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  • Rosenkilde Silverman posted an update 8 hours, 21 minutes ago

    The aortic wall is composed of highly dynamic cell populations and extracellular matrix. In response to changes in the biomechanical environment, aortic cells and extracellular matrix modulate their structure and functions to increase aortic wall strength and meet the hemodynamic demand. Compromise in the structural and functional integrity of aortic components leads to aortic degeneration, biomechanical failure, and the development of aortic aneurysms and dissections (AAD). A better understanding of the molecular pathogenesis of AAD will facilitate the development of effective medications to treat these conditions. Here, we summarize recent findings on AAD published in ATVB. In this issue, we focus on the dynamics of aortic cells and extracellular matrix in AAD; in the next issue, we will focus on the role of signaling pathways in AAD.OBJECTIVE We focused on drivers in close proximity to vehicles with advanced driver assistance systems (ADAS). We examined whether the belief that an approaching vehicle is equipped with automatic emergency braking (AEB) influences behavior of those drivers. BACKGROUND In addition to benefits of ADAS, previous studies have demonstrated negative behavioral adaptation, that is, behavioral changes after introduction of ADAS, by its users. However, little is known about whether negative behavioral adaptation can occur for nonusers in close proximity to vehicles with ADAS. METHOD Experienced (Experiment 1) and novice (Experiment 2) drivers drove a simulator vehicle without ADAS and tried to pass through intersections. We manipulated participants’ belief about whether an approaching vehicle had AEB and time-to-arrival of the approaching vehicle. Participants kept constant speed or pressed the brake pedal before entering each intersection. In Experiment 2, participants rated their trust in AEB by a questionnaire after driving. RESULTS In both experiments, belief about the approaching vehicle’s AEB did not influence braking probability; however, belief delayed initiation of braking. The effect of belief on braking latency was only observed when trust in AEB was higher in Experiment 2. CONCLUSION Negative behavioral adaptation can occur for nonusers in close proximity to users of AEB, and trust in AEB plays an important role. APPLICATION When evaluating the effect of ADAS, the possible behavioral change of surrounding nonusers as well as users should be taken into account. To establish consumers’ trust accurately, advertisements (e.g., TV commercials) must carefully consider their messages.Objective Study goals were to (1) provide a rationale for developing a composite primary outcome score that includes symptom severity for attention-deficit/hyperactivity disorder (ADHD) and emotional dysregulation, plus symptom-induced impairment; (2) demonstrate weighting methods to calculate the composite score using a sample of children diagnosed with ADHD and aggression; and (3) identify the optimal weighting method most sensitive to change, as measured by effect sizes. Methods We conducted secondary data analyses from the previously conducted Treatment of Severe Childhood Aggression (TOSCA) study. Children aged 6-12 years were recruited through academic medical centers or community referrals. The composite primary outcome comprised the ADHD, oppositional defiant disorder, disruptive mood dysregulation disorder, and peer conflict subscales from the Child and Adolescent Symptom Inventory (CASI), a DSM (Diagnostic and Statistical Manual)-referenced rating scale of symptom severity and symptom-induced impairical limitations associated with multiple comparisons. Among the five similar weighting methods, the two best appear to be the equal item and equal subscale weighting methods.Importance Chondrolaryngoplasty or reduction of laryngeal prominence is a gender affirmation surgery for transgender women, or for male patients desiring an aesthetic surgery. PI3K inhibitor Several variations of the procedure were suggested, yet to date, all described chondrolaryngoplasty procedures involved a visible neck scar. Objective To describe a novel technique for scarless chondrolaryngoplasty, transoral endoscopic vestibular approach (TOEVA)-chondrolaryngoplasty, and to report the results of first ever performed cases. Design, Setting, and Participants This was a prospective cohort at an academic referral center. Adult transgender women, interested in chondrolaryngoplasty who never had previous surgery of their neck or vocal folds, were offered both transcervical chondrolaryngoplasty and scarless TOEVA-chondrolaryngoplasty. Four patients aged 21 to 33 years, who preferred TOEVA-chondrolaryngoplasty, were consented and recruited. Interventions The surgical technique was successfully examined on two cadavers. Subseqfied with the surgical results as measured by the outcome instrument; three out of the four patients responded with perfect scores, and the fourth patient responded with 90% of the perfect score. Conclusions This report is the first description of scarless chondrolaryngoplasty through TOEVA. On a series of four patients, TOEVA-chondrolaryngoplasty appeared to be safe, with no adverse events or major complication, and with extremely high patient satisfaction. Further clinical evidence is required to establish a widespread use of this surgical technique. Level of Evidence NA.OBJECTIVES The aim of this study was to develop an ultrasound consolidated score (UCS) in determining the activity of Crohn’s disease (CD) and evaluate it with reference to simple endoscopic score (SES). METHODS From June 2014 to June 2017, 66 patients with CD were retrospectively enrolled in this study. Each patient underwent endoscopy and transabdominal ultrasound (US) examination. The morphological symmetry, echogenicity of bowel wall, bowel wall layer structure, echogenicity of peri-bowel fat, bowel wall thickness (BWT), and Limberg type on power Doppler US were assessed with transabdominal US, and an UCS scoring system was developed based on these characteristics. Endoscopic results were used as the reference standard and SES was calculated to determine the CD activity. Receiver operating characteristic curve analysis was performed to assess the diagnostic performance for determining CD activity and the correlation between UCS and SES was assessed using Spearman correlation analysis. RESULTS 330 intestinal segments in 66 patients were included.

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