A thyroidea ima artery variation providing collateral circulation to the mediastinum.

The thyroidea ima artery (TIA) is a highly variable arterial deviation of the blood supply to the thyroid gland with critical implications for surgical neck procedures such as tracheostomy. Though relatively common in the population at large (~ 4%), most TIA variations are related to the origin of the artery and whether it emerges from the common sites of the brachiocephalic trunk, aortic arch, and right common carotid artery, or another more unique vessel-as opposed to its dispersion pattern. TIA variants generally supply the thyroid gland, occasionally co-occurring with absent thyroid arteries. Here, we report on a unique case of a four-pronged variation of the TIA discovered during an anatomy laboratory dissection of first-year medical students. This variant originated from the brachiocephalic trunk and had three branches terminating in the thyroid gland and a fourth branch traveling into the thorax to provide accessory circulation in the mediastinum. Specifically, small arterial branches from the inferior TIA branch supplied the anterior pericardium and surrounding adipose tissue, in addition to normal pericardiacophrenic circulation. We discuss the potential embryological and clinical relevance of this unique variation and voice further support for imaging as a requirement before surgical neck procedures to prevent catastrophic bleeding in the event of a TIA variant.

Incidental Attitude Formation via the Surveillance Task: A Preregistered Replication of the Olson and Fazio (2001) Study.

Evaluative conditioning is one of the most widely studied procedures for establishing and changing attitudes. The surveillance task is a highly cited evaluative-conditioning paradigm and one that is claimed to generate attitudes without awareness. The potential for evaluative-conditioning effects to occur without awareness continues to fuel conceptual, theoretical, and applied developments. Yet few published studies have used this task, and most are characterized by small samples and small effect sizes. We conducted a high-powered (N = 1,478 adult participants), preregistered close replication of the original surveillance-task study (Olson & Fazio, 2001). We obtained evidence for a small evaluative-conditioning effect when "aware" participants were excluded using the original criterion-therefore replicating the original effect. However, no such effect emerged when three other awareness criteria were used. We suggest that there is a need for caution when using evidence from the surveillance-task effect to make theoretical and practical claims about "unaware" evaluative-conditioning effects.

No evidence of consolidation of evaluative conditioning during waking rest and sleep.

Research on evaluative conditioning (EC) shows that attitudes can emerge from co-occurrences of stimuli, and accumulating evidence suggests that EC usually depends on memory for these stimulus contingencies. Therefore, processes known to aid memory retention may be relevant for the development of stable attitudes. One such process may be memory consolidation, assumed to be promoted by waking rest and sleep. In two pre-registered experiments, we investigated whether waking rest (vs. cognitive activity, Experiment 1) and sleep (vs. wakefulness, Experiment 2) in between conditioning and measurement of EC, consolidate contingency memory and EC. Contrary to our predictions, waking rest (vs. cognitive activity) promoted neither contingency memory nor EC effects. Sleep (vs. wakefulness) decreased forgetting of contingency memory but crucially, it did not attenuate the impact of counterconditioning on contingency memory. Sleep also did not influence EC effects, nor the reduction of EC by counterconditioning. EC effects in both experiments were predicted by contingency memory. Yet, unexpectedly, EC effects occurred in the absence of contingency memory after waking rest, but neither after sleep nor in the active control conditions. Our findings emphasise a role of contingency memory in EC, but it remains unclear whether this role changes during waking rest.

Evaluative conditioning with fear- and disgust-evoking stimuli: no evidence that they increase learning without explicit memory.

Evaluative conditioning (EC) is a change in the liking of a stimulus (conditioned stimulus or CS) due to its previous pairings with another stimulus (unconditioned stimulus or US). In three experiments, we investigated if conditioning CSs with fear or disgust evoking USs increase EC effects that do not require explicit memory. Experiment 1 used images to manipulate the type of US between participants, Experiment 2 used auditory stimuli to manipulate the type of US within participants, and Experiment 3 used both images and auditory stimuli to manipulate the type of US within participants. All experiments failed to provide evidence that fear/disgust-evoking USs lead to larger EC effects without explicit memory than non-fear/non-disgust-evoking USs. Most results are in line with the assumption that the found EC effects are based on explicit memory. The results contribute to the larger goal in EC research of determining which conditions can lead to EC effects in the absence of explicit memory.

Early stent fractures in superficial femoral artery resulting multiple pseudoaneurysm formation within one year: a case report.

BACKGROUND: Though fracture is known complication of stenting, pseudoaneurysm asscoiated with stent fracture is an extremely rare complication. This has previoulsy been described to occur at least one or more years following initial stent placement. Here we present a case of multi-site stent fracture leading to two separate SFA pseudoaneurysms within one year of placement, successfully treated with covered stents. CASE PRESENTATION: A 72-year-old male presented with severe claudication of his left lower extremity (Rutherford 3), found to have long segment SFA chronic total occlusion (CTO). Patient successfully underwent endovascular revascularization. Follow-up duplex ultrasound (US) at one year demonstrated a focus of severe in-stent restenosis (ISR). During repeat angiogram for treatment of the stenosis, stent fracture and pseudoaneurysm was seen in the distal SFA, which was treated successfully with a self-expanding covered stent. Additional stent fractures and pseudoanerusyms were subseuqently identified on follow-up, necessitating a third angiogram, and these were successfully repaired using overlapping covered stents, without further recurrence. CONCLUSIONS: Superficial femoral artery stent fractures leading to pseudoaneurysms are extremely rare, particularly within first year of stent placement. Endovascular repair with covered stents has proven to be an effective treatment option with decreased procedural morbidity compared to surgical repair.

The Role of Computed Tomography in the Management of Hospitalized Patients With COVID-19.

The emergence of SARS-CoV-2 at the end of 2019 sparked the beginning of the COVID-19 pandemic. Even though it was a novel virus, the workup of suspected COVID-19 included standard protocols used for the investigation of similar respiratory infections and pneumonia. One of the most important diagnostic tests in this regard is computed tomography (CT). CT scans have a high sensitivity in diagnosing COVID-19, and many of the characteristic imaging findings of COVID-19 are used in its diagnosis. The role of CT in COVID-19 management is expanding as more and more hospital practices adopt regular CT use in both the initial workup and continued care of COVID-19 patients. CT has helped hospitalists diagnose complications such as pulmonary embolism, subcutaneous emphysema, pneumomediastinum, pneumothoraces, and nosocomial pneumonia. Although mainly used as a diagnostic tool, the prognostic role of CT in COVID-19 patients is developing. In this review, we explore the role of CT in the management of hospitalized patients with COVID-19, specifically elucidating its use as a diagnostic and prognostic modality, as well as its ability to guide hospital decision-making regarding complex cases. We will highlight important time points when CT scans are used: the initial encounter, the time at admission, and during hospitalization.

The influence of misinformation manipulations on evaluative conditioning.

We tested the influence of misinformation on evaluative conditioning (EC) by giving false information about the contingencies between CS and US stimuli after a conditioning procedure. This was done by asking participants questions about the USs while inaccurately suggesting that some CSs had been paired with a US that had the opposite valence than the US it had actually been paired with. For CS-US pairs from other conditions, accurate suggestions or no suggestions at all were given to participants. This manipulation significantly moderated EC effects. For pairs that were combined with inaccurate information we found a reversed EC effect, while we found a standard EC effect for both pairs combined with no suggestions and pairs combined with accurate suggestions. Additional analyses showed that the misinformation manipulation also moderated memory for the pairs. These results show that misinformation manipulations cannot only influence explicit memory but also attitudes. Furthermore, and in line with some theories of EC, they support the relevance of explicit memory for EC effects.