The inheritance of reaction to ustilago zeae in maize

This archival publication may not reflect current scientific knowledge or recommendations

Minimal versus conventional cardiopulmonary bypass: assessment of intraoperative myocardial damage in coronary bypass surgery

Objective: Minimal extracorporeal circulation (mini-ECC) is a new technology, consisting of a centrifugal pump, an oxygenator, and a modified suction system. The main advantage of mini-ECC is the reduction of tubing length (reduction of the priming volume). Additional beneficial effects are a decrease of coagulation cascade and a reduction of blood transfusion in patients undergoing coronary artery bypass grafting (CABG) surgery. We compared the intraoperative and early postoperative myocardial damage and outcome of patients who underwent CABG surgery with conventional cardiopulmonary bypass (CPB) or mini-ECC. Methods: One hundred and thirty-six consecutive patients who underwent isolated CABG surgery at our institution were prospectively studied. Fifty-four patients (39.7%) were operated with mini-ECC. Patient characteristics were similar in both groups. The most interesting intraoperative details as well as in-hospital outcome were assessed. Results: There was no difference in mortality between the two groups. Cross-clamping time was similar in both groups (p = 0.07). Defibrillation was required in one patient in the mini-ECC group (1.9%) and in 38 patients (46.3%) in the CPB group (p < 0.001). In the mini-ECC group, the requirement of inotropic support and incidence of atrial fibrillation was significantly lower than in the CPB group. Postoperative creatine kinase isoenzyme MB (CK-MB) and cardiac Troponin I (cTnI) were significantly lower in the mini-ECC group (p < 0.05). Duration of ventilation, length of stay in the intensive care unit and total hospitalization time were significantly shorter in patients operated with mini-ECC (p < 0.05). Conclusion: Mini-ECC is a safe procedure and is followed by a diminished release of CK-MB and cTnI than after CPB. Postoperative recovery is accelerated following mini-ECC and there is a significantly lower incidence of postoperative atrial fibrillatio

Learning Layer-wise Equivariances Automatically using Gradients

Convolutions encode equivariance symmetries into neural networks leading to better generalisation performance. However, symmetries provide fixed hard constraints on the functions a network can represent, need to be specified in advance, and can not be adapted. Our goal is to allow flexible symmetry constraints that can automatically be learned from data using gradients. Learning symmetry and associated weight connectivity structures from scratch is difficult for two reasons. First, it requires efficient and flexible parameterisations of layer-wise equivariances. Secondly, symmetries act as constraints and are therefore not encouraged by training losses measuring data fit. To overcome these challenges, we improve parameterisations of soft equivariance and learn the amount of equivariance in layers by optimising the marginal likelihood, estimated using differentiable Laplace approximations. The objective balances data fit and model complexity enabling layer-wise symmetry discovery in deep networks. We demonstrate the ability to automatically learn layer-wise equivariances on image classification tasks, achieving equivalent or improved performance over baselines with hard-coded symmetry

Risk factors for secondary dilatation of the aorta after acute type A aortic dissection

Objectives: Prompt diagnosis of subsequent dilatation of the dissected aorta is crucial to reduce late mortality in these patients. This study focuses on risk factors for dilatation of the aorta after type A aortic dissection (AADA) affecting a normal-sized or slightly dilated aorta. Methods: Overall 531 CT scans were analysed. Patients were included in the study if at least 3 CT scans were available after operative repair. 64 patients (59.8%) out of 107 patients full-field the inclusion criteria. Volumetric analyses of the aorta were performed. Patients were divided in 3 groups: group A included 26 patients (40.6%) without progression of the aortic diameter, group 2, 27 patients (42.2%) with slight progression and group 3, 11 patients (17.2%) with important progression, requiring surgery in 9 patients (81.8%). Risk-factors for progression of the aortic size were analysed and compared between the groups. Results: Patients from group 3 were younger 57.7±13.4 vs. 61.9±11.6 in group 1 (P≪0.05) and were more frequent female (45.4 vs. 23.1%; P≪0.05). Dissection of the supraaortic branches (100 vs. 80.8%; P≪0.05), the presence of preoperative cerebral, visceral or peripheral malperfusion (54.6 vs. 26.9%; P≪0.05) and contrast enhancement in the false lumen during the follow-up (72.7 vs. 57.7%; P=0.07) were additional risk factors for late aortic dilatation in these patients. Conclusions: Acute type A aortic dissection in younger patients, involving the supraaortic branches and/or combined with malperfusion syndrome favour secondary dilatation. A close follow-up is mandatory to prevent acute complications of the diseased downstream aorta following repair of a AAD

Risk factors for secondary dilatation of the aorta after acute type A aortic dissection

Objectives: Prompt diagnosis of subsequent dilatation of the dissected aorta is crucial to reduce late mortality in these patients. This study focuses on risk factors for dilatation of the aorta after type A aortic dissection (AADA) affecting a normal-sized or slightly dilated aorta. Methods: Overall 531 CT scans were analysed. Patients were included in the study if at least 3 CT scans were available after operative repair. 64 patients (59.8%) out of 107 patients full-field the inclusion criteria. Volumetric analyses of the aorta were performed. Patients were divided in 3 groups: group A included 26 patients (40.6%) without progression of the aortic diameter, group 2, 27 patients (42.2%) with slight progression and group 3, 11 patients (17.2%) with important progression, requiring surgery in 9 patients (81.8%). Risk-factors for progression of the aortic size were analysed and compared between the groups. Results: Patients from group 3 were younger 57.7±13.4 vs. 61.9±11.6 in group 1 (P≪0.05) and were more frequent female (45.4 vs. 23.1%; P≪0.05). Dissection of the supraaortic branches (100 vs. 80.8%; P≪0.05), the presence of preoperative cerebral, visceral or peripheral malperfusion (54.6 vs. 26.9%; P≪0.05) and contrast enhancement in the false lumen during the follow-up (72.7 vs. 57.7%; P=0.07) were additional risk factors for late aortic dilatation in these patients. Conclusions: Acute type A aortic dissection in younger patients, involving the supraaortic branches and/or combined with malperfusion syndrome favour secondary dilatation. A close follow-up is mandatory to prevent acute complications of the diseased downstream aorta following repair of a AADA

The Shelhigh No-React® bovine internal mammary artery: a questionable alternative conduit in coronary bypass surgery?

Background: Increasing age and comorbidities among patients undergoing coronary artery bypass surgery (CABG) stimulates the exhaustive research for alternative grafts. No-React® treatment should render the tissue resistant against degeneration and reduce early inflammatory response. The aim of the present study was an invasive assessment of the patency of No-React® bovine internal mammary artery (NRIMA grafts) used as bypass conduit in CABG surgery. Patients and methods: Nineteen NRIMA grafts were used in 17 patients (2.9%) out of a total of 572 patients undergoing CABG surgery within a 12-month period. All intraoperative data were assessed and in-hospital outcome was analysed. Follow-up examination was performed 7.0±4.0 months after initial surgery, including clinical status and coronary angiography to assess patency of the NRIMA grafts. Results: Average perioperative flow of all NRIMA grafts was 71±60ml/min. One patient died in hospital due to a multi-organ failure. Four patients refused invasive assessment. Follow-up was complete in 12 patients with overall 13 NRIMA grafts. Nine NRIMA grafts (69.2%) were used for the right coronary system, two NRIMA grafts (15.4%) on the LAD and two on the circumflex artery. Graft patency was 23.1% and was independent of the intraoperative flow measurement. Conclusions: NRIMA grafts show a very low patency and cannot be recommended as coronary bypass graft conduits. Patency was independent of the perioperative flow, assessed by Doppler ultrasound. Because of this unsatisfying observation, this type of graft should be utilised as a last resource conduit and used only to revascularise less important target vessels, such as the end branches of the right coronary arter

Temporary neurological dysfunction after surgery of the thoracic aorta: a predictor of poor outcome and impaired quality of life

Background: Transient neurological dysfunction (TND) consists of postoperative confusion, delirium and agitation. It is underestimated after surgery on the thoracic aorta and its influence on long-term quality of life (QoL) has not yet been studied. This study aimed to assess the influence of TND on short- and long-term outcome following surgery of the ascending aorta and proximal arch. Methods: Nine hundred and seven patients undergoing surgery of the ascending aorta and the proximal aortic arch at our institution were included. Two hundred and ninety patients (31.9%) underwent surgery because of acute aortic dissection type A (AADA) and 617 patients because of aortic aneurysm. In 547 patients (60.3%) the distal anastomosis was performed using deep hypothermic circulatory arrest (DHCA). TND was defined as a Glasgow coma scale (GCS) value <13. All surviving patients had a clinical follow up and QoL was assessed with an SF-36 questionnaire. Results: Overall in-hospital mortality was 8.3%. TND occurred in 89 patients (9.8%). As compared to patients without TND, those who suffered from TND were older (66.4 vs 59.9 years, p<0.01) underwent more frequently emergent procedures (53% vs 32%, p<0.05) and surgery under DHCA (84.3% vs 57.7%, p<0.05). However, duration of DHCA and extent of surgery did not influence the incidence of TND. In-hospital mortality in the group of patients with TND compared to the group without TND was similar (12.0% vs 11.4%; p=ns). Patients with TND suffered more frequently from coronary artery disease (28% vs 20.8%, p=ns) and were more frequently admitted in a compromised haemodynamic condition (23.6% vs 9.9%, p<0.05). Postoperative course revealed more pulmonary complications such as prolonged mechanical ventilation. Additional to their transient neurological dysfunction, significantly more patients had strokes with permanent neurological loss of function (14.6% vs 4.8%, p<0.05) compared to the patients without TND. ICU and hospital stay were significantly prolonged in TND patients (18±13 days vs 12±7 days, p<0.05). Over a mean follow-up interval of 27±14 months, patients with TND showed a significantly impaired QoL. Conclusion: The neurological outcome following surgery of the ascending aorta and proximal aortic arch is of paramount importance. The impact of TND on short- and long-term outcome is underestimated and negatively affects the short- and long-term outcom

Susceptibility of wheat varieties and hybrids to fusarial head blight in Minnesota

This archival publication may not reflect current scientific knowledge or recommendations

SARS-CoV-2 / COVID-19 in patients on the Swiss national transplant waiting list.

The impact of coronavirus disease 2019 (COVID-19) on patients listed for solid organ transplantation has not been systematically investigated to date. Thus, we assessed occurrence and effects of infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on patients on the Swiss national waiting list for solid organ transplantation. Patient data were retrospectively extracted from the Swiss Organ Allocation System (SOAS). From 16 March to 31 May 2020, we included all patients listed for solid organ transplantation on the Swiss national waiting list who were tested positive for SARS-CoV-2. Severity of COVID-19 was categorised as follows: stage I, mild symptoms; stage II, moderate to severe symptoms; stage III, critical symptoms; stage IV, death. We compared the incidence rate (laboratory-confirmed cases of SARS-CoV-2), the hospital admission rate (number of admissions of SARS-CoV-2-positive individuals), and the case fatality rate (number of deaths of SARS-CoV-2-positive individuals) in our study population with the general Swiss population during the study period, calculating age-adjusted standardised incidence ratios and standardised mortality ratios, with 95% confidence intervals (CIs). A total of 1439 patients were registered on the Swiss national solid organ transplantation waiting list on 31 May 31 2020. Twenty-four (1.7%) waiting list patients were reported to test positive for SARS-CoV-2 in the study period. The median age was 56 years (interquartile range 45.3&amp;ndash;65.8), and 14 (58%) were male. Of all patients tested positive for SARS-CoV-2, two patients were asymptomatic, 14 (58%) presented in COVID-19 stage I, 3 (13%) in stage II, and 5 (21%) in stage III. Eight patients (33%) were admitted to hospital, four (17%) required intensive care, and three (13%) mechanical ventilation. Twenty-two patients (92%) of all those infected recovered, but two male patients aged &amp;gt;65 years with multiple comorbidities died in hospital from respiratory failure. Comparing our study population with the general Swiss population, the age-adjusted standardised incidence ratio was 4.1 (95% CI 2.7&amp;ndash;6.0). The overall rate of SARS-CoV-2 infections in candidates awaiting solid organ transplantation was four times higher than in the Swiss general population; however, the frequency of testing likely played a role. Given the small sample size of affected patients, conclusions have to be drawn cautiously and results need verification in larger cohorts

Singly- and doubly-deuterated formaldehyde in massive star-forming regions

Deuterated molecules are good tracers of the evolutionary stage of star-forming cores. During the star formation process, deuterated molecules are expected to be enhanced in cold, dense pre-stellar cores and to deplete after protostellar birth. In this paper we study the deuteration fraction of formaldehyde in high-mass star-forming cores at different evolutionary stages to investigate whether the deuteration fraction of formaldehyde can be used as an evolutionary tracer. Using the APEX SEPIA Band 5 receiver, we extended our pilot study of the $J$=3$\rightarrow$2 rotational lines of HDCO and D$_2$CO to eleven high-mass star-forming regions that host objects at different evolutionary stages. High-resolution follow-up observations of eight objects in ALMA Band 6 were performed to reveal the size of the H$_2$CO emission and to give an estimate of the deuteration fractions HDCO/H$_2$CO and D$_2$CO/HDCO at scales of $\sim$6" (0.04-0.15 pc at the distance of our targets). Our observations show that singly- and doubly deuterated H$_2$CO are detected toward high-mass protostellar objects (HMPOs) and ultracompact HII regions (UCHII regions), the deuteration fraction of H$_2$CO is also found to decrease by an order of magnitude from the earlier HMPO phases to the latest evolutionary stage (UCHII), from $\sim$0.13 to $\sim$0.01. We have not detected HDCO and D$_2$CO emission from the youngest sources (high-mass starless cores, HMSCs). Our extended study supports the results of the previous pilot study: the deuteration fraction of formaldehyde decreases with evolutionary stage, but higher sensitivity observations are needed to provide more stringent constraints on the D/H ratio during the HMSC phase. The calculated upper limits for the HMSC sources are high, so the trend between HMSC and HMPO phases cannot be constrained.Comment: 15 pages, 4 figures, 4 tables, accepted for publication in A&