 survivors: A prospective monocentric study in Latin America.

Introduction: Severe COVID-19 can result in long-term sequelae known as "chronic COVID," characterized by a wide range of persistent physical and mental symptoms. Chest imaging and pulmonary function test alterations have been observed in recovered patients. Most studies focus on up to a 3-month follow-up after symptom onset or hospital discharge, with few reports on long-term follow-up and limited evidence regarding disease progression in Latin America. Methods: This study aims to describe the clinical characteristics and changes in pulmonary function, imaging, and quality of life in severe and critical COVID-19 patients requiring ICU admission in a high-complexity hospital in Latin America. A prospective cohort of survivors underwent clinical, radiological, pulmonary function, and quality of life assessments 6 and 12 months post-discharge. Results: One hundred twelve patients were included, all of whom attended the 6-month follow-up, and 99 returned for the 12-month follow-up. Most subjects had no previous respiratory symptoms or significant medical history. At the end of the follow-up period, 74% of the patients showed interstitial infiltrates in chest tomography and a higher frequency of fibroatelectatic tracts and parenchymal bands. Pulmonary function tests returned to normal ranges, except for carbon monoxide diffusion, but no altered scores were reported in the questionnaires. Conclusion: Despite residual radiological findings, most parameters studied in severe and critical COVID-19 survivors improved over the 12-month follow-up period. Regardless of the imaging abnormalities, the improvement in variables such as symptomatic relief and normal pulmonary function suggests that these alterations are transient. Carbon monoxide diffusion did not normalize by the end of the follow-up, which is consistent with the abnormalities reported in multiple studies, indicating a potential disease-related pattern.

Exploring the spatial interference effects elicited by social and non-social targets: A conditional accuracy function approach.

Recent studies employing the spatial interference paradigm reveal qualitative differences in congruency effects between gaze and arrow targets. Typically, arrows produce a standard congruency effect (SCE), with faster responses when target direction aligns with its location. Conversely, gaze targets often lead to a reversed congruency effect (RCE), where responses are slower in similar conditions. We explored this dissociation using the Conditional Accuracy Function (CAF) to assess accuracy across reaction time bins. Using a hierarchical linear mixed modelling approach to compare cropped eyes, and full faces as social stimuli, and arrows as non-social stimuli, we synthesized findings from 11 studies, which led to three distinct models. The results showed that with non-social targets, incongruent trials exhibited lower accuracy rates in the first bin than in subsequent bins, while congruent trials maintained stable accuracy throughout the distribution. Conversely, social targets revealed a dissociation within the fastest responses; alongside a general reduction in accuracy for both congruency conditions, congruent trials resulted in even lower accuracy rates than incongruent ones. These results suggest with gaze targets that additional information, perhaps social, in addition to the automatic capture by the irrelevant target location, is being processed during the earlier stages of processing.

First year report of the IMSS Multicenter Hip Fracture Registry.

The population has aged; there is a greater risk of osteoporosis and hip fracture. We describe the standards of care for hip fractures in various hospitals of Mexico. A total of 1042 subjects participated. The acute mortality was 4.3%. SIGNIFICANCE: Hip fracture registries provide a means to compare care and establish improvement processes. BACKGROUND: The Mexican population has aged; thus, there is a greater risk of osteoporosis, and its main consequence is hip fracture due to fragility. Its incidence is high, and it is expected to increase due to aging in our country. International guidelines provide standardized recommendations for the care of people with hip fractures, while hip fracture registries provide a means to compare care with local, national, and international clinical standards and establish improvement processes. OBJECTIVE: Describe the standards of care for hip fractures in various hospital centers of the Mexican Social Security Institute. METHODS: This was an observational, multicenter, longitudinal, and descriptive study. It included 24 hospital centers in Mexico. Informed consent was obtained. Data were recorded during the hospital stay, epidemiological data, and management, and follow-up was carried out 30 and 120 days after discharge. The information was analyzed using SPSS version 22.0. RESULTS: A total of 1042 subjects aged 79.5 ± 7.6 years participated, mostly women (n = 739; 70.9%) from the community (n = 1,021; 98.0%) and with functional independence (Barthel 80.9 ± 22.2). The transfer time to the emergency room was 4.6 ± 14.6 days. Pertrochanteric hip fracture was the most common (n = 570, 54.7%). The most common type of procedure was dynamic hip screw (DHS) (n = 399; 40.1%). Documented thromboprophylaxis was granted in 91.5% (n = 953) and antibiotic prophylaxis in 53.0% (n = 552) of the patients. The goal of 36 h for the surgical procedure was achieved in 7.6% of the subjects (n = 76), with the most frequent cause being a delay in scheduling (n = 673, 67.6%). The mean time from emergency room to surgery was 7.8 ± 7.0 days. The acute mortality rate was 4.3%. Secondary pharmacologic prevention upon discharge occurred in 64.2% of patients. At 30 days, 370 subjects (37.1%) were lost to follow-up, with a mortality of 3%, while at 120 days, 166 subjects (27.8%) were lost, with a mortality of 2.8%. CONCLUSION: In the hospital centers where the study was carried out, there are still no standards of care for hip fractures, which makes it necessary to rethink the care for this population group through a strategy focused on meeting those standards.

Physical performance and technical specific skills of women football players with cerebral palsy.

This study aimed to determine the physical performance profile (ability to change direction, vertical and horizontal jump, sprint ability, and dribbling-specific skills) of the first women football players with cerebral palsy (CP) who participated in an international CP football competition, accounting for their sport classes. We also examined the relationships between the different physical performance variables. Forty-five female players with CP (24.9 ± 7.5 years) were categorised into three sport classes based on their impairment severity: 19 were FT1 (severe impairments); 21 FT2; and 5 FT3 (mild impairments). Various physical performance tests were conducted, including the 505 change of direction test; vertical and horizontal jumps; 10 m sprint test; and the dribbling speed test. Significant correlations were observed between the change of direction ability, sprint (r = 0.89; p < 0.01), and dribbling tests (r = 0.71; p < 0.01), as well as between horizontal jump and sprint time (r = - 0.74; p < 0.01). FT1 players demonstrated poorer performance compared to FT3 in the 505 test and standing broad jump (p < 0.05; dg = -1.79 and 1.22 respectively), but also lower vertical jump heights (p < 0.05; dg = -0.91 to -1.57) and increased time required for sprint (p < 0.05; dg = 0.88 to 1.16) and dribbling tests (p < 0.05; dg = 0.85 to 1.44) compared to both FT2 and FT3 players. These findings offer valuable insights into the physical performance characteristics of female footballers with CP, which can guide training and sport enhancement programs for this unique para-sport population.

New findings in the metabolism of the saffron apocarotenoids, crocins and crocetin, by the human gut microbiota.

The main constituents of saffron are the apocarotenoids crocins and crocetin, present in the stigmas. Numerous healthy properties, especially those related to the effects on the central nervous system, have been attributed to these compounds but the metabolites responsible for these effects are still unknown. Previous evidences in animal models suggest a role for the gut microbiota in the pharmacokinetics and the neuroprotective effects of these compounds. However, the interaction between these apocarotenoids and the gut microbiota has been poorly studied. In this article, we have thoroughly investigated the batch fermentation of crocin-1 and crocetin (10 µM) with human fecal samples of two donors at different incubation times (0-240 h) using a metabolomic approach. We corroborated a rapid transformation of crocin-1 which looses the glucose molecules through de-glycosylation reactions until its complete transformation into crocetin in 6 hours. A group of intermediate crocins with different degrees of glycosylation were detected in a very short time. Crocetin was further metabolized and new microbial metabolites produced by double-bond reduction and demethylation reactions were identified for the first time: dihydro and tetrahydro crocetins and di-demethyl crocetin. In addition, we detected changes in the levels of the short chain fatty acids valeric acid and hexanoic acid suggesting further structural modifications of crocetin or changes in the catabolic production of these compounds. This research is a pioneering study of the action of the human gut microbiota on the saffron apocarotenoids and goes one step further towards the discovery of metabolites potentially involved in the benefits of saffron.

Extrinsically conducting MOFs: guest-promoted enhancement of electrical conductivity, thin film fabrication and applications.

Conductive metal-organic frameworks are of current interest in chemical science because of their applications in chemiresistive sensing, electrochemical energy storage, electrocatalysis, etc. Different strategies have been employed to design conductive frameworks. In this review, we discuss the influence of different types of guest species incorporated within the pores or channels of metal-organic frameworks (MOFs) and porous coordination polymers (PCPs) to generate charge transfer pathways and modulate their electrical conductivity. We have classified dopants or guest species into three different categories: (i) metal-based dopants, (ii) molecule and molecular entities and (iii) organic conducting polymers. Different types of metal ions, metal nano-clusters and metal oxides have been used to enhance electrical conductivity in MOFs. Metal ions and metal nano-clusters depend on the hopping process for efficient charge transfer whereas metal-oxides show charge transport through the metal-oxygen pathway. Several types of molecules or molecular entities ranging from neutral TCNQ, I2, and fullerene to ionic methyl viologen, organometallic like nickelcarborane, etc. have been used. In these cases, the charge transfer process varies with the guest species. When organic conducting polymers are the guest, the charge transport occurs through the polymer chains, mostly based on extended π-conjugation. Here we provide a comprehensive and critical review of these strategies to add electrical conductivity to the, in most cases, otherwise insulating MOFs and PCPs. We point out the guest encapsulation process, the geometry and structure of the resulting host-guest complex, the host-guest interactions and the charge transport mechanism for each case. We also present the methods for thin film fabrication of conducting MOFs (both, liquid-phase and gas-phase based methods) and their most relevant applications like electrocatalysis, sensing, charge storage, photoconductivity, photocatalysis,… We end this review with the main obstacles and challenges to be faced and the appealing perspectives of these 21st century materials.

Isolated attosecond pulse generation in a semi-infinite gas cell driven by time-gated phase matching.

Isolated attosecond pulse (IAP) generation usually involves the use of short-medium gas cells operated at high pressures. In contrast, long-medium schemes at low pressures are commonly perceived as inherently unsuitable for IAP generation due to the nonlinear phenomena that challenge favourable phase-matching conditions. Here we provide clear experimental evidence on the generation of isolated extreme-ultraviolet attosecond pulses in a semi-infinite gas cell, demonstrating the use of extended-medium geometries for effective production of IAPs. To gain a deeper understanding we develop a simulation method for high-order harmonic generation (HHG), which combines nonlinear propagation with macroscopic HHG solving the 3D time-dependent Schrödinger equation at the single-atom level. Our simulations reveal that the nonlinear spatio-temporal reshaping of the driving field, observed in the experiment as a bright plasma channel, acts as a self-regulating mechanism boosting the phase-matching conditions for the generation of IAPs.

A New Fibrin-Heparine Coated Self-Expanding Stent for the Rescue Treatment of Intracranial Stenosis-a Multicentric Study.

INTRODUCTION: Rescue intracranial stenting is necessary to provide sufficient recanalization after mechanical thrombectomy (MT) in patients with acute large vessel occlusions (LVO) due to an underlying intracranial atherosclerotic disease (ICAD). The CREDO heal is a novel stent that provides a potentially lower thrombogenicity due to surface modification. We present the first multicentric experience with the CREDO heal for acute rescue stenting. METHODS: Data of 81 patients who underwent rescue stenting after MT at 12 centers in Germany and Spain were prospectively collected and retrospectively evaluated. RESULTS: Final mTICI 2b­3 was reached in 95.1% after median two MT maneuvers and stenting. Four periprocedural complications resulted in clinical deterioration (4.9%). Intraparenchymal hemorrhage occurred in one patient (1.2%) and functional independence at FU was reached by 42% of the patients. Most interventions were performed under Gp IIb/IIIa inhibitors. CONCLUSION: CREDO heal was effective and safe in our case series. However, more data is needed to define the optimal antithrombotic regime. The use under single antiplatelet medication is not supported by our study.

"Insights into vessel perforations during thrombectomy: Characteristics of a severe complication and the effect of thrombolysis".

INTRODUCTION: Thrombectomy complications remain poorly explored. This study aims to characterize periprocedural intracranial vessel perforation including the effect of thrombolysis on patient outcomes. PATIENTS AND METHODS: In this multicenter retrospective cohort study, consecutive patients with vessel perforation during thrombectomy between January 2015 and April 2023 were included. Vessel perforation was defined as active extravasation on digital subtraction angiography. The primary outcome was modified Rankin Scale (mRS) at 90 days. Factors associated with the primary outcome were assessed using proportional odds models. RESULTS: 459 patients with vessel perforation were included (mean age 72.5 ± 13.6 years, 59% female, 41% received thrombolysis). Mortality at 90 days was 51.9% and 16.3% of patients reached mRS 0-2 at 90 days. Thrombolysis was not associated with worse outcome at 90 days. Perforation of a large vessel (LV) as opposed to medium/distal vessel perforation was independently associated with worse outcome at 90 days (aOR 1.709, p = 0.04) and LV perforation was associated with poorer survival probability (HR 1.389, p = 0.021). Patients with active bleeding >20 min had worse survival probability, too (HR 1.797, p = 0.009). Thrombolysis was not associated with longer bleeding duration. Bleeding cessation was achieved faster by permanent vessel occlusion compared to temporary measures (median difference: 4 min, p < 0.001). DISCUSSION AND CONCLUSION: Vessel perforation during thrombectomy is a severe and frequently fatal complication. This study does not suggest that thrombolysis significantly attributes to worse prognosis. Prompt cessation of active bleeding within 20 min is critical, emphasizing the need for interventionalists to be trained in complication management.