Endovascular Repair of Ascending Aortic Dissection A Novel Treatment Option for Patients Judged Unfit for Direct Surgical Repair

ObjectivesThis paper sought to report the outcomes of patients who are considered unfit for urgent surgical repair of ascending aortic dissections (AADs) who were treated using a novel endovascular repair strategy.BackgroundAAD is best treated by direct surgical repair. Patients who are unable to undergo this form of treatment have poor prognoses. Previously, clinical case reports related to endovascular repair of AAD have been controversial.MethodsBetween May 2009 and January 2011, 41 consecutive patients with AAD were treated in our institution. Fifteen patients were considered poor candidates for direct surgical repair and subsequently underwent the endovascular repair.ResultsThe nature of the referral process to our tertiary care facility made the median time from aortic dissection onset to treatment 25.5 days (range: 6 to 353 days). Dissections in 5 patients (33.3%) were considered acute, and those in 10 patients (66.7%) were considered chronic. The rate of successful stent-graft deployment was 100%, and there were no major morbidities or deaths in the perioperative period. Median follow-up was 26 months (range: 16 to 35 months). One new dissection occurred in the aortic arch at 3 months and was treated with a branched endograft. Significant enlargements of true lumens and decreases of false lumens and overall thoracic aorta were noted after the procedures.ConclusionsEndovascular repair of AAD was an appropriate treatment option in patients who were considered poor candidates for traditional direct surgical repair by the clinical criteria used in our institution. A larger series of cases with longer follow-up is needed to substantiate these results

Activin A and BMP4 Signaling Expands Potency of Mouse Embryonic Stem Cells in Serum-Free Media.

Inhibitors of Mek1/2 and Gsk3β, known as 2i, and, together with leukemia inhibitory factor, enhance the derivation of embryonic stem cells (ESCs) and promote ground-state pluripotency (2i/L-ESCs). However, recent reports show that prolonged Mek1/2 suppression impairs developmental potential of ESCs, and is rescued by serum (S/L-ESCs). Here, we show that culturing ESCs in Activin A and BMP4, and in the absence of MEK1/2 inhibitor (ABC/L medium), establishes advanced stem cells derived from ESCs (esASCs). We demonstrate that esASCs contributed to germline lineages, full-term chimeras and generated esASC-derived mice by tetraploid complementation. We show that, in contrast to 2i/L-ESCs, esASCs display distinct molecular signatures and a stable hypermethylated epigenome, which is reversible and similar to serum-cultured ESCs. Importantly, we also derived novel ASCs (blASCs) from blastocysts in ABC/L medium. Our results provide insights into the derivation of novel ESCs with DNA hypermethylation from blastocysts in chemically defined medium

Existence of infinitely many radial solutions for quasilinear Schrodinger equations

In this article we prove the existence of radial solutions with arbitrarily many sign changes for quasilinear Schrodinger equation $$-\sum_{i,j=1}^{N}\partial_j(a_{ij}(u)\partial_iu) +\frac{1}{2}\sum_{i,j=1}^{N}a'_{ij}(u)\partial_iu\partial_ju+V(x)u =|u|^{p-1}u,~x\in\mathbb{R}^N,$$ where $N\geq3$, $p\in(1,\frac{3N+2}{N-2})$. The proof is accomplished by using minimization under a constraint

Multiplicity of homoclinic solutions for second-order Hamiltonian systems

By using a modified function technique and variational methods, we establish the existence of infinitely many homoclinic solutions for a second-order Hamiltonian system $ddot{u}-L(t)u+F_u(t,u)=0$, for all t in R, where no coercive condition for F(t,u) at infinity is imposed

A 3-fold "Butterfly Valve" in Command of the Encapsulation's Kinetic Stability. Molecular Baskets at Work

Molecular basket 1, composed of a semirigid tris-norbornadiene framework and three revolving pyridine-based gates at the rim, has been built to "dynamically" enclose space and as such regulate molecular encapsulation. The gates were shown to fold via intramolecular hydrogen bonding and thereby form a G(3v) symmetrical receptor: the (1)H NMR resonance for the amide N-H protons of the pyridine gates appeared downfield (delta = 10.98 ppm), and the N-H vibrational stretch (IR) was observed at 3176 cm(-1). Accordingly, density functional theory (DFT, B3LYP) investigations revealed for the closed conformers of 1 to be energetically the most stable and dominant. The gearing of the pyridine "gates", about their axis, led to the interconversion of two dynamic enantiomers 1(A) and 1(B) comprising the clockwise and counterclockwise seam of intramolecular hydrogen bonds. Dynamic (1)H NMR spectroscopic measurements and line-shape simulations suggested that the energy barrier of 10.0 kcal/mol (Delta G(A/B)(double dagger), 298 K) is required for the 1(A/B) interconversion, when CCl(4) occupies the cavity of 1. Likewise, the activation free energy for CCl4 departing the basket was found to be 13.1 kcal/mol (Delta G(double dagger), 298 K), whereas the thermodynamic stability of 1:CCl(4) complex was -2.7 kcal/mol (Delta G degrees, 298 K). In view of that, CCI4 (but also (CH(3))(3)CBr) was proposed to escape from, and a molecule of solvent to enter, the basket when the gates rotate about their axis: the exit of CCl(4) requires the activation energy of 12.7 kcal/mol (Delta G(A/B)(double dagger) + Delta G degrees), similar to the experimentally found 13.1 kcal/mol (Delta G(double dagger))

A Zoning Earthquake Casualty Prediction Model Based on Machine Learning

The evaluation of mortality in earthquake-stricken areas is vital for the emergency response during rescue operations. Hence, an effective and universal approach for accurately predicting the number of casualties due to an earthquake is needed. To obtain a precise casualty prediction method that can be applied to regions with different geographical environments, a spatial division method based on regional differences and a zoning casualty prediction method based on support vector regression (SVR) are proposed in this study. This study comprises three parts: (1) evaluating the importance of influential features on seismic fatality based on random forest to select indicators for the prediction model; (2) dividing the study area into different grades of risk zones with a strata fault line dataset and WorldPop population dataset; and (3) developing a zoning support vector regression model (Z-SVR) with optimal parameters that is suitable for different risk areas. We selected 30 historical earthquakes that occurred in China’s mainland from 1950 to 2017 to examine the prediction performance of Z-SVR and compared its performance with those of other widely used machine learning methods. The results show that Z-SVR outperformed the other machine learning methods and can further enhance the accuracy of casualty prediction