Liquid Embolics: A Guide to Currently Available and Pipeline Products

2021 ◽  
Author(s):  
Shamar Young ◽  
Alessandro Gasparetto ◽  
Jafar Golzarian
Keyword(s):  
New Agents ◽  
Safety And Efficacy ◽  
Clinical Indications ◽  
Embolic Agents ◽  
Clinical Scenarios ◽  
Wide Range ◽  
Potential Benefits ◽  
Ongoing Development

AbstractOver the last decade, several publications have reported the safety and efficacy of liquid embolics in a wide range of clinical indications. The expansion of clinical scenarios in which liquid embolics are utilized has been in part driven by some of the advantages these materials hold over other embolic agents. For instance, liquid embolics do not rely on the patient's ability to form clot and can be delivered more distally then coils at times. While several liquid embolics are commercially available, and in some cases have been for decades, there are limitations to these materials as well. The potential benefits of liquid embolics combined with the limitations of available materials have led to the ongoing development of several new agents. This review aims to familiarize the reader with both available liquid embolics and those that are relatively new or in development.

scholarly journals Introduction: Endovascular Neurosurgery

2019 ◽  
Vol 46 (Suppl_1) ◽  
pp. V1
Author(s):  
Elad I. Levy ◽  
Stephan A. Munich ◽  
Robert H. Rosenwasser ◽  
Peter Kan ◽  
B. Gregory Thompson
Keyword(s):  
Three Dimensional ◽  
Cerebral Aneurysms ◽  
Standard Of Care ◽  
Stroke Treatment ◽  
Road Map ◽  
Embolic Agents ◽  
Liquid Embolic ◽  
Wide Range ◽  
Ongoing Development ◽  
Improved Technology

Remarkable developments in the field of endovascular neurosurgery have been witnessed in the last decade. The success of endovascular therapy for ischemic stroke treatment is now irrefutable, making it an accepted standard of care. Endovascular treatment of cerebral aneurysms is no longer limited to primary coiling but now includes options such as stent or balloon assistance and flow diversion and applications utilizing neck reconstruction, intrasaccular, and bifurcation-specific devices. Balloons, liquid embolic agents, and flow-directed catheters have revolutionized the treatment of arteriovenous malformations and fistulae. The ongoing development of endovascular tools has led to novel and expanding approaches (for example, transvenous arteriovenous malformation embolization and transradial access). With improved technology, transposterior communicating artery access and other endovascular strategies are being applied successfully across the anterior and posterior circulations and to lesions once deemed only surgically approachable. Yet, we would be remiss to attribute the successes of endovascular strategies only to the development of their tools. Improvements in both noninvasive and angiographic imaging (such as three-dimensional road map guidance) have provided a greater understanding of pathologic entities and allowed the pursuit of endovascular cures.In this issue of Neurosurgical Focus, we present a wide range of endovascular strategies for a variety of neurovascular pathologies. We hope this video supplement will not only demonstrate the applicability of tried-and-true endovascular strategies to difficult clinical situations but also highlight new and developing endovascular technologies. We thank the authors for their outstanding contributions.

scholarly journals A Phase II Safety and Efficacy Study on Prognosis of Moderate Pneumonia in COVID-19 patients with Regular Intravenous Immunoglobulin Therapy

2021 ◽  
Author(s):  
Raman R S ◽  
Vijaykumar Bhagwan Barge ◽  
Anil Kumar Darivenula ◽  
Himanshu Dandu ◽  
Rakesh R Kartha ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Randomized Study ◽  
Standard Of Care ◽  
Immunoglobulin Therapy ◽  
Clinical Trial Registry ◽  
Open Label ◽  
Intravenous Immunoglobulin Therapy ◽  
Safety And Efficacy ◽  
Therapeutic Benefits ◽  
Wide Range

Abstract Background Currently, there is no specific drug for the treatment of COVID-19. Therapeutic benefits of intravenous immunoglobin (IVIG) have been demonstrated in wide range of diseases. The present study is conducted to evaluate the safety and efficacy of IVIG in the treatment of COVID-19 patients with moderate pneumonia. Methods An open-label, multicenter, comparative, randomized study was conducted on COVID-19 patients with moderate pneumonia. 100 eligible patients were randomized in 1:1 ratio either to receive IVIG + standard of care (SOC) or SOC. Results Duration of hospital stay was significantly shorter in IVIG group to that of SOC alone (7.7 Vs. 17.5 days). Duration for normalization of body temperature, oxygen saturation and mechanical ventilation were significantly shorter in IVIG compared to SOC. Percentages of patients on mechanical ventilation in two groups were not significantly different (24% Vs. 38%). Median time to RT-PCR negativity was significantly shorter with IVIG than SOC (7 Vs.18 days). There were only mild to moderate adverse events in both groups except for one patient (2%), who died in SOC. Conclusions IVIG was safe and efficacious as an adjuvant with other antiviral drugs in the treatment of COVID-19. The trial was registered under Clinical Trial Registry, India (CTRI/2020/06/026222).

scholarly journals Near-Infrared Spectroscopy for Monitoring Sternocleidomastoid Muscular Oxygenation during Isometric Flexion for Patients with Mild Nonspecific Neck Pain: A Pilot Study

Sensors ◽  
2020 ◽  
Vol 20 (8) ◽  
pp. 2197
Author(s):  
Chia-Chi Yang ◽  
Po-Ching Yang ◽  
Jia-Jin J. Chen ◽  
Yi-Horng Lai ◽  
Chia-Han Hu ◽  
...  
Keyword(s):  
Infrared Spectroscopy ◽  
Neck Pain ◽  
Near Infrared Spectroscopy ◽  
Isometric Contraction ◽  
Oxidative Metabolism ◽  
Near Infrared ◽  
Maximum Voluntary Isometric Contraction ◽  
Clinical Scenarios ◽  
Wide Range ◽  
Asymptomatic Individuals

Since there is merit in noninvasive monitoring of muscular oxidative metabolism for near-infrared spectroscopy in a wide range of clinical scenarios, the present study attempted to evaluate the clinical usability for featuring the modulatory strategies of sternocleidomastoid muscular oxygenation using near-infrared spectroscopy in mild nonspecific neck pain patients. The muscular oxygenation variables of the dominant or affected sternocleidomastoid muscles of interest were extracted at 25% of the maximum voluntary isometric contraction from ten patients (5 males and 5 females, 23.6 ± 4.2 years) and asymptomatic individuals (6 males and 4 females, 24.0 ± 5.1 years) using near-infrared spectroscopy. Only a shorter half-deoxygenation time of oxygen saturation during a sternocleidomastoid isometric contraction was noted in patients compared to asymptomatic individuals (10.43 ± 1.79 s vs. 13.82 ± 1.42 s, p < 0.001). Even though the lack of statically significant differences in most of the muscular oxygenation variables failed to refine the definite pathogenic mechanisms underlying nonspecific neck pain, the findings of modulatory strategies of faster deoxygenation implied that near-infrared spectroscopy appears to have practical potential to provide relevant physiological information regarding muscular oxidative metabolism and constituted convincing preliminary evidences of the adaptive manipulations rather than pathological responses of oxidative metabolism capacity of sternocleidomastoid muscles in nonspecific neck patients with mild disability.

Investment in the agricultural sector as a way to solve food security problems in developing countries: the example of investment activity of the US agribusiness

2021 ◽  
Author(s):  
Elena Stepanovna Ustinovich ◽  
Tatyana Petrovna Boldyreva
Keyword(s):  
Developing Countries ◽  
Large Scale ◽  
Agricultural Sector ◽  
International Investment ◽  
Investment Activity ◽  
Agricultural Investment ◽  
Wide Range ◽  
The Us ◽  
The World ◽  
Potential Benefits

It is clear to everyone that investment in the agricultural sector in developing countries is one of the most effective ways to reduce poverty and hunger in the world. Agricultural investment can generate a wide range of development opportunities. However, these benefi ts cannot be expected to arise automatically. Some forms of large-scale investment pose significant risks to investor states. It should be noted, however, that, despite discussions about the potential benefits and risks of international investment, there is still no evidence of negative actual consequences for the countries receiving investments. This article examines the issues of investment activity in relation to developing countries using the example of US agribusiness entities.

scholarly journals Model Contrast of Autonomous Vehicle Impacts on Traffic

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Derek Hungness ◽  
Raj Bridgelall
Keyword(s):  
Autonomous Vehicles ◽  
Travel Demand ◽  
Autonomous Vehicle ◽  
Sociodemographic Factors ◽  
Vehicle Miles Traveled ◽  
The Road ◽  
Traffic Conditions ◽  
Demand Models ◽  
Wide Range ◽  
Potential Benefits

The adoption of connected and autonomous vehicles (CAVs) is in its infancy. Therefore, very little is known about their potential impacts on traffic. Meanwhile, researchers and market analysts predict a wide range of possibilities about their potential benefits and the timing of their deployments. Planners traditionally use various types of travel demand models to forecast future traffic conditions. However, such models do not yet integrate any expected impacts from CAV deployments. Consequently, many long-range transportation plans do not yet account for their eventual deployment. To address some of these uncertainties, this work modified an existing model for Madison, Wisconsin. To compare outcomes, the authors used identical parameter changes and simulation scenarios for a model of Gainesville, Florida. Both models show that with increasing levels of CAV deployment, both the vehicle miles traveled and the average congestion speed will increase. However, there are some important exceptions due to differences in the road network layout, geospatial features, sociodemographic factors, land-use, and access to transit.

Armchair Auditors: Crowdsourcing Analysis of Government Expenditures

2015 ◽  
Vol 12 (1) ◽  
pp. 71-91 ◽  
Author(s):  
Daniel E. O'Leary
Keyword(s):  
United Kingdom ◽  
Local Governments ◽  
Open Data ◽  
Information And Communications Technology ◽  
Government Expenditures ◽  
Data Movement ◽  
The United Kingdom ◽  
Wide Range ◽  
Potential Benefits ◽  
Open Data Movement

ABSTRACT Increasingly, there is interest in using information and communications technology (ICT) to help build a “better world.” As an example, the United Kingdom has initiated an “open data” movement to disclose financial information about federal and local governments and other organizations. This has led to the use of a wide range of technologies (Internet, Databases, Web 2.0, etc.) to facilitate disclosure. However, since there is a huge cost of generating and maintaining open data, there also is a concern: “will anyone do anything with the data?” In a speech in 2009, David Cameron, the Prime Minister of the United Kingdom, used the term “armchair auditor” to describe crowdsourcing analysis of that data. In that speech, Cameron (2009) noted: “Just imagine the effect that an army of armchair auditors is going to have on those expense claims.” Accordingly, as more and more countries and organizations generate open data, those “armchair auditors” could play an increasingly important role: to help crowdsource monitoring of government expenditures. This paper investigates a number of potential benefits and a number of emerging concerns associated with armchair auditors.

scholarly journals From Unpleasant to Unbearable—Why and How to Implement an Upper Limit to Pain And Other Forms of Suffering in Research with Animals

ILAR Journal ◽  
2020 ◽  
Author(s):  
I Anna S Olsson ◽  
Christine J Nicol ◽  
Steven M Niemi ◽  
Peter Sandøe
Keyword(s):  
Animal Experiments ◽  
The European Union ◽  
Animal Suffering ◽  
Social Functions ◽  
In Vivo Assays ◽  
Negative State ◽  
Wide Range ◽  
Potential Benefits ◽  
Degree Of Control

Abstract The focus of this paper is the requirement that the use of live animals in experiments and in vivo assays should never be allowed if those uses involve severe suffering. This requirement was first implemented in Danish legislation, was later adopted by the European Union, and has had limited uptake in North America. Animal suffering can arise from exposure to a wide range of different external and internal events that threaten biological or social functions, while the severity of suffering may be influenced by the animals’ perceptions of their own situation and the degree of control they are able to exert. Severe suffering is more than an incremental increase in negative state(s) but involves a qualitative shift whereby the normal mechanisms to contain or keep negative states at arm’s length no longer function. The result of severe suffering will be a loss of the ability of cope. The idea of putting a cap on severe suffering may be justified from multiple ethical perspectives. In most, if not all, cases it is possible to avoid imposing severe suffering on animals during experiments without giving up the potential benefits of finding new ways to cure, prevent, or alleviate serious human diseases and generate other important knowledge. From this it follows that there is a strong ethical case to favor a regulatory ban on animal experiments involving severe suffering.

scholarly journals Multimodality Imaging in the Diagnostic Work-Up of Endocarditis and Cardiac Implantable Electronic Device (CIED) Infection

2020 ◽  
Vol 9 (7) ◽  
pp. 2237
Author(s):  
Nicola Galea ◽  
Francesco Bandera ◽  
Chiara Lauri ◽  
Camillo Autore ◽  
Andrea Laghi ◽  
...  
Keyword(s):  
Clinical Decision Making ◽  
Electronic Device ◽  
Multimodality Imaging ◽  
Nuclear Imaging ◽  
Clinical Decision ◽  
Cardiac Device ◽  
Systemic Complications ◽  
Advantages And Disadvantages ◽  
Clinical Scenarios ◽  
Wide Range

Infective endocarditis (IE) is a serious cardiac condition, which includes a wide range of clinical presentations, with varying degrees of severity. The diagnosis is multifactorial and a proper characterization of disease requires the identification of the primary site of infection (usually the cardiac valve) and the search of secondary systemic complications. Early depiction of local complications or distant embolization has a great impact on patient management and prognosis, as it may induce to aggressive antibiotic treatment or, in more advanced cases, cardiac surgery. In this setting, the multimodality imaging has assumed a pivotal role in the clinical decision making and it requires the physician to be aware of the advantages and disadvantages of each imaging technique. Echocardiography is the first imaging test, but it has several limitations. Therefore, the integration with other imaging modalities (computed tomography, magnetic resonance imaging, nuclear imaging) becomes often necessary. Different strategies should be applied depending on whether the infection is suspected or already ascertained, whether located in native or prosthetic valves, in the left or right chambers, or if it involves an implanted cardiac device. In addition, detection of extracardiac IE-related lesions is crucial for a correct management and treatment. The aim of this review is to illustrate strengths and weaknesses of the various methods in the most common clinical scenarios.

HR-ANALYST: ACHIEVEMENTS, CAPABILITIES AND CONDITIONS OF USE

2017 ◽  
Vol 6 (1) ◽  
pp. 5-11
Author(s):  
Коновалова ◽  
Valyeriya Konovalova
Keyword(s):  
Organizational Performance ◽  
Corporate Culture ◽  
Practical Application ◽  
Key Factors ◽  
Current State ◽  
Wide Range ◽  
Productivity Increase ◽  
Potential Benefits ◽  
Staffing Needs ◽  
Interaction Management

The article deals with problems of HR analytics and its practical application to improve management decisions of individual and organizational performance. The results of Russian and foreign research on the current state of and prospects for the use of HR analysts are summarizes. The levels of HR analysts (from the drafting of HR-metrics to predictive modeling) are allocated, their characteristics are disclosed. The examples of the successful use of HR analysts in modern practice are given, special attention is paid to predictive analysts, the author highlights the potential benefits of organizing, its use for a wide range of tasks: forecasting staffing needs, forecasting staff turnover, improving recruitment, better interaction management talent, identifying the most valuable employees, corporate culture and management involvement, identifying key factors for motivation and success, increase staff productivity, increase efficiency of training and formation of competencies.

scholarly journals Switching away from Cigarette Smoking with JUUL: Populations of Special Interest

2021 ◽  
Vol 45 (3) ◽  
pp. 486-504
Author(s):  
Sooyong Kim ◽  
Saul Shiffman ◽  
Gem M. Le
Keyword(s):  
Cigarette Smoking ◽  
Low Income ◽  
Special Interest ◽  
Depression And Anxiety ◽  
Dual Use ◽  
Wide Range ◽  
Potential Benefits ◽  
Race Ethnicity ◽  
Demographic Subgroups ◽  
Over Time

Objectives: In this study, we examined complete switching away from cigarettes across various medico-socio-demographic subpopulations of adult smokers who purchased a JUUL Starter Kit (JSK) electronic nicotine delivery system. Methods: We analyzed trajectories of smoking over 12 months in 17,986 adult smokers who purchased a JSK. Populations of special interest were characterized by race/ethnicity, income, diagnoses of potentially smoking-related illness (SRI), depression, and anxiety. Results: Across all 16 subgroups examined, a consistent pattern of trends was observed where complete switching increased, and dual-use decreased over time. Non-Hispanic Asian race/ethnicity, low income, diagnoses of potential SRI, depression, and anxiety were associated with significantly lower switching rates; however, complete switching rates at month 12 were near 50% for all groups, and surpassed the dual-use rates in all subgroups except for those with potential SRI. Conclusions: Substantial rates of complete switching were consistently achieved across all medico-socio-demographic subgroups 12 months following the purchase of the JSK. The potential benefits of switching with JUUL on smokers are likely to be experienced by a wide range of adult smokers.

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