Short and Intermediate Term Outcomes of the Convergent Procedure: Initial Experience in a Tertiary Referral Center

PURPOSE: The Convergent procedure is a hybrid, multidisciplinary treatment for symptomatic atrial fibrillation (AF) consisting of minimally invasive surgical epicardial ablation and percutaneous/catheter endocardial ablation. We investigated outcomes following introduction of the Convergent procedure at our institution. METHODS: Retrospective study examining single-center outcomes. Demographic, procedural, and post-procedural variables were collected with follow-up data obtained at 3, 6, and 12 months. RESULTS: In all, 36 patients with paroxysmal (11%) or persistent/long-standing persistent (89%) AF underwent the Convergent procedure. 36% also underwent concomitant left atrial appendage (LAA) exclusion by thoracoscopic placement of an epicardial clip. Mean age 60.6 ± 8.0 years with mean arrhythmia burden of 3.9 ± 2.7 years. All patients had failed prior attempts at medical management, 81% had failed prior cardioversion, and 17% had failed prior catheter ablation. Convergent was performed successfully in all patients with no peri-procedural deaths or major complications. At 3 and 12 months, 77.8% and 77.3% of patients, respectively, were free from symptomatic arrhythmia. 65.8% were off anti-arrhythmic medication at 12 months. CONCLUSIONS: The Convergent procedure is safe and has good short- and intermediate-term clinical success rates. This unique hybrid approach combines strengths of surgical and catheter ablation and should be part of any comprehensive AF treatment program

Evolution by Evaluation

This paper describes the process of formally evaluating an E-Learning system that has been in use for several years. Professional usability evaluation offers deeper insight into user behaviour and needs than accidental feedback collection or introspection by system developers. A first analysis of the evaluation samples shows satisfaction of users with the general design of the system but also dissatisfaction with certain aspects of navigation that would otherwise have escaped our attention. State of the art formal evaluation turned out to be instrumental in making an existing system considerably more user-friendly

Model-Independent Quantum Phases Classifier

Machine learning has revolutionized many fields of science and technology. Through the $k$-Nearest Neighbors algorithm, we develop a model-independent classifier, where the algorithm can classify phases of a model to which it has never had access. For this, we study three distinct spin-$1$ models with some common phases: the XXZ chains with uniaxial single-ion-type anisotropy, the bound alternating XXZ chains, and the bilinear biquadratic chain. We show that, with high probability, algorithms trained with two of these models can determine common phases with the third. It is the first step toward a universal classifier, where an algorithm is able to detect any phase with no knowledge about the Hamiltonian, only knowing partial information about the quantum state

T-cell acute lymphoblastic leukemia with t(7;14)(p15;q11.2)/HOXA-TCRA/D and biallelic deletion of CDKN2A. Case report and literature review

Case report and literature review on T-cell acute lymphoblastic leukemia with t(7;14)(p15;q11.2)/HOXA-TCRA/D and biallelic deletion of CDKN2

The rostral micro‐tooth morphology of blue marlin, Makaira nigricans

Billfish rostra potentially have several functions; however, their role in feeding is unequivocal in some species. Recent work linked morphological variation in rostral micro‐teeth to differences in feeding behavior in two billfish species, the striped marlin (Kajikia audax) and the sailfish (Istiophorus platypterus). Here, we present the rostral micro‐tooth morphology for a third billfish species, the blue marlin (Makaira nigricans), for which the use of the rostrum in feeding behavior is still undocumented from systematic observations in the wild. We measured the micro‐teeth on rostrum tips of blue marlin, striped marlin, and sailfish using a micro–computed tomography approach and compared the tooth morphology among the three species. This was done after an analysis of video‐recorded hunting behavior of striped marlin and sailfish revealed that both species strike prey predominantly with the first third of the rostrum, which provided the justification to focus our analysis on the rostrum tips. In blue marlin, intact micro‐teeth were longer compared to striped marlin but not to sailfish. Blue marlin had a higher fraction of broken teeth than both striped marlin and sailfish, and broken teeth were distributed more evenly on the rostrum. Micro‐tooth regrowth was equally low in both marlin species but higher in sailfish. Based on the differences and similarities in the micro‐tooth morphology between the billfish species, we discuss potential feeding‐related rostrum use in blue marlin. We put forward the hypothesis that blue marlin might use their rostra in high‐speed dashes as observed in striped marlin, rather than in the high‐precision rostral strikes described for sailfish, possibly focusing on larger prey organisms.Deutsche Forschungsgemeinschaft http://dx.doi.org/10.13039/501100001659Peer Reviewe

Metabolic profiling identifies trehalose as an abundant and diurnally fluctuating metabolite in the microalga Ostreococcus tauri

© 2017, The Author(s).Introduction: The picoeukaryotic alga Ostreococcus tauri (Chlorophyta) belongs to the widespread group of marine prasinophytes. Despite its ecological importance, little is known about the metabolism of this alga. Objectives: In this work, changes in the metabolome were quantified when O. tauri was grown under alternating cycles of 12 h light and 12 h darkness. Methods: Algal metabolism was analyzed by gas chromatography-mass spectrometry. Using fluorescence-activated cell sorting, the bacteria associated with O. tauri were depleted to below 0.1% of total cells at the time of metabolic profiling. Results: Of 111 metabolites quantified over light–dark cycles, 20 (18%) showed clear diurnal variations. The strongest fluctuations were found for trehalose. With an intracellular concentration of 1.6 mM in the dark, this disaccharide was six times more abundant at night than during the day. This fluctuation pattern of trehalose may be a consequence of starch degradation or of the synchronized cell cycle. On the other hand, maltose (and also sucrose) was below the detection limit (~10 μM). Accumulation of glycine in the light is in agreement with the presence of a classical glycolate pathway of photorespiration. We also provide evidence for the presence of fatty acid methyl and ethyl esters in O. tauri. Conclusions: This study shows how the metabolism of O. tauri adapts to day and night and gives new insights into the configuration of the carbon metabolism. In addition, several less common metabolites were identified

Evolution by Evaluation

This paper describes the process of formally evaluating an E-Learning system that has been in use for several years. Professional usability evaluation offers deeper insight into user behaviour and needs than accidental feedback collection or introspection by system developers. A first analysis of the evaluation samples shows satisfaction of users with the general design of the system but also dissatisfaction with certain aspects of navigation that would otherwise have escaped our attention. State of the art formal evaluation turned out to be instrumental in making an existing system considerably more user-friendly