Polar localization of plasma membrane Ca2+/Mg2+ ATPase correlates with the pattern of steady ionic currents in eggs of Lymnaea stagnalis and Bithynia tentaculata (Mollusca)

During extrusion of the first polar body in eggs of Lymnaea stagnalis and Bithynia tentaculata a localized Ca2+ /Mg2+ ATPase activity was detected, using Ando's enzyme-cytochemical method for electron microscopy [Ando et al. (1981) Acta Histochem Cytochem 14:705-726]. The enzyme activity was distributed in a polar fashion, along the cytoplasmic face of the plasma membrane. In the eggs of Lymnaea it was found only in the vegetal hemisphere, whereas in Bithynia eggs it was localized both in the vegetal hemisphere and at the animal pole. This pattern of enzyme activity corresponds to the polar pattern of transcellular ionic currents measured with the vibrating probe, which we showed to be partially carried or regulated by calcium [Zivkovic and Dohmen (1989) Biol Bull (Woods Hole) 176 (Suppl):103-109]. The characteristics of the ATPase were studied using a variety of approaches such as ion and substrate depletions and substitutions, addition of specific inhibitors of ATPase activity, treatment with EDTA/EGTA and electron energy-loss spectrometry. The results indicate that, in Lymnaea, there are at least two enzymatic entities. The first one is a Ca2+ /Mg2+ ATPase localized along the membrane and in the cortex of the vegetal hemisphere. The second one is a Ca2+-stimulated ATPase (calcium pump of the plasma membrane) localized in a small region of the membrane at the vegetal pole. We speculate that in the eggs of Lymnaea and Bithynia a functional relationship exists between the plasma-membrane-associated ATPase activity and the transcellular ionic currents measured in the same region

Nanoelectronic COupled problems solutions - nanoCOPS: modelling, multirate, model order reduction, uncertainty quantification, fast fault simulation

The FP7 project nanoCOPS derives new methods for simulation during development of designs of integrated products. It covers advanced simulation techniques for electromagnetics with feedback couplings to electronic circuits, heat and stress. It is inspired by interest from semiconductor industry and by a simulation tool vendor in electronic design automation. The project is on-going and the paper presents the outcomes achieved after the first half of the project duration

Iliofemoral Tortuosity Increases the Risk of Access-Site-Related Complications After Aortic Valve Implantation and Plug-Based Access-Site Closure

BACKGROUND: Access-site-related complications are often related to high-risk anatomy and technical pitfalls and impair the outcomes of transfemoral aortic valve implantations (TAVIs). Calcification and tortuosity are widely recognized risk factors, and their impact on procedural planning is left to the implanting experts’ discretion. To facilitate decision-making, we introduced a quantitative measure for iliofemoral tortuosity and assessed its predictive value for access-site-related vascular and bleeding complications. METHODS: We performed a single-centre prospective cohort study of consecutive, percutaneous transfemoral TAVI performed between April 2019 and March 2020. Medical history and all-cause mortality were extracted from the electronic patient files. Arterial anatomy and calcifications were evaluated using 3mensio Structural Heart software. The primary outcome was access-site-related vascular or bleeding complications. RESULTS: In this elderly, intermediate-risk population, we registered the primary outcome in 43 patients (39%), and major access-site complications in 10 patients (9.2%). Complete hemostasis was achieved in 77 patients (70.6%), by the application of the MANTA plug alone. In the group with access-site-related adverse events, compared with the group without, the tortuosity index was higher median (26% interquartile range [IQR 18%-33%] vs median 19% [IQR 13%-29%], respectively; P = 0.012), as was maximal angulation median (50° [IQR 40°-59°] vs median 43° [IQR 36°-51°], respectively; P = 0.026) were higher. Both variables had a significant effect on our primary outcome, with odds ratios (OR) of 3.1 (tortuosity, P = 0.005) and 2.6 (angulation, P = 0.020). The degree of angulation was a predictor of major complications too (odds ratio 7 [1.4-34.8]; P = 0.017). CONCLUSIONS: Steeper angles and greater arterial elongation increase the risk of vascular and bleeding complications after femoral TAVI with the utilization of a plug-based closure device

Iliofemoral Tortuosity Increases the Risk of Access-Site-Related Complications After Aortic Valve Implantation and Plug-Based Access-Site Closure

Background: Access-site-related complications are often related to high-risk anatomy and technical pitfalls and impair the outcomes of transfemoral aortic valve implantations (TAVIs). Calcification and tortuosity are widely recognized risk factors, and their impact on procedural planning is left to the implanting experts' discretion. To facilitate decision-making, we introduced a quantitative measure for iliofemoral tortuosity and assessed its predictive value for access-site-related vascular and bleeding complications. Methods: We performed a single-centre prospective cohort study of consecutive, percutaneous transfemoral TAVI performed between April 2019 and March 2020. Medical history and all-cause mortality were extracted from the electronic patient files. Arterial anatomy and calcifications were evaluated using 3mensio Structural Heart software. The primary outcome was access-site-related vascular or bleeding complications. Results: In this elderly, intermediate-risk population, we registered the primary outcome in 43 patients (39%), and major access-site complications in 10 patients (9.2%). Complete hemostasis was achieved in 77 patients (70.6%), by the application of the MANTA plug alone. In the group with access-site-related adverse events, compared with the group without, the tortuosity index was higher median (26% interquartile range [IQR 18%-33%] vs median 19% [IQR 13%-29%], respectively; P = 0.012), as was maximal angulation median (50° [IQR 40°-59°] vs median 43° [IQR 36°-51°], respectively; P = 0.026) were higher. Both variables had a significant effect on our primary outcome, with odds ratios (OR) of 3.1 (tortuosity, P = 0.005) and 2.6 (angulation, P = 0.020). The degree of angulation was a predictor of major complications too (odds ratio 7 [1.4-34.8]; P = 0.017). Conclusions: Steeper angles and greater arterial elongation increase the risk of vascular and bleeding complications after femoral TAVI with the utilization of a plug-based closure device

Better outcome at lower costs after implementing a CRT-care pathway:comprehensive evaluation of real-world data

Abstract Aims Cardiac resynchronization therapy (CRT) requires intensive, complex, and multidisciplinary care for heart failure (HF) patients. Due to limitations in time, resources, and coordination of care, in current practice, this is often incomplete. We evaluated the effect of the introduction of a CRT‐care pathway (CRT‐CPW) on clinical outcome and costs. Methods and results The CRT‐CPW focused on structuring CRT patient selection, implantation, and follow‐up management. To facilitate and guarantee quality, checklists were introduced. The CRT‐CPW was implemented in the Maastricht University Medical Centre in 2014. Physician‐led usual care was restructured to a nurse‐led care pathway. A retrospective comparison of data from CRT patients receiving usual care (2012–2014, 222 patients) and patients receiving care according to CRT‐CPW (2015–2018, 241 patients) was performed. The primary outcome was the composite of all‐cause mortality and HF hospitalization. Hospital‐related costs of cardiovascular care after CRT implantation were analysed to address cost‐effectiveness of the CRT‐CPW. Demographics were comparable in the usual care and CRT‐CPW groups. Kaplan–Meier estimates of the occurrence of the primary endpoint showed a significant improvement in the CRT‐CPW group (25.7% vs. 34.7%, hazard ratio 0.56; confidence interval 0.40–0.78; P < 0.005), at 36 months of follow‐up. The total costs for cardiology‐related hospitalizations were significantly reduced in the CRT‐CPW group [€17 698 (14 192–21 195) vs. 19 933 (16 980–22 991), P < 0.001]. Bootstrap cost‐effectiveness analyses showed that implementation of CRT‐CPW would be an economically dominant strategy in 90.7% of bootstrap samples. Conclusions The introduction of a novel multidisciplinary, nurse‐led care pathway for CRT patients resulted in significant reduction of the combination of all‐cause mortality and HF hospitalizations, at reduced cardiovascular‐related hospital costs