bluuebunny/crossref_metadata_2025 huggingface dataset:
Prediction of Donor Heart Acceptance for Transplant and Its Clinical Implications: Results From The Donor Heart Study
Authors: Wayda Brian , Weng Yingjie , Zhang Shiqi , Luikart Helen , Pearson Thomas , Nieto Javier , Nicely Bruce , Geraghty P.J. , Belcher John , Nguyen John , Neidlinger Nikole , Groat Tahnee , Malinoski Darren , Zaroff Jonathan G. , Khush Kiran K.
Published: September 2024

BACKGROUND:

Despite a shortage of potential donors for heart transplant in the United States, most potential donor hearts are discarded. We evaluated predictors of donor heart acceptance in the United States and applied machine learning methods to improve prediction.

METHODS:

We included a nationwide (2005–2020) cohort of potential heart donors in the United States (n=73 948) from the Scientific Registry of Transplant Recipients and a more recent (2015–2020) rigorously phenotyped cohort of potential donors from DHS (Donor Heart Study; n=4130). We identified predictors of acceptance for heart transplant in both cohorts using multivariate logistic regression, incorporating time-interaction terms to characterize their varying effects over time. We fit models predicting acceptance for transplant in a 50% training subset of DHS using logistic regression, least absolute shrinkage and selection operator, and random forest algorithms and compared their performance in the remaining 50% (test) of the subset.

RESULTS:

Predictors of donor heart acceptance were similar in the nationwide and DHS cohorts. Among these, older age (
P
value for time interaction, 0.0001) has become increasingly predictive of discard over time while other factors, including those related to drug use, infection, and mild cardiac diagnostic abnormalities, have become less influential (
P
value for time interaction, <0.05 for all). A random forest model (area under the curve, 0.908; accuracy, 0.831) outperformed other prediction algorithms in the test subset and was used as the basis of a novel web-based prediction tool.

CONCLUSIONS:

Predictors of donor heart acceptance for transplantation have changed significantly over the last 2 decades, likely reflecting evolving evidence regarding their impact on posttransplant outcomes. Real-time prediction of donor heart acceptance, using our web-based tool, may improve efficiency during donor management and heart allocation.
NT-proBNP and Cardiac Troponin I, but Not Cardiac Troponin T, Are Associated With 7-Year Changes in Cardiac Structure and Function in Older Adults: The ARIC Study
Authors: Myhre Peder L. , Claggett Brian , Ballantyne Christie M. , Hoogeveen Ron C. , Selvin Elizabeth , Matsushita Kunihiro , Kitzman Dalane , Konety Suma , Mosley Thomas , Shah Amil M.
Published: September 2024

BACKGROUND:

Higher circulating concentrations of NT-proBNP (N-terminal pro-B-type natriuretic peptide) and high-sensitivity cardiac troponin T (hs-cTnT) and I (hs-cTnI) are associated with left ventricular remodeling and with incident heart failure. The associations of these cardiac biomarkers with changes in cardiac structure and function over time are uncharacterized.

METHODS:

Among 2006 participants in the ARIC prospective cohort study (Atherosclerosis Risk in Communities) who were free of overt cardiovascular disease and underwent echocardiography at study visits 5 (2011– 2013) and 7 (2018–2019), we assessed the associations of NT-proBNP, hs-cTnT, and hs-cTnI concentrations at visit 5 with changes in left ventricular structure and function between visits 5 and 7 (≈7-year change) using multivariable linear regression with the biomarkers modeled as restricted cubic splines. Models were adjusted for age, sex, race, body mass index, smoking, diabetes, hypertension, and renal function at visit 5; blood pressure and heart rate at both visits; and the baseline value of the echocardiographic parameter of interest.

RESULTS:

Mean±SD age was 74±4 years at visit 5; 61% were women; and 23% were Black adults. Median (25th–75th percentile) concentrations at visit 5 of NT-proBNP, hs-cTnT, and hs-cTnI were 87 ng/L (50–157 ng/L), 9 ng/L (6–12 ng/L), and 2.6 ng/L (1.9–3.9 ng/L). In adjusted models, elevated baseline concentrations of NT-proBNP and hs-cTnI were significantly associated with 7-year decline in left ventricular systolic function (ejection fraction, longitudinal and circumferential strain) and worsening diastolic indices. In contrast, elevated baseline concentrations of hs-cTnT were not significantly associated with 7-year changes in cardiac structure, systolic function, or diastolic function (all
P
>0.05).

CONCLUSIONS:

Higher concentrations of NT-proBNP and hs-cTnI, but not hs-cTnT, were associated with greater declines in left ventricular function over ≈7 years in late life independently of traditional cardiovascular risk factors.
Circulating Autoantibodies Targeting TREK-1 in Patients With Short-Coupled Ventricular Fibrillation
Authors: Li Jin , Janin Alexandre , Patoughi Mona , Gaudreault Nathalie , Kis Lenke , Moha Ou Maati Hamid , Bossé Yohan , Steinberg Christian
Published: September 2024

BACKGROUND:

Short-coupled ventricular fibrillation (SCVF) is increasingly being recognized as a distinct primary electrical disorder and cause of otherwise unexplained cardiac arrest. However, the pathophysiology of SCVF remains largely elusive. Despite extensive genetic screening, there is no convincing evidence of a robust monogenic disease gene, thus raising the speculations for alternative pathogeneses. The role of autoimmune mechanisms in SCVF has not been investigated so far. The objective of this study was to screen for circulating autoantibodies in patients with SCVF and assess their role in arrhythmogenesis.

METHODS:

This is a prospective, single-center, case-control study enrolling cardiac arrest survivors diagnosed with SCVF or idiopathic ventricular fibrillation (IVF) between 2019 and 2023 at the Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval Inherited Arrhythmia Clinic in Canada. Plasma samples were screened for autoantibodies targeting cardiac ion channels using peptide microarray technology. Identified target autoantibodies were then purified from pooled plasma samples for subsequent cellular electrophysiological studies.

RESULTS:

Fourteen patients with SCVF (n=4 [29% of patients] female patients; median age, 45 years [interquartile range: 36, 59]; n=14 [100% of patients] non-Hispanic White) and 19 patients with idiopathic ventricular fibrillation (n=8 [42%] female patients; median age, 49 years [38, 57]; n=19 [100%] non-Hispanic White) were enrolled in the study and compared with 38 (n=20 [53%] female subjects; median age, 45 years [29, 66]; n=36 [95%] non-Hispanic White) sex-, age- and ethnicity-matched healthy controls. During the study period, 11 (79%) SCVF probands experienced ventricular fibrillation recurrence after a median of 4.3 months (interquartile range, 0.3–20.7). Autoantibodies targeting cardiac TREK-1 (TWIK [tandem of pore-domains in a weakly inward rectifying potassium channel]–related potassium channel 1 were identified in 7 (50%) patients with SCVF (
P
=0.049). Patch clamp experiments demonstrated channel-activating properties of anti–TREK-1 autoantibodies that are antagonized by quinidine in both HEK293 cells and human induced pluripotent stem cell–derived cardiomyocytes.

CONCLUSIONS:

Patients with SCVF harbor circulating autoantibodies against the cardiac TREK-1 channel. Anti–TREK-1 autoantibodies not only present the first reported biomarker for SCVF, but our functional studies also suggest a direct implication in the arrhythmogenesis of SCVF.
Monitoring the Dissolution Behavior of Novel Pharmaceutical Cocrystals Consisting of Antimalarial Drug Artemisinin with Probe-Type Low-Frequency Raman Spectrometer
Authors: Kudo Takayuki , Miura Soichiro , Takatori Kazuhiko , Titapiwatanakun Varin , Palanisamy Vasanthi , Yamamoto Katsuhiko , Ikeda Yukihiro , Fukami Toshiro
Published: September 2024

Artemisinin (ART) is a most promising antimalarial agent. However, its low aqueous solubility limits its oral absorption, resulting in low bioavailability. In this study, we have successfully discovered a novel cocrystal with 2-methyl resorcinol (ART-2MRE) providing improved solubility compared with a previously reported cocrystal with resorcinol (ART-RES). Single crystal X-ray structure analysis revealed that the ART-2MRE cocrystal was composed of ART and 2MRE in a molar ratio of 2 : 1. Though the ART-2MRE and ART-RES cocrystals were found to have similarities in their crystal structures, with one layer of a cocrystal former and two layers of ART arranged in alternating rows, the ART-2MRE cocrystal showed higher dissolution rate than ART-RES cocrystal. In situ real-time low-frequency (LF) Raman monitoring and powder X-ray diffraction (PXRD) measurements of the crystals during the dissolution test proved useful to investigate the dissolution behavior of the cocrystals. Low-frequency Raman monitoring revealed that as dissolution progressed, there was a continuous shift from the peak unique to the ART-2MRE cocrystal to the peak unique to the ART stable form. Similar observations were obtained in PXRD measurements as well. Furthermore, experiments were conducted by adding a polymer to the dissolution test solution to investigate the dissolution behavior under supersaturation, indicating the possibility of differences in the dissolution behavior between the ART-2MRE cocrystal and ART-RES cocrystal. Understanding the dissolution behavior from cocrystals is essential in developing cocrystals.
Feature Selection and Spectral Indices for Identifying Maize Stress Types
Authors: Li Yanru , Yang Keming , Wu Bing
Published: September 2024

This study aims to identify different types of stress on maize leaves using feature selection and spectral index methods. Spectral data were collected from leaves under heavy metal, water, fertilizer stress, as well as under normal healthy conditions. Preprocessing steps such as continuum removal (CR), standard normal variable (SNV) transformation, multiple scattering correction (MSC), detrend correction (DT), and first-order derivative (FOD) were applied to the raw spectra. Various feature selection methods including ReliefF, chi-square test, recursive feature elimination (FRE), mutual information (MI), random forest (RF), and gradient boosting tree (GBT) were employed to determine the importance scores of different spectral bands, thus identifying sensitive spectral features capable of distinguishing various stress types. Spectral indices for stress type differentiation were constructed using label correlation method. Classification models were built using support vector machine (SVM), K-nearest neighbors (KNN), Gaussian naive Bayes (GNB), extreme gradient boosting (XGBoost), RF, and adaptive boosting (AdaBoost) algorithms. Results indicate that the characteristic spectral bands for differentiating stress types are primarily distributed around the red edge (near 700–800 nm) and water absorption valley (near 1900 nm). Spectral indices constructed using combinations of spectral bands around the near-infrared plateau absorption valley (near 1185 nm) and water absorption valley (near 1460 nm) effectively differentiate maize stress types. Among the modeling classification algorithms, RF and AdaBoost algorithms exhibited optimal performance, demonstrating high classification accuracy on both training and validation sets. These findings hold promise for providing new technical support for maize stress monitoring and diagnosis in agricultural production.
Book review: Razak Khan, Minority Pasts: Locality, Emotions, and Belonging in Princely Rampur
Authors: Ismail Zara
Published: September 2024

Razak Khan, Minority Pasts: Locality, Emotions, and Belonging in Princely Rampur (New Delhi: Oxford University Press, 2022), 336 pp.
Two Supreme Court Judgments on the Fairness of Elections in India
Authors: Jha Satish K.
Published: September 2024

The commentary looks at the two landmark judgements delivered by the Supreme Court in recent months on the electoral process in India which is the lifelines of liberal democracy. The judgements deal with the appointment of CEC and other election commissioners along with the funding of elections. In the Anoop Baranwal case, The Supreme Court has tried to insulate the election commission from control of the government of the day in order to make it a neutral institution. In the Electoral Bond case, the court has tried to create a level playing field among political contestants during the election. But the judgements have not been able to plug all holes in the electoral process as many lacunae remains. The judgements of the Supreme Court will go a long way in ensuring free and fair election in India.
Understanding p-values and significance
Authors: Altman Naomi , Krzywinski Martin
Published: September 2024

P-values combined with estimates of effect size are used to assess the importance of experimental results. However, their interpretation can be invalidated by selection bias when testing multiple hypotheses, fitting multiple models or even informally selecting results that seem interesting after observing the data. We offer an introduction to principled uses of p-values (targeted at the non-specialist) and identify questionable practices to be avoided.
Simulation methodologies to determine statistical power in laboratory animal research studies
Authors: Jeffers Angela , Konrad Kathryn , Larson Gary , Allen-Moyer Katherine , Cunny Helen , Shockley Keith
Published: September 2024

Null hypothesis significance testing is a statistical tool commonly employed throughout laboratory animal research. When experimental results are reported, the reproducibility of the results is of utmost importance. Establishing standard, robust, and adequately powered statistical methodology in the analysis of laboratory animal data is critical to ensure reproducible and valid results. Simulation studies are a reliable method for assessing the power of statistical tests, however, biologists may not be familiar with simulation studies for power despite their efficacy and accessibility. Through an example of simulated Harlan Sprague-Dawley (HSD) rat organ weight data, we highlight the importance of conducting power analyses in laboratory animal research. Using simulations to determine statistical power prior to an experiment is a financially and ethically sound way to validate statistical tests and to help ensure reproducibility of findings in line with the 4R principles of animal welfare.
Anti-swing position control of super-twisting sliding mode for underactuated tower crane based on nonlinear marine predator algorithm
Authors: Zhu Xiangshuai , He Qin , Zhang Runjun , Mao Ruinian , Zhao Chen
Published: September 2024

Due to the nonlinear, underactuated, and strongly coupled characteristics of tower cranes, issues such as inaccurate load positioning and severe swinging are prone to occur during transportation, making the control problem extremely complex. To address these issues, this paper has designed a super-twisting robust sliding mode controller based on the nonlinear marine predator algorithm (NMPA) to ensure the accurate positioning of the desired location during the transportation process of the tower crane while reducing the oscillation of the load. First, a nonlinear dynamic model of a four-degree-of-freedom tower crane considering friction is constructed. Second, to address the difficulty of effectively controlling the underactuated tower crane system model due to its nonlinearity and strong coupling, the super-twisting algorithm is introduced, and a super-twisting sliding mode controller for anti-swing positioning during the crane transportation process is designed. Then, the parameters of the super-twisting sliding mode controller are optimized using the NMPA to suppress sliding mode chattering and quickly achieve the system’s steady state. Finally, the stability of the nonlinear tower crane system is analyzed using Lyapunov’s theory and LaSalle’s invariance principle to ensure the closed-loop stability of the error dynamics. The simulation results show that the proposed control method exhibits excellent load anti-sway performance and robustness.
An Evaluation of the First Clinical Posting in Psychiatry of the Competency-Based Medical Education (CBME) Curriculum for Undergraduate Medical Students in India
Authors: Perugu Shalini , Sreedaran Priya , Chari Uttara , Sethuraman Bhuvaneshwari , Salazar Luke Joshua
Published: September 2024

Background:

The new competency-based medical education (CBME) curriculum presents an opportunity to address the many deficiencies in undergraduate (UG) psychiatry education in India. There are no published reports of such evaluations of psychiatry teaching programs based on the new CBME curriculum.

Methods:

We performed a cross-sectional evaluation of the first clinical posting in psychiatry of the new CBME curriculum using the following metrics: clinical skills, knowledge, attitudes towards psychiatry, self-efficacy in performing the specific learning objectives (SLOs), and satisfaction with specific teaching–learning and assessment methods implemented.

Results:

The mean knowledge score after the posting was significantly higher compared to the mean knowledge score at baseline (7.79 vs 5.45, p<0.001). The mean clinical skills score after the posting was 13.77 (0–20 range). Improvement was noted in the mean scores on all three sub-scales of the attitudes toward psychiatry scale. However, the improvement in scores was statistically significant only on the ‘Stigma of Psychiatry’ sub-scale. The mean scores on the items of the self-efficacy scale were between 63.41 and 77.73 (0–100 range). The mean scores on all items of the satisfaction scale were between 4 (somewhat satisfied) and 5 (very satisfied).

Conclusion:

We have described an evaluation of the first clinical posting in psychiatry of the new CBME curriculum. The posting was effective in imparting knowledge and clinical skills and potentially bringing about favorable changes in the attitudes toward psychiatry among UG medical students. The students also perceived confidence in performing the SLOs and were satisfied with the teaching-learning methods and assessment methods implemented.
Clinical effects of CYP2D6 phenoconversion in patients with psychosis
Authors: De Brabander Emma Y , Breddels Esmee , van Amelsvoort Therese , van Westrhenen Roos ,   GROUP Investigators
Published: September 2024

Background:

Pharmacogenetics is considered a promising avenue for improving treatment outcomes, yet evidence arguing for the use of pharmacogenetics in the treatment of psychotic disorders is mixed and clinical usefulness is under debate. Many patients with psychosis use multiple medications, which can alter the metabolic capacity of CYP enzymes, a process called phenoconversion. In clinical studies, treatment outcomes of drugs for psychosis management may have been influenced by phenoconversion.

Aim:

Here we evaluate the impact and predictive value of CYP2D6 phenoconversion in patients with psychotic disorders under pharmacological treatment.

Method:

Phenoconversion-corrected phenotype was determined by accounting for inhibitor strength. Phenoconversion-corrected and genotype-predicted phenotypes were compared in association with side effects, subjective well-being and symptom severity.

Results:

Phenoconversion led to a large increase in poor metabolizers (PMs; 17–82, 16% of sample), due to concomitant use of the serotonin reuptake inhibitors fluoxetine and paroxetine. Neither CYP2D6-predicted nor phenoconversion-corrected phenotype was robustly associated with outcome measures. Risperidone, however, was most affected by the CYP2D6 genotype.

Conclusion:

Polypharmacy and phenoconversion were prevalent and accounted for a significant increase in PMs. CYP2D6 may play a limited role in side effects, symptoms and well-being measures. However, due to the high frequency of occurrence, phenoconversion should be considered in future clinical trials.
Abnormal brain regional activity in acute thyrotoxic myopathy assessed by resting-state functional MRI
Authors: Kuang Yaqi , Liang Xinghuan , Ye Wei , Fu Shien , Qin Yingfen , Ma Yan , Luo Zuojie
Published: September 2024

Background

The neurophysiological mechanisms underlying manifestations of bulbar paralysis in acute thyrotoxic myopathy (ATM) and the afflicted brain areas are unclear.

Purpose

We used resting-state functional magnetic resonance imaging (rs-fMRI) to evaluate the regional brain activities in patients with ATM.

Material and Methods

In total, 16 patients with ATM, 16 patients with hyperthyroidism without ATM, and 16 healthy controls underwent functional MRI scans. By calculating the fractional amplitude of low-frequency fluctuation (fALFF), regional homogeneity (ReHo), and functional connectivity (FC), we assessed variations in resting-state cerebral activity. The correlation between the resting-state functional indexes and clinical assessments was also explored.

Results

Compared to the hyperthyroid patients, patients with ATM had stronger ReHo in the left precentral gyrus, reduced ReHo in the left orbitofrontal gyrus (OFG), and decreased FC in the left precentral gyri, left superior frontal gyrus (SFG), and left middle frontal gyrus (MFG). Patients with ATM showed reduced fALFF and ReHo in the right SFG and decreased ReHo in the bilateral supplementary motor area (SMA). A significantly decreased FC in the left SFG and left MFG, right precentral gyrus, and the orbital part of the right interior frontal gyrus was observed in patients with ATM compared to healthy controls. Additionally, fALFF and ReHo values were positively correlated with serum thyroid-related hormones and antibodies.

Conclusion

The findings of rs-fMRI demonstrate that particular brain regions’ functional activity was aberrant in individuals with ATM, especially in SFG area. This finding may help with better understanding of underlying pathophysiology of patients with ATM.
Observational, retrospective real-world evidence study demonstrates safety, performance and usefulness of antimicrobial central venous catheters
Authors: Philbeck Thomas E. , Bardin Amy , McDonald John G.
Published: September 2024

Objective

To collect real-world data to demonstrate the safety and performance of Arrowg+ard Blue® /Arrowg+ard Blue Plus® (AGB/AGB+) central venous catheters (CVCs).

Methods

This observational, retrospective study involved patients who required AGB/AGB+ CVCs at designated general hospitals in USA (22), UK (19) and Germany (2). Data were extracted from electronic medical records. There were no specific inclusion/exclusion criteria. Primary endpoint was successful treatment without an adverse event (AE). Secondary endpoint was rate of AEs.

Results

In total, 384 cases were included from 43 centres and most patients (74%) were >35 years of age. A success rate of 99%, and an overall AE rate of 0.8% were observed. Moreover, the overall infection rate was lower than typically reported for standard catheters. In addition, power injection of contrast media was successful in all 51 cases.

Conclusions

This study indicates the AGB/AGB+ CVCs perform as intended with a high success rate and few AEs. Further large-scale, controlled studies are required to confirm our findings.
Ideas Lab as funding instrument: navigating tensions in establishing transdisciplinary research projects
Authors: Kaisler R. E. , Bluemel C. , Palfinger T.
Published: September 2024

Traditional funding models allow for little external collaboration and exploration. To overcome ‘siloing’ of disciplines and enable more risky research, the Ideas Lab method was developed to enable new multidisciplinary ways of working. In this study, we explore the Ideas Lab as a cooperative funding instrument enabling transdisciplinary collaboration. We interviewed eight researchers participating in the Austrian Ideas Lab in 2017 after a 4-year project implementation and analysed their applications prior to the 5-day workshop. Researchers dealt with high pressure and stress and applied coping mechanisms to manage social dynamics. They changed their ways of working, dipping into new research areas, gaining new skills, and applying new engagement strategies with stakeholders as early as possible in the process. Openness and flexibility were essential to adjust to inputs from stakeholders. We conclude that the characteristics of the Ideas Lab as a funding instrument are well suited to the establishment and implementation of transdisciplinary research projects.
Mobbing Exposed by Deck Cadets at Onboard Training during the Internship Period
Authors: Çelik Maşalaci Burcu
Published: September 2024

The aim of this study is to determine whether oceangoing officer candidates encounter mobbing “psychological terror in the workplace” during their onboard training period and analyze whether there is a dimensional difference between the mobbing behaviors experienced by the deck cadets. The attendees of the study are a total 212 oceangoing officer candidates who have sea experience and are studying for a BSc degree in maritime transportation engineering. The demographic information of cadets, along with the details about the internship process and the Leymann Inventory of Psychological Terror (LIPT) items was analyzed using statistical tests by SPSS and association rule mining methods with the SPSS modeler. The study results demonstrate that, regardless of the ship type or internship duration, the cadets were subjected to mobbing in the sub-dimension of Self-expression and communication and Occupational situation and quality of life. The cadets who reported experiencing occupational stress indicated that their career expectations changed after the internship. The presence of “only one cadet on board” was identified as a significant antecedent factor affecting not only Self-expression and communication and Occupational situation and quality of life but also occupational stress and changes in work expectations after internship.
Impact of xylene exposure during organogenesis on foeto-placental efficiency and foetal viability: Exploring its association with oxidative stress-induced inflammation and apoptosis in utero
Authors: Suaidi Noor Asyikin , Alshawsh Mohammed Abdullah , Hoe See-Ziau , Mokhtar Mohd Helmy , Md Zin Siti Rosmani
Published: September 2024

The potential maternal and foetal toxicity resulting from exposure to xylene at or below the allowable limit of 100 ppm during gestation is not thoroughly studied. The aim of this study was to investigate maternal and foetal outcomes following prenatal exposure to xylene during organogenesis. Pregnant Sprague Dawley (SD) rats were administered intraperitoneal (IP) corn oil (vehicle), 100, 500, and 1000 parts per million (ppm) of xylene from gestational day (GD) 6 until GD17. Clinical signs, maternal weight gain, and food consumption were recorded daily. A caesarean hysterectomy was performed on GD21 to assess the reproductive and foetal outcomes. Exposure to 1000 ppm of xylene caused a significant decrease in the maternal body weight and food consumption, and an increase in intrauterine foetal deaths. Foetal assessment revealed a significant decrease in foetal weight in both male and female foetuses of female rats treated with 500 and 1000 ppm. Male placental weight was significantly decreased in all xylene-treated groups, while 1000 ppm xylene significantly decreased female placental weight. Histologically, marked uterine inflammatory lesions, fibrosis of the liver and renal tissues, as well as increased placental glycogen content were observed. Immunohistochemistry revealed a significant increase in lipid peroxidation and apoptotic markers. Thus, the foeto-maternal toxicities of xylene have been shown to be mediated by a systemic inflammatory response that exacerbates intrauterine oxidative stress and impairs foeto-placental transfer, leading to an increase in foetal mortality.
Model predictive control with real-time variable weight for civil aircraft towing taxi-out control systems
Authors: Qin Jiahao , Ma Jiaqi , Lin Qiwei , Wu Hao , Zhang Wei
Published: September 2024

Unlike the traditional method of taxying, where civil aircraft reach the runway by relying on their engines, the new mode of towing taxi-out may become preferred because of its lower energy consumption, lower emissions, and higher efficiency. To improve the tracking accuracy and lateral stability of the towing system, this study used a two-level time-varying weight control method (RMPC) based on model predictive control (MPC) and fuzzy control. The tractor speed and front wheel angle were set as the control variables in the MPC controller, and the real-time lateral displacement error and yaw angle error of the tractor were set as the fuzzy control inputs. The influence of the weight matrix on the accuracy and stability of path tracking was coordinated by online optimization of the MPC objective function weight. The simulations of multiple working conditions were performed using TruckSim software in Simulink, which showed that the proposed control method can limit the lateral displacement error of the tractor and aircraft within 0.4 m, which can be reduced by 70.83% and 77.4% compared with the single MPC, respectively. Additionally, the maximum yaw angle errors of the tractor and aircraft are reduced by 76.11% and 51.31% compared with the single MPC, respectively. Furthermore, the yaw angle error of tractors can be limited to 4° and that of aircraft can be limited to 6.5°, which is an improvement of the lateral stability and driving safety for the civil aircraft towing system. The new controller may provide technical insights and support for the practical development and safe application of the towing taxi-out mode.
Leriche Memorial Lecture at 24th World Congress ‘Takayasu's Arteritis in Asia’
Authors: Mishima Yoshio
Published: September 2024

An uncommon type of chronic and progressive arteritis characterized by peculiar ocular findings, an absent radial pulse and hypersensitivity of the carotid body and sinus was first described in 1908 by Takayasu, a Japanese ophthalmologist. This disorder was defined as a clinical entity by Shimizu in 1948. Takayasu's arteritis was initially thought to be confined to the Orient. Subsequent reports however indicated that this condition affected all races and has a worldwide distribution. It is also referred to as pulseless disease, aortitis syndrome, and non-specific aortoarteritis. The current widespread interest in this disease has mainly been in the Japanese literature.

Takayasu's arteritis predominates in women in the second and third decade. Recently, the classical pulseless disease has declined and symptoms resulting from hypertension and aortic regurgitation are recognised as the most important factors in prognosis.
Development of Oral Heparin Therapy for Prophylaxis and Treatment of Deep Venous Thrombosis
Authors: Money Samuel R. , York John W.
Published: September 2024

Objective:

To review the current research and published literature regarding the development of oral heparin therapy for the prophylaxis and treatment of deep venous thrombosis.

Background:

Currently, the accepted practice of prophylaxis and/or treatment of acute deep venous thrombosis (DVT) is intravenous or subcutaneous (SQ) heparin followed by oral warfarin or SC low molecular weight heparin (LMWH) therapy followed by warfarin. Both of which are less than ideal. More recently, advances have been made towards an effective oral heparin preparation that would resolve many of the drawbacks to the current therapies.

Methods:

A review of the current and relevant English literature identified via a search of the Medline database from January 1990 to present.

Results:

Initial oral heparin therapy for DVT was unsuccessful due to presumed inadequate intestinal absorption as a result of heparin's molecular and structural characteristics. The development of oral heparin therapy, based on combining heparin with the carrier molecule Sodium N-(8[2-hydroxybenzoyl]amino) caprylate (SNAC) to enhance its intestinal absorption and bioavailability for the prophylaxis and treatment of DVT has been demonstrated to be effective in animal models. More recent efforts have been aimed at human trials.

Conclusion:

Recent advances in prophylaxis and treatment of DVT have stimulated great interest among researchers to develop an effective, convenient, and well tolerated oral therapy. An effective oral heparin therapy may represent an ideal method of prophylaxis and treatment of DVT.
Different Behavior of Sequential versus Single Left Internal Mammary Artery to Left Anterior Descending Area Grafts
Authors: Hartman J. M. , Kelder J.C. , Ackerstaff R.G.A. , Bal E.T. , Vermeulen F.E.E. , Bogers A.J.J.C.
Published: September 2024

To study echo Doppler characteristics of sequential versus single left internal mammary artery (LIMA) to left anterior descending (LAD) area grafts transthoracic echo Doppler at the LIMA origin and angiography were performed pre- and postoperatively.

In 17 patients single LIMA to LAD (group I) and in 45 patients sequential LIMA to LAD area (group II) bypass grafting was performed. All patients show an early postoperative shift towards diastolic coronary Doppler velocity spectra. Only group II shows a further significant late increase in diastolic, velocity time integral and some systolic echo Doppler parameters at rest. Diastolic peak and diastolic as well as total mean and velocity time integral maximal values are significantly higher in group II in late postoperative hyperemic response. Preoperative and late control angiography showed no significant differences in overall grading of native LAD stenosis between both groups. The large coronary reserve in LIMA sequential grafts may contribute to an improved long-term patency.
Inflammatory Solitary Iliac Artery Aneurysms: A Report of two Cases
Authors: Shindo S. , Kubota K. , Kojima A. , Lyori K. , Ishimoto T. , Kobayashi M. , Kamiya K. , Tada Y.
Published: September 2024

Inflammatory abdominal aortic aneurysms are associated with atherosclerosis, which are characterized by specific clinical manifestation. We treated two patients with unilateral solitary iliac artery aneurysms with perianeurysmal fibrosis which compressed the ureter resulting in ipsilateral hydronephrosis. After the iliac artery aneurysm was repaired with a prosthetic graft, the hydronephrosis resolved. Microscopically, there was clear evidence of atherosclerosis in one case. There was a characteristic inflammatory reaction around the adventitia in both aneurysms. Localized iliac perianeurysmal fibrosis has not been particularly described. The clinicopathologic similarities between these cases and inflammatory abdominal aortic aneurysms suggest the same pathogenesis.
Outcome of Transaxillary Rib Resection for Thoracic Outlet Syndrome — a 10 Year Experience
Authors: Fulford P. E. , Baguneid M. S. , Ibrahim M. R. , Schady W. , Walker M. G.
Published: September 2024

Background:

This study assessed the outcome of transaxillary first and/or cervical rib resection in a unit, which has a policy of combined assessment by a neurologist and vascular surgeon.

Methods:

61 patients underwent 83 transaxillary rib resections for thoracic outlet syndrome. A retrospective casenote review of these patients was undertaken. All patients completed a telephone questionnaire regarding long-term outcome.

Results:

Post-operative outpatient assessment at a median of 6 months recorded 91.5% improved, of whom 61.5% were symptom-free. 61% were available for the telephone questionnaire at a median follow-up of 4 yr. 74% reported an improvement, with complete resolution in 58%. Six described temporary improvement following surgery.

Conclusion:

Transaxillary rib resection is a safe and effective procedure, allowing almost two thirds of patients a return to normal activity. Combined assessment by vascular and neurological teams may help in patient selection for surgery, as well as the accurate long-term assessment of outcome.
Femoral Arteriovenous Fistulas Complicating Percutaneous Cardiac Procedures
Authors: Sieunarine K. , Ibach G. , Prendergast F. J.
Published: September 2024

Arteriovenous fistulas resulting from cardiac interventional radiological procedures are reported to be rare. Three patients are presented who developed femoral arteriovenous fistulas after cardiac catheterization. The fistulas were discovered incidentally. The patients had symptoms of intermittent claudication which improved after correction of the fistula alone in two patients, suggesting that the fistulas were contributing to the symptoms of claudication. The reported incidence of 0.28% for arteriovenous fistulas after Interventional procedures is probably an underestimate because they are often symptomless and only discovered Incidentally during examination for another problem. When discovered they should be corrected because they can cause reduction in blood flow to the affected limb and produce symptoms If occlusive disease is already present.
Purulently Infected Abdominal Aortic Aneurysm: in Situ Reconstruction with Transmesocolic Omental Transposition Technique
Authors: Yokoyama H. , Maida K. , Takahashi S. , Tanaka S.
Published: September 2024

A new omental transposition technique was applied to a patient who underwent resection and in situ reconstruction of purulently infected abdominal aortic aneurysm to prevent recurrent retroperitoneal and graft infection. After wide separation from the transverse colon, the omental pedicle was transposed to the infrarenal retroperitoneal space through an opening of the transverse mesocolon to wrap the prosthetic graft and fill the infected space. The postoperative course was uneventful without any sign of recurrent infection in follow-up lasting 8 months. The authors' experience suggest that this ‘transmesocolic’ technique is an effective modality for critically ill patients with infected abdominal aorta.
Prosthetic Graft Infection Involving the Thoracic Aorta: Graft Excision and Extra-Anatomic Revascularization
Authors: Ko W. , Fantini G. A.
Published: September 2024

Late-appearing infection of prosthetic grafts continues to plague the vascular surgeon. Although generally caused by biofllm-producing coagulase-negattve staphylococci, other Gram-positive, as well as Gram-negative, organisms may also be etiologic. Extra-anatomic revascularization with either simultaneous or staged removal of the entire contaminated prosthesis has emerged as the preferred method of management of the infected aortic prosthesis. In addition to the usual technical problems accompanying surgery for aortic graft infection, operation for prosthetic graft infection involving the ascending aorta and aortic arch introduces the potential problem of temporary cerebral ischemia. The successful management of a 64-year-old woman with late Staphylococcus aureus infection of an aortoinnominate-left subclavian bifurcation graft by graft excision and extra-anatomic revascularization, in whom intraoperative cerebral ischemia was circumvented by initial placement of a right femoroaxillary bypass graft is described here.
The Future of Carotid Surgery: Changes and Problems to Solve
Authors: Strandness D. E.
Published: September 2024

With the publication of the results of clinical trials and acceptance of the role of carotid endarterectomy for treatment of carotid bifurcation disease, it will be up to the surgeons to set the standards for performance that are consistent with the expected outcome. This is a complex issue that will have to be addressed and monitored continually to ensure that patients obtain the optimal and expected results. It will be incumbent on the surgical community to not only set the standards but also to set up mechanisms to monitor the performance of surgeons involved in this procedure. From a scientific standpoint, a great deal of work needs to be done to identify those changes in the plaque that are responsible for the production of clinical events. At present, the only finding that is predictive of outcome is the degree of narrowing. Whereas it is the high-grade lesions that lead to events, the majority will remain benign and not lead to cerebral ischemia. To carry out such research it will be necessary to develop three-dimensional imaging methods that permit measurement of the fibrous cap and the materials beneath it. Since plaque cap rupture with embolization, and in some cases, thrombosis, are the primary causes of clinical events, it will be necessary to measure the cap thickness in symptom-free as well as symptomatic patients. Since high-resolution ultrasonography can identify precisely the site of plaque removal, repeat studies of this area will permit its use as a method for documenting the extent and rate of arterial wall healing, and those factors that might protect against the development of myointimal hyperplasia.
Recurrent Left Atrial Myxoma
Authors: Alkhulaifi A. M. , Horner S. , Pugsley W. B. , Sturridge M. F.
Published: September 2024

Based on statistics from the UK, the incidence of myxoma is about 1:1 000000/year. Three recent cases of recurrent myxoma are reported, one where excision was probably incomplete, one where tumour implantation may have occurred and one where a mesenchymal sarcoma was misinterpreted histologically. The relative importance of these three factors in recurrence of cardiac tumours after surgical excision is discussed.
Acute Ischaemia of the Lower Limb and Sciatic Artery Aneurysm
Authors: Saey J. P. , Fastrez J.
Published: September 2024

Persistent sciatic artery is a rare abnormality but complications are frequent, especially secondary to aneurysmal degeneration. Typical symptoms include sciatic pain associated with a pulsatile mass in the buttock and/or an acute ischaemia of the lower limb. The successful surgical management of one such case is described, together with a brief review of the literature.
Interruption of the Inferior Vena Cava Using the Vascor Filter: Preliminary Series of 51 Cases
Authors: Rudondy Ph. , Ferdani M. , Reggi M. , Jausseran J. M.
Published: September 2024

Between February 1991 and October 1991, vena cava filters made of Vascor (Toulon. France) were inserted into 51 patients. The male:female ratio was 29:22 and mean age 74 (range 45–94) years. Diagnosis of thrombophlebitis was established by venography in 48 patients (94%) and ultrasonography in three (6%). Thrombosis was unilateral in 49 patients and bilateral in two, involved the pelvic veins in 38 (75%) and the leg veins in 13 (25%). Of the 51 patients, 17 (33%) presented pulmonary emboli and 12 (24%) had waving supracrural clots. The Vascor umbrella filter is a two-stage stainless-steel device with attachment tabs for anchoring and centring. It can be placed either percutaneously using a 7-gauge French introducer via the jugular, subclavian or brachial vein or surgically. In the present series, placement was achieved percutaneously via the jugular vein, in 49 cases (96%) and surgically in two (4%). Postoperative and follow-up examinations included coagulation tests, Doppler ultrasonography and abdominal radiography. In the immediate postoperative period, one patient developed a pneumothorax which was treated by pleural drainage and five died from cancer within the first month after placement. There were no postoperative accidents and no patient had recurrent embolism. In three patients, the filter tilted 30° and in one caval thrombosis was identified. Follow-up examinations were performed in 46 patients, with a mean duration of 12 months. Ten patients have died. Caval thrombosis occurred in two patients (4%) but proximal migration of the filter and recurrence of pulmonary embolism have not been observed.
Mediastinal and Pericardial Complications after Heart Transplantation. Not-So-Unusual Postoperative Problems?
Authors: Carrier M. , Hudon G. , Paquet E. , Leung T. K. , White M. , Pelletier G. B. , Pelletier L. C.
Published: September 2024

Of a total of 133 patients who underwent heart transplantation, 16(12%) had pericardial and mediastinal complications. Non-infectious pericardial complications, pericardial effusion and constriction were noted in ten patients, and infectious pericarditis or mediastinitis in six. Cardiac echocardiography, catheterization and magnetic resonance imaging were useful in assessing these problems. All patients underwent surgical treatment, pericardial drainage, pericardectomy or muscle flap closure. Twelve (75%) of these 16 patients are long-term survivors. In conclusion, pericardial and mediastinal complications are common after heart transplantation, and aggressive surgical treatment is most often effective in their control.
Surgical Treatment of Ventricular Septal Defect and Ruptured Sinus of Valsalva Associated with Infective Endocarditis
Authors: Sugimoto T. , Ogawa K. , Asada T. , Mukohara N. , Higami T. , Obo H. , Kawamura T.
Published: September 2024

Two patients with ventricular septal detect of Kirklin type I and ruptured right coronary sinus of Valsalva associated with infective endocarditis were operated on. Both had bacillus vegetation clinging to the aortic and pulmonary valves and the right ventricular intimal wall around the septal defect. Aortic and pulmonary regurgitation were also found. The surgical approach included vertical incision of the right ventricular outflow tract and pulmonary trunk and transverse aortotomy. The right coronary sinus of Valsalva showed distinct aneurysmal change in one patient. The aortic valve and infected Valsalva sinus were excised in both cases, and the pulmonary valve and right ventricular wall where infection extended thoroughly débrided. The resulting defect, including the ventricular septal defect and excised right Valsalva sinus and aortic annulus, was closed with one patch, and the prosthetic valve inserted in the position of the original aortic valve using this patch as part of the annulus. Both patients had a good postoperative course and are doing well, although slight pulmonary regurgitation persists.
Immediate Haemodialysis and staged fasciotomy in the treatment of reperfusion injury
Authors: Urayama H. , Harada T. , Kawasuji M. , Watanabe Y.
Published: September 2024

A 67-year-old man was admitted with traumatic arterial occlusion in his leg 24 h after an accident. A double-lumen catheter was inserted into the left iliac vein, after revascularization, and haemodialysis started using a new membrane dialyser to remove myoglobin effectively. Intramuscular pressure of the limb was measured and, when it was 35 mmHg, staged fasciotomy was performed. A modification of the procedure used to prevent myonephropathic metabolic syndrome and compartment syndrome is described.
Reduction of Myocardial Necrosis by Positioning the Intra-Aortic Balloon Pump in the Ascending Aorta
Authors: Lazar H. L. , Matsuura H. , Rivers S. , Shemin R. J.
Published: September 2024

The presence of severe peripheral vascular disease may necessitate inserting an intra-aortic balloon pump (IABP) directly Into the ascending aorta. As positioning an 1ABP into the descending aorta may be hazardous and difficult through the ascending aorta, this experimental study sought to determine the effects of positioning an IABP in the ascending aorta on myocardial recovery during urgent surgical revascularization. The second and third diagonal coronary arteries in 30 pigs were occluded with snares for 90 min followed by 30 min of cardioplegic arrest and 180 min of reperfusion with the snares released. During the period of coronary occlusion, ten pigs received an IABP in the descending aorta, ten had an ascending aorta IABP and ten received no IABP support. The best recovery of wall motion, least tissue acidosis and lowest area of necrosis occurred when an IABP was positioned in the ascending aorta. It is concluded that myocardial recovery is enchanced when an IABP is positioned in the ascending aorta during urgent surgical revascularization.