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Iron sulfide and metal melt veins in chondritic materials are associated with advanced stages of dynamic shock. The shock‐induced residual temperatures liquefy the sulfide component and enable melt distribution. However, the distribution mechanism is not yet fully understood. Capillary forces are proposed as agents of melt distribution; yet, no laboratory experiments were conducted to assess the role that capillary forces play in the redistribution of iron sulfide in post‐shock conditions. To investigate this further, we conducted thermal experiments under reducing conditions (N2(g)) using dunitic fragments, suitable chondritic analog materials that were doped with synthesized troilite (stoichiometric exact FeS). We observed extensive iron sulfide (troilite) migration that partially resembles that of ordinary chondrites, without the additional influence of shock pressure‐induced fracturing. The iron sulfide melt infiltrated grain boundaries and pre‐existing fractures that darkened the analog material pervasively. We also observed that the iron sulfide melt, which mobilized into grain boundaries, got systematically enriched in Ni from the surrounding host olivine. Consequently, FeNi metal fractionated from the melt in several places. Our results indicate that capillary forces majorly contribute to melt migration in the heated post‐shock environment. [ABSTRACT FROM AUTHOR]

Summary: Variation in leaf venation network architecture may reflect trade‐offs among multiple functions including efficiency, resilience, support, cost, and resistance to drought and herbivory. However, our knowledge about architecture‐function trade‐offs is mostly based on studies examining a small number of functional axes, so we still lack a more integrative picture of multidimensional trade‐offs.Here, we measured architecture and functional traits on 122 ferns and angiosperms species to describe how trade‐offs vary across phylogenetic groups and vein spatial scales (small, medium, and large vein width) and determine whether architecture traits at each scale have independent or integrated effects on each function.We found that generalized architecture‐function trade‐offs are weak. Architecture strongly predicts leaf support and damage resistance axes but weakly predicts efficiency and resilience axes. Architecture traits at different spatial scales contribute to different functional axes, allowing plants to independently modulate different functions by varying network properties at each scale.This independence of vein architecture traits within and across spatial scales may enable evolution of multiple alternative leaf network designs with similar functioning. [ABSTRACT FROM AUTHOR]

This paper explores the role of performativity in political organization, especially in relation to horizontality and verticality. Taking its cues from the heightened interest in horizontal and vertical organization following the post-2010 movements of the squares and new forms of party politics that have emerged in their wake, the paper draws on Michael Saward’s and Judith Butler’s accounts of the performativity of representation and assembly, respectively, to develop an original synthesis of a discursive-organizational approach based on Laclau’s and Mouffe’s discourse theory with an understanding of the role of performativity in horizontal and vertical forms of party organization. Following initial considerations on performativity as a category that tends to be implicitly assumed but under-theorized in theoretical perspectives on post-squares organization (e.g. Chantal Mouffe and Rodrigo Nunes), the paper presents readings of Saward’s and Butler’s understandings of performativity, which are then linked to existing and ongoing work on movement parties and Volksparteien of a new type (VNTs) as prototypical types of horizontal and vertical party organization. In this vein, the paper develops an integrated framework of Discursive-Organizational Analysis (DOA) that combines post-foundational discourse analysis (PDA) with performativity theory and serves as a bridge between the semantic and pragmatic aspects of discourse. [ABSTRACT FROM AUTHOR]

Purpose: To determine the timing of symptomatic venous thromboemboli (VTE) in patients sustaining a pelvic and/or acetabular fracture. Secondly, to evaluate for any factors that may influence this timing. Methods: A retrospective cohort of 47 patients with acetabular and/or pelvic ring injuries who developed VTEs at a single academic level I trauma center were identified from 2012 to 2018. The chronology of VTE diagnosis in relation to date of injury, initial surgery, final surgery, and date of discharge was evaluated. Patients who developed VTEs were then evaluated based on known risk factors for VTE to determine if any of these affected timing. Results: Symptomatic VTEs were diagnosed in 3.8% of patients with pelvic and/or acetabular fractures. In patients who developed a thromboembolism, diagnosis occurred on average 21.5 (± 19.2), 20.7 (± 19.9), 9.8 (± 23.4), and 4.3 (± 27.6) days after injury, index procedure, final procedure, and date of discharge. 25% of patients developed VTE more than 4 weeks after their initial injury. No known risk factors effected the timing of VTE. Conclusion: The 2015 OTA expert panel recommends 4 weeks of anticoagulation for orthopedic trauma patients at high risk of VTE, which may be too short a duration. In our cohort, 25% of VTEs occurred greater than 4 weeks after injury. Additional research is needed to clarify the exact duration of anticoagulation after pelvic and acetabular fractures; however, surgeons may want to consider anticoagulating patients for greater than 4 weeks. Level of evidence: Level III—retrospective cohort. [ABSTRACT FROM AUTHOR]

Venous thromboembolic disease (VTE) occupies an important place as a cause of morbidity and mortality in surgical patients in all specialties. Despite the existence of guidelines for thrombo prophylaxis in surgery, it is not clear due to the lack of current evidence, how to develop antithrombotic prophylaxis in varicose vein surgery and many questions arise when the surgeon is faced with a patient to be operated on. A comprehensive review of the literature was conducted to examine the evidence about the prevention of the venous thromboembolism in varicose veins surgery patients, and aims to guide the reader through questions that arise in daily practice, discussing the different scenarios presented in the literature for the choice of the most appropriate prophylaxis for each case. The lack of conclusive literature determines that risk should be individualized using available scales and other procedure-related factors, so that the type and duration of prophylaxis can be determined on a case-by-case basis. [ABSTRACT FROM AUTHOR]

Background: Bariatric surgery has been proven safe in end-stage kidney disease (ESKD); however, few studies have evaluated whether a history of bariatric surgery impacts transplant-specific outcomes. We hypothesize that a history of bariatric surgery at the time of transplant does not adversely impact transplant-specific outcomes. Methods: The IBM MarketScan Commercial Claims and Encounters database was queried for patients with a history of kidney transplant between 2000 and 2021. Patients were stratified into three groups based on bariatric surgery status and body mass index (BMI) at the time of transplant: patients with obesity (O), patients without obesity (NO), and patients with a history of bariatric surgery (BS). Inverse probability of treatment weighting was used to control for confounding. Adjusted hazard ratios (aHRs) describing the risk of transplant-specific and postoperative outcomes were estimated using weighted Kaplan–Meier curves. Primary outcomes included 30-day and 1-year risk of transplant-specific outcomes. Secondary outcomes included 30-day and 1-year postoperative complications and 30-day and 1-year risk of wound-related complications. Results: We identified 14,806 patients; 128 in the BS group, 1572 in the O group, and 13,106 in the NO group. There was no difference in 30-day or 1-year risk of transplant-specific complications between the BS and NO group or the O and NO group. Patients with obesity (O) were more likely to experience wound infection (aHR 1.49, 95% CI 1.12–1.99), wound dehiscence (aHR 2.2, 95% CI 1.5–3.2), and minor reoperation (aHR 1.52, 95% CI 1.23–1.89) at 1 year. BS patients had increased risk of wound infection at 1 year (aHR 2.79, 95% CI 1.26–6.16), but were without increase in risk of minor or major reoperation. Conclusion: A history of bariatric surgery does not adversely affect transplant-specific outcomes after kidney transplant. Bariatric surgery can be safely utilized to improve the transplant candidacy of patients with obesity with CKD and ESKD. [ABSTRACT FROM AUTHOR]

Tinnitus refers to the perception of sound without any external stimuli which can be pulsatile or non-pulsatile. Dilated mastoid emissary vein (MEV) can cause pulsatile tinnitus. Herein, we report a case of persistent pulsatile tinnitus with dilated MEV managed successfully with percutaneous coiling of MEV in a 36 years male. [ABSTRACT FROM AUTHOR]

Introduction: Conventional nasolabial flap has been widely used for reconstruction for head and neck defects. Recent decades witnessed modification of this flap like islanded version based on subcutaneous pedicle or facial artery and vein. The later modification obviated a need for pedicle division, secondary procedures and facilitates reach of the flap to distant sites. Especially, the islanded nasolabial flap pedicled on facial artery and vein can have a long pedicle to conveniently reach the tongue, floor of mouth when the flap is routed through retromandibular area. Methods: A retrospective analysis was done on 14 patients analyzing the functional outcome like deglutition, speech, and aesthetic outcome of flap donor area, recruiting patients in which islanded nasolabial flap was done based on facial vessels for early stages of cancer tongue and lip. Results: In our series of 14 operated cases, all flaps survived. All the flaps were islanded over the skeletonized facial artery and vein. Tip necrosis occurred in one case. The donor site was closed primarily in all cases. The average speech scoring was grade five, Vancouver scar score of the flap donor area was 2.5 and intelligible speech was difficult in only three cases in follow up. Conclusion: We found this flap useful for reconstruction of small to moderate size defects of oral malignancy following excision with acceptable aesthetic and functional outcome in most of the patients. [ABSTRACT FROM AUTHOR]

Background: The effectiveness of a concomitant intra-aortic balloon pump (IABP) with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) intervention in acute myocardial infarction with cardiogenic shock (AMICS) patients is contested in the literature. This study sought to compare short-term mortality weaning rate from VA-ECMOin AMICS cases. Methods: We conducted a literature review and compared the primary and secondary endpoints in the following treatment groups of AMICS patients: (1) VA-ECMO plus IABP vs. IABP alone and (2) VA-ECMO plus IABP vs. VA-ECMO alone. The primary endpoint was in-hospital all-cause mortality; while 30-days mortality, weaning from VA-ECMO, and vascular complications comprised secondary endpoints. Results: VA-ECMO concomitant with IABP was administered to 3,580 (76.4%) patients, while IABP alone and VA-ECMO alone treatments accounted for 1.7% and 21.9% of the patients, respectively. We found that in-hospital mortality was significantly lower in patients treated with VA-ECMO plus IABP vs. VA-ECMO alone (odds ratio (OR) = 0.52; 95% Confidence Interval (CI) = 0.21–1.31; I-squared statistic (I 2 = 30%) or IABP alone (OR = 0.20; 95% CI = 0.08–0.55; I 2 = 0%). Additionally, 30-days mortality was significantly lower in patients treated with VA-ECMO plus IABP vs. VA-ECMO alone (OR = 0.31; 95% CI = 0.25–0.40; I 2 = 0%) or IABP alone (OR = 0.24; 95% CI = 0.11–0.50; I 2 = 0%). A significant difference was observed in weaning from VA-ECMO in patients treated with VA-ECMO plus IABP vs. VA-ECMO alone (OR = 1.91; 95% CI = 1.09–3.33; I 2 = 0%). Conclusion: In-hospital and 30-days mortality were significantly lower in AMICS patients treated with VA-ECMO plus IABP vs. VA-ECMO alone or IABP alone. VA-ECMO with concomitant IABP could increase the proportion of patients weaned from VA-ECMO, significantly reducing in-hospital mortality, without increasing complications. [ABSTRACT FROM AUTHOR]

ABSTRACT Adrenal vein sampling (AVS) is the current recommended procedure for identifying unilateral subtypes of primary aldosteronism (PA), which are amenable to surgery with the potential for cure. AVS is a technically challenging procedure usually undertaken by interventional radiologists at tertiary centres. However, there are numerous variations in AVS protocols relating to patient preparation, sampling techniques and interpretation which may impact the success of AVS and patient care. To reduce practice variations, improve the success rates of AVS and optimise patient outcomes, we established an Australian and New Zealand AVS Working Group and developed evidence‐based expert consensus recommendations for the preparation, performance and interpretation of AVS. These recommendations can be used by all healthcare professionals in a multidisciplinary team who look after the diagnosis and management of PA. [ABSTRACT FROM AUTHOR]

Hand vein identification stands out to be an increasingly popular approach for biometric identification due to its distinctiveness and convenience. While state-of-the-art techniques are able to achieve good performance, they share two common drawbacks: (1) complex preprocessing procedures, e.g., vein enhancement and Region of Interest (ROI) extraction, and (2) vein information loss due to hand ROI partition. To address these issues, we propose VeinTr, an end-to-end full-hand vein identification approach. In particular, our VeinTr consists of three components: a local feature extractor, a lightweight transformer, and a global feature decoder. We first obtain local features via convolution-based ResNet-like blocks. Then the attention mechanism is employed to aggregate global features from local features, which can be then decoded as global hand vein features. Finally, a global feature decoder is applied to generate robust hand features. By doing so, VeinTr is capable of directly extracting robust hand vein features from raw hand vein images. We evaluate our method on CASIA, TPV, and PLUSVein hand vein datasets. Experimental results show that our approach outperforms the state-of-the-art methods and has strong inter-dataset generalization abilities. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of retaining the vessels around the orbicularis oculi muscle on reducing local swelling after blepharoplasty. Methods: A total of 309 patients undergoing blepharoplasty (total incision) were observed and randomly assigned to three groups; (A) conventional operation; (B) preservation of deep vessels; (C) preservation of anterior vessels of orbicularis oculi muscle. The groups were compared based on intraoperative blood loss, operation time, swelling, satisfaction, and complications. Results: Among the 309 patients, 39 were lost to follow‐up. c Additionally, A had the shortest operation time, followed by C with slightly longer duration. On the 7th day, 15th day, and 1 month after surgery, both B and C demonstrated significantly lower levels of swelling compared to A. Moreover, patient satisfaction was higher in B and C than in A. Conclusion: Retaining either superficial or deep veins of the orbicularis oculi muscle can effectively reduce short‐term postoperative swelling. However, when retaining the superficial central group of this muscle during surgery, it is crucial to strictly control the amount of surrounding tissue around vessels. [ABSTRACT FROM AUTHOR]

Copper possesses very strong chacophile properties, but under the conditions found in meteorites, its behavior is like that of siderophile elements. The Suizhou meteorite is a highly shocked L6 chondrite. Troilite and taenite are considered the main primary carrier of copper in this meteorite, and the post-shock thermal episode is considered the main reason that elemental Cu migrates from its original host phase and forms metallic grains. The Suizhou meteorite contains a few very thin shock melt veins. The occurrence and behavior of metallic copper in this meteorite were studied by optical microscopic examination, electron microprobe analyses, and high-resolution X-ray elemental intensity mapping. Our results show that metallic copper is abundant in the Suizhou chondritic rock. Metallic copper grains adjacent to small troilite grains inside FeNi metal are the most common occurrence, and those at the FeNi metal–troilite interface are the second most common case. The metallic copper grains occurring at the interface of FeNi metal/troililte and silicate are rather rare. Metallic copper grains are not observed within the Suizhou shock veins, Instead, Cu in elemental form is transferred through shock metamorphism into FeNi metal + troilite intergrowths. Four different occurrence types of Cu in the FeNi metal + troilite intergrowths have been identified: the concentrations of Cu in the FeNi + FeS intergrowths for four occurrence types are rather close, we estimate it might be lower than 1 wt%. [ABSTRACT FROM AUTHOR]

Venous thromboembolism is a frequent complication of acute hospital care, and this extends to inpatient rehabilitation. The timely use of appropriate thromboprophylaxis in patients who are at risk is a strong, evidence-based patient safety priority that has reduced clinically important venous thromboembolism, associated mortality and costs of care. While there has been extensive research on optimal approaches to venous thromboembolism prophylaxis in acute care, there is a paucity of high-quality evidence specific to patients in the rehabilitation setting, and there are no clinical practice guidelines that make recommendations for (or against) thromboprophylaxis across the broad spectrum of rehabilitation patients. Herein, we provide an evidence-informed review of the topic with practice suggestions. We conducted a series of literature searches to assess the risks of venous thromboembolism and its prevention related to inpatient rehabilitation as well as in major rehabilitation subgroups. Mobilization alone does not eliminate the risk of venous thromboembolism after another thrombotic insult. Low molecular weight heparins and direct oral anticoagulants are the principal current modalities of thromboprophylaxis. Based on the literature, we make suggestions for venous thromboembolism prevention and include an approach for consideration by rehabilitation units that can be aligned with local practice. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) is associated with an increase in venous thrombotic and cardiovascular (CV) events has been reported during hospitalization. No systematic ultrasound follow-up to evaluate sequelae was ever that took place carried out prospectively associated with the evaluation of CV morbidity-mortality at 3 months post-discharge. Consecutive patients hospitalized for COVID-19 in the Amiens-Picardie University Hospital between 1st February and 31st August 2020 were included. The primary objective was the thrombosis incidence at 3 months after hospital discharge. Thrombosis was defined as either venous thromboembolism (VTE) or a CV event (CVE: myocardial infarction (MI), stroke or peripheral arterial disease). A secondary objective was to determine the risk factors for thrombotic events. We included 498 patients (279 men; 56%) of median age 66 (55-76) years. The primary composite outcome occurred in 27 patients (5.4%); 19 patients (3.8%) presented a CVE (stroke, n = 5; MI, n = 9; and peripheral arterial disease, n = 5). Two patients (0.8%) presented VTE. Six patients (1.2%) died. In multivariate analysis, a previous CVE was associated with thrombosis (OR 3.11; 95% CI 1.17-8.24). COVID-19 was significantly associated with thrombotic events post hospital discharge. Special attention should be given to CVE in the follow-up of patients with a previous thrombotic event. [ABSTRACT FROM AUTHOR]

Venous thromboembolism (VTE), including both pulmonary embolism (PE) and deep vein thrombosis (DVT), is the leading cause of maternal death in developed countries. Pregnancy is associated with an increased risk of VTE due to physiologic changes during the obstetric period that promote a hypercoagulable state. Appropriate use of prophylactic anticoagulants can decrease the event rate of thrombus formation in at-risk patients. In the United States, there is not a validated risk-assessment tool for VTE in obstetric patients or a clear consensus on initiation and optimal dosing strategy for the prophylactic use of anticoagulants. This article reviews the mechanism of coagulation disturbance that leads to an increased risk of VTE in obstetric patients, as well as the available literature surrounding pharmacologic prophylaxis. [ABSTRACT FROM AUTHOR]

Introduction: Venous thromboembolism (VTE) remains a leading cause of preventable harm among hospitalized patients. Pharmacologic VTE prophylaxis reduces the rate of in-hospital VTE by 60%, but medication administration is often missed for various reasons. Electronic medical record (EMR) prompts may be a useful tool to decrease withholding of critical VTE chemoprophylaxis medications. Methods: In August 2021, an EMR prompt was implemented at a tertiary referral academic medical center mandating nursing staff to contact a provider for approval before withholding VTE chemoprophylaxis. A pre-intervention group from August 2020 to August 2021 was compared to a post-intervention group from August 2021 to August 2022. Rates of VTE chemoprophylaxis withholding were compared between the groups with a P <.01 considered significant. Results: A total of 16,395 patients prescribed VTE chemoprophylaxis were reviewed, with 13,395 (81.7%) receiving low molecular weight heparin. Of the 16,395 patients included, 10,701 (65.3%) were medical and 5694 (34.7%) were surgical. Patients in the pre-intervention cohort (n = 8803) and post-intervention cohort (n = 7592) were similar in hospital length of stay and duration of DVT prophylaxis. In the post-intervention group, the frequency of surgical patients with at least one missed dose had increased by 4.2% (P =.002), with the trauma and acute care surgery (TACS) show an increase of 6.6% (P <.001). However, the frequency of medical patients and non-TACS patients with missed doses decreased by 3.1% (P =.002) and 1.0% (<.001), respectively. Conclusions: EMR prompts appear to be a low-cost intervention that increases the rate of VTE prophylaxis administration among medical and elective surgery patients. [ABSTRACT FROM AUTHOR]

Venous thromboembolism prophylaxis with subcutaneous unfractionated heparin or low molecular weight heparin is a common practice in hospitalized patients. Typically, prophylactic doses of these medications have poor bioavailability and thus do not reach therapeutic serum concentrations. However, in certain circumstances, heparin binding proteins may become saturated. Here we report a case series of 5 patients who had elevated anti-Xa levels while receiving prophylactic dosing of subcutaneous unfractionated heparin. [ABSTRACT FROM AUTHOR]

During standard cadaveric dissection we encountered multiple vascular variations in the retroperitoneum: duplicated and dilated left ovarian vein with the coexistence of a persistent right mesonephric artery. [ABSTRACT FROM AUTHOR]

Background: Patients undergoing non-major orthopedic surgery often face an increased risk of venous thromboembolism due to the necessity of immobilization postoperatively. Current guidelines commonly recommend the use of low-molecular-weight heparin (LMWH) for prophylaxis, but it is associated with low patient compliance and certain side effects. We conducted a meta-analysis of randomized controlled trials (RCTs) to assess the effectiveness and safety of rivaroxaban or LMWH for thromboprophylaxis following non-major orthopedic surgery. Method: Relevant literature was systematically searched in PubMed, Web of Science, Cochrane Library, and Embase from their inception to October 1, 2023, to evaluate the effectiveness and safety of rivaroxaban or LMWH in RCTs for thromboprophylaxis following non-major orthopedic surgery. Results: A total of 5 randomized controlled trials involving 5,101 patients were included. There was no statistically significant difference in the preventive effect against venous thromboembolism (VTE) when using rivaroxaban or LMWH following non-major orthopedic surgery (RR 0.80; 95%CI 0.31 to 2.07). In terms of safety, there was also no statistically significant difference in the incidence of bleeding events in patients undergoing non-major orthopedic surgery when using rivaroxaban or LMWH (RR 1.15; 95% CI 0.75 to 1.76). Conclusion: In non-major orthopedic surgery, the risk of venous thromboembolism and bleeding complications is similar when using rivaroxaban or LMWH. [ABSTRACT FROM AUTHOR]

Background: Tentorial dural arteriovenous fistulas (dAVFs) are categorized based on venous drainage and location. Although their angioarchitecture may initially appear intimidating, once "decodified," treatment is straightforward. Posteromedial tentorial dAVFs have an arterialized draining vein that emanates from the inferior tentorium along the posterior third of the straight sinus, just slightly off the midline. Method: With the aid of anatomical dissections, intraoperative photos, and operative videos, we outline the key steps for surgical treatment of posteromedial tentorial dAVFs. Conclusion: Posteromedial tentorial dAVFs constitute a precise and well-defined subtype of tentorial dAVF for which surgical ligation has an important role. [ABSTRACT FROM AUTHOR]

Euonymus fangdingianus, a new species from southwestern China and northern Vietnam, is described and illustrated. This species differs from its congeners mainly in having large and thick leaf blade, abaxially black‐punctate blade, impressed and abaxially prominent veins, cauliflorous inflorescences, 5‐merous dark purple flowers, and obovoid capsules with angles and grooves. A photograph image and conservation assessment for the new species are provided. In addition, the cauliflory in E. fangdingianus, an unusual flowering pattern in Euonymus, is preliminarily described. [ABSTRACT FROM AUTHOR]

Scholars usually consider the Historia anatomica corporis humani, published in 1600 by André du Laurens, as an obsolete defense of Galenic principles against the novelty of Vesalian material. Although du Laurens’s book plagiarized many illustrations from Vesalius’s De humani corporis fabrica (1543), critics such as Choulant insisted that the Historia’s iconography had “no particular anatomical or artistic value.” However, four of the Historia’s engravings appear to be original. One of these, the Tabula hæc veram spinalis medullae et nervorum ab ea prodeuntium effigiem exprimit, is now famous for depicting the intradural spinal nerves as a horsetail, leading to the addition of the term cauda equina to the anatomical lexicon. A less flamboyant figure from the same plate shows small blood vessels coursing over the surface of the cervical spinal cord. This drawing may be the first published depiction of anterior spinal arteries and veins. [ABSTRACT FROM AUTHOR]

Structural features are capable of effectively capturing the overall texture variations in images. However, in locally prominent areas with visible veins, other characteristics such as directionality, convexity–concavity, and curvature also play a crucial role in recognition, and their impact cannot be overlooked. This paper introduces a novel approach, the histogram of variable curvature directional binary statistical (HVCDBS), which combines the structural and directional features of images. The proposed method is designed for extracting discriminative multifeature information in vein recognition. First, a multidirection and multicurvature Gabor filter is introduced for convolution with vein images, yielding directional and convexity–concavity information at each pixel, along with curvature information for the corresponding curve. Simultaneously incorporating the original image feature information, these four aspects of information are fused and encoded to construct a variable curvature binary pattern (VCBP) with multifeatures. Second, the feature map containing multifeature information is blockwise processed to build variable curvature binary statistical features. Finally, competitive Gabor directional binary statistical features are combined, and a matching score‐level fusion scheme is employed based on maximizing the interclass distance and minimizing the intraclass distance to determine the optimal weights. This process fuses the two feature maps into a one‐dimensional feature vector, achieving an effective representation of vein images. Extensive experiments were conducted on four widely utilized vein databases, and the results indicate that the proposed algorithm, compared with solely extraction of structural features, achieved higher recognition rates and lower equal error rates. [ABSTRACT FROM AUTHOR]

A new procercopid species Stellularis kazuoensis sp. nov. is established and described from the Lower Cretaceous Jiufotang Formation in the Kazuo Basin, western Liaoning Province, NE China. It is characterised by the tegmen with singular RA, RP and M veins; vein M+CuA about half length of vein R; vein RA curved in apical area; and crossvein m-cua apicad of CuA2 end but basad of ir and r-m. The new species not only increases the diversity of Procercopidae but also provides more tegminal information of the genus Stellularis. The venational distinctions on tegmen between S. kazuoensis sp. nov. and the other species of Stellularis are schematically shown and discussed. The record of fossil insects from the Jiufotang Formation is also summarised. [ABSTRACT FROM AUTHOR]

The evaluation of white matter lesions (WMLs) showing the central vein sign (CVS) and paramagnetic rim lesions (PRLs) has been suggested to enhance the diagnostic work‐up of adult multiple sclerosis (MS). We aimed to evaluate the fulfillment of different CVS criteria and the added value of PRLs in 22 pediatric MS patients. Eleven patients (50%) fulfilled the 40%‐rule threshold. Nineteen (86%) patients had ≥3 CVS+ WMLs or ≥1 PRL, whereas 17 (77%) had ≥6 CVS+ WMLs or ≥1 PRL. A simplified CVS‐based approach, with the combined evaluation of ≥1 PRL in patients with ≥6 CVS+ WMLs, may improve MS diagnosis in pediatric patients. [ABSTRACT FROM AUTHOR]

Simple Summary: The development of cancer is associated with coagulation disorders. Blood cancers should be particularly associated with hypercoagulability and thus thromboembolic complications. An essential finding of this study is that arterial thromboembolism (myocardial infarction or stroke) occurs significantly more often than venous thromboembolism (pulmonary embolism or/and thrombosis) preceding the diagnosis of hematological malignancy. Interestingly, venous thromboembolism occurs significantly more often in acute leukemia (myeloid or lymphocytic) and chronic myeloproliferative disease. However, the chance of venous thromboembolism is increased before and after the diagnosis of myeloproliferative disease. More research is needed on the relationship between venous thromboembolism development and myeloproliferative disease progression. Objectives. Venous and arterial thromboembolism (VTE/ATE) often coexist with onco-hematologic diagnosis. This study aimed to assess the time relationship between the diagnosis of VTE/ATE and blood cancers. The second aim was to identify VTE/ATE risk factors related to the type of hematology disease and cardiac history. Methods. A total of 1283 patients underwent cardio-oncology evaluation at the Institute of Hematology and Transfusion Medicine in Warsaw from March 2021 through March 2023 (2 years), and 101 (7.8%) cases were identified with VTE/ATE. Results. ATE compared with VTE significantly occurred more often before the diagnosis and treatment of hematologic malignancy: 33/47 (70.2%) vs. 15/54 (27.8%), p < 0.0001. The risk of a VTE episode is exceptionally high in the first months after the diagnosis of an onco-hematological disease and the initiation of anticancer treatment. The higher frequency of VTE was associated with acute myeloid leukemia (17 cases/270 patients/6.30%/p = 0.055), acute lymphocytic leukemia (7 cases/76 patients/9.21%/p = 0.025), and chronic myeloproliferative disease (7 cases/48 patients/14.58%/p = 0.0003). Only the risk of VTE was significantly increased before (OR = 6.79; 95% CI: 1.85–24.95; p = 0.004) and after diagnosis of myeloproliferative disease (OR = 3.12; 95% CI: 1.06–9.16; p = 0.04). Conclusions. ATEs occur more often than VTE before a diagnosis of blood cancer. The risk of VTE is exceptionally high before and after diagnosis of chronic myeloproliferative disease. [ABSTRACT FROM AUTHOR]

Simple Summary: People living with cancer are at a higher risk of developing a venous thromboembolism (VTE). A VTE may interrupt anticancer therapy, which increases the risk of mortality. Cancer treatment guidelines recommend the use of preventive anticoagulants only in those at high risk of a VTE, identified by a valid risk assessment tool, such as the Khorana score. However, the Khorana score at its original cut-off value of 3 points has a low sensitivity and discriminatory capability in lung cancer patients, and the updated Khorana score with a 2-point cut-off value lacks validation in this population. Other risk scores, such as the PROTECHT, CONKO, and COMPASS-CAT scores, have not been validated in large lung cancer cohorts. The aim of this study was to evaluate these four existing risk scores in this patient population. We validated the Khorana score with a cut-off value of 2 points and the CONKO score with a cut-off value of 2 points. Background: The purpose of this study was to evaluate the discriminatory capability of the Khorana, PROTECHT, CONKO, and COMPASS-CAT scores in ambulatory patients with lung cancer. Methods: This retrospective cohort study included 591 patients with newly diagnosed lung cancer. A symptomatic or incidental VTE occurred in 108 patients. Results: The Khorana score at a 2-point threshold had a discriminatory capability with an odds ratio (OR) of 1.80 and an AUC of 0.57 for 6 months, and an OR of 1.51 and an AUC of 0.55 for 12 months. The CONKO score at a 2-point threshold had a stronger discriminatory capability for both 6 months and 12 months with ORs of 3.00 and 2.13, and AUCs of 0.63 and 0.59, respectively. Additionally, higher white blood cell counts, higher neutrophil counts, hypoalbuminaemia, and not undergoing lung surgery were related to VTE occurrence (p < 0.05). Conclusions: The Khorana score with the 2-point threshold was validated in ambulatory patients with lung cancer, with the results indicating a decline in its discriminatory capability over time (at 12 months vs. 6 months from diagnosis). The CONKO score at the original 2-point threshold showed a stronger discriminatory capability but further validation with a larger sample size is recommended. The identified predictors should be further investigated in future research. [ABSTRACT FROM AUTHOR]

Finger vein (FV) biometrics have garnered considerable attention due to their inherent non-contact nature and high security, exhibiting tremendous potential in identity authentication and beyond. Nevertheless, challenges pertaining to the scarcity of training data and inconsistent image quality continue to impede the effectiveness of finger vein recognition (FVR) systems. To tackle these challenges, we introduce the visual feature-guided diamond convolutional network (dubbed 'VF-DCN'), a uniquely configured multi-scale and multi-orientation convolutional neural network. The VF-DCN showcases three pivotal innovations: Firstly, it meticulously tunes the convolutional kernels through multi-scale Log-Gabor filters. Secondly, it implements a distinctive diamond-shaped convolutional kernel architecture inspired by human visual perception. This design intelligently allocates more orientational filters to medium scales, which inherently carry richer information. In contrast, at extreme scales, the use of orientational filters is minimized to simulate the natural blurring of objects at extreme focal lengths. Thirdly, the network boasts a deliberate three-layer configuration and fully unsupervised training process, prioritizing simplicity and optimal performance. Extensive experiments are conducted on four FV databases, including MMCBNU_6000, FV_USM, HKPU, and ZSC_FV. The experimental results reveal that VF-DCN achieves remarkable improvement with equal error rates (EERs) of 0.17 % , 0.19 % , 2.11 % , and 0.65 % , respectively, and Accuracy Rates (ACC) of 100 % , 99.97 % , 98.92 % , and 99.36 % , respectively. These results indicate that, compared with some existing FVR approaches, the proposed VF-DCN not only achieves notable recognition accuracy but also shows fewer number of parameters and lower model complexity. Moreover, VF-DCN exhibits superior robustness across diverse FV databases. [ABSTRACT FROM AUTHOR]

ABSTRACT The importance of treating non‐pulmonary vein (PV) foci is increasing with improvements in the durability of PV isolation. We describe two cases wherein non‐PV foci were induced by mechanical irritation and conventional induction in the same area, which was impossible to induce after ablation, suggesting a relationship between mechanical irritation and induction of non‐PV foci. In a recurrent case of non‐PV foci, atrial fibrillation (AF) was induced only by mechanical irritation. No recurrence has been observed since the ablation of the area. Thus, treatment of the AF induction site with mechanical irritation could be considered an effective therapy for non‐PV foci. [ABSTRACT FROM AUTHOR]

Background: Venous thromboembolism (VTE) in pregnancy is a major cause of maternal morbidity and mortality, and the use of preventive low-molecular-weight heparin (LMWH) can be challenging. Clinical guidelines recommend eliciting pregnant individuals' preferences towards the use of daily injections of LMWH and discussing the best option through a shared decision-making (SDM) approach. Our aim was to identify individuals' preferences concerning each of the main clinical outcomes, and categorize attributes influencing the use of LMWH during pregnancy. Methods: Design: Convergent mixed-methods. Participants: Pregnant women or those planning a pregnancy with VTE recurrence risk. Intervention: A SDM intervention about thromboprophylaxis with LMWH in pregnancy. Analysis: Quantitatively, we report preference scores assigned to each of the health states. Qualitatively, we categorized preference attributes using Burke's pentad of motives framework: act (what needs to be done), scene (patient's context), agent (perspectives and influence of people involved in the decision), agency (aspects of the medication), and purpose (patient's goals). We use mixed-method convergent analysis to report findings using side-by-side comparison of concordance/discordance. Results: We comprehensively determined preferences for using LMWH by pregnant individuals at risk of VTE: through value elicitation exercises we found that the least valued health state was to experience a pulmonary embolism (PE), followed by major obstetrical bleeding (MOB), deep vein thrombosis (DVT), and using daily injections of LMWH (valued as closest to a 'healthy pregnancy'); through interviews we found that: previous experiences, access to care (scene) and shared decision-making (agent) affected preferences. LMWH's benefits were noted, but substantial drawbacks were described (agency). For participants, the main goal of using LMWH was avoiding any risks in pregnancy (purpose). Side-by-side comparisons revealed concordance and discordance between health states and motives. Conclusions: Mixed-methods provide a nuanced understanding of LMWH preferences, by quantifying health states preferences and exploring attributes qualitatively. Incorporating both methods may improve patient-centered care around preference-sensitive decisions in thromboprophylaxis during pregnancy. [ABSTRACT FROM AUTHOR]

Background: Hepatic vein embolization in double vein embolization (DVE) can be performed with transhepatic, transjugular or transfemoral access. This study evaluates the feasibility and technical success of using a transfemoral access for the hepatic vein embolization in patients undergoing preoperative to induce hypertrophy of the future liver remnant (FLR). Material and methods: Retrospective analysis of single center cohort including 17 consecutive patients. The baseline standardized FLR was 18.2% (range 14.7–24.9). Portal vein embolization was performed with vascular plugs and glue through an ipsilateral transhepatic access. Hepatic vein embolization was performed using vascular plugs. Access for the hepatic vein was either transhepatic, transjugular or transfemoral. Technical success, number of hepatic veins embolized and complications were registered. In addition, volumetric data including degree of hypertrophy (DH) and kinetic growth rate (KGR), and resection data were registered. R: Seven of the 17 patients had transfemoral hepatic vein embolization, with 100% technical success. No severe complications were registered. In the whole cohort, the median number of hepatic veins embolized was 2 (1–6). DH was 8.6% (3.0–19.4) and KGR was 3.6%/week (1.4–7.4), without significant differences between the patients having transfemoral versus transhepatic /transjugular access (p = 0.48 and 0.54 respectively). Time from DVE to surgery was median 4.8 weeks (2.6–33.9) for the whole cohort, with one patient declining surgery, two having explorative laparotomy and one patient having change of surgical strategy due to insufficient growth. Conclusion: Transfemoral access is a feasible option with a high degree of technical success for hepatic vein embolization in patients with small future liver remnants needing DVE. [ABSTRACT FROM AUTHOR]

Flue-cured tobacco (FCT) can be classified into upper (B), middle (C), and lower (X) parts based on characteristics such as the FCT's main veins, leaf shape, color, and thickness. Accurately measuring the geometric parameters of the main veins is crucial for identifying the different parts. However, this task has proven to be challenging. Therefore, segmenting the main veins is a prerequisite to reducing calculation errors and improving the precision of part identification. To obtain enough semantic information and improve segmentation accuracy, we propose a fine segmentation model (MSHF-Net) of FCT's main veins based on multi-level-scale features of hybrid fusion. Firstly, MobileNetV2 with a dilated convolution layer (DMobileNetV2) is selected as the backbone network for feature extraction, which optimizes training and inference speed to minimize computing costs. Subsequently, Hybrid Fusion Atrous Spatial Pyramid Pooling (HFASPP) is designed to be the strengthened backbone module for capturing more high-level semantic information, effectively preventing intermittent segmentation of some main veins. Additionally, considering the low proportion of main vein targets in the original image, the double shallow feature branches (DSFBS) are included to obtain more low-level semantic information. Finally, a channel attention mechanism (ECANet) is added to enhance useful information and eliminate redundant information after the hybrid fusion of high-low-level semantic information, preventing mis-segmentation of regions. Experimental validation demonstrates the efficiency of the MSHF-Net, with parameters of only 7.92 M, thus ensuring minimal computational requirements. The model achieves an impressive mean intersection over union (MIoU) of 85.57% and mean pixel accuracy (mPA) of 93.10% on a diverse test set of FCT parts. When applied to segment main veins in a 2296 × 1548 × 3 tobacco image, the model takes just over 0.1 s. It is noteworthy that none of the 291 randomly segmented tobacco leaf main veins show mis-segmentation, highlighting the model's robustness and practical applicability in various scenarios. These results emphasize the superior segmentation performance of the proposed model, establishing a crucial foundation for accurately discriminating FCT parts. [ABSTRACT FROM AUTHOR]

The given text discusses Sperner's lemma, a combinatorial result related to topology, and its applications in various mathematical concepts such as simplicial complexes, orientations, and colorings. The text provides technical explanations, proofs, and examples to support the understanding of these concepts. It also mentions previous works and suggests further research in the field. The author acknowledges the contributions of others and mentions funding from the Simons Foundation. [Extracted from the article]

Background: Cerebrospinal fluid (CSF) oligoclonal bands (OCB) are a diagnostic biomarker in multiple sclerosis (MS). The central vein sign (CVS) is an imaging biomarker for MS that may improve diagnostic accuracy. Objectives: The objective of the study is to examine the diagnostic performance of simplified CVS methods in comparison to OCB in participants with clinical or radiological suspicion for MS. Methods: Participants from the CentrAl Vein Sign in MS (CAVS-MS) pilot study with CSF testing were included. Select-3 and Select-6 (counting up to three or six CVS+ lesions per scan) were rated on post-gadolinium FLAIR* images. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value for Select-3, Select-6, OCB, and combinations thereof were calculated for MS diagnosis at baseline and at 12 months. Results: Of 53 participants, 25 were OCB+. At baseline, sensitivity for MS diagnosis was 0.75 for OCB, 0.83 for Select-3, and 0.71 for Select-6. Specificity for MS diagnosis was 0.76 for OCB, 0.48 for Select-3, and 0.86 for Select-6. At 12 months, PPV for MS diagnosis was 0.95 for Select-6 and 1.00 for Select-6 with OCB+ status. Discussion: Results suggest similar diagnostic performance of simplified CVS methods and OCB. Ongoing studies will refine whether CVS could be used in replacement or in conjunction with OCB. [ABSTRACT FROM AUTHOR]

Background: Sleeve gastrectomy is the most common bariatric procedure and its long-term complications include inadequate weight loss, weight regain, and de novo GERD, often requiring revisional surgery. Revisions, notably re-sleeve and conversion to Roux-en-Y gastric bypass (RYGB), are frequently performed, but safety data is limited. Herein, we used the MBSAQIP database to compare 30 day outcomes of primary sleeve gastrectomy (SG) with re-sleeve (RS) and SG to RYGB conversion. Methods: Patients who underwent primary SG, RS, and SG to RYGB conversion within the MBSAQIP data registry from January 1, 2020 to December 31, 2022 were included in this study. Using Propensity Score Matching analysis, the cohorts were matched for 23 preoperative characteristics. We then compared 30 day postoperative outcomes and bariatric-specific complications between primary SG and RS (analysis 1) and between RS and SG to RYGB conversion (analysis 2). Results: A total of 302,961 were included. The matched cohorts in analysis 1 (n = 1630) and analysis 2 (n = 1633) had similar pre-operative characteristics. Propensity-matched outcomes in analysis 1 showed that patients in the RS group had significantly higher staple line leak (1.3% vs. 0.1%, p < 0.001) when compared to primary SG. Similarly, longer operative times (90.16 ± 51.90 min vs. 68.32 ± 37.54 min, p < 0.001) and higher rates of readmissions (5.5% vs. 2.1%, p < 0.001), reoperations (2.3% vs. 0.6%, p < 0.001), interventions (2.5% vs. 0.4%, p < 0.001) were found in those who underwent RS. In analysis 2, RS showed higher leak rates (1.3% vs. 0.5%, p = 0.015) when compared to conversion from SG to RYGB. Conclusion: The RS group has a higher risk of staple line leaks compared to primary SG and conversion from SG to RYGB. In our study, there was a 2.6-fold increase in staple line leak after re-sleeve compared to RYGB conversion and a 13-fold increase compared to primary SG. [ABSTRACT FROM AUTHOR]

Chronic kidney disease (CKD) remains a significant global health issue and is a leading cause of mortality worldwide. Patients with CKD have an increased risk of developing atrial fibrillation (AF) and venous thromboembolism (VTE). While direct oral anticoagulants (DOACs) have become a standard of care for anticoagulation (AC) in patients with AF and VTE, the appropriate use of these agents in comorbid kidney impairment warrants detailed discussion. This scientific narrative review summarizes the effectiveness and safety of apixaban use in patients with renal dysfunction by assessing the current published pharmacokinetic, interventional, observational, and guideline data. Apixaban is a highly selective, orally active, direct inhibitor of factor Xa, with well-established pharmacokinetics and consistent clinical outcomes across a broad range of patient populations, including those with kidney impairment. Overall, the scientific literature has shown that apixaban has a favorable clinical efficacy and safety profile compared with vitamin K antagonists for patients with AF or VTE and comorbid kidney impairment. These data support the approved label dosing strategy of apixaban in reducing the risk of stroke/systemic embolism in patients with nonvalvular AF and in treating VTE across all ranges of kidney function. Both clinician experience and knowledge of patient-specific factors may be required in the management of comorbid patients with advanced CKD or those requiring dialysis, as data on these patients are limited. [ABSTRACT FROM AUTHOR]

On the White Sea islands and coast of North Karelia, in the Chupa sector of the Belomorian mobile belt (BMB), carbonate–silicate and quartz veins are localized in bodies of Early Proterozoic metabasites and their contacts with host gneisses. The isotopic characteristics of coarse crystal vein carbonates (δ18O and δ13C), as well as associated quartz (δ18O) and biotite (δ18O and δD), were studied. The isotopic composition of oxygen suggests biotite–quartz–carbonate equilibria during the formation of veins at temperatures of 520–450°C. The O and H isotopic characteristics of biotite correspond to the equilibrium of the fluid with metamorphic rocks. At the same time, the isotopic compositions of O and C carbonates indicate different CO2 sources in fluids. There are three groups of carbonates according to δ18О and δ13С. The first group shows "magmatic" isotopic characteristics of the CO2 source (δ18ОVSMOW = 7.1...12.1‰; δ13СVPDB = –6.3...–4.5‰). Carbonates of the second group have high δ18О and δ13С, characteristic of Precambrian sedimentary carbonates (δ18ОVSMOW = 21.9...24.7‰; δ13СVPDB = –2.2...–2‰), similar to those described earlier in the neighboring Engozero sector of the BMB. In the third group, the δ13С values are similar to the carbonates of the first group, and δ18О, to the second group (δ13СVPDB = –1.7...0.9‰, δ18ОVSMOW = 6...12‰). The O and C isotopic compositions of carbonates of the third group can be obtained from the action of a putative magmatic fluid on both the primary sedimentary source of metamorphic fluids and redeposited vein carbonates. [ABSTRACT FROM AUTHOR]

Paediatric neurovascular anomalies associated with the vein of Galen (VG) comprise of a spectrum of rare, complex, and life-threatening conditions. In this group, the "vein of Galen aneurysmal dilatation" (VGAD) is a distinct entity that often presents with progressive neurological symptoms in older children. Acute haemorrhage in VGAD is uncommon. We present an unusual presentation of VGAD in a neonate and discuss the challenges faced in the management. [ABSTRACT FROM AUTHOR]

Background Prior studies have shown an increased risk of complications and flap loss with the use of vein grafts in microsurgery. We hypothesize that indication for use of a vein graft can affect flap complications and loss rates. Methods We performed a retrospective review of all patients at our institution from 2010 to 2020 who underwent free flap reconstruction and required use of a vein graft. Indications for vein grafting included: salvage of flap during primary operation after microvascular compromise, augmentation of flow during primary operation, lengthening of the flap pedicle during the primary operation, and salvage of the flap during a secondary salvage operation after microvascular compromise. Results A total of 79 patients met the study inclusion criteria. There were significant differences among the vein graft indication groups and the following: area of reconstruction (p = 0.002), vein graft length (p = 0.018), vessels grafted (p = 0.001), vein graft donor site (p = 0.011), and total flap loss (p = 0.047). Of the four indications for vein grafting, salvage of the flap during secondary salvage operation after microvascular compromise had the highest rate of total flap loss (26.7%). There were no significant associations between other flap complications and vein graft indications. Conclusion Vein graft use in the primary reconstructive setting is efficacious, with low risk of thrombosis. Use in secondary procedures, however, is associated with higher rates of total flap loss, likely due to the thrombotic process, which was initiated prior to the use of the graft resulting in the salvage procedure and not secondary to the graft itself. [ABSTRACT FROM AUTHOR]

Background: As the elderly population continues to grow worldwide, it becomes crucial to explore safe and effective treatment options to manage venous thromboembolic disease in this vulnerable demographic group. Methods: We carried out a retrospective cohort study (January 2017–December 2021) to analyse the efficacy and safety of bemiparin as a treatment for venous thromboembolic disease in 223 patients. We compared patients aged ≥65 years (elderly; n = 153) with patients aged less than 65 years (adults; n = 70) for a combined end point of death, recurrent thromboembolism, and major bleeding at 30 days. Results: Elderly (mean age 79 ± 7.7 years) and adult patients (mean age 51.5 ± 11.6 years) received similar bemiparin doses 8470 ± 2362 International units (IU)/d versus 8754 ± 1593 IU/d, during a similar median [Interquartile range] period of 28 [9–118] versus 30 [10–90] days, respectively. At 30‐day follow up a total of 24 elderly patients (15.7%), reached at least one of the end points, as compared with six adult patients (8.6%) (absolute difference 7.1%; 95% confidence interval [95% CI], −1.6 to 15.8). Recurrence of venous thromboembolic disease occurred in five elderly patients (3.3%) and in five adult patients (7.1%) (absolute difference −3.9%; 95% CI, −10.5 to 2.8). There were two episodes of major bleeding each in elderly (1.3%) and adult (2.9%) patients (absolute difference −1.6%; 95% CI, −5.8 to 2.7). Conclusion: Bemiparin showed a similar efficacy and safety profile in the treatment of venous thromboembolic disease in elderly and adult patients. [ABSTRACT FROM AUTHOR]

Aim: This study was conducted to compare the satisfaction of patients diagnosed with diabetes mellitus regarding blood glucose measurement based on the blood glucose measurement techniques (intravenous and capillary) used. Material and Method: A randomized controlled study was conducted with 110 patients with diabetes mellitus. Patients were randomized into the experimental group (n=55) and control group (n=55). Patient Information Form, Diabetes Fear of Injecting and Self-testing Questionnaire (D-FISQ), and Blood Glucose Measurement Patient Satisfaction Form were used in the study. The control group patients had their blood sugar measured using capillary blood from a finger prick. The experimental group patients had their blood glucose measured intravenously using venous blood, followed by capillary blood glucose measurement from a finger prick. Data analysis was conducted using chi-square test and independent t-test. Results: There were statistically significant differences in the satisfaction of diabetic patients with the blood glucose measurement technique between the use of venous blood and intravenous blood glucose measurement by finger prick (p<0.05). Conclusion: The measurement of blood glucose using venous blood obtained by an intravenous catheter positively affects patient satisfaction compared to the finger prick technique of measuring capillary blood glucose in patients with diabetes. [ABSTRACT FROM AUTHOR]

Background Foreign bodies that migrate into the heart may include medical devices dislodged from their original location or, rarely, external particles (shrapnel and other foreign bodies) that penetrate the vein, remain intraluminal, and migrate via the venous blood flow to the right heart. Most reported entry sites of these external foreign bodies were in the torso, thigh, or neck; none of them penetrated through a distal extremity of the body. We report a case where shrapnel was found in the right ventricle (RV) following penetrating injury to the hand. Case summary An otherwise healthy 24-year-old man presented with an isolated shrapnel injury to his right hand and forearm from an explosion trauma. Computed tomography demonstrated multiple small metal objects in the forearm, hand, and wrist. Additionally, a 3 × 3.5 mm metal object was found in the RV, consistent with a metal shrapnel embolus from the forearm. Echocardiography indicated the fragment to be in a fixed position within the RV, without any additional pathology. Discussion Even shrapnel that penetrates through the hand or forearm may migrate to the heart. In this case, following a multidisciplinary discussion, a conservative approach was recommended based on the following condition: lack of symptoms, small size of the foreign body, no obstruction of venous effluent, low risk of significant embolization to the pulmonary vasculature, absence of fever or endocarditis, no current evidence or risk of valve dysfunction, and no myocardial irritation indicated by arrhythmia. The patient was instructed to avoid magnetic resonance imaging scans. [ABSTRACT FROM AUTHOR]

Limited reports have evaluated the utility of the popliteal vein (PV) specific to cannulation. The objective of this study was to characterize the diameter and length of the PV to evaluate this area as a potential cannulation site. The popliteal region in 23 formalin-embalmed, prosected donors was dissected, and the PV was exposed from the adductor hiatus (AH) superiorly to the small saphenous vein (SSV) inferiorly. The diameter of the popliteal vein was measured at the AH, SSV, and half of the distance from the AH to the SSV (MID) using a brass plumb bob. The length of the PV was measured to the AH, SSV, MID, and femoral condyles (FCs). Overall, the mean diameters and mean lengths for the combined population were calculated, as well as individual limbs (right, left) and anatomical sex. Univariate analysis used to evaluate differences in mean diameter and length measurements based on anatomical sex revealed significant differences (p < 0.05) for both diameter and length at all the landmarks evaluated. Multivariate analysis of PV diameter at the AH and SSV landmarks was statistically significant (p < 0.05) when laterally and anatomical comparing sex. These data provide full characterization of the PV in support of its utility in vascular access. [ABSTRACT FROM AUTHOR]

Veins of the lower extremity can be categorized into three hierarchically ordered groups: the epifascial, the interfascial, and the deep ones. In the past, the interfascial veins, e.g., the great saphenous vein, were categorized as superficial veins. But nowadays, experts recommend regarding these veins as a separate group because of their unique topography and clinical relevance. In order to better understand the venous anatomy of the lower limbs, which is highly variable, one should also comprehend their embryological development. Venous embryogenesis in the lower limb consists of three stages. During the first stage the primitive fibular vein is the main vein of the extremity. During the second stage it is replaced by the axial vein and finally by the femoral vein. In some adult individuals this embryonic or fetal venous anatomy is still present. Unfortunately, current anatomical textbooks and atlases, as well as traditional cadaver dissections, are not very useful regarding these issues. Therefore, undergraduate teaching of anatomy can be challenging. New educational tools, such as ultrasonography, seem indispensable to teach the anatomy of these veins properly. [ABSTRACT FROM AUTHOR]

Scholars often approach the Amazon to explain the materiality of resource extraction in mining, oil, and agribusinesses. This region has been less used for theorizing the different scales and dimensions of extractivism, and its relationship with mega-infrastructures. This paper contributes to this endeavor by reflecting on the IIRSA, an ambitious portfolio of mega-infrastructure projects aimed at facilitating international trade with little concern for biodiversity and indigenous rights. Based on the analysis of policy documents and interviews, this study explores how infrastructure development in the Amazon relates to extractive activities and contributes to a deeper understanding of extractivism. [ABSTRACT FROM AUTHOR]

BACKGROUND: The Colorado potato beetle (CPB), Leptinotarsa decemlineata, is a major potato (Solanum tuberosum) pest, infesting over 16 million km2 and causing substantial economic losses. The insect cuticle forms an apical extracellular matrix (ECM) envelope covering exposed organs to direct morphogenesis and confer structural protection. While select chitinase (Cht) genes have proven essential for larval development, their potential activities directing ECM remodeling underlying adult wing maturation remain undefined. RESULTS: We investigated the expression patterns and performed an oral RNA interference (RNAi) screen targeting 19 LdChts in late‐instar L. decemlineata larvae. Subsequently, we assessed their effects on adult eclosion and wing characteristics. Knockdown of LdCht5, LdCht7, LdCht10, LdIDGF2, and LdIDGF4, as well as others from Group IV (LdCht15, LdCht12, LdCht17, and LdCht13) and Groups VII–X (LdCht2, LdCht11, LdCht1, and LdCht3), resulting in shrunken, misshapen elytra with reduced areal density, as well as transverse wrinkling and impaired wing‐tip folding in hindwings. Scanning electron micrographs revealed eroded elytral ridges alongside thinned, ruptured hindwing veins, indicative of mechanical fragility post‐LdCht suppression. Spectroscopic analysis uncovered biomolecular alterations underlying the elytral anomalies, including decreases in peaks representing chitin, proteins, and lipids. This loss of essential ECM components provides evidence for the fragility, wrinkling, and shrinkage observed in the RNAi groups. CONCLUSION: Our findings elucidate the crucial role of chitinases in the turnover of chitinous cuticles on beetle wings, offering insights into RNAi‐based control strategies against this invasive pest. © 2024 Society of Chemical Industry. [ABSTRACT FROM AUTHOR]

ABSTRACT Joint swarms can be important components of fractured reservoirs. They are often explained as damage around faults or related to mechanical differences between layers, although this does not explain the close spacing of the joints. Joint swarms around Bergen (Norway) are described, which are not related to exposed faults and are not influenced by layering or foliation in the Lower Palaeozoic gneisses. We suggest an evolution whereby: (1) a zone of microcracks develops; (2) one microcrack propagates and becomes connected to a source of mineralising fluid; (3) the fracture becomes a microvein, with a higher tensile strength than the microcracked host rock; (4) another microcrack propagates and the cycle is repeated, producing a zone of microveins; (5) the veins are partly weathered out, producing an apparent joint swarm, or the microveins crack at or near the ground‐surface. Joint swarms in exposed analogues may therefore not occur at reservoir depths. [ABSTRACT FROM AUTHOR]

Objective: To investigate the clinical significance of using 3D printing guides in modified unilateral puncture percutaneous vertebroplasty (PVP) for the treatment of osteoporotic vertebral compression fractures (OVCF), and to explore a new method for preventing paravertebral vein leakage during PVP in conjunction with a previous study of the optimal puncture-side bone cement/vertebral volume ratio(PSBCV/VV%). Methods: This retrospective study analyzed 99 patients who underwent unilateral puncture PVP between January 2023 and December 2023. Patients were divided into a guide plate group (46 patients) and a conventional group (53 patients). The guide plate group underwent modified unilateral puncture PVP with the guidance of 3D printing guides, while the conventional group underwent unilateral puncture PVP using the conventional pedicle approach. The distribution of bone cement, surgical outcomes, and the occurrence of cement leakage into paravertebral veins were observed in both groups. Results: The guide plate group had significantly shorter operating time and required fewer fluoroscopies compared to the conventional group. The amount of bone cement volume (BCV) used in the guide plate group was higher, but the amount of bone cement volume on the puncture side(PSBCV), the PSBCV/VV%, and the rate of paravertebral vein leakage were lower in the guide plate group compared to the conventional group (P < 0.05). Within each group, significant improvements in anterior vertebral margin height, Cobb angle, visual analog scale (VAS) score, and Oswestry Disability Index (ODI) were observed at 1 day and 1 month postoperatively compared to preoperative values (P < 0.05). Conclusion: Using 3D printing guides in modified unilateral puncture PVP is a safe and effective method for treating OVCF. And it has the advantages of short operation time, less fluoroscopy, even distribution of bone cement, and a low rate of paravertebral vein leakage. [ABSTRACT FROM AUTHOR]