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Nuclear magnetic resonance offers a wide range of tools to analyse ionic jump processes in crystalline and amorphous solids. Both high-resolution and time-domain [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text] NMR helps throw light on the origins of rapid self-diffusion in materials being relevant for energy storage. It is well accepted that [Formula: see text] ions are subjected to extremely slow exchange processes in compounds with strong site preferences. The loss of this site preference may lead to rapid cation diffusion, as is also well known for glassy materials. Further examples that benefit from this effect include, e.g. cation-mixed, high-entropy fluorides [Formula: see text], Li-bearing garnets ([Formula: see text]) and thiophosphates such as [Formula: see text]. In non-equilibrium phases site disorder, polyhedra distortions, strain and the various types of defects will affect both the activation energy and the corresponding attempt frequencies. Whereas in [Formula: see text] ([Formula: see text]) cation mixing influences F anion dynamics, in [Formula: see text] ([Formula: see text]) the potential landscape can be manipulated by anion site disorder. On the other hand, in the mixed conductor [Formula: see text] cation-cation repulsions immediately lead to a boost in [Formula: see text] diffusivity at the early stages of chemical lithiation. Finally, rapid diffusion is also expected for materials that are able to guide the ions along (macroscopic) pathways with confined (or low-dimensional) dimensions, as is the case in layer-structured [Formula: see text] or [Formula: see text]. Diffusion on fractal systems complements this type of diffusion. This article is part of the Theo Murphy meeting issue 'Understanding fast-ion conduction in solid electrolytes'.

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Lithium-thiophosphates have attracted great attention as they offer a rich playground to develop tailor-made solid electrolytes for clean energy storage systems. Here, we used poorly conducting Li6PS5I, which can be converted into a fast ion conductor by high-energy ball-milling to understand the fundamental guidelines that enable the Li+ ions to quickly diffuse through a polarizable but distorted matrix. In stark contrast to well-crystalline Li6PS5I (10-6 S cm-1), the ionic conductivity of its defect-rich nanostructured analog touches almost the mS cm-1 regime. Most likely, this immense enhancement originates from site disorder and polyhedral distortions introduced during mechanical treatment. We used the spin probes 7Li and 31P to monitor nuclear spin relaxation that is directly induced by Li+ translational and/or PS4 3- rotational motions. Compared to the ordered form, 7Li spin-lattice relaxation (SLR) in nano-Li6PS5I reveals an additional ultrafast process that is governed by activation energy as low as 160 meV. Presumably, this new relaxation peak, appearing at T max = 281 K, reflects extremely rapid Li hopping processes with a jump rate in the order of 109 s-1 at T max. Thus, the thiophosphate transforms from a poor electrolyte with island-like local diffusivity to a fast ion conductor with 3D cross-linked diffusion routes enabling long-range transport. On the other hand, the original 31P nuclear magnetic resonance (NMR) SLR rate peak, pointing to an effective 31P-31P spin relaxation source in ordered Li6PS5I, is either absent for the distorted form or shifts toward much higher temperatures. Assuming the 31P NMR peak as being a result of PS4 3- rotational jump processes, NMR unveils that disorder significantly slows down anion dynamics. The latter finding might also have broader implications and sheds light on the vital question how rotational dynamics are to be manipulated to effectively enhance Li+ cation transport.

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Myocardial perforation is a rare yet serious complication following cardiac pacemaker or defibrillator device procedures. In this article, the authors describe a case of right ventricular pacemaker lead perforation presenting to our hospital's medical assessment unit with a clinical presentation suggestive of an acute pulmonary embolism. Treatment dose low molecular weight heparin (LMWH) was commenced while awaiting CT scan. CT images were negative for PE however demonstrated RV lead perforation. Echocardiogram demonstrated pericardial effusion with the tip of RV lead in the pericardial free space. A rapid deterioration in the patient's haemodynamics prompted an emergency pericardial drain insertion and successful RV lead re-position in the cardiac catheter lab. The patient recovered well and was discharged with routine pacemaker clinic follow-up.

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BACKGROUND: Interventional techniques are commonly performed with adjunctive therapy including clopidogrel, ticlopidine, abciximab and heparin. We wished to assess the current British use of antiplatelet and anticoagulant agents as adjunctive therapies in interventional cardiology in the light of the available evidence base regarding their usage. METHODS: A simple structured questionnaire was sent between August and October 1999 to all interventional cardiology consultants working in the UK regarding their usage of abciximab (ReoPro), heparin, clopidogrel (Plavix) and ticlopidine (Ticlid) peri-procedurally. RESULTS: 68% of consultants responded over the next 4 months, with many replying jointly for a centre rather than individually. Average abciximab use was 8.3% of interventional cases. Eighty-two percent of clinicians used clopidogrel in stented patients. Exact dosages varied considerably. Fifty-three percent of clinicians gave 10000 IU or more of heparin routinely. CONCLUSIONS: These figures are not in line with the published evidence and British interventionists appear to have adopted various strategies to target the use of these agents. In particular, abciximab appears to be being administered reactively, as and when problems arise in the catheterisation lab.

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OBJECTIVE: Stent thrombosis and in-stent restenosis remain problematic in certain patient sub-groups. c7E3-Fab (ReoPro, abciximab) inhibits the platelet glycoprotein IIb/IIIa receptor as well as the smooth muscle cell alpha(v)beta3 receptor, and thus may influence both processes, especially if high local concentrations could be achieved. We have studied the adsorption and elution characteristics of c7E3-Fab on commercially available polymer-coated stents. We have also investigated the effect of such antibody binding on platelet deposition in vitro, and on antibody deposition into ex vivo human saphenous vein wall to assess whether such stents may influence stent thrombosis and restenosis. METHODS AND RESULTS: Adsorption was measured using a radioisotope technique after immersing segments of polymer-coated stents in c7E3-Fab solutions. Uptake was dependent on antibody concentration and duration of immersion of wire in the solution. After 22 h (at 5 mg ml(-1)), 1146+/-101 ng cm(-1) wire was adsorbed. In an in vitro perfusion circuit, the antibody eluted slowly, with 53% remaining after 12 days washing. To determine the value that such stents might have in clinical practise, adsorption to balloon-mounted stents was assessed at room temperature, using commercially available c7E3-Fab (2 mg ml(-1)). Efficacy of eluting c7E3-Fab was determined by measuring deposition of 111-Indium platelets. Immersing stents in c7E3-Fab for 20 min inhibited platelet deposition by 82.3% compared to controls (P=0.018). Deployment of treated stents in ex vivo saphenous vein resulted in the deposition of c7E3-Fab in the intima and media. CONCLUSIONS: c7E3-Fab can be passively adsorbed onto polymer-coated stents. It elutes slowly and in a predictable manner, significantly inhibiting platelet deposition in vitro. These studies pave the way to developing stent-based delivery of a potent anti-platelet agent that may additionally affect smooth muscle cell activity.

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In high-risk and complicated coronary intervention, the risk of acute closure is unpredictable. Thrombus and platelet deposition at the intervention site may also have further effects on subsequent restenosis. In vivo infusion of activated protein C has previously been shown to achieve potent anticoagulation without any haemostatic side effects. We now evaluated the in vitro and in vivo efficacy of polymer-coated coronary stents loaded with purified rabbit Activated Protein C (APC). By measuring 125I-fibrinogen/fibrin deposition APC-loaded stent-wires were antithrombotic compared to albumin-loaded, inhibited-APC-loaded, plain polymer-coated and stainless steel stent-wires. In a balloon injury rabbit iliac artery model, APC-loaded stents did not occlude (0/14) compared to plain stents (9/15) and BSA-loaded stents (2/4). Relative 111In-labelled platelet deposition showed a similarly significant degree of inhibition. In conclusion, APC-loading could render stents significantly less thrombotic. Whether an effective antithrombogenic stent like this effectively reduces restenosis rates warrants further evaluation.

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