bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Walrus balloon-guide catheter through sheathless radial approach for mechanical thrombectomy of right middle cerebral artery occlusion
Authors: Dossani Rimal H , Waqas Muhammad , Rai Hamid H , Monteiro Andre , Almayman Faisal , Cappuzzo Justin M , Davies Jason M 
Published: August 2021

The literature demonstrates a favorable first pass effect with balloon-guide catheter (BGC) for mechanical thrombectomy. An 8F BGC is routinely used with femoral access. We present the first video report of 8F BGC advanced through the radial artery using a sheathless technique (video 1). An approximately 70-year-old patient presented with left-sided hemiplegia, neglect, and dysarthria. A CT angiogram demonstrated right M1 occlusion, and the patient underwent urgent mechanical thrombectomy. Radial approach was preferred owing to patient history of anticoagulation. A 6F Sim Select intermediate catheter was used to minimize the step off as the 8F BGC was advanced into the radial artery over an 035 exchange-length Advantage Glidewire. A skin nick over the Glidewire Advantage facilitated the introduction of the 8F BGC into the radial artery. Standard mechanical thrombectomy using a combination of stent retriever and aspiration catheter (Solumbra technique) was performed, and thrombolysis in cerebral infarction 3 recanalization was achieved after a single pass. The National Institutes of Health Scale score improved from 12 to 4, with mild left facial droop, dysarthria, and decreased speech fluency. The patient was discharged from the hospital on postoperative day 2. Ultrasound should be used for immediate assessment of radial artery size and conversion to femoral access without delay if the radial artery is less than 2.5 mm.Video 1
Stimulation of mitochondrial hydrogen sulfide and glutathione production improves the Frank–Starling response of the rat heart via a nitric oxide–dependent pathway
Authors: Goshovska Yulia V. , Fedichkina Raisa A. , Korkach Yulia P. , Sagach Vadym F. 
Published: August 2021

The Frank–Starling response of the heart is known to be mediated by nitric oxide (NO) signaling, which is regulated by reduced glutathione (GSH) and hydrogen sulfide (H2S). We hypothesized that stimulation of endogenous H2S or GSH synthesis would improve the Frank–Starling response. Wistar male rats were injected with propargylglycine (PAG; 11.3 mg/kg, 40 min, n = 12), an inhibitor of H2S-producing enzyme (cystationine-γ-lyase), and l-cysteine (121 mg/kg, 30 min, n = 20), a precursor of H2S and GSH. Pretreatment with PAG or l-cysteine separately slightly improved the pressure-volume (P-V) dependence of the isolated rat heart, but the combination of PAG and l-cysteine (n = 12) improved heart contractile activity. H2S content, Ca2+-dependent NOS activity (cNOS) activity, nitrate reductase activity, and nitrite content increased by 2, 3.83, 2.5, and 1.3 times in cardiac mitochondria, and GSH and oxidized glutathione (GSSG) levels increased by 2.24 and 1.86 times in the heart homogenates of the PAG + l-cysteine group compared with the control (all P < 0.05). Inhibition of glutathione with DL-buthionine-sulfoximine (BSO; 22.2 mg/kg, 40 min, n = 6) drastically decreased Frank–Starling response of the heart and prevented PAG + l-cysteine–induced increase of GSH and GSSG levels (BSO + PAG + l-cysteine, n = 9). Inhibition of NOS, N-nitro-l-arginine-methylester hydrochloride (l-NAME; 40 min, 27 mg/kg) abolished positive inotropy induced by PAG+l-cysteine pretreatment (l-NAME + PAG + l-cysteine, n = 7). Thus, PAG + l-cysteine administration improves the Frank–Starling response by upregulating mitochondrial H2S, glutathione, and NO synthesis, which may be a promising approach in the treatment of myocardial dysfunction.
Finding the art in systems conversions, naming
Authors: Meil Doug , Aoun Mario Antoine 
Published: August 2021

The
Communications
website, http://cacm.acm.org, features more than a dozen bloggers in the BLOG@CACM community. In each issue of
Communications
, we'll publish selected posts or excerpts.

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Follow us on Twitter at http://twitter.com/blogCACM

http://cacm.acm.org/blogs/blog-cacm
Doug Meil considers a third distinct type of development, while Mario Antoine Aoun ponders alternate names for ACM.
Vaccination with Polyclonal Antibody Stimulator (PAS) Prevents Pancreatic Carcinogenesis in the KRAS Mouse Model
Authors: Smith Jill P. , Cao Hong , Chen Wenqiang , Kallakury Bhaskar , Phillips Teresa , Sutton Lynda , Cato Allen 
Published: August 2021

Abstract

The incidence of pancreatic cancer is increasing significantly and will soon become the second leading cause of cancer-related deaths in the United States. We have previously shown that the gastrointestinal peptide gastrin, which is only expressed in the fetal pancreas and not in the adult pancreas, is activated during pancreatic carcinogenesis where it stimulates growth in an autocrine fashion. In this investigation, we used transgenic LSL-KrasG12D/+; P48-Cre mice that develop precancerous pancreatic intraepithelial neoplasia (PanIN) lesions and pancreatic cancer over time. Starting at 3 months of age, mice were either left untreated (control) or were treated with a gastrin-targeted vaccine, polyclonal antibody stimulator (PAS 250 μg) followed by a monthly booster until the mice reached 8 months of age when pancreata were excised, and analyzed by histology for PanIN grade in a blinded fashion. High-grade PanIN-3 lesions were significantly less in PAS-treated mice (P = 0.0077), and cancers developed in 33% of the control mice but only in 10% of the PAS-treated mice. Compared with the control mice, fibrosis was reduced by &gt;50%, arginase positive M2 macrophages were reduced by 74%, and CD8+ T cells were increased by 73% in the pancreas extracellular matrix in PAS-treated mice.

Prevention Relevance:
PAS vaccination significantly decreased high-grade PanIN lesions and altered the pancreas microenvironment, rendering it less carcinogenic.
Transnational by Default: Online Child Sexual Abuse Respects No Borders
Authors: Witting Sabine K. 
Published: August 2021

Abstract
Combatting child sexual abuse on the internet requires a high level of harmonisation of both substantive and procedural laws, as online child sexual abuse is transnational by default: while the transnational nature of child sexual abuse material used to be the exception before the advent of the internet, it is now the rule. In order to prosecute and investigate online child sexual abuse across country borders, states rely heavily on extraterritorial jurisdiction clauses as well as informal and formal law enforcement collaboration channels. This paper analyses existing channels in the opsc, Budapest Convention and Lanzarote Convention, particularly against the background of the recently published crc Committee Guidelines regarding the implementation of the Optional Protocol to the Convention on the Rights of the Child on the sale of children, child prostitution and child pornography (crc/c/156), and provides for concrete guidance on how to ensure that the best interests of the child in the prosecution and investigation of transnational crimes such as online child sexual abuse is the primary consideration.
CT Findings of Firework Injuries to the Head and Neck
Authors: Yi Yangtian , Ginat Daniel Thomas 
Published: August 2021

Objectives: The purpose of this study is to review the CT imaging findings of injuries in the head and neck caused by fireworks through a case series. Methods: The imaging database from the University of Chicago Medicine was searched with “fireworks,” “firecrackers,” and “mortar” as keywords and CT as the imaging modality. Cases without acute CT findings or initial CT scans were excluded. Results: Eighteen cases with acute CT findings of head and neck firework injuries were identified and included. The associated injuries included skull fractures (5, 28%), ocular injuries (7, 39%), soft tissue trauma (18, 100%), retained foreign bodies (8, 44%), and intracranial trauma (2, 11%). Conclusions: Fireworks can cause injuries of varying severity in the head and neck, including blunt and penetrating trauma, that warrant CT evaluation.
Subjective Voice Outcomes in Surgeon Versus Technician-Monitored Recurrent Laryngeal Nerves in Thyroidectomy
Authors: Peckham Merry , Rose Tyler , King Deanne , Moreno Mauricio , Stack Brendan C. , Vural Emre 
Published: August 2021

Objectives: To compare subjective voice outcomes and postoperative laryngoscopic examination findings of patients with subjective voice complaints between surgeon-monitored and certified technician–monitored thyroidectomies. Methods: Patients who underwent hemithyroidectomy, total thyroidectomy, and completion thyroidectomy using a nerve monitoring system between November 2015 and June 2018 were included in the study. Retrospective chart review was carried out to assess how often patients reported voice changes and to record postoperative flexible laryngoscopic findings of patients when that examination was performed. Data were analyzed using the χ2 test to identify significant differences in outcomes for the 2 groups. Results: A total of 293 procedures was performed among 3 surgeons. Surgeons monitored the nerves in 147 cases and a certified technician monitored the nerves in 146 cases. Subjective voice changes were identified in 11 (7.48%) cases in the surgeon-monitored group and in 20 (13.70%) cases in the technician-monitored group ( P = .084). Among the patients who expressed subjective voice changes, 7 patients were identified with vocal cord hypomobility or immobility in the surgeon-monitored group and 13 patients had an abnormal examination in the technician-monitored group ( P = .234). Conclusions: Subjective voice changes or proven vocal cord mobility problems were not different between surgeon-monitored patients and technician-monitored patients in thyroidectomies.
Kinematic Alterations After Anterior Cruciate Ligament Reconstruction via Transtibial Techniques With Medial Meniscal Repair Versus Partial Medial Meniscectomy
Authors: Wang Ming , Lin Zefeng , Wang Wanshun , Chen Lingling , Xia Hong , Zhang Yu , Huang Wenhan 
Published: August 2021

Background: The treatment strategies for meniscal injuries during anterior cruciate ligament (ACL) reconstruction remain a topic of debate. Hypothesis: After ACL reconstruction, knee kinematics would be affected by different medial meniscal treatment (partial medial meniscectomy [PMM] and medial meniscal repair [MMR]). Study Design: Controlled laboratory study. Methods: A total of 161 patients underwent primary single-bundle ACL reconstruction and simultaneous medial meniscal treatment. Of these, 32 patients were eligible to participate in the kinematic assessment at 24.8 ± 1.7 months after surgery. Patients were divided into 2 groups: (1) those who underwent MMR (Group MMR; n = 18) and (2) those who underwent PMM (Group PMM; n = 14). Twenty healthy participants (Group Intact) were recruited who were comparable in age, body mass index, and sex. The kinematic parameters were collected using an optical tracking system during treadmill gait. Range of motion and kinematic parameters at key events during the gait cycle were compared between the 3 groups. The primary outcomes were the differences in adduction/abduction and internal/external rotation. Results: Patients in Group PMM walked with increased adduction as compared with those in Group Intact during the early stance phase ( P = .003; η2 = 0.172) and midstance phase ( P = .003; η2 = 0.167). In terms of internal/external rotation, patients in Group PMM walked with significantly larger tibial external rotation when compared with Group MMR by approximately 3.4° to 3.7° (loading response: P = .026, η2 = 0.090; midstance: P = .035, η2 = 0.093) and Group Intact ( P = .028; η2 = 0.095) in the early stance phase. In addition, there was significantly increased anterior tibial translation in Groups MMR and PMM compared with Group Intact. Conclusion: ACL reconstruction (via transtibial technique) with concurrent PMM demonstrated larger adduction and external tibial rotation at 24 months of follow-up during level walking. Clinical Relevance: Patients undergoing different medial meniscal treatment strategies in the presence of ACL reconstruction showed distinct knee kinematics. These results suggest that MMR is strongly recommended during ACL reconstructive surgery to reduce the abnormal kinematics close to that of the ACL-intact condition.
Examining the Association of Billed Advance Care Planning With End-of-Life Hospital Admissions Among Advanced Cancer Patients in Hospice
Authors: Prater Laura C. , O’Rourke Brian , Schnell Patrick , Xu Wendy , Li Yiting , Gustin Jillian , Lockwood Bethany , Lustberg Maryam , White Susan , Happ Mary Beth , Retchin Sheldon M. , Wickizer Thomas M. , Bose-Brill Seuli 
Published: August 2021

Background: Advance care planning (ACP), or the consideration and communication of care preferences for the end-of-life (EOL), is a critical process for improving quality of care for patients with advanced cancer. The incorporation of billed service codes for ACP allows for new inquiries on the association between systematic ACP and improved EOL outcomes. Objective: Using the IBM MarketScan® Database, we conducted a retrospective medical claims analysis for patients with an advanced cancer diagnosis and referral to hospice between January 2016 and December 2017. We evaluated the association between billed ACP services and EOL hospital admissions in the final 30 days of life. Design: This is a cross-sectional retrospective cohort study. Participants: A total of 3,705 patients met the study criteria. Main Measures: ACP was measured via the presence of a billed ACP encounter (codes 99497 and 99498) prior to the last 30 days of life; hospital admissions included a dichotomous indicator for inpatient admission in the final 30 days of life. Key Results: Controlling for key covariates, patients who received billed ACP were less likely to experience inpatient hospital admissions in the final 30 days of life compared to those not receiving billed ACP (OR: 0.34; p < 0.001). Conclusion: The receipt of a billed ACP encounter is associated with reduced EOL hospital admissions in a population of patients with advanced cancer on hospice care. Strategies for consistent, anticipatory delivery of billable ACP services prior to hospice referral may prevent potentially undesired late-life hospital admissions.
Influence of the inclination angle on the sound field in an irregular enclosure containing two elastic walls
Authors: Cui Huaifeng , Hu Rufu , Luo Shaoying , Chen Nan 
Published: August 2021

The sound field model of an irregular enclosure with two elastic walls and an inclined wall is established by the modal theory. The modal parameters of the irregular enclosure are obtained by the envelope rectangular technique. The influence of the inclination wall angle on the sound field in the irregular enclosure is discussed. When the inclination angle is increased from 0° to 45°, the resonance frequencies of the acoustic enclosure are basically reduced in the frequency range of 0∼250 Hz. When the inclination angle is increased from 0° to 45° every 15° interval, the amplitude of a certain acoustic mode itself decreases, while the amplitudes of the acoustic modes coupled to it basically increase. The acoustic potential energy peaks in the enclosure basically shift to the low frequency with the increase of the inclination angle. Furthermore, the change trend of the acoustic potential energy is regular in the low-order modes, but relatively chaotic in the high-order modes. In addition, in order to verify that the accurate description of the primary sound field is the basis of effective noise control, the two-elastic plate model is deliberately treated as one-elastic plate model, and its influence on the performance of active noise control is discussed. Also, if the multi-elastic plate model is regarded as a simplified automobile cab, the research results can be used for the preliminary acoustic design of the cab; that is, the research results can be used for the acoustic design of similar models.
Dynamic cushioning energy absorption of paper composite sandwich structures with corrugation and honeycomb cores under drop impact
Authors: Ji Meijuan , Guo Yanfeng , Han Xuxiang , Fu Yungang , Kang Jianfen , Wei Qing 
Published: August 2021

The paper composite sandwich structure with corrugation and honeycomb cores has been widely used in civil and national defense industries, and the cushioning energy absorption characteristic is a key indicator to evaluate the performance of this composite structure. Therefore, this paper is focused on the influences of honeycomb thickness on the shock acceleration response and deformation characteristics to analyze cushioning energy absorption performance of the composite structure by various experimental tests. The experimental result shows that the paper corrugation layer firstly comes into crushed, and then the paper honeycomb layer is crushed. Additionally, the large honeycomb thickness may cause the secondary collapse of paper honeycomb layer. Under the same impact energy or impact mass, the cushioning energy absorption of the single-sided composite sandwich structure is better than that of the double-sided structure with the same honeycomb thickness. However, the impact resistance of the double-sided composite structure is better than that of the single-sided structure. For the paper composite sandwich structures with the honeycomb thicknesses 10, 15, 20, and 25 mm, the increase of honeycomb thickness would decrease the cushioning energy absorption of the whole structure under the drop impact with low energy. However, under the drop impact with high energy, the influence of honeycomb thickness on cushioning energy absorption is contrary. For the paper composite sandwich structure, the specific energy absorption, unit volume energy absorption, and stroke efficiency for the honeycomb thicknesses 10, 15, 20, and 25 mm are higher than those for the honeycomb thickness 70 mm. Therefore, the low honeycomb thickness is more advantageous for the cushioning energy absorption of paper composite sandwich structure.
Outcomes of Total Endovascular Aortic Arch Repair with Surgeon-Modified Fenestrated Stent-Grafts on Zone 0 Landing for Aortic Arch Pathologies
Authors: Li Xiaoye , Zhang Lei , Song Chao , Zhang Hao , Xia Shibo , Li Haiyan , Jing Zaiping , Lu Qingsheng 
Published: August 2021

Objectives This study evaluated the feasibility and safety of total endovascular aortic arch repair with surgeon-modified fenestrated stent-graft on zone 0 landing for aortic arch pathologies. Methods Between June 2016 and October 2019, 37 consecutive patients underwent total endovascular arch repair with surgeon-modified fenestrated stent-grafts on zone 0 landing. Outcomes included technical success, perioperative and follow-up morbidity and mortality, and branch artery patency. Results During the study period, 37 patients were treated with total endovascular aortic arch repair with surgeon-modified fenestrated stent-graft. Twenty-one (56.8%) patients were diagnosed with aortic dissections, 15 (40.5%) patients with aneurysms, and 1 (2.7%) patient required reintervention due to endoleak and sac expansion from previous thoracic endovascular aortic repair for thoracoabdominal aneurysm. The proximal landing zone for all patients were in zone 0, and all branch arteries of aortic arch were reconstructed. Technical success was achieved in 34 cases (91.9%). Three (8.1%) patients had fenestrations misaligned with target arteries, and the chimney technique was applied as a complementary measure. Thirty-day mortality rate was 5.4% (n=2). Thirty-day stroke rate was 5.4% (n=2). Thirty-day reintervention rate was 2.7% (n=1). At a median follow-up of 20 months (range, 3–49 months), 5 (13.5%) patients died, including 2 aortic-related deaths, 1 nonaortic-related death, and 2 deaths of unknown reason. One (2.7%) patient had stroke. Four patients (10.8%) had reintervention during the follow-up, including 2 cases of left subclavian artery occlusion and 2 cases of type II endoleak. The estimated survival (±SE) at 2 years was 72.4%±9.7% (95% CI 53.4%–91.4%). The estimated freedom from reintervention (±SE) at 2 years was 87.4%±5.9% (95% CI 75.84%–98.96%). Conclusions Total endovascular aortic arch repair with surgeon-modified fenestrated stent-grafts on zone 0 landing is an alternate option for the treatment of aortic arch pathologies in experienced centers.
TRIACCESS Study: Randomized Comparison Between Radial, Femoral, and Pedal Access for Percutaneous Femoro-popliteal Artery Angioplasty
Authors: Ruzsa Zoltán , Csavajda Ádám , Hizoh István , Deák Mónika , Sótonyi Péter , Bertrand Olivier F. , Kwan Tak , Merkely Béla , Nemes Balázs 
Published: August 2021

Background The aim of this randomized study was to compare the success and complication rates of different access sites for the treatment of superficial artery stenosis. Methods and Results A total of 180 consecutive patients were randomized in a prospective study to treat symptomatic superficial femoral artery stenosis via radial (RA), femoral (FA), or pedal artery (PA) access. Technical success was achieved in 96.7%, 100%, and 100% of the patients in the RA, FA, and PA groups, respectively (p=0.33). Secondary access sites were used in 30%, 3.3%, and 30% of the patients in the RA, FA, and PA access groups, respectively (p=0.0002). Recanalization for chronic total occlusion was performed in 34/36 (94.4%), 30/30 (100%), and 46/46 (100%) patients in the RA, FA, and PA groups, respectively (p=0.17). The X-ray dose was significantly lower in the PA group than that in the RA and FA access groups (63.1 vs 162 vs 153 Dyn, p=0.0004). The cumulative rates of access site complications in the RA, FA, and PA groups were 3.3% (0% major and 3.3% minor), 16.7% (3.3% major and 13.3% minor), and 3.3% (3.3% major and 0% minor) (p=0.0085), respectively. The cumulative incidence of MACEs at 6 months in the RA, FA, and PA groups was 5%, 6.7%, and 1.7%, respectively. The cumulative incidence of MALEs at 6 months in the RA, FA, and PA groups was 20%, 16.7%, and 9.2%, respectively (p=0.54). Conclusion Femoral artery intervention can be safely and effectively performed using radial, femoral, and pedal access, but radial and pedal access is associated with a lower access site complication rate and hospitalization. Pedal access is associated with a lower X-ray dose than that with radial and femoral access.