Publications by authors named "Hynes N"

Article Synopsis
  • - Type-B Aortic Dissection is a serious cardiovascular issue that impacts 3.5 people per 100,000 each year and involves a tear in the aorta's inner layer; this study focuses on using 2D Convolutional Neural Networks (CNN) for segmenting relevant areas in CT angiography images.
  • - Researchers tested three variations of the U-Net model, with the U-Net using the VGG19 encoder achieving the highest performance scores: 80.48% mean Dice score and 72.93% IoU score.
  • - The results showed that while the 2D U-Net models performed well in segmenting true and false lumen, they were less effective in false lumen thrombus segmentation compared
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Introduction: The precise mechanism of rupture in abdominal aortic aneurysms (AAAs) has not yet been uncovered. The phenomenological failure criterion of the coefficient of proportionality between von Mises stress and tissue strength does not account for any mechanistic foundation of tissue fracture. Experimental studies have shown that arterial failure is a stepwise process of fibrous delamination (mode II) and kinking (mode I) between layers.

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Over the past two decades, there has been extensive research into surveillance methods for the post-endovascular repair of abdominal aortic aneurysms, highlighting the importance of these technologies in supplementing or even replacing conventional image-screening modalities. This review aims to provide an overview of the current status of alternative surveillance solutions for endovascular aneurysm repair, while also identifying potential aneurysm features that could be used to develop novel monitoring technologies. It offers a comprehensive review of these recent clinical advances, comparing new and standard clinical practices.

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Background: Tyrosine kinase inhibitors targeting the vascular endothelial growth factor (VEGF) inhibitor pathway with immune checkpoint blockade have shown promising outcomes in managing metastatic renal cancer. However, they increase the risk of a person developing high blood pressure and cardiovascular complications.

Case Summary: In this study, we report the case of a 73-year-old woman on axitinib and pembrolizumab for her Stage 4 renal cell carcinoma.

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Background: This study evaluates the implications of blood pressure homeostasis in bilateral vs. unilateral carotid surgeries, focusing on the incidence of postoperative hypertension, hyperperfusion syndrome, and stroke as primary outcomes. It further delves into the secondary outcomes encompassing major adverse cardiovascular events and all-cause mortality.

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Article Synopsis
  • The study investigates the effectiveness of the immunomodulator baricitinib when combined with remdesivir for hospitalized COVID-19 patients, focusing on those identified as high-risk based on specific blood count metrics.
  • In the high-risk group, the combination therapy showed significant benefits, including a lower risk of death, reduced likelihood of needing invasive ventilation, and improved recovery rates compared to the placebo group.
  • The findings suggest that baricitinib+remdesivir can enhance treatment outcomes for high-risk COVID-19 patients, although it is noted that the analysis is based on data prior to the emergence of newer SARS-CoV-2 variants.
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Healthcare workers (HCWs) at community hospitals, also known as frontline hospitals (FLHs), may encounter patients with possible infectious diseases, including those caused by high-consequence pathogens such as We created and piloted a 1-day, in-person, didactic and skills training program to determine the feasibility and acceptability of implementing an educational program to enhance the knowledge and skills needed to respond when a patient with a potential high-consequence pathogen presents to an FLH. The Maryland Department of Health queried all 104 state FLHs to identify their interest in participating in the pilot training program. HCWs from 12 (75%) of the 16 interested FLHs participated in the program before it was interrupted by the COVID-19 pandemic.

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Background: Endovascular aortic repair (EVAR) is an established and attractive alternative to open surgical repair (OSR) of abdominal aortic aneurysms (AAA) due to its superior short-term safety profile. However, opinions are divided regarding its long-term cost-effectiveness. We compared the total yearly cost of running endovascular and OSR services in a single tertiary center to determine whether fenestrated EVAR (FEVAR) represents a clinically efficacious, affordable treatment option.

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In recent years, the transportation industry has faced the challenge of cutting costs, meeting increasingly stringent environmental regulations, and significantly increasing transportation volumes. One approach to meeting these challenges is to develop new, improved transportation vehicles using new materials and innovative joining techniques. Multi-material structures are becoming an alternative to body parts.

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Vascular compression syndromes (VCS) are rare diseases, but they may cause significant symptoms interfering with the quality of life (QoL) of patients who are often in their younger age. Given their infrequent occurrence, multiform clinical and anatomical presentation, and absence of dedicated guidelines from scientific societies, further knowledge of these conditions is required to investigate and treat them using modern imaging and surgical (open or endovascular) techniques. This consensus document will focus on known VCS, affecting the arterial and venous system.

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Article Synopsis
  • Clinical trials during infectious disease outbreaks like COVID-19 often face challenges in quickly enrolling a representative study population, which can impact treatment identification against morbidity and mortality.
  • The study assessed participant demographics in the Adaptive COVID-19 Treatment Trial (ACTT) by comparing enrolled data against COVID-19 surveillance networks and US Census information, focusing on sex, race, ethnicity, and age.
  • Results showed that while ACTT's demographic makeup somewhat aligned with COVID-NET data, it highlighted discrepancies such as a lower proportion of females enrolled compared to reference datasets, indicating that using surveillance data is more relevant than census data in understanding the affected population.
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Background: Research shows associations between bullying victimization and substance use for teens. However, more research about this relationship for younger adolescents and across race/ethnicity is needed.

Methods: Prevalence and pooled logistic regression analyses of 2019 Middle School Youth Risk Behavior Survey data from 13 states (N = 74,059 students) examined associations between self-reported bulling victimization (at school, electronically, and both) and having ever tried cigarette smoking, alcohol, or marijuana; used an electronic vapor product; or misused prescription pain medicine.

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Article Synopsis
  • A secondary analysis of the ACTT-2 trial found that baricitinib significantly reduced secondary infections by 50%.
  • This reduction was observed even after considering various patient characteristics before and after randomization.
  • The results highlight a new benefit of baricitinib and reinforce its safety as a treatment option for COVID-19.
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Background: Thoracoabdominal acute aortic syndrome is associated with high morbidity and mortality. We aim to scrutinize our evolving strategies for acute aortic syndrome (AAS) management using minimally invasive and adaptive surgical techniques over two decades.

Methods: This is a longitudinal observational study at our tertiary vascular centre from 2002 to 2021.

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Introduction: Over the past decade, there have been outbreaks associated with high consequence infectious diseases such as Ebola virus disease, Lassa fever, and Monkeypox. The proper handling of clinical waste from patients infected with such pathogens is critical to ensure healthcare personnel and community safety.

Methods: Mock clinical waste bags were created to simulate four distinct waste streams: personal protective equipment (PPE), dry linens, wet linens, and solidified liquids.

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Objectives: We aim to scrutinize our evolving re-intervention strategies following primary endovascular aortic aneurysm repair (EVAR) - EVAR GORE SalvAge Fabric Technique (ARAFAT), aortic sac double breasting with endograft preservation, and stent-graft explantation.

Methods: We performed 1,555 aortic interventions over the study period, including 910 EVARs. Factors associated with the need for reintervention and the likelihood of chronic fabric fatigue failure (CFFF) were investigated.

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Article Synopsis
  • The study assessed the progression of COVID-19 treatment standards (SOC) and their impact on patient recovery and mortality rates during 2020-2021, using data from the Adaptive COVID-19 Treatment Trial (ACTT).
  • Results indicated that outcomes improved significantly from ACTT-2 to ACTT-3, with notable reductions in mortality and intubation rates, although the improvements from ACTT-1 to ACTT-2 were less pronounced.
  • The analysis also explored various factors that could explain these trends, including changes in SOC, surges in COVID-19 cases, and the emergence of different virus variants, highlighting an increase in the use of dexamethasone in later trials.
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Memo1 deletion in mice causes premature aging and an unbalanced metabolism partially resembling Fgf23 and Klotho loss-of-function animals. We report a role for Memo's redox function in renal FGF23-Klotho signaling using mice with postnatally induced Memo deficiency in the whole body (cKO). Memo cKO mice showed impaired FGF23-driven renal ERK phosphorylation and transcriptional responses.

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Vision-impaired (VI) golf is a global para-sport currently played under several different classification systems under different bodies. This study aimed to gather expert opinion to determine whether the current classification systems are fit for the purpose intended and to identify any particular issues where VI impacts the game of golf for the disabled (G4D). A panel of 20 participants with expertise in G4D took part in a three-round Delphi study.

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This review discusses the impact of endovascular aneurysm repair on cardiovascular (CV) hemodynamics and the role of stent-graft material, i.e., polytetrafluoroethylene (PTFE) vs.

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Objectives: This study aimed to identify facilitators and barriers to participation in vision impaired golf.

Design: Semistructured interviews were conducted with 12 vision impaired golfers, 10 guides, and 5 novices during the British VI Golf Open tournament in August 2021.

Results: Qualitative content analysis identified the benefits, facilitators, and challenges of playing vision impaired golf.

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Endovascular aneurysm repair of the abdominal aorta (EVAR) and of the thoracic aorta (TEVAR) have revolutionised therapeutic strategies in the management of aortic pathology, and endovascular repair is now an established and attractive alternative to open surgical repair (OSR) due to its superior short-term safety profile. However, opinions are divided regarding its long-term cost-effectiveness, which is reflected in the controversial NICE guidelines on abdominal aortic aneurysm (AAA) repair published in 2018, which advised against EVAR for elective aortic repair due to high secondary intervention rates and resultant associated costs. There is no doubt that OSR continues to have a valuable role to play in aortic repair, but it is not universally applicable, especially in older and sicker patients.

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Background: Early diagnosis and treatment of under-recognized retroperitoneal fibrosis (RPF) are essential before reaching the poorly responsive fibrotic stage. Although most patients respond to medical therapy, relapses and unresponsiveness are common. However, open surgery in medically resistant patients is associated with major adverse clinical events.

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Current global trends demand the replacement of synthetic fibres with natural fibres in polymeric composites. The present work makes use of Prosopis juliflora, a plant that is a threat to the environment as a partial replacement in a hybrid composite. Individual Prosopis juliflora fibres are added to matrices at ratios of 12, 6, 9 and 8 wt % and glass fibres are added discretely at ratios of 28, 24, 21 and 32 wt % into matrices as well.

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