X-ray computed tomography was applied in imaging 3D printed gyroids used for bioseparation in order to visualize and characterize structures from the entire geometry down to individual nanopores. Methacrylate prints were fabricated with feature sizes of 500 µm, 300 µm and 200 µm, with the material phase exhibiting a porous substructure in all cases. Two X-ray scanners achieved pixel sizes from 5 µm to 16 nm to produce digital representations of samples across multiple length scales as the basis for geometric analysis and flow simulation. At the gyroid scale, imaged samples were visually compared to the original computed aided designs to analyze printing fidelity across all feature sizes. An individual 500 µm feature, part of the overall gyroid structure, was compared and overlaid between the design and imaged volumes where individual printed layers could be identified. Internal subvolumes of all feature sizes were segmented into material and void phases for permeable flow analysis. Small pieces of 3D printed material were optimized for nanotomographic imaging at a pixel size of 63 nm, with all three gyroid samples exhibiting similar geometric characteristics when measured. An average porosity of 45% was obtained that was within the expected design range and a tortuosity factor of 2.52 was measured. Applying a voidage network map enabled the size, location and connectivity of individual pores to be identified, obtaining an average internal pore size of 793 nm. Using the Avizo XLAB plugin at a bulk diffusivity of 7.00 x10 -11 m 2s -1 resulted in a simulated material diffusivity of 2.17 x10 -11 m 2s -1 ± 0.16 x10 -11 m 2s -1.

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the world. With the deepening understanding of NAFLD, more and more evidence has shown that NAFLD is a group of highly heterogeneous diseases, which is closely related to metabolic dysfunction. Recent studies have shown that the occurrence of nonalcoholic fatty liver disease is closely related to the dysbiosis of intestinal flora. However, due to the abuse of antibiotics, long-term use of broad-spectrum antibiotics is the most common cause of intestinal flora disorders. Endocrine and metabolic disorders caused by intestinal microbiota imbalance promote the occurrence of obesity, and on this basis induce the emergence of NAFLD. In response to the current situation of antibiotic resisftance pandemic, phage therapy has emerged as a potential solution to solve the problem of bacterial resistance. Relevant clinical studies have shown that fecal bacterial transplantation (FMT) can improve the clinical symptoms of patients with chronic liver disease, in which phage participate in the regulating effect. This suggests that phages may play a role in the treatment of non-alcoholic fatty liver disease caused by antibiotic resistance, but there is insufficient clinical evidence to support this therapy. Therefore, this review will discuss the mechanism of non-alcoholic fatty liver disease caused by antibiotics resistance and evaluate the therapeutic effect of bacteriophages.

The methodology for production of biologics is going through a paradigm shift from batch-wise operation to continuous production. Lot of efforts are focused on integration, intensification and continuous operation for decreased foot-print, material, equipment and increased productivity and product quality. These integrated continuous processes with on-line analytics becomes complex processes, which requires automation, monitoring and control of the operation, even unmanned or remote, which means bioprocesses with high level of automation or even autonomous capabilities. The development of these digital solutions becomes an important part of the process development and needs to be assessed early in the development chain. This work discusses a platform that allow fast development, advanced studies and validation of digital solutions for integrated continuous downstream processes. It uses an open, flexible and extendable real-time supervisory controller, called Orbit, developed in Python. Orbit makes it possible to communicate with a set of different physical setups and on the same time perform real-time execution. Integrated continuous processing often imply parallel operation of several setups and network of Orbit controllers makes it possible to synchronize complex process system. Data handling, storage and analysis are important properties for handling heterogeneous and asynchronous data generated in complex downstream systems. Digital twin applications, such as advanced model-based and plant-wide monitoring and control, are exemplified using computational extensions in Orbit, exploiting data and models. Examples of novel digital solutions in integrated downstream processes are automatic operation parameter optimization, Kalman filter monitoring and model-based batch-to-batch control.

A document by Gabriele Pradel. Click on the document to view its contents.

Cancer is the primary cause of death worldwide, accounting for almost 10 million deaths. The most prevalent are lung, breast, colorectal, and skin cancer. Cancer does not obey the cell cycle which can lead to the formation of tumors. The biogenic amine histamine is synthesized by histidine. Increased amounts of histamine have been linked to the regulation of several tumors. The histamine receptors (H1, H2, H3, and H4) are distributed throughout the skin, where H1 and H2 are the primary targets for drug therapy. Repurposing of the current antihistamine drugs can be cost-effective, safe medications and allied with lesser adverse effects. Researchers examined Six H1-antihistamines (Cetirizine, clemastine, desloratadine, loratadine, ebastine, and fexofenadine) in a nationwide wide cohort study of all Swedish patients with ten types of immunogenic (melanoma, bladder cancer, kidney, prostate, lung, pancreatic, colorectal, breast cancer, and Hodgkin lymphoma) and six non-immunogenic (thyroid cancer, liver, ovarian, brain cancer and lymphoma) tumors. The study shows that Desloratadine and loratadine upsurge the survival rate for many tumors by inhibiting the growth of tumors and promoting apoptotic cell death. The other H1 receptor antagonist Cloperastine knockdown FGF13 expression which is responsible for anticancer agent cisplatin-resistance and selectively kills HeLa cisR cells. Some findings believe H1 receptor antagonists should be investigated in randomized clinical trials for immunogenic tumors. These drugs can be a curative therapy for several tumors including that prognosis with limited treatment options.

Heat waves are predicted to be detrimental for organismal physiology with costs for survival that could be reflected in markers of biological state such as telomeres. Changes in early life telomere dynamics driven by thermal stress are of particular interest during the early post-natal stages of altricial birds because nestlings quickly shift from being ectothermic to poikilothermic to endothermic after hatching. Telomeres of ectothermic and endothermic organisms respond differently to environmental temperature, but investigations within species that transition from ectothermy to endothermy are lacking. Also, ambient temperature influences parental brooding behavior, which will alter the temperature experienced by offspring and thereby, potentially, their telomeres. We exposed zebra finch nestlings to experimental heat waves, and compared their telomere dynamics to that of a control group at 5, 12 and 80 days of age that correspond to three different thermoregulatory stages (ectothermic, poikilothermic and endothermic respectively); we also recorded parental brooding, offspring sex, mass, growth rates, brood size and hatch order. Nestling mass showed an inverse relationship with telomere length, and nestlings exposed to heat waves showed lower telomere attrition during their first 12 days of life (poikilothermic stage) compared to controls. Additionally, parents of heated broods reduced the time they spent brooding offspring (at five days old) compared to controls. Lower brooding effort was associated with shorter telomeres in 12 day old nestlings. Our results indicate that the effect of heat waves on telomere dynamics likely varies depending on age and thermoregulatory stage of the offspring in combination with parental brooding behavior during growth.

Animals host complex bacterial communities in their gastrointestinal tracts, with which they share a mutualistic interaction. The numerous effects these interactions grant to the host include regulation of the immune system, defense against pathogen invasion, aid in digestion of otherwise indigestible foodstuffs and even changing host behaviour. Stress, such as environmental pollution, parasites, predators and intraspecies competition, can alter the composition of the gut microbiome, which in turn can change host-microbiome interactions in ways that are detrimental to the host such as causing metabolic dysfunction and inflammation. While host-microbiome interactions have been extensively studied in humans and captive animals, studies into wild animal microbiomes have been scarce. We assessed effects of disturbed environment on gut health of bank voles exposed to radionuclides in natural habitat using a combined approach of transcriptomics, microbial community analysis by 16S amplicon sequencing, histological staining analyses of colon tissue and quantification of gut microbiota -produced short-chain fatty acids in faecal matter and blood that act as mediators of host-microbiome interactions. We found signs of weakened mucus layer and related changes in Clca1 and Agr2 gene expression and microbiome composition in animals exposed to radionuclides. These results imply that disturbed environment can have widely reaching effects through gut health.

Vultures are a specialized species group, utilizing wide habitat and forage niches and their long-term survival depends on the protection of their critical habitats. Taking a landscape approach, we modelled the distribution of nest sites (n = 30) and roost sites (n = 31) of cliff-nesting vultures (four species) in the Greater Panna Landscape (GPL), central India. We performed Random Forest (RF), Generalized Linear Model (GLM) and Boosted Regression Tree (BRT) algorithms. The AUC values for the predictive distribution of nests were 0.97, 0.90, 0.97 for RF, GLM and BRT, respectively, while for roost distribution it was found to be 0.76, 0.63, 0.74 for RF, GLM and BRT, respectively. We ensembled the predictions of all three methods for better accuracy and combined the model outputs. We then performed zonation analysis on the final map and used Human footprint as a proxy for conservation cost to define spatial prioritization for conservation inputs. The results reveal that the GPL has a total of 9,402 sq. km. area within the top 20 ranks in terms of conservation prioritization for nesting and roosting. Given the cost value, the top 20 ranked units will account for approximately 60% of the critical habitats and these may be the focus of long-term conservation inputs to sustain the vulture populations in the landscape. The spatially explicit outputs based on the robust methodology involving intensive fieldwork and ensembled modelling offer a basis for local scale and landscape scale actions, which can be replicated in other parts of the vulture distribution ranges.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can lead to diverse clinical manifestations and pathologies that involve multiple organs. Even though the disease severity is manifested mainly in the respiratory tract, which is the primary target of SARS-CoV-2 infection, acute kidney injury in the form of acute tubular necrosis has also been noted in some COVID-19 cases. It is not entirely clear whether renal cells can be infected by the virus that might be involved in acute kidney disorder. In a recent publication by Radovic and colleagues (1) that has been selected as the editor’s choice paper published in the Journal of Medical Virology, the authors provided strong histopathological and immunofluorescence evidence of SARS-CoV-2 infection and tissue injury of renal parenchymal and tubular epithelial cells, which strongly suggest an active viral replication in the kidney of some severe and fatal COVID-19 cases, and to a lesser extent, a potential role for innate immune cells in viral infection and renal disease pathogenesis.

Varicella is a highly prevalent infectious disease with a similar transmission pathway to coronavirus disease 2019 (COVID-19). In the context of the COVID-19 pandemic, anti-COVID-19 non-pharmaceutical interventions (NPIs) have been implemented to prevent the spread of the infection. This study aims to analyze varicella’s epidemiological characteristics and further investigate the effect of anti-COVID-19 NPIs on varicella in Xi’an, northwestern China. Based on the varicella surveillance data, search engine indices, meteorological factors from 2011 to 2021 in Xi’an, and different levels of emergency response to COVID-19 during the pandemic, we applied Bayesian Structural Time Series models and interrupted time series analysis to predict the counterfactual incidence of varicella and quantify the impact of varying NPIs intensities on varicella. From 2011 to 2021, varicella incidence increased, especially in 2019, with a high incidence of 111.69/100,000. However, there was a sharp decrease of 43.18% in 2020 compared with 2019, and the peak of varicella incidence in 2020 was lower than in previous years from the 21st to the 25th week. In 2021, the seasonality of varicella incidence gradually returned to a seasonal pattern in 2011-2019. The results suggest that anti-COVID-19 NPIs effectively reduce the incidence of varicella, and this reduction has spatiotemporal heterogeneity.

The growing use of technology and social media has resulted in the emergence of digital influencers, a new profession capable of changing the mentalities and behaviours of those who follow them. This study arises to better understand the potential impact digital influencers might have on the Portuguese population’s purchase behaviour and patterns, and for this purpose, seven hypotheses were formulated. An online questionnaire was conducted to respond to these theoretical assumptions and collected data from 175 respondents. A total of 129 valid answers were considered. It was possible to conclude that purchase intention does not necessarily translate into a purchase action. It was also concluded that the relationship between social network use and the purchase of products/services recommended by influencers is only significant for Instagram. Furthermore, individuals’ Generation is not significantly linked with purchasing a product/service recommended by influencers. Furthermore, a small percentage of respondents have also identified themselves as impulsive shoppers and perceived Instagram as their favourite social network. With the results of this study, it is also possible to state that the influencer’s opinion was classified as the last factor considered in the purchase decision process. Additionally, there is a weak negative association between purchasing a product/service recommended by influencers with sponsorship disclosure and remunerated partnership, which decreases credibility and discourages purchasing.

PECS identifies couples who may have had children with autosomal recessive diseases. The current prevalence of carrier status for these conditions in China is not well defined. This study assesses the prevalence of carrier status of selected genetic conditions utilizing an expanded genetic carrier screening panel in a large population of china patients. Methods: A retrospective chart review of all patients tested with a single PECS panel at Xinjiang jiayin hospital from 2019 to 2021 were included, and the prevalence of pathogenic positive carrier status in the china population was evaluated. The pathogenic variants were classified as per the American College of Medical Genetics criteria. Results: 6437 individuals were analyzed with PECS testing for 208 genetic conditions. 2749 carriers (42.71%) were identified with 799 pathogenic variants in 166 different genes. The most prevalent alleles found were associated with Hemochromatosis, Deafness autosomal recessive 1A, cystic fibrosis, Gilbert syndrome, Phenylketonuria, and Krabbe disease. 71 of the 2653 participating couples (2.68%) were identified as being at-risk couples. Conclusion: This study reviews the Chinese population-based carrier screening panel prevalence, which is different from other countries, possibly due to the different panel/screening platform used. In order to get a better study of the prevalence of carrier screening in the Chinese population, the genetic screening scope should be expanded to obtain more carrier conditions. At the same time, we suggest that couples who have needs for fertility, regardless of their ethnic background, should undergo carrier screening and genetic counseling prior to receiving reproductive medicine treatment

A document by Laila Alkhouli. Click on the document to view its contents.

Conventional methods of producing a synthesis gas are expensive and complex installations. In order to overcome the complexity and expense of such installations, it is proposed to generate the synthesis gas within autothermal fixed bed reactors that utilize structured catalysts and different surface features to generate the heat necessary to support endothermic heating requirements of the steam reforming reactions. The present study is focused primarily upon the thermal chemical reaction characteristics of autothermal fixed-bed reactors with structured catalysts and different surface features. The heat capacity, thermal conductivity, and viscosity of the mixture are calculated as a mass-weighted average of the values for each constituent. In addition, the material properties of each individual species are functions of the local temperature. When solving the species mass transport equations, binary mass diffusion coefficients are used directly. Only isotropic catalyst structures are considered and the permeability and inertial resistance factor are held constant. The effective thermal conductivity of the catalyst structure system including the porous structure and intervening gas is calculated based upon the porosity of the porous medium, the fluid phase thermal conductivity, and the porous medium effective thermal conductivity as measured in air at ambient conditions. The present study aims to explore how to effectively generate the synthesis gas within autothermal fixed bed reactors that utilize structured catalysts and different surface features. Particular emphasis is placed upon the heat and mass transport phenomena involved in autothermal fixed bed steam reforming reactors. The results indicate that for catalytic thermal chemical reactions, both kinetic impediments are substantially reduced permitting realization of theoretical or near theoretical reaction kinetics. The heat transfer chamber is in thermal contact with the reaction chamber volume, the heat transfer chamber transferring heat at the enhanced heat transfer rate across the wall between the heat transfer chamber and the reaction chamber, thereby obtaining the enhanced production rate per reaction chamber volume for the thermal chemical reaction. Structured catalyst configurations result in high rates of heat transport from the oxidation side to the reforming side. Typically, combustion takes place at low or near-atmospheric pressure, although high pressure combustion is widely practiced. The heat that is generated on the combustion side is quickly transferred on the reforming side. The heat integrated reforming reactor offers several advantages over conventional flame-based reforming reactors. The incorporation of a simultaneous endothermic reaction to provide an improved heat sink may enable a typical heat flux of roughly an order of magnitude above the convective cooling heat flux. The wall can be constructed from any material, but materials that offer low resistance to heat transfer such as metals and metallic alloys are preferred. In this configuration, heat is generated by combustion in the catalytic chamber and is transported very easily and efficiently though the wall to the reforming chamber where the heat demanding reforming reactions take place. The presence of a catalyst and lower temperatures permit significantly higher space velocities to be used compared to flame-based reformers.Keywords: Hydrocarbons; Reactors; Structures; Properties; Reforming; Combustion

Solar vapour generation (SVG) represents a promising technique for seawater desalination to alleviate the global water crisis and energy shortage. One of its main bottleneck problems is that the evaporation efficiency and stability are limited by salt crystallization under high-salinity brines. Herein, we demonstrate that the 3D porous melamine-foam (MF) wrapped by a type of self-assembling composite materials based on reduced polyoxometalates (i.e. heteropoly blue, HPB), oleic acid (OA) and polypyrrole (PPy) (labeled with MF@HPB-PPyn-OA) can serve as efficient and stable SVG material at high-salinity. Structural characterizations of MF@HPB-PPyn-OA indicate that both hydrophilic region of HPBs and hydrophobic region of OA co-exist on the surface of composite materials, optimizing the hydrophilic and hydrophobic interfaces of the SVG materials, and fully exerting its functionality for ultrahigh water-evaporation and anti-salt fouling. The optimal MF@HPB-PPy10-OA operates continuously and stably for over 100 h in 10 wt% brine. Furthermore, MF@HPB-PPy10-OA accomplishes complete salt-water separation of 10 wt% brine with 3.3 kg m-2 h-1 under 1-sun irradiation, yielding salt harvesting efficiency of 96.5%, which belongs to the record-high of high-salinity systems reported so far and reaches zero liquid discharge. Moreover, the low-cost of MF@HPB-PPy10-OA (2.56 $/m2) suggests its potential application in the practical SVG technique.

Transition metal-based nanomaterials exhibit promising potential as highly active and low-cost electrocatalyst for alkaline water splitting, which can be achieved via elaborating compositional modulation and structural manipulation. This, however, normally involves multiple or even complex synthetic procedures. Herein, we report a simple one-step sulfidation of FeMnZn multi–metal skeletons for the preparation of highly efficient electrocatalysts. The incorporation of Mn and Zn induced hierarchical nano/micro sheet–to–sheet supported on open porous skeleton (FeMnZn/Mn-FeS, FMZS2), which not only facilitates electron/ion transport but also expands the accessible surface. Meanwhile, the Mn is introduced to optimize the adsorption/desorption ability of intermediates on the S sites in FeS. The resultant effect leads to remarkable electrocatalytic performance with good durability. Notably, the optimized FMZS2 delivers a 20 mA cm–2 at low overpotential of 118 mV for HER and a 100 mA cm–2 at overpotential of 390 mV for OER, outperfoming Pt/C and IrO2 catalyst, respectively. Moreover, the assembled alkaline electrolyzer also has good overall water splitting capability, which is better than that of the noble metal ones.

The continued quest for finding a low-power and high-performance hardware algorithm for signed number multiplication led to designing a simple and novel radix-8 signed number multiplier with 3-bit grouping and partial product reduction performed using magnitudes of the multiplicand and the multiplier. The pre-computation stage constitutes magnitude calculation and non-trivial computations required to generate partial products. A new partial product reduction strategy is deployed in the design to improve the speed with low cost. 8 X 8, 16 X 16, 32 X 32, and 64 X 64 designs are presented for the proposed architectures. Performance results include area, power, delay, and power-delay-product of synthesized and post-layout designs using 32 nm CMOS technology with 1.05 V supply voltage.

Background and purpose Obesity may be more likely to lead to asthma, that is, obesity asthma. Children are the age stage of high incidence of asthma. Obesity asthma may be more refractory in children with asthma, and is more likely to produce glucocorticoid resistance, which greatly leads to the risk of severe disease in children with asthma. However, approaches to combating Obesity Asthma/Childhood Asthma complications are limited by conditions. Existing evidence shows that chrysophanol has antibacterial and anti-inflammatory, fat reduction, anticough, promoting gastrointestinal functional homeostasis and immune regulation. Experimental methods Through systematic pharmacological and bioinformatics analysis, we evaluated the physical and chemical properties and biological activities of chrysophanol, and further analyzed its binding activities, targets, biological functions and mechanisms. Key results It was found that chrysophanol can play the ideal physical and chemical properties and biological activities. The PPI network screened 144 common targets of drugs and diseases, and 15 hub targets were obtained. Then, the top 10 hub targets were identified, namely EGFR, HSP90AA1, ESR1, HIF1A, STAT3, SRC, PTGS2, MTOR, MMP9, PIK3CA, and verified in the protein-ligand blind docking. Enrichment analysis showed that chrysophanol may be involved in inflammation regulation, EGFR tyrosine kinase inhibitor resistance, HIF-1 signaling pathway, Neutrophil extracellular trap formation，and so on. Conclusions and implications Our fingdings indicate that chrysophanol can reduce airway inflammation and remodeling through multi-pathway and multi-target, and provide evidence for the application of chrysophanol in Obesity Asthma/Childhood Asthma comorbidities. The predicted results will be strictly verified by experiments.

With the increasing demand for electricity, power distribution utilities must provide an efficient and appropriate Service Restoration (SR) strategy to restore customers as soon as possible after power outages. The heuristic SR algorithm presented in this article is a bi-stage algorithm that initially re-energizes some loads quickly by remote-controlled switches in the first stage and then proceeds to restore the rest of the network in the second stage. In addition to solving the restoration problem in a bi-stage algorithm, determining the optimal Switching Sequences (SSs) and applying the Energy Not Supplied (EENS) as objective function included in this study. Also, taking into account the time of occurrence of the failure and the daily load curve, the position of the maintenance team, load transfer capability and the traffic conditions of the network has increased the attractiveness and practicality of the proposed method. The heuristic SR algorithm was applied on a standard IEEE 69-bus system in various scenarios. The results indicated a significant difference in the solutions of the problem and the ENS in different scenarios. Finally, it was found that using this heuristic method would lead to optimal, accurate, and applicable solutions for SR in distribution networks.

In this study, total knee arthroplasty was performed in a patient with pigmented villonodular synovitis. During surgery, severe black discoloration of the articular cartilage and menisci was observed in the patient. According to literatures, this is the first case report of severe articular cartilage pigmentation in a patient with PVNS.

This note concerns the problem of k-hop connectivity in a network of mobile agents, which is achieved if any pair of agents can communicate with each other through a link of k-1 or fewer intermediate nodes. We propose linear constraints involving binary optimization variables to ensure k-hop connectivity. Such constraints are then integrated into a Mixed-Integer Linear Programming (MILP) trajectory planning model. Simulation results illustrate the application of the proposed method and the effect of varying k in the context of a mission involving the visitation of multiple targets.

A document by Sujie Li. Click on the document to view its contents.

Despite the increasing popularity of DNA metabarcoding in the assessment of aquatic ecosystems using fish eDNA or ichthyoplankton, challenges have hampered its broader application in the Neotropical freshwaters. Using five mock communities composed of fish species from two Neotropical river basins, we evaluated the influence of DNA concentration and choice of mitochondrial 12S molecular markers (MiFish, NeoFish and Teleo) on species detection and Relative Read Abundance (RRA) using DNA metabarcoding. Of the three 12S markers analysed, only MiFish detected all species from all mock communities. The performance of a taxonomy-free approach using ASV/MOTUs was not as precise as assigning DNA reads to species using a curated 12S library that includes approximately 100 fish species, since more than one ASV/MOTU was observed for the same specimen. Thus, here we showcase the importance of a custom reference database to allow precise assignment of Neotropical fish species in metabarcoding studies and that the RRA is dependent on community composition, marker and DNA concentration. We highlight the importance of controlled experiments using known species communities before large investments are made in assessing biodiversity using non-invasive methods that apply DNA metabarcoding.

BACKGROUND Conduction system pacing (CSP) in recent years is being considered as the ideal pacing strategy. Lumen less leads (LLLs) have been the predominantly used technology since its inception until recently. We herein share the largest single-center experience of Stylet-driven leads (SDLs) using deflectable mapping catheter, a recent technology for conduction system pacing at both HB and LB areas, and their medium-term outcomes. MATERIALS AND METHODS Patients with standard pacing indications were enrolled between June 2021 and November 2022. The aim of this study was to evaluate safety and feasibility of CSP using SDL guided by deflectable mapping delivery catheter by analyzing implant tools, parameters during implant and follow- up. RESULTS A total of 37 patients (mean age 67.16 + 9.89 years, 53.3% males, 31 pacemakers, 4 His-CRT-Ps and 2 dual chamber Defibrillators, Mean follow up duration 210.7 + 25.1 days) were enrolled. HBP was the default strategy. Procedural success was seen in 17/37 (45.9%) patients. Incidence of lead dislodgement was 17.6%. LBBaP was tried in the rest (20/37). A septal curve was manually made in 3 patients. Procedural success was seen in all patients (3/3) in whom septal curve was added and in 12/17 (70.5%) patients without it. Compared to HBP, procedural parameters didn’t differ significantly for LBBaP. Sensing and Pacing parameters remained stable on follow up. CONCLUSION Use of SDL is adequate for both HB and LB areas. Preeshaping the deflectable mapping catheter can help in achieving better results and also lower the overall procedure time.