Jack Joseph Hall

Chronic limb-threatening ischaemia is the severest manifestation of peripheral arterial disease and presents with ischaemic pain at rest or tissue loss (ulceration, gangrene, or both), or both. We compared the effectiveness of a vein bypass first with a best endovascular treatment first revascularisation strategy in terms of preventing major amputation and death in patients with chronic limb threatening ischaemia who required an infra-popliteal, with or without an additional more proximal infra-inguinal, revascularisation procedure to restore limb perfusion.Bypass versus Angioplasty for Severe Ischaemia of the Leg (BASIL)-2 was an open-label, pragmatic, multicentre, phase 3, randomised trial done at 41 vascular surgery units in the UK (n=39), Sweden (n=1), and Denmark (n=1). Eligible patients were those who presented to hospital-based vascular surgery units with chronic limb-threatening ischaemia due to atherosclerotic disease and who required an infra-popliteal, with or without an additional more proximal infra-inguinal, revascularisation procedure to restore limb perfusion. Participants were randomly assigned (1:1) to receive either vein bypass (vein bypass group) or best endovascular treatment (best endovascular treatment group) as their first revascularisation procedure through a secure online randomisation system. Participants were excluded if they had ischaemic pain or tissue loss considered not to be primarily due to atherosclerotic peripheral artery disease. Most vein bypasses used the great saphenous vein and originated from the common or superficial femoral arteries. Most endovascular interventions comprised plain balloon angioplasty with selective use of plain or drug eluting stents. Participants were followed up for a minimum of 2 years. Data were collected locally at participating centres. In England, Wales, and Sweden, centralised databases were used to collect information on amputations and deaths. Data were analysed centrally at the Birmingham Clinical Trials Unit. The primary outcome was amputation-free survival defined as time to first major (above the ankle) amputation or death from any cause measured in the intention-to-treat population. Safety was assessed by monitoring serious adverse events up to 30-days after first revascularisation. The trial is registered with the ISRCTN registry, ISRCTN27728689.Between July 22, 2014, and Nov 30, 2020, 345 participants (65 [19%] women and 280 [81%] men; median age 72·5 years [62·7-79·3]) with chronic limb-threatening ischaemia were enrolled in the trial and randomly assigned: 172 (50%) to the vein bypass group and 173 (50%) to the best endovascular treatment group. Major amputation or death occurred in 108 (63%) of 172 patients in the vein bypass group and 92 (53%) of 173 patients in the best endovascular treatment group (adjusted hazard ratio [HR] 1·35 [95% CI 1·02-1·80]; p=0·037). 91 (53%) of 172 patients in the vein bypass group and 77 (45%) of 173 patients in the best endovascular treatment group died (adjusted HR 1·37 [95% CI 1·00-1·87]). In both groups the most common causes of morbidity and death, including that occurring within 30 days of their first revascularisation, were cardiovascular (61 deaths in the vein bypass group and 49 in the best endovascular treatment group) and respiratory events (25 deaths in the vein bypass group and 23 in the best endovascular treatment group; number of cardiovascular and respiratory deaths were not mutually exclusive).In the BASIL-2 trial, a best endovascular treatment first revascularisation strategy was associated with a better amputation-free survival, which was largely driven by fewer deaths in the best endovascular treatment group. These data suggest that more patients with chronic limb-threatening ischaemia who required an infra-popliteal, with or without an additional more proximal infra-inguinal, revascularisation procedure to restore limb perfusion should be considered for a best endovascular treatment first revascularisation strategy.UK National Institute of Health Research Health Technology Programme.

The goal of this research was to assess non-inferiority of the next-generation TAXUS Liberté stent (Boston Scientific Corp., Natick, Massachusetts) versus the TAXUS Express stent (Boston Scientific Corp.).The introduction of drug-eluting stents (DES) has shifted clinical practice towards more complex lesion subsets, prompting the need for more deliverable DES. TAXUS Liberté was designed to combine the established polymer-based, paclitaxel-elution TAXUS technology with the more advanced Liberté stent platform.The TAXUS ATLAS study is a global, prospective, single-arm trial evaluating outcomes in de novo coronary lesions visually estimated to be 10 to 28 mm in length in vessels 2.5 to 4.0 mm in diameter. The control group is an entry-criteria-matched population of TAXUS Express patients from the TAXUS IV and V trials. The primary end point is non-inferiority of TAXUS Liberté versus TAXUS Express for 9-month target vessel revascularization.Despite similar inclusion criteria, quantitative coronary angiography-determined baseline lesion characteristics were significantly more complex for TAXUS Liberté than TAXUS Express. The primary non-inferiority end point was met with the 1-sided 95% confidence bound of 2.98% less than the pre-specified non-inferiority margin of 3% (p = 0.0487).Despite the treatment of more complex lesions with TAXUS Liberté, the primary end point was met, demonstrating that TAXUS Liberté is non-inferior to TAXUS Express. The successful transfer of the proven TAXUS technology to the more advanced TAXUS Liberté platform was demonstrated. (TAXUS ATLAS: TAXUS Liberté-SR Stent for the Treatment of De Novo Coronary Artery Lesions; http://www.clinicaltrials.gov/ct/show/NCT00371709?order=1; NCT00371709).

The TAXUS ATLAS Small Vessel (SV) and Long Lesion (LL) multicenter studies compared the performance of the thin-strut (0.0038 inch) TAXUS Liberté 2.25-mm stent (Boston Scientific; Natick, Massachusetts) and the TAXUS Liberté 38-mm long stent (Boston Scientific; Natick, Massachusetts) with the earlier paclitaxel-eluting TAXUS Express (Boston Scientific) stent that has identical polymer, drug dosage, and release kinetics but different stent geometry and thicker struts (0.0052 inch).The TAXUS Liberté stent was designed with thinner and more even strut spacing to provide more uniform drug distribution, as well as increased flexibility and conformability. Clinical benefits of the new stent design have not been evaluated.The TAXUS ATLAS SV and LL studies are nonrandomized studies comparing outcomes of the TAXUS Liberté 2.25 mm (N = 261) and TAXUS Liberté 38 mm (N = 150) stents to TAXUS Express historical control groups derived from the TAXUS IV and V trials. Inclusion/exclusion criteria for TAXUS Express and Liberté groups were similar in both studies.Each study met its primary end point of noninferiority of 9-month in-segment diameter stenosis. Furthermore, TAXUS Liberté 2.25 mm, when compared with TAXUS Express, significantly reduced the rate of both 9-month angiographic restenosis (18.5% vs. 32.7%, p = 0.0219) and 12-month target lesion revascularization (6.1% vs. 16.9%, p = 0.0039). In addition, TAXUS Liberté 38 mm significantly reduced the risk of 12-month myocardial infarction compared with TAXUS Express (1.4% vs. 6.5%, p = 0.0246).The thinner-strut TAXUS Liberté stent improved outcomes compared with the earlier TAXUS Express stent in both SVs and LLs (A Study of the TAXUS Liberté Stent for the Treatment of de Novo Coronary Artery Lesions in Small Vessels; NCT00371748; A Study of the TAXUS Liberté Stent for the Treatment of Long De Novo Coronary Artery Lesions; NCT00371475).

In the randomized PLATINUM trial, the PROMUS Element platinum-chromium everolimus-eluting stent (PtCr-EES; Boston Scientific, Natick, Massachusetts) was noninferior to the XIENCE V cobalt-chromium everolimus-eluting stent (CoCr-EES; Boston Scientific and Abbott Vascular, Santa Clara, California) for the primary end point of 1-year target lesion failure. This study reports the 3-year outcomes. Patients (n = 1,530) with 1 or 2 de novo native coronary artery lesions (baseline vessel diameter ≥2.50 mm to ≤4.25 mm and length ≤24 mm) were randomized 1:1 to PtCr-EES versus CoCr-EES. Three-year follow-up was available in 93.9% (703 of 749) of patients with CoCr-EES and 96.7% (733 of 758) of patients with PtCr-EES. Comparing CoCr-EES with PtCr-EES, 3-year rates of death (4.3% vs 3.7%, hazard ratio [HR] 0.88, 95% confidence interval [CI] 0.52 to 1.48, p = 0.62), cardiac death (1.9% vs 1.2%, HR 0.63, 95% CI 0.27 to 1.45, p = 0.27), myocardial infarction (2.5% vs 2.3%, HR 0.92, 95% CI 0.48 to 1.79, p = 0.81), ischemia-driven target lesion revascularization (4.9% vs 3.5%, HR 0.72, 95% CI 0.43 to 1.20, p = 0.21), and Academic Research Consortium definite or probable stent thrombosis (0.5% vs 0.7%, HR 1.23, 95% CI 0.33 to 4.57, p = 0.76) were not significantly different. In conclusion, 3-year results of the PLATINUM randomized, controlled, clinical trial demonstrate comparable safety and efficacy outcomes of the PROMUS Element PtCr-EES and the XIENCE V CoCr-EES. In the randomized PLATINUM trial, the PROMUS Element platinum-chromium everolimus-eluting stent (PtCr-EES; Boston Scientific, Natick, Massachusetts) was noninferior to the XIENCE V cobalt-chromium everolimus-eluting stent (CoCr-EES; Boston Scientific and Abbott Vascular, Santa Clara, California) for the primary end point of 1-year target lesion failure. This study reports the 3-year outcomes. Patients (n = 1,530) with 1 or 2 de novo native coronary artery lesions (baseline vessel diameter ≥2.50 mm to ≤4.25 mm and length ≤24 mm) were randomized 1:1 to PtCr-EES versus CoCr-EES. Three-year follow-up was available in 93.9% (703 of 749) of patients with CoCr-EES and 96.7% (733 of 758) of patients with PtCr-EES. Comparing CoCr-EES with PtCr-EES, 3-year rates of death (4.3% vs 3.7%, hazard ratio [HR] 0.88, 95% confidence interval [CI] 0.52 to 1.48, p = 0.62), cardiac death (1.9% vs 1.2%, HR 0.63, 95% CI 0.27 to 1.45, p = 0.27), myocardial infarction (2.5% vs 2.3%, HR 0.92, 95% CI 0.48 to 1.79, p = 0.81), ischemia-driven target lesion revascularization (4.9% vs 3.5%, HR 0.72, 95% CI 0.43 to 1.20, p = 0.21), and Academic Research Consortium definite or probable stent thrombosis (0.5% vs 0.7%, HR 1.23, 95% CI 0.33 to 4.57, p = 0.76) were not significantly different. In conclusion, 3-year results of the PLATINUM randomized, controlled, clinical trial demonstrate comparable safety and efficacy outcomes of the PROMUS Element PtCr-EES and the XIENCE V CoCr-EES.

The aim of this study was to assess the relative efficacy and safety of the second-generation TAXUS Liberté paclitaxel-eluting stent (PES) in patients with and without diabetes mellitus.Diabetic patients suffer from accelerated atherosclerosis and increased risk of restenosis after coronary interventions; however, prior data suggest that PES might blunt this effect, providing equal benefit in diabetic and nondiabetic patients.A pooled analysis of all 4 TAXUS ATLAS studies was conducted that included 413 diabetic and 1,116 nondiabetic subjects treated with the TAXUS Liberté stent for de novo coronary lesions. Angiographic and intravascular ultrasound outcomes at 9 months and clinical outcomes at 9 and 12 months were compared in patients with and without diabetes. Propensity score and multivariate adjustments were performed to correct for baseline differences.In-stent angiographic restenosis (13.0% vs. 9.6%, p = 0.12), late luminal loss (0.40 mm vs. 0.38 mm, p = 0.58), and intimal hyperplasia (14.8% vs. 13.4%, p = 0.29) were similar for diabetic and nondiabetic subjects. After propensity adjustment, 12-month target lesion revascularization rates were similar for diabetic and nondiabetic subjects (6.4% vs. 4.7%, p = 0.18), with no differences in mortality, myocardial infarction, or stent thrombosis. However, the rate of target vessel revascularization (TVR) was higher for diabetic subjects due to increased TVR outside the target lesion (TVR Remote).Similar clinical, angiographic, and intravascular ultrasound outcomes were observed for both diabetic and nondiabetic subjects treated with TAXUS Liberté, suggesting that this PES attenuates the effect of diabetes on restenosis after percutaneous coronary intervention, yielding comparable efficacy and safety in diabetic and nondiabetic patients. (TAXUS ATLAS; NCT00371709, NCT00371423, NCT00371748, and NCT00371475).

This study was conducted to determine whether direct stenting with TAXUS Liberté is noninferior to stenting after pre-dilation. Direct stenting is performed in approximately 30% of patients, but data on clinical and angiographic outcomes with drug-eluting stents are limited. The TAXUS ATLAS DIRECT STENT is a single-arm, multicenter study that enrolled patients with de novo coronary lesions visually estimated to be 10 to 28 mm in length in vessels 2.5 to 4.0 mm in diameter. The control group is the quantitative coronary angiography (QCA) subset of the TAXUS ATLAS trial, which used identical inclusion and exclusion criteria but mandated pre-dilation. The primary end point is 9-month analysis-segment percent diameter stenosis (%DS). Baseline patient characteristics were similar between the groups. On QCA analysis, significantly shorter lesions with larger lumen diameter and less calcification were observed in the direct stent group. Direct stenting was successful in 97.6% of patients and was associated with a shorter procedure time and fewer complications. Follow-up %DS was noninferior for direct stent (26.41%) versus pre-dilation (29.14%) with a 1-sided 95% confidence interval of the difference between the groups (−0.34%) well below the pre-specified noninferiority margin (6.75%). Additionally, significantly lower restenosis (5.9% vs. 11.4%, p = 0.0229) and target lesion revascularization (TLR) 2.9% vs. 7.8%, p = 0.0087) rates were seen for direct stent versus pre-dilation. Direct stenting of TAXUS Liberté is feasible and highly successful in carefully selected lesions. Direct stenting is noninferior to stenting after pre-dilation on the basis of %DS and can significantly reduce procedural time, procedural complications, and possibly angiographic restenosis and TLR. (TAXUS Liberté-SR Paclitaxel-Eluting Coronary Stent System; NCT00371423).

We report limits on annual modulation of the low-energy event rate from the Cryogenic Dark Matter Search (CDMS II) experiment at the Soudan Underground Laboratory. Such a modulation could be produced by interactions from Weakly Interacting Massive Particles (WIMPs) with masses ~10 GeV/c^2. We find no evidence for annual modulation in the event rate of veto-anticoincident single-detector interactions consistent with nuclear recoils, and constrain the magnitude of any modulation to <0.06 event [keVnr kg day]^-1 in the 5-11.9 keVnr energy range at the 99% confidence level. These results disfavor an explanation for the reported modulation in the 1.2-3.2 keVee energy range in CoGeNT in terms of nuclear recoils resulting from elastic scattering of WIMPs at >98% confidence. For events consistent with electron recoils, no significant modulation is observed for either single- or multiple-detector interactions in the 3.0-7.4 keVee range.

The climate crisis and the degradation of the world's ecosystems require humanity to take immediate action. The international scientific community has a responsibility to limit the negative environmental impacts of basic research. The HECAP+ communities (High Energy Physics, Cosmology, Astroparticle Physics, and Hadron and Nuclear Physics) make use of common and similar experimental infrastructure, such as accelerators and observatories, and rely similarly on the processing of big data. Our communities therefore face similar challenges to improving the sustainability of our research. This document aims to reflect on the environmental impacts of our work practices and research infrastructure, to highlight best practice, to make recommendations for positive changes, and to identify the opportunities and challenges that such changes present for wider aspects of social responsibility.

Our experience suggests transradial arterial access with 5Fr catheters can be used for cardiac angiography with a low incidence of clinical complications, and supports the findings of previous investigators. Subclinical complications at the catheterization site were infrequent in this study (1 patient with asymptomatic radial artery occlusion). The presence of a palpable radial pulse may not be a reliable estimate of artery patency as evidenced by our patient with a palpable pulse due to retrograde flow. The theoretical advantage of the procedure is derived from the dual vascular supply to the hand. Radial artery occlusion, while uncommon, results in no ischemic sequelae in the setting of a patent ulnar artery.

To report the final, cumulative, 5-year outcomes from the TAXUS ATLAS program, which studied the use of the TAXUS Liberté paclitaxel-eluting stent in de-novo coronary artery lesions.TAXUS ATLAS Workhorse, Small Vessel, and Long Lesion are nonrandomized studies comparing TAXUS Liberté (N=871), TAXUS Liberté 2.25 mm (N=261), and TAXUS Liberté 38 mm (N=150) stents, respectively, with case-matched TAXUS Express historical controls.In the unadjusted analysis, TAXUS Liberté showed comparable 5-year rates of major adverse cardiac events (27.1% TAXUS Express vs. 26.2% TAXUS Liberté, P=0.70) in workhorse lesions and greater 5-year cumulative freedom from target lesion revascularization (78.4 vs. 87.3%, P=0.03) in small vessels. In addition, a lower periprocedural myocardial infarction rate (MI, 4.1 vs. 0.0%; P=0.01) was observed in long lesions versus TAXUS Express. After propensity score adjustment, no statistically significant effect of TAXUS Liberté on the 5-year rates of TLR in small vessels (17.9 vs. 13.3%, P=0.36) or MI in long lesions (9.1 vs. 7.0%, P=0.53) was found, although the rates remained numerically lower with TAXUS Liberté.Cumulative 5-year results of the TAXUS ATLAS studies suggest that the TAXUS Liberté stent provides similar safety and effectiveness in workhorse lesions, and may provide lower revascularization rates in small vessels and lower periprocedural MI rates in long lesions compared with the TAXUS Express stent, although no statistically significant differences were found following propensity adjustment.

The objective of this intravascular ultrasound (IVUS) analysis was to evaluate the vascular response of the thin-strut TAXUS Liberté stent compared with the otherwise identical TAXUS Express stent.The TAXUS ATLAS and TAXUS ATLAS Long Lesion studies are nonrandomized trials comparing the thin-strut TAXUS Liberté stent to historical TAXUS Express controls from the TAXUS IV and TAXUS V trials. A total of 377 patients enrolled in the two TAXUS ATLAS studies were randomly selected for the IVUS subset and compared to 314 TAXUS Express IVUS controls.Despite increased lesion complexity in the TAXUS Liberté group, neointimal formation at 9 months was similar in both stents (TAXUS Liberté 13.8±11.0%; TAXUS Express 13.1±13.8%, P=.56). However, this neointima covered more of the overall stent in the TAXUS Liberté (67.9±32.5%) compared with the TAXUS Express (54.4±37.2%, P<.001), suggesting more uniform neointimal distribution. TAXUS Liberté also showed less pronounced negative remodeling at both stent edges and had significantly less (4.3% vs. 9.6%, P=.04) late incomplete stent apposition (ISA).Despite identical polymer and drug release characteristic, the thin-strut TAXUS Liberté stent demonstrates improved neointimal coverage, better edge remodeling, and less late ISA vs. TAXUS Express, hereby highlighting the importance of the platform design for drug-eluting stents.

Background: The long-term impact of treating de novo coronary lesions in native vessels and challenging small vessel and long lesion subsets with TAXUS Liberté stents is unknown. This report examines the 3-year efficacy and safety from the TAXUS ATLAS program. Methods and Results: TAXUS ATLAS WH, Small Vessel, and Long Lesion are non-randomized studies comparing TAXUS Liberté (n=871), TAXUS Liberté 2.25mm (n=261), and TAXUS Liberté 38mm (n=150) stents, respectively, to case-matched TAXUS Express historical controls. TAXUS Liberté demonstrated comparable 3-year rates of major adverse cardiac events (19.0% vs. 20.2%, P=0.51) in de novo lesions, reduced target lesion revascularization (TLR, 10.0% vs. 22.1%, P=0.008) in small vessels, and reduced myocardial infarction (MI, 2.9% vs. 10.4%; P=0.01) and stent thrombosis (ST, 0.0% vs. 3.9%, P=0.03) in long lesions vs. TAXUS Express. After propensity score adjustment, no statistically significant effect of TAXUS Liberté on TLR (9.7% vs. 16.9%, P=0.12) in small vessels or MI (2.9% vs. 7.9%, P=0.05) in long lesions was noted, although reduced ST (0.0% vs. 2.7%, P=0.02) remained in long lesions. Multivariate analyses demonstrated that TAXUS Liberté treatment significantly reduced TLR by 66% in small vessels, and MI by 75% in long lesions, vs. TAXUS Express. Conclusions: TAXUS Liberté suggests durable 3-year effectiveness in reducing restenosis and improved clinical outcomes in small vessels and long lesions compared with TAXUS Express. (Circ J 2011; 75: 1120-1129)

Percutaneous coronary intervention (PCI) of coronary artery bifurcation lesions entails technical challenges and carries a higher risk of adverse events on follow-up, driven by repeat revascularisation and stent thrombosis. While most bifurcations can be tackled with a provisional (single-stent) approach, more complex lesions involving both branches (true bifurcation lesions) require a two-stent approach. In the latter context, several techniques have been proposed. Among them, the crush technique has dramatically evolved in recent years, and its more recent iterations have been shown to provide excellent and durable results, both for left main and non-left main bifurcations. The aim of the present work is to discuss the technical aspects and outcomes of the variants of the crush technique from the first description in the early 2000s to the present day.

Received 3 September 2013DOI:https://doi.org/10.1103/PhysRevD.88.059901© 2013 American Physical Society

The climate crisis and the degradation of the world's ecosystems require humanity to take immediate action. The international scientific community has a responsibility to limit the negative environmental impacts of basic research. The HECAP+ communities (High Energy Physics, Cosmology, Astroparticle Physics, and Hadron and Nuclear Physics) make use of common and similar experimental infrastructure, such as accelerators and observatories, and rely similarly on the processing of big data. Our communities therefore face similar challenges to improving the sustainability of our research. This document aims to reflect on the environmental impacts of our work practices and research infrastructure, to highlight best practice, to make recommendations for positive changes, and to identify the opportunities and challenges that such changes present for wider aspects of social responsibility.

Abstract With the increase in energy prices and the drive to reduce carbon emission, this paper presents an investigation of the use of smart office environments to monitor and evaluate the sustainability and behaviour of employees and the utilisation of space and resources. This paper presents analysis of data in an office environment in a company in Derby city to attempt to understand the behaviour of employees, pattern of work, power consumption and performance of heating and air-conditioning systems. Data from occupancy, room temperature, CO 2 , humidity, lighting, air temperature, windows status are all collected and analysed. The data also included external environmental conditions. The results indicate some correlation between CO 2 levels and the number of employees. They also show correlation between outside and inside environmental conditions. In addition, the utilisation of space was also monitored, and the results demonstrate low utilisation during most days, this was due to Covid-19 and to working from home and off-site patterns. However, the data is found useful to inform future decisions about the actual space needed for normal working conditions.

Abstract Background Skeletal muscle indices have been associated with improved peri-operative outcomes after surgical resection of non-small-cell lung cancer (NSCLC). However, it is unclear if these indices can predict long term cancer specific outcomes. Methods NSCLC patients undergoing lobectomy at our institute between 2009–2015 were included in this analysis ( N = 492). Preoperative CT scans were used to quantify skeletal muscle index (SMI) at L4 using sliceOmatic software. Cox proportional modelling was performed for overall (OS) and recurrence free survival (RFS). Results For all patients, median SMI was 45.7 cm 2 /m 2 (IQR, 40–53.8). SMI was negatively associated with age ( R = -0.2; p &lt; 0.05) and positively associated with BMI ( R = 0.46; P &lt; 0.05). No association with either OS or RFS was seen with univariate cox modelling. However, multivariable modelling for SMI with patient age, gender, race, smoking status, DLCO and FEV 1 (% predicted), American Society of Anesthesiology (ASA) score, tumor histology and stage, and postoperative neoadjuvant therapy showed improved OS (HR = 0.97; P = 0.0005) and RFS (HR = 0.97; P = 0.01) with SMI. Using sex specific median SMI as cutoff, a lower SMI was associated with poor OS (HR = 1.65, P = 0.001) and RFS (HR = 1.47, P = 0.03). Conclusions SMI is associated with improved outcomes after resection of NSCLC. Further studies are needed to understand the biological basis of this observation. This study provides additional rationale for designing and implementation of rehabilitation trials after surgical resection, to gain durable oncologic benefit.

Background : The TAXUS Liberté (TL) 38 mm stent, the longest drug-eluting stent, was designed with more uniform drug distribution, thinner struts and increased flexibility and conformability for use specifically in very long lesions. Long lesions have been identified as a risk factor for instent restenosis, stent thrombosis and incomplete apposition. Thus, TAXUS ATLAS Long Lesion (LL) assesses the performance of the TL 38 mm stent vs the TAXUS Express (TE) stent. Methods : TAXUS ATLAS LL is a prospective, non-randomized trial enrolling 150 pts from 24 global sites. Pts undergoing single TL stent implantation of a de novo lesion visually estimated to be 26 – 34 mm in length, with a reference vessel diameter of 2.7 – 4.0 mm, were enrolled. A subset of patients underwent IVUS at 9m. The TE Control consists of a lesion-matched cohort derived from TAXUS IV and TAXUS V. The primary endpoint is non-inferiority of 9m % diameter stenosis (%DS) of the analysis segment as determined by quanitative coronary angiography (QCA). Results : Baseline pt characteristics were well-matched between the TL and TE arms. However, the TL pts presented with longer and more complex lesions (by QCA). Procedure time was significantly shorter for TL, and the use of multiple stents was significantly less in TL vs TE. Compared to TE, TL demonstrated non-inferiority for 9m %DS, analysis segment (pre-specified non-inferiority margin = 6.89%, difference = −0.93%, upper 1-sided 95% Confidence Interval = 3.19%, p=0.0010); thus, the primary endpoint objective was met. The cardiac death or MI rate was significantly lower for TL, while other clinical and angiographic parameters were similar between the groups. There were no stent thromboses for TL. The incidence of early or late incomplete apposition was low and comparable between TL and TE. Conclusions : The TL 38 mm stent, the longest drug-eluting stent, demonstrated similar efficacy in reducing stenosis but an enhanced safety profile in very long lesions vs TE.

We report on the results of a search for a Weakly Interacting Massive Particle (WIMP) signal in low-energy data of the Cryogenic Dark Matter Search experiment using a maximum likelihood analysis. A background model is constructed using GEANT4 to simulate the surface-event background from ^(210)Pb decay-chain events, while using independent calibration data to model the gamma background. Fitting this background model to the data results in no statistically significant WIMP component. In addition, we perform fits using an analytic ad hoc background model proposed by Collar and Fields, who claimed to find a large excess of signal-like events in our data. We confirm the strong preference for a signal hypothesis in their analysis under these assumptions, but excesses are observed in both single- and multiple-scatter events, which implies the signal is not caused by WIMPs, but rather reflects the inadequacy of their background model.

Hunteria is a genus of plant in family Apocynaceae.It comprises of 12 species but more prevalent are Hunteria umbellata and Hunteria zeylanica.Taditionally H. umbellata have been used in the treatment of yaws and sexually transmitted infections, stomach ache, ulcers, diabetes mellitus and dysmenorrhoea.H. zeylanica is used to cure stomach-ache, wounds and cuts.H. umbellata has a relatively low oral toxicity profile but its prolonged use, particularly, at high doses should be with great caution.The phytochemical analysis of the H. umbellata plant extract revealed the presence of saponins, steroids, tannins, volatile oils, phenols and copious amount of alkaloids.H. zeylanica leaves and stem bark prominently contains alkaloids.Scientific researchers have shown that H. umbellata and H. zeylanica were active against various diseases such as bacterial infections, pain, fever, inflammation, diabetes, in obesity, hyperlipidemia, heart problems, in child birth and malaria.Aim of the current review is to explore potential species of Genus Hunteria for ethnopharmacology, toxicological studies, safety, phytochemical investigation and pharmacological properties. INTRODUCTION: Genus Hunteria:Hunteria is a genus of plant in family Apocynaceae first described as a genus in 1824.It is native to Guinea-Bissau, Sierra Leone, Liberia, Ivory Coast, Ghana, Benin, Nigeria, Cameroon, Gabon and Democratic Republic of Congo Africa and to South and Southeast Asia. 1 The genus hunteria includes following species 1 along with their distribution.

Let $X$ be a quasi-compact and quasi-separated scheme. There are two fundamental and pervasive facts about the unbounded derived category of $X$: (1) $\mathsf{D}_{\mathrm{qc}}(X)$ is compactly generated by perfect complexes and (2) if $X$ is noetherian or has affine diagonal, then the functor $\Psi_X \colon \mathsf{D}(\mathsf{QCoh}(X)) \to \mathsf{D}_{\mathrm{qc}}(X)$ is an equivalence. Our main results are that for algebraic stacks in positive characteristic, the assertions (1) and (2) are typically false.

Sensors play a key role in detecting both charged particles and photons for all three frontiers in Particle Physics.The signals from an individual sensor that can be used include ionization deposited, phonons created, or light emitted from excitations of the material.The individual sensors are then typically arrayed for detection of individual particles or groups of particles.Mounting of new, ever higher performance experiments, often depend on advances in sensors in a range of performance characteristics.These performance metrics can include position resolution for passing particles, time resolution on particles impacting the sensor, and overall rate capabilities.In addition the feasible detector area and cost frequently provides a limit to what can be built and therefore is often another area where improvements are important.Finally, radiation tolerance is becoming a requirement in a broad array of devices.We present a status report on a broad category of sensors, including challenges for the future and work in progress to solve those challenges.

Sensors play a key role in detecting both charged particles and photons for all three frontiers in Particle Physics. The signals from an individual sensor that can be used include ionization deposited, phonons created, or light emitted from excitations of the material. The individual sensors are then typically arrayed for detection of individual particles or groups of particles. Mounting of new, ever higher performance experiments, often depend on advances in sensors in a range of performance characteristics. These performance metrics can include position resolution for passing particles, time resolution on particles impacting the sensor, and overall rate capabilities. In addition the feasible detector area and cost frequently provides a limit to what can be built and therefore is often another area where improvements are important. Finally, radiation tolerance is becoming a requirement in a broad array of devices. We present a status report on a broad category of sensors, including challenges for the future and work in progress to solve those challenges

We prove that cohomology and base change holds for algebraic stacks, generalizing work of Brochard in the tame case. We also show that Hom-spaces on algebraic stacks are represented by abelian cones, generalizing results of Grothendieck, Brochard, Olsson, Lieblich, and Roth--Starr. To accomplish all of this, we prove that a wide class of Ext-functors in algebraic geometry are coherent (in the sense of M. Auslander).

We give a proof of openness of versality using coherent functors. As an application, we streamline Artin's criterion for algebraicity of a stack. We also introduce multi-step obstruction theories, employing them to produce obstruction theories for the stack of coherent sheaves, the Quot functor, and spaces of maps in the presence of non-flatness.

We give a variant of Artin algebraization along closed subschemes and closed substacks. Our main application is the existence of \'etale, smooth, or syntomic neighborhoods of closed subschemes and closed substacks. In particular, we prove local structure theorems for stacks and their derived counterparts and the existence of henselizations along linearly fundamental closed substacks. These results establish the existence of Ferrand pushouts, which answers positively a question of Temkin-Tyomkin.

Let $X$ be an algebraic stack with quasi-affine diagonal of finite type over a field $k$ of characteristic $0$. We extend the well-known equivalence $\mathsf{D}^+(\mathsf{QCoh}(X)) \simeq \mathsf{D}_{\mathrm{qc}}^+(X)$ to unbounded derived categories. We also prove that if $X$ is smooth over $k$, then $\mathsf{D}_{\mathrm{qc}}(X)$ is compactly generated. We accomplish the former using the descendable algebras of Mathew. We also establish related results in positive and mixed characteristics.

Background: Diabetics suffer from accelerated atherosclerosis, co-morbidities and an increased risk of restenosis. Paclitaxel is hypothesized to inhibit restenosis even in the presence of insulin r...

Cognition is the process of knowing. As carried out by a dynamical system, it is the process by which the system absorbs information into its state. A complex network of agents cognizes knowledge about its environment, internal dynamics and initial state by forming emergent, macro-level patterns. Such patterns require each agent to find its place while partially aware of the whole pattern. Such partial awareness can be achieved by separating the system dynamics into two parts by timescale: the propagation dynamics and the pattern dynamics. The fast propagation dynamics describe the spread of signals across the network. If they converge to a fixed point for any quasi-static state of the slow pattern dynamics, that fixed point represents an aggregate of macro-level information. On longer timescales, agents coordinate via positive feedback to form patterns, which are defined using closed walks in the graph of agents. Patterns can be coherent, in that every part of the pattern depends on every other part for context. Coherent patterns are acausal, in that (a) they cannot be predicted and (b) no part of the stored knowledge can be mapped to any part of the pattern, or vice versa. A cognitive network's knowledge is encoded or embodied by the selection of patterns which emerge. The theory of cognition summarized here can model autocatalytic reaction-diffusion systems, artificial neural networks, market economies and ant colony optimization, among many other real and virtual systems. This theory suggests a new understanding of complexity as a lattice of contexts rather than a single measure.

We prove a new and unified GAGA theorem. This recovers all analytic and formal GAGA results in the literature, and is also valid in the non-noetherian setting. Our method can also be used to establish various Lefschetz theorems and comparison results for the Fargues-Fontaine curve.

We prove that an algebraic stack with affine stabilizers over an arbitrary (possibly mixed-characteristic) base is \'etale locally a quotient stack around any point with a linearly reductive stabilizer. This generalizes earlier work by the authors (stacks over algebraically closed fields) and by Abramovich, Olsson and Vistoli (stacks with finite inertia). In addition, we prove a number of foundational results, which are new even over a field. We expect these results to be as consequential to the study of algebraic stacks as our local structure theorems. They include various coherent completeness and effectivity results for adic sequences of algebraic stacks. Finally, we give several applications of our results and methods, such as structure theorems for linearly reductive group schemes and generalizations to the relative setting of Sumihiro's theorem on torus actions and Luna's \'etale slice theorem.

Abstract : A microcomputer-based algorithm for estimation of the three parameters of a generalized Gumbel (extreme value type I) distribution class is presented. The parameters are shift, scale, and shape. The classical Gumbel distribution results if the shape parameter is equal to unity. Three-parameter as well as two-parameter (shape equal to unity) estimation can be performed for given histogram data. Parameter estimation is accomplished by means of the maximum-likelihood principle. The derivative equations which result from the associated logarithmic likelihood function are used. A more comprehensive presentation of generalized Gumbel distribution estimation which also allows treatment of population data and which includes moment estimates and maximum- likelihood estimates by direct optimization of the logarithmic likelihood function will be presented elsewhere.

We introduce the theory of unipotent morphisms of algebraic stacks. We give two applications: (1) a unipotent analogue of Gabber's Theorem for torsion $\mathbf{G}_m$-gerbes and (2) smooth Deligne-Mumford stacks with quasi-projective coarse spaces satisfy the resolution property in positive characteristic. Our main tool is a descent result for flags, which we prove using results of Sch\"appi.

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The procedure most often used for drilling laterals from horizontal completions requires a retrievable bridge plug to be set in the casing. The bridge plug serves as the base for orienting and setting the whipstock used to mill the window in the casing so that the drilling of the lateral section can be initiated,In recent years, monobore completions have allowed operators to drill lateral sections through the tubing. Using coiled tubing drilling technology, this procedure can often be performed without killing the well and without pulling the present completion. With this method, a horizontal lateral can be drilled with the well flowing, which allows efficient removal of the cuttings and minimizes formation permeability impairment.If, however, the well completion has wireline nipples or sliding sleeves installed in the tubing, the operation becomes significantly more difficult. This is due to the limited selection of bridge plugs that can be passed freely through the restricted bores of the nipples or sleeves, and then, can be set securely in the casing. If the well has been drilled horizontally, bridge plugs that must be set and retrieved with wireline (either slickline or electric line) cannot be used as they cannot be run into horizontal sections of the wells. Further, retrievable bridge plugs run on tubing or drill pipe would require that the well be killed, the Christmas tree nippled down, and a blowout preventer (BOP) stack installed on the well, Since retrievable bridge plugs run on tubing and drill pipe are frequently hydraulically set, and tubing rotation may be required to release from the bridge plug, a rig or well pulling hoist to perform the workover would be needed. Thus, any economic advantage of performing the workover operation with coiled tubing would be lost.For these reasons, the retrievable bridge plug most commonly used when being set with coiled tubing is the inflatable bridge plug. This plug can be run through the most common restrictions in the tubing (nipples and circulating sleeves) and the element inflated to create the seal against the casing wall, The primary drawback to inflatable bridge plugs is their relatively low differential pressure ratings when compared to other retrievable bridge plugs. If, due to casing damage or other well conditions, the inflatable bridge plug cannot be set, the operator may be left with few viable options for completing the drilling program. This paper will discuss such a case, In this scenario, repeated attempts to set an inflatable bridge plug failed during the operator's drilling program, and a slickline running tool and nippleless lock mandrel were adapted for use with coiled tubing to provide a solution. Use of the slickline running tool with coiled tubing string had never before been attempted. How the adaptation variables were addressed and the considerations for running the nippleless lock on the coiled tubing string will be the focus of the paper.In addition to providing an innovative solution for a difficult service problem, combing these technologies will undoubtedly offer viable alternatives for other service needs.P. 387