Smallest Halos in Thermal Wino Dark Matter

(Mini) split supersymmetry explains the observed Higgs mass and evades stringent constraints, while keeping good features of TeV-scale supersymmetry other than the little hierarchy problem. Such scenarios naturally predict thermal wino dark matter whose mass is around $3 \, {\rm TeV}$. Its non-perturbatively enhanced annihilation is a promising target of indirect detection experiments. It is known that identifying the smallest halos is essential for reducing an uncertainty in interpreting indirect detection experiments. Despite its importance, the smallest halos of thermal wino dark matter have not been well understood and thus are investigated in this work. In particular, we remark on two aspects: 1) the neutral wino is in kinetic equilibrium with primordial plasma predominantly through inelastic processes involving the slightly heavier charged wino; and 2) the resultant density contrast shows larger powers at dark acoustic oscillation peaks than in cold dark matter, which is known as an overshooting phenomenon. By taking them into account, we provide a rigorous estimate of the boost factor. Our result facilitates accurately pinning down thermal wino dark matter through vigorous efforts in indirect detection experiments.Comment: 12 pages, 7 figures; matched to the PRD version, author list changed, evaluation of the boost factor significantly improve

Spontaneous Cardiac Hypertrophy in a Crl:CD(SD) Rat

Cardiac hypertrophy was observed in a 9-week-old Crl:CD(SD) rat that died unexpectedly. The animal was allocated to the control group of a toxicity study, and no abnormalities in its general conditions, body weight or food intake were observed. Necropsy revealed an increase in heart weight. Gross examination indicated cardiac enlargement with thickening of the right and left ventricular walls. Histopathological examination revealed hypertrophy of the cardiomyocytes in the right and left ventricular walls and the interventricular septum. Electron microscopic examination indicated bizarre nuclei and accumulation of an increased number of various sizes of mitochondria in the perinuclear region of the hypertrophied myocytes. Hypertrophied myocytes connected by intensely folded intercalated disks were also observed. Based on these findings, the animal was diagnosed with cardiac hypertrophy. This is the first case report of cardiac hypertrophy in this strain

Hospital teaching status and trascatheter aortic valve replacement outcomes in the United States: Analysis of the national inpatient sample

BackgroundEvidence suggests that medical service offerings vary by hospital teaching status. However, little is known about how these translate to patient outcomes. We therefore sought to evaluate this gap in knowledge in patients undergoing Transcatheter aortic valve replacement (TAVR) in the United States.MethodsThis study was conducted using the National Inpatient Sample (NIS) in the United States from 2011 to 2014. Teaching status was classified, as teaching vs. nonteaching and endpoints were clinical outcomes, length of stay and cost. Procedureâ related complications were identified via ICDâ 9 coding and analysis was performed via mixed effect model.ResultsAn estimated 33,790 TAVR procedures were performed in the U.S between 2011 and 2014, out of which 89.3% were in teaching hospitals. Mean (SD) age was 81.4 (8.5) and 47% were females. There was no significant difference between teaching versus nonteaching hospitals in regards to the primary outcome of inâ hospital mortality and secondary outcomes of several cardiovascular and other end points except for a high rates of acute kidney injury (AKI) (OR: 1.34 [95% CI, 1.04â 1.72]) and lower rate for use of mechanical circulatory support devices in teaching vs. nonteaching centers. The mean length of stay was significantly higher in teaching hospitals (7.7 days) vs. nonteaching hospitals (6.8 days) (Pâ =â 0.002) and so was the median cost of hospitalization (USD 50,814 vs. USD 48, 787, Pâ =â 0.02) for teaching vs. nonteaching centers.ConclusionMost TAVR related shortâ term outcomes including all cause inâ hospital mortality are about the same in teaching and nonteaching hospitals. However, AKI, length of hospital stay and TAVR related cost were significantly higher in teaching than nonteaching hospitals. There was more use of mechanical circulatory support in nonteaching than teaching hospitals.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141703/1/ccd27236.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141703/2/ccd27236_am.pd

A Case Report of a Malignant Fibrous Histiocytoma in a T-cell Receptor β Chain and p53 Double-knockout Mouse

A subcutaneous tumor was found in the right abdomen of a 16-week-old male TCRβ and p53 double-knockout mouse. The tumor had indistinct borders with the surrounding tissue. The cut surface after formalin fixation was pale yellowish white, partially dark red and partly white. Histologically, the tumor was composed of three distinct regions. The first region showed pleomorphic cells arranged in sheets. The second region showed spindle cells arranged in interlacing fascicles. The final region contained a mixture of the above mentioned two types of cells. Furthermore, a small amount of collagen fibers, round cells, multinucleated giant cells, and cells with eosinophilic granules were observed between these tumor cells. Immunohistochemical examination and electron microscopy identified that the pleomorphic cells and spindle cells were histiocytes and fibroblasts, respectively, and that the round cells were undifferentiated mesenchymal cells. Based on these findings, the tumor was diagnosed as a malignant fibrous histiocytoma

Meta-Analysis of Hospital-Volume Relationship in Transcatheter Aortic Valve Implantation

BACKGROUND: Whether a volume-outcome relationship, that is, higher volume centres have better outcomes compared with lower volume hospitals, exists in transcatheter aortic valve implantation (TAVI) has not yet been systematically explored. METHODS: We performed a systematic review and meta-analysis to evaluate whether highest or intermediate annual TAVI volume hospitals has better short-term (in-hospital or 30-days) mortality compared with the lowest volume hospitals. Odds ratio (OR) and 95% confidence interval (CI) was calculated with the Mantel-Haenszel method. RESULTS: We identified 10 publications from nine different countries including TAVI performed between 2005-2017. Included patients were mainly high-risk cohorts. We included five and six studies to assess volume-outcome relationship in the highest and intermediate volume hospitals compared with the lowest volume hospitals, respectively. Our results showed that in both the highest (OR 0.66, 95%CI 0.53-0.83, p=0.0003, I(2)=78%) and intermediate (OR 0.85, 95%CI 0.79-0.92, p\u3c0.0001, I(2)=0%) volume hospitals, there was a statistically significant volume-outcome relationship for short-term mortality compared with the lowest volume hospitals. CONCLUSIONS: Our review suggests a significant volume-outcome relationship post-TAVI in both the highest and intermediate volume hospitals compared with the lowest volume hospitals mainly in high surgical risk patients. The high heterogeneity in this relationship between the highest and the lowest volume hospitals warrant cautious interpretation. Whether this relationship remains significant in low-risk cohort requires further study

Hospital Variation of 30-Day Readmission Rate Following Transcatheter Aortic Valve Implantation

OBJECTIVES: Thirty-day readmission rate is one of the hospital quality metrics. Outcomes of transcatheter aortic valve implantation (TAVI) have improved significantly, but it remains unclear whether hospital-level variance in 30-day readmission rate exists in the contemporary TAVI era. METHODS: From the 2017 US Nationwide Readmission Database, endovascular TAVI were identified. The unadjusted 30-day readmission rate and 30-day risk-standardised readmission rate (RSRR) were calculated and we then conducted model testing to determine the relative contribution of hospital characteristics, patient-level covariates and economic status to the variation in readmission rates observed between the hospitals. RESULTS: A total of 44 899 TAVI from 338 hospitals were identified. The range of unadjusted 30-day readmission rate and 30-day RSRR was 2.0%-33.3% and 9.4%-15.3%, respectively. Median 30-day RSRR was 11.8% and there was a significant hospital-level variation (median OR 1.22, 95% CI 1.16 to 1.32, p\u3c0.01) and this was similar in both readmissions caused due to major cardiac and non-cardiac conditions. Patient, hospital and economic factors accounted for 9.6%, 1.9% and 3.8% of the variability in hospital readmission rate, respectively. CONCLUSIONS: There was significant hospital-level variation in 30-day RSRR following TAVI. Further measures are required to mitigate this variance in the readmission rate

Risk of Ischemic Stroke in Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement in Patients With Prior Stroke

It has not been well studied whether transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR) have lower risk of ischemic stroke (IS) in those with prior history of IS. From the Nationwide Readmission Database from October 2015 to November 2017, TAVI and SAVR above age 50 were identified with the International Classification of Diseases, Tenth Revision, Clinical Modification/Procedure Coding System codes. Transapical TAVI and SAVR with concomitant bypass, mitral, or tricuspid surgery were excluded. The primary outcome was in-hospital IS. A total of 92,435 TAVI (13,292 with prior stroke) and 68,651 SAVR (5,365 with prior stroke) were identified. In-hospital IS was significantly lower in TAVI compared with SAVR (3.7% vs 8.0%, adjusted odds ratio 0.65, 95% confidence interval 0.47 to 0.89, p \u3c0.01) with prior stroke whereas it was similar between TAVI and SAVR (1.7% vs 2.1%, adjusted odds ratio 0.97, 95% confidence interval 0.78 to 1.19, p = 0.75) in those without prior stroke (P interaction \u3c 0.001). In-hospital mortality, acute kidney injury, and bleeding were lower in TAVI compared with SAVR in patients with and without prior stroke (P interaction \u3e 0.05 for all). This analysis of a national claims database showed that TAVI was associated with a lower risk of in-hospital IS compared with SAVR among patients with prior stroke