Randomized comparison of ePTFE/nitinol self-expanding stent graft vs prosthetic femoral-popliteal bypass in the treatment of superficial femoral artery occlusive disease

BackgroundA randomized prospective study comparing the treatment of superficial femoral artery occlusive disease percutaneously with an expanded polytetrafluoroethylene (ePTFE)/nitinol self-expanding stent graft (stent-graft) vs surgical femoral to above knee popliteal artery bypass with synthetic graft material.MethodsOne hundred limbs in 86 patients with superficial femoral artery occlusive disease were evaluated from March 2004 to May 2005. Patient symptoms included both claudication and limb threatening ischemia with or without tissue loss. The TransAtlantic InterSociety Consensus (TASC) II A (N = 18), B (N = 56), C (N = 11), and D (N = 15) lesions were included. Patients were randomized prospectively into one of two treatment groups; a percutaneous treatment group (group A; N = 50) with angioplasty and placement of one or more stent-grafts or a surgical treatment group (group B; N = 50) with a femoral to above knee popliteal artery bypass using synthetic conduit (Dacron graft or ePTFE). Patients were followed for a total of 24 months. Follow-up evaluation included clinical assessment and physical examination, ankle-brachial indices (ABI), and color flow duplex sonography at 3, 6, 9, 12, 18, and 24 months.ResultsThe mean total lesion length of the treated arterial segment in the stent-graft group was 25.6 cm (SD ± 15 cm). The stent-graft group demonstrated a primary patency of 81%, 72%, and 63% with a secondary patency of 86%, 83%, and 74% at 6, 12, and 24 months, respectively. The surgical femoral-popliteal group demonstrated a primary patency of 84%, 77%, and 64% with a secondary patency of 89%, 86%, and 76% at 6, 12, and 24 months, respectively. No statistical difference was found between the two groups with respect to primary (P = .716) or secondary patency (P = .695). Grouping of less severe (TASC II A/B) vs more severe (TASC II C/D) lesions demonstrated patency at 24 months for the femoral-popliteal arm of 63% and 67%, respectively while that of the stent-graft arm was 64% and 47%, respectively. Secondary patency was 76% in both TASC classifications for the femoral-popliteal arm with 78% and 47% patency found respectively in the stent-graft group. These resulted in no significant difference for primary (P = .978) or secondary (P = .653) patency overall, although there is a trend for decreased patency with higher TASC II lesions.ConclusionManagement of superficial femoral artery occlusive disease with percutaneous stent-grafts exhibits similar primary patency at 24-month follow-up when compared with conventional femoral-popliteal artery bypass grafting with synthetic conduit. This treatment method may offer an alternative to treatment of the superficial femoral artery segment for revascularization when prosthetic bypass is being considered or when autologous conduit is unavailable

Maternal Sensitivity And Latency To Positive Emotion Following Challenge: Pathways Through Effortful Control

The ability to self‐generate positive emotions is an important component of emotion regulation. In this study, we focus on children's latency to express positive emotions following challenging situations and assess whether this ability operates through early maternal sensitivity and children's effortful control. Longitudinal relations between maternal sensitivity, infant negative affect, effortful control, and latency to positive emotion following challenge were examined in 156 children who were 33 months of age. Structural equation models supported the hypothesis that maternal sensitivity during infancy predicted better effortful control and, in turn, shorter latencies to positive emotions following challenge at 33 months. Directions for future research are discussed. RESUMEN La habilidad para autogenerar emociones positivas es un componente importante de la regulación de la emoción. En este estudio, nos enfocamos en el estado latente de los niños para expresar emociones positivas después de situaciones desafiantes y evaluar si esta habilidad opera a través de la temprana sensibilidad maternal y el esforzado control de los niños. Se examinaron las relaciones longitudinales entre la sensibilidad maternal, el efecto negativo del infante, el control esforzado, y el estado latente hacia la emoción positiva después de situaciones desafiantes, en 156 niños de 33 meses. Los modelos de ecuación estructural apoyaron la hipótesis de que la sensibilidad maternal durante la infancia predijo un mejor control esforzado y, a la vuelta, los más cortos estados latentes hacia emociones positivas después de situaciones desafiantes a los 33 meses. Se discuten las directrices para la investigación futura. RÉSUMÉ La capacité à auto‐générer des émotions positives est une composante importante de la régulation des émotions. Dans cette étude nous nous concentrons sur la latence des enfants à exprimer des émotions positives après des situations difficiles et nous évaluons si cette capacité opère à travers une sensibilité maternelle précoce et le contrôle fait avec effort des enfants. Les relations longitudinales entre la sensibilité maternelle, l’affect négatif du nourrisson, le contrôle fait avec effort et la latence et l’émotion positive après des difficultés ont été examinés chez 156 enfants de 33 mois. Des modèles d’équation structurelle ont soutenu l’hypothèse selon laquelle la sensibilité maternelle durant la petite enfance prédisait un meilleur contrôle avec effort et ensuite des latences plus courtes vers des émotions positives après des difficultés à 33 mois. Des directions pour des recherches à venir sont discutées. ZUSAMMENFASSUNG Die Fähigkeit, positive Emotionen selbst zu erzeugen, ist ein wichtiger Bestandteil der Emotionsregulation. In dieser Studie fokussieren wir auf die Latenzzeit von Kindern, positive Emotionen nach herausfordernden Situationen zu zeigen, und beurteilen, ob diese Fähigkeit durch frühe mütterliche Feinfühligkeit und bewusste Kontrolle der Kinder beeinflusst wird. Longitudinale Beziehungen zwischen mütterlicher Feinfühligkeit, dem negativen Affekt des Säuglings, bewusster Kontrolle und der Latenzzeit hinichtlich positiver Emotionen nach einer Herausforderung wurden bei 156 Kindern im Alter von 33 Monaten untersucht. Strukturgleichungsmodelle unterstützten die Hypothese, dass die Feinfühligkeit der Mütter während des Säuglingsalters eine bewusstere Kontrolle und wiederum kürzere Latenzzeiten für positive Emotionen nach einer Herausforderung im Alter von 33 Monaten voraussagen konnte. Hinweise für die zukünftige Forschung werden diskutiert. ABSTRACT The ability to self‐generate positive emotions is an important component of emotion regulation. In this study, we focus on children's latency to express positive emotions following challenging situations and assess whether this ability operates through early maternal sensitivity and children's effortful control. 抄録：ポジティブな情緒を自己生成する能力ability to self‐generate positive emotionsは、情緒調節の重要な構成要素である。この研究で、私たちは困難な状況の後に、子どもがポジティブな情緒を表出するまでの潜伏時間に焦点付け、この能力が早期の母親の感受性と子どもの努力したコントロールを通して作用するかどうかを評価する。母親の感受性、乳児のネガティブな感情、努力したコントロール、および困難後のポジティブな情緒表出潜時の縦断的な関係が、156人の33か月児について調査された。構造方程式モデルによって、乳児期の母親の感受性が、33か月時のより良い努力したコントロールと、次に、より短い困難後のポジティブな情緒表出潜時を予測するという仮説が支持された。Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106874/1/imhj21445.pd

Anticipatory representations of reward and threat in perceptual areas from preadolescence to late adolescence

This study examined whether changes in perceptual processes can partially account for the increase in reward-orientated behaviour during adolescence. This was investigated by examining reinforcementdependent potentiation to discriminative stimuli (SD) that predicted rewarding or threatening outcomes. To that end, perceptual event-related potentials that are modulated by motivationally salient stimuli, the N170 and Late Positive Potential (LPP), were recorded from 30 preadolescents (9–12 years), 30 adolescents (13–17 years), and 34 late adolescents (18–23 years) while they completed an instrumental task in which they emitted or omitted a motor response to obtain rewards and avoid losses. The LPP, but not the N170, showed age, but not gender, differences in reinforcement-dependent potentiation; preadolescents, adolescents, and late adolescents showed potentiation to SD that predicted a threat, whereas only preadolescents showed potentiation to SD that predicted a reward. Notably, the magnitude of threat-related LPP reinforcement-dependent potentiation decreased during the course of adolescence. In addition, greater sensation seeking was associated with greater LPP amplitudes in preadolescent males, but smaller LPP amplitudes in late adolescent males. Critically, these findings provide initial evidence for developmental differences in value-related coding in perceptual areas, where adolescents show greater perceptual biases to avoidance-related cues than to reward-related cue

A review of the practical relevance of IS strategy scholarly research

While studies suggest that IS strategy is an important topic for practitioners, in-depth explorations of the potential practical relevance of this research area are lacking. In this paper, we develop a multidimensional framework of potential practical relevance and use it to conduct a multimethod descriptive review of 109 IS strategy papers published over the past 10 years in top IS journals. The framework contributes to the IS literature by synthesizing various characteristics that make a research project conducive to being practically relevant. The review highlights how IS strategy research has offered the potential for practical relevance in the past and recommends opportunities to increase this, especially in the digitalization era