Design and Mechanical Properties of a Novel Cerebral Flow Diverter Stent

Brain arterial aneurysms are localised dilatation in the wall of cerebral arteries that are common among adult population and associated with high incidence of morbidity and mortality. Using flow diverter stent alone to treat cerebral aneurysm is recognized as a safe and effective method. However, flow diverter stents currently available have limitations due to their braided structures. In this paper a novel flow diverter stent is proposed. It is made out of nitinol tubes that provide adequate radial stiffness and tailored surface coverage to overcome problems of currently available braided stents while retaining low porosity and excellent longitudinal flexibility. Finite element analysis using Abaqus has been conducted to investigate radial stiffness, longitudinal flexibility, and maximum strain during packaging of a series of novel stent designs with varied geometric parameters. Results show that porosity below 70% can be achieved and provides radial stiffness and longitudinal flexibility comparable to those of the Neuroform stent that is commonly used for stent assisted coiling. The novel flow diverter has showed great potential for direct treatment of cerebral aneurysms.     

3DTEE imaging of a descending aorta floating thrombus in a patient with calciphylaxis

We present a case of a 68‐year‐old man with calciphylaxis, who was found to have a floating thrombus in the descending aorta on a transesophageal echocardiogram. The use of 3D echocardiography demonstrated nicely the free motion of the thrombus, emerging from an atherosclerotic plaque in the descending aorta. Anticoagulation was started for thromboembolism prevention.     

Dissemination of Misinformative and Biased Information about Prostate Cancer on YouTube

YouTube is a social media platform with more than 1 billion users and >600 000 videos about prostate cancer. Two small studies examined the quality of prostate cancer videos on YouTube, but did not use validated instruments, examine user interactions, or characterize the spread of misinformation. We performed the largest, most comprehensive examination of prostate cancer information on YouTube to date, including the first 150 videos on screening and treatment. We used the validated DISCERN quality criteria for consumer health information and the Patient Education Materials Assessment Tool, and compared results for user engagement. The videos in our sample had up to 1.3 million views (average 45 223) and the overall quality of information was moderate. More videos described benefits (75%) than harms (53%), and only 50% promoted shared decision-making as recommended in current guidelines. Only 54% of the videos defined medical terms and few provided summaries or references. There was a significant negative correlation between scientific quality and viewer engagement (views/month p = 0.004; thumbs up/views p = 0.015). The comments section underneath some videos contained advertising and peer-to-peer medical advice. A total of 115 videos (77%) contained potentially misinformative and/or biased content within the video or comments section, with a total reach of >6 million viewers.