Single-center experience in the treatment of visceral artery aneurysms

Background: Visceral artery aneurysms (VAAs), although rare, represent a life-threatening disease with high mortality rates. With the more frequent use of diagnostic tests, there has been an incidental detection of these lesions which are mostly asymptomatic. It follows that surgeons are increasingly called to decide on the most appropriate management of VAAs between an open surgical or endovascular approach and among the different endovascular options currently available. The aim of this retrospective study was to evaluate the results of open surgery and interventional endovascular strategies of visceral artery aneurysms with respect to technical success, therapy-associated complications, and postinterventional follow-up in the elective and emergency situation. Methods: From January 1992 to January 2017, 125 open surgical or endovascular interventions for VAA were performed at our institution. Once the VAA was diagnosed and the indication for treatment was assessed, the preoperative diagnostic work-up consisted of contrast computed tomography (CT) or magnetic resonance imaging (MRI) and, in some patients, digital subtraction angiography. Follow-up included clinical and duplex ultrasound scan (DUS) and contrast-enhanced ultrasound to assess the treated vessel patency and organ perfusion after 1, 6, and 12 months, and yearly thereafter. CT or MRI controls were also performed at 1 year of follow-up and only when DUS was not diagnostic or showed a complication thereafter. After the first 5 years of follow-up, the status of the patient was obtained by a structured telephone survey. Results: The treatment option was endovascular in 56 of 125 cases (44.8%). Technical success was 98.3%. In one case, the procedure was interrupted for the extensive dissection of the afferent vessel. Twenty-six patients were treated by coil embolization while 29 with covered stenting. The endovascular approach was in emergency in two cases (3.6%). In the endovascular group, mortality was nil. Complications occurred in 5 cases (8.9%): 1 subacute intestinal ischemia caused by superior mesenteric artery dissection, 2 aneurysm reperfusion, 1 stent thrombosis, and 1 massive splenic hematoma. In 69 (55.2%) cases, surgical treatment was preferred, with 24 VAA resections and 45 arterial reconstructions. In 20 cases (29%), open surgery was performed in emergency conditions. In the surgical group, 8 emergency patients (40%) died intraoperatively. The mortality after elective surgical interventions was nil. Complications after surgery were 4 graft late thrombosis (5.8%): asymptomatic in three cases and requiring splenectomy in one. Conclusions: There is no overall consensus regarding the indications for treatment of VAA. Currently in emergent setting, the endovascular approach should be considered as the first choice because of its reduced invasiveness, faster way to access and bleeding control; this accounts for the lower morality of the interventional therapy than open surgery. Endovascular approach is effective for elective repair of VAAs, but procedure-related complications may occur in a not negligible number of patients. Given comparable mortality rates and low procedure-related complication rate, surgical approach still has space in the elective management of VAAs, especially for aneurysms unsuitable or challenging for the endovascular option in patients with low surgical risk. The size, location, and morphology of VAAs, systemic or local comorbidities, and specific anatomical situations such as previous abdominal surgery should dictate treatment choice

Response of the Arctic Pteropod Limacina helicina to projected future environmental conditions

Thecosome pteropods (pelagic mollusks) can play a key role in the food web of various marine ecosystems. They are a food source for zooplankton or higher predators such as fishes, whales and birds that is particularly important in high latitude areas. Since they harbor a highly soluble aragonitic shell, they could be very sensitive to ocean acidification driven by the increase of anthropogenic CO2 emissions. The effect of changes in the seawater chemistry was investigated on Limacina helicina, a key species of Arctic pelagic ecosystems. Individuals were kept in the laboratory under controlled pCO2 levels of 280, 380, 550, 760 and 1020 matm and at control (0uC) and elevated (4uC) temperatures. The respiration rate was unaffected by pCO2 at control temperature, but significantly increased as a function of the pCO2 level at elevated temperature. pCO2 had no effect on the gut clearance rate at either temperature. Precipitation of CaCO3, measured as the incorporation of 45Ca, significantly declined as a function of pCO2 at both temperatures. The decrease in calcium carbonate precipitation was highly correlated to the aragonite saturation state. Even though this study demonstrates that pteropods are able to precipitate calcium carbonate at low aragonite saturation state, the results support the current concern for the future of Arctic pteropods, as the production of their shell appears to be very sensitive to decreased pH. A decline of pteropod populations would likely cause dramatic changes to various pelagic ecosystems

A dataset for investigating socio-ecological changes in Arctic fjords

The collection of in situ data is generally a costly process, with the Arctic being no exception. Indeed, there has been a perception that the Arctic is lacking in situ sampling; however, after many years of concerted effort and international collaboration, the Arctic is now rather well sampled, with many cruise expeditions every year. For example, the GLODAP (Global Ocean Data Analysis Project) product has a greater density of in situ sampling points within the Arctic than along the Equator. While this is useful for open-ocean processes, the fjords of the Arctic, which serve as crucially important intersections of terrestrial, coastal, and marine processes, are sampled in a much more ad hoc process. This is not to say they are not well sampled but rather that the data are more difficult to source and combine for further analysis. It was therefore noted that the fjords of the Arctic are lacking in FAIR (findable, accessible, interoperable, and reusable) data. To address this issue, a single dataset has been created from publicly available, predominantly in situ data from seven study sites in Svalbard and Greenland. After finding and accessing the data from a number of online platforms, they were amalgamated into a single project-wide standard, ensuring their interoperability. The dataset was then uploaded to PANGAEA so that it can be findable and reusable in the future. The focus of the data collection was driven by the key drivers of change in Arctic fjords identified in a companion review paper. To demonstrate the usability of this dataset, an analysis of the relationship between the different drivers was performed. Via the use of an Arctic biogeochemical model, these relationships were projected forward to 2100 via Representative Carbon Pathways (RCPs) 2.6, 4.5, and 8.5. This dataset is a work in progress, and as new datasets containing the relevant key drivers are released, they will be added to an updated version planned for the middle of 2024. The dataset (Schlegel and Gattuso, 2022) is available on PANGAEA at https://doi.org/10.1594/PANGAEA.953115. A live version is available at the FACE-IT WP1 site and can be accessed by clicking the “Data access” tab: https://face-it-project.github.io/WP1/ (last access: 17 August 2023).</p

Computer Controlled Solid State Lighting Assembly to Emulate Diurnal Cycle and Improve Circadian Rhythm Control

A light system can simultaneously emulate more than one different diurnal cycle to individually improve circadian rhythm control for more than one observer by having each light fixture autonomously self-controlled. Each light fixture is mountable in respective locations to individually treat respective observers. Each light fixture includes one or more light elements mounted to a housing and are controllable to emit a selected light intensity at a selected light temperature. A micro controller is contained in the housing and includes memory containing instructions for one or more automatic diurnal cycle protocols. The micro controller is in communication with the memory and the one or more light elements to execute the instructions to configure the light fixture to vary the light intensity and the light temperature of the emitted light

Impact of ocean acidification on a key Arctic pelagic mollusc (Limacina helicina)

Thecosome pteropods (shelled pelagic molluscs) can play an important role in the food web of various ecosystems and play a key role in the cycling of carbon and carbonate. Since they harbor an aragonitic shell, they could be very sensitive to ocean acidification driven by the increase of anthropogenic CO2 emissions. The impact of changes in the carbonate chemistry was investigated on Limacina helicina, a key species of Arctic ecosystems. Pteropods were kept in culture under controlled pH conditions corresponding to pCO2 levels of 350 and 760 μatm. Calcification was estimated using a fluorochrome and the radioisotope 45Ca. It exhibits a 28% decrease at the pH value expected for 2100 compared to the present pH value. This result supports the concern for the future of pteropods in a high-CO2 world, as well as of those species dependent upon them as a food resource. A decline of their populations would likely cause dramatic changes to the structure, function and services of polar ecosystems

Carbon fluxes in coral reefs. II. Eulerian study of inorganic carbon dynamics and measurement of air-sea CO₂ exchanges

Air-sea CO2 exchanges and the partial pressure of CO2 were measured in surface water overlying 2 coral reefs: Moorea (French Polynesia, austral winter, August 1992), where coral diversity and surface cover are low, and Yonge Reef (Great Barrier Reef, austral summer, December 1993), where coral diversity and cover are comparatively higher. A procedure is proposed to estimate the potential CO2 exchange with the atmosphere by taking into account both the saturation level of oceanic seawater and the equilibration process occurring after water leaves the reef. It is shown that both sites were net sources of CO2 to the atmosphere as a result of the effect of calcification on the dynamics of the inorganic carbon system. The potential global CO2 evasion from the ocean to the atmosphere is about 4 times higher at Yonge Reef than at Moorea. It is also demonstrated that, at both sites, the major exchange of CO2 from sea to air occurs as seawater returns to chemical equilibrium after it has crossed and left the reef. The dynamics of inorganic carbon were studied using the so-called homogeneous buffer factor [beta = dln(pCO(2))/dln(DIC)] (where pCO(2) is the CO2 partial pressure in surface water and DIC is dissolved inorganic carbon), which gave estimates that approximately 80% of the change in inorganic carbon was related to photosynthesis and respiration. This approach showed that the calcification rate was proportional to the net organic production during the day and to the respiration rate at night

Evaluation of data-based estimates of anthropogenic carbon in the Arctic Ocean

The Arctic Ocean is particularly vulnerable to ocean acidification, a process that is mainly driven by the uptake of anthropogenic carbon (Cant) from the atmosphere. Although Cant concentrations cannot be measured directly in the ocean, they have been estimated using data-based methods such as the transient time distribution (TTD) approach, which characterizes the ventilation of water masses with inert transient tracers, such as CFC-12. Here, we evaluate the TTD approach in the Arctic Ocean using an eddying ocean model as a test bed. When the TTD approach is applied to simulated CFC-12 in that model, it underestimates the same model's directly simulated Cant concentrations by up to 12%, a bias that stems from its idealized assumption of gas equilibrium between atmosphere and surface water, both for CFC-12 and anthropogenic CO2. Unlike the idealized assumption, the simulated partial pressure of CFC-12 (pCFC-12) in Arctic surface waters is undersaturated relative to that in the atmosphere in regions and times of deep-water formation, while the simulated equivalent for Cant is supersaturated. After accounting for the TTD approach's negative bias, the total amount of Cant in the Arctic Ocean in 2005 increases by 8% to 3.3 ± 0.3 Pg C. By combining the adjusted TTD approach with scenarios of future atmospheric CO2, it is estimated that all Arctic waters, from surface to depth, would become corrosive to aragonite by the middle of the next century even if atmospheric CO2 could be stabilized at 540 ppm

A Novel Approach for Engaging Academia in Collaborative Projects with NASA through the X-Hab Academic Innovation Challenge

The X-Hab Academic Innovation Challenge, currently in its sixth year of execution, provides university students with the opportunity to be on the forefront of innovation. The X-Hab Challenge, for short, is designed to engage and retain students in Science, Technology, Engineering and Math (STEM). NASA identifies necessary technologies and studies for deep space missions and invites universities from around the country to develop concepts, prototypes, and lessons learned that will help shape future space missions and awards seed funds to design and produce functional products of interest as proposed by university teams according to their interests and expertise. Universities propose on a variety of projects suggested by NASA and are then judged on technical merit, academic integration, leveraged funding, and outreach. The universities assemble a multi-discipline team of students and advisors that invest months working together, developing concepts, and frequently producing working prototypes. Not only are students able to gain quality experience, working real world problems that have the possibility to be implemented, but they work closely with subject matter experts from NASA who guide them through an official engineering development process

Hot, Sour and Breathless – Ocean under Stress.

ISBN 978-0-9519618-6-