Guidelines for hospital privileges in vascular surgery and endovascular interventions: Recommendations of the Society for Vascular Surgery

The Hospital Privileges Practice Guideline Writing Group of the Society for Vascular Surgery is making the following five recommendations concerning guidelines for hospital privileges for vascular surgery and endovascular therapy. Advanced endovascular procedures are currently entrenched in the everyday practice of specialized vascular interventionalists, including vascular surgeons, but open vascular surgery remains uniquely essential to the specialty. First, we endorse the Residency Review Committee for Surgery recommendations regarding open and endovascular cases during vascular residency and fellowship training. Second, applicants for new hospital privileges wishing to perform vascular surgery should have completed an Accreditation Council for Graduate Medical Education-accredited vascular surgery residency or fellowship or American Osteopathic Association-accredited training program before 2020 and should obtain American Board of Surgery certification in vascular surgery or American Osteopathic Association certification within 7 years of completion of their training. Third, we recommend that applicants for renewal of hospital privileges in vascular surgery include physicians who are board certified in vascular surgery, general surgery, or cardiothoracic surgery. These physicians with an established practice in vascular surgery should participate in Maintenance of Certification programs as established by the American Board of Surgery and maintain their respective board certification. Fourth, we provide recommendations concerning guidelines for endovascular procedures for vascular surgeons and other vascular interventionalists who are applying for new or renewed hospital privileges. All physicians performing open or endovascular procedures should track outcomes using nationally validated registries, ideally by the Vascular Quality Initiative. Fifth, we endorse the Intersocietal Accreditation Commission recommendations for noninvasive vascular laboratory interpretations and examinations to become a Registered Physician in Vascular Interpretation, which is included in the requirements for board eligibility in vascular surgery, but recommend that only physicians with demonstrated clinical experience in the diagnosis and management of vascular disease be allowed to interpret these studies.     

The Role of Cardiac Electrophysiology in Myocardial Regenerative Stem Cell Therapy

Recent advances in stem cell biology and tissue engineering have put forth new therapeutic paradigms for treatment of myocardial disease. The aim of stem cell therapy for myocardial regeneration has been directed to induce angiogenesis for ischemic heart disease and/or introduction of new cardiomyocytes to improve the mechanical function of the failing heart. Encouraged by positive preliminary results in mouse models of myocardial infarction, clinical trials have utilized autologous skeletal myoblasts and bone-marrow-derived stem cells to treat patients in various clinical settings including acute myocardial injury, chronic angina, and heart failure [1–3]. These studies have collectively shown, at best, modest improvement in cardiac function. This may be due to the fact that there is little evidence to support actual formation and/or integration of transplanted cells into the recipient myocardium. More recent and emerging data supports the finding that electrical stimulation may be an effective catalyst for sustained functional organization, integration, and maturation of transplanted cell populations into the host myocardium. A therapeutic model that utilizes electrical stimulation and/or achieves cardiac resynchronization in conjunction with stem cell transplantation may be an effective means to achieve successful myocardial regenerative therapy.     

The great imposter: A case report of IgG4‐RD hypertrophic pachymeningitis with skull lytic lesion and pulmonary nodules

Immunoglobulin G4‐related disease (Ig4RD) is an inflammatory condition with unique clinical, serological, and pathological features. In this study, we report a challenging diagnostic clinical case of Ig4RD diagnosed based on histopathology. This unique imitating nature reinforces that it is crucial to consider the diagnosis of IgG4‐RD in those presenting with pachymeningitis.     

Efficacy of extract from Ononis spinosa L.on ethanol-induced gastric ulcer in rats

OBJECTIVE:To investigate the efficacy of the ex-tract from Ononis spinosa L.(O.spinosa)on etha-nol-induced gastric ulcer in rats.METHODS:Phytochemical constitue...     

Circulation of Brucellaceae,Anaplasma and Ehrlichia spp. in borderline of Iran,Azerbaijan, and Armenia

Objective: To estimate the infection of ticks to Anaplasma, Ehrlichia, Babesia, Theileria, and Brucellaceae using molecular methods in borderline of Iran, Azerbaijan, and Armenia.Methods: Totally, 2 022 ticks were collected from different livestock. Then, species were diagnosed under stereomicroscope according to valid morphological keys. Tick DNA was extracted followed by PCR to detect Anaplasma, Ehrlichia, Theileria, Babesia and Brucellaceae infection in ticks. Results: A total of 498 males [24.62%(95% CI 22.76%-26.57%)], 741 females [36.64%(95% CI 34.54%-38.79%)], 782 nymphs [38.67%(95% CI 36.55%-40.84%)] and 1 larva [0.04%(95% CI 0.00%-0.28%)] were identified. Among identified samples, we found four genera including Hyalomma, Rhipicephalus, Haemaphysalis, and Dermacentor. Molecular assay revealed that the prevalence of ticks to Anaplasma or Ehrlichia, and Brucellaceae was 22.02%(95% CI 16.01%-29.06%) and 15.03%(95% CI 9.43%-22.26%), respectively. Phylogenetic analysis showed that the identified Anaplasma sp. had the most similarity with Anaplasma centrale, Anaplasma platys, Anaplasma camelii, and Anaplasma phagocytophilum, submitted in Gen Bank. Furthermore, the detected Ehrlichia sp. and Brucellaceae bacterium had the most similarity with Ehrlichia ruminantium and Mycoplana peli, respectively. However, no sign of the presence of Theileria and Babesia spp. was seen in the studied samples. Conclusions: Anaplasmosis, ehrlichiosis and brucellosis should be considered as important health threats in northwestern Iran and consistent monitoring on infection of ticks and livestock should be performed regularly.     

Novel insertion mutation in the PLA2G6 gene in an Iranian family with infantile neuroaxonal dystrophy

BackgroundInfantile neuroaxonal dystrophy is an autosomal recessive neurological disorder. Individuals with infantile neuroaxonal dystrophy experience progressive loss of vision, mental skills and muscular control, and other variable clinical signs. Pathogenic variants in the PLA2G6 gene, encoding phospholipase A2, are recognized to be the fundamental reason for infantile neuroaxonal dystrophy. This study aimed to detect pathogenic variant in a consanguine Iranian family with infantile neuroaxonal dystrophy.MethodsThe mutation screening was done by whole exome sequencing followed by direct Sanger sequencing.ResultsWe identified a homozygous insertion mutation, {"type":"entrez-nucleotide","attrs":{"text":"NM_003560","term_id":"1653962520"}}NM_003560: c.1548_1549insCG (p.G517Rfs*29) in exon 10 of PLA2G6 in the patient. The parents were heterozygous for variant.ConclusionsBecause of the clinical heterogeneity and rarity of infantile neuroaxonal dystrophy, whole exome sequencing is critical to confirm the diagnosis and is an excellent tool for INAD management.     

Prediction of Rockfill Materials’ Shear Strength Using Various Kernel Function-Based Regression Models—A Comparative Perspective

The mechanical behavior of the rockfill materials (RFMs) used in a dam’s shell must be evaluated for the safe and cost-effective design of embankment dams. However, the characterization of RFMs with specific reference to shear strength is challenging and costly, as the materials may contain particles larger than 500 mm in diameter. This study explores the potential of various kernel function-based Gaussian process regression (GPR) models to predict the shear strength of RFMs. A total of 165 datasets compiled from the literature were selected to train and test the proposed models. Comparing the developed models based on the GPR method shows that the superlative model was the Pearson universal kernel (PUK) model with an R-squared (R²) of 0.9806, a correlation coefficient (r) of 0.9903, a mean absolute error (MAE) of 0.0646 MPa, a root mean square error (RMSE) of 0.0965 MPa, a relative absolute error (RAE) of 13.0776%, and a root relative squared error (RRSE) of 14.6311% in the training phase, while it performed equally well in the testing phase, with R² = 0.9455, r = 0.9724, MAE = 0.1048 MPa, RMSE = 0.1443 MPa, RAE = 21.8554%, and RRSE = 23.6865%. The prediction results of the GPR-PUK model are found to be more accurate and are in good agreement with the actual shear strength of RFMs, thus verifying the feasibility and effectiveness of the model.     

Influence of Sequential Liquid Ammonia and Caustic Mercerization Pre-Treatment on Dyeing Performance of Knit Cotton Fabric

A two-stage sequential pretreatment including caustic mercerization (CM) and liquid ammonia (LA) treatment was applied to investigate the influence on dyeing performance and handle of knit cotton fabric, and the relationship between dye size and dyeing properties. Various techniques were applied to characterize all the treated fabrics. X-ray diffraction (XRD) and Fourier-transform infrared (FTIR) analyses of the treated fabrics confirmed that both sequential treatments decreased the crystallinity of cotton fabric more than only the CM or LA treatment. The pattern of cellulose I was transferred to a mixed configuration of cellulose II and cellulose III after the CM/LA or LA/CM treatment. Thermal performances measured by thermogravimetric analysis (TGA) and differential thermogravimetry (DTG) techniques showed that the thermal stability of the treated cotton only marginally decreased. The wicking height increased after the sequential CM/LA treatment, indicating that the hydrophilicity of the fabric increased. The dye absorption and color uniformity were better for the reactive dye with a smaller molecular weight (Reactive Red 2) compared with the one with a larger molecular weight (Reactive Red 195). The total dye fixation efficiency (T%) increased to 72.93% and 73.24% for Reactive Red 2 dyeings of CM/LA- and LA/CM-cotton fabric from 46.75% of the untreated fabric, respectively; the T% increased to 65.33% and 72.27% for Reactive Red 195 dyeings of CM/LA- and LA/CM-cotton fabric from 35.17% of the untreated fabric, respectively. The colorfastness and dye exhaustion and fixation percentages of the samples were enhanced after the treatments. Furthermore, compared to the single CM or LA treatment, the softness handle properties were further improved after the fabrics were sequentially treated by CM/LA. The developed pre-treatment of CM/LA can be used in the textile industry to promote the dyeability, handle, and mechanical properties of knit cotton fabrics.     

COVID-19-induced immune thrombocytopenic purpura; Immunopathogenesis and clinical implications

Following the outbreak of the COVID-19 pandemic, millions of people around the world have been affected with SARS-CoV-2 infection. In addition to the typical symptoms, thrombotic events, lymphopenia, and thrombocytopenia have been reported in COVID-19 patients. Immune thrombocytopenic purpura (ITP) is one of the thrombotic events that occur in some COVID-19 patients. Hyperinflammation, cytokine storms, and immune dysregulation in some patients are the cause to the main COVID-19 complications such as ALI (acute lung injury), acute respiratory distress syndrome (ARDS), and multiple organ failure. Disruption in the differentiation of T-cells, enhanced differentiation of Th17 and Th1, cell death (pyroptosis), hyper-inflammation and dysfunction of inflammatory neutrophils and macrophages, and hyperactivity of NLRP3-inflammasome are among the important factors that may be the cause to COVID-19-induced ITP. This study aimed to give an overview of the findings on the immunopathogenesis of ITP and COVID-19-induced ITP. Further studies are required to better understand the exact immunopathogenesis and effective treatments for ITP, especially in inflammatory disorders.