Effect on false-lumen status of a combined vascular and endovascular approach for the treatment of acute type A aortic dissection

OBJECTIVE The aim of the study is to evaluate midterm results with regard to false-lumen status of a combined vascular and endovascular approach for the treatment of acute type A aortic dissection. METHODS We performed ascending/hemiarch replacement during hypothermic circulatory arrest with additional open implantation of the Djumbodis Dissection System (non-self-expanding bare metal stent) to readapt the dissected layers in the arch and the proximal descending aorta in a consecutive series of 15 patients (mean age 61 years, 20% female) suffering from acute type A aortic dissections. The primary end point was the status of the false lumen at the level of the stent. RESULTS We observed three in-hospital deaths (20%). Complete thrombosis of the false lumen was observed in one patient (8%). In 25% of patients, partial thrombosis of the false lumen was observed. The remaining patients had continuing antegrade perfusion. Surgical conversion during a mean follow-up of 37 months was required in two patients (16%) due to continuing enlargement of the distal arch and the proximal descending aorta. No late deaths were observed. CONCLUSION Additional implantation of the Djumbodis Dissection System to readapt the dissected layers in the arch and the proximal descending aorta does not seem to have additive value as an adjunct to standard ascending/hemiarch replacement with regard to closure of the false lumen in the arch and the proximal descending aorta. The most limiting factor seems to be the non-self-expanding capability of the devic

Forward Flux Sampling for rare event simulations

Rare events are ubiquitous in many different fields, yet they are notoriously difficult to simulate because few, if any, events are observed in a conventiona l simulation run. Over the past several decades, specialised simulation methods have been developed to overcome this problem. We review one recently-developed class of such methods, known as Forward Flux Sampling. Forward Flux Sampling uses a series of interfaces between the initial and final states to calculate rate constants and generate transition paths, for rare events in equilibrium or nonequilibrium systems with stochastic dynamics. This review draws together a number of recent advances, summarizes several applications of the method and highlights challenges that remain to be overcome.Comment: minor typos in the manuscript. J.Phys.:Condensed Matter (accepted for publication

New HI-detected Galaxies in the Zone of Avoidance

We present the first results of a blind HI survey for galaxies in the southern Zone of Avoidance with a multibeam receiver on the Parkes telescope. This survey is eventually expected to catalog several thousand galaxies within Galactic latitude |b|<5 degrees, mostly unrecognised before due to Galactic extinction and confusion. We present here results of the first three detections to have been imaged with the Australia Telescope Compact Array (ATCA). The galaxies all lie near Galactic longitude 325 degrees and were selected because of their large angular sizes, up to 1.3 degrees. Linear sizes range from 53 to 108 kpc. The first galaxy is a massive 5.7x10^11 solar mass disk galaxy with a faint optical counterpart, SGC 1511.1--5249. The second is probably an interacting group of galaxies straddling the Galactic equator. No optical identification is possible. The third object appears to be an interacting pair of low column density galaxies, possibly belonging to an extended Circinus or Centaurus A galaxy group. No optical counterpart has been seen despite the predicted extinction (A(B) = 2.7 - 4.4 mag) not being excessive. We discuss the implications of the results, in particular the low HI column densities (~10^19 atoms/sq.cm) found for two of the three galaxies.Comment: 17 pages, 8 figures (Fig.1 in three parts, Fig.5 in two parts). To appear in Astronomical Journal (Dec 1998). See http://www.atnf.csiro.au/research/multibea

The 1000 Brightest HIPASS Galaxies: HI Mass Function and Omega_HI

We present a new accurate measurement of the HI mass function of galaxies from the HIPASS Bright Galaxy Catalog, a sample of 1000 galaxies with the highest HI peak flux densities in the southern hemisphere (Koribalski et al. 2003). This sample spans nearly four orders of magnitude in HI mass (from log M_HI/M_sun=6.8 to 10.6, H0=75) and is the largest sample of HI selected galaxies to date. We develop a bivariate maximum likelihood technique to measure the space density of galaxies, and show that this is a robust method, insensitive to the effects of large scale structure. The resulting HI mass function can be fitted satisfactorily with a Schechter function with faint-end slope alpha=-1.30. This slope is found to be dependent on morphological type, with later type galaxies giving steeper slopes. We extensively test various effects that potentially bias the determination of the HI mass function, including peculiar motions of galaxies, large scale structure, selection bias, and inclination effects, and quantify these biases. The large sample of galaxies enables an accurate measurement of the cosmological mass density of neutral gas: Omega_HI=(3.8 +/- 0.6) x 10^{-4}. Low surface brightness galaxies contribute only 15% to this value, consistent with previous findings.Comment: accepted for publication in Astronomical Journal, 16 pages, including 17 figures. Corrected typos and reference

Classification of Ventricular Septal Defects for the Eleventh Iteration of the International Classification of Diseases—Striving for Consensus: A Report From the International Society for Nomenclature of Paediatric and Congenital Heart Disease

The definition and classification of ventricular septal defects have been fraught with controversy. The International Society for Nomenclature of Paediatric and Congenital Heart Disease is a group of international specialists in pediatric cardiology, cardiac surgery, cardiac morphology, and cardiac pathology that has met annually for the past 9 years in an effort to unify by consensus the divergent approaches to describe ventricular septal defects. These efforts have culminated in acceptance of the classification system by the World Health Organization into the 11th Iteration of the International Classification of Diseases. The scheme to categorize a ventricular septal defect uses both its location and the structures along its borders, thereby bridging the two most popular and disparate classification approaches and providing a common language for describing each phenotype. Although the first-order terms are based on the geographic categories of central perimembranous, inlet, trabecular muscular, and outlet defects, inlet and outlet defects are further characterized by descriptors that incorporate the borders of the defect, namely the perimembranous, muscular, and juxta-arterial types. The Society recognizes that it is equally valid to classify these defects by geography or borders, so the emphasis in this system is on the second-order terms that incorporate both geography and borders to describe each phenotype. The unified terminology should help the medical community describe with better precision all types of ventricular septal defects

Nomenclature for Pediatric and Congenital Cardiac Care: Unification of Clinical and Administrative Nomenclature – The 2021 International Paediatric and Congenital Cardiac Code (IPCCC) and the Eleventh Revision of the International Classification of Diseases (ICD-11)

Substantial progress has been made in the standardization of nomenclature for paediatric and congenital cardiac care. In 1936, Maude Abbott published her Atlas of Congenital Cardiac Disease, which was the first formal attempt to classify congenital heart disease. The International Paediatric and Congenital Cardiac Code ( IPCCC ) is now utilized worldwide and has most recently become the paediatric and congenital cardiac component of the Eleventh Revision of the International Classification of Diseases ( ICD-11 ). The most recent publication of the IPCCC was in 2017. This manuscript provides an updated 2021 version of the IPCCC . The International Society for Nomenclature of Paediatric and Congenital Heart Disease ( ISNPCHD ), in collaboration with the World Health Organization (WHO), developed the paediatric and congenital cardiac nomenclature that is now within the eleventh version of the International Classification of Diseases (ICD-11). This unification of IPCCC and ICD-11 is the IPCCC ICD-11 Nomenclature and is the first time that the clinical nomenclature for paediatric and congenital cardiac care and the administrative nomenclature for paediatric and congenital cardiac care are harmonized. The resultant congenital cardiac component of ICD-11 was increased from 29 congenital cardiac codes in ICD-9 and 73 congenital cardiac codes in ICD-10 to 318 codes submitted by ISNPCHD through 2018 for incorporation into ICD-11. After these 318 terms were incorporated into ICD-11 in 2018, the WHO ICD-11 team added an additional 49 terms, some of which are acceptable legacy terms from ICD-10, while others provide greater granularity than the ISNPCHD thought was originally acceptable. Thus, the total number of paediatric and congenital cardiac terms in ICD-11 is 367. In this manuscript, we describe and review the terminology, hierarchy, and definitions of the IPCCC ICD-11 Nomenclature . This article, therefore, presents a global system of nomenclature for paediatric and congenital cardiac care that unifies clinical and administrative nomenclature. The members of ISNPCHD realize that the nomenclature published in this manuscript will continue to evolve. The version of the IPCCC that was published in 2017 has evolved and changed, and it is now replaced by this 2021 version. In the future, ISNPCHD will again publish updated versions of IPCCC , as IPCCC continues to evolve

A Kinetic Model of Trp-Cage Folding from Multiple Biased Molecular Dynamics Simulations

Trp-cage is a designed 20-residue polypeptide that, in spite of its size, shares several features with larger globular proteins. Although the system has been intensively investigated experimentally and theoretically, its folding mechanism is not yet fully understood. Indeed, some experiments suggest a two-state behavior, while others point to the presence of intermediates. In this work we show that the results of a bias-exchange metadynamics simulation can be used for constructing a detailed thermodynamic and kinetic model of the system. The model, although constructed from a biased simulation, has a quality similar to those extracted from the analysis of long unbiased molecular dynamics trajectories. This is demonstrated by a careful benchmark of the approach on a smaller system, the solvated Ace-Ala3-Nme peptide. For the Trp-cage folding, the model predicts that the relaxation time of 3100 ns observed experimentally is due to the presence of a compact molten globule-like conformation. This state has an occupancy of only 3% at 300 K, but acts as a kinetic trap. Instead, non-compact structures relax to the folded state on the sub-microsecond timescale. The model also predicts the presence of a state at of 4.4 Å from the NMR structure in which the Trp strongly interacts with Pro12. This state can explain the abnormal temperature dependence of the and chemical shifts. The structures of the two most stable misfolded intermediates are in agreement with NMR experiments on the unfolded protein. Our work shows that, using biased molecular dynamics trajectories, it is possible to construct a model describing in detail the Trp-cage folding kinetics and thermodynamics in agreement with experimental data

The 1000 brightest HIPASS galaxies: Newly cataloged galaxies

The H I Parkes All-Sky Survey (HIPASS) is a blind 21 cm survey for extragalactic neutral hydrogen, covering the whole southern sky. The HIPASS Bright Galaxy Catalog (BGC) is a subset of HIPASS and contains the 1000 H I brightest (peak flux density) galaxies. Here we present the 138 HIPASS BGC galaxies that had no redshift measured prior to the Parkes multibeam H I surveys. Of the 138 galaxies, 87 are newly cataloged. Newly cataloged is defined as having no optical ( or infrared) counterpart in the NASA/IPAC Extragalactic Database. Using the Digitized Sky Survey, we identify optical counterparts for almost half of the newly cataloged galaxies, which are typically of irregular or Magellanic morphological type. Several H I sources appear to be associated with compact groups or pairs of galaxies rather than an individual galaxy. The majority ( 57) of the newly cataloged galaxies lie within 10degrees of the Galactic plane and are missing from optical surveys as a result of confusion with stars or dust extinction. This sample also includes newly cataloged galaxies first discovered by Henning et al. in the H I shallow survey of the zone of avoidance. The other 30 newly cataloged galaxies escaped detection because of their low surface brightness or optical compactness. Only one of these, HIPASS J0546-68, has no obvious optical counterpart, as it is obscured by the Large Magellanic Cloud. We find that the newly cataloged galaxies with -b->10degrees are generally lower in H I mass and narrower in velocity width compared with the total HIPASS BGC. In contrast, newly cataloged galaxies behind the Milky Way are found to be statistically similar to the entire HIPASS BGC. In addition to these galaxies, the HIPASS BGC contains four previously unknown H I clouds

Atomic-Resolution Simulations Predict a Transition State for Vesicle Fusion Defined by Contact of a Few Lipid Tails

Membrane fusion is essential to both cellular vesicle trafficking and infection by enveloped viruses. While the fusion protein assemblies that catalyze fusion are readily identifiable, the specific activities of the proteins involved and nature of the membrane changes they induce remain unknown. Here, we use many atomic-resolution simulations of vesicle fusion to examine the molecular mechanisms for fusion in detail. We employ committor analysis for these million-atom vesicle fusion simulations to identify a transition state for fusion stalk formation. In our simulations, this transition state occurs when the bulk properties of each lipid bilayer remain in a lamellar state but a few hydrophobic tails bulge into the hydrophilic interface layer and make contact to nucleate a stalk. Additional simulations of influenza fusion peptides in lipid bilayers show that the peptides promote similar local protrusion of lipid tails. Comparing these two sets of simulations, we obtain a common set of structural changes between the transition state for stalk formation and the local environment of peptides known to catalyze fusion. Our results thus suggest that the specific molecular properties of individual lipids are highly important to vesicle fusion and yield an explicit structural model that could help explain the mechanism of catalysis by fusion proteins