Geometric mismatch of pulmonary and aortic anuli in children undergoing the Ross procedure: Implications for surgical management and autograft valve function

AbstractBackground: There is often substantial mismatch between the diameters of the pulmonary and aortic anuli in young patients with systemic outflow tract disease. To implant the autologous pulmonary valve in the aortic position under such circumstances, it is necessary to adapt the geometry of the systemic outflow tract. The effects of such adaptations on autograft function in children are not well known. Methods: To determine factors predictive of autograft regurgitation, we analyzed 41 cases of children who have undergone the Ross procedure. The diameter of the pulmonary valve was greater (by at least 3 mm) than that of the aortic valve in 20 cases, equal (within 2 mm) in 12 cases, and less (by at least 3 mm) in nine cases, with differences ranging from +10 to –12 mm. In 12 patients with a larger pulmonary anulus, aortoventriculoplasty was used to correct the mismatch. In patients with a larger aortic anulus, the mismatch was corrected by gradual adjustment along the circumference of the autograft, rather than by tailoring of the native aortic anulus. Results: At follow-up (median 31 months), two patients had undergone reoperation on the neoaortic valve for moderate regurgitation. In the remaining 38 cases, autograft regurgitation was as follows: none or trivial in 30, mild in seven, and moderate in one. There was no correlation between regurgitation and age, geometric mismatch, or previous or concurrent procedures. Conclusions: Subtle technical factors that may result in distortion of the valve complex are probably more important determinants of autograft regurgitation than are indication for repair, geometric mismatch, or previous or concomitant outflow tract procedures. Significant mismatch of the semilunar anuli is not a contraindication to the Ross procedure in children. (J Thorac Cardiovasc Surg 1998;115:1255-63

Influence of Metoprolol Dosage Release Formulation on the Pharmacokinetic Drug Interaction With Paroxetine

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/97158/1/0091270010365559.pd

Savant Genome Browser 2: visualization and analysis for population-scale genomics

High-throughput sequencing (HTS) technologies are providing an unprecedented capacity for data generation, and there is a corresponding need for efficient data exploration and analysis capabilities. Although most existing tools for HTS data analysis are developed for either automated (e.g. genotyping) or visualization (e.g. genome browsing) purposes, such tools are most powerful when combined. For example, integration of visualization and computation allows users to iteratively refine their analyses by updating computational parameters within the visual framework in real-time. Here we introduce the second version of the Savant Genome Browser, a standalone program for visual and computational analysis of HTS data. Savant substantially improves upon its predecessor and existing tools by introducing innovative visualization modes and navigation interfaces for several genomic datatypes, and synergizing visual and automated analyses in a way that is powerful yet easy even for non-expert users. We also present a number of plugins that were developed by the Savant Community, which demonstrate the power of integrating visual and automated analyses using Savant. The Savant Genome Browser is freely available (open source) at www.savantbrowser.co

The ecological footprint remains a misleading metric of global sustainability

Linus Blomqvist, Barry W. Brook, Erle C. Ellis, Peter M. Kareiva, Ted Nordhaus, Michael Shellenberge

A Cohort Study of Traffic-Related Air Pollution and Mortality in Toronto, Ontario, Canada

BackgroundChronic exposure to traffic-related air pollution (TRAP) may contribute to premature mortality, but few studies to date have addressed this topic.ObjectivesIn this study we assessed the association between TRAP and mortality in Toronto, Ontario, Canada.MethodsWe collected nitrogen dioxide samples over two seasons using duplicate two-sided Ogawa passive diffusion samplers at 143 locations across Toronto. We calibrated land use regressions to predict NO2 exposure on a fine scale within Toronto. We used interpolations to predict levels of particulate matter with aerodynamic diameter < or = 2.5 microm (PM(2.5)) and ozone levels. We assigned predicted pollution exposures to 2,360 subjects from a respiratory clinic, and abstracted health data on these subjects from medical billings, lung function tests, and diagnoses by pulmonologists. We tracked mortality between 1992 and 2002. We used standard and multilevel Cox proportional hazard models to test associations between air pollution and mortality.ResultsAfter controlling for age, sex, lung function, obesity, smoking, and neighborhood deprivation, we observed a 17% increase in all-cause mortality and a 40% increase in circulatory mortality from an exposure contrast across the interquartile range of 4 ppb NO2. We observed no significant associations with other pollutants.ConclusionsExposure to TRAP was significantly associated with increased all-cause and circulatory mortality in this cohort. A high prevalence of cardiopulmonary disease in the cohort probably limits inference of the findings to populations with a substantial proportion of susceptible individuals

Integrating local environmental observations and remote sensing to better understand the life cycle of a thermokarst lake in Arctic Alaska

On 29 June 2022, local observers reported the drainage of a 0.5 ha lake near Qikiqtaġruk (Kotzebue), Alaska, that prompted this collaborative study on the life cycle of a thermokarst lake in the Arctic. Prior to its drainage, the lake expanded from 0.13 ha in 1951 to 0.54 ha in 2021 at lateral rates that ranged from 0.25 to 0.35 m/year. During the drainage event, we estimate that 18,500 m3 of water drained from the lake into Kotzebue Sound, forming a 125-m-long thermo-erosional gully that incised 2 to 14 m in ice-rich permafrost. Between 29 June and 18 August 2022, the drainage gully expanded from 1 m to >10 m wide, mobilizing ~8,500 m3 of material through erosion and thaw. By reconstructing a pre-lake disturbance terrain model, we show that thaw subsidence occurs rapidly (0.78 m/year) upon transition from tundra to lake but that over a seventy-year period it slows to 0.12 m/year. The combination of multiple remote sensing tools and local environmental observations provided a rich data set that allowed us to assess rates of lake expansion relative to rates of sub-lake permafrost thaw subsidence as well as hypothesizing about the potential role of beavers in arctic lake drainage

Understanding Dwarf Galaxies in order to Understand Dark Matter

Much progress has been made in recent years by the galaxy simulation community in making realistic galaxies, mostly by more accurately capturing the effects of baryons on the structural evolution of dark matter halos at high resolutions. This progress has altered theoretical expectations for galaxy evolution within a Cold Dark Matter (CDM) model, reconciling many earlier discrepancies between theory and observations. Despite this reconciliation, CDM may not be an accurate model for our Universe. Much more work must be done to understand the predictions for galaxy formation within alternative dark matter models.Comment: Refereed contribution to the Proceedings of the Simons Symposium on Illuminating Dark Matter, to be published by Springe