Initial United States experience with the Paracor HeartNet⁎⁎Paracor Medical, Inc, Sunnyvale, Calif. myocardial constraint device for heart failure

ObjectiveThis study was undertaken to review the initial results and surgical safety data for the US Food and Drug Administration safety and feasibility trial of the Paracor HeartNet (Paracor Medical, Inc, Sunnyvale, Calif.) myocardial constraint device.MethodsPatients with New York Heart Association functional class II or III heart failure underwent device implantation (n = 21) through a left minithoracotomy.ResultsThe average age was 53 years (31–72 years). There were 18 men and 3 women, and 17 patients had nonischemic etiology of heart failure. Mean heart failure duration was 8.3 years (1.4-18.8 years). Average ejection fraction was 22% (11%-33%), with an average left ventricular end-diastolic dimension of 74 mm (55-94 mm). Previous medical therapy included angiotensin-converting enzyme inhibitors, β-blockers, diuretics, digoxin, and aldosterone receptor blockers. At implantation, 17 patients had implantable electronic devices: 1 biventricular pacemaker, 11 biventricular pacemakers with cardioverter-defibrillators, and 5 implantable cardioverter-defibrillators. Patient comorbidities included hypertension in 10 cases, diabetes mellitus in 8, myocardial infarction in 1, and ventricular tachycardia in 8. Mean operative time was 68 minutes (42–102 minutes), and implantation time averaged 15 minutes (5–51 minutes). The average time to ambulation was 1.6 days (1–4 days). The intensive care unit stay averaged 3.3 days (1–16 days), and hospital stay averaged 6.3 days (4–16 days). Atrial fibrillation occurred in 2 patients, and there were 2 in-hospital deaths.ConclusionsThe Paracor device can be implanted in patients with heart failure and reduced left ventricular function with a high degree of success. Significant surgical complications were infrequent. The initial US experience supports the conduct of a randomized, controlled, pivotal trial

Modifications of the metal and support during the deactivation and regeneration of Au/C catalysts for the hydrochlorination of acetylene

The effect of the gold oxidation state and carbon structure on the activity of Au/C catalysts for the hydrochlorination of acetylene was investigated by a combined approach using TPR, XPS and porosimetry determinations. The activity of the catalyst in the synthesis of vinyl chloride monomer was found to be dependent on the presence of Au3+ species in the catalyst. However, by preparing catalysts with different Au3+ content it was possible to determine the existence of a threshold Au3+ amount, beyond which the excess of Au3+ was not active for the reaction. This was explained by the existence of active sites at the Au/C interface, and not just by the presence of Au3+ species on top of Au nanoparticles, as explained by current models for these catalysts. It was also possible to determine the existence of a subset of Au nanoclusters which do not take part in the reaction, as well as changes in the textural properties of the carbon that can affect its long term reusability

Multimode solutions of first-order elliptic quasilinear systems obtained from Riemann invariants

Two new approaches to solving first-order quasilinear elliptic systems of PDEs in many dimensions are proposed. The first method is based on an analysis of multimode solutions expressible in terms of Riemann invariants, based on links between two techniques, that of the symmetry reduction method and of the generalized method of characteristics. A variant of the conditional symmetry method for constructing this type of solution is proposed. A specific feature of that approach is an algebraic-geometric point of view, which allows the introduction of specific first-order side conditions consistent with the original system of PDEs, leading to a generalization of the Riemann invariant method for solving elliptic homogeneous systems of PDEs. A further generalization of the Riemann invariants method to the case of inhomogeneous systems, based on the introduction of specific rotation matrices, enables us to weaken the integrability condition. It allows us to establish a connection between the structure of the set of integral elements and the possibility of constructing specific classes of simple mode solutions. These theoretical considerations are illustrated by the examples of an ideal plastic flow in its elliptic region and a system describing a nonlinear interaction of waves and particles. Several new classes of solutions are obtained in explicit form, including the general integral for the latter system of equations

A single vertebrate DNA virus protein disarms invertebrate immunity to RNA virus infection

Virus-host interactions drive a remarkable diversity of immune responses and countermeasures. We found that two RNA viruses with broad host ranges, vesicular stomatitis virus (VSV) and Sindbis virus (SINV), are completely restricted in their replication after entry into Lepidopteran cells. This restriction is overcome when cells are co-infected with vaccinia virus (VACV), a vertebrate DNA virus. Using RNAi screening, we show that Lepidopteran RNAi, Nuclear Factor-kappaB, and ubiquitin-proteasome pathways restrict RNA virus infection. Surprisingly, a highly conserved, uncharacterized VACV protein, A51R, can partially overcome this virus restriction. We show that A51R is also critical for VACV replication in vertebrate cells and for pathogenesis in mice. Interestingly, A51R colocalizes with, and stabilizes, host microtubules and also associates with ubiquitin. We show that A51R promotes viral protein stability, possibly by preventing ubiquitin-dependent targeting of viral proteins for destruction. Importantly, our studies reveal exciting new opportunities to study virus-host interactions in experimentally-tractable Lepidopteran systems

Aqua regia activated Au/C catalysts for the hydrochlorination of acetylene

Au/C catalysts are effective materials for the gas phase hydrochlorination of acetylene to vinyl chloride monomer, and to date, the most effective catalyst preparation protocol makes use of impregnation using aqua regia. In the present study, the effect of this solvent is evaluated and discussed in detail by modifying the ratio of HCl and HNO3 and the temperature of the impregnation step. These factors are observed to affect the Au3+/Au0 ratio of the final catalyst, in addition to the modification of the functional groups of the carbon used as support. The results can be rationalised by the oxidation effect of HNO3 on both the gold nanoparticles and the functional groups on the carbon surface, as well as a nucleation effect of HCl towards gold over the carbon support

Soliton surfaces via zero-curvature representation of differential equations

The main aim of this paper is to introduce a new version of the Fokas-Gel'fand formula for immersion of soliton surfaces in Lie algebras. The paper contains a detailed exposition of the technique for obtaining exact forms of 2D-surfaces associated with any solution of a given nonlinear ordinary differential equation (ODE) which can be written in zero-curvature form. That is, for any generalized symmetry of the zero-curvature condition of the associated integrable model, it is possible to construct soliton surfaces whose Gauss-Mainardi-Codazzi equations are equivalent to infinitesimal deformations of the zero-curvature representation of the considered model. Conversely, it is shown (Proposition 1) that for a given immersion function of a 2D-soliton surface in a Lie algebra, it possible to derive the associated generalized vector field in evolutionary form which characterizes all symmetries of the zero-curvature condition. The theoretical considerations are illustrated via surfaces associated with the Painlev\'e equations P1, P2 and P3, including transcendental functions, the special cases of the rational and Airy solutions of P2 and the classical solutions of P3.Comment: 28 pages, 2 figure

Simulation-Based Training in Cardiac Surgery

BACKGROUND: Operating room surgical training has significant limitations. This study hypothesized that some skills could be learned efficiently and safely by using simulation with component task training, deliberate practice, progressive complexity, and experienced coaching to produce safer cardiac surgeons. METHODS: Training modules included cardiopulmonary bypass, coronary artery bypass grafting, aortic valve replacement, massive air embolism, acute intraoperative aortic dissection, and sudden deterioration in cardiac function. Using deliberate practice, first-year cardiothoracic surgical residents at eight institutions were trained and evaluated on component tasks for each module and later on full cardiac operations. Evaluations were based on five-point Likert-scale tools indexed by module, session, task items, and repetitions. Statistical analyses relied on generalized linear model estimation and corresponding confidence intervals. RESULTS: The 27 residents who participated demonstrated improvement with practice repetitions resulting in excellent final scores per module (mean ± two SEs): cardiopulmonary bypass, 4.80 ± 0.12; coronary artery bypass grafting, 4.41 ± 0.19; aortic valve replacement, 4.51 ± 0.20; massive air embolism, 0.68 ± 0.14; acute intraoperative aortic dissection, 4.52 ± 0.17; and sudden deterioration in cardiac function, 4.76 ± 0.16. The transient detrimental effect of time away from training was also evident. CONCLUSIONS: Overall performance in component tasks and complete cardiac surgical procedures improved during simulation-based training. Simulation-based training imparts skill sets for management of adverse events and can help produce safer surgeons

Low luminosity Type II supernovae - IV. SN 2020cxd and SN 2021aai, at the edges of the sub-luminous supernovae class

Photometric and spectroscopic data for two Low Luminosity Type IIP Supernovae (LL SNe IIP) 2020cxd and 2021aai are presented. SN 2020cxd was discovered 2 d after explosion at an absolute magnitude of Mr = -14.02 ± 0.21 mag, subsequently settling on a plateau which lasts for ∼120 d. Through the luminosity of the late light curve tail, we infer a synthesized 56Ni mass of (1.8 ± 0.5) × 10-3 M⊙. During the early evolutionary phases, optical spectra show a blue continuum ($T\, \gt$8000 K) with broad Balmer lines displaying a P Cygni profile, while at later phases, Ca ii, Fe ii, Sc ii, and Ba ii lines dominate the spectra. Hydrodynamical modelling of the observables yields $R\, \simeq$ 575 R⊙ for the progenitor star, with Mej = 7.5 M⊙ and $E\, \simeq$ 0.097 foe emitted during the explosion. This low-energy event originating from a low-mass progenitor star is compatible with both the explosion of a red supergiant (RSG) star and with an Electron Capture Supernova arising from a super asymptotic giant branch star. SN 2021aai reaches a maximum luminosity of Mr = -16.57 ± 0.23 mag (correcting for AV = 1.92 mag), at the end of its remarkably long plateau (∼140 d). The estimated 56Ni mass is (1.4 ± 0.5) × 10-2 M⊙. The expansion velocities are compatible with those of other LL SNe IIP (few 103 km s-1). The physical parameters obtained through hydrodynamical modelling are $R\, \simeq$ 575 R⊙, Mej = 15.5 M⊙, and E = 0.4 foe. SN 2021aai is therefore interpreted as the explosion of an RSG, with properties that bridge the class of LL SNe IIP with standard SN IIP events.GV acknowledges INAF for funding his PhD fellowship within the PhD School in Astronomy at the University of Padova. MLP acknowledges support from the plan ‘programma ricerca di ateneo UNICT 2020-22 linea 2” of the University of Catania. AR acknowledges support from ANID BECAS/DOCTORADO NACIONAL 21202412. NER acknowledges partial support from MIUR, PRIN 2017 (grant 20179ZF5KS), from the Spanish MICINN grant PID2019-108709GB-I00 and FEDER funds, and from the programme Unidad de Excelencia María de Maeztu CEX2020-001058-M. LG acknowledges financial support from the Spanish Ministerio de Ciencia e Innovación (MCIN), the Agencia Estatal de Investigación (AEI) 10.13039/501100011033, and the European Social Fund (ESF) ‘Investing in your future’ under the 2019 Ramón y Cajal programme RYC2019-027683-I and the PID2020-115253GA-I00 HOSTFLOWS project, from Centro Superior de Investigaciones Científicas (CSIC) under the PIE project 20215AT016, and the programme Unidad de Excelencia María de Maeztu CEX2020-001058-M. TMB acknowledges financial support from the Spanish Ministerio de Ciencia e Innovación (MCIN), the Agencia Estatal de Investigación (AEI) 10.13039/501100011033 under the PID2020-115253GA-I00 HOSTFLOWS project, and from Centro Superior de Investigaciones Científicas (CSIC) under the PIE project 20215AT016, and the programme Unidad de Excelencia María de Maeztu CEX2020-001058-M. Y-ZC is funded by China Postdoctoral Science Foundation (grant no. 2021M691821