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Abstract Glycerol electrooxidation is a promising alternative to oxygen evolution as an anodic reaction for efficient hydrogen production. However, the performance of electrocatalysts in this reaction is still limited by CO poisoning and products of lower value form due to C−C cleavage. In this study, PtCu/C catalysts with different metal ratios were investigated for glycerol electrooxidation in acidic media. The addition of Cu to the benchmark Pt/C catalyst increased the activity, productivity, as well as stability due to electronic and structural effects. The best performer Pt7Cu3/C showed an increase in mass activity of 56 %. Lower accumulation of intermediates was proven in electrolysis experiments, leading to an increased selectivity of 90 % to valuable C3‐products. The combined methodology of comprehensive electrochemical characterization and application in electrolysis experiments provides a practical approach for improving glycerol assisted hydrogen production addressing major challenges such as CO poisoning and stability.

Background: Mitral transcatheter‐edge‐to‐edge‐repair (M‐TEER) is mostly done with using general anesthesia (GA). Limited data including specific risk factors exist for a deep sedation (DS) approach. Methods and Results: 464 M‐TEER procedures were included for comparison of a DS approach versus those who required a conversion to GA. Specific predefined risk factors were analyzed to identify those patients who might not benefit from a DS strategy by the need of conversion to GA. The conversion rate from DS to GA was 6.7% (n = 433 successful DS and n = 31 conversion to GA). Mean age was 80 years. Classical surgical risk scores did not show any significant difference between the two groups. Patients with DS had a higher procedural success rate (96.1% versus 80.1%; p < 0.001). The time on the intensive care unit (ICU) (3.9 h versus 126 h; p = 0.023) was shorter for patients with DS. Patients who were in the need for a conversion to GA had a lower 30‐day and 1‐year survival rate. A multivariate analysis for conversion to GA showed body mass index (p = 0.023), pre‐existing kidney failure (p < 0.001), obstructive sleep apnea syndrome (OSAS) (p = 0.031), systolic pulmonary pressure value (p = 0.013), and concomitant tricuspid regurgitation (p = 0.049) as risk factors. Conclusions: Using DS in M‐TEER is feasible with a low conversion rate to GA. In case of a conversion, the procedure is less successful regarding reduction of MR and more complications occurred with a lower survival rate up to 12 months. These data suggest that conversion from DS to GA is high risk. Therefore, we could identify different predictors for the need of a conversion to GA. However, our results could only be hypothesis‐generated and should be evaluated in a randomized study. [ABSTRACT FROM AUTHOR]

This article studies the flexural behavior of thin-walled specimens with square hollow sections fabricated using fused deposition modeling (FDM). The specimens were 3D printed from an ABS filament reinforced with aramid fibers. Four wall thicknesses were analyzed. The strength data were collected during three-point flexural tests. There are visible, clear differences in the flexural properties between the X- or Y-oriented specimens and those printed in the Z direction, and they vary up to 70%. It was also found that the flexural strength was dependent on the G-codes controlling the print head’s motion, path, and position. For specimens with a thickness up to 1.4 mm, the infill pattern was linear, whereas 1.8 mm and 2 mm specimens needed a stitch, which had some negative effects on the strength properties.

A 47-year-old man, smoker, was transferred to the Department of Cardiology Catheterization Laboratory at the National Heart Foundation (NHF) Hospital & Research Institute [1] in Dhaka, Bangladesh, from a remote hospital after streptokinase failure to reperfuse anterior ST-elevation acute myocardial infarction (STEMI). The patient had presented in a local hospital with a severe retrosternal pain of 6-hour duration (transportation > 2 h). A diagnosis of anterior STEMI was made. The patient received i.v. morphine (8 mg) and intravenous streptokinase (STK, 1.5 million units i.v.) as the first-line reperfusion therapy in most areas of Bangladesh. Other medications were oral aspirin (300 mg), loading dose of generic clopidogrel (300 mg), and high-dose (80 mg) generic atorvastatin, all of which are now manufactured in the country.

Stroke, a vascular disease of the brain, is the #1 cause of disability and a major cause of death worldwide. Stroke has a major negative impact on the life of stroke-affected individuals, their families and the society. A significant proportion of stroke victims indicate that would have preferred death over their after-stroke quality of life. Mechanical thrombectomy (MT), opening the occluded artery using mechanical aspiration or a thrombus-entrapment device, is a guideline-mandated (class I, level of evidence A) treatment modality in patients with large vessel occlusion stroke. MT clinical benefit magnitude indicates that a universal access to this treatment strategy should be the standard of care. Today there is a substantial geographic variation in MT deliverability, with large-scale disparities in MT implementation. In many countries effective access to MT remains severely limited. In addition, many of the MT-treated patients are treated too late for a good functional outcome because of logistic delays that include transportations to remotely located, scarce, comprehensive stroke centres. Position Paper from the European Society of Cardiology Council on Stroke and European Association for Percutaneous Cardiovascular Interventions on interdisciplinary management of acute ischaemic stroke, developed with the support of the European Board of Neurointervention fills an important gap in systematically enabling interventional cardiologists to support stroke intervention in the geographic areas of unmet needs in particular. We review strengths and weaknesses of the document, and suggest directions for the next steps that are swiftly needed to deliver MT to stroke patients more effectively.

AimsCardiopoietic cells, produced through cardiogenic conditioning of patients' mesenchymal stem cells, have shown preliminary efficacy. The Congestive Heart Failure Cardiopoietic Regenerative Therapy (CHART-1) trial aimed to validate cardiopoiesis-based biotherapy in a larger heart failure cohort.Methods and resultsThis multinational, randomized, double-blind, sham-controlled study was conducted in 39 hospitals. Patients with symptomatic ischaemic heart failure on guideline-directed therapy (n = 484) were screened; n = 348 underwent bone marrow harvest and mesenchymal stem cell expansion. Those achieving > 24 million mesenchymal stem cells (n = 315) were randomized to cardiopoietic cells delivered endomyocardially with a retention-enhanced catheter (n = 157) or sham procedure (n = 158). Procedures were performed as randomized in 271 patients (n = 120 cardiopoietic cells, n = 151 sham). The primary efficacy endpoint was a Finkelstein-Schoenfeld hierarchical composite (all-cause mortality, worsening heart failure, Minnesota Living with Heart Failure Questionnaire score, 6-min walk distance, left ventricular end-systolic volume, and ejection fraction) at 39 weeks. The primary outcome was neutral (Mann-Whitney estimator 0.54, 95% confidence interval [CI] 0.47-0.61 [value > 0.5 favours cell treatment], P = 0.27). Exploratory analyses suggested a benefit of cell treatment on the primary composite in patients with baseline left ventricular end-diastolic volume 200-370 mL (60% of patients) (Mann-Whitney estimator 0.61, 95% CI 0.52-0.70, P = 0.015). No difference was observed in serious adverse events. One (0.9%) cardiopoietic cell patient and 9 (5.4%) sham patients experienced aborted or sudden cardiac death.ConclusionThe primary endpoint was neutral, with safety demonstrated across the cohort. Further evaluation of cardiopoietic cell therapy in patients with elevated end-diastolic volume is warranted.

Introduction. Carotid artery stenting (CAS) using conventional (single-layer) stents is associated with worse clinical outcomes in diabetes mellitus (DM) vs. non-DM patients: an effect driven largely by lesion-related adverse events. CAS outcomes with MicroNet-covered stents (MCS) in diabetic patients have not been evaluated. Aim. To compare short- and long-term clinical outcomes and restenosis rate in DM vs. non-DM patients with carotid stenosis treated using MCS. Materials and Methods. In a prospective study in all-comer symptomatic and increased-stroke-risk asymptomatic carotid stenosis, 101 consecutive patients (age 51-86 years, 41% diabetics) underwent 106 MCS-CAS. Clinical outcomes and duplex ultrasound velocities were assessed periprocedurally and at 30 days/12 months. Results. Baseline characteristics of DM vs. non-DM patients were similar except for a higher prevalence of recent cerebral symptoms in DM. Type 1 and type 1+2 plaques were more prevalent in DM patients (26.7% vs. 9.8%, p=0.02; 62.2% vs. 37.7%, p=0.01). Proximal embolic protection was more prevalent in DM (60% vs. 36%; p=0.015). 30-day clinical complications were limited to a single periprocedural minor stroke in DM (2.4% vs. 0%, p=0.22). 12-month in-stent velocities and clinical outcomes were not different (death rate 4.8% vs. 3.3%; p=0.69; no new strokes). Restenosis rate was not different (0% vs. 1.7%, p=0.22). Conclusions. MCS may offset the adverse impact of DM on periprocedural, 30-day, and 12-month clinical complications of CAS and minimize the risk of in-stent restenosis. In this increased-stroke-risk cohort, adverse event rate was low both in DM and non-DM. Further larger-scale clinical datasets including extended follow-ups are warranted.