Safety and effectiveness of the LVIS and LVIS Jr devices for the treatment of intracranial aneurysms: Final results of the LEPI multicenter cohort study.

BACKGROUND: The Low profile visualized intraluminal support (LVIS)/LVIS Jr is a self-expanding braiding stent for the treatment of intracranial aneurysm. This study is to determine the safety and effectiveness of the LVIS/LVIS Jr for the treatment of intracranial aneurysms in a real-world setting. METHODS: This prospective, observational, multicenter study enrolled patients with unruptured, ruptured and recanalized intracranial aneurysms treated with the LVIS stents, between February 2018 to December 2019. Primary endpoint was the cumulative morbidity and mortality rate (CMMR) assessed at 12 months follow-up (FU). RESULTS: A total of 130 patients were included (62.3 % women, mean age 55.9 ± 11.4) on an intention-to-treat basis. Four patients (3.1 %) had 2 target aneurysms; 134 total aneurysms were treated. The aneurysms were mainly located on the middle cerebral artery (41/134; 30.6 %) and the anterior communicating artery (31/134; 23.1 %). The CMMR at 1 year linked to the procedure and/or device was 4.6 % (6/130). The overall mortality was 1.5 % (2/130), none of these deaths adjudged as being linked to the procedure and/or device. All aneurysms (134/134, 100 %) were successfully treated with LVIS stent and/or other devices. At a mean FU of 16.8 months post-procedure, complete/nearly complete occlusion was achieved in 112 aneurysms (92.6 %), and only 3 patients (2.5 %) required aneurysm retreatment. CONCLUSION: This study provides evidence that the LVIS/LVIS Jr devices are safe and effective in the treatment of complex intracranial aneurysms, with very high rates of adequate occlusion at FU. These angiographic results are stable over time with an acceptable complication rate. TRIAL REGISTRATION: ClinicalTrial.gov under NCT03553771.

Modeling and forecasting biogas production from anaerobic digestion process for sustainable resource energy recovery.

Anaerobic digestion (AD) is one of the most extensively accepted processes for organic waste cleanup, and production of both bioenergy and organic fertilizer. Numerous mathematical models have been conceived for modeling the anaerobic process. In this study, a new modified dynamic mathematical model for the simulation of the biochemical and physicochemical processes involved in the AD process for biogas production was proposed. The model was validated, and a sensitivity analysis based on the OAT approach (one-at-a-time) was carried out as a screening technique to identify the most sensitive parameters. The model was developed by updating the bio-chemical framework and including more details concerning the physico-chemical process. The fraction XP was incorporated into the model as a particulate inert product arising from biomass decay (inoculum). New components were included to distinguish between the substrate and inoculum, and a surface-based kinetics was used to model the substrate disintegration. Additionally, the sulfate reduction process and hydrogen sulfide production have been included. The model was validated using data extracted from the literature. The model's ability to generate accurate predictions was testified using statistical metrics. The model exhibited excellent performance in forecasting the parameters related to the biogas process, with measurements falling within a reasonable error margin. The relative absolute error (rAE) and root mean square error (RMSE) were both less than 5 %, indicating a high ability of the current model in comparison with the literature. Additionally, the scatter index (SI) was below 10 %, and the Nash-Sutcliffe efficiency (NES) approached one, which affirms the model's accuracy and reliability. Finally, the model was applied to investigate the performances of the AD of food waste (FW). The findings of this study support the robustness of the developed model and its applicability as a virtual platform to evaluate the efficiency of the AD treatment and to forecast biogas production and its quality, CO2 emission, and energy potential across various organic solid waste types.

Predictors of futile recanalization in nonagenarians treated with mechanical thrombectomy: a multi-center observational study.

BACKGROUND: There is a lack of data regarding patients aged 90 years or older undergoing mechanical thrombectomy and their predictors of futile recanalization. AIMS: We sought to evaluate the predictors of futile recanalization in patients ≥ 90 years with large vessel occlusion undergoing mechanical thrombectomy. METHODS: This multi-center observational retrospective study included patients ≥ 90 years consecutively treated with mechanical thrombectomy in four thrombectomy capable centers between January 1st, 2016 and 30th March 2023. Futile recanalization was defined as large vessel occlusion patients experiencing a 90-day poor outcome (mRS 3-6) despite successful recanalization (mTICI ≥ 2b) after mechanical thrombectomy. RESULTS: Our cohort included 139 patients ≥ 90 years with acute ischemic stroke due to anterior circulation large vessel occlusion treated with mechanical thrombectomy. One hundred seventeen of one hundred thirty-nine patients ≥ 90 years who achieved successful recanalization were included in the analysis (seventy-six female (64.9%)), of whom thirty-one (26.49%) experienced effective recanalization and eighty-six (73.51%) experienced futile recanalization. Patients with futile recanalization had higher NIHSS on admission (p < 0.001); they were less frequently treated with intravenous thrombolysis (p = 0.048), had more often general anesthesia (p = 0.011), and longer door to groin puncture delay (p = 0.002). Univariable regression analysis showed that use of intravenous thrombolysis (0.29, 95% CI 0.02-0.79, p = 0.034) and site of occlusion distal vs proximal (0.34, 95% CI 0.11-0.97, p = 0.044) were associated with reduced probability of futile recanalization while NIHSS on admission (1.29, 95% CI 1.16-1.45, p < 0.001), NIHSS at 24 h (1.15, 95% CI 1.07-1.25, p = 0.002), type of anesthesia used (4.18, 95% CI 1.57-11.08, p = 0.004), and door to groin puncture time (1.02, 95% CI 1.00-1.05, p = 0.005) were associated with increased probability of futile recanalization. Multivariable regression analysis showed that use of intravenous thrombolysis (0.44, 95% CI 0.09-0.88, p = 0.039) was associated with reduced probability of futile recanalization. CONCLUSION: Our study seems to suggest that mechanical thrombectomy with intravenous thrombolysis is associated with reduced probability of futile recanalization in a multi-center cohort of patients aged 90 years or older.

Biogas production from recycled paper mill wastewater by UASB digester: Optimal and mesophilic conditions.

The anaerobic digestion (AD) has become an alternative source and an attractive treatment method. Up-flow Anaerobic Sludge Blanket (UASB) digester has been designed to treat the Recycled paper mill wastewater (RPMW) in Morocco. This paper provides a research on anaerobic digestion of RPMW using UASB technology. The UASB digester was designed following the characterization of wastewater and the feed rate, with the volume of 70 liters. The UASB reactor treating the RPMW was operated for 130 days with minimal overload problems. The experiments were carried out in the mesophilic temperature (37 °C) at different organic loading rates (OLR). A daily analysis was performed to ensure the efficiency of the digester. In this study, the AD experiment was performed in continuous mode with an effluent inlet flow rate equal to 1 L/h. Using the optimal OLR value 5.18 g COD/Ld and with an effluent 5,7 g COD/L, a biogas yield of 92 N mL/g COD removed (at normal temperature and pressure) was obtained during the RPMW anaerobic treatment. The reactor was operated at an optimal hydraulic retention time (HRT) of 15.14 h with a biogas production volume of the optimal value 62.5 L/d. These results indicate that RPMW can be effectively treated in a UASB reactor with the advantage of producing biogas. We tested our system with RPMW, to see the production capacity of the UASB system, which the objective is to develop the system for the industrial scale.

Development and evaluation of a multiplex reverse-transcription real-time PCR assay for detection of equine respiratory disease viruses.

We developed a multiplex reverse-transcription real-time PCR (RT-rtPCR) assay for the simultaneous detection of the main equine respiratory viruses: equid alphaherpesviruses 1 and 4 (EHV-1, -4) and equine influenza virus (EIV; species Influenza A virus). The primers and probes amplified only the targeted viruses, and there were no inter-assay cross-amplifications or nonspecific interactions. The multiplex assay efficiencies were 92.5%, 97%, and 90% for EHV-1, EHV-4, and EIV, respectively. The R2 values of the monoplex and multiplex assays were ⩾0.990, and the slopes were -3.37 to -3.59. The performance of the assay was evaluated by analyzing 152 samples from clinically infected horses. EHV-1 DNA was detected in 12 samples, EHV-4 DNA in 9 samples, and both EHV-1 and EHV-4 in 4 samples. The accuracy of the assay was confirmed by comparing these results using commercial rtPCR and RT-rtPCR kits. Our multiplex RT-rtPCR was a sensitive, specific, accurate, and cost-effective method for the detection of the target viruses whether they occur alone or as part of coinfections.

Gastrointestinal helminths of stray cats in Alexandria, Egypt: A fecal examination survey study.

This study investigates the prevalence of gastrointestinal (GI) helminths among stray cats in Alexandria city, Egypt. Between May 2013 and April 2015, a total of 170 fecal samples were randomly collected from cats and examined parasitologically. GI helminths were found in 58.23% of the samples, comprising cestodes (23.52%), nematodes (20%), and trematodes (14.70%). The prevalent cestodes found were Dipylidium caninum (18.82%), Hymenolepis spp. (3.52%), and Taenia taeniaeformis (1.17%). The prevalent nematodes were Toxocara cati (8.23%), Toxascaris leonina (8.32%), hook worms (1.76%), and lastly Trichuris sp., Physaloptera sp., and Strongyloides cati (0.58% for each). The trem\atodes eggs comprised Heterophyids (11.76%), Alaria spp. (1.76%) and Mesostepahnus spp. (1.17%). The current study highlights the high prevalence of GI helminths in stray cats in Alexandria, Egypt and provides new and updated results that may help in the effort to control these parasites. Further investigations of GI parasites detected in cats in Egypt, particularly of those that play a role in public health, are recommended.