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Glycans, carbohydrates, and glycoconjugates are involved in many crucial biological processes, such as disease development, immune responses, and cell–cell recognition. Glycans and carbohydrates are known for the large number of isomeric features associated with their structures, making analysis challenging compared with other biomolecules. Mass spectrometry has become the primary method of structural characterization for carbohydrates, glycans, and glycoconjugates. Metal adduction is especially important for the mass spectrometric analysis of carbohydrates and glycans. Metal‐ion adduction to carbohydrates and glycoconjugates affects ion formation and the three‐dimensional, gas‐phase structures. Herein, we discuss how metal‐ion adduction impacts ionization, ion mobility, ion activation and dissociation, and hydrogen/deuterium exchange for carbohydrates and glycoconjugates. We also compare the use of different metals for these various techniques and highlight the value in using metals as charge carriers for these analyses. Finally, we provide recommendations for selecting a metal for analysis of carbohydrate adducts and describe areas for continued research. [ABSTRACT FROM AUTHOR]

Background: The axillary artery (AX) access for intra‐aortic balloon pump (IABP) as a bridge to heart transplant (HT) allows mobility while awaiting a suitable donor. As end‐stage heart failure patients often have an implantable cardioverter defibrillator (ICD) on the left side, the left AX approach may be avoided due to the perception of difficult access and proximity of two devices. We aimed to evaluate the outcomes of patients bridged to HT with a left‐sided AX IABP with or without ipsilateral ICDs. Methods: We retrospectively reviewed HT candidates at our institution supported by left‐sided axillary IABP from November 2019 to February 2024, dividing them into two groups based on the presence (Group ICD, n = 48) or absence (Group No‐ICD, N = 19) of an ipsilateral left‐sided ICD. The exposure time was defined as the time from skin incision to the beginning of anastomoses of a Dacron graft. Results: Technical success was achieved in 100% of the cohort, with median exposure times for AX access similar between groups (ICD, 12 [7.8, 18.2] vs. No ICD, 11 [7, 19] min; p = 0.75). The rate of procedural adverse events, such as significant access site bleeding and ipsilateral limb ischemia, did not significantly differ between both groups. Device malfunction rates were comparable (ICD, 29.2% vs. No ICD, 15.8%; p = 0.35). Posttransplant, in‐hospital mortality, severe primary graft dysfunction, and stroke rates were comparable in both groups. Conclusion: The presence of an ipsilateral left‐sided ICD does not adversely impact the procedural efficacy, complication rates, or posttransplant outcomes of left‐sided AX IABP insertion in HT candidates. [ABSTRACT FROM AUTHOR]

Background: A major issue of cardiac implantable electronic device therapy in pediatric patients is the high incidence of lead dysfunctions and associated reinterventions. This study aims to analyze the timing and mode of generator and lead dysfunction. Methods: Retrospective single‐center analysis of 283 children and young adults with an epicardial pacemaker or implantable cardioverter defibrillator therapy from 1998 to 2018. Results: Mean age at implant was 6.1 years (SD ± 5.8 years) and median follow‐up 6.4 years (IQR, 3.4–10.4 years) with a total of 1998.1 patient‐years of cardiac device therapy. A total of 120 lead‐related complications were observed in 82 patients (29.0%). They were detected by device interrogation (n = 86), symptoms (n = 13), intraoperative findings (n = 7), routine chest radiography (n = 5), routine ECG (n = 4), patient alert sound by device (n = 3), and physical examination (n = 2). It was possible to find the date of the event on the device memory in 21 out of 120 lead dysfunctions (18%) with a median time interval between occurrence and detection of 1.3 months (IQR, 0.2–5.0 months). Moreover, 20 generator‐related complications were found in 13 patients. Conclusions: Early recognition of lead and generator dysfunction remains challenging in pediatric patients. As symptoms are relatively rare conditions in the context of PM and ICD dysfunction, close patient monitoring is mandatory, even in asymptomatic patients with a good clinical course. To further improve the safety of pediatric pacing systems, more durable epicardial electrodes are desirable. [ABSTRACT FROM AUTHOR]

Background: Lynch syndrome represents one of the most common cancer predispositions worldwide and is caused by germline pathogenic variants (PV) in DNA mismatch repair (MMR) genes. We repeatedly identified a PV in the MMR gene PMS2, c.1831dup, accounting for 27% of all Swiss PMS2 PV index patients identified. Notably, 2/18 index patients had been diagnosed with colorectal cancer (CRC) before age 30. Methods: In this study, we investigated if this PV could (i) represent a founder variant by haplotype analysis and (ii) be associated with a more severe clinical phenotype. Results: Haplotype analysis identified a shared common region of about 0.7 Mb/1.3 cM in 13 (81%) out of 16 index patients. Genotype–phenotype correlations, combining data from the 18 Swiss and 18 literature‐derived PMS2 c.1831dup PV index patients and comparing them to 43 Swiss index patients carrying other PMS2 PVs, indicate that the PMS2 c.1831dup variant may be associated with earlier (<50 y) age at CRC diagnosis (55% vs. 29%, respectively; p = 0.047). Notably, 30% (9/30) of cancers from c.1831dup carriers displayed atypical MMR protein expression patterns on immunohistochemistry. Conclusion: Our results suggest that the PMS2 c.1831dup PV represents a, probably ancient, founder mutation and is possibly associated with an earlier CRC diagnosis compared to other PMS2 PVs. [ABSTRACT FROM AUTHOR]

Many charged organic molecules behave as persistent and hazardous pollutants with harmful effects on human health and ecosystems. They are widely distributed related to their charged molecular structure that provides water solubility. In order to track the fate and behavior of such pollutants, charged dyes with specific absorption in the visible spectra serve as convenient model compounds. We provide a platform of smart adsorbers that efficiently remediate positively and negatively charged dyes (crystal violet and Amaranth) from water. Metal oxide nanoparticles serve as a core with an intrinsically large surface area. The surface potential was tuned towards positive or negative by decorating the cores with self‐assembled monolayers of dedicated long‐chained phosphonic acid derivatives. Selective remediation of the dyes was obtained with corresponding oppositely charged core‐shell nanoparticles. Mixed dye solution can be cleaned by a cascade approach or by applying both particle systems simultaneously. The removal efficiency was determined as a function of particle concentration via UV‐spectroscopy. The results of remediation experiments at different pH values and using superparamagnetic iron oxide nanoparticle cores lead to a simple process with recycling capability. [ABSTRACT FROM AUTHOR]

Background: Successful periodontal therapy can lead to poor esthetic results, especially in the anterior region, for which there are treatment options such as direct composite or indirect veneer restorations. Until now, there are no data describing the long‐term results of veneer restorations in periodontally treated patients. The aim of this retrospective study was to evaluate the outcome of anterior porcelain veneer restorations in periodontally compromised and noncompromised patients. Methods: Periodontally healthy and periodontally compromised patients, who had received anterior veneer restorations at least 5 years ago, were invited to a follow‐up examination. Groups were divided according to their periodontal diagnosis (periodontally healthy, stage I/II, stage III/IV). Tooth loss, veneer loss, biologic parameters, and complication rates were examined. Also, veneers were evaluated according to modified United States Public Health Service criteria. Results: A total of 68 patients with 312 veneers were examined with a mean follow‐up time of 8 years. Veneered teeth in patients with periodontitis stage III/IV showed no difference regarding tooth‐specific, overall, and functional veneer survival when compared to periodontally healthy patients (Kaplan–Meier analyses). In Cox regression analysis, follow‐up time had an impact on complications and veneer loss, whereas periodontal diagnosis showed no significant influence on the survival of restorations. Comparative tests showed that patients with severe periodontitis at baseline have slightly lower veneer survival rates after 8 years and slightly higher complication rates after 13 years. Conclusion: Long‐term results and complication rates of veneer restorations in periodontally compromised patients are comparable to periodontally healthy patients over a mean follow‐up of 8 years. [ABSTRACT FROM AUTHOR]

We conducted a multisite replication of Yang and Lyster's (2010) study investigating the effects of recasts and prompts on learning English regular and irregular past tense. Our study was conducted with intact high school and vocational school classes in Italy and Bosnia. Our participants were young adolescents (14–15 and 16–17 years old), a population that has been largely ignored in second language acquisition (SLA) research. We followed the design of the original study, but we also included a few modifications regarding the elicitation materials. The findings from our study did not fully align with Yang and Lyster's results. We found no effect of group and no evidence of the superiority of either prompts or recasts in either written or oral data in either Bosnia or Italy. However, we found a steady increase in scores over time from pretest to posttests in oral data in all groups at both sites. A one‐page Accessible Summary of this article in nontechnical language is freely available in the Supporting Information online and at https://oasis‐database.org [ABSTRACT FROM AUTHOR]

Beyond their CO2 emittance when burned as fuels, hydrocarbons (HCs) serve as omnipresent raw materials and commodities. No matter if as liquid oil spills or the endless amounts of plastic roaming the oceans, HCs behave as persistent pollutants with water as main carrier to distribute. Even if their general chemical structure [‐(CH2)n‐] is quite simple, the endless range of n leads to contaminations of different appearances and properties. A water remediation method based on superparamagnetic iron oxide nanoparticles (SPIONs) modified with self‐assembled monolayers of alkyl phosphonic acid derivatives is presented. These molecules enable the SPIONs to non‐covalently bind HCs, independently from the molecular weight, size and morphology. The attractive interaction is mainly based on hydrophobic and Coulomb interaction, which allows recycling of the SPIONs. The superparamagnetic core allows a simple magnetic collection and separation from the water phase which makes it a promising addition to wastewater treatment. Agglomerates of collected plastic "waste" even exhibit superior adsorption properties for crude oil, another hydrocarbon waste which gives these collected wastes a second life. This upcycling approach combined with presented recycling methods enables a complete recycling loop. [ABSTRACT FROM AUTHOR]

Background and Purpose: In multiple sclerosis (MS), brain atrophy measurements have emerged as an important biomarker reflecting neurodegeneration and disability progression. However, due to several potential confounders, investigation of brain atrophy in clinical routine and even in controlled clinical studies can be challenging. The aim of this study was to investigate the short‐term dynamics of brain atrophy development after initiation of disease‐modifying therapy (DMT) in a "real‐world setting." Methods: In this retrospective study, we included MS patients starting DMT (natalizumab, fingolimod, dimethyl fumarate, or interferon‐ß1a) or without DMT, availability of a baseline MRI, and two annual follow‐up scans on the same MRI system. Two‐timepoint percentage brain volume changes (PBVCs) were calculated. Results: Fifty‐five MS patients (12 patients starting DMT with natalizumab, 7 fingolimod, 14 dimethyl fumarate, 11 interferon‐ß1a, and 11 patients without DMT) were included. We found the highest PBVCs in the first 12 months after initiation of natalizumab treatment. Furthermore, the PBVCs in our study were very much comparable to the results observed by other groups, as well as for fingolimod, dimethyl fumarate, and interferon‐ß1a. Conclusion: We found PBVCs that are comparable to the results of previous studies, suggesting that brain atrophy, assessed on 3D MRI data sets acquired on the same 3T MRI, provides a robust MS biomarker. [ABSTRACT FROM AUTHOR]

The Waukesha Biota (Brandon Bridge Formation Lagerstätte) is a diverse assemblage of early Silurian (437 Ma) shallow marine fossils from Wisconsin, USA. Their exceptional preservation, in finely laminated dolomitic mudstones, was mediated by tidally‐influenced conditions and/or microbial entombment. Shelly biomineralized animals are rare, but soft‐bodied organisms are common. Arthropods dominate, including trilobites, phyllocarids, ostracodes, a thylacocephalan, a synziphosurine and various enigmatic groups. The fauna also includes evolutionary 'holdovers', such as palaeoscolecids and a lobopodian. [ABSTRACT FROM AUTHOR]

Background: Dysfunctional breathing (DB) is a common, but largely underappreciated, cause of chronic dyspnoea. Under visual inspection, most subjects with DB present with larger sequential changes in ventilation (V̇E) and breathing pattern (tidal volume (VT) and breathing frequency (f)) before and/or during incremental cardiopulmonary exercise testing (CPET). Currently, however, there are no objective criteria to indicate increased ventilatory variability in these subjects. Methods: Twenty chronically dyspnoeic subjects with DB and 10 age‐ and sex‐matched controls performed CPET on a cycle ergometer. Cut‐offs to indicate increased V̇E, VT, f, and f/VT ratio variability (Δ = highest‐lowest 20 s arithmetic mean) over the last resting minute (rest), the 2sd min of unloaded exercise (unload), and the 3rd min of loaded exercise (load) were established by ROC curve analyses. Results: Subjects with DB presented with increased V̇E, higher ventilatory variability, higher dyspnoea burden, and lower exercise capacity compared to controls (p < 0.05). ΔV̇Eload (>4.1 L/min), Δfrest (>5 breaths/min; bpm), Δfunload (>4 bpm), Δfload (>5 bpm), Δf/VTrest (>4.9 bpm/L), and Δf/VTload (>1.3 bpm/L) differentiated DB from a normal pattern (areas under the curve ranging from 0.729 to 0.845). High Δf, in particular, was associated with DB across all CPET phases. Conclusions: This study provides objective criteria to indicate increased ventilatory variability during incremental CPET in dyspnoeic subjects with DB. Large variability in breathing frequency seems particularly useful in this context, a finding that should be prospectively confirmed in larger studies. [ABSTRACT FROM AUTHOR]

Background: Little is known about safety and efficacy of the use of Impella 5.5 compared to previous iterations in the setting of Impella with Veno‐Arterial Extracorporeal Membrane Oxygenation Support as ECPELLA. Methods: Consecutive patients who were treated by ECPELLA with surgically implanted axillary Impella 5.5 (N = 13) were compared with patients supported by ECPELLA with percutaneous femoral Impella CP or 2.5 (Control, N = 13). Results: The total ECPELLA flow was higher in ECPELLA 5.5 group (6.9 vs. 5.4 L/min, p = 0.019). Actual hospital survival was higher than predicted and comparable in both groups (ECPELLA 5.5, 61.5% vs. Control, 53.8%, p = 0.691). Both total device complications (ECPELLA 5.5, 7.7% vs. Control, 46.1%, p = 0.021) and Impella‐specific complications (ECPELLA 5.5, 0% vs. Control, 30.8%, p = 0.012) were significantly lower in the ECPELLA 5.5 group. Conclusions: Utilization of Impella 5.5 in the setting of ECPELLA provides greater hemodynamic support with a lower risk of complications compared to Impella CP or 2.5. [ABSTRACT FROM AUTHOR]

Over the past decade, considerable progress has been made by higher education institutions (HEIs) to align with sustainable development goals. Specifically, aspects of sustainable development have been integrated into the existing mandates of HEIs – education, research and operations. The main objective of the current study was to assess a sub‐group of African HEIs that have an explicit mandate for implementation science and pursue development assistance‐type services and to describe their added value to advance sustainable development. We conducted a qualitative situational assessment, including 22 institutions from 13 countries. Interviews and surveys were done with 42 participants composed of director‐level representatives and staff members engaged both in research and implementation. The data were subjected to qualitative content analysis. The main strengths of the participating organisations vis‐à‐vis implementation projects and wider sustainable development were the quality of implementation, local relevance of the research and uptake of research evidence into policy and practice. A major weakness was the challenge of operating such a bi‐sectoral model, while maintaining high‐level performance in both areas. Yet, the examined research−implementation institutions draw from and combine the competences of research, education and implementation and have a distinctive role to play in the attainment of sustainable development, especially when operating by an optimised support system and within strong research ecosystems. Based on our study, we provide a definition of research−implementation organisations that may serve institutions to enhance their standing, their operations and their significance for sustainable development. [ABSTRACT FROM AUTHOR]

We developed an optimized shock absorber structure for foldable OLED displays using FEA (finite element analysis) which includes thin OCA and metal film with slits. Our AMOLED prototype passed a 200k times in‐fold bending test with 1.5mm bending radius and a ball drop test of 100g from the height of 60cm. [ABSTRACT FROM AUTHOR]

Background and Purpose: In multiple sclerosis (MS), iron rim lesions (IRLs) are characterized by pronounced tissue matrix damage. The T1/T2‐weighted (T1/T2w) ratio represents a postprocessing MRI approach to investigate tissue integrity, but studies investigating spinal cord pathology are missing until now. The aim of this study was to characterize tissue integrity using the T1/T2w ratio in lesions and the normal‐appearing white and gray matter (NAWM, NAGM) in the spinal cord and brain in MS patients with and without brain IRLs. Methods: Forty MS patients (20 patients with at least one brain IRL and 20 age‐ and sex‐matched patients without IRLs) were included. Normalized cross‐sectional area (nCSA) of the upper cervical cord was calculated in addition to T1/T2w values and standard brain and spinal cord MRI parameters. Results: Patients with IRLs had higher disability scores, a smaller nCSA, and a higher cervical T2 lesion volume. T1/T2w values of brain IRLs were significantly lower compared to non‐IRLs (p <.001). Furthermore, T1/T2w values of lesions were significantly lower compared to the NAGM and NAWM, both in the brain and the spinal cord (p <.05 for all comparisons). T1/T2w values of the NAGM and NAWM in the brain and spinal cord did not statistically differ between the IRL group and the non‐IRL group. Conclusion: IRLs constitute an imaging marker of disease severity. T1/T2w ratio maps represent an interesting technique to capture diffuse tissue properties. Calculation of T1/T2w ratio maps of the spinal cord might provide additional insights into the pathophysiological processes of MS. [ABSTRACT FROM AUTHOR]

Background: In heart transplantation (HT), peripheral veno‐arterial extracorporeal membranous oxygenation (VA‐ECMO) is utilized preoperatively as a direct bridge to HT or postoperatively for primary graft dysfunction (PGD). Little is known about wound complications of an arterial VA‐ECMO cannulation site which can be fatal. Methods: From 2009 to 2021, outcomes of 80 HT recipients who were supported with peripheral VA‐ECMO either preoperatively or postoperatively were compared based on the site of arterial cannulation: axillary (AX: N = 49) versus femoral artery (FA: N = 31). Results: Patients in the AX group were older (AX: 59 years vs. 52 years, p =.006), and less likely to have extracorporeal cardiopulmonary resuscitation (0% vs. 12.9%, p =.040). Survival to discharge (AX, 81.6% vs. FA. 90.3%, p =.460), incidence of stroke (10.2% vs. 6.5%, p =.863), VA‐ECMO cannulation‐related bleeding (6.1% vs. 12.9%, p =.522), and arm or limb ischemia (0% vs. 3.2%, p =.816) were comparable. ECMO cannulation‐related wound complications were lower in the AX group (AX, 4.1% vs. FA, 45.2%, p <.001) including the wound infections (2.0% vs. 32.3%, p <.001). In FA group, all organisms were gram‐negative species. In univariate logistic regression analysis, AX cannulation was associated with less ECMO cannulation‐related wound complications (Odds ratio,.23, p <.001). There was no difference between cutdown and percutaneous FA insertion regarding cannulation‐related complications. Conclusions: Given the lower rate of wound complications and comparable hospital outcomes with femoral cannulation, axillary VA‐ECMO may be an excellent option in HT candidates or recipients when possible [ABSTRACT FROM AUTHOR]

Influenza A viruses (IAV) circulate endemically among many wild aquatic bird populations that seasonally migrate between wintering grounds in southern latitudes to breeding ranges along the perimeter of the circumpolar arctic. Arctic and subarctic zones are hypothesized to serve as ecologic drivers of the intercontinental movement and reassortment of IAVs due to high densities of disparate populations of long distance migratory and native bird species present during breeding seasons. Iceland is a staging ground that connects the East Atlantic and North Atlantic American flyways, providing a unique study system for characterizing viral flow between eastern and western hemispheres. Using Bayesian phylodynamic analyses, we sought to evaluate the viral connectivity of Iceland to proximal regions and how inter‐species transmission and reassortment dynamics in this region influence the geographic spread of low and highly pathogenic IAVs. Findings demonstrate that IAV movement in the arctic and subarctic reflects wild bird migration around the perimeter of the circumpolar north, favouring short‐distance flights between proximal regions rather than long distance flights over the polar interior. Iceland connects virus movement between mainland Europe and North America, consistent with the westward migration of wild birds from mainland Europe to Northeastern Canada and Greenland. Though virus diffusion rates were similar among avian taxonomic groups in Iceland, gulls play an outsized role as sinks of IAVs from other avian hosts prior to onward migration. These data identify patterns of virus movement in northern latitudes and inform future surveillance strategies related to seasonal and emergent IAVs with potential public health concern. [ABSTRACT FROM AUTHOR]

Recent discoveries of trackways and trails on ancient tidal flats at Blackberry Hill, Wisconsin, USA, have transformed our understanding of the initial invasion of land, 500 Ma. Huge slug‐like molluscs grazed on microbial mats. Euthycarcinoid (stem myriapod) death traces (mortichnia) suggest that they did not come onto land to feed or breed, but simply to survive; Moon was closer to Earth then, and massive tides stranded animals in tidal pools that gradually dried up. [ABSTRACT FROM AUTHOR]

The formation of mixed shell‐by‐shell (SbS) systems with tunable shell compositions is demonstrated by using molecular self‐assembly driven by chemical recognition motifs. Aluminum oxide nanoparticles (AlOx‐NPs) act as template surface for a self‐assembled monolayer (SAM) of either partially fluorinated fluoroalkyl or alkyl chained phosphonic acid derivatives or defined stoichiometric mixtures of those. By providing an equimolar mixture of corresponding fluoroalkyl and alkyl‐chained amphiphiles in water, the stoichiometry of underlaying mixed SAM on the NP‐surface preferentially directs the composition of the secondary self‐assembly. The composition of the shell‐by‐shell assemblies is studied by high performance liquid chromatography and fluorescence spectroscopy. The concept allows the formation of NP‐templated vesicle‐like bilayer structures, even consisting of orthogonal chain structures in tunable composition driven by chemical recognition and hydrophobic segregation. [ABSTRACT FROM AUTHOR]

Photoelectrons are crucial to atmospheric physics. They heat the atmosphere, strengthen planetary ambipolar electric fields, and enhance the outflow of ions to space. However, there exist only a handful of measurements of their energy spectrum near the peak of photoproduction. We present calibrated energy spectra of pristine photoelectrons at their source by a prototype Dual Electrostatic Analyzer (DESA) instrument flown on 11 July 2021 aboard the Dynamo‐2 sounding rocket (NASA № 36.357). Photopeaks arising from 30.4 nm He‐II spectral line were observed throughout the flight above 120 km. DESA also successfully resolved the rarely observed N2 absorption feature. Below 10 eV observations were in good agreement with the GLOW suprathermal electron. Above 10 eV fluxes substantially deviated from the model by as much as an order of magnitude. Plain Language Summary: We designed, built, and flew a new scientific instrument for the measurement of photoelectrons which are created when sunlight shines on the upper atmosphere. The instrument was launched on a suborbital rocket from NASA Wallops Flight Facility just before 2 p.m. on 11 July 2021. The rocket flew to an altitude of 131 km before splashing down in the Atlantic Ocean 8 min later. The instrument gathered scientific data during the flight, measuring the energy spectrum of electrons in Earth's ionosphere. Historical observations of electron spectra at these altitudes are extremely rare, and are often uncalibrated and/or not archived. We present calibrated observations of the pristine spectra of Earth's electrons near their source as a reference for future computer modeling and exploration of Earth's ionosphere. Key Points: We present in situ observations from a plasma spectrometer flown on a rocket to 131 km in the daytime mid‐latitude ionosphereThe instrument returned calibrated measurements of the energy spectra of pristine photoelectrons near the peak of productionThe N2 absorption feature and He‐II photopeaks were partially resolved. Observations are compared with the GLOW electron model [ABSTRACT FROM AUTHOR]

Background: In children, invasive electrophysiological studies (EPS) and radiofrequency catheter ablations (RFA) of supraventricular tachycardia (SVT) are often performed under general anesthesia. Atrioventricular nodal reentrant tachycardia (AVNRT) and ectopic atrial tachycardia (EAT) must be inducible during EPS as reliable diagnosis and subsequent therapy are not possible in sinus rhythm. This study aims to assess the problem of noninducible AVNRT and EAT under general anesthesia. Methods and results: Anesthesia protocols of 166 patients undergoing EPS were retrospectively analyzed. 122 AVNRT patients were compared to 22 whose tachycardia was not inducible but probably due to an AVNRT mechanism. Another 16 patients with inducible EAT were compared to 6 whose EAT appeared on surface ECG but not during EPS. Demographic characteristics were similar among all groups. Inducibility did not differ (p =.42) between AVNRT patients with inhalational anesthesia (sevoflurane and/or nitrous oxide) and patients with intravenous anesthesia (propofol with/without remifentanil). The EAT group exhibited lower inducibility under intravenous anesthesia (64%) than under inhalational (88%), however without significance (p =.35). Conclusion: Tachycardia induction succeeds with similar frequency under both inhalational and intravenous general anesthesia in children with AVNRT. In children with EAT, inhalational anesthesia is associated with a trend towards better inducibility. [ABSTRACT FROM AUTHOR]

Optimal flow balance between Impella 5.5 and veno‐arterial extracorporeal membrane oxygenation (ECMO) support in the setting of EC‐PELLA (ECMO+Impella) is unknown. Outcomes of high Impella 5.5 flow in the setting of EC‐PELLA support were reviewed (N = 7). EC‐PELLA was successfully explanted in 6 patients (bridge‐to‐transplant, N = 1; bridge‐to‐recovery, N = 5). The median duration of EC‐PELLA support in explanted patients was 6 days. Survival at discharge was 71.4% (5 patients). In terms of device‐related events, either VA‐ECMO or Impella‐related complications were not experienced. The median performance level of Impella 5.5 was P5 at the time of starting EC‐PELLA support and then increased with time up to the median of P8 with increment of the Impella flow, and index (L/min/m2). The percentage of Impella flow per total EC‐ PELLA flow reached 50% after 48 h of support. The vasoactive‐inotropic score and serum lactate level improved after institution of EC‐PELLA support as well as the pulmonary artery pressures and central venous pressure. In conclusion, a high pump flow from Impella 5.5 with partial VA‐ECMO support in the setting of EC‐PELLA provided great support with favorable survival and device‐related complications rate. [ABSTRACT FROM AUTHOR]

Background: Rett syndrome (RTT) is a rare neurodevelopmental disorder associated with pathogenic MECP2 variants. Because the MECP2 gene is subject to X‐chromosome inactivation (XCI), factors including MECP2 genotypic variation, tissue differences in XCI, and skewing of XCI all likely contribute to the clinical severity of individuals with RTT. Methods: We analyzed the XCI patterns from blood samples of 320 individuals and their mothers. It includes individuals with RTT (n = 287) and other syndromes sharing overlapping phenotypes with RTT (such as CDKL5 Deficiency Disorder [CDD, n = 16]). XCI status in each proband/mother duo and the parental origin of the preferentially inactivated X chromosome were analyzed. Results: The average XCI ratio in probands was slightly increased compared to their unaffected mothers (73% vs. 69%, p =.0006). Among the duos with informative XCI data, the majority of individuals with classic RTT had their paternal allele preferentially inactivated (n = 180/220, 82%). In sharp contrast, individuals with CDD had their maternal allele preferentially inactivated (n = 10/12, 83%). Our data indicate a weak positive correlation between XCI skewing ratio and clinical severity scale (CSS) scores in classic RTT patients with maternal allele preferentially inactivated XCI (rs = 0.35, n = 40), but not in those with paternal allele preferentially inactivated XCI (rs = −0.06, n = 180). The most frequent MECP2 pathogenic variants were enriched in individuals with highly/moderately skewed XCI patterns, suggesting an association with higher levels of XCI skewing. Conclusion: These results extend our understanding of the pathogenesis of RTT and other syndromes with overlapping clinical features by providing insight into the both XCI and the preferential XCI of parental alleles. [ABSTRACT FROM AUTHOR]

Background and Purpose: Transient global amnesia (TGA) is a rare neurological disorder causing a transient disturbance of episodic long‐term memory. Its etiology remains yet to be identified; the only consistently reported findings in patients with TGA are small hyperintense lesions in the hippocampus on diffusion‐weighted magnetic resonance imaging (DWI). The aim of this study was to define whether these lesions are subfield specific, as suggested previously. Methods: High‐resolution multiplanar reformation T1 and DWI of the hippocampus were acquired in 25 patients after TGA with a total of 43 hippocampal lesions. Hippocampal subfields were determined using the FreeSurfer software and the location of the DWI lesions was transformed to the T1 images after data co‐registration. Additionally, hippocampal subfield volumes in each patient were calculated and compared with that of 20 healthy controls. Results: Hippocampal lesions were most frequently detected in the cornu ammonis area 1 (CA1) subfield (30.2%), the hippocampal tail (28.0%), and the subiculum (21.0%); however, lesions were also found in other subfields. There was no significant difference between patients and controls concerning the volumes of the hippocampal subfields. Conclusions: Contrasting previous assumptions, we found DWI hyperintense lesions not to be restricted to the CA1 subfield. The visualization of focal hippocampal lesions on diffusion imaging located to several different hippocampal subfields suggests a potential pathophysiology of TGA independent of microstructural hippocampal anatomy and subfield‐specific vulnerability. [ABSTRACT FROM AUTHOR]

Purpose: The current standard in reconstructing defects of the orbital floor, by using the concept of mirroring, is time‐consuming and ignores the natural asymmetry of the skull. By using a statistical shape model (SSM), the reconstruction can be automatized and improved in accuracy. The present study aims to show the possibilities of the virtual reconstruction of artificial defects of the orbital floor using an SSM and its potentials for clinical implementation. Methods: Based on 131 unaffected CT scans of the midface, an SSM was created which contained the shape variability of the orbital floor. Nineteen midface CT scans, that were not included in the SSM, were manually segmented to establish ground truth (control group). Then artificial defects of larger and smaller sizes were created and reconstructed using SSM (Group I) and the gold standard of mirroring (Group II). Eventually, a comparison to the surface of the manual segmentation (control group) was performed. Results: The proposed method of reconstruction using an SSM leads to more precise reconstruction results, compared with the conventional method of mirroring. Whereas mirroring led to the reconstruction errors of 0.7 mm for small defects and 0.73 mm for large defects, reconstruction using SSM led to deviations of 0.26 mm (small defect) and, respectively, 0.34 mm (large defect). Conclusions: The presented approach is an effective and accurate method for reconstructing the orbital floor. In connection with modern computer‐aided design and manufacturing, individual patient‐specific implants could be produced according to SSM‐based reconstructions and could replace current methods using manual bending techniques. By acknowledging the natural asymmetry of the human skull, the SSM‐based approach achieves higher accuracy in reconstructing injured orbits. [ABSTRACT FROM AUTHOR]

The mechanical behavior of low (and negative) thermal expansion and low stiffness Al2TiO5 materials and Al2TiO5-3Al2O3.2SiO2-ZrTiO4 composite materials was studied by diametral compression test at room temperature 400 and 800°C. The effect of both temperature and composition was analyzed. Stressstrain curves were obtained and, from them, apparent elastic modulus (Eapp) and mechanical strength (σF) were determined. Fracture mechanisms and fracture patterns were also analyzed. All materials showed a brittle behavior up to 800°C. The thermal variation of σF, that was even higher as testing temperature increased, was interpreted based on the microcracks behavior. A double linear correlation of Eapp was found with temperature (T) and zircon content ([Z]), with a fitting coefficient > .9. The particular low stiffness and the mechanical and thermal behavior of the studied materials suggest that they would be able to withstand thermal stresses. [ABSTRACT FROM AUTHOR]

Epidermal choristoma is a rare, congenital lesion in which islands of ectopic skin are found within the oral cavity. They present as pigmented macules or papules on the tongue. Histologic appearances are characteristic and benign. We present three cases review the current literature and recommend observation of the lesion rather than complete excision should be considered as a reasonable management option. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion The Organ Care System (OCS) (Transmedics, Andover, MA) reduces cold ischemic time of donor hearts by producing a normothermic beating state during ex vivo perfusion, enabling extended ex situ intervals, which potentially increases donor pool. We aimed to compare outcomes in utilization of OCS and conventional cold storage technique.Consecutive heart transplants following brain death at our institution between May 2022 and July 2023 were analyzed. Recipients were divided into those receiving hearts preserved with OCS [N = 15] and those with conventional cold storage (Control, N = 27), with OCS utilization when anticipated ischemic time was more than 4 h. Pre‐transplant characteristics and transplant outcomes were compared.OCS utilization allowed a significant increase in distance traveled for heart retrieval (OCS, 624 ± 269 vs. Control, 153 ± 128 miles, p < 0.001), with longer mean total preservation times (6.2 ± 1.1 vs 2.6 ± 0.6 h, p < 0.001). All but one patient displayed a general decrease or plateau in lactate throughout perfusion time by OCS. Both groups experienced similar rates of severe primary graft dysfunction (OCS, 6.7% [N = 1] vs. Control, 11.1% [N = 3], p = 0.63), with 100% in‐hospital survival in the OCS group compared to 96.3% in the Control group (p = 0.34). Kaplan–Meier survival analysis showed that estimated one‐year survival were comparable (OCS, 93.3 ± 6.4% vs. Control, 88.9 ± 6.0%, p = 0.61).With a mean preservation time of around 6 h and distance covered of over 600 miles, our results using OCS indicate a potential to safely increase the quantity and viability of accessible organs, thus broadening the donor pool without negatively affecting outcomes. [ABSTRACT FROM AUTHOR]