Porcelain aorta does not mean inoperability but needs special strategies

Porcelain aorta is not an absolute contraindication for aortic valve and/or coronary bypass grafting but it requires a special strategy and individualized approach to minimize the risk of embolic complications and technical problems during opening and/or closing the aortotomy. Keywords: Aortic valve replacement; Coronary bypass grafting; Hypothermic circulatory arrest; Porcelain aorta; Xeno-pericardial patc

A case series of rare pathologies of the aorta and the aortic arch in adolescents and younger adults: Transfer of experience for an individualized approach

Objective: While aneurysm of the aortic root, interrupted aortic arch, and aortic coarctation are the most frequent aortic diseases in adolescents and younger adults, there are a number of rare pathologies of the thoracic aorta that need individualized treatment. Patients: We present a small case series of unusual aortic pathologies in patients presenting with a broad spectrum of symptoms: tiredness, dysphagia, dyspnea, arterial hypertension, renal failure, and claudication. (1). Segmental agenesia of the descending aorta. (2). Balanced double aortic arch with complete vascular ring. (3). Right descending aortic arch, left lusorian artery with Kommerell diverticulum. (4). Large patent ductus (2.5 cm) and ventricular septal defect. (5). Aneurysm of the aortic arch in the presence of tuberous sclerosis. (6). Pseudo-aneurysm of the proximal descending aorta following coarctation patch plasty. (7). Supravalvular aortic stenosis combined with severe aortic valve stenosis. (8). Pseudo-aneurysm following ascendens-to-descendens bypass because of recurrent coarctation. (9). Takayasu arteriitis with severe stenosis in the thoraco-abdominal aorta. Results: The following procedures were performed, using individualized cardiopulmonary bypass, canulation and cerebral protection strategies. (1). Ascending to supraceliac extra-anatomic bypass. (2). Division of the ductus ligament and of the anterior aortic arch distally to the left subclavian artery. (3). Excision of the Kommerell diverticulum and translocation of the left subclavian artery. (4). Patch closure of the aorto-pulmonary window (patent ductus) and closure of the ventricular septal defect. (5). Complete aortic arch replacement combined with debranching of the supra-aortic vessels. (6). Graft interposition of the proximal descending aorta. (7). Enlargement of the ascending aorta and aortic valve replacement. (8). Exclusion of the pseudo-aneurysm, end-to-side graft interposition. (9). Ascending aorta to infrarenal aorta or ascending to bi-iliac artery bypass (planned). All patients were operated on without operative mortality. One patient died in-hospital from pulmonary complications one week after surgery. One patient is still awaiting surgery. All other patients recovered very well from the operation and did not show any residual symptoms. Conclusion: Rare pathologies of the thoracic aorta in younger patients may cause a broad spectrum of unusual symptoms; in some of them, diagnosis is delayed. Cross-sectional imaging is mandatory for optimal operative planning Surgical treatment can be performed with very satisfying results. The prognosis of these patients is usually favorable following surgery. Keywords: adolescents; aortic arch; ascending aorta; cerebral protection; circulatory arrest; results; surgery; younger adults

A 4-Planet System Orbiting the K0V Star HD 141399

We present precision radial velocity (RV) data sets from Keck-HIRES and from Lick Observatory's new Automated Planet Finder Telescope and Levy Spectrometer on Mt. Hamilton that reveal a multiple-planet system orbiting the nearby, slightly evolved, K-type star HD 141399. Our 91 observations over 10.5 years suggest the presence of four planets with orbital periods of 94.35, 202.08, 1070.35, and 3717.35 days and minimum masses of 0.46, 1.36, 1.22, and 0.69 Jupiter masses respectively. The orbital eccentricities of the three inner planets are small, and the phase curves are well sampled. The inner two planets lie just outside the 2:1 resonance, suggesting that the system may have experienced dissipative evolution during the protoplanetary disk phase. The fourth companion is a Jupiter-like planet with a Jupiter-like orbital period. Its orbital eccentricity is consistent with zero, but more data will be required for an accurate eccentricity determination.Comment: 11 pages, 13 figures, To appear in the Astrophysical Journa

Aortic wrapping is life-saving in high-risk acute aortic dissection and intramural haematoma

Aortic wrapping is a controversial repair in patients presenting with acute type A aortic dissection or intramural haematoma, but this method may be a potential alternative to medical treatment or conventional repair in patients aged >80 years and in those presenting with prohibitive co-morbidities such as stroke, circulatory collapse, full oral anticoagulation with the last generation drugs. We report on 5 high-risk and/or patients over 80 years who received external aortic wrapping with or without cardiopulmonary bypass during the last 18 months. All survived the procedure and could be extubated early postoperatively. No patient remained on the intensive care longer than 2 days and all were discharged without additional complications. Postoperative radiological control was acceptable and no patient had any new aortic event up to 18 months postoperatively

Discovery of the element with atomic number 112 (IUPAC Technical Report)

The IUPAC/IUPAP Joint Working Party (JWP) on the priority of claims to the discovery of new elements has reviewed the relevant literature pertaining to several claims. In accordance with the criteria for the discovery of elements previously established by the 1992 IUPAC/IUPAP Transfermium Working Group (TWG), and reiterated by the 1999 and 2003 IUPAC/IUPAP JWPs, it was determined that the 1996 and 2002 claims by the Hofmann et al. research collaborations for the discovery of the element with atomic number 112 at Gesellschaft für Schwerionenforschung (GSI) share in the fulfillment of those criteria. A synopsis of Z = 112 experiments and related efforts is presented. A subsequent report will address identification of higher-Z elements including those of odd atomic numbe

Case report: Eighteen nails gun shots in the head, thorax and abdomen but still conscious at admission: A challenging patient for the cardiac surgeon!

We report an unusual case of multiple penetrating cerebral, cardiac and abdominal injuries following a suicidal attempt using a nail gun. Successful treatment required several emergency procedures and resulted from a wise interdisciplinary management and timing of surgery

Emerging Artificial Societies Through Learning

The NewTies project is implementing a simulation in which societies of agents are expected to de-velop autonomously as a result of individual, population and social learning. These societies are expected to be able to solve environmental challenges by acting collectively. The challenges are in-tended to be analogous to those faced by early, simple, small-scale human societies. This report on work in progress outlines the major features of the system as it is currently conceived within the project, including the design of the agents, the environment, the mechanism for the evolution of language and the peer-to-peer infrastructure on which the simulation runs.Artificial Societies, Evolution of Language, Decision Trees, Peer-To-Peer Networks, Social Learning

Development and characterization of an ice-selecting pumped counterflow virtual impactor (IS-PCVI) to study ice crystal residuals

Separation of particles that play a role in cloud activation and ice nucleation from interstitial aerosols has become necessary to further understand aerosol-cloud interactions. The pumped counterflow virtual impactor (PCVI), which uses a vacuum pump to accelerate the particles and increase their momentum, provides an accessible option for dynamic and inertial separation of cloud elements. However, the use of a traditional PCVI to extract large cloud hydrometeors is difficult mainly due to its small cut-size diameters ( 100 %), where a mixture of droplets and ice crystals was formed during the expansion experiment. In parallel, the flow conditions of the IS-PCVI were actively controlled, such that it separated ice crystals from a mixture of ice crystals and cloud droplets, which were of diameter  ≥  10 µm. These large ice crystals were passed through the heated evaporation section to remove the water content. Afterwards, the residuals were characterized with a suite of online and offline instruments downstream of the IS-PCVI. These results were used to assess the optimized operating parameters of the device in terms of (1) the critical cut-size diameter, (2) the transmission efficiency and (3) the counterflow-to-input flow ratio. Particle losses were characterized by comparing the residual number concentration to the rejected interstitial particle number concentration. Overall results suggest that the IS-PCVI enables inertial separation of particles with a volume-equivalent particle size in the range of  ~ 10–30 µm in diameter with small inadvertent intrusion (~  5 %) of unwanted particles