The Bell-Bottom Technique versus Branched Stent Grafts in Endovascular Treatment of Diseased Common Iliac Artery: A Systematic Review and Meta-Analysis.

OBJECTIVES: To evaluate whether the use of iliac branched endoprosthesis reduces perioperative complications compared to the bell-bottom technique in patients with common iliac artery aneurysm or ectasia. METHODS: We conducted a systematic search of studies in the PubMed, Embase, and Cochrane databases up to March 2024. Following the PRISMA protocol, 91 articles were analyzed. A restricted maximum likelihood model with random effects with odds ratios and 95% confidence intervals was applied for binary outcomes. Heterogeneity was assessed using the Cochrane Q test and Higgins and Thompson's I2 statistic. Significance was defined as a p-value < 0.05. RESULTS: Six cohort studies involving 2,899 patients were included, of which 863 underwent repair with branched endoprosthesis. There was no statistically significant difference observed for endoleaks: of any type (OR 0.41; 95% CI 0.10 to 1.60; p=0.20), type 1a (OR 1.12; 95% CI 0.20 to 6.40; p=0.90), type 1b (OR 0.63; 95% CI 0.20 to 1.97; p=0.42), and type 2 (OR 0.52; 95% CI 0.10 to 2.71; p=0.44). However, type 3 endoleaks were less frequent in the bell-bottom group (OR 9.00; 95% CI 1.09 to 74.17; p=0.04) . Additionally, perioperative mortality (OR 0.73; 95% CI 0.41 to 1.27; p=0.26), mesenteric ischemia (OR 0.14; 95% CI 0.01 to 2.54; p=0.18), iliac artery injury (p=0.06) and buttock claudication (OR 0.14; 95% CI 0.02 to 1.08; p=0.06) also did not statistically differ between the two groups. CONCLUSIONS: Branched endoprosthesis and bell-bottom techniques did not differ regarding perioperative mortality rates, internal iliac artery occlusion, and mesenteric ischemia rates. However, the use of branched endoprostheses was associated with a higher incidence of type 3 endoleaks compared to the bell-bottom technique.

Secure Aggregation Protocol Based on DC-Nets and Secret Sharing for Decentralized Federated Learning.

In the era of big data, millions and millions of data are generated every second by different types of devices. Training machine-learning models with these data has become increasingly common. However, the data used for training are often sensitive and may contain information such as medical, banking, or consumer records, for example. These data can cause problems in people's lives if they are leaked and also incur sanctions for companies that leak personal information for any reason. In this context, Federated Learning emerges as a solution to the privacy of personal data. However, even when only the gradients of the local models are shared with the central server, some attacks can reconstruct user data, allowing a malicious server to violate the FL principle, which is to ensure the privacy of local data. We propose a secure aggregation protocol for Decentralized Federated Learning, which does not require a central server to orchestrate the aggregation process. To achieve this, we combined a Multi-Secret-Sharing scheme with a Dining Cryptographers Network. We validate the proposed protocol in simulations using the MNIST handwritten digits dataset. This protocol achieves results comparable to Federated Learning with the FedAvg protocol while adding a layer of privacy to the models. Furthermore, it obtains a timing performance that does not significantly affect the total training time, unlike protocols that use Homomorphic Encryption.

Nestin and NG2 transgenes reveal two populations of perivascular cells stimulated by photobiomodulation.

Pericytes and glial cells are known to collaborate in dental pulp tissue repair. Cell-based therapies that stimulate these stromal components may be of therapeutic relevance for partially vital dental pulp conditions. This study aimed to examine the early effect of photobiomodulation (PBM) in pericytes from experimentally injured pulp tissue. To accomplish this, we used the Nestin-GFP/NG2-DsRed mice, which could allow the identification of distinct pericyte phenotypes. We discovered the presence of two pericytes subsets within the dental pulp, the Nestin + NG2+ (type-2) and Nestin- NG2+ (type-1). Upon injury, PBM treatment led to a significant increase in Nestin+ cells and pericytes. This boost was mainly conferred by the more committed pericyte subset (NestinNG2+ ). PBM also stimulated terminal blood vessels sprouting adjacent to the injury site while maintaining signs of pulp vitality. In vitro, PBM induced VEGF upregulation, improved dental pulp cells proliferation and migration, and favored their mineralization potential. Herein, different subsets of perivascular cells were unveiled in the pulp tissue. PBM enhanced not only NG2+ cells but nestin-expressing progenitors in the injured dental pulp.

Vascular e-Learning During the COVID-19 Pandemic: The EL-COVID Survey.

BACKGROUND: The corona virus disease (COVID-19) pandemic has radically changed the possibilities for vascular surgeons and trainees to exchange knowledge and experience. The aim of the present survey is to inventorize the e-learning needs of vascular surgeons and trainees as well as the strengths and weaknesses of vascular e-Learning. METHODS: An online survey consisting of 18 questions was created in English, with a separate bilingual English-Mandarin version. The survey was dispersed to vascular surgeons and trainees worldwide through social media and via direct messaging from June 15, 2020 to October 15, 2020. RESULTS: Eight hundred and fifty-six records from 84 different countries could be included. Most participants attended several online activities (>4: n = 461, 54%; 2-4: n = 300, 35%; 1: n = 95, 11%) and evaluated online activities as positive or very positive (84.7%). In deciding upon participation, the topic of the activity was most important (n = 440, 51.4%), followed by the reputation of the presenter or the panel (n = 178, 20.8%), but not necessarily receiving accreditation or certification (n = 52, 6.1%). The survey identified several shortcomings in vascular e-Learning during the pandemic: limited possibility to attend due to lack of time and increased workload (n = 432, 50.5%), no protected/allocated time (n = 488, 57%) and no accreditation or certification, while technical shortcomings were only a minor problem (n = 25, 2.9%). CONCLUSIONS: During the COVID-19 pandemic vascular e-Learning has been used frequently and was appreciated by vascular professionals from around the globe. The survey identified strengths and weaknesses in current e-Learning that can be used to further improve online learning in vascular surgery.

Effect of Hostile Solutions on the Residual Fatigue Life of Kevlar/Epoxy Composites after Impact Loading.

Due to the enormous benefits inherent to composite materials, they have been widely used in the most diverse fields of engineering. Therefore, it is not surprising that in many of these applications they can be exposed to hostile environments, which can affect the mechanical performance of such materials. Therefore, the main goal of this work was to study the effect of immersion into different hostile solutions on the impact strength and, subsequently, to evaluate the residual fatigue life. For this purpose, the specimens were initially immersed into solutions of hydrochloric acid (HCl), sodium hydroxide (NaOH), sulphuric acid (H2SO4), diesel, distilled water, and seawater. Subsequently, the specimens were subjected to impact loads with an energy of 12 J and, finally, subjected to fatigue loads to assess the residual fatigue life. Seawater and NaOH solution provided the lowest impact strength. This was confirmed by the lower energy restored and impact bending stiffness (IBS), a parameter that allows evaluating the damage resistance of a composite. In terms of restored energy, for example, the seawater promoted a decrease around 30.4% in relation to the value obtained with non-immersed samples, while this value was 27.6% for the alkaline solution (NaOH). In terms of IBS, the lowest values were also obtained with these solutions (437.4 and 444.9 N/mm, respectively). Finally, the lowest residual fatigue life was also observed for these two solutions, and it was noticed that there was a direct relationship between the IBS and the residual fatigue life.

Endovascular treatment of wide-neck saccular renal artery aneurysm with waffle-cone technique.

In the past, treatment of visceral artery aneurysms (VAAs) was exclusively surgical. These aneurysms were rarely diagnosed in elective or emergency cases. Development of imaging techniques and endovascular procedures has changed the history of the therapeutic options for this pathology. Endovascular management of VAAs has arisen to advances in endovascular techniques and has achieved high efficacy.

No passado, o tratamento de aneurismas da artéria visceral (VAAs) era exclusivamente cirúrgico e raramente diagnosticado em casos eletivos ou de emergência. O desenvolvimento de técnicas de imagem e procedimentos endovasculares mudou a história das opções terapêuticas dessa patologia. O manejo endovascular de VAAs surgiu devido ao avanço das técnicas endovasculares, o qual apresentou uma alta eficácia.

Hancornia speciosa serum fraction latex stimulates the angiogenesis and extracellular matrix remodeling processes.

The Hancornia speciosa latex reveals angiogenic, osteogenic, and anti-inflammatory properties, which present its potential for developing of wound healing drugs; however, the latex compounds responsible for angiogenesis remain unknown. One strategy to screen these active compounds is evaluation of latex fractions. This study aimed to obtain different fractions of latex and evaluate its angiogenic activity separately using the chick chorioallantoic membrane (CAM) assay. The serum (SE) fraction was responsible for angiogenesis, which was subject to biochemical characterization and computational simulations in order to understand the contribution of H. speciosa latex in wound healing process. Our results revealed weak antioxidant potential and absence of antimicrobial activity in the SE fraction. Phytochemical analysis identified chlorogenic acids (CGA) as the main compound of SE fraction. CGA bioactivity predictions identify different molecules associated with extracellular matrix (ECM) remodeling, such as metalloproteinases, which also are overexpressed in our CAM assay experiment. Docking simulations revealed the interactions between CGA and matrix metalloproteinase 2. In conclusion, SE latex fraction stimulates angiogenesis and may influence ECM remodeling. These properties may contribute to the wound healing process, and also confirm the widespread use of this plant.

Presence of antigenotoxic and anticytotoxic effects of the chalcone 1E,4E-1-(4-chlorophenyl)-5-(2,6,6-trimethylcyclohexen-1-yl)penta-1,4-dien-3-one using in vitro and in vivo assays.

Chalcones are chemically defined as α,ß-unsaturated ketones with a 1,3-diphenyl-2-propen-1-one nucleus. These compounds occur naturally in plants and are considered precursors of flavonoids. Given that evaluating genetic toxicology tests is essential in investigating the safe use and chemopreventive potential of different natural and synthetic compounds, this study aimed to assess the genotoxic, cytotoxic, antigenotoxic, and anticytotoxic activity of the chalcone 1E,4E-1-(4-chlorophenyl)-5-(2,6,6-trimethylcyclohexen-1-yl)penta-1,4-dien-3-one (CAB7ß). The CAB7ß was synthesized via Claisen-Schmidt reaction. The Ames test was applied using the co-treatment model as well as a micronucleus assay of mouse bone marrow with co-, pre- and post-treatment models. Our results indicate no genotoxic effect for CAB7ß in any of the tests applied. At all the concentrations used, CAB7ß showed a significant DNA protective effect against the mutagenic action of 4-nitroquinoline-1-oxide and sodium azide according to the Ames test, and against doxorubicin in the co-, pre- and post-treatment models of the micronucleus assay. CAB7ß alone displayed cytotoxic activity in the micronucleus test. At concentrations of 12,5 and 50 µg/plate, CAB7ß showed a moderate cytotoxic profile only in Salmonella typhimurium strain TA98. However, an anticytotoxic effect was observed against S. typhimurium strain TA100 for all the concentrations tested and during co-, pre- and post-treatment in the micronucleus assay. It was concluded that CAB7ß exhibited a slightly cytotoxic effect in S. typhimurium strain TA98 and significant antigenotoxic and anticytotoxic effects in cells of mouse, making it a promising candidate in chemoprevention and possibly in the development of new cancer treatments.

Functional response of Euseius concordis feeding on Oligonychus ilicis (Acari: Phytoseiidae, Tetranychidae).

Oligonychus ilicis (McGregor) (Acari: Tetranychidae), commonly known as the southern red mite, or as the coffee red spider mite in Brazil, is one of the main species of herbivorous mites that causes serious damage to coffee plants (Coffea spp.) and thus negatively affects coffee production. Among the biocontrol agents, predatory mites of the family Phytoseiidae play an important role in many biological control programs worldwide due to their potential as suppressor of mite populations mainly from the family Tetranychidae. One of the phytoseiid mites usually associated with O. ilicis is Euseius concordis (Chant), which often occurs abundantly in the coffee crops of Minas Gerais State, Brazil. This study was conducted to assess the predation potential of E. concordis feeding on the larvae and nymph stages of O. ilicis on coffee plants (Coffea arabica L.). Logistic regression analysis revealed a Holling type II functional response, showing that the number of O. ilicis killed by E. concordis increased gradually as the density of O. ilicis increased. Average daily oviposition also increased with prey densities above 6.3 mites/cm2, indicating that maximum oviposition rate is about 1 egg/day. Results of this study suggest that E. concordis has the potential to reduce O. ilicis populations, and this predatory mite can therefore be considered an important natural enemy of the pest O. ilicis in coffee plantations.

Is gene therapy for limb ischemia a reality?

The concept of angiogenic therapy emerged in the early 1990s. The method employs genes that encode growth factors to promote formation of new vessels and remodeling of collateral vessels. Since the procedure involved in this therapy usually only consists of local injections of vectors, the process is minimally invasive, quick, and simple to perform. However, since the first clinical evidence of the effects of gene therapy with vascular endothelial growth factor (VEGF) was observed in patients with peripheral artery disease, to date only two angiogenic therapy drugs have been approved, one in Russia and another in Japan, which seem a very small number, in view of the large volume of investment made in pre-clinical and clinical studies. After all, can we conclude that angiogenic therapy is a reality?

Can we manage prophylactic therapy in COVID-19 patients to prevent severe illness complications?

Many patients with COVID-19 have thromboembolic complications that worsen their prognosis. Herein, the authors propose a modified version of the CHA2DS2-VASc score, including 1 point for COVID-19, so that prophylaxis to protect against thromboembolic events would be indicated before the condition becomes severe. The advantages of this modification would be prevention of the patient's condition worsening due to thromboembolic problems and reduction of the likelihood of a need for intensive care and mechanical ventilation, reducing mortality.

Antitumor effectiveness and mechanism of action of Ru(II)/amino acid/diphosphine complexes in the peritoneal carcinomatosis progression.

Peritoneal carcinomatosis is considered as a potentially lethal clinical condition, and the therapeutic options are limited. The antitumor effectiveness of the [Ru(l-Met)(bipy)(dppb)]PF6(1) and the [Ru(l-Trp)(bipy)(dppb)]PF6(2) complexes were evaluated in the peritoneal carcinomatosis model, Ehrlich ascites carcinoma-bearing Swiss mice. This is the first study that evaluated the effect of Ru(II)/amino acid complexes for antitumor activity in vivo. Complexes 1 and 2 (2 and 6 mg kg-1) showed tumor growth inhibition ranging from moderate to high. The mean survival time of animal groups treated with complexes 1 and 2 was higher than in the negative and vehicle control groups. The induction of Ehrlich ascites carcinoma in mice led to alterations in hematological and biochemical parameters, and not the treatment with complexes 1 and 2. The treatment of Ehrlich ascites carcinoma-bearing mice with complexes 1 and 2 increased the number of Annexin V positive cells and cleaved caspase-3 levels and induced changes in the cell morphology and in the cell cycle phases by induction of sub-G1 and G0/G1 cell cycle arrest. In addition, these complexes reduce angiogenesis induced by Ehrlich ascites carcinoma cells in chick embryo chorioallantoic membrane model. The treatment with the LAT1 inhibitor decreased the sensitivity of the Ehrlich ascites carcinoma cells to complexes 1 and 2 in vitro-which suggests that the LAT1 could be related to the mechanism of action of amino acid/ruthenium(II) complexes, consequently decreasing the glucose uptake. Therefore, these complexes could be used to reduce tumor growth and increase mean survival time with less toxicity than cisplatin. Besides, these complexes induce apoptosis by combination of different mechanism of action.

Antigenotoxicity protection of Carapa guianensis oil against mitomycin C and cyclophosphamide in mouse bone marrow.

The aim of this study was to evaluate the possible protective of C. guianensis oil against MMC and CP, which are direct- and indirect-acting chemical mutagens, using the micronucleus test. Three experiments were performed. First the C. guianensis oil was co-administered to mice at doses of 250, 500 and 1000 mg/kg bw with 4 mg/kg bw MMC or 50 mg/kg bw CP. Second, the mutagenic drug (CP) was administered ip 50 mg/kg bw and after 6 and 12 hours 250 and 500 mg/kg bw of C. guianensis oil were administered. In the last, C. guianensis oil was administrated (250 and 500 mg/kg bw) during five days and after it was administered ip 50 mg/kg bw CP. The results obtained showed that the C. guianensis oil is not cytotoxic neither genotoxic to mouse bone marrow. Regarding the antimutagenic effect, all doses of C. guianensis oil were significantly (p < 0.05) effective in reducing the frequency of micronucleated polychromatic erythrocytes, when compared with MMC or CP alone. Based on these results, our results suggest that the C. guianensis oil shows medicinal potential as an antimutagenic agent, modulating the mutagenicity caused by both direct- and indirect-acting chemical mutagens, in a mammalian model.

Chemopreventive effect and angiogenic activity of punicalagin isolated from leaves of Lafoensia pacari A. St.-Hil.

Punicalagin is the major ellagitannin constituent from leaves of Lafoensia pacari, a Brazilian medicinal plant widely used for the treatment of peptic ulcer and wound healing. Genotoxic, cytotoxic, antigenotoxic, and anticytotoxic effects of punicalagin were assessed using micronucleus (MN) test and comet assay in mice. Due to the extensive use of L. pacari in the wound healing process, we also assessed the angiogenic activity of punicalagin using the chick chorioallantoic membrane (CAM) angiogenic assay. The highest dose of punicalagin (50mg/kg) showed significant cytotoxic effect by MN test and in the co-treatment with cyclophosphamide (CPA), this cytotoxicity was enhanced. Co-treatment, pre-treatment and post-treatment of punicalagin with CPA led to a significant reduction in the number of DNA breaks and in the frequency of CPA-induced MN, indicating antigenotoxic effect. Using the CAM model, punicalagin exhibited angiogenic activity in all doses mainly at the lowest concentration (12.5µg/µL). Therefore, these findings indicate an effective chemopreventive role of punicalagin and a high capacity to induce DNA repair. Also, the angiogenic activity presented by punicalagin in this study could contribute for the processes of tissue repairing and wound healing.

Physicochemical/photophysical characterization and angiogenic properties of Curcuma longa essential oil.

This study analyzed the physicochemical and photophysical properties of essential oil of Curcuma longa and its angiogenic potential. The results showed that curcumin is the main fluorescent component present in the oil, although the amount is relatively small. The experimental chorioallantoic membrane model was used to evaluate angiogenic activity, showing a significant increase in the vascular network of Curcuma longa and positive control groups when compared to the neutral and inhibitor controls (P <0.05), but no significant difference was found between Curcuma longa essential oil and the positive control (P >0.05). Histological analysis showed extensive neovascularization, hyperemia and inflammation in the positive control group and Curcuma longa when compared to other controls (P <0.05), characteristic factors of the angiogenesis process. In conclusion, Curcuma longa oil showed considerable proangiogenic activity and could be a potential compound in medical applications.

Locking intramedullary nails compared with locking plates for two- and three-part proximal humeral surgical neck fractures: a randomized controlled trial.

BACKGROUND: Previous studies have shown good clinical results in patients with proximal humeral fractures (PHFs) treated with locking intramedullary nails or locking plates. Our study compared the clinical and radiographic outcomes in patients with 2- and 3-part surgical neck fractures. METHODS: In this prospective, randomized controlled trial, 72 patients with 2- or 3-part surgical neck PHFs were randomly assigned to receive fixation with locking intramedullary nails (nail group) or locking plates (plate group). The primary outcome was the 12-month Constant-Murley score. The secondary outcomes included the Disabilities of the Arm, Shoulder and Hand score, the visual analog scale pain score, the shoulder passive range of motion, the neck-shaft angle, and complication rates. RESULTS: There was no significant mean treatment group difference in the Constant-Murley score at 12 months (70.3 points for the nail group vs. 71.5 points for the plate group; P = .750) or at individual follow-up assessments. There were no differences in the 3-, 6- and 12-month Disabilities of the Arm, Shoulder and Hand scores, visual analog scale scores, and range of motion, except for the medial rotation at 6 months. The neck-shaft angle was equivalent between the groups at 12 months. There were significant differences over 12 months in total complication rates (P = .002) and reoperation rates (P = .041). There were no significant differences for the rotator cuff tear rate (P = .672). CONCLUSION: Fixation of PHFs with locking plates or locking intramedullary nails produces similar clinical and radiologic results. Nevertheless, the complication and reoperation rates were higher in the nail group.

Hancornia speciosa latex for biomedical applications: physical and chemical properties, biocompatibility assessment and angiogenic activity.

The latex obtained from Hancornia speciosa is used in folk medicine for treatment of several diseases, such as acne, warts, diabetes, gastritis and inflammation. In this work, we describe the biocompatibility assessment and angiogenic properties of H. speciosa latex and its potential application in medicine. The physical-chemical characterization was carried out following different methodologies (CHN elemental analyses; thermogravimetric analyses and Fourier transform infrared spectroscopy). The biocompatibility was evaluated through cytotoxicity and genotoxicity tests in fibroblast mouse cells and the angiogenic properties were evaluated using the chick chorioallantoic membrane (CAM) assay model. The physical-chemical results showed that the structure of Hancornia speciosa latex biomembrane is very similar to that of Hevea brasiliensis (commercially available product). Moreover, the cytotoxicity and genotoxicity assays showed that H. speciosa latex is biocompatible with life systems and can be a good biomaterial for medical applications. The CAM test showed the efficient ability of H. speciosa latex in neovascularization of tissues. The histological analysis was in accordance with the results obtained in the CAM assay. Our data indicate that the latex obtained from H. speciosa and eluted in water showed significant angiogenic activity without any cytotoxic or genotoxic effects on life systems. The same did not occur with H. speciosa latex stabilized with ammonia. Addition of ammonia does not have significant effects on the structure of biomembranes, but showed a smaller cell survival and a significant genotoxicity effect. This study contributes to the understanding of the potentialities of H. speciosa latex as a source of new phytomedicines.