In tandem and diffuse coronary disease, iFR pullback predicted the physiological outcome of PCI with a high degree of accuracy. Compared with angiography alone, availability of iFR pullback altered revascularization procedural planning in nearly one-third of patients.

Local variations in soil type and (to a lesser extent) topography determine seismic amplification, thereby establishing spatial patterns in the damages caused by large earthquakes, such as the two that occurred in Chiapas, Mexico on 6 October 1975 and 7 September 2017. The latter, of Mw 8.2, was the region’s strongest during the last 100 years. Based upon damage patterns, an analysis was made to identify the effects of sediment thickness and type upon seismic amplification in the urban zone of Chiapa de Corzo, Chiapas. Salgado et al., (2004) had shown that the fundamental periods of soil vibration in the city vary from0.14 s to0.39 s. From those periods, and using the model presented in Newmark and Rosenbleuth (1976), with an average shear-wave velocity of 150 m/s, the variation of the sediment thicknesses that cause site effects in the area was determined. The thicknesses ranged between 7.12 and 14.6 m. Finally, through the use of a map prepared with GIS software, a spatial correlation was made with the historical earthquake damage recorded within the city.

La ciudad de Tuxtla Gutiérrez, Chiapas, ha presentado históricamente procesos de remoción en masa en la zona sur del valle, específicamente en los depósitos de talud cuya génesis se determina a partir de la mesa kárstica de Copoya, geoforma sometida a intenso fracturamiento, procesos de disolución y erosivos, que dan como resultado desprendimiento de grandes bloques. Estos se distribuyen en las márgenes de la mesa, siendo alterados y destruidos por intemperismo, del cual se generan partículas de menor tamaño que reposan sobre limolitas, lutitas y areniscas. Esta condición determina que las laderas sean inestables por naturaleza.El Mapa de Amenazas por Procesos de Remoción en Masa (PRM), se elaboró a partir del método Heurístico con combinación de análisis multicriterio, y determina cinco niveles de amenaza en la zona urbana, abarcando los siguientes porcentajes: Muy baja 5%, Baja 27.1%, Media 39.3%, Alta 15.3% y Muy Alta 13.3%, siendo esta última la que se distribuye en su mayor parte en los depósitos de talud, alrededor de la Mesa de Copoya, lo que confirma su situación de máximo peligro.Para Tuxtla Gutiérrez se calcula una población expuesta de aproximadamente 62,500 habitantes (11.6% del total) que residen tanto en la parte sur de la ciudad como en 30 localidades rurales asentadas en los flancos de la mesa de Copoya; se estiman poco más de 28,000 viviendas expuestas agrupadas en 850 manzanas.Las tendencias actuales del crecimiento de la ciudad, hacen evidente la necesidad de ordenar y reglamentar las nuevas edificaciones.

Background:The role of circulating progenitor cells (CPC) in vascular repair following everolimus-eluting stent (EES) implantation is largely unknown. The aim of the study was to investigate the relationship between temporal variation in CPC levels following EES implantation and the degree of peri-procedural vascular damage, and stent healing, as measured by optical coherence tomography (OCT).Methods and Results: CPC populations (CD133+/KDR+/CD45low) included patients with stable coronary artery disease undergoing stent implantation, and were evaluated using a flow cytometry technique both at baseline and at 1 week. OCT evaluation was performed immediately post-implantation to quantify the stent-related injury and at a 9-month follow up to assess the mid-term vascular response. Twenty patients (mean age 66±9 years; 80% male) with EES-treated stenoses (n=24) were included in this study. Vascular injury score was associated with the 1-week increase of CD133+/KDR+/CD45low (β 0.28 [95% CI 0.15; 0.41]; P<0.001) and with maximum neointimal thickness at a 9-month follow up (β 0.008 [95% CI 0.0004; 0.002]; P=0.04). Inverse relationships between numbers of uncoated and apposed struts for the 9-month and the 1-week delta values of CD133+/KDR+/CD45low (β −12.53 [95% CI −22.17; −2.90]; P=0.011), were also found. Conclusions:The extent of vessel wall injury influences early changes in the levels of CPC and had an effect on mid-term vascular healing after EES implantation. Early CPC mobilisation was associated with mid-term strut coverage.

Materials/Methods: Twelve patients with large (mean = 7.0 cm, range: 5.2-7.8 cm, diameter) lung masses from at least Stage II non-small-cell lung cancer (NSCLC) or oligometastatic lung disease from a separate primary site underwent 50 Gy to the planning target volume (PTV) with a 60 Gy SIB to the volume approximately 1 cm interior to the standard gross tumor volume (GTV) margin in 5 fractions. Highly conformal SIB SBRT plans were generated using 3-6 non-coplanar partial VMAT arcs with 6MV-FFF beam and advanced Acuros-based dose engine for tissues heterogeneity corrections. Treatments were delivered every other day using online conebeam CT guidance. Plan quality and treatment delivery efficiency were reported. Outcomes reported include tumor local control (LC), distant failure (DF), lung and rib toxicity. Median follow-up interval was 8 months (1 to 22 months). Results: Mean GTV and PTV was 92.9 § 40.0 cc and 188.8 § 45.4 cc. Mean dose to GTV and PTV was 58.1 § 1.9 Gy and 55.5 § 1.2 Gy, translating to the corresponding average biological effective dose (BED10, with a/b = 10Gy) of 125 Gy and 117 Gy, respectively. All SIB SBRT plans met RTOG requirements for intermediate dose fall-off and organs at risk (OAR) sparing. Mean values of V20Gy, V10Gy and mean lung dose were 13.6 § 3.4%, 22.9 § 6.8%, and 7.5 § 1.8Gy, respectively. Average maximal doses to OAR were as follows: spinal cord < 12.5 Gy, heart < 33.9 Gy, esophagus < 17.7 Gy, ribs < 48.2 Gy and skin < 23.9 Gy. Average beam-on time was 3.5 § 0.3 min. Estimated mean treatment time including pre-treatment conebeam CT imaging and patient repositioning was within 15 min. All patients tolerated the SIB-SBRT treatment. 10 patients demonstrated LC, 1 had definite progression, and 1 had ostensible progression with atelectasis complicating the picture. The three patients with oligometastatic disease from stage IV head and neck or sarcoma progressed elsewhere, although the treated site was well controlled. One patient had evidence of grade 2 chest wall pain and treated with NSAIDS; however, 11 patients showed no evidence of rib fracture or chest wall pain. No patients developed grade 2+ pulmonary toxicity or radiation-induced pneumonitis. Conclusion: Escalating core tumor dose via SIB-SBRT (higher than 100Gy BED10) is safe, fast, and efficacious treatment for large lung masses with promising LC rates and no adverse treatment related toxicity. Fast delivery of SIB SBRT treatment could reduce intrafraction motion error due to coughing or pain, making geographic miss unlikely and improving the patient comfort and clinic workflow. Longer clinical follow up results in a larger patient population treated with this approach is warranted.