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Background: New ischaemic brain lesions on magnetic resonance imaging (MRI) are reported in up to 86% of patients after transcatheter edge-to-edge repair of the mitral valve (TEER-MV). Knowledge of the exact procedural step(s) that carry the highest risk for cerebral embolisation may help to further improve the procedure.
Aims: The aim of this study was to identify the procedural step(s) that are associated with an increased risk of cerebral embolisation during TEER-MV with the MitraClip system. Furthermore, the risk of overt stroke and silent brain ischaemia after TEER-MV was assessed.
Methods: In this prospective, pre-specified observational study, all patients underwent continuous transcranial Doppler examination during TEER-MV to detect microembolic signals (MES). MES were assigned to specific procedural steps: (1) transseptal puncture and placement of the guide, (2) advancing and adjustment of the clip in the left atrium, (3) device interaction with the MV, and (4) removal of the clip delivery system and the guide. Neurological examination using the National Institutes of Health Stroke Scale (NIHSS) and cerebral MRI were performed before and after TEER-MV.
Results: Fifty-four patients were included. The number of MES differed significantly between the procedural steps with the highest numbers observed during device interaction with the MV. Mild neurological deterioration (NIHSS ≤3) occurred in 9/54 patients. New ischaemic lesions were detected in 21/24 patients who underwent MRI. Larger infarct volume was significantly associated with neurological deterioration.
Conclusions: Cerebral embolisation is immanent to TEER-MV and predominantly occurs during device interaction with the MV. Improvements to the procedure may focus on this procedural step.
Trotz wachsender Bedeutung von Talent Management (TM) in Unternehmen gelingt es nicht, der Talentknappheit zu begegnen. Die Corona-Pandemie verschärft die Situation. Denn der bislang nicht ausgeschöpfte Anteil qualifizierter Frauen auf dem Arbeitsmarkt wächst u. a., weil sich anteilig mehr Frauen als Männer zur Erfüllung von Sorgeaufgaben vom Arbeitsmarkt zurückziehen. Gleichzeitig werden Maßnahmen zur Vereinbarung von Berufs- und Privatleben bislang bei der Rekrutierung und Bindung von Talenten nicht oder unzureichend thematisiert. Auf der Basis der wissenschaftlichen Diskussion wird daher die Frage untersucht, inwiefern sich Vereinbarkeitsangebote von Talenten karriereunschädlich nutzen lassen.
Currently, the modelling of drying processes of plant tissues pre-treated by pulsed electric field (PEF) is following experimentally identified curves or separate heat and mass transfer and diffusion models with different levels of accuracy. This research had two major objectives: mathematical modeling and control of drying process of different vegetables pretreated by PEF during convective drying. The mathematical modeling was based on Luikov's heat and mass transfer model along with properties of different vegetables. Computer modelling was done using the difference method for predicting moisture and the temperature potentials of untreated and PEF-treated vegetables. The formulation and the solution procedures were applied to simulate the simultaneous heat and mass transfer in selected vegetables subjected to the convective drying. Suggested model had a good correlation with experimental results. Moreover, cell disintegration index can be used as a controllable parameter in heat and mass transfer models to predict drying behavior of potato, onion, and carrot tissues. Obtained drying models can be used as a mathematical tool to predict drying behavior for various types of agricultural products pre-treated by pulsed electric field.
The impact of Pulsed Electric Fields (PEF) on the peeling ability of different fruits and vegetables in particular tomatoes, peaches, peppers, and oranges were investigated. Samples were exposed to a fixed electric field strength of 2.15 kV/cm. The specific energy ranged from 0.6 kJ/kg to 50.3 kJ/kg. The treated raw materials were analysed regarding to the peeling ability, skin size and weight and firmness. The best result for tomatoes at a specific energy of 1.2 kJ/kg induced a high score of peeling ability that led to less product loss and could therefore increase the yield by 33.84%–41.53% compared to untreated samples. Moreover, an increased skin size by a factor of 3.7 was observed. However, PEF had no significant impact on peeling ability of oranges, peppers, and peaches. Although oranges showed an improvement in peeling ability by up to 32%, this cannot be traced back to the PEF treatment. The different properties and structures of the raw materials were discussed and provided indications about the limitation of PEF.