Heparin and air filters reduce embolic events caused by intra-arterial cerebral angiography - A prospective, randomized trial

Background-Intra-arterial cerebral angiography is associated with a low risk for neurological complications, but clinically silent ischemic events after angiography have been seen in a substantial number of patients.Methods and Results-In a prospective study, diffusion-weighted magnetic resonance imaging (DW-MRI) before and after intra-arterial cerebral angiography and transcranial Doppler sonography during angiography were used to evaluate the frequency of cerebral embolism. One hundred fifty diagnostic cerebral angiographies were randomized into 50 procedures, each using conventional angiographic technique, or systemic heparin treatment throughout the procedure, or air filters between the catheter and both the contrast medium syringe and the catheter flushing. There was no neurological complication during or after angiography. Overall, DW-MRI revealed 26 new ischemic lesions in 17 patients (11%). In the control group, 11 patients showed a total of 18 lesions. In the heparin group, 3 patients showed a total of 4 lesions. In the air filter group, 3 patients exhibited a total of 4 lesions. The reduced incidence of ischemic events in the heparin and air filter groups compared with the control group was significantly different (P=0.002). Transcranial Doppler sonography demonstrated a large number of microembolic signals that was significantly lower in the air filter group compared with the heparin and control groups (P=0.01), which did not differ from each other.Conclusions-Air filters and heparin both reduce the incidence of silent ischemic events detected by DW-MRI after intra-arterial cerebral angiography and can potentially lower clinically overt ischemic complications. This may apply to any intra-arterial angiographic procedure

Semi-automatic engineering and tailoring of high-efficiency Bragg-reflection waveguide samples for quantum photonic applications

Austrian Science Fund (FWF) (I-2065, J-4125); German Research Foundation (DFG) (SCHN1376/2-1); European Research Council (ERC) (EnSeNa 257531); State of Bavaria; China Scholarship Council (201503170272)Semiconductor alloys of aluminum gallium arsenide (AlGaAs) exhibit strong second-order optical nonlinearities. This makes them prime candidates for the integration of devices for classical nonlinear optical frequency conversion or photon-pair production, for example, through the parametric down-conversion (PDC) process. Within this material system, Bragg-reflection waveguides (BRW) are a promising platform, but the specifics of the fabrication process and the peculiar optical properties of the alloys require careful engineering. Previously, BRW samples have been mostly derived analytically from design equations using a fixed set of aluminum concentrations. This approach limits the variety and flexibility of the device design. Here, we present a comprehensive guide to the design and analysis of advanced BRW samples and show how to automatize these tasks. Then, nonlinear optimization techniques are employed to tailor the BRW epitaxial structure towards a specific design goal. As a demonstration of our approach, we search for the optimal effective nonlinearity and mode overlap which indicate an improved conversion efficiency or PDC pair production rate. However, the methodology itself is much more versatile as any parameter related to the optical properties of the waveguide, for example the phasematching wavelength or modal dispersion, may be incorporated as design goals. Further, we use the developed tools to gain a reliable insight in the fabrication tolerances and challenges of real-world sample imperfections. One such example is the common thickness gradient along the wafer, which strongly influences the photon-pair rate and spectral properties of the PDC process. Detailed models and a better understanding of the optical properties of a realistic BRW structure are not only useful for investigating current samples, but also provide important feedback for the design and fabrication of potential future turn-key devices. This approach limits the variety and exibility of the device design. Here, we present a comprehensive guide to the design and analysis of advanced BRW samples and show how to automatize these tasks. Then, nonlinear optimization techniques are employed to tailor the BRW epitaxial structure towards a specific design goal. As a demonstration of our approach, we search for the optimal effective nonlinearity and mode overlap which indicate an improved conversion effciency or PDC pair production rate. However, the methodology itself is much more versatile as any parameter related to the optical properties of the waveguide, for example the phasematching wavelength or modal dispersion, may be incorporated as design goals. Further, we use the developed tools to gain a reliable insight in the fabrication tolerances and challenges of real-world sample imperfections. One such example is the common thickness gradient along the wafer, which strongly influences the photon-pair rate and spectral properties of the PDC process. Detailed models and a better understanding of the optical properties of a realistic BRW structure are not only useful for investigating current samples, but also provide important feedback for the design and fabrication of potential future turn-key devices.PostprintPeer reviewe

A Heuristic Approach to Storage System Design With Simultaneous Assignment of Goods

In the paper at hand, we analyze the planning of manually operated storage systems consisting of different storage areas. When solving design problems like dimensioning or equipment selection, the assignment of goods to storage areas has to be considered. Based on a general model to describe the geometry and performance calculation of a warehouse, we present a heuristic approach to assign goods to storage areas while simultaneously determining the design of the storage areas in a way that generates the lowest running costs. Our approach aims to support planners during the rough planning stage by providing a quick overview of different solution alternatives. To evaluate our approach, we apply it to an example from industrial practice

Renal and Skeletal Anomalies in a Cohort of Individuals With Clinically Presumed Hereditary Nephropathy Analyzed by Molecular Genetic Testing

Background: Chronic kidney disease (CKD) in childhood and adolescence occurs with a median incidence of 9 per million of the age-related population. Over 70% of CKD cases under the age of 25 years can be attributed to a hereditary kidney disease. Among these are hereditary podocytopathies, ciliopathies and (monogenic) congenital anomalies of the kidney and urinary tract (CAKUT). These disease entities can present with a vast variety of extrarenal manifestations. So far, skeletal anomalies (SA) have been infrequently described as extrarenal manifestation in these entities. The aim of this study was to retrospectively investigate a cohort of individuals with hereditary podocytopathies, ciliopathies or CAKUT, in which molecular genetic testing had been performed, for the extrarenal manifestation of SA. Material and Methods: A cohort of 65 unrelated individuals with a clinically presumed hereditary podocytopathy (focal segmental glomerulosclerosis, steroid resistant nephrotic syndrome), ciliopathy (nephronophthisis, Bardet-Biedl syndrome, autosomal recessive/dominant polycystic kidney disease), or CAKUT was screened for SA. Data was acquired using a standardized questionnaire and medical reports. 57/65 (88%) of the index cases were analyzed using exome sequencing (ES). Results: 8/65 (12%) index individuals presented with a hereditary podocytopathy, ciliopathy, or CAKUT and an additional skeletal phenotype. In 5/8 families (63%), pathogenic variants in known disease-associated genes (1x BBS1, 1x MAFB, 2x PBX1, 1x SIX2) could be identified. Conclusions: This study highlights the genetic heterogeneity and clinical variability of hereditary nephropathies in respect of skeletal anomalies as extrarenal manifestation