YouTube Atherectomy Videos: What Industry is Telling Us About this Endovascular Procedure

BACKGROUND: Patients are turning to the Internet and YouTube for information about their providers, disease states and potential interventions. Endovascular atherectomy is a common procedure undertaken in the treatment of peripheral vascular disease especially in outpatient treatment centers despite its cost. Little is known how this procedure is portrayed in online video content. We set forth to search YouTube to gain insight to how industry and non-industry portrays this endovascular technology. METHODS: YouTube (www.youtube.com) website was accessed in July 2017 with a cleared cached web browser for the key search word “atherectomy”. The top 100 videos with greater than 100 views were examined. All results were separated into two categories - industry (I) or non-industry (NI) sources. The duration of video, age of video, total video views, academic information, cost information and if outpatient treatment center focused care were also collected. RESULTS: A total of 100 videos were examined. The videos were separated into two groups: Industry (n=20) and Non-Industry (n=80). Videos from Industry and Non-Industry were similar in content in terms of duration (4.8 ± 4.5 and 5.6 ± 4.4 minutes), creation time (3.3 ± 2.2 and 3.4 ± 1.9 years), and total views (7386 ± 14,593 and 5560 ± 13,181). Proportions of videos from each group that contained educational content were also similar (70% and 70%). However, only 7% (n=7) of the videos reference the procedure being linked to care in outpatient treatment center. Only 3% (n=3) mentioned the cost of the procedure. All of these videos from each of these categories were from non-industry sources. Conclusion: In our sampling of “Atherectomy” YouTube videos, we find similar video content in terms of duration, creation time, total views and educational content. Interestingly, the cost and its association with outpatient treatment labs is mentioned in only a minority of the videos and only from non-industry sources. These data should inform the vascular surgery community the lack of public understanding of this endovascular technology as evidenced in YouTube videos

Intermediate-mass black holes in dwarf galaxies out to redshift ∼\sim 2.4 in the Chandra COSMOS Legacy Survey

We present a sample of 40 AGN in dwarf galaxies at redshifts $z \lesssim$ 2.4. The galaxies are drawn from the \textit{Chandra} COSMOS-Legacy survey as having stellar masses $10^{7}\leq M_{*}\leq3 \times 10^{9}$ M$_{\odot}$. Most of the dwarf galaxies are star-forming. After removing the contribution from star formation to the X-ray emission, the AGN luminosities of the 40 dwarf galaxies are in the range $L_\mathrm{0.5-10 keV} \sim10^{39} - 10^{44}$ erg s$^{-1}$. With 12 sources at $z > 0.5$, our sample constitutes the highest-redshift discovery of AGN in dwarf galaxies. The record-holder is cid\_1192, at $z = 2.39$ and with $L_\mathrm{0.5-10 keV} \sim 10^{44}$ erg s$^{-1}$. One of the dwarf galaxies has $M_\mathrm{*} = 6.6 \times 10^{7}$ M$_{\odot}$ and is the least massive galaxy found so far to host an AGN. All the AGN are of type 2 and consistent with hosting intermediate-mass black holes (BHs) with masses $\sim 10^{4} - 10^{5}$ M$_{\odot}$ and typical Eddington ratios $> 1\%$. We also study the evolution, corrected for completeness, of AGN fraction with stellar mass, X-ray luminosity, and redshift in dwarf galaxies out to $z$ = 0.7. We find that the AGN fraction for $10^{9}< M_{*}\leq3 \times 10^{9}$ M$_{\odot}$ and $L_\mathrm{X} \sim 10^{41}-10^{42}$ erg s$^{-1}$ is $\sim$0.4\% for $z \leq$ 0.3 and that it decreases with X-ray luminosity and decreasing stellar mass. Unlike massive galaxies, the AGN fraction seems to decrease with redshift, suggesting that AGN in dwarf galaxies evolve differently than those in high-mass galaxies. Mindful of potential caveats, the results seem to favor a direct collapse formation mechanism for the seed BHs in the early Universe.Comment: 16 pages, 10 figures, accepted for publication in MNRA

Socio-Economic Factors Affecting Smallholder Tree Planting and Management Intentions in Leyte Province, The Philippines

Survey data have been collected from four rural communities in Leyte Province, the Philippines, on household tree planting and management intentions, as well as the socio-economic characteristics, attitudes to tree planting and management, farming practices and the number of trees planted. In relation to intended tree planting and management activities, respondents were asked a series of structured questions as to what tree species they intend to plant, how many individual trees of each of those species they plan to plant, and for what purpose they propose to plant each of the tree species. This paper reports the results of analyses of the stated tree management intentions of households in the four communities and identifies the socio-economic factors that influence householders' tree management intentions. Respondents were generally enthusiastic about the possibility for further tree planting on their land, 75% indicating they would undertake planting. About 60% indicated an interest in commercial tree farming, with no significant differences in this level of interest between communities. It was found that a number of socio-economic variables indicating higher levels of land ownership and previous experience in the forestry industry are related to the intention to plant trees to produce timber for sale. These include the use of materials from public lands, participation in community organisations and community forestry programs, and the present management of trees to produce timber for sale

Complete response of skull base inverted papilloma to chemotherapy: Case report.

BackgroundInverted papilloma (IP) is the most common benign sinonasal neoplasm. Endoscopic techniques, improved understanding of pathophysiology, and novel surgical approaches have allowed rhinologists to treat IPs more effectively, with surgery being the mainstay of therapy. Frontal sinus IP poses a challenge for surgical therapy due to complex anatomy and potentially difficult surgical access.ObjectivesWe reported a unique case of a massive frontal sinus IP that presented with intracranial and orbital extension, with near resolution after chemotherapy.MethodsA retrospective case review of a patient with a frontal sinus IP treated at a tertiary academic medical center.ResultsA 75-year-old male patient presented with nasal obstruction, purulent nasal discharge, and a growing left supraorbital mass. Endoscopy demonstrated a mass that filled both frontal and ethmoid sinuses, with orbital invasion. There also was substantial erosion of the posterior table, which measured 1.73 × 1.40 cm. A biopsy specimen demonstrated IP with carcinoma in situ. The patient was deemed unresectable on initial evaluation and, subsequently, underwent chemotherapy (carboplatin and paclitaxel). The tumor had a dramatic response to chemotherapy, and the patient elected for definitive surgery to remove any residual disease. During surgery, only a small focus of IP was found along the superior wall of the frontal sinus. No tumor was found elsewhere, including at the site of skull base erosion. The final pathology was IP without carcinoma in situ or dysplasia.ConclusionThis was the first reported case of chemotherapeutic "debulking" of IP, which facilitated surgical resection, despite substantial intracranial and orbital involvement. Although nearly all IPs can be treated surgically, rare cases, such as unresectable tumors, may benefit from systemic chemotherapy

Experimental evidence of guided resonances in photonic crystals with aperiodically-ordered supercells

We report on the first experimental evidence of guided resonances (GRs) in photonic crystal slabs based on aperiodically-ordered supercells. Using the Ammann-Beenker (quasiperiodic, 8-fold symmetric) tiling geometry, we present our study on the fabrication, experimental characterization, and full-wave numerical simulation of two representative structures (with different filling parameters) operating at near-infrared wavelengths (1300-1600 nm). Our results show a fairly good agreement between measurements and numerical predictions, and pave the way for the development of new strategies (based, e.g., on the lattice symmetry breaking) for GR engineering.Comment: 10 pages, 5 figures (minor revisions