Transcutanous aortic valve replacement with Medtronic CoreValve in a publicprivate partnership hospital complex

Objective: The aim of this study was to assess the initial experience of transcutaneous aortic valve implantation (TAVI) in a high risk aortic stenosis population not suitable for conventional surgical valve replacement. Background: No data exist for TAVI with Medtronic CoreValve in South Africa and especially not in a public private partnership hospital complex. Methods: Retrospective data regarding severe aortic stenosis evaluation, risk stratifi cation and management were evaluated over a 24 month period. Results: A total of 106 patients were evaluated of whom17 were accepted for surgical valve replacement (SVR) while TAVI was attempted in 25. The CoreValve was successfully implanted in 96% (24/25) of the cases. No procedural or peri-procedural deaths occurred. Threepatients required permanent pacemaker insertion in the peri-procedural period and 2 patients had vascular access complications requiring blood transfusion only. Median hospital stay was 3.7days (range: 2 - 7). Aortic valve gradient showed a signifi cant reduction after valve implantation, which was sustained during follow-up (p<0.001). NYHA class symptomatology also improved from a median of 3.3 to 1.0 (p<0.001). During follow-up there were 4 late deaths, not related to the procedure, occurring after 78 to 193 days. Average cost for private and government patients were R268 000.00 and R163 000.00 respectively. Conclusions: The CoreValve can be implanted with a high success rate. Short term mortality and morbidity are acceptable. Signifi cant symptomatic improvement is gained at follow-up. The fi nancial implications are important

Dynamic Impedance of Two-Dimensional Superconducting Films Near the Superconducting Transition

The sheet impedances, Z(w,T), of several superconducting a-Mo77Ge23 films and one In/InOx film have been measured in zero field using a two-coil mutual inductance technique at frequencies from 100 Hz to 100 kHz. Z(w,T) is found to have three contributions: the inductive superfluid, renormalized by nonvortex phase fluctuations; conventional vortex-antivortex pairs, whose contribution turns on very rapidly just below the usual Kosterlitz-Thouless-Berezinskii unbinding temperature; and an anomalous contribution. The latter is predominantly resistive, persists well below the KTB temperature, and is weakly dependent on frequency down to remarkably low frequencies, at least 100 Hz. It increases with T as e-U'(T)/kT, where the activation energy, U'(T), is about half the energy to create a vortex-antivortex pair, indicating that the frequency dependence is that of individual excitations, rather than critical behavior.Comment: 10 pages, 10 figs; subm PR

Tuberculosis research in South Africa over the past 30 years: From bench to bedside

The South African Medical Research Council Centre for Tuberculosis Research has a rich history of high-impact research that has influenced our understating of this hyper-epidemic which is further exacerbated by the emergence and spread of drug-resistant forms of the disease. This review aims to summarise the past 30 years of research conducted in the Centre which has influenced the way that tuberculosis (TB) is diagnosed and treated. The review includes the development of new technologies for rapid screening of people with probable TB and the repurposing of human diagnostics for wildlife conservation

Inertial Mass of a Vortex in Cuprate Superconductors

We present here a calculation of the inertial mass of a moving vortex in cuprate superconductors. This is a poorly known basic quantity of obvious interest in vortex dynamics. The motion of a vortex causes a dipolar density distortion and an associated electric field which is screened. The energy cost of the density distortion as well as the related screened electric field contribute to the vortex mass, which is small because of efficient screening. As a preliminary, we present a discussion and calculation of the vortex mass using a microscopically derivable phase-only action functional for the far region which shows that the contribution from the far region is negligible, and that most of it arises from the (small) core region of the vortex. A calculation based on a phenomenological Ginzburg-Landau functional is performed in the core region. Unfortunately such a calculation is unreliable, the reasons for it are discussed. A credible calculation of the vortex mass thus requires a fully microscopic, non-coarse grained theory. This is developed, and results are presented for a s-wave BCS like gap, with parameters appropriate to the cuprates. The mass, about 0.5 $m_e$ per layer, for magnetic field along the $c$ axis, arises from deformation of quasiparticle states bound in the core, and screening effects mentioned above. We discuss earlier results, possible extensions to d-wave symmetry, and observability of effects dependent on the inertial mass.Comment: 27 pages, Latex, 3 figures available on request, to appear in Physical Review

Sequence-based prediction for vaccine strain selection and identification of antigenic variability in foot-and-mouth disease virus

Identifying when past exposure to an infectious disease will protect against newly emerging strains is central to understanding the spread and the severity of epidemics, but the prediction of viral cross-protection remains an important unsolved problem. For foot-and-mouth disease virus (FMDV) research in particular, improved methods for predicting this cross-protection are critical for predicting the severity of outbreaks within endemic settings where multiple serotypes and subtypes commonly co-circulate, as well as for deciding whether appropriate vaccine(s) exist and how much they could mitigate the effects of any outbreak. To identify antigenic relationships and their predictors, we used linear mixed effects models to account for variation in pairwise cross-neutralization titres using only viral sequences and structural data. We identified those substitutions in surface-exposed structural proteins that are correlates of loss of cross-reactivity. These allowed prediction of both the best vaccine match for any single virus and the breadth of coverage of new vaccine candidates from their capsid sequences as effectively as or better than serology. Sub-sequences chosen by the model-building process all contained sites that are known epitopes on other serotypes. Furthermore, for the SAT1 serotype, for which epitopes have never previously been identified, we provide strong evidence - by controlling for phylogenetic structure - for the presence of three epitopes across a panel of viruses and quantify the relative significance of some individual residues in determining cross-neutralization. Identifying and quantifying the importance of sites that predict viral strain cross-reactivity not just for single viruses but across entire serotypes can help in the design of vaccines with better targeting and broader coverage. These techniques can be generalized to any infectious agents where cross-reactivity assays have been carried out. As the parameterization uses pre-existing datasets, this approach quickly and cheaply increases both our understanding of antigenic relationships and our power to control disease

The apparatus composition and architecture of Erismodus quadridactylus and the implications for element homology in prioniodinin conodonts

The apparatus composition and architecture of prioniodinin conodonts is poorly understood, largely because few prioniodinin taxa are represented by articulated oral feeding apparatuses (natural assemblages) in the fossil record, but also due to the highly variable gradational morphology of their constituent elements that makes apparatus reconstruction problematic. We describe here a natural assemblage of Erismodus quadridactylus (Stauffer), a prioniodinin, from the Sandbian (Late Ordovician) of North Dakota, USA. The assemblage demonstrates that the apparatus architecture of Erismodus is similar to those of late Palaeozoic prioniodinins namely, Kladognathus Rexroad and Hibbardella Bassler, but also has similarities with ozarkodinin apparatuses. In addition, there is evidence to suggest that E. quadridactylus shares topological similarities to balognathid architecture, with respect to the position of its inferred P elements. The apparatus composition and architecture presented here indicate that, at least with respect to the M–S array, an ‘ozarkodinin‐type’ bauplan is probably more widely representative across prioniodontids. The assemblage demonstrates that element morphotypes traditionally considered to lie within the S array are M elements, whereas others traditionally interpreted as P elements are found in the S array. These observations are used as a basis for refining concepts of element homology among prioniodinin conodonts and their closest relatives

A multidisciplinary study of a small, temporarily open/closed South African estuary, with particular emphasis on the influence of mouth state on the ecology of the system

In 2005/2006 a multidisciplinary research programme that included studies on the hydrodynamics, sediment dynamics, macronutrients, microalgae, macrophytes, zoobenthos, hyperbenthos, zooplankton, ichthyoplankton, fish and birds of the temporarily open/closed East Kleinemonde Estuary was conducted. Particular attention was given to the responses of the different ecosystem components to the opening and closing of the estuary mouth and how this is driven by both riverine and marine events. Using a complementary dataset of daily estuary mouth conditions spanning a 14-year period, five distinct phases of the estuary were identified, including closed (average = 90% of the days), outflow (<1%), tidal (9%) and semi-closed (<1%). The open-mouth phase is critical for the movements of a number of estuary-associated fish (e.g. Rhabdosargus holubi) and invertebrates (e.g. Scylla serrata) between the estuary and sea. The timing of this open phase has a direct influence on the ability of certain estuaryassociated fish (e.g. Lithognathus lithognathus) and invertebrates (e.g. Palaemon peringueyi) to successfully recruit into the system, with a spring opening (October/November) being regarded as optimal for most species. The type of mouth-breaching event and outflow phase is also important in terms of the subsequent salinity regime once the berm barrier forms. A deep mouth breaching following a large river flood tends to result in major tidal inputs of marine water prior to mouth closure and therefore higher salinities (15–25). Conversely, a shallow mouth breaching with reduced tidal exchange during the open phase often leads to a much lower salinity regime at the time of mouth closure (5–15). The biota, especially the submerged macrophytes, respond very differently to the above two scenarios, with Ruppia cirrhosa benefiting from the former and Potamogeton pectinatus from the latter. River flooding and the associated outflow of large volumes of water through the estuary can result in major declines in zooplankton, zoobenthos, hyperbenthos and fish populations during this phase. However, this resetting of the estuary is necessary because certain marine invertebrate and fish species are dependent on the opening of the estuary mouth in order to facilitate recruitment of larvae and post-larvae into the system from the sea. Slight increases in the numbers of certain piscivorous and resident wading bird species were recorded when the estuary mouth opened, possibly linked to increased feeding opportunities during that phase

Vortex Lattice Melting in 2D Superconducting Networks and Films

We carry out MC studies of 2D superconducting networks, in an applied magnetic field, for square and honeycomb geometries. We consider both dilute systems (f=1/q) and systems near full frustration (f=1/2-1/q). For the dilute case (which models a film as q->infinity), we find two transitions: at T_c(f)~1/q there is a depinning transition from a pinned to a floating vortex lattice; at T_m(f)~constant the floating vortex lattice melts into an isotropic liquid. We analyze this melting according to the Kosterlitz- Thouless theory of dislocation mediated melting, and find that the melting is weakly first order. For the case near full frustration, the system can be described in terms of the density of defects in an otherwise fully frustrated vortex pattern. We find pinned solid, floating solid, and liquid defect phases, as well as a higher sharp transition corresponding to the disordering of the fully frustrated background.Comment: 55 pages, RevTex3.0, 25 figures (available by mail by contacting [email protected]