Video-Assisted Thoracoscopy For Penetrating Cardiac Box Injury in Stable Patients

Introduction: In high-volume trauma centers, especially in developing countries, penetrating cardiac box injuries are frequent. Although many aspects of penetrating chest injuries have been well established, video-assisted thoracoscopy is still finding its place in cardiac box trauma and algorithmic approaches are still lacking. The purpose of this manuscript is to provide a streamlined recommendation for penetrating cardiac box injury in stable patients. Methods: Literature review was carried out using PubMed/ MEDLINE and Google Scholar databases to identify articles describing the characteristics and concepts of penetrating cardiac box trauma, including the characteristics of tamponade, cardiac ultrasound, indications and techniques of pericardial windows and, especially, the role of video-assisted thoracoscopy in stable patients. Results: Penetrating cardiac box injuries, whether by stab or gunshot wounds, require rapid surgical consultation. Unstable patients require immediate open surgery, however, determining which stable patients should be taken to thoracoscopic surgery is still controversial. Here, the classification of penetrating cardiac box injury used in Colombia is detailed, as well as the algorithmic approach to these types of trauma. Conclusion: Although open surgery is mandatory in unstable patients with penetrating cardiac box injuries, a more conservative and minimally invasive approach may be undertaken in stable patients. As rapid decision-making is critical in the trauma bay, surgeons working in high-volume trauma centers should expose themselves to thoracoscopy and always consider this possibility in the setting of penetrating cardiac box injuries in stable patients, always in the context of an experienced trauma team

A heterometallic [LnLn′Ln] lanthanide complex as a qubit with embedded quantum error correction

We show that a [Er-Ce-Er] molecular trinuclear coordination compound is a promising platform to implement the three-qubit quantum error correction code protecting against pure dephasing, the most important error in magnetic molecules. We characterize it by preparing the [Lu-Ce-Lu] and [Er-La-Er] analogues, which contain only one of the two types of qubit, and by combining magnetometry, low-temperature specific heat and electron paramagnetic resonance measurements on both the elementary constituents and the trimer. Using the resulting parameters, we demonstrate by numerical simulations that the proposed molecular device can efficiently suppress pure dephasing of the spin qubits

Essentially pure partial trisomy 6(p21.31-p25) (case report and literature review)

To achieve a better clinical delineation of the 6p syndrome through the description of a patient with partial trisomy 6(p21.31-p25) comparing his characteristics with international reports and to discuss aspects of the phenotype of this syndrom

Accident causation and pre-accidental driving situations. Part 3. Summary report

This report aims to present the final results of the descriptive statistical, in-depth and risk analysis performed within TRACE Work Package ‘WP2-Type of situations’, in order to identify the main problems and the magnitude of these problems related to accident causation and risk factors for the following four types of situations: the stabilized situations, the specific manoeuvres, the intersection situations and the degraded situations. The different analysis (descriptive, in-depth and risk) of each of these five tasks has been performed using the available European accident databases within TRACE (national, in-depth and exposure databases). The objectives achieved in this WP are: • Identify and quantify accident causation factors associated to particular types of driving and pre-accidental situations, at a statistical level, by analyzing various available databases in Europe. • Obtain a focused understanding of accident causation issues related to these types of situations at an in-depth level by analyzing data from available in-depth databases. • Identify the level of risk associated to these selected types of situation in causing accidents

Accident causation and pre-accidental driving situations. Part 2. In-depth accident causation analysis

WP2 of the European Project TRACE is concerned with “Types of Situations” to analyse the causation of road traffic accidents from the pre-accidental driving situation point of view. Four complementary situations were defined: stabilized situations, intersection, specific manoeuvre and degradation scenario. To reach this objective, the analysis is based on a common methodology composed on 3 steps: the “descriptive analysis” which from general statistics will allow to identify among the studied situations those them relevant and to give their characteristics, the “in-depth analysis” allowing to obtain accident causes from the generic description of the problems identified in the previous step and the risk analysis identifying the risk of being involved in an accident taking into account the results obtained from the ‘in–depth’ level. This report is dedicated to the identification of the accident causes analysed for the pre-accidental driving situation point of view, i.e. the circumstances in which the driver is involved just prior the accident. This analysis has been conducted from the scenarios identified for each type of situation during the descriptive analysis realized in a first part (Report D2.1: Accident causation and pre-accidental driving situations. Part 1. Overview and general statistics). These results are based on the study of disaggregated data (in-depth accidents collection databases) available via WP8 in TRACE. With the identification of the main causes and contributing factor, the aspect related to the human functional failure has been taken into account. This innovative concept studied in TRACE WP5, has been used here in order to have a more complete overview of the problems in working on each road users involved in the accident and not only on the whole accident

Structural Heart Alterations in Brugada Syndrome: Is it Really a Channelopathy? A Systematic Review

Brugada syndrome (BrS) is classified as an inherited cardiac channelopathy attributed to dysfunctional ion channels and/or associated proteins in cardiomyocytes rather than to structural heart alterations. However, hearts of some BrS patients exhibit slight histologic abnormalities, suggesting that BrS could be a phenotypic variant of arrhythmogenic cardiomyopathy. We performed a systematic review of the literature following Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA) criteria. Our comprehensive analysis of structural findings did not reveal enough definitive evidence for reclassification of BrS as a cardiomyopathy. The collection and comprehensive analysis of new cases with a definitive BrS diagnosis are needed to clarify whether some of these structural features may have key roles in the pathophysiological pathways associated with malignant arrhythmogenic episodes

Search for muon-neutrino emission from GeV and TeV gamma-ray flaring blazars using five years of data of the ANTARES telescope

The ANTARES telescope is well-suited for detecting astrophysical transient neutrino sources as it can observe a full hemisphere of the sky at all times with a high duty cycle. The background due to atmospheric particles can be drastically reduced, and the point-source sensitivity improved, by selecting a narrow time window around possible neutrino production periods. Blazars, being radio-loud active galactic nuclei with their jets pointing almost directly towards the observer, are particularly attractive potential neutrino point sources, since they are among the most likely sources of the very high-energy cosmic rays. Neutrinos and gamma rays may be produced in hadronic interactions with the surrounding medium. Moreover, blazars generally show high time variability in their light curves at different wavelengths and on various time scales. This paper presents a time-dependent analysis applied to a selection of flaring gamma-ray blazars observed by the FERMI/LAT experiment and by TeV Cherenkov telescopes using five years of ANTARES data taken from 2008 to 2012. The results are compatible with fluctuations of the background. Upper limits on the neutrino fluence have been produced and compared to the measured gamma-ray spectral energy distribution.Comment: 27 pages, 16 figure

Discerning the Ambiguous Role of Missense TTN Variants in Inherited Arrhythmogenic Syndromes

The titin gene (TTN) is associated with several diseases, including inherited arrhythmias. Most of these diagnoses are attributed to rare TTN variants encoding truncated forms, but missense variants represent a diagnostic challenge for clinical genetics. The proper interpretation of genetic data is critical for translation into the clinical setting. Notably, many TTN variants were classified before 2015, when the American College of Medical Genetics and Genomics (ACMG) published recommendations to accurately classify genetic variants. Our aim was to perform an exhaustive reanalysis of rare missense TTN variants that were classified before 2015, and that have ambiguous roles in inherited arrhythmogenic syndromes. Rare missense TTN variants classified before 2015 were updated following the ACMG recommendations and according to all the currently available data. Our cohort included 193 individuals definitively diagnosed with an inherited arrhythmogenic syndrome before 2015. Our analysis resulted in the reclassification of 36.8% of the missense variants from unknown to benign/likely benign. Of all the remaining variants, currently classified as of unknown significance, 38.3% showed a potential, but not confirmed, deleterious role. Most of these rare missense TTN variants with a suspected deleterious role were identified in patients diagnosed with hypertrophic cardiomyopathy. More than 35% of the rare missense TTN variants previously classified as ambiguous were reclassified as not deleterious, mainly because of improved population frequencies. Despite being inconclusive, almost 40% of the variants showed a potentially deleterious role in inherited arrhythmogenic syndromes. Our results highlight the importance of the periodical reclassification of rare missense TTN variants to improve genetic diagnoses and help increase the accuracy of personalized medicine