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The long-term results of thoracic endovascular aortic repair (TEVAR) for uncomplicated type B aortic dissection (uTBAD) have been associated with improved aorta-specific survival and delayed disease progression compared with medical therapy alone. In 2020, the Society for Vascular Surgery (SVS) and Society for Thoracic Surgeons (STS) reported new reporting standards and classification for TBAD. We assessed the effectiveness of TEVAR in the treatment of uTBAD stratified by the updated classification using the Vascular Quality Initiative database. The Vascular Quality Initiative registry was queried for patients who had undergone TEVAR for uTBAD from August 2014 to November 2020. We analyzed the outcomes stratified by the SVS/STS reporting standards. The cohort was then grouped and compared using the updated chronicity classification (hyperacute, <24 hours; acute, 1-14 days; subacute, 15-90 days; and chronic, >90 days) and univariable methods (χ2, analysis of variance), multivariable logistic regression, and survival analysis (Kaplan-Meier, Cox regression). Of 1476 TEVARs, 121 (8.2%) were for hyperacute, 833 (56.4%) for acute, 316 (21.4%) for subacute, and 206 (14.0%) for chronic uTBAD. The rates of in-hospital stroke for hyperacute and acute uTBAD were significantly higher than was the rate for chronic uTBAD. The rate of spinal cord ischemia (SCI) was significantly higher for hyperacute and subacute uTBAD than for chronic uTBAD but not for acute vs chronic uTBAD. After multivariable adjustment, no significant difference was found in the 30-day mortality between the four groups. However, the adjusted stroke risk was more than sixfold higher for hyperacute uTBAD than for chronic uTBAD (odds ratio [OR], 6.78; 95% confidence interval [CI], 1.83-25.17; P =.004) and more than threefold higher for acute than for chronic uTBAD (OR, 3.42; 95% CI, 1.04-11.24; P =.043). The adjusted risk of SCI was also significantly higher for hyperacute and subacute than for chronic uTBAD (OR, 19.17; 95% CI, 2.42-151.90; P =.005; and OR, 8.64; 95% CI, 1.11-67.21; P =.039, respectively) but not for acute vs chronic uTBAD (OR, 6.95; 95% CI, 0.93-51.88; P =.059). The risk of postoperative reintervention was threefold higher for hyperacute vs chronic uTBAD (OR, 3.02; 95% CI, 1.19-7.69; P =.02). The Kaplan-Meier survival estimates revealed that the 1-year survival rate for hyperacute, acute, subacute, and chronic uTBAD was 83.2%, 87.2%, 92.3%, and 92.9%, respectively (P =.010). However, no significant differences were found in the hazard of 1-year mortality after adjustment for potential confounders. Using the updated SVS/STS chronicity classification, we found an increased risk of perioperative stroke, SCI, and the need for reintervention after TEVAR for uTBAD in the hyperacute periods compared with the chronic period. The updated classification should be incorporated into all future study designs for TEVAR trials. We would recommend avoiding TEVAR for uTBAD in the hyperacute phase. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Ophthalmology is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Popliteal artery aneurysms (PAAs) are rare in women, with only ∼5% of all PAAs occurring in women. The aim of the present study was to investigate whether sex disparities exist for patients treated with open PAA repair. We reviewed all patients with PAAs who had undergone open PAA repair in the Vascular Quality Initiative from January 2010 to July 2021. Univariate analyses and multivariable logistic or Cox regression analyses controlling for potential confounders were performed. The study outcomes included primary patency, major amputation, overall survival, and amputation-free survival at 1 year. The study included 3807 adult patients, of whom 160 were women (4.2%). The female patients were younger (age, 66.1 years vs 68.3 years; P =.012) and less likely to have coronary artery disease (14.5% vs 23.4%; P =.009). However, the women were more likely to be taking aspirin (69.2% vs 60.4%; P =.019) and statins (67.8% vs 60.4%; P <.001) and to undergo repair for symptomatic disease (77.5% vs 64.1%; P =.001). No difference was found between the women and men in primary patency (95.2% vs 90.8%; P =.230) and overall survival (94.3% vs 96.1%; P =.270). Amputation-free survival was lower for women than for men (91.4% vs 95.3%; P =.033). This finding resulted from by lower freedom from major amputation for women (96.1% vs 98.9%; P =.010). After adjustment for confounders, no differences were found between the women and men regarding the loss of primary patency and all-cause mortality. For symptomatic PAAs, the risk of major amputation was threefold greater for women (adjusted hazard ratio, 3.09; 95% confidence interval, 1.05-9.06; P =.040), and the risk of the composite end point of major amputation or death was twofold higher for women than for men (adjusted hazard ratio, 1.97; 95% confidence interval, 1.02-3.79; P =.043). In our large national study of patients with PAAs, women were more likely to be treated for symptomatic PAAs. The risk of 1-year major amputation was threefold greater for women with symptomatic PAAs than for men with a similar presentation. Early recognition and treatment of PAAs in women before the PAAs have become symptomatic could optimize limb salvage outcomes in women. [ABSTRACT FROM AUTHOR]

Vaccines are a powerful and relatively safe tool to protect against a range of serious diseases. Nonetheless, a sizeable minority of people express 'vaccination hesitancy'. Accordingly, understanding the bases of this hesitancy represents a significant public health opportunity. In the present study we sought to examine the role of Big Five personality traits and general intelligence as predictors of vaccination hesitancy across two vaccination types in a large (N = 9667) sample of UK adults drawn from the Understanding Society longitudinal household study. We found that lower levels of general intelligence were associated with COVID-19 and seasonal flu vaccination hesitancy, and lower levels of neuroticism was associated with COVID-19 vaccination hesitancy. Although the self-reported reasons for being vaccine hesitant indicated a range of factors were important to people, lower general intelligence was associated with virtually all of these reasons. In contrast, Big Five personality traits showed more nuanced patterns of association. [ABSTRACT FROM AUTHOR]

Although several studies have evaluated the impact of obesity on outcomes after abdominal aortic aneurysm repair, literature examining this association in thoracic endovascular aortic repair (TEVAR) is sparse. Here, we use a multi-institutional, international database to assess the role of body mass index (BMI) on adverse outcomes in patients who underwent TEVAR for descending thoracic aortic aneurysms (DTAA) and type B dissections (TBD). A retrospective review of all patients who underwent TEVAR for DTAA or TBD from August 2014 to August 2020 was performed. Patients who were underweight (BMI <18.5 kg/m2) or obese (BMI ≥30 kg/m2) were compared with those of normal weight (≥18.5 to <30 kg/m2). Adjustment for confounding was done with multivariable logistic regression or Cox proportional hazards regression as appropriate for studying postoperative or 1-year outcomes. Primary outcomes were 30-day and 1-year mortality. Other outcomes included any postoperative complication, stroke, and spinal cord ischemia. A total of 3423 participants were included in the study, of whom 3.3% (n = 113) were underweight, 65.9% (n = 2253) had normal weight, and 30.8% (n = 1053) were obese. Compared with normal weight, there was no significant difference in 30-day mortality in underweight patients (odds ratio [OR], 1.81; 95% confidence interval [CI], 0.80-4.14; P =.156). Obese patients who underwent TEVAR for TBD had a 2.7-fold increase in the odds of 30-day mortality compared with normal weight (OR, 2.67; 95% CI, 1.52-4.68; P =.001). Obese and normal weight patients with DTAA had equivalent odds of 30-day mortality (OR, 1.32; 95% CI, 0.79-2.23; P =.292). The adjusted hazard of 1-year mortality was 2-fold higher in underweight patients compared with normal weight (hazard ratio, 2.15; 95% CI, 1.41-3.29; P <.001), driven by a higher risk of mortality among patients with thoracic aortic aneurysm (OR, 2.62; 95% CI, 1.63-4.21; P <.001). There was no significant difference in 1-year mortality risk between normal weight and obesity in both DTAA (OR, 0.77; 95% CI, 0.54-1.09; P =.146) and TBD (OR, 1.26; 95% CI, 0.85-1.86; P =.248). In this study, obese patients who underwent TEVAR for DTAA had comparable 30-day and 1-year mortality risk as normal weight individuals. Obese patients who underwent TEVAR for TBD demonstrated a 2.7-fold increase in the odds of 30-day mortality, but equivalent mortality risk as normal weight patients at 1 year. TEVAR represents a safe minimally invasive option for treatment of DTAA in obese patients. Future work should be directed toward minimizing perioperative mortality among patients with TBD to optimize TEVAR outcomes. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Ophthalmology is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Recent studies have suggested that the low risk of stroke and death associated with transcarotid artery revascularization (TCAR) is partially attributable to a robust dynamic flow reversal system and the avoidance of the atherosclerotic aortic arch during stenting. However, the benefits of flow reversal compared with distal embolic protection (DEP) in reducing stroke or death in TCAR have not been studied. All patients undergoing carotid artery stenting (CAS) via the transcarotid route with either dynamic flow reversal (TCAR) or DEP (TCAS-DEP) in the Vascular Quality Initiative from September 2016 to November 2019 were analyzed. Both multivariable logistic regression and nearest neighbor propensity score-matched analysis were performed to explore the differences in outcomes between the two procedures. The primary outcome was in-hospital stroke or death. The secondary outcomes were stroke, death, myocardial infarction (MI), and the composite of stroke, death, and MI. A secondary analysis was performed to compare transcarotid stenting with DEP vs transfemoral CAS with DEP to evaluate the effects of crossing the aortic arch. A total of 8426 patients were identified (TCAS-DEP, n = 287; 3.4%). TCAR was associated with a lower risk of in-hospital stroke or death (1.6% vs 5.2%; odds ratio [OR], 0.35; 95% confidence interval [CI], 0.20-0.64; P =.001), stroke (1.4% vs 4.2%; OR, 0.37; 95% CI, 0.20-0.68; P =.002), and stroke/death/MI (2.0% vs 5.2%; OR, 0.41; 95% CI, 0.23-0.71; P =.001) compared with TCAS-DEP. Among the 274 pairs of patients identified with propensity score matching, TCAR was associated with a lower risk of stroke/death (1.1% vs 4.7%; risk ratio [RR], 0.23; 95% CI, 0.06-0.81; P =.021) and stroke (0.4% vs 4.0%; RR, 0.09; 95% CI, 0.01-0.70; P =.006) compared with TCAS-DEP but no differences in stroke/death/MI (1.8% vs 4.7%; RR, 0.38; 95% CI, 0.15-1.02; P =.077). The secondary analysis found no differences in stroke between TCAS-DEP and transfemoral CAS with DEP (4.9% vs 3.7%; RR, 1.3; 95% CI, 0.36-1.63; P =.65). Compared with TCAS-DEP, TCAR was associated with a lower risk of perioperative stroke or death and stroke. This finding implies that dynamic flow reversal might provide better neuroprotection than does a distal embolic filter in reducing the perioperative risk of stroke. Avoiding the aortic arch did not confer any reduction in the stroke rate. The present findings serve to separate the clinical benefit of dynamic flow reversal from that of avoiding the aortic arch during TCAR. [Display omitted] [ABSTRACT FROM AUTHOR]

Background: Information about the frequency and timing of subsequent cutaneous squamous cell carcinoma (cSCC), along with associated risk factors, is limited. However, this information is crucial to guide follow-up care for these patients.Objective: To evaluate the risk and timing of subsequent cSCC in patients who presented with an initial diagnosis of cSCC.Methods: Retrospective review of an institutional review board-approved, single-institution registry of invasive cSCC. All patients had at least 2 primary cSCCs diagnosed on 2 separate dates 2 months apart.Results: A total of 299 primary cSCCs were included. At 6 months from initial cSCC diagnosis, 18.06% (n = 54) of patients developed subsequent cSCC; at 1 year, 31.77% (n = 94); at 3 years, 67.56% (n = 202); and at 5 years, 87.96% (n = 263) developed subsequent cSCC. Risk factors associated with subsequent cSCC include age at initial diagnosis (hazard ratio [HR], 1.02; 95% confidence interval, 1.004-1.027; P = .008), T2 stage (HR, 1.66; 95% CI, 1.07-2.57; P = .025), and poor tumor grade. Tumor grades well, moderate, and unknown have HRs of 0.21 (P < .001), 0.16 (P .001), and 0.25 (P = .001), respectively.Conclusions: Of patients who develop subsequent cSCC, 18.06% do so within 6 months, and 31.77% do so within 1 year of initial cSCC diagnosis. Patients with advanced age, poor histologic differentiation, and American Joint Committee on Cancer T2 stage are at highest risk. Close clinical follow-up after the initial diagnosis is recommended. [ABSTRACT FROM AUTHOR]

• Trauma computed tomography (CT) scans can be used to derive bone density. • Phantom-less CT measurement of pelvic bone mineral density (BMD) was validated. • Pelvic BMD was measured from CT scans of 252 motor vehicle crash (MVC) occupants. • BMD at the anterior superior iliac spine and the iliac crest declined with age. • Regressions suggest pelvic BMD is a contributing factor for pelvic fracture in MVCs. Motor vehicle crash (MVC) occupants routinely get a computed tomography (CT) scan to screen for internal injury, and this CT can be leveraged to opportunistically derive bone mineral density (BMD). This study aimed to develop and validate a method to measure pelvic BMD in CT scans without a phantom, and examine associations of pelvic BMD with age and pelvic fracture incidence in seriously injured MVC occupants from the Crash Injury Research and Engineering Network (CIREN) study. A phantom-less muscle-fat calibration technique to measure pelvic BMD was validated using 45 quantitative CT scans with a bone calibration phantom. The technique was then used to measure pelvic BMD from CT scans of 252 CIREN occupants (ages 16+) in frontal MVCs who had sustained either abdominal or pelvic injury. Pelvic BMD was analyzed in relation to age and pelvic fracture incidence. In the validation set, phantom-based calibration vs. phantom-less muscle-fat calibration yielded similar BMD values at the anterior superior iliac spine (ASIS; R2 = 0.95, p < 0.001) and iliac crest (R2 = 0.90, p < 0.001). Pelvic BMD was measured in 150 female and 102 male CIREN occupants aged 16–89, and 25% of these occupants sustained pelvic fracture. BMD at the ASIS and iliac crest declined with age (p < 0.001). For instance, iliac crest BMD decreased an average of 25 mg/cm3 per decade of age. The rate of iliac crest BMD decline was 7.6 mg/cm3 more per decade of age in occupants with pelvic fracture compared to those not sustaining pelvic fracture. Findings suggest pelvic BMD may be a contributing risk factor for pelvic fracture in MVCs. [ABSTRACT FROM AUTHOR]

The gut microbiota is important for maintaining homeostasis of the host. Gut microbes represent the initial site for toxicant processing following dietary exposures to environmental contaminants. The diet is the primary route of exposure to polychlorinated biphenyls (PCBs), which are absorbed via the gut, and subsequently interfere with neurodevelopment and behavior. Developmental exposures to PCBs have been linked to increased risk of neurodevelopmental disorders (NDD), including autism spectrum disorder (ASD), which are also associated with a high prevalence of gastrointestinal (GI) distress and intestinal dysbiosis. We hypothesized that developmental PCB exposure impacts colonization of the gut microbiota, resulting in GI pathophysiology, in a genetically susceptible host. Mouse dams expressing two heritable human mutations (double mutants [DM]) that result in abnormal Ca2+ dynamics and produce behavioral deficits (gain of function mutation in the ryanodine receptor 1 [T4826I- RYR1 ] and a human CGG repeat expansion [170–200 CGG repeats] in the fragile X mental retardation gene 1 [ FMR1 premutation]). DM and congenic wild type (WT) controls were exposed to PCBs (0–6 mg/kg/d) in the diet starting 2 weeks before gestation and continuing through postnatal day 21 (P21). Intestinal physiology (Ussing chambers), inflammation (qPCR) and gut microbiome (16S sequencing) studies were performed in offspring mice (P28–P30). Developmental exposure to PCBs in the maternal diet caused significant mucosal barrier defects in ileum and colon (increased secretory state and tight junction permeability) of juvenile DM mice. Furthermore, PCB exposure increased the intestinal inflammatory profile (Il6, Il1β , and Il22), and resulted in dysbiosis of the gut microbiota, including altered β-diversity, in juvenile DM mice developmentally exposed to 1 mg/kg/d PCBs when compared to WT controls. Collectively, these findings demonstrate a novel interaction between PCB exposure and the gut microbiota in a genetically susceptible host that provide novel insight into environmental risk factors for neurodevelopmental disorders. Image 1 • Developmental PCBs cause intestinal pathophysiology and dysbiosis in juvenile mice with mutations affecting Ca2+ signaling. • Cytokine expression in both the ileum and colon is altered in a tissue, dose, and genotype specific manner. • Intestinal dysbiosis is characterized by altered diversity and colonization of specific taxa. [ABSTRACT FROM AUTHOR]

For the past half century, the versatile nature of demonstratives across languages has increasingly attracted attention in language typology. The present study contributes to this research agenda by examining the grammaticalisation pathways of two distal demonstratives in the Lobr dialect of Dagaare (Niger-Congo: Gur), namely, n ɛ , an adnominal demonstrative, and l ɛ , a pronominal demonstrative. The analysis reveals that the adnominal demonstrative n ɛ first got reanalysed as an identifying copula verb and, subsequently fused with third person pronouns, ʋ and a , to derive identifying pronouns, n ʋ and na respectively. Further, the identifying pronouns n ʋ and na fused with the attributive copula ι to derive the focus particle nι. The identifying pronoun na has also been reanalysed into an affirmative final particle. On the other hand, the pronominal demonstrative l ɛ first developed into a scalar demonstrative determiner and then into an intensifier. Subsequently, the scalar demonstrative determiner evolved into a copula, which fused with third person pronouns ʋ , a and b ɛ to derive the emphatic counterparts of these pronouns, comprising ʋ l ɛ , al ɛ and b ɛ l ɛ respectively. These are further cliticised and have evolved into adnominal demonstratives and then postnominal focus particles. These grammaticalisation trajectories contribute to a finer-grained and richer account of the diachrony and typology of demonstratives, including the substantivizing role of morpho-phonemic fusion on the development of grammaticalisation chains. [ABSTRACT FROM AUTHOR]

Summary Rare variants enriched for functions in chromatin regulation and neuronal synapses have been linked to autism. How chromatin and DNA methylation interact with environmental exposures at synaptic genes in autism etiologies is currently unclear. Using whole-genome bisulfite sequencing in brain tissue and a neuronal cell culture model carrying a 15q11.2-q13.3 maternal duplication, we find that significant global DNA hypomethylation is enriched over autism candidate genes and affects gene expression. The cumulative effect of multiple chromosomal duplications and exposure to the pervasive persistent organic pollutant PCB 95 altered methylation of more than 1,000 genes. Hypomethylated genes were enriched for H2A.Z, increased maternal UBE3A in Dup15q corresponded to reduced levels of RING1B, and bivalently modified H2A.Z was altered by PCB 95 and duplication. These results demonstrate the compounding effects of genetic and environmental insults on the neuronal methylome that converge upon dysregulation of chromatin and synaptic genes. [ABSTRACT FROM AUTHOR]

We aimed to calculate the weekly growth of the incidence and the effective reproductive number (Rt) of the 2022 Monkeypox epidemic during its introduction in Brazil. We described the case distribution in the country and calculated the incidence trend and the Rt in the four geographical states with the highest case reports. By using two regression approaches, count model and the Prais-Winsten, we calculated the relative incidence increase. Moreover, we estimated the Rt for the period between the 24th and the 50th days after the first official report, using a serial interval reported in another population and two alternative values (± 3 days). Up to August 22, 3.896 Monkeypox cases were confirmed in Brazil. The weekly incidence increases were between 37.5% (95% CI: 20.7% - 56,6%) and 82.1% (95% CI: 59.5%–107.8%), and all estimates of Rt were significantly higher than 1 in the four states analyzed. The Monkeypox outbreak in Brazil is a significant public health emergency that requires coordinated public health strategies such as testing, contact tracing, and vaccination. [ABSTRACT FROM AUTHOR]

In Liberia, 75% of those who died from 2014 Ebola epidemic were women and the effects of this gruelling epidemic were more severely felt by pregnant women. This immediately raised fears about the long-term impacts of the epidemic on maternal and child health. As part of a larger study, this paper uses Andersen’s behavioural model of health care utilization and Goffman’s stigma theory to explain the timing and utilization of maternal health services before the outbreak of the Ebola epidemic as a background to the potential long-term effects on maternal health. We conducted survival and multiple regression analysis using the 2007 (N = 3524) and 2013 (N = 5127) Liberia’s Demographic and Health Survey (LDHS) data. Our sample consisted of women of reproductive age (15–49 years) that had given birth in the last five years preceding the survey year. The findings show that from 2007 to 2013, there was an overall improvement in the timing of first antenatal care (ANC) visits (TR = 0.92, p < 0.001), number of ANC visits and delivery with skilled birth attendants. The results also show county and regional disparities in the utilization of ANC services with South Eastern A region emerging as a relatively vulnerable place. Also, access to ANC services defined by distance to a health facility strongly predicted utilization. We argue that the Ebola epidemic likely eroded many of the previous gains in maternal health care, and may have left a lingering negative effect on the access and utilization of maternal health services in the long-term. The study makes relevant policy recommendations. [ABSTRACT FROM AUTHOR]

We investigate the diffusive Leslie–Gower predator–prey model. Travelling wave solutions were found and a minimum wave speed relationship was derived. Linear stability analysis was performed in addition to full numerical simulation of the model. All travelling waves were found to be stable. [ABSTRACT FROM AUTHOR]

Noise and odour annoyances are important considerations in research on health effects of air pollution and traffic noise. Cumulative exposures can occur via several chemical hazards or a combination of chemical and stressor-based hazards, and related health outcomes can be generalized as manifestations of physiological and/or psychological stress responses. A major research challenge in this field is to understand the combined health effects of physiological and psychological responses to exposure. The SF-12 Health Survey is a health related quality of life (HRQoL) instrument designed for the assessment of functional mental and physical health in clinical practice and therefore well suited to research on physiological health outcomes of exposure. However, previous research has not assessed its sensitivity to psychological stress as measured by noise annoyance and odour annoyance. The current study validated and tested this application of the SF-12 Health Survey in a cross-sectional study (n = 603) that included exposure assessment for traffic noise and air pollution in Windsor, Ontario, Canada. The results indicated that SF-12 scores in Windsor were lower than Canadian normative data. A structural equation model demonstrated that this was partially due to noise and odour annoyances, which were associated with covarying exposures to ambient nitrogen dioxide and traffic noise. More specifically, noise annoyance had a significant and negative effect on both mental and physical health factors of the SF-12 and there was a significant covariance between noise annoyance and odour annoyance. The study confirmed a significant effect of psychological responses to cumulative exposures on HRQoL. The SF-12 Health Survey shows promise with respect to assessing the cumulative health effects of outdoor air pollution and traffic noise. [ABSTRACT FROM AUTHOR]

Two new photosensitizer complexes were synthesized featuring 4,4′-dicyano-2,2′-bipyridine binding moieties to better facilitate water and zinc reduction. DFT calculations, electrochemical characterization, and photophysical studies revealed the presence of a narrower HOMO–LUMO gap than 2,2′-bipyridine analogs, and shorter excited-state lifetimes. These properties were reflected in the water reduction studies; the newly-synthesized compounds surpassed current art when using colloidal catalysts, but were less efficient when using molecular catalysts. The complexes were also shown to facilitate Zn(II) photoreduction. [ABSTRACT FROM AUTHOR]

Combined suprainguinal and infrainguinal revascularization is sometimes necessary in the treatment of patients with chronic limb-threatening ischemia (CLTI). However, data on outcomes of concomitant revascularization procedures are lacking. We studied the outcomes of patients with CLTI who underwent suprainguinal bypass (SIB) alone, SIB with concomitant infrainguinal bypass (IIB), and SIB with concomitant infrainguinal peripheral endovascular intervention (IIPVI). We reviewed all patients in the Vascular Quality Initiative with CLTI who underwent SIB from January 2010 to June 2020. Logistic regression, Kaplan-Meier survival estimates, log-rank tests, and Cox regression were used to analyze outcomes. Outcomes were 30-day mortality, perioperative myocardial infarction, perioperative major amputation, 1-year amputation-free survival, and 5-year survival. Of 8037 patients included, 81.3% (n = 6537) underwent SIB alone, 9.7% (n = 783) underwent SIB+IIB, and 8.9% (n = 717) underwent SIB+IIPVI. The indication for surgery was rest pain in 5040 (62.5%) and tissue loss in 3031 (37.6%). There were no significant differences in 30-day mortality and perioperative myocardial infarction rates. However, there was 2.8-fold increased odds of perioperative major amputation in both SIB+IIPVI (odds ratio [OR], 2.76; 95% confidence interval [CI], 1.30-5.88; P =.008) and SIB+IIB (OR, 2.79; 95% CI, 1.38-5.54; P =.004) among patients with rest pain as compared with SIB alone. Comparing SIB+IIPVI with SIB alone, there were no significant differences in 1-year freedom from amputation and amputation-free survival. SIB+IIPVI was associated with a 27% increased risk of 5-year mortality (hazard ratio [HR], 1.27; 95% CI, 1.03-1.55; P =.035). Compared with SIB alone, SIB+IIB was associated with 97% increased risk of 1-year major amputation among patients with rest pain (HR, 1.97; 95% CI, 1.06-3.69; P =.033), but a 47% decreased risk of 1-year major amputation or death for patients with tissue loss (HR, 0.53; 95% CI, 0.37-0.78; P =.001). SIB+IIPVI, compared with SIB+IIB, was associated with a two-fold increased risk of 1-year major amputation or death (HR, 2.04; 95% CI, 1.04-2.23), P =.003) and a 52% increased risk of 5-year mortality (HR,1.52; 95% CI, 1.04-2.24; P =.032) among patients with tissue loss. This study shows that SIB with concomitant infrainguinal revascularization in patients with rest pain is associated with an increased risk of amputation, whereas SIB+IIB in patients with tissue loss is associated with decreased risk of amputation or death. SIB+IIB outperformed SIB+IIPVI in patients with tissue loss. SIB with infrainguinal revascularization should be limited in patients with rest pain in line with current guidelines, but SIB+IIB may be preferred in patients with tissue loss. [ABSTRACT FROM AUTHOR]

Thoracic endovascular aortic repair (TEVAR) for descending thoracic aortic aneurysm (DTAA) is associated with high perioperative survival, although mortality is a possible outcome. However, no risk score has been developed to predict mortality after TEVAR for intact DTAA to aid in risk discussion and preoperative patient selection. Our objective was to use a multi-institutional database to develop a 30-day mortality risk calculator for TEVAR after DTAA repair. The Vascular Quality Initiative database was queried for patients treated with TEVAR for intact DTAA between August 2014 and August 2020. Univariable and multivariable analyses aided in developing a 30-day mortality risk score. Internal validation was done with K -fold cross-validation and calibration curve analysis. Of 2141 patients included in the analysis, 90 (4.2%) died within 30 days after the procedure. Clinically relevant variables identified to be independently associated with 30-day mortality and therefore used to derive the predictive model included age 75 years or greater (odds ratio [OR], 2.27; 95% confidence interval [CI], 1.50-3.44; P <.001), coronary artery disease (OR, 1.60; 95% CI, 1.03-2.47; P =.036), American Society of Anesthesiologists class IV/V (OR, 2.39; 95% CI, 1.39-4.10; P =.002), urgent vs elective procedure (OR, 3.47; 95% CI, 1.90-6.33; P <.001), emergent vs elective procedure (OR, 5.27; 95% CI, 2.36-11.75; P <.001), prior carotid revascularization (OR, 3.24; 95% CI, 1.64-6.39; P =.001), and proximal landing zone <3 (OR, 2.51; 95% CI, 1.65-3.81; P <.001). The model showed an area under the receiver operating characteristic curve of 0.75. Internal validation demonstrated a bias-corrected area under the receiver operating characteristic curve of 0.73 (95% CI, 0.66-0.79) and a calibration slope of 1.00 with a corresponding intercept of 0.00. This study provides a novel clinically relevant risk prediction model to estimate 30-day mortality risk after TEVAR for DTAA. The TEVAR Mortality Risk Calculator provides useful prognostic information to guide patient selection and facilitate preoperative discussions and shared decision making. An easily accessible online version of the TEVAR Mortality Risk Score is available to facilitate ease of use. [ABSTRACT FROM AUTHOR]

Highlights: [•] Non-dioxin-like PCBs enhance ryanodine receptor. [•] Ortho and para chlorine substitution define efficacy at the ryanodine receptor. [•] Active congeners display additivity toward ryanodine receptor activation. [•] PCB concentrations that occur in fish tissue enhance ryanodine receptor activity. [•] PBDEs may contribute to PCB induced toxicity at the ryanodine receptor. [Copyright &y& Elsevier]

Abstract: An empirical model for determining the monthly average daily global solar radiation on a horizontal surface for Makurdi, Nigeria (Latitude 7°7′N and Longitude 8°6′E) was developed using the Angstrom–Page equation. The solar radiation (W/m2), hours of bright sunshine and cloudiness were measured hourly from 0600 H to 1800 H daily for 18 months. The constants ‘a’ and ‘b’ of the Angstrom linear type equation were determined by plotting the clearness index (H/Ho) against the possible sunshine hours (ns/N) to obtain the line of best fit. The constant ‘a’ was obtained from the intercept of the line on the y-axis while the constant ‘b’ was obtained from the slope of the line. The developed model for determining the global horizontal solar radiation at the location was H = Ho [0.17 + 0.68(n/N)] with a coefficient of correlation of 0.78. The mean bias error and root mean square error that were used to test the performance of the constants were 0.17% and 1.22% respectively. The measured solar radiation was compared with the solar radiation predicted by the model and no significant difference was found between them using F-LSD at P ≤ 0.05. [Copyright &y& Elsevier]

Abstract: Chronic low-level polychlorinated biphenyl (PCB) exposures remain a significant public health concern since results from epidemiological studies indicate that PCB burden is associated with immune system dysfunction, cardiovascular disease, and impairment of the developing nervous system. Of these various adverse health effects, developmental neurotoxicity has emerged as a particularly vulnerable endpoint in PCB toxicity. Arguably the most pervasive biological effects of PCBs could be mediated by their ability to alter the spatial and temporal fidelity of Ca2+ signals through one or more receptor-mediated processes. This review will focus on our current knowledge of the structure and function of ryanodine receptors (RyRs) in muscle and nerve cells and how PCBs and related non-coplanar structures alter these functions. The molecular and cellular mechanisms by which non-coplanar PCBs and related structures alter local and global Ca2+ signaling properties and the possible short and long-term consequences of these perturbations on neurodevelopment and neurodegeneration are reviewed. [Copyright &y& Elsevier]

Abstract: This study examined the differential effect of extreme impoverishment on breast cancer care in urban Canada and the United States. Ontario and California registry-based samples diagnosed between 1998 and 2000 were followed until 2006. Extremely poor and affluent neighborhoods were compared. Poverty was associated with non-localized disease, surgical and radiation therapy (RT) waits, non-receipt of breast conserving surgery, RT and hormonal therapy, and shorter survival in California, but not in Ontario. Extremely poor Ontario women were consistently advantaged on care indices over their California counterparts. More inclusive health insurance coverage in Canada seems the most plausible explanation for such Canadian breast cancer care advantages. [Copyright &y& Elsevier]

Abstract: This study re-examined the differential effect of socioeconomic status on the survival of women with breast cancer in Canada and the United States. Ontario and California cancer registries provided 1,913 cases from urban and rural places. Stage-adjusted cohorts (1998–2000) were followed until 2006. Socioeconomic data were taken from population censuses. SES-survival associations were observed in California, but not in Ontario, and Canadian survival advantages in low-income areas were replicated. A better controlled and updated comparison reaffirmed the equity advantage of Canadian health care. [Copyright &y& Elsevier]