bluuebunny/crossref_metadata_2025 huggingface dataset:
Outflow cannula alignment in continuous flow left ventricular devices is associated with stroke
Authors: Kassi Mahwash , Agrawal Tanushree , Xu Jiaqiong , Marcos-Abdala Hernan Gerardo , Araujo-Gutierrez Raquel , Macgillivray Thomas , Suarez Erik E , Yousefzai Rayan , Fida Nadia , Kim Ju H , Hussain Imad , Guha Ashrith , Trachtenberg Barry , Bhimaraj Arvind , Chang Su Min , Estep Jerry
Published: March 2023

We sought to evaluate whether differences in left ventricular assist device (LVAD) canula alignment are associated with stroke. There is a paucity of clinical data on contribution of LVAD canulae alignment to strokes. We conducted a retrospective analysis of patients who underwent LVAD implantation at Houston Methodist hospital from 2011 to 2016 and included those who had undergone cardiac computed tomography (CT) with contrast. LVAD graft alignment using X-ray, echocardiography, and cardiac CT was evaluated. The primary outcome was stroke within 1 year of LVAD implantation. Of the 101 patients that underwent LVAD Implantation and cardiac CT scan during the study period, 78 met inclusion criteria. The primary outcome occurred in 12 (15.4%) patients with a median time to stroke of 77 days (interquartile range: 42–132 days). Of these, 10 patients had an ischemic and two had hemorrhagic strokes. The predominant device type was Heart Mate II (94.8%). Patients with LVAD outflow cannula to aortic angle lesser than 37.5° and those with outflow graft diameter of anastomosis less than 1.5 cm (assessed by cardiac CT) had significantly higher stroke risk ( p < 0.001 and p = 0.01 respectively). In HMII patients, a lower LVAD speed at the time of CT scan was associated with stroke. Further studies are needed to identify optimal outflow graft configuration to mitigate stroke risk.
Vitamin D deficiency and driveline infection in patients with a left ventricular assist device implant
Authors: Zittermann Armin , Pilz Stefan , Morshuis Michiel , Gummert Jan F , Milting Hendrik
Published: March 2023

Driveline infection is a frequent complication in recipients of durable left ventricular assist devices (LVAD), but its cause is largely unclear. Since vitamin D supplementation can reduce the risk of infections, we aimed at investigating the association of vitamin D deficiency with driveline infection. In 154 patients with continuous flow LVAD implants, we assessed 2-year risk of driveline infection according to vitamin D status (circulating 25-hydroxyvitamin D < 25 nmol/L or ⩾25 nmol/L). Of the study cohort, 34% ( n = 53) had 25-hydroxyvitamin D concentrations <25 nmol/L. Kaplan-Meir estimates of 2-year freedom from driveline infection were in the vitamin D deficient and vitamin D non-deficient groups 49.7% and 74.2%, respectively ( p = 0.017). Covariate-adjusted hazard ratio of driveline infection for the vitamin D deficient versus non-deficient group was 2.51 [95% CI: 1.11–5.69; p = 0.028). Circulating concentrations of endocrine regulators of calcium and phosphorus metabolism such as parathyroid hormone, 1,25-dihydroxyvitamin D, and fibroblast growth factor-23 were not significantly associated with the risk of driveline infection ( p-values > 0.15). In total, our data indicate that in LVAD recipients deficient vitamin D status is a predictor of driveline infection, but future studies are needed to investigate whether these associations are causal.
Race, Repression and the Future of New Labor Activism
Authors: Wingfield Adia Harvey
Published: March 2023

Labor activism is on the rise in the U.S., and workers and organizers are taking new and intriguing steps to have more voice, involvement, and power in their workplaces. This begs the question of whether this new surge in labor activism will have long-term consequences or amount to a “flash in the pan.” In this paper, I argue that the success of current labor activism will hinge on two factors: whether organizers successfully confront longstanding racial disparities in workplaces and occupations, and the ability to preempt and survive the resulting state repression and organizational backlash.
Binary Resin-Curing Agent Systems for Fabricating Epoxy and Graphene Oxide-loaded Epoxy Films
Authors: Ahmadi-khaneghah Aziz , Khosravi-ardakani Sara , Jahani Abolfazl , Behniafar Hossein
Published: March 2023

In this research, diglycidyl ethers of bisphenol-A (BADGE) and polyethylene glycol (PEGDGE) were binarily cured with a mixture of diamine curing agents including isophorone diamine and polyethylene glycol diamine (PEGDA) in the absence/presence of aminated graphene oxide nanoplatelets (AGNPs, 0.5 wt.%). Four molar ratios of diglycidyl ethers and curing agents were used stoichiometrically in isothermal curing systems. The films prepared from the epoxy networks were entirely strong and pliable. All epoxy thermosets were evaluated using field emission-scanning electron microscopy (FE-SEM), Fourier transform infrared (FT-IR) spectroscopy, X-ray diffraction (XRD), and diffuse reflectance-ultraviolet/visible spectroscopy (DR-UV/vis). The absorption coefficients of the epoxy and AGNPs-loaded epoxy materials decreased with increasing the molar ratio of PEGDGE resin and polyethylene glycol diamine curing agent. According to dynamic mechanical analysis no phase heterogeneity occurred in the structure of the prepared thermostats. When the thermoset materials were loaded by AGNPs filler, the peaks associated with alpha relaxations shifted to higher temperatures. Moreover, thermogravimetric analysis demonstrated that the thermal stability of the prepared epoxy thermosets slightly increased after the addition of the nanoplatelets. In addition, the thermal resistance of the prepared thermosets decreased to some extent by increasing the participation rate of monomers containing polyoxyethylene.
Control mechanism of vortex-generator jet on turbulent separation in a highly loaded compressor cascade
Authors: Zhiyuan Cao , Cheng Song , Wei Guo , Chuxuan Wang , Xi Gao , Bo Liu
Published: March 2023

The active flow control technique of vortex-generator jet (VGJ) was used to control the turbulent separation of a highly loaded compressor cascade at a high incidence. VGJ schemes on suction surface with different jet locations, skewed angles, pitch angles were numerically performed and the control mechanism of VGJ parameters on the flow field of the cascade was revealed. For avoiding the effect of endwall boundary layer, both endwall surfaces of the cascade were set to translational periodicity boundary (TPB). Results show that VGJ significantly eliminates the turbulent separation and improves the performance of cascade. The overall loss coefficient of cascade is reduced by 52.3% at most. The optimal VGJ location in this study is not separation location but 7% axial chord downstream of it, which is probably due to the ultra-high loading of the cascade. The spanwise location and intensity of jet vortices are mainly affected by skewed angle, and will increase with the skewed angle. The VGJ case with a higher pitch angle features better control effect on suction surface but increases the pitchwise scale of the low-velocity region. In addition, as pitch angle increases, the mixing loss between mainstream and jet flow increases, which brings a negative effect on cascade performance. In order to enhance the momentum transporting between mainstream flow and separation flow, counter vortex-generator jet (CVGJ) schemes were designed and studied. Though CVGJ strengthens the jet vortices near the trailing edge and achieves minimum loss near TPB sections at 150% axial chord section, the interaction of jet vortices with opposite rotating direction brings extra loss, which leads to the control effect of CVGJ is weaker than that of VGJ.
A theoretical and experimental investigation into surface generation in ultra-precision diamond milling
Authors: Guo Pan , Yu Jinjie , Gao Dongdong , Tong Li , Xiong Zhiwen , Zhang Shaojian
Published: March 2023

Ultra-precision diamond milling (UPDM) provides a promising generation of high-quality surface up to sub-micrometric form accuracy and nanometric surface roughness. Prior to its machining process, the investigation on surface generation would be beneficial to achieve desired quality with reduced cost and boosted productivity. However, few studies discussed this issue so far. In this study, a theoretical and experimental investigation into surface generation was carried out in UPDM. Firstly, a geometric model was built up considering the material removal process between the milling tool and the workpiece. Secondly, surface generation process was elaborated according to the developed model. Finally, UPDM experiments were performed on a typical brass material at different cutting conditions and surface texture parameters were characterized according to ISO 25178-2. Autocorrelation function (ACF) analysis was employed for a detailed evaluation of surface generation. The results showed that the static factors (cutting parameters) as well as the dynamic factors (material effects and spindle vibration), which were associated with the cutting conditions, yielded a great influence on surface generation. Surface texture characterization indicated that there was a good consistence between simulation and experiment, demonstrating the feasibility of the proposed method. ACF analysis indicated that, with the increased feedrate/step ratio, surface generation approximately achieved a transition from the periodical surface (dominated by cutting residuals) to the random surface (determined by multiple components). Significantly, this study draws up a fundamental understanding toward surface generation in UPDM.
CFRP cylindrical tubes equipped with thin-walled semi-circular lateral corrugated inner stiffeners subjected to quasi-static latitudinal impact
Authors: Shirzadifar Mohammad , Marzbanrad Javad
Published: March 2023

Recently, versatile tubes with different cross-sectional cores have been suggested to reduce impact failures of protective structures. One method for improving cylindrical tube bending stiffness is using thin-walled corrugated cores. This paper investigates the effects of using semi-circular lateral corrugated stiffeners on the elastic behaviors of the CFRP cylindrical tubes subjected to quasi-static latitudinal impact. Based on suggested bending characteristics, analytical equations of elastic behaviors for the cylindrical tube equipped with a semi-circular lateral corrugated core have been derived. The equations are considered for the CFRP tubes stiffened with 4, 6, 8, and 12 semi-circular lateral corrugated waves. Obtained strain results conducted from low-velocity FEM analysis and impact experiments employing the GOM DIC software verified the derived equations with more than 82% accuracy. Additionally, it is found that the CFRP tube stiffened with a four-wave lateral corrugated core displays a positive impact failure of 74% compared to the non-stiffened tube.
Color-Evasive Cognition: The Unavoidable Impact of Scientific Racism in the Founding of a Field
Authors: Thomas Ayanna K. , McKinney de Royston Maxine , Powell Shameka
Published: March 2023

Cognitive psychology has traditionally focused on investigating principles of cognition that are universal across the human species. The motivation to identify “cognitive universals” stems from the close relationship between biology and human cognition and from the theoretical architecture presupposed by the information-processing model. In this article, we argue that the underlying theoretical assumption of universality also stems from epistemological and methodological assumptions that laws of cognition can be effectively developed only by controlling for variables deemed to be outside the scope of internal cognition. These assumptions have resulted in the development of a science of human cognition based on the performance and behavior of a White, English-speaking, normatively invisible, racially color-evasive, socially dominant (WEIRD) class. In this article, we identify how scientific racism has influenced the study of cognition and offer perspective on how researchers may reconsider many of the premises that undergird our approach.
A standardized technique for lateral unicompartmental knee arthroplasty
Authors: Wen Tao , Xue Huaming , Ma Tong , Yang Tao , Xue Long , Tu Yihui
Published: March 2023

Objectives

We developed a new standardized procedure for lateral unicompartmental knee arthroplasty (UKA) to maximize the benefits and minimize the risks of surgery in patients with osteoarthritis (OA).

Methods

This retrospective study recruited patients who underwent lateral UKA at our hospital between January 2014 and January 2016. Demographic characteristics and preoperative and postoperative American Knee Society (AKS) clinical scores (including pain, clinical, and knee mobility scores) were collected.

Results

A total of 158 patients (35 male and 123 female) who underwent 160 lateral UKAs were analyzed. Their AKS clinical scores (0–100 points) improved from 53.1 ± 4.1 (range 45–62) preoperatively to 97.0 ± 1.7 (range 92–99) ( p < 0.001) postoperatively with additional improvements of 9.1 ± 1.8 (range 3–14) to 47.3 ± 1.5 (range 45–49) ( p < 0.001) for pain, 49.7 ± 9.7 (range 35–70) to 97.1 ± 4.1 (range 90–100) ( p < 0.001) for function, and 105.0 ± 4.4° (equivalent to ∼100–115°) to 125.5 ± 5.3° (∼110–135°) ( p < 0.001) for a range of motion (ROM). No patients required reoperations or revisions. Two patients were readmitted within 60 days due to severe knee swelling.

Conclusion

The lateral UKA protocol was reproducible and the patients had a good postoperative outcomes. Yet, large-scale, multi-center, prospective studies are needed to further confirm our findings.
Measuring 25-hydroxyvitamin D in cats: comparison of a whole-blood lateral flow assay, 2 dried-blood-spot tests, and serum LC-MS/MS
Authors: Brodlie Hannah , Quimby Jessica , Rudinsky Adam J. , Paschall Rene E. , Brusach Katelyn , Klein Hannah , Winston Jenessa A. , Parker Valerie J.
Published: March 2023

Measuring 25-hydroxyvitamin D (25D) can be a challenge in veterinary medicine because of laboratory accessibility and required sample volume. We compared 2 dried-blood-spot (DBS) tests and a lateral flow assay (LFA) to the gold standard, liquid chromatography–tandem mass spectrometry (LC-MS/MS). We hypothesized that there would be good agreement among the tests, within a clinically significant limit of agreement of ± 25 nmol/L. We collected blood from 6 healthy purpose-bred 2-y-old cats at 6 times over 6 wk, and measured 25D concentrations with all 4 tests. Agreement of the 3 candidate tests and LC-MS/MS was evaluated via Bland–Altman analysis, Passing–Bablok regression, and Lin correlation coefficients. Bland–Altman analysis demonstrated that the mean bias was >± 25 nmol/L for all 3 candidate tests in comparison to serum LC-MS/MS concentrations. The 95% CIs for the mean bias did not include zero, further supporting the presence of significant bias among methods. Additionally, all 3 tests had poor agreement with serum LC-MS/MS concentrations when analyzed by Lin correlation coefficient analysis, and bias between methods was further characterized by Passing–Bablok analysis. Based on these results, none of these 3 tests is recommended as an alternative to LC-MS/MS testing for 25D measurement in cats.
Characterizing Interventions and Family Assistance of a Nurse Navigation Program in Orofacial Cleft Care
Authors: Wagner Connor S , Barrero Carlos E , Kumar Satvika L , Pontell Matthew E , Salinero Lauren K , Bartlett Scott P , Taylor Jesse A , Folsom Nancy , Swanson Jordan W
Published: March 2023

Objective

Characterize the interventions and assistance employed by a cleft nurse navigator (CNN) which have mediated improvement in care equity at our institution.

Design

Retrospective study.

Setting

Academic tertiary care center.

Patients, Participants

Patients presenting with cleft lip and/or cleft palate presenting between August 2020 and August 2021 with exclusions for syndromic diagnosis, Pierre-Robin sequence, late (> 6 months) presentation, and prior cleft surgery at outside institutions.

Interventions

Multidisciplinary cleft nurse navigator program

Main Outcome Measure(s)

Family interactions with the CNN by phone, text, and email across the first year of life including feeding support, nasoalveolar molding (NAM) assistance, appointment scheduling, financial assistance, addressing perioperative concerns, and facilitating physician consults. Patient weight and surgical timing were also recorded.

Results

Sixty-nine patients were included with a total of 639 interactions between the CNN and families. Scheduling support (30%), addressing perioperative concerns (22%), and feeding support (20%) were the most common interactions. Feeding support and NAM assistance were heavily distributed in the first 3 months of life compared to after 3 months ( P < .001). Median age at first contact was 1 week (range: 22 weeks gestation-14 weeks). There was no difference in the proportion of families receiving feeding support, NAM assistance, or scheduling assistance based on insurance status or race ( P > .05 for all).

Conclusions

Scheduling assistance, addressing perioperative concerns, and feeding support are the predominant methods by which the CNN interacts with and assists families of patients with cleft conditions. CNN service distribution is largely equitable between demographic groups.
Ureteral Metastasis of Colonic Adenocarcinoma with Enteroblastic Differentiation: A Rare Case to be Distinguished from Clear Cell Adenocarcinoma of the Urinary Tract
Authors: Minato Hiroshi , Yoshikawa Akane , Tsuyama Sho , Katayanagi Kazuyoshi , Hayashi Kengo , Sakimura Yusuke , Bando Hiroyuki , Hori Tomohiro , Kito Yosuke
Published: March 2023

Adenocarcinomas with enteroblastic differentiation are rare clear cell tumors that are positive for enteroblastic markers. Enteroblastic differentiation is particularly uncommon in colorectal adenocarcinomas. Herein, we report a case of clear cell adenocarcinoma with enteroblastic differentiation in the sigmoid colon of a 38-year-old Japanese woman that metastasized to the lower left ureter. After neoadjuvant chemotherapy, the patient underwent low anterior resection. The tumor consisted of tubular, cribriform, and focal micropapillary proliferation of clear cells immunopositive for spalt-like transcription factor 4 (SALL4), glypican 3, and alpha-fetoprotein. Six months after the colonic resection, a tumor was found in the left lower ureter, which was resected. The ureteral tumor revealed clear cell adenocarcinoma, which was identical to the colonic tumor proliferating in the ureteral mucosa. Metastatic ureteral tumors are rare. We performed a literature search and found only 50 reported cases of ureteral metastases from colorectal cancer. Of these, only 10 metastatic tumors were identified in the ureteral mucosa. No case of ureteral metastasis of clear cell colorectal adenocarcinoma or colorectal adenocarcinoma with enteroblastic differentiation has been reported. Hence, it can be challenging to distinguish them from clear cell adenocarcinoma of the urinary tract and/or clear cell urothelial carcinoma. This paper discussed the differential diagnosis of these tumors and reviewed the clinicopathological features of colorectal carcinomas metastasizing to the ureter.
Prescribing practices of oncology pharmacists working in ambulatory cancer centers in Alberta
Authors: Hynes Kyia , Folkman Frances , Dersch-Mills Deonne , Marin Helen , Ghosh Sunita , Chambers Carole
Published: March 2023

Objective

To describe and quantify independent prescribing of oncology pharmacists working in adult, ambulatory cancer centers in Alberta, Canada.

Methods

A retrospective chart review of oncology pharmacists prescribing in the electronic health record, ARIA® was conducted. Prescriptions from January 1, 2018 to June 30, 2018 were analyzed. Descriptive statistics were used to quantify prescription volume and class of medications prescribed. A cross-sectional analysis was then performed on a random sample to determine the type of prescription intervention and evaluate pharmacist documentation.

Results

Over 6 months, 3474 prescriptions were ordered by 33 clinically deployed pharmacists. The median number of medications prescribed was 7 per month (interquartile range: 1.50–27.00; Range: 0.17–79.5). When prescribing was standardized by pharmacist's time clinically deployed, the median was 21.67 (interquartile range: 5.00–79.67; range: 0.67–216.67) prescriptions per month per full-time equivalent. The most prescribed class of medication was antiemetic (24.1%). From a sample of 346 prescriptions, 172 (50%) were new medications initiated, 160 (46%) were the continuation of existing prescriptions and 14 (4%) were prescription dosage adjustments. Adherence to the specified documentation standards was 47%.

Conclusions

Oncology pharmacists utilize their independent prescribing to initiate and continue supportive care medications for cancer patients. The prescribing volume varied greatly among pharmacists. Opportunities exist to further engage pharmacist prescribing.
In search of a landing place for persons with disabilities: A critique of South Africa’s skills development programme
Authors: Botha Michele , Fischer Mogensen Karina , Ebrahim Adèle , Brand Dominique
Published: March 2023

South African legislation is viewed as progressive in relation to persons with disabilities. Policies addressing socio-economic inequality include a focus on promoting skills development and employment for persons with disabilities. A predominant instrument for providing post-school training and work opportunities to disadvantaged youth, including persons with disabilities, is learnership programmes funded through the Sector Education and Training Authorities (SETAs). Despite enabling policies and investment in learnerships, persons with disabilities comprise only 1.3% of the workforce, while an estimated 15% of the population are disabled. This situation opens up the skills development strategy, and supporting legislation, for some critical review. Using Critical Disability Studies as a lens, this paper offers three critiques concerning the operation of learnerships for disability inclusion in South Africa; (1) neglecting to align skills development and market needs holds persons with disabilities in a cycle of training and poverty; (2) focusing exclusively on providing hard skills fails to account for complex challenges faced by persons with disabilities; and (3) viewing skills development and inclusive employment as a charitable endeavour fails to achieve social justice. This paper argues that the planning and implementation of learnerships should respond to current debates concerning holistic approaches to inclusive development.
A study on dynamic stress of planetary gear transmission in non-inertial system
Authors: Wei Jing , Cao Miaofei , Zhang Aiqiang , Cheng Hao , Peng Bin
Published: March 2023

Considering the comprehensive effect of the internal non-inertial system of planetary gear transmission (PGT) and external non-inertial system of the body, combined with the modified Heywood formula and Hertz formula, a calculation model for the dynamic bending stress and contact dynamic stress of the PGT in a non-inertial system (NIS) is proposed. The stress non-inertial coefficients ( KNI) describing the influence of the additional effects on the dynamic stress in the non-inertial system are defined. Additionally, the variation law of non-inertial coefficients under two typical non-inertial conditions of variable-speed horizontal flight and somersault motion was studied. The effect of gear installation and manufacturing errors on the non-inertial coefficients under two maneuvering conditions was analyzed. The results indicated that non-inertial coefficients increase with an increase in the maneuverability of the body, and the variable-speed horizontal flight and somersault motion have significant effects on the changing trend of non-inertial coefficients with the gear installation and manufacturing errors. Compared with the gear error, the effect of the NIS has a significant influence on the non-inertial coefficients.
Asking for help without asking for help: How victims request and police offer assistance in cases of domestic violence when perpetrators are potentially co-present
Authors: Stokoe Elizabeth , Richardson Emma
Published: March 2023

Requesting police assistance can be especially challenging in cases of domestic violence, since perpetrators may be able to overhear victims’ telephone calls. This means that callers may not be able to make direct requests for help. Simultaneously, a routine task for police call-takers is to categorize incoming calls as genuine rather than, say, accidental or nuisance. We collected and transcribed 192 audio-recorded calls to a UK police service, which included interactions between callers and call-takers as well as between national operators and local call-takers. The latter provided access to the professional parties’ pre-transfer discussion and interpretation of what kind of trouble might be occurring in silent and otherwise ambiguous calls. Using conversation analysis, we found that, as well as unambiguous requests for help (e.g. ‘I need you to come because of assault by my partner’), callers formulated apparently inapposite turns (‘hiya, you all right?’) and used non-lexical resources (e.g. breaths) to build actions which also mobilized assistance. Professional call-takers’ discussions included domestic violence-implicative interpretations (e.g. ‘I heard a woman shout’). Parties collaboratively leveraged the affordances of turn design and sequence to request and offer help without revealing to potentially overhearing parties that callers were talking to the police. Our findings have implications for understanding how actions like requesting are accomplished in social interaction, as well as for training call-takers to recognize and act on communicative ambiguities in cases of domestic violence. Data are in British English.
Category relations and norms of feelings in children’s performances of a boyfriend-girlfriend culture
Authors: Andréasson Fredrik , Evaldsson Ann-Carita
Published: March 2023

This study explores how preteen children in everyday interaction mobilize relationship categories to negotiate what counts as appropriate romantic feelings among peers. The analysis draws on ethnomethodological work on membership categorization and conversation analysis, integrated with ethnographic knowledge of children’s social life. Particular attention is on how children make claims of and resist membership in a particular relationship category (that of boyfriend-girlfriend). The sequential analysis shows how category-based claims of ‘liking someone’ and ‘being together,’ indexing a boyfriend-girlfriend relationship, are responded to with resistance and denials. Categorical claims are also turned into public performances of relational pairing invoking the normative character of romantic matchmaking. The findings suggest that norms of feelings play a central role in preteen children’s emotional behavior, and serve as important cultural resources for children to address their emergent concerns regarding peer group relationships.
A qualitative study of the sources of chronic obstructive pulmonary disease-related emotional distress
Authors: Zanolari Diana , Händler-Schuster Daniela , Clarenbach Christian , Schmid-Mohler Gabriela
Published: March 2023

Objective

The aim of this study is to identify the sources of illness-related emotional distress from the perspective of individuals living with mild to severe chronic obstructive pulmonary disease (COPD).

Methods

A qualitative study design with purposive sampling was applied at a Swiss University Hospital. Eleven interviews were conducted with individuals who suffered from COPD. To analyze data, framework analysis was used, guided by the recently presented model of illness-related emotional distress.

Results

Six main sources for COPD-related emotional distress were identified: physical symptoms, treatment, restricted mobility, restricted social participation, unpredictability of disease course and COPD as stigmatizing disease. Additionally, life events, multimorbidity and living situation were found to be sources of non-COPD-related distress. Negative emotions ranged from anger, sadness, and frustration to desperation giving rise to the desire to die. Although most patients experience emotional distress regardless of the severity of COPD, the sources of distress appear to have an individual manifestation.

Discussion

There is a need for a careful assessment of emotional distress among patients with COPD at all stages of the disease to provide patient-tailored interventions.
Intravascular Lithotripsy and Drug-Coated Balloon Angioplasty for Severely Calcified Common Femoral Artery Atherosclerotic Disease
Authors: Stavroulakis Konstantinos , Torsello Giovanni , Chlouverakis Gregory , Bisdas Theodosios , Damerau Sarah , Tsilimparis Nikolaos , Argyriou Angeliki
Published: March 2023

Objectives:

Intravascular lithotripsy (IVL) followed by drug-coated balloon (DCB) angioplasty might be a valuable alternative to surgery for calcified common femoral artery (CFA) atherosclerotic disease. Nonetheless, the 12 months performance of this treatment strategy remains unknown. This study reports on the 12 months outcomes of IVL with adjunctive DCB angioplasty for calcified CFA lesions.

Methods:

This is a retrospective single-center, single-arm study. Consecutive patients treated by IVL and DCB for calcified CFA disease between February 2017 and September 2020 were evaluated. The primary measure outcome of this analysis was primary patency. Procedural technical success (<30% stenosis), freedom from target lesion revascularization (TLR), secondary patency, and overall mortality were additionally analyzed.

Results:

Thirty-three (n=33) patients were included in this study. The majority presented with lifestyle limiting claudication (n=20, 61%), 52% (n=17) of the patients had chronic kidney disease (CKD) and 33% (n=11) had diabetes. The procedural technical success was 97% (n=32). A flow-limiting dissection post IVL was observed in 2 patients (6%) and a peripheral embolization in a single patient (3%), while the bail-out stenting rate amounted to 12% (n=4). No perforation was observed. The median length of hospital stay was 2 days (interquartile range 2–3). At 12 months, the primary patency was 72%. The freedom from TLR and the secondary patency rates were 94% and 88%, respectively. The 12-month survival amounted to 100% and 75% (n=25) of the patients were asymptomatic or presented with mild claudication. The presence of chronic limb-threatening ischemia (CLTI) (hazard ratio [HR], 0.92; confidence interval (CI); 0.18–4.8, p=0.7) or CKD (HR, 1.30; 95% CI, 0.29–5.8; p=0.72), as well as the use of a 7 mm IVL catheter (HR, 0.59; 95% CI, 0.13–2.63; p=0.49) or of high-dose DCB (HR, 0.68; 95% CI, 0.13–3.53; p=0.65) did not influence the primary patency.

Conclusions:

In this study, the combination of IVL and DCB angioplasty for calcified CFA disease was associated with low risk for periprocedural complications, acceptable 12 months clinical outcomes, and low rates of reinterventions.

Clinical Impact

Intravascular lithotripsy in combination with DCB angioplasty can be an alternative to surgery in highly selected patients with CFA atherosclerotic disease. In this Cohort the combination therapy lead to acceptable clinical results and low reintervention rates at 12 months.
Antihypertensive Effect of Kolaviron, a Bioflavonoid From Garcinia kola, in L-NAME Induced Hypertension in Rats
Authors: Olatoye Francis J. , Akindele Abidemi James , Balogun Okikioluwa E. , Awodele Olufunsho , Adejare Abdullahi A.
Published: March 2023

The antihypertensive effect of Kolaviron (KV) has been demonstrated in ethanol- and sucrose-model of hypertension in our previous studies. However, there remains a need to further confirm and validate this effect in other models of hypertension. This study was devised to appraise the antihypertensive action of KV in N(G)-nitro-L-arginine methyl ester (L-NAME) induced experimental format of hypertension. Thirty-six (36) male Wistar rats were divided into 6 groups of 6 animals each. Group I represents the control group while Group II animals received L-NAME 40 mg/kg only. Groups III to V animals received L-NAME 40 mg/kg and 50, 100, and 200 mg/kg KV, respectively. Group VI animals received L-NAME 40 mg/kg and 0.14 mg/kg Lisinopril (LIS). Treatment was done orally for 28 days after which blood pressure was determined via the invasive method. After this, vital organs and blood were retrieved for analysis. KV and LIS elicited significant contraction ( P < .01-.001) in blood pressure producing up to 27%, 24%, and 22% reduction in systolic blood pressure, diastolic blood pressure, and mean arterial pressure, respectively. In addition, KV elicited a notable rise ( P < .05-.001) in catalase, reduced glutathione, and superoxide dismutase in the blood and vital organs. Results from this study further demonstrate and confirm that KV possesses notable blood pressure-lowering effect possibly through its well-documented antioxidant effect. Additional studies are advocated to validate the results from this study and determine the precise mechanism for the antihypertensive action of KV.
The Essential Oils of Rubber Rabbitbrush (Ericameria nauseosa) from North-Central Utah and Southwestern Idaho
Authors: Stirling Jacob , Platt Benjamin G. , Satyal Prabodh , Swor Kathy , Setzer William N.
Published: March 2023

Background: Rabbitbrush ( Ericameria nauseosa) is a conspicuous member of plant communities in the deserts of western North America. The plant is an important winter forage for several ungulates in the region and has been used in Native American ethnopharmacology. Methods: Several specimens were collected from North Central Utah (8 samples) and Southwestern Idaho (6 samples). The essential oils were obtained by hydrodistillation and analyzed by gas chromatographic techniques. The data were analyzed using agglomerative hierarchical cluster analysis (HCA), principal component analysis (PCA), and Pearson correlation analysis. Results: Essential oil yields ranged from 0.030% to 2.011%. The major components in the essential oils were β-phellandrene (1.8%-56.5%), β-pinene (0.%3-23.3%), limonene (0.7%-22.3%), and ( Z)-β-ocimene (0.0%-29.3%). With the exception of 1 sample from Utah, the essential oils showed greater than 50% similarity in composition. There were significant differences in percentages of some components, however. Sabinene, β-phellandrene, cosmene, 1,3,8- p-menthatriene, terpinen-4-ol, and β-eudesmol concentrations were higher in the Idaho samples while myrcene, limonene, geranyl acetate, ( E)-β-caryophyllene, γ-curcumene, germacrene D, α-muurolene, γ-cadinene, and δ-cadinene concentrations were significantly higher in the Utah samples. Chiral gas chromatography–mass spectrometry showed the chiral monoterpenoids to be dominated by the (−)-enantiomers, but there were some differences in enantiomeric distribution in the essential oils from Utah compared to those from Idaho. Conclusion: The essential oil compositions in this work are qualitatively similar to those reported previously. However, there were quantitative differences in chemical composition and enantiomeric distributions between the Utah samples and the Idaho samples. Additional research is needed to compare essential oil composition from other geographical locations in western North America.
Pure spinal intraosseous arteriovenous fistula: A case report
Authors: Ito Koki , Ryu Bikei , Shima Shogo , Mochizuki Tatsuki , Sato Shinsuke , Inoue Tatsuya , Niimi Yasunari
Published: March 2023

Spinal osseous arteriovenous fistula (AVF) is a rare disease with a characteristic angioarchitecture involving an intraosseous venous pouch (VP) of the vertebral body where the feeders are converging. Using spinal angiography alone, it is difficult to distinguish spinal osseous AVF from classical spinal epidural AVF (EDAVF) with fistulas in the epidural VP and bone erosion because both subtypes have an angiographically similar dilated VP appearance. Thus, spinal osseous AVF may be often misdiagnosed as spinal EDAVF. With advancing imaging techniques, it would be possible to determine the exact location of the fistula. Here, we present the case of a 37-year-old woman with a pure spinal thoracic osseous AVF and radiculopathy. She was diagnosed with spinal intraosseous AVF using high-resolution three-dimensional rotational angiography (3D-RA). The fistula was located in the Th1 lateral mass with a VP where multiple osseous feeders were converging. There was paravertebral venous drainage without intradural venous drainage. Transvenous embolization with Onyx and coils was performed through the azygos vein to the lateral epidural venous plexus, resulting in complete obliteration. This case suggests that 3D-RA reconstructed images are essential for accurate diagnosis and successful treatment of this condition. It is important to occlude only intraosseous VPs by accurate subtype diagnosis. Transvenous embolization is a treatment option for spinal intraosseous AVF with paravertebral epidural venous drainage.
The intervention of oligarchy in the Indonesian legislative process
Authors: Tambunan Derwin
Published: March 2023

Contemporary scholarship suggests that in post-Soeharto Indonesia, politics have become more democratic, replacing a brutal military dictatorship with considerable autocratic governance that appears to value a democratic governance system. However, exactly why there has not been an actual change in democratic policy-making in the parliament remains poorly understood. Contemporary scholarship asserts that the Indonesian policy-making process is characterized by ‘empty ritual’ instead of a genuine political process, due to the oligarchic nature of Indonesian politics. Nonetheless, there are few explanations of how or to what extent oligarchy dictates the policy-making process at the legislative level; instead, we are left with an unclear picture of the current political process of policy-making in the parliament. This study aims to fill this gap and investigate how oligarchy has used cartel-like strategies to overcome the legislative process in the parliament. A literature review and analysis of secondary data sources were employed to answer these questions. The findings show that the persistence of oligarchic cartels is evident in the legislative process of the Election Act 7/2017. This suggests that Indonesian oligarchs have hijacked the parliament's democratic policy-making process, finding ways to achieve consensus in passing bills and thereby evading complex disputes to dictate policy to their economic and political benefit.
Multisensory Music Performance with Cymatic Images
Authors: Ritchie Laura
Published: March 2023

Jill Jarman completed the musical composition Resonance for solo cello in 2022 with the intention that it would be heard, seen, and felt as a multisensory experience. The cellist Laura Ritchie produced cymatic images for each of the musical pitches in the work, compiled them in a video, and rehearsed to be able to perform the first live synchronized multisensory performance with integrated mathematically accurate cymatic images. The cymatic images were generated using a tonescope emulator in the Cymatic Frequency Emulator software package. Images were compiled and arranged on screen in time and space to create a visual representation of the musical sounds. The resulting video accompanied live performances to enable the audience to have a full experience of the musical notes in physical, visual, and aural forms. Challenges of production and opportunities for future applications of this research are discussed.
Arterial Switch Operation in Patients With Single Sinus Coronary Artery Anatomy: Risk Factors for Mortality From a Lower-Middle Income Country
Authors: Ly Thinh Truong Nguyen , Nguyen Tuan Mai , Mai Dinh Duyen , Tran Quang Vinh , Doan Vuong Anh
Published: March 2023

Background: This study evaluates mortality and intermediate outcomes of the arterial switch operation (ASO) for transposition or Taussig-Bing anomaly with single sinus coronary artery (CA) anatomy in a high-volume cardiac program in Vietnam. Methods: We retrospectively reviewed and performed risk factor analysis pertaining to 41 consecutive patients who presented with single sinus CA anatomy and who underwent ASO from January 2010 to December 2016 in our center. Results: The median age at operation was 43 days [interquartile range (IQR): 20-65] and the median weight was 3.6 kg (IQR: 3.4-4.0). Four in-hospital deaths (9.8%), of which one was related to coronary insufficiency. There were no late deaths, with a median follow-up time of 7.2 years. Survival for all patients with single sinus CA was 90.2% at 1 year and remained constant at 5 years and 10 years after ASO. The presence of a coexisting aortic arch anomaly was the only risk factor for overall mortality identified in this study (hazard ratio: 8.66, P  =  .031, 95% confidence interval: 1.21-61.92). There were three cardiac reoperations. Freedom from reintervention after ASO for patients with single sinus CA at 1 year, 5 years, and 10 years were 97.3%, 91.9%, and 91.9%, respectively. Interestingly, among all patients undergoing ASO during this time period (n  =  304), single-sinus CA anatomy was not a risk factor for overall death ( P  =  .758). Conclusions: In a high-volume cardiac program in a lower middle-income country like Vietnam, ASO can be safely performed with single sinus CA anatomy, irrespective of the presenting coronary anatomy.
Interventricular Septal Hematoma Complicating Ventricular Assist Device Placement in an Infant: Case Report and Review of the Literature
Authors: Mongé Michael C , Kalb Elizabeth , Ramlogan Sandhya , Joong Anna
Published: March 2023

Interventricular septal hematoma is a rare and life-threatening complication of pediatric cardiac surgery. Commonly seen following ventricular septal defect repair, it has also been associated with ventricular assist device (VAD) placement. Although conservative management is usually successful, operative drainage of interventricular septal hematoma occurring in pediatric patients undergoing VAD implantation should be considered.
Complexing Governance Styles: Connecting Politics and Policy in Governance Theories
Authors: Filgueiras Fernando , Palotti Pedro , Testa Graziella G.
Published: March 2023

Governance theories consider policy steering as modes sustained in hierarchies, markets, and networks. If governance depoliticizes public management structures, then populism and technocratic forms’ emergence in politics is a threat to public governance. This article analyzes governance styles, showing how a reconciliation between the dimensions of policy and politics is necessary to think about policy steering’s complexity and its ensuing paths. We develop a typology of governance styles to address policy and political dynamics. This typology shows how different governance styles combine pluralist, populist, and technocratic elements, along with hierarchies, markets, and networks. We illustrate our typology with different policies conceived in distinct political regimes in Brazil. We argue that governance theories must incorporate a perspective of political conflict, path dependence, and contingency. This perspective on political conflict is essential for understanding governance reforms and how they shape public management practices.
Impact of China’s Local Government Competition and Environmental Regulation on Total Factor Productivity
Authors: Qin Lingui , Liu Songqi , Zhan Cuijing , Duan Xiaofang , Li Shuaishuai , Hou Yao
Published: March 2023

In the transition of China’s economy toward high-quality development, it will be increasingly important to coordinate the relationship between local government competition, environmental regulation, and the transformation of the economic growth mode. To explore the impact of local government competition and environmental regulation on total factor productivity (TFP), in this study empirical analysis models were established using panel data of 30 provinces in China from 2001 to 2017. Local government competition was measured from the perspectives of foreign direct investment (FDI), fiscal expenditure, and tax. The results show that local government competition has a positive impact on the improvement in TFP. Taking environmental regulation into consideration, the impact of local government competition on TFP is weakened. Furthermore, under the current intensity of environmental regulation, local government fiscal expenditure competition and tax competition both lead to improvement in TFP, while FDI competition has the opposite effect. This paper explores the heterogeneity of the impact of local government competition and environmental regulation on TFP under different local government competition levels. Under the influence of environmental regulations, local government FDI competition has a negative impact on the improvement in TFP, particularly in “low” FDI competition areas. Local government fiscal expenditure competition has a positive impact on the improvement in TFP, particularly in “low” fiscal expenditure competition areas. The current level of local government tax competition has a negative impact on the improvement in TFP in “high” tax competition areas, whereas it has a positive impact on the improvement in TFP in “low” tax competition areas.
Preoperative Serum Albumin Level Predicts Length of Stay and Perioperative Adverse Events Following Vertebral Corpectomy and Posterior Stabilization for Metastatic Spine Disease
Authors: Hirase Takashi , Taghlabi Khaled M. , Cruz-Garza Jesus G. , Faraji Amir H. , Marco Rex A. W. , Saifi Comron
Published: March 2023

Study Design

Retrospective review of a prospectively collected national database

Objectives

To determine the association between preoperative serum albumin levels and perioperative adverse events (AEs) following vertebral corpectomy and posterior stabilization for metastatic spine disease.

Methods

The 2010 to 2019 American College of Surgeons’ National Surgical Quality Improvement (ACS-NSQIP) database was used to identify all patients undergoing vertebral corpectomy and posterior stabilization for metastatic spine disease. Receiver operative characteristic (ROC) curve analysis was used to determine preoperative serum albumin cut-off values for predicting perioperative AEs. Low preoperative serum albumin was defined as serum albumin below this cut-off value.

Results

A total of 301 patients were included in the study. ROC curve analysis demonstrated serum albumin < 3.25 g/dL as a cut-off value for predicting perioperative AEs. The low serum albumin group had a higher overall perioperative AEs ( P = .041), longer post-operative LOS ( P < .001), higher 30-day reoperation rate ( P = .014), and a higher in-hospital mortality rate ( P = .046). Multivariate analysis demonstrated that low preoperative serum albumin was associated with higher perioperative AEs.

Conclusions

Low serum albumin level is associated with higher perioperative AEs, longer postoperative LOS, and higher rates of 30-day reoperation and in-hospital mortality among patients undergoing vertebral corpectomy and posterior stabilization for metastatic spine disease. Strategies to improve preoperative nutritional status in patients undergoing this procedure may improve these perioperative outcome measures within this surgical population.

Level of Evidence

III