Aspiration thrombectomy using a novel 088 catheter and specialized delivery catheter

2021 ◽  
pp. neurintsurg-2021-018318
Author(s):  
James Caldwell ◽  
Ben McGuinness ◽  
Shane S Lee ◽  
P Alan Barber ◽  
Andrew Holden ◽  
...  
Keyword(s):  
Phase 1 ◽  
Phase 2 ◽  
Phase 3 ◽  
Vessel Occlusion ◽  
Aspiration Thrombectomy ◽  
Aspiration System ◽  
First Pass ◽  
Reperfusion Rate ◽  
Delivery Catheter ◽  
Three Phases

BackgroundWe describe the first-in-human experience using the Route 92 Medical Aspiration System to perform thrombectomy in the initial 45 consecutive stroke patients enrolled in the SUMMIT NZ trial. This aspiration system includes a specifically designed delivery catheter which enables delivery of 0.070 inch and 0.088 inch aspiration catheters.MethodsThe SUMMIT NZ trial is a prospective, multicenter, single-arm study with core lab imaging adjudication. Patients presenting with acute ischemic stroke from large vessel occlusion are eligible to enrol. The study has had three phases which transitioned from use of the 0.070 inch to the 0.088 inch catheter.ResultsVessel occlusions were located in the internal carotid artery (27%), M1 (60%) and M2 (13%). Median baseline National Institutes of Health Stroke Scale (NIHSS) was 16 (IQR 10). Across the three phases, the first-pass reperfusion rate of modified Thrombolysis In Cerebral Infarction (mTICI) ≥2b was 62% using the Route 92 Medical system; this rate was 29% in phase 1, 56% in phase 2, and 80% in phase 3. The first-pass reperfusion rate of mTICI ≥2c was 42% overall, 29% in phase 1, 33% in phase 2%, and 55% in phase 3. A final reperfusion rate of mTICI ≥2b was achieved in 96% of cases, with 36% of cases using adjunctive devices. Patients had an average improvement of 6.7 points in NIHSS from baseline at 24 hours, and at 90 days 48% were functionally independent (modified Rankin Scale 0–2).ConclusionsIn this early experience, the Route 92 Medical Aspiration System has been effective and safe. The system has design features that improve catheter deliverability and have the potential to increase first-pass reperfusion rates in aspiration thrombectomy.

Post-Moult Behaviour in the Water-Stick Insect Ranatra Linearis

Behaviour ◽  
1980 ◽  
Vol 73 (3-4) ◽  
pp. 304-324 ◽  
Author(s):  
Ann Cloarec
Keyword(s):  
Environmental Factor ◽  
Phase 1 ◽  
Stick Insect ◽  
Phase 2 ◽  
Potential Prey ◽  
Phase 3 ◽  
Opening And Closing ◽  
Prey Items ◽  
Three Phases

AbstractThe four hour period in Ranatra nymphs between moulting and cuticle darkening is characterized by particular foreleg movements: (i) slow opening and closing of claws (OCT); (ii) moving foreleg femur tips towards the head (B2F). Post-moult behaviour has been divided into three phases: phase 1, lasting about 25 min, claws usually closed, few OCT movements and few B2F movements occur; phase 2 with claws open and forelegs stretched out in front, lasts on average 25 min; during longer phase 3 (205 min on average) many OCT and B2F movements occur. Age does not influence the duration of phases. The number of OCT and B2F movements during phase 3 increases significantly with age. An environmental factor such as presence of potential prey can influence this behaviour. Phases 1 and 3 last longer in absence of prey items than in their presence. The rates of B2F and OCT movements during phase 3 are significantly higher in the presence of prey, for all instars.

scholarly journals Rock and Roll Styles and Genres in Poland (1957–1973)

2016 ◽  
Vol 13 (1) ◽  
pp. 106-112
Author(s):  
Mariusz Gradowski
Keyword(s):  
Popular Music ◽  
Folk Music ◽  
Phase 1 ◽  
Political Context ◽  
Rock And Roll ◽  
Phase 2 ◽  
Musical Culture ◽  
Phase 3 ◽  
Three Phases

Abstract This paper describes the process of establishing rock and roll styles and genres (as defined by Allan F. Moore) in Polish musical culture. My Ph.D. research has revealed three phases in this process. Phase 1: imitation (1957-1962), phase 2: Polonisation (1962-1967) and phase 3: artistic re-interpretation (1967-1973). I present the detailed characteristics of each phase (i.e. their socio-political context, the phenomenon of cover versions, the fusion of rock and roll with local folk music, the development of original artistic language) as well as providing musical examples (mostly from Czesław Niemen’s recordings, which remain one of the most interesting examples of Polish popular music).

scholarly journals Sustained impact of electronic alerts on rate of prophylaxis against venous thromboembolism

2011 ◽  
Vol 106 (10) ◽  
pp. 734-738 ◽  
Author(s):  
Patrick Beeler ◽  
Nils Kucher ◽  
Jürg Blaser
Keyword(s):  
Venous Thromboembolism ◽  
Phase 1 ◽  
Intervention Group ◽  
Control Group ◽  
Phase 2 ◽  
Medical Patients ◽  
Phase 3 ◽  
Electronic Alerts ◽  
Over Time ◽  
Three Phases

SummaryAdvanced electronic alerts (eAlerts) and computerised physician order entry (CPOE) increase adequate thromboprophylaxis orders among hospitalised medical patients. It remains unclear whether eAlerts maintain their efficacy over time, after withdrawal of continuing medical education (CME) on eAlerts and on thromboprophylaxis indications from the study staff. We analysed 5,317 hospital cases from the University Hospital Zurich during 2006–2009: 1,854 cases from a medical ward with eAlerts (intervention group) and 3,463 cases from a surgical ward without eAlerts (control group). In the intervention group, an eAlert with hospital-specific venous thromboembolism (VTE) prevention guidelines was issued in the electronic patient chart 6 hours after admission if no pharmacological or mechanical thromboprophylaxis had been ordered. Data were analysed for three phases: pre-implementation (phase 1), eAlert implementation with CME (phase 2), and post-implementation without CME (phase 3). The rates of thromboprophylaxis in the intervention group were 43.4% in phase 1 and 66.7% in phase 2 (p<0.001), and increased further to 73.6% in phase 3 (p=0.011). Early thromboprophylaxis orders within 12 hours after admission were more often placed in phase 2 and 3 as compared to phase 1 (67.1% vs. 52.1%, p<0.001). In the surgical control group, the thromboprophylaxis rates in the three phases were 88.6%, 90.7%, 90.6% (p=0.16). Advanced eAlerts may provide sustained efficacy over time, with stable rates of thromboprophylaxis orders among hospitalised medical patients.

scholarly journals Efficacy of a Direct Aspiration First-Pass Technique (ADAPT) for Endovascular Treatment in Different Etiologies of Large Vessel Occlusion: Embolism vs. Intracranial Atherosclerotic Stenosis

2021 ◽  
Vol 12 ◽  
Author(s):  
Geng Liao ◽  
Zhenyu Zhang ◽  
Guangzhi Zhang ◽  
Weijie Du ◽  
Chaomao Li ◽  
...  
Keyword(s):  
Multivariate Logistic Regression Analysis ◽  
Large Vessel ◽  
Large Vessel Occlusion ◽  
Vessel Occlusion ◽  
Aspiration Thrombectomy ◽  
Intracranial Atherosclerotic Stenosis ◽  
Atherosclerotic Stenosis ◽  
First Pass ◽  
Baseline Characteristics ◽  
Reperfusion Rate

Background and Aims: Aspiration thrombectomy is an effective method of recanalizing large vessel occlusion (LVO). However, the efficacy of a direct aspiration first-pass technique (ADAPT) for recanalization of LVO of different etiologies is not properly understood.Methods: The prospectively collected database on ADAPT was reviewed retrospectively. We defined two groups of enrolled patients: the embolism-related occlusions (EMB-O) group and the intracranial atherosclerotic stenosis (ICAS)-related occlusion (ICAS-O) group. Baseline characteristics, procedural variables, and post-procedural variables were collected. Multivariate logistic regression analysis was used to identify first-pass recanalization predictors.Results: Of 114 registered patients, 94 were eligible for this study (51 patients in the EMB-O group and 43 patients in the ICAS-O group). Achieving successful reperfusion immediately after direct aspiration was more frequent in the EMB-O group than in the ICAS-O group (64.71 vs. 27.91%, respectively, p = 0.006), with fewer additional rescue treatments needed (35.29 vs. 70.09%, respectively, p = 0.001). The EMB-O group also showed a higher final successful reperfusion rate (96.8 vs. 74.41%, p = 0.006). However, the 90-day good functional outcomes were not affected by the groups. Independent predictors of first-pass success of aspiration included the isolated middle cerebral artery site of occlusion, embolic etiology, and use of larger bore catheters.Conclusions: The efficacy of ADAPT recanalization approach was better in EMB-O than in ICAS-O. In case of embolic etiology and the isolated MCA site of occlusion, using a larger aspiration catheter for direct aspiration thrombectomy may be reasonable.

scholarly journals In pursuit of intercultural communicative competence: An investigation into English language policy and practices at a private university in Indonesia

2021 ◽  
Author(s):  
◽  
Fenty Lidya Siregar
Keyword(s):  
Cultural Diversity ◽  
English Language ◽  
Phase 1 ◽  
Private University ◽  
Teaching Staff ◽  
Phase 2 ◽  
Phase 3 ◽  
Policy Makers ◽  
Culture And Language ◽  
Three Phases

<p>Intercultural language teaching and learning (ILTL) in Asian contexts is an area of growing interest. Reflecting this growth, this study investigated the viability of adopting an intercultural stance in English as a Foreign Language (EFL) instruction at tertiary level in Indonesia.  The research was carried out in three phases. Phase 1 was a document analysis of Indonesia’s English language education policy (ELEP). Phase 2 was a case study which investigated the ELEP underlying two English programmes at a Private University of Indonesia (PUI). It focused on examining the construction of culture and language in curricula of two English programmes, teachers’ beliefs and practices, and students’ beliefs. Phase 3 was an autoethnographic study of my own ILTL in one of the English programmes in PUI. The data was collected from records of my autobiography and one-semester of reflective teaching practice.  The findings of the three phases showed challenges and opportunities of cultivating interculturality in the context. First, the findings of Phase 1 revealed how the need for cultivating respect for cultural diversity – for political unity and social harmony – within the country influenced the ways in which culture and language were constructed in the ELEP. Since policies relating to cultural and linguistic diversity at the national level were influenced by political agenda, they also highlighted an essentialist view of culture. Second, the findings of Phase 2 echoed the findings of Phase 1. The data revealed deeply ingrained essentialist beliefs about culture, and a separation of culture and language in the design and implementation of the curriculum. However, some teaching staff aspired to cultivate intercultural understanding and to help students to understand their own culture and other cultures. Third, the findings of Phase 3 showed the complexity of implementing ILTL. This included challenges in the forms of linguistic goals imposed by the curriculum, no in-house community of practice, and multifaceted classroom behaviour. Despite this, the opportunities for cultivating interculturality were also present in the forms of teaching resources that reflect global and local linguistic and cultural diversity, teacher’s questions that prompt students to decentre, and various activities for students to be active in their own learning (such as group or pair discussions, rehearsals, and role-plays). On top of that, this phase revealed the complexity of collecting evidence of students’ learning and my ethical dilemmas due to various philosophical views embedded in my identities, the teaching context, and the construct of ILTL.  Through its three-phase approach, the study brought outsider and insider dimensions to the task of understanding the fertility of the ground for intercultural teaching in the context of tertiary English classroom in Indonesia. It revealed that the implementation of ILTL can be initiated by teachers who are willing to take an intercultural stance; however, they also need support from community and policy makers to smooth the process and maximise the outcome. It is hoped that the study can inform the work of teachers, teacher educators, and policy makers regarding what it means to be an intercultural learner and teacher in tertiary education in Indonesia and elsewhere.</p>

scholarly journals In pursuit of intercultural communicative competence: An investigation into English language policy and practices at a private university in Indonesia

2021 ◽  
Author(s):  
◽  
Fenty Lidya Siregar
Keyword(s):  
Cultural Diversity ◽  
English Language ◽  
Phase 1 ◽  
Private University ◽  
Teaching Staff ◽  
Phase 2 ◽  
Phase 3 ◽  
Policy Makers ◽  
Culture And Language ◽  
Three Phases

<p>Intercultural language teaching and learning (ILTL) in Asian contexts is an area of growing interest. Reflecting this growth, this study investigated the viability of adopting an intercultural stance in English as a Foreign Language (EFL) instruction at tertiary level in Indonesia.  The research was carried out in three phases. Phase 1 was a document analysis of Indonesia’s English language education policy (ELEP). Phase 2 was a case study which investigated the ELEP underlying two English programmes at a Private University of Indonesia (PUI). It focused on examining the construction of culture and language in curricula of two English programmes, teachers’ beliefs and practices, and students’ beliefs. Phase 3 was an autoethnographic study of my own ILTL in one of the English programmes in PUI. The data was collected from records of my autobiography and one-semester of reflective teaching practice.  The findings of the three phases showed challenges and opportunities of cultivating interculturality in the context. First, the findings of Phase 1 revealed how the need for cultivating respect for cultural diversity – for political unity and social harmony – within the country influenced the ways in which culture and language were constructed in the ELEP. Since policies relating to cultural and linguistic diversity at the national level were influenced by political agenda, they also highlighted an essentialist view of culture. Second, the findings of Phase 2 echoed the findings of Phase 1. The data revealed deeply ingrained essentialist beliefs about culture, and a separation of culture and language in the design and implementation of the curriculum. However, some teaching staff aspired to cultivate intercultural understanding and to help students to understand their own culture and other cultures. Third, the findings of Phase 3 showed the complexity of implementing ILTL. This included challenges in the forms of linguistic goals imposed by the curriculum, no in-house community of practice, and multifaceted classroom behaviour. Despite this, the opportunities for cultivating interculturality were also present in the forms of teaching resources that reflect global and local linguistic and cultural diversity, teacher’s questions that prompt students to decentre, and various activities for students to be active in their own learning (such as group or pair discussions, rehearsals, and role-plays). On top of that, this phase revealed the complexity of collecting evidence of students’ learning and my ethical dilemmas due to various philosophical views embedded in my identities, the teaching context, and the construct of ILTL.  Through its three-phase approach, the study brought outsider and insider dimensions to the task of understanding the fertility of the ground for intercultural teaching in the context of tertiary English classroom in Indonesia. It revealed that the implementation of ILTL can be initiated by teachers who are willing to take an intercultural stance; however, they also need support from community and policy makers to smooth the process and maximise the outcome. It is hoped that the study can inform the work of teachers, teacher educators, and policy makers regarding what it means to be an intercultural learner and teacher in tertiary education in Indonesia and elsewhere.</p>

Early recumbent folding in some westernmost exposures of the Shuswap Complex, southern Okanagan, British Columbia

1979 ◽  
Vol 16 (4) ◽  
pp. 877-894 ◽  
Author(s):  
John V. Ross ◽  
James S. Christie
Keyword(s):  
British Columbia ◽  
Phase 1 ◽  
Strain Analysis ◽  
Phase 2 ◽  
Phase 3 ◽  
Early Stages ◽  
Three Phases ◽  
Okanagan Valley

A sequence of three phases of recumbent folding has been established within some western-most exposures of gneiss of the Shuswap Complex, near Vaseaux Lake, in the southern Okanagan Valley of British Columbia. These three structural events comprise large northerly trending recumbent folds (Phase 1) that have been refolded, first about northeasterly dipping axial surfaces (Phase 2) and secondly about southerly dipping axial surfaces (Phase 3).Much of the ductile strain visible in these rocks appears associated with Phase 2. Strain analysis of plastically deformed garnets, originally synkinematically developed during early stages of Phase 2, indicates that the growth of Phase 2 recumbent folds was associated with extreme flattening strain across their axial surfaces, accompanied by intense constriction subparallel with their hinge lines. A similar but less intense mode of strain appears associated with Phase 3 folds. No useful strain markers are associated with Phase 1 and perhaps this was a translational phase of strain.The Phase 3 event probably is an early part of the Columbian Orogeny, with Phases 1 and 2 being formed either during or earlier than the Permo-Triassic.Early Tertiary events have gently warped and fractured these three early main structures.

PENERAPAN MODEL QUANTUM LEARNING UNTUK MENINGKATKAN HASIL BELAJAR AUTOCAD SISWA KELAS X TEKNIK PEMESINAN SMK NEGERI 1 STABAT

2013 ◽  
Vol 5 (1) ◽  
Author(s):  
Abdul Hasan Saragih
Keyword(s):  
Positive Response ◽  
Phase 1 ◽  
First Grade ◽  
Learning Model ◽  
Second Phase ◽  
Phase 2 ◽  
Phase 3 ◽  
The Third ◽  
Third Phase ◽  
Quantum Learning

This classroom research was conducted on the autocad instructions to the first grade of mechinary class of SMK Negeri 1 Stabat aiming at : (1) improving the student’ archievementon autocad instructional to the student of mechinary architecture class of SMK Negeri 1 Stabat, (2) applying Quantum Learning Model to the students of mechinary class of SMK Negeri 1 Stabat, arising the positive response to autocad subject by applying Quantum Learning Model of the students of mechinary class of SMK Negeri 1 Stabat. The result shows that (1) by applying quantum learning model, the students’ achievement improves significantly. The improvement ofthe achievement of the 34 students is very satisfactory; on the first phase, 27 students passed (70.59%), 10 students failed (29.41%). On the second phase 27 students (79.41%) passed and 7 students (20.59%) failed. On the third phase 30 students (88.24%) passed and 4 students (11.76%) failed. The application of quantum learning model in SMK Negeri 1 Stabat proved satisfying. This was visible from the activeness of the students from phase 1 to 3. The activeness average of the students was 74.31% on phase 1,81.35% on phase 2, and 83.63% on phase 3. (3) The application of the quantum learning model on teaching autocad was very positively welcome by the students of mechinary class of SMK Negeri 1 Stabat. On phase 1 the improvement was 81.53% . It improved to 86.15% on phase 3. Therefore, The improvement ofstudent’ response can be categorized good.

Clinical Drug Development for the Treatment of Pulmonary Arterial Hypertension: Collaboration With the Pharmaceutical Industry and Regulatory Agencies

2010 ◽  
Vol 9 (4) ◽  
pp. 214-219
Author(s):  
Robyn J. Barst
Keyword(s):  
Clinical Trials ◽  
Pulmonary Arterial Hypertension ◽  
Drug Development ◽  
Phase 1 ◽  
Preclinical Studies ◽  
Phase 2 ◽  
Phase 3 ◽  
Preclinical Testing ◽  
New Drug ◽  
Pulmonary Arterial

Drug development is the entire process of introducing a new drug to the market. It involves drug discovery, screening, preclinical testing, an Investigational New Drug (IND) application in the US or a Clinical Trial Application (CTA) in the EU, phase 1–3 clinical trials, a New Drug Application (NDA), Food and Drug Administration (FDA) review and approval, and postapproval studies required for continuing safety evaluation. Preclinical testing assesses safety and biologic activity, phase 1 determines safety and dosage, phase 2 evaluates efficacy and side effects, and phase 3 confirms efficacy and monitors adverse effects in a larger number of patients. Postapproval studies provide additional postmarketing data. On average, it takes 15 years from preclinical studies to regulatory approval by the FDA: about 3.5–6.5 years for preclinical, 1–1.5 years for phase 1, 2 years for phase 2, 3–3.5 years for phase 3, and 1.5–2.5 years for filing the NDA and completing the FDA review process. Of approximately 5000 compounds evaluated in preclinical studies, about 5 compounds enter clinical trials, and 1 compound is approved (Tufts Center for the Study of Drug Development, 2011). Most drug development programs include approximately 35–40 phase 1 studies, 15 phase 2 studies, and 3–5 pivotal trials with more than 5000 patients enrolled. Thus, to produce safe and effective drugs in a regulated environment is a highly complex process. Against this backdrop, what is the best way to develop drugs for pulmonary arterial hypertension (PAH), an orphan disease often rapidly fatal within several years of diagnosis and in which spontaneous regression does not occur?

scholarly journals PSVI-3 Dietary supplementation with coated omega-3 fatty acids has positive effects on growth performance and nutrients digestibility in weaned pigs

2020 ◽  
Vol 98 (Supplement_3) ◽  
pp. 196-197
Author(s):  
Woo Jung Seok ◽  
Je min Ahn ◽  
Jing Hu ◽  
Dexin Dang ◽  
Yanjiao Li ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Growth Performance ◽  
Phase 1 ◽  
Dietary Supplementation ◽  
Basal Diet ◽  
Phase 2 ◽  
Omega 3 ◽  
Phase 3 ◽  
Linear Effect ◽  
Weaning Pigs

Abstract The objective of this study was to evaluate the effects of dietary supplementation of coated omega-3 fatty acid (n-3 CFA) by corn cob power silica on performance of weaning pigs. A total of 200 weaned pigs [(Landrace x Yorkshire) x Duroc, average initial body weight at 6.97 ± 1.22 kg] were randomly assigned to four experimental treatments in a 6-week experiment in 3 phases as follows: CON, basal diet; 2) 0.3CFA, CON + phase 1(0.3% n-3CFA), phase 2(0.2% n-3CFA), phase 3(0.1% n-3CFA); 3) 0.6CFA, CON + phase 1(0.6% n-3CFA), phase 2(0.4% n-3CFA), phase 3(0.2% n-3CFA); 4) 0.9CFA, CON + phase 1(0.9% n-3CFA), phase 2(0.6% n-3CFA), phase 3 (0.3% n-3CFA). Each treatment had 10 replicates with 5 pigs (three gilts and two barrows) per replicate. The data were analyzed using the GLM procedure of SAS as a randomized complete block design. Pen served as the experimental unit. Linear, quadratic and cubic polynomial contrasts were used to examine effect of dietary treatment with coated n-3FA in the basal diet. Variability in the data was expressed as the standard error of means and P&lt; 0.05 was considered to statistically significant. Increasing the level of n-3CFA in the diet linearly increased ADG and G/F of pigs (Table 1). Increasing the level of n-3CFA showed a linear increment in the digestibility of DM (83.59, 84.38, 85.13, 85.89 %) whereas nitrogen digestibility (81.79, 82.38, 82.96, 83.64 %) showed a trend (linear effect, p=0.0594) at the end of experiment. The fecal lactobacillus count was increased (7.22, 7.27, 7.33, 7.35 log10cfu/g) with the increase in the supplemental level of n-3CFA (linear effect; p&lt; 0.05). However, there were no differences in the concentration of serum haptoglobin, or fecal E. coli, Clostridium and Salmonella counts despite the increase in n-3CFA levels in the diet. Supplementation of the diet with coated n-3 fatty acids positively affected growth performance and digestibility of dry matter and nitrogen, and enhanced the count of lactobacillus in weaning pigs.

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