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06-1550 Robbe, M.-F., et al. Numerical simulation of an explosion in a small-scale replica of a fast breeder reactor. Computer Assisted Mechanics and Engineering Sciences (Poland) 12(4): 413-442, 2005 (cames@ippt.gov.pl). [...]

Background: Both CT angiography and CT perfusion involve the administration and tracking of a contrast medium bolus for different purposes. In this study, we aim to compare the diagnostic accuracy and subjective image quality of CTP-angiographic reconstructions with conventional CTA for occlusion detection in ischemic stroke patients., Methods: In this retrospective study, patients with a final diagnosis of ischemic stroke and who underwent both CTA and CTP from September 2020 up to and including September 2021 were included. CTP-AR was reconstructed from the 1 mm CTP series at the time of maximum arterial inflow. Three reviewers with different levels of experience assessed both CTA and CTP for occlusion detection, expressed certainty, and rated subjective image quality. The reference standard was set at the consensus meeting. Pooled sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Differences in subjective and objective image quality and certainty were assessed using Kendall's tau correlation and paired samples t-tests., Results: In total, 107/210 included patients had an occlusion based on our reference standard. Pooled sensitivity and specificity for occlusion detection were 90% (95%CI 85-93) and 94% (95%CI 90-97) for CTA, and 89% (95%CI 84-93) and 93% (95%CI 89-96) for CTP-AR, respectively. The pooled certainty did not significantly differ between CTA and CTP-AR (P=.43). The pooled subjective image quality scores significantly differed between CTA and CTP-AR (τ = 0.3, P<.001), where one reviewer rated subjective image quality higher in CTA and two reviewer in CTP-AR., Conclusion: CTP-AR has comparable diagnostic accuracy to conventional CTA imaging for occlusion detection in ischemic stroke patients. Thus, using CTP-AR instead of CTA plus CTP may conserve contrast medium., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: WHZ reports speaker fees from Stryker, Cerenovus, Medtronic, Microvention and Nicolab, and consulting fees from Philips (all paid to institution); chaired the advisory boards of WeTrust (Philips) and ANAIS ([Advanced Neurovascular Access in Combination With a Stent Retriever in Patients With Acute Ischemic Stroke]; Anaconda) (all paid to institution); and chaired the advisory board of InExtremis (CHU Montpellier, Montpellier, France) for which no payments were received. AAP received an institutional grant from Siemens Healthineers and Bayer Healthcare. Other co-authors have nothing to disclose., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: Direct aspiration during endovascular treatment (EVT) for acute ischemic stroke (AIS) patients is safe and effective. The 'Soft torqueable catheter Optimized For Intracranial Access' (Sofia) catheter is commonly used. Data on differences between 5Fr and 6Fr Sofia is limited. Hence, we aimed to compare the clinical, technical, and safety outcomes between both Sofia catheters in AIS patients., Methods: Patients with an intracranial anterior circulation occlusion from the 'Maastricht Stroke Quality-registry' (MaSQ-registry), who underwent EVT for AIS from September 2020 to February 2023, and treated with the Sofia catheter in the first-line technique were included. Outcomes included a shift on the modified Rankin Scale (mRS) score at 90 days, favorable functional outcome (mRS 0-2), first-attempt recanalization rate, and per procedural complications. Multivariable regression analyses were performed with adjustments., Results: Out of 511 registered patients in the MaSQ-registry, 366 patients were included. 281 patients (77 %) were treated with the Sofia 6Fr. No shift towards better outcomes on the ordinal mRS score at 90 days was observed in the Sofia 6Fr group compared to the 5Fr (adjusted common[ac] OR:1.34, 95 %CI:0.70-2.56). Favorable functional outcome (aOR:1.24, 95 %CI:0.49-3.13), and per procedural complications (aOR:1.04, 95 %CI:0.41-2.64) did not differ significantly between Sofia 6Fr and 5Fr. The Sofia 6Fr achieved higher first-attempt successful recanalization rates (53 % versus 34 %; aOR:2.28, 95 %CI:1.11-4.69), and lower total thrombectomy attempts (median:1 versus 2; aβ:-0.63, 95 %CI:-1.21 to -0.05)., Conclusions: The use of 6Fr Sofia aspiration catheter leads in this single-center registry to higher first-attempt successful recanalization rates and fewer thrombectomy attempts compared to the 5Fr Sofia catheter. However, this did not reflect in better clinical outcomes., Competing Interests: Declaration of competing interest WHvZ reports speaker fees from Stryker, Cerenovus, and Nicolab, and consulting fees from Philips (all paid to institution); participated in the advisory boards of WeTrust (Philips) and ANAIS (Anaconda) (all paid to institution); and participated in the advisory boards of InEcxtremis (CHU Montpellier, Montpellier, France) and DISTAL (University Hospital Basel, Basel, Switzerland), studies for which no payments were received. All other authors declare no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Purpose: Pre- and post-endovascular treatment (EVT) imaging may aid in predicting functional outcomes in acute middle cerebral artery (MCA) ischemic stroke. Low post-EVT contrast extravasation (CE)-ASPECTS is associated with poor functional outcomes. Besides the MCA regions included in the ASPECTS score, CE may be seen in the mesial temporal (MT) region. In this study, we investigated the frequency and prognostic implication of MT-CE in acute ischemic stroke patients., Methods: Patients with an acute ischemic stroke due to anterior large vessel occlusion who received EVT and post-EVT DECT between 2010 and 2019 were included. Iodine overlay maps of DECT were assessed for the occurrence of CE, using the ASPECTS for occurrence in the MCA region and, calculating a CE-ASPECTS, for whether the MT region was involved. Multivariable linear and logistic regression were used to assess the relationship between involvement of MT-CE and 24-48h NIHSS, mRS, and mortality on a multiple imputed dataset. All models were adjusted significant variables in univariate analyses and for total CE-ASPECTS., Results: 501/651 patients met the inclusion criteria. MT-CE occurred in 97 (19 %) patients, and was more often present in patients with internal carotid artery occlusions. MT-CE was associated with higher NIHSS scores at 24-hours (aβ 2.2, 95 % CI 0.09-4.31), with increased risk of higher mRS scores (acOR 1.88, 95 % CI 1.16-3.06), and with increased risk of mortality (aOR 2.12, 95 % CI 1.16-3.86)., Conclusion: MT-CE is a common finding on post-EVT DECT and is an independent predictor for worse functional outcomes., Competing Interests: Declaration of competing interest W.Z reports consulting fees from Philips, and speaker fees from Stryker, Cerenovus, and Nicolab (all paid to the institution). Moreover, he is participating in the Safety Monitoring Board or Advisory Board of WeTrust (Philips), InEcxtremis (CHU Montpellier), ANAIS (Anaconda), and DISTAL (University of Hospital Basal) studies. A.P received an institutional grant from Siemens Healthineers and Bayer Healthcare. Other co-authors have nothing to disclose., (Copyright © 2024. Published by Elsevier Inc.)

Background: CT perfusion angiographic reconstructions (CTP-AR), derived at the peak arterial inflow, have demonstrated similar diagnostic accuracy to CTA for occlusion detection in the anterior circulation. Colour-coded CTP maps may aid in localizing an occlusion. This study aim to assess the additional value of CTP maps for occlusion detection in ischemic stroke patients assessed with CTA or CTP-AR., Methods: In this single center retrospective study, ischemic stroke patients who underwent both CTA and CTP from September 2020 up to and including September 2021 were included. The 1 mm CTP series at peak arterial inflow corresponds to the CTP-AR. Following the initial assessment of CTA and CTP-AR for occlusion detection, three readers with varying levels of experienced, reassessed the CTA and CTP-AR with access to the color-coded CTP maps. Each CTA and CTP-AR was reviewed by two readers, and certainty of assessment was recorded. The reference standard was determined through a consensus meeting. Differences in certainty were assessed using a t-test for paired samples., Results: Out of 210 patients, 107 patients had an occlusion based on our reference standard. The addition of CTP maps resulted in the finding of 11 (2.6%) additional occlusions out of 420 CTA readings and 9 (2.1%) out of 420 CTP-AR readings, primarily involving distal occlusions. After addition of CTP maps, 7 (1.6%) initial assessments on CTA and 3 (0.7%) initial assessments on CTP-AR were deemed false positive. The overall certainty of all readers significantly (P < 0.001) increased after addition of CTP maps., Conclusion: The usage of CTP maps improved occlusion detection on both CTA and CTP-AR, especially for distal occlusions, and resulted in the increase of the overall level of certainty among readers with varying levels of experience., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Background: Blood brain barrier disruption (BBBD) can be visualized by contrast extravasation (CE) after endovascular treatment (EVT) in patients with acute ischemic stroke. Elevated blood pressure is a risk factor for BBBD. However, the association between procedural blood pressure and CE post-EVT is unknown., Methods: In this single-center retrospective study, we analyzed 501 eligible patients who received a dual energy CT (DECT) immediately post-EVT for acute ischemic stroke. Procedural blood pressure values (SBP mean , SBP max, SBP max-min, and MAP mean ) were collected. CE was quantified by measuring the maximum parenchymal iodine concentration on DECT iodine overlay map reconstructions. As a measure for the extent of BBBD, we created CE-ASPECTS by deducting one point per hyperdense ASPECTS region on iodine overlay maps. The association between blood pressure and CE was assessed using multivariable linear regression., Results: The procedural SBP mean , SBP max , and MAP mean were 150 ± 26 mmHg, 173 ± 29 mmHg, and 101 ± 17 mmHg, respectively. The median maximum iodine concentration on post-EVT DECT was 1.2 mg/ml (IQR 0.7-2.0), and median CE-ASPECTS was 8 (IQR 5-11). The maximum iodine concentration was not associated with blood pressure. SBP mean , SBP max, and MAP mean were significantly associated with CE-ASPECTS (per 10 mmHg, β = -0.2, 95 % CI -0.31 to -0.09, β = -0.15, 95 % CI -0.25 to -0.06, β = -0.33, 95 % CI -0.49 to -0.17, respectively)., Conclusion: In acute ischemic stroke patients undergoing EVT, particularly in patients achieving successful recanalization, SBP mean , SBP max , and MAP mean are associated with the extent of BBBD on immediate post-EVT DECT, but not with maximum iodine concentration., Competing Interests: Declaration of competing interest W.Z reports consulting fees from Philips, and speaker fees from Stryker, Cerenovus, and Nicolab (all paid to the institution). Moreover, he is participating in the Safety Monitoring Board or Advisory Board of WeTrust (Philips), InEcxtremis (CHU Montpellier), ANAIS (Anaconda), and DISTAL (University of Hospital Basal) studies. A.P received an institutional grant from Siemens Healthineers and Bayer Healthcare. Other co-authors have nothing to disclose., (Copyright © 2024. Published by Elsevier Inc.)

Purpose: After endovascular therapy (EVT) for ischemic stroke, post-EVT CT imaging often shows areas of contrast extravasation (CE) caused by blood brain barrier disruption (BBBD). Before EVT, CT-perfusion (CTP) can be used to estimate salvageable tissue (penumbra) and irrevocably damaged infarction (core). In this study, we aimed to correlate CTP deficits to CE, as a surrogate marker for BBBD, after EVT for ischemic stroke., Methods: In this single center study, EVT patients between 2010 and 2020 in whom both CTP at baseline and DECT post-EVT was performed were included. The presence of core and penumbra on CTP was assessed per ASPECTS region, resulting in a CTP-ASPECTS core and a CTP-ASPECTS core+penumbra . Likewise, CE on DECT was scored per ASPECTS region, resulting in a CE-ASPECTS. Correlation was assessed using Kendall's tau correlation and positive predictive values (PPV) were calculated per ASPECTS region. Bland-Altman plots were created to visualize the agreement between the two scores., Results: 194 patients met our inclusion criteria. The median core and penumbra were 8 cc (IQR 1-25) and 103 cc (IQR 68-141), respectively. The median CTP-ASPECTS core , CTP-ASPECTS core+penumbra , and CE-ASPECTS were 7 (IQR 4-9), 3 (IQR 1-4), and 6 (IQR 4-9), respectively. The correlation between CTP-ASPECTS core and CE-ASPECTS was τ = 0.21, P <.001, and τ = 0.13, P =.02 between CTP-ASPECTS core+penumbra and CE-ASPECTS. Bland-Altman plots showed a mean difference (CTP-ASPECTS minus CE-ASPECTS) of 0.27 (95 %CI -6.7-7.2) for CTP-ASPECTS core and -3.2 (95 %CI -9.7-3.2) for CTP-ASPECTS core+penumbra . The PPVs of the CTP-ASPECTS core and CTP-ASPECTS core+penumbra were highest for the basal ganglia., Conclusion: There is a weak although significant correlation between pre-EVT CTP-ASPECTS and post-EVT CE-ASPECTS. The weak correlation may be attributed to various imaging limitations as well as patient related factors., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: W.Z reports consulting fees from Philips, and speaker fees from Stryker, Cerenovus, and Nicolab (all paid to the institution). Moreover, he is participating in the Safety Monitoring Board or Advisory Board of WeTrust (Philips), InEcxtremis (CHU Montpellier), ANAIS (Anaconda), and DISTAL (University of Hospital Basal) studies. A.P received an institutional grant from Siemens Healthineers and Bayer Healthcare. Other co-authors have nothing to disclose., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: To provide a systematic review and meta-analysis that evaluates the diagnostic accuracy of contrast-enhanced mammography (CEM) compared to standard contrast-enhanced breast magnetic resonance imaging (breast MRI). Like breast MRI, CEM enables tumour visualization by contrast accumulation. CEM seems to be a viable substitute for breast MRI. Methods: This systematic search assessed the diagnostic accuracy of these techniques in women with suspicious breast lesions on prior imaging or physical examination, who have undergone both breast MRI and CEM. CEM had to be performed on a commercially available system. The MRI sequence parameters had to be described sufficiently to ensure that standard breast MRI sequence protocols were used. Pooled values of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio (DOR), were estimated using bivariate mixed-effects logistic regression modeling. Hierarchical summary receiver operating characteristic curves for CEM and breast MRI were also constructed. Results: Six studies (607 patients with 775 lesions) met the predefined inclusion criteria. Pooled sensitivity was 96% for CEM and 97% for breast MRI. Pooled specificity was 77% for both modalities. DOR was 79.5 for CEM and 122.9 for breast MRI. Between-study heterogeneity expressed as the I 2 -index was substantial with values over 80%. Conclusion: Pooled sensitivity was high for both CEM and breast MRI, with moderate specificity. The pooled DOR estimates, however, indicate higher overall diagnostic performance of breast MRI compared to CEM. Nonetheless, current scientific evidence is too limited to prematurely discard CEM as an alternative for breast MRI., Competing Interests: Competing Interests: MJ received a speaker's fee from GE Healthcare. JW received institutional grants from AGFA, Bayer Healthcare, Bard Medical, GE Healthcare, Optimed, Philips Healthcare, Siemens Healthineers. ML received a research grant and several speaker's fees from GE Healthcare, Tromp Medical, Bayer and Guerbet. The other authors have declared that no competing interests exist., (© The author(s).)

Within the heritage field, the application of strain gauges on wood surfaces is a little-explored but inexpensive and effective method to analyse the environmental appropriateness of rooms for the wooden heritage collections they contain. This contribution proposes a wood sensor connected to a data logger to identify short moments with an elevated risk of harm. Two experiments were performed to obtain insights pertaining to the applicability of wood sensors to evaluate preservation conditions. (1) The representativeness of strain gauges on dummies was tested for their use in evaluating the preservation conditions of a range of wooden objects exposed to the same environment. For this, three situations were mimicked: a bare wood surface, a wood surface covered with a preparation layer, and a wood surface covered with a preparation and varnish layer. (2) The usability of strain gauges to monitor the wood behaviour in real-time measurements was tested with a monitoring campaign of almost two years in a church where a new heating system was installed. The results of both experiments are promising, and the authors encourage a broader application of strain gauges in the heritage field.

In spite of the Gent consensus on perforator flap terminology, widespread confusion still exists regarding the true description of these flaps, making it hard to understand these surgical procedures in comparison with conventional flap techniques. The value of perforator flaps can be better understood by further clarifying certain aspects of previous descriptions. The authors would like to propose enriching the standard Gent nomenclature with optional terms that specify additional aspects of the perforator flap such as including the vessel of origin, the type of vascular dissection, the muscle involved, and the type of perforator vessel. When describing a new flap, these terms will help clarify the anatomical aspects and the surgical approach. Lastly, a better understanding will help in the ongoing debates on this type of surgery and will aid in its dissemination and adoption into reconstructive practice.

Potassium (K+) channels contribute to the regulation of cell proliferation and apoptosis and are also involved in tumor generation and malignant growth. Using immunohistochemical analysis, we investigated the expression of four K+ channels GIRK1 (G-Protein Inwardly Rectifying Potassium Channel 1), Ca2+-activated K channel (K Ca 1.1), voltage activated K+ channels (KV 1.1 and KV 1.3) and of the anti-apoptotic protein Bcl2 in normal and cancerous breast tissues and compared their expression with clinicopathological data. GIRK1 was overexpressed in carcinomatous tissues. In contrast, K V 1.1 and K V 1.3 were less expressed in cancerous tissue. The expression of Bcl-2 was similar in both tissues. As to the clinicopathological data, a correlation between K Ca 1.1 channel and estrogen receptor (ER) expression was observed. GIRK1 was overexpressed in breast carcinoma suggesting its involvement in proliferation and oncogenesis and its possible use as a putative pharmaceutical target. The correlation between K Ca 1.1 channel and ER suggests the involvement of this channel in proliferation. The loss of expression of the two channels K V 1.1 and K V 1.3 may correspond to their role in apoptosis.

The involvement of women with mental health problems in cancer screening was examined in order to explore service delivery options among this particular group. Structured interviews were used to identify the utilization of cancer screening and barriers experienced in accessing such screening among this group. The sample of women reported similar utilization rates of cancer screening as the general female population of the same Australian state. However, they identified a number of barriers to effective access to cancer screening. In response to the interview finding that consumers valued screening services from a well-known provider in a familiar environment, a series of women's health clinics were offered within a mental health service. This experience is described and was used to try to better understand barriers to cancer screening experienced by women with mental health problems. The women's health clinics were most efficiently offered in conjunction with hospital-based psychiatric services.

The analysis of 101 cases has shown that early excision and grafting is the choice for hand burns. The indications are deep second degree and third degree burns. The excision is performed before the 4th post burn day, by tangential excision or direct knife dissection according to the site and depth. Immediate covering of all excised areas, usually by split-thickness skin autografts, is essential. The combination of early excision and grafting, active physiotherapy, Jobst compressive gloves and hydrotherapy guarantees the best cosmetic and functional results.