bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimizing Monotone Chance-Constrained Submodular Functions Using Evolutionary Multiobjective Algorithms
Authors: Neumann Aneta , Neumann Frank
Published: September 2024

Many real-world optimization problems can be stated in terms of submodular functions. Furthermore, these real-world problems often involve uncertainties which may lead to the violation of given constraints. A lot of evolutionary multiobjective algorithms following the Pareto optimization approach have recently been analyzed and applied to submodular problems with different types of constraints. We present a first runtime analysis of evolutionary multiobjective algorithms based on Pareto optimization for chance-constrained submodular functions. Here the constraint involves stochastic components and the constraint can only be violated with a small probability of α. We investigate the classical GSEMO algorithm for two different bi-objective formulations using tail bounds to determine the feasibility of solutions. We show that the algorithm GSEMO obtains the same worst case performance guarantees for monotone submodular functions as recently analyzed greedy algorithms for the case of uniform IID weights and uniformly distributed weights with the same dispersion when using the appropriate bi-objective formulation. As part of our investigations, we also point out situations where the use of tail bounds in the first bi-objective formulation can prevent GSEMO from obtaining good solutions in the case of uniformly distributed weights with the same dispersion if the objective function is submodular but non-monotone due to a single element impacting monotonicity. Furthermore, we investigate the behavior of the evolutionary multiobjective algorithms GSEMO, NSGA-II, and SPEA2 on different submodular chance-constrained network problems. Our experimental results show that the use of evolutionary multiobjective algorithms leads to significant performance improvements compared to state-of-the-art greedy algorithms for submodular optimization.
Sculpture Is a Verb: Remembering Richard
Authors: Krauss Rosalind E.
Published: September 2024

Rosalind Krauss analyzes aspects of Richard Serra's oeuvre, and Clement Greenberg's opposition to it, by way of a discussion of several of his sculptures, particularly One Ton Prop (House of Cards), as well as Verb List, locating the essence of Serra's work in that of the medium of sculpture itself: contrapposto.

The article begins: “My flight from the house of Greenberg (Judd called us “Greenbergers”) began with Richard Serra: In conversation, Clem would dismiss him outright.

“I think this derived from his indignant reading of One Ton Prop: House of Cards, with its four lead plates abutted corner-to-corner, indeed like a “house of cards.” My guess is that Clem made a snap judgment from this almost-cube that Serra was a Minimalist—an aesthetic neighbor of Flavin and Judd. But from the first, starting with my encounter with One Ton Prop at the Whitney's Anti-Illusion exhibition in 1969, I have seen Serra's work as being adamantly opposed to Minimalism and exploring, instead, sculpture's “aesthetic support.” All mediums derive their logic from such a core postulate. We could say that poetry's is metaphor; ceramics' is symmetry (as the two hands shape the wet clay on the pottery wheel); and sculpture's is most emphatically that of contrapposto: the bilateral articulation of the human form in terms of weight and support.”

“Contrapposto: art-history speak for counterpoise—the necessary balance for the upright human posture. Freud tells a simple evolutionary story in Civilization and Its Discontents, the dénouement of which is the moment mankind stood up—left the ground behind and rose above it on his two legs. This moment engineered a momentous realignment of man's perceptual organs, he reasoned. Nose and teeth and jaws receded before the supremacy of eyes and ears, the animality of pawing and sniffing being replaced by the visual, giving way, instead, to beauty and detachment. Thus the mental space in the armor of humanity expanded. Detachment in turn opened onto newly established cognitive zones: reflection, logic, memory.

“Perceptual distance opened a space within which memory developed and with it the grasp of history—of the moment of realization that one has left the ground. The brevity of that moment contracts it into a timeless purity, and the purity of this snap of the fingers makes it abstract.”
Strategic Ambivalence
Authors: Tolson Hannah
Published: September 2024

Contributing to scholarship on gender in Evangelical Christianity, this article focuses on the notion of male headship. With existing literature concerned with male headship within the marital sphere, this study also investigates beliefs about male headship in church settings, and the interconnections between these two topics. Interviews with ten British, Evangelical women were conducted on male headship, gender roles, and gender discrimination in church. This study found that participants generally affirmed male headship within the marital and familial sphere, showing ambivalence towards male headship in the church. This ambivalence helps participants stay in churches which bar women from church governing roles, despite participants expressing support for women in church leadership.
Nomos Empsychos: towards a Historiography of the Greek Living Law Idea
Authors: Tussay Ákos
Published: September 2024

In the Middle Ages, the idea of legislative sovereignty was expressed with reference to a host of commonplace arguments, such as pater legis, Sol Iustitiae, or lex animata. And many believe that it was the Roman legal concept of animate law which eventually laid the foundation for the elaboration of the idea of absolute power in the late Middle Ages. If this hypothesis is correct, the philosophic background of some late medieval and early modern absolutistic doctrines of political government could be sought after as early as the classical Greek descriptions of a king who is nomos empsychos, that is, a living law. In this article, I intend to consider this intellectual tradition, and raise some doubts about the merits of the above claim, arguing instead for a separate consideration of the individual sources of the nomos empsychos concept. As such, I am tracing the genealogy of the expression to the fifth-century Pythagorean, Archytas of Tarentum, and I am demonstrating that originally the nomos empsychos was inseparably associated with an intrinsically Archytean tradition.
Retrieval of Boundary Layer Precipitable Water from GOES ABI Using Machine Learning Techniques
Authors: Lee Yoonjin , Hilburn Kyle , Bansal Akansha Singh
Published: September 2024

Low-level moisture is an important ingredient for forecasting severe storms, especially over the Great Plains where severe storms often develop along the dryline. Although ground-based observation systems such as lidar or radiosondes on weather balloons provide accurate information on low-level moisture, data are provided at limited locations, and the low temporal resolution of radiosondes makes it difficult to track a rapidly developing dryline. Geostationary satellites provide high spatial and temporal observation, but the channels of current geostationary satellites are mostly sensitive to water vapor at mid- to upper levels. However, the split window difference (SWD) between the “clean” window channel (10.3 μm) and the “dirty” window channel (12.3 μm) is commonly used for estimating low-level water vapor. However, this estimation is complicated by surface temperature contributions, dependence on the lapse rate, and nonlinear relationships between SWD and moisture. This study applies machine learning techniques to infer boundary layer precipitable water (BLPW) from Geostationary Operational Environmental Satellite (GOES) Advanced Baseline Imager (ABI) data. Since there are few observations that cover wide regions for training convolutional neural networks, especially for the atmosphere above the surface, High-Resolution Rapid Refresh (HRRR) model outputs are used as the truth for training. Statistical results show that using ABI channel 13, 14, and 15 brightness temperatures, skin temperature, solar zenith angle, and GOES total precipitable water product as additional inputs shows the lowest mean-square error (MSE). Case study results show that the model developed in this study is good at capturing strong moisture gradients and depicting a dryline.

Significance Statement

Knowledge of low-level moisture is important for monitoring drylines and moisture convergence preceding convective initiation. Traditional observations lack the spatial resolution, spatial coverage, or temporal update frequency needed by forecasters. The latest generation of Geostationary Operational Environmental Satellite (GOES), the GOES-R series, provides high spatial resolution and rapid temporal updates. However, the estimation of low-level moisture using the Advanced Baseline Imager (ABI) is complicated by dependencies on other variables and nonlinear relationships. Machine learning is shown to provide good estimates of low-level moisture from ABI observations. This application of machine learning to GOES-R can improve the ability to monitor low-level moisture and forecast convective initiation.
Is Affirmative Consent the Answer? Yes, Sort of, Maybe
Authors: McCormack Sorcha , Herring Jonathan
Published: September 2024

Recently, there have been some powerful calls in the media for the law to adopt an affirmative consent model in relation to the law on rape. This article explores this proposal. It argues that while there is much that is attractive about the concept of affirmative consent, it needs considerable unpacking and explanation before it can be accepted. Indeed, if adopted at a simplistic level, it carries considerable dangers. The article presents six ambiguities around what is meant by affirmative consent but concludes with a proposal as to what an appropriate nuanced model of could look like.
Songwriting Workgroups: Leveraging the Power of Collaboration in the Music Classroom
Authors: Randles Clint
Published: September 2024

Songwriting pedagogy is in its infancy in music education. This article presents a new way to think about pedagogy that utilizes student workgroups that more closely align with the ways songs are written in the real world. Implications for music education’s connections to the world of contemporary commercial music are provided.
An effective CNN-MHSA method for the fault diagnosis of ZPW-2000A track circuit
Authors: Ke Ting , Zhang Yajiang , Hu Qizheng , Zhang Chuanlei
Published: September 2024

The mainstream methods for fault diagnosis of ZPW-2000A track circuits are overly complex in extracting features from sequence data, and their feature extraction capability is relatively limited, thus impacting the performance of fault diagnosis. To address this issue, we propose a fault diagnosis model for track circuits, named as convolutional neural network incorporating multi-head self-attention mechanism (CNN-MHSA). On one hand, the local features of sequence data are locally sensed and extracted by the convolutional layer; on the other hand, the global features of sequence data are captured by establishing long-distance dependency relationships through the multi-head self-attention layer. The dual extraction of local and global features enables accurate diagnosis of faults. Finally, we collect 27 fault modes and 2 normal operation modes in the simulation system and conduct a large number of numerical experiments. The experimental results show that the fault diagnosis accuracy of the CNN-MHSA model in this paper can reach 97.45%, which is an improvement of 0.64%, 0.44%, 0.44%, 0.44%, 0.33%, 0.22%, and 0.11% compared with models such as Decision Tree, Random Forest, CatBoost, long short-term memory (LSTM), convolutional neural network (CNN), and CNN-LSTM. It also has obvious advantages in evaluation metrics such as precision, recall, Macro-F1, and Micro-F1, as well as other evaluation metrics. Therefore, the model significantly improves the comprehensive performance of ZPW-2000A track circuit fault diagnosis and can be used as a more effective fault diagnosis method.
Dyadic Isolation in Social Interactions: The Role of Depressive Symptoms
Authors: Hoffman Marion , Stadtfeld Christoph , Elmer Timon
Published: September 2024

Dyadic isolation is the tendency of some individuals to be involved in pairwise interactions rather than in larger group interactions. This article investigates the interpersonal processes associated with the dyadic isolation of individuals with depressive symptoms. We hypothesize that such individuals tend to initiate more and stay longer in dyadic interactions compared to group interactions (dyadic preference hypothesis) and that individuals—irrespective of their own level of depressive symptoms—tend to join and stay longer in interactions when interaction partners have lower levels of depressive symptoms (depression avoidance hypothesis). We analyze two data sets (N = 123) of face-to-face interaction events (N = 86,915) collected with proximity badges at a social event. Hypotheses are tested using a relational event model (DyNAM-i) specifically tailored for modeling group interactions. In line with the dyadic preference hypotheses, individuals with higher levels of depressive symptoms are found to be more likely to join and stay in dyadic interactions. Post hoc analyses reveal that this result only applies to female participants. We find limited support for the depression avoidance hypotheses.
Migration and Education in the Global South: A Study of South American Origin Children in the Argentinean Educational System
Authors: Zuccotti Carolina V.
Published: September 2024

The question of how the children of migrants compare to natives in destination countries has long occupied the research agenda of migration and integration scholars. But, while there are many studies that have explored this issue in the Global North, with special attention to South–North migrants, little is known about integration patterns of South–South migrants, that is, Southern migrants and their children residing in the Global South. This article addresses this concern by studying one of the key indicators of migrant integration—the educational achievement of the children of migrants—in one of the most popular migration corridors in the Global South—that of South Americans who emigrated to Argentina. Using census microdata from 2010, the article explores the educational attainment and educational reproduction of Bolivian-, Paraguayan-, Peruvian-, and Chilean-origin children in comparison with that of their native Argentine counterparts. The analysis distinguishes between 1.5 and second-generation children and focuses on young people between 6 and 21 years old who live with at least one parent. Two dimensions of educational attainment are explored: school attendance and educational level. The results show that the role of parental education tends to be weaker among migrant-origin groups. This has implications for the educational gap. In general, migrant-origin groups are advantaged over native Argentines among those with low-educated parents. Conversely, they present no differences or are disadvantaged among those with middle–high educated parents. This is observed for both 1.5 and second generations, with variations based on the outcome and national origin. Possible explanations are offered.
Differential and resonant solidarities: A materialist approach to the early career experience
Authors: Leicht Caroline V , Bengtsson Meuller Elsa , Borowetz Taylor , Hiraide Lydia Ayame , Pruszynski Katie
Published: September 2024

Navigating academia as early career academics (ECAs) is increasingly challenging, with many facing structural inequities, the rise of precarious work, and the increased marketisation of higher education in the United Kingdom and beyond. The purpose of this article is to provide a platform for learnings and insights gleaned from our experiences as five ECAs who worked together to lead the ‘early career network’ for a learned association between 2021 and 2023. In the article, we explore some of the challenges, opportunities, and call for actions that come out of our own encounters with the neoliberal higher education landscape as both students and workers in the social sciences. We propose a dual conceptualisation of solidarity as both resonant and differential, and mobilise this theoretical contribution to reflect on themes of community, materiality, care, knowledge, and labour as key strands which shape the interface between ECAs and complex higher education ecologies. Theoretically and practically, we aim to facilitate solidarity in early career communities, mobilising ‘ECA’ as more than a purely temporal category. Finally, we make recommendations to colleagues across the discipline for forging and nourishing collaborative, healthy, and inclusive environments in which ECAs can thrive.
The Elusive Borders of Regional Feeling: Re-Imagining the Federalist Map in Early West Germany
Authors: DeWaal Jeremy
Published: September 2024

While a rich body of work on nations and national borderlands has demonstrated how the ideal of the nation state resulted in ever greater (and often violent) demands for geographic fixity, this article shows how territorial visions of regional communities permitted a tremendous level of flexibility and were able to hold highly divergent geographic imaginings in suspension. The article seeks to demonstrate this by looking at a unique moment in post-war West German history when spatial planers, parliamentary committees, regionalists and an army of experts sought to determine the boundaries of regional belonging in preparation for a planned redrawing of the West German federal map. Many believed that a viable federalist democracy required stronger federal states rooted in a sense of regional community. The states created by the Allies were initially seen as temporary, and Article 29 of the new constitution required that states be redrawn by considering boundaries of regional belonging. The intense efforts of experts, politicians, and regionalists, however, ultimately failed and revealed widely diverging ideas about which territories corresponded to a common sense of regional community. Conflicting historic state borders, the historic force of physical geographies, confession, orientation to urban centres, a profusion of dialect borders, and regional cultural practices all shaped geographic visions of region, but simultaneously underpinned widely-variant cognitive maps. While the failure to redraw the West German map resulted in this episode of history largely being forgotten, I argue that it speaks volumes about how forms of community beyond and beneath the nation state have been imagined in territorial space.
Aligning police practice with hate crime theory: The case for using risk assessments to improve police response to victims of hate
Authors: Trickett Loretta , Bryan Timothy
Published: September 2024

In England and Wales, police forces have been urged to improve their response to victims. Despite this, many victims continue not to report to police, and those that do often report distrust and dissatisfaction with police response. Across the hate crime strands, victims have little confidence in the capacity of police to act empathetically, to respond to hate crime effectively, or to take hate crime victimisation seriously. In this paper, we argue that risk assessments (RAs) represent a useful tool to bridge the gap between the reality of hate crime victimisation and current practice. We suggest that RAs – tools designed to assess a victim’s risk of potential future victimisation – can not only help the police to implement safeguarding but also provide a fuller understanding of the impact and harms of hate crime, so that police have a more holistic perspective. The use of RA may ensure that victim perspectives remain at the centre of police response.
Clinical practice guideline for the prevention and management of peritoneal dialysis associated infections in children: 2024 update
Authors: Warady Bradley A , Same Rebecca , Borzych-Duzalka Dagmara , Neu Alicia M , El Mikati Ibrahim , Mustafa Reem A , Begin Brandy , Nourse Peter , Bakkaloglu Sevcan A , Chadha Vimal , Cano Francisco , Yap Hui Kim , Shen Qian , Newland Jason , Verrina Enrico , Wirtz Ann L , Smith Valerie , Schaefer Franz
Published: September 2024

Infection-related complications remain the most significant cause for morbidity and technique failure in infants, children and adolescents who receive maintenance peritoneal dialysis (PD). The 2024 update of the Clinical Practice Guideline for the Prevention and Management of Peritoneal Dialysis Associated Infection in Children builds upon previous such guidelines published in 2000 and 2012 and provides comprehensive treatment guidance as recommended by an international group of pediatric PD experts based upon a review of published literature and pediatric PD registry data. The workgroup prioritized updating key clinical issues contained in the 2012 guidelines, in addition to addressing additional questions developed using the PICO format. A variety of new guideline statements, highlighted by those pertaining to antibiotic therapy of peritonitis as a result of the evolution of antibiotic susceptibilities, antibiotic stewardship and clinical registry data, as well as new clinical benchmarks, are included. Recommendations for future research designed to fill important knowledge gaps are also provided.
A new periodic shaft model for broadband ultra-low-frequency vibration reduction in spinning shafts
Authors: Hajhosseini Mohammad
Published: September 2024

Vibration isolation is found in periodic structures having a special feature known as vibration band gap. A periodic shaft model is proposed and analyzed in this study. This model is composed of a spinning solid shaft carrying periodic arrays of outer cantilever hollow shafts. The generalized differential quadrature rule (GDQR) method combined with the Bloch theorem is used to calculate the vibration band gaps of this periodic shaft. Results are verified by the forced vibration responses obtained using the GDQR method. Results indicate that for each length of the hollow shafts, there is a spinning velocity range for which the first band gap starts from zero frequency. In other words, each model of this periodic shaft can be used for vibration reduction over an ultra-low-frequency band gap at different spinning velocities. Results also indicate that there is a model with specific value of the hollow shafts length for which the second band gap is very close to the first band. For this model, the width of the ultra-low-frequency band gap is much greater than other models. Finally, verification of the GDQR method shows that it can be used as a precise numerical method for free and forced vibration analysis of the spinning shafts.
Reconstructive Surgery for Deep Venous Reflux: A Report on 144 Cases
Authors: Perrin M.
Published: September 2024

This retrospective study was conducted on 144 lower extremities (133 patients) with deep venous reflux treated with surgery to restore venous valvular function. Clinically, 51% of patients were in class C5–C6, and based on etiology, patients were equally divided into primary and secondary venous disease. Four surgical procedures were used: valvuloplasty ( n = 85), transposition ( n = 18), transplantation ( n = 32), or Psathakis' technique II ( n = 9). The procedure chosen was determined mainly by the feasibility of the technique in the above-mentioned preferred order. Thus, 76% of valvuloplasties were performed for primary venous insufficiency. A postoperative venography routinely performed soon after surgery demonstrated a large number of segmental thromboses (20.3%). Their number was statistically different in primary and secondary (PTS) venous disease, respectively 8.8 vs 32.3%. Clinical and hemodynamic results were evaluated (duration of follow-up: 12–168 months) based on etiology and type of procedure. A correlation was established between clinical result (venous ulcer) and efficacy of valvular reconstruction. The latter was satisfactory in valvuloplasties ( P = 0.005) but not in venous transfer ( P = 0.35). Overall results were better for primary venous insufficiency than in postthrombotic syndromes ( P = 0.03).
An Unusual Cause of Femoral Embolus
Authors: Wijesinghe L.D. , Coughlin P.A. , Gill K.
Published: September 2024

Acute lower limb ischaemia is associated with high morbidity and mortality. The authors describe an unusual cause of arterial occlusion two weeks following aorto-coronary bypass surgery. This case should make vascular surgeons aware of the possibility of prosthetic materials acting as emboli. Furthermore, they should also be mindful that the presenting symptom may be at a site and time remote from the original intervention.
Oral Anticoagulation Therapy during Pregnancy in Patients with Mechanical Mitral Valves: A Prospective Study
Authors: Hassouna A. , Allam H.
Published: September 2024

Reports on phenindione toxicity have limited its use as an oral anticoagulant. Our aim was to evaluate its risks in pregnant women. Thirty-one pregnancies in 29 women with mitral (±aortic) St. Jude mechanical valves were followed-up prospectively. Eighteen patients received phenindione. Eleven patients (37.9%) received in addition to phenindione 225 mg dipyridamole, which was given in three doses. The target INR was 2.5–3.5 in the former and 2–2.5 in the latter treatment. A fortnight before delivery, intravenous heparinotherapy was substituted. There were no maternal complications, apart from a single postpartum hemorrhage (3.2%). After the deliveries the results were: 26 mature babies (83.9%). 3 premature babies (9.7%) and 2 cases of stillbirth (6.4%). Outcome was dose related; being 57.2±20.9 mg/day for mature babies and 82.5±11.2 mg/day for prematures and stillbirths ( P=0.016). Phenindione provided safe and effective anticoagulation during pregnancy. A larger study is necessary to confirm the relationship between the dosage and outcome.
Colour Duplex Scanning Versus Angiography: A Retrospective Assessment of Carotid Stenosis
Authors: Rodrigus I. E. , De Maeseneer M. G. , Van Schil P. E. Y. , Pickut B. A. , d'Archambeau O. C. , Vanmaele R. G.
Published: September 2024

A retrospective study was performed to investigate the reliability of colour duplex scanning as a screening method in detecting carotid artery disease. The results of this technique and digital subtraction arteriography of 100 carotid bifurcations in 50 patients undergoing carotid endarterectomy were compared. In accordance with suggested standard reports dealing with cerebrovascular disease, the diameter reduction was classified in one of five categories: < 20%, 20–59%, 60–79%, 80–99% and total occlusion. In 78% the gradings determined using digital subtraction arteriography and duplex scanning correlated perfectly, and in 99% of the studied bifurcations the difference was not more than one grade. The sensitivity and specificity of colour duplex scanning in detecting a stenosis with a diameter reduction of more than 60% was 98% and 87.7%, respectively. The best non-invasive method to identify carotid bifurcation disease is duplex scanning. Although the role of duplex scanning as an alternative to angiography is currently evolving, the authors still advocate carotid angiography when surgery is considered.
Cell Viability of Aortic Allografts after Long-Term Cryopreservation and Clinical Application to Aortic Root Replacement in a Patient with Aortitis
Authors: Motomura N. , Eishi K. , Kitoh H. , Kawazoe K. , Kitoh Y. , Kawashima Y. , Oka T.
Published: September 2024

A key point in the establishment of a tissue cryopreservation system is to maintain cell viability for an extended period. The viability of the tissue cells in the authors' cryopreservation system was examined, and the first clinical application reported. The tissue culture method demonstrated 95% of rat aortas (21 of 22 specimens) and 88% of human cardiac valves (seven of eight) to be viable after 6.4 months and 5.8 months of cryopreservation. respectively. The first clinical case, a 54-year-old man with aortic valve replacement and complications of aortitis, underwent successful aortic root replacement. Whereas the use of allografts in aortitis cases is controversial, such an approach was assumed reasonable because the mechanical stress between the native aortic annulus and the inserted valve could be reduced by aortic root replacement with the allograft.
Endothelial Cell Injury in the Human Saphenous Vein: A Comparative Study of Two Valvulotomes
Authors: Hager J. C. , Barman A. A. , Moideen A. S. , Chaudhry S. S. , Barman S. A.
Published: September 2024

Use of valvulotomes in non-reversed venous conduits carries the potential of venous endothelial cell injury. Earlier studies have shown that there is a significant decrease in the number of endothelial cells present in the human saphenous vein when employing the circular (LeMaitre) valvulotome. The present study was performed to evaluate and compare the LeMaitre and modified Hall valvulotome techniques on vascular endothelial cells from human saphenous vein. The results of the present study indicate that while both valvulotomes caused a significant decrease in the number of endothelial cells, the modified Hall instrument was less damaging to the vascular endothelium than the LeMaitre valvulotome. These results suggest that the modified Hall valvulotome technique may be more beneficial in maintaining endothelial cell function when the use of a valvulotome is warranted.
Differential Mechanisms of Failure of Autogenous and Non-Autogenous Bypass Conduits: An Assessment Following Successful Graft Thrombolysis
Authors: Ouriel K. , Shortell C. K. , Green R. M. , DeWeese J. A.
Published: September 2024

The advent of graft thrombolysis has provided an objective means for evaluating the etiology of graft occlusion. Over a 10-year period, intra-arterial urokinase (102 cases) or streptokinase (seven cases) was used in 109 infrainguinal conduits (30 autogenous and 79 non-autogenous) that failed 30 days or more after implantantion. Thrombolysis was not achieved in 19 additional graft occlusions; these cases were excluded from study because of an inability to define the mechanism of failure. Non-invasive laboratory data were available within 6 months of graft occlusion in 82 (75%) of the cases, with Doppler segmental studies in 80 cases (73%) and duplex ultrasonography studies in 39 cases (36%). Pre-failure non-invasive laboratory abnormalities were detected more frequently in autogenous grafts (21 of 24 patients, 88%), while non-autogenous grafts usually occluded without prior hemodynamic change (11 of 58 patients had abnormalities, 19%) (P< 0.001). Thrombolysis uncovered anatomic defects responsible for thombosis in 27 (90%) of 30 autogenous grafts compared with only 32 (41%) of non-autogenous conduits (P< 0.001). The most common lesions underlying autogenous graft failure comprised stenoses within the body of the graft (11 cases, 37%), while the most common lesions in failed non-autogenous grafts appeared to be stenoses at an anastomosis (21 cases, 27%). Thus, the mechanisms underlying the late failure of autogenous and non-autogenous grafts differ markedly; autogenous grafts most commonly fail as a result of the gradual development of lesions intrinsic to the graft, while non-autogenous grafts fail precipitously, presumably as a result of some non-anatomic mechanism.
Popliteal Vein Aneurysm
Authors: Zahrani H. A. Al
Published: September 2024

The successful management of a popliteal vein aneurysm in a 25-year-old Saudi man is described. An extensive review of the English literature revealed another 11 similar cases.
Epicardial Electric Shock Ablation of the Left Lateral Accessory Pathway
Authors: Suwalski K. , Pytkowski M. , Żelazny P. , Wojciechowski D. , Sitkowska E. , Sadowski Z. , Sitkowski W.
Published: September 2024

Fifty patients with drug-resistant, recurrent tachyarrhythmias causing Wolff-Parkinson-White syndrome underwent surgery between 1990 and 1992. All recognized surgical methods for accessory pathway destruction were performed. Epicardial electric shock ablation was first used as a method of surgically destroying an accessory atrioventricular pathway in 1983. This technique avoids the need for cardioplegia and hypothermia during operation. The procedure is based on the application of a series of two to five electrical shocks (50-150J) to the region of the atrioventricular groove where the accessory pathway has been previously located. Some 32 patients with a left free wall accessory pathway underwent this operation. Cardioplegia and hypothermia were not required in 22 patients with an accessory pathway located in the left lateral position. In the second group comprising ten patients with a left lateral accessory pathway, four were diagnosed as having a second pathway and four had concomitant heart pathology such as coronary artery disease — one had an atrial septal defect and another had a ventricular septal defect. Accessory pathway ablation was carried out in these ten patients using epicardial electric shock under normothermic cardiopulmonary bypass. Concomitant heart pathology was corrected at the second stage of the operation under cardiopulmonary bypass with cardioplegia and hypothermia. Postoperative electrophysiological studies confirmed that the accessory pathway had been destroyed in all patients. The only side effects of epicardial electric shock application were transient ST elevation < 1 mm in four patients, transient atrioventricular block in two and moderate sinus tachycardia in three. These were all minor side effects. It is concluded that epicardial electric shock ablation is a useful and safe method for destroying left free wall accessory pathways that avoids the necessity for hypothermia and cardioplegia.
Papaverine Injures the Endothelium of the Internal Mammary Artery
Authors: Cooper G. J. , Gillot T. , Parry E. A. , Kennedy A. , Wilkinson G. A. L.
Published: September 2024

Intraluminal injection of papaverine may be employed to dilate the internal mammary artery for use as a coronary artery bypass graft. The biochemical and morphological consequences of exposing the endothelium of the internal mammary artery to papaverine have been investigated. Biochemical injury was assessed by measuring changes in basal and vortex-stimulated prostaglandin I2 production, and morphological damage by scanning electron microscopy. Segments of internal mammary artery from 10 patients were placed In one of three solutions; papaverine (1.5 mg/ml of normal saline), normal saline acidified to the pH of the papaverine solution, and normal saline alone. Basal production of prostaglandin l2 was similar in the three groups but vortex-stimulated production was significantly lower in segments stored In papaverine (18.3pg/mg) and acidified saline (19.1 pg/mg) compared with that of saline alone (43.6pg/mg). No consistent morphological difference was found by scanning electron microscopy. It was concluded that the low pH of the papaverine solution injured the endothelium of the internal mammary artery.
Prophylaxis of Graft Infection with Rifampicin-Bonded Gelseal Graft: 2-Year Follow-Up of a Prospective Clinical Trial
Authors: D'Addato M. , Curti T. , Freyrie A. ,   Italian Investigators Group
Published: September 2024

Between March 1991 and June 1992, 600 patients were treated with mono-, bifemoral or iliofemoral arterial graft revascularization for occlusions and/or aneurysms. The patients were divided into two groups: group A (n = 296) received a Gelseal Vascutek graft immersed for 15 min before implant in a solution containing 1 mg/ml rifampicin; group B (n = 304) received an untreated Gelseal Vascutek graft. Both groups received perioperative antibiotic treatment with cephalosporins. Clinical follow-up was performed at 1, 6, 12 and 24 months after surgery to exclude signs of graft infection. Statistical analysis (x2) of pre-, intra- and postoperative risk factors showed both groups to be well matched. Among 600 patients treated, the 2-year follow-up showed 12 cases of graft infection (2.0%): five in group A (1.7%) and seven in group B (2.3%) (P= n.s.). All cases of graft infection originated in the groin and Staphylococcus aureus was isolated in 50% of cases. Statistical analysis (Mann-Whitney U test) showed a significant prevalence of lymphatic complications and immediate redo surgery in patients with graft infection. Of the 12 cases with infection, one was lost to follow-up, three were treated with total graft removal, six with partial graft removal and two with conservative therapy: there were no deaths. In spite of the relatively limited series and follow-up, no statistically significant difference emerged from the clinical use of vascular grafts pretreated with antibiotics.
Primary Subclavian-axillary Vein Thrombosis: Consensus and Commentary
Authors: Rutherford R. B. , Hurlbert S. N.
Published: September 2024

Fifteen multiple-choice questions concerning options in the management of primary subclavian-axillary vein thrombosis were discussed by a panel of experts and then voted upon by 25 attending vascular surgeons with a special interest in venous disease and considerable experience in subclavian-axillary vein thrombosis. The large majority favored, or agreed upon: (1)early clot removal for active, healthy patients with a need/desire to use the involved limb in work or sport; (2) catheter-directed thrombolysis as initial therapy-, (3) further therapy based on follow-up positional venography; (4) surgical relief of demonstrated thoracic outlet compression after a brief period of anticoagulant therapy; (5) conservative therapy if post-lysis venogram showed either (a) no extrinsic compression or (b) a short residual occlusion; and (6) intervention for residual intrinsic lesions with over 50% narrowing. However, there was little unanimity regarding the most appropriate intervention for residual stenoses, with opinion split between surgical and percutaneous transluminal angioplasty. For residual symptomatic occlusion 66% favored jugular vein turndown; only 10% would perform first rib removal.
Ischaemia of the Hand after Radial Artery Monitoring
Authors: Sfeir R. , Khoury S. , Khoury Gh. , Rustum J. , Ghabash M.
Published: September 2024

Percutaneous radial artery cannulation is commonly used for continuous monitoring of blood pressure and estimation of arterial blood gases. The purpose of this study is to define the incidence of radial artery thrombosis and associated hand ischaemia after cannulation. A prospective study of 40 patients who underwent radial artery cannulation was carried out with patients examined before and after cannulation for radial and ulnar pulses. Doppler waveforms, and Anger/brachial and finger/wrist pressure indices were obtained. After cannulation 27.5% of patients developed abnormal radial artery flows with 10% having absent pulses and none having any symptoms of hand ischaemia. Radial artery cannulation is a safe procedure when performed properly and is associated with a very low incidence of hand ischaemia, despite a 27.5% incidence of abnormal radial artery flow after cannulation.
Coeliac Artery Aneurysm: A Case Report
Authors: Ghoddousi I. , Kojouri K. , Fazel I.
Published: September 2024

Coeliac artery aneurysm is a rare but potentially fatal disease. In this paper a case of coeliac artery aneurysm is presented which was diagnosed before rupture and treated electively by resection and graft replacement between the aorta, common hepatic artery and superior mesenteric artery.
Angina Pectoris Treated by Thoracoscopic Sympathecotomy
Authors: Claes G. , Drott C. , Wettervik C. , Tygesen H. , Emanuelsson H. , Lomsky M. , Rådberg G.
Published: September 2024

Open surgical sympathectomy has previously been shown effective in relieving severe angina pectoris. The method was hampered by high morbidity and mortality. The authors have developed a minimally invasive technique of dividing only the sympathetic chain endoscopically and obtained good results with no serious complications in patients operated on for severe palmar hyperhidrosis. This method was used in 43 patients with severe angina pectoris who were not eligible for coronary artery bypass grafting or percutaneous transluminal coronary angioplasty. There was no mortality or any severe complications. Some 19 patients became symptom-free while 22 were improved and two unchanged after surgery. The frequency of anginal attacks was significantly reduced, as was the consumption of nitroglycerine tablets. The maximum exercise capacity was significantly increased and ST-segment depression reduced.
Processed Bovine Pericardium as Patch Angioplasty for Carotid Endarterectomy: A Preliminary Report
Authors: Biasi G. M. , Mingazzini P. , Baronio L. , Sampaolo A.
Published: September 2024

Although the routine use of a patch for closure of the arteriotomy after carotid endarterectomy is still debated, patch angioplasty is frequently used to avoid residual stenosis and to lower the incidence of later restenosis. Several materials are widely used for carotid patching, notably, autologous vein, Dacron and polytetrafluorethylene (PTFE). During recent years a heterologous stabilized graft made from bovine pericardium has been introduced. This paper reports the authors' experience of 52 carotid endarterectomies in which a patch of bovine pericardium was used to close the arteriotomy. The patients were followed with colour-duplex scanning over 12–30 months. This biograft did not require preclotting and proved to be easy to suture. Follow-up did not uncover any complications related to graft use. Although this is a preliminary report, it is concluded that bovine pericardium is a promising material for carotid patch angioplasty.
Thromboxane A2 Receptor Density Increases during Chronic Exposure to Thromboxane A2 Receptor Antagonists after Porcine Carotid Bypass
Authors: Brothers T. E. , Robison J. G. , Elliott B. M. , Boggs J. M. , Halushka P. V.
Published: September 2024

Domestic swine ( n = 12 in each group) were randomized to daily treatment with the thromboxane A2 (TXA2) receptor antagonist BMS-180291 (group I), aspirin (group II), or no drug (group III) prior to prosthetic carotid graft implantation. Platelet and arterial wall receptor density were measured by equilibrium binding using 125I-BOP. At 6 weeks, means (s.e.m.) platelet receptor density (pmol/mg) had increased in groups I (3.3(0.6) versus 1.8(0.3); P<0.05) and II (2.6(0.6) versus 1.7(0.2); P<0.05), but not in group III (1.3(0.3) versus 1.2(0.2)). Aortic membrane TXA2 receptor density (fmol/mg) was significantly greater ( P<0.05) in groups I (150(50)) and II (68(10)) compared with group III (39(6)). Chronic exposure to a TXA2 receptor antagonist or aspirin is associated with increased platelet and aortic receptor density in pigs. Published by Elsevier Science Ltd.
Surgical Management of Type a Aortic Dissection: Evaluation of Predisposing Factors for Postoperative Neurologic Complication and Late Reoperation
Authors: Ahn Hyuk , Kim Kwhanmien , Chae Hum , Rho Joon Ryang
Published: September 2024

The technique of cerebral protection during hypothermic circulatory arrest remains controversial. Forty-seven patients underwent operations for type A aortic dissection in the past 9 years. During hypothermic circulatory arrest, selective cerebral perfusion and retrograde cerebral perfusion was applied in 12 and seven patients, respectively. The mortality rate was 28.6% in patients without adjunctive cerebral perfusion, 25.0% in selective cerebral perfusion patients, and zero in the retrograde cerebral perfusion group ( P > 0.05). However, there was no mortality by cerebral injury in cerebral perfusion groups ( P = 0.03). Age ( P = 0.001), hypothermic circulatory arrest time ( P = 0.012). and acuity ( P = 0.013) were predisposing factors for cerebral injury, but cerebral perfusion has not yet been found to be a protective factor ( P = 0.56). Nine late reoperations and three deaths occurred during the follow-up period. Marfan syndrome was the only predisposing factor for late reoperation ( P = 0.016). In summary, although further studies are still required, retrograde cerebral perfusion is a possible cerebral protective factor. In addition, periodic follow-up is mandatory, especially in patients with Marfan syndrome.
The Effect of Probucol on Intimal Thickening of Autologous Vein Grafts in Hyperlipidemic Rabbit
Authors: Itoh H. , Komori K. , Okazaki J. , Mawatari K. , Kawasaki K. , Kuma S. , Eguchi D. , Sugimachi K.
Published: September 2024

Probucol is used to treat hypercholesterolemia and also has an anti-atherogenic effect. The effects of probucol on intimal thickening of autologous vein graft in hyperlipidemic rabbits with poor distal run-off were investigated. A poor distal run-off model was prepared in the right hindlimb of 18 rabbits allocated to four groups depending on diet: normolipidemic commercial diet (NL group, n = 5); hyperlipidemic diet (HL group, n = 5); commercial diet with 1% probucol (NP group, n = 4); and hyperlipidemic diet with 1% probucol (HP group, n = 4). After 4 weeks the femoral vein grafts were implanted into normal ( n = 18) or poor ( n = 18) runoff limbs. Vein grafts were harvested 4 weeks after implantation. Intimal thickening of the graft was measured and macrophages therein examined immunohistochemically. The serum cholesterol level was not reduced by probucol treatment. The mean flow rate of the graft was significantly reduced in the poor run-off limb. On histological examination intimal thickening in the poor run-off limb was significantly greater than that of controls, while intimal thickening in the HL and HP groups was enhanced compared with that in the NL and NP groups, respectively. mean intimal thichening in each limb in HP group rabbits was significantly lower than that in HL rabbits (μm): control (HL/HP): 99.4(7.4)/58.8(0.7) ( P < 0.05); poor run-off (HL/HP): 155.3(9.6)/130.3(7.3) ( P < 0.05). There was no difference between NL and NP (μm): control (NL/NP): 44.6(24.7)/31.5(12.8); poor run-off (HL/HP): 115.3(13.8)/97.5(34.0). In addition, enhanced intimal thickening due to poor distal run-off was not suppressed. Immunohistochemical staining showed intimal macrophage infiltration in the HL and HP groups; however, macrophage infiltration in grafts in the HP group was less than in the HL group. In conclusion, under hyperlipidemic conditions, probucol decreased intimal thickening enhancement of the vein graft, and suppressed intimal macrophage infiltration. These findings were similar to the anti-atherogenic effect of probucol in the native artery. Hence, probucol administration after vascular reconstruction with vein grafts in patients with hyperlipidemia may be beneficial.
Mechanism of Abrupt Hypotension with Stretch of Right Atrium during Cardiac Surgery
Authors: Tokunaga S. , Imaizumi T. , Kawachi Y. , Fukae K. , Tominaga R. , Takeshita A. , Yasui H.
Published: September 2024

During cardiac surgery abrupt hypotension sometimes occurs by the atrium being pulled, though the hypotensive mechanism is not known. The effects of mechanical stretching of the right atrium on haemodynamics and renal sympathetic nerve activity in the anesthetized rabbit was investigated. During stretching of the right atrial appendage with a metal weight (right atrial stretch), both mean arterial pressure (mAP) and renal sympathetic nerve activity significantly decreased. Bilateral vagotomy significantly reduced the change in mean arterial pressure with right atrial stretch ( P < 0.01), and significantly increased renal sympathetic nerve activity ( P < 0.01). The duration of the decreases of mean arterial pressure with right atrial stretch was significantly shortened after vagotomy. Decreases of blood flow of the descending aorta with right atrial stretch were observed and not affected by vagotomy. These results suggest that hypotension with mechanical stimulation of the right atrium is not only due to the decrease in cardiac output but also to sympathetic inhibition through the vagus via cardiac baroreflex.