Influence of external flows on crystal growth: numerical investigation

We use a combined phase-field/lattice-Boltzmann scheme [D. Medvedev, K. Kassner, Phys. Rev. E {\bf 72}, 056703 (2005)] to simulate non-facetted crystal growth from an undercooled melt in external flows. Selected growth parameters are determined numerically. For growth patterns at moderate to high undercooling and relatively large anisotropy, the values of the tip radius and selection parameter plotted as a function of the Peclet number fall approximately on single curves. Hence, it may be argued that a parallel flow changes the selected tip radius and growth velocity solely by modifying (increasing) the Peclet number. This has interesting implications for the availability of current selection theories as predictors of growth characteristics under flow. At smaller anisotropy, a modification of the morphology diagram in the plane undercooling versus anisotropy is observed. The transition line from dendrites to doublons is shifted in favour of dendritic patterns, which become faster than doublons as the flow speed is increased, thus rendering the basin of attraction of dendritic structures larger. For small anisotropy and Prandtl number, we find oscillations of the tip velocity in the presence of flow. On increasing the fluid viscosity or decreasing the flow velocity, we observe a reduction in the amplitude of these oscillations.Comment: 10 pages, 7 figures, accepted for Physical Review E; size of some images had to be substantially reduced in comparison to original, resulting in low qualit

Prediction, prevention, and management of right ventricular failure after left ventricular assist device implantation: A comprehensive review

Left ventricular assist devices (LVADs) are increasingly common across the heart failure population. Right ventricular failure (RVF) is a feared complication that can occur in the early post-operative phase or during the outpatient follow-up. Multiple tools are available to the clinician to carefully estimate the individual risk of developing RVF after LVAD implantation. This review will provide a comprehensive overview of available tools for RVF prognostication, including patient-specific and right ventricle (RV)-specific echocardiographic and hemodynamic parameters, to provide guidance in patient selection during LVAD candidacy. We also offer a multidisciplinary approach to the management of early RVF, including indications and management of right ventricular assist devices in this setting to provide tools that help managing the failing RV

Extracorporeal Membrane Oxygenation for Graft Dysfunction Early After Heart Transplantation: A Systematic Review and Meta-analysis

Introduction: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is a prevailing option for the management of severe early graft dysfunction. This systematic review and individual patient data (IPD) meta-analysis aims to evaluate (1) mortality, (2) rates of major complications, (3) prognostic factors, and (4) the effect of different VA-ECMO strategies on outcomes in adult heart transplant (HT) recipients supported with VA-ECMO. Methods and Results: We conducted a systematic search and included studies of adults (≥18 years) who received VA-ECMO during their index hospitalization after HT and reported on mortality at any timepoint. We pooled data using random effects models. To identify prognostic factors, we analysed IPD using mixed effects logistic regression. We assessed the certainty in the evidence using the GRADE framework. We included 49 observational studies of 1477 patients who received VA-ECMO after HT, of which 15 studies provided IPD for 448 patients. There were no differences in mortality estimates between IPD and non-IPD studies. The short-term (30-day/in-hospital) mortality estimate was 33% (moderate certainty, 95% confidence interval [CI] 28%–39%) and 1-year mortality estimate 50% (moderate certainty, 95% CI 43%–57%). Recipient age (odds ratio 1.02, 95% CI 1.01–1.04) and prior sternotomy (OR 1.57, 95% CI 0.99–2.49) are associated with increased short-term mortality. There is low certainty evidence that early intraoperative cannulation and peripheral cannulation reduce the risk of short-term death. Conclusions: One-third of patients who receive VA-ECMO for early graft dysfunction do not survive 30 days or to hospital discharge, and one-half do not survive to 1 year after HT. Improving outcomes will require ongoing research focused on optimizing VA-ECMO strategies and care in the first year after HT

Browsers, grazers or mix-feeders? Study of the diet of extinct Pleistocene Eurasian forest rhinoceros Stephanorhinus kirchbergensis (J¨ager, 1839) and woolly rhinoceros Coelodonta antiquitatis (Blumenbach, 1799)

The wooly rhinoceros (Coelodonta antiquitatis) and forest rhinoceros (Stephanorhinus kirchbergensis) were prominent representatives of the Middle and Late Pleistocene glacial and interglacial faunas of Eurasia. Their diet has traditionally been inferred on functional morphology of the dentition and skull. In rare cases, food remains are preserved in the fossas of the teeth or as gut content. New approaches to infer diet include the study of isotopes and mesowear. Here we apply all four methods to infer the diet of these emblematic rhinoceros’ species and compare the food actually taken with the food available, as indicated by independent botanical data from the localities where the rhinoceros’ fossils were found: Gorz´ow Wielkopolski (Eemian) and Starunia (Middle Vistulian) as well as analysis of literature data. We also made inferences on the season of death of these individuals. Our results indicate that the woolly rhino in both Europe and Asia (Siberia) was mainly a grazer, although at different times of the year and depending on the region its diet was also supplemented by leaves of shrubs and trees. According to the results of isotope studies, there were important individual variations. The data show a clear seasonal variation in the isotope composition of this rhino’s diet. In contrast, Stephanorhinus kirchbergensis was a browser, though its diet included low-growing vegetation. Its habitat consisted of various types of forests, from riparian to deciduous and mixed forests, and open areas. The diet of this species consisted of selected items of vegetation, also including plants growing near both flowing and standing waters. The food remains from the fossae of the teeth indicated flexible browsing, confirming the previous interpretations based on functional morphology and stable isotopes. Long-term data from mesowear and microwear across a wider range of S. kirchbergensis fossils indicate a more mixed diet with a browsing component. The different diets of both of rhinoceros reflect not only the different habitats, but also climate changes that occurred during the Late Pleistocene

Special Considerations in the Care of Women With Advanced Heart Failure

Advanced heart failure (AHF) is associated with increased morbidity and mortality, and greater healthcare utilization. Recognition requires a thorough clinical assessment and appropriate risk stratification. There are persisting inequities in the allocation of AHF therapies. Women are less likely to be referred for evaluation of candidacy for heart transplantation or left ventricular assist device despite facing a higher risk of AHF-related mortality. Sex-specific risk factors influence progression to advanced disease and should be considered when evaluating women for advanced therapies. The purpose of this review is to discuss the role of sex hormones on the pathophysiology of AHF, describe the clinical presentation, diagnostic evaluation and definitive therapies of AHF in women with special attention to pregnancy, lactation, contraception and menopause. Future studies are needed to address areas of equipoise in the care of women with AHF

Stephanorhinus kirchbergensis (Jäger, 1839) (Mammalia, Rhinocerotidae) from the Po Valley (Lombardia, Northern Italy): possible diet/nutrition and living conditions

In July 2013, a Stephanorhinus kirchbergensis (Jäger, 1839) skull was found along the Po river near Spinadesco (Cremona, Lombardia, Northern Italy). It was found in an excellent preservation status even if without the lower jaw as well as the third left upper molar. At that time, a certain amount of plant remains was found inside the dental fossettae. Later pollen analyses on this material were carried out in order to hypothesize the possible diet/nutrition as well as the related living conditions of S. kirchbergensis on that territory. These analyses revealed that the material consists of peat containing an amount of 496 pollen and spores. In an absolutely hypothetical way, this made possible to assume that S. kirchbergensis from Spinadesco lived in interglacial periods within the MIS 19–MIS 5 time span (late Middle Pleistocene). The pollen complex is suggesting a palaeoenvironmental landscape like a grassy vast alluvial plain above which there were mesophilic forests dominated by beeches, therefore in a moderately humid climate. S. kirchbergensis from Spinadesco probably consumed twigs of the sea buckhorn (Hippophae rhamnoides L.) and Rosaceae shrubs as well as Asteraceae grasses. Finally, the most probable time of its death and its relative burial was in a spring or in a summer period coinciding with blossom period for sea buckhorn. Up to now as few S. kirchbergensis remains were found in a relatively limited number of localities on the vast Eurasian landmass, it still appears to be a rare species. Furthermore, no chrono- or biostratigraphic data are available in most of the cases. The S. kirchbergensis skull from Spinadesco represents one of these cases