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Aim: The diagnosis of hypertrophic cardiomyopathy (HCM) with moderate hypertrophy is challenging. Hypertensive heart disease (HHD) is the most common differential diagnosis that mimics the LVH of HCM. The aim of this study was to compare the QRS duration in HCM and HHD to create a novel diagnostic tool to identify primary HCM. Methods and results: We conducted an international retrospective multicentre study enrolling patients with true HCM and HHD. A total of 547 individuals with HCM and 139 with HHD were included. The median QRS duration was significantly shorter in HCM than in HHD (88 ms [80–94] vs. 98 ms [88–108]; P < 0.01). Multivariable logistic regression identified for the novel diagnostic HCM (D‐HCM) score: absence of antihypertensive drugs (+2); family history of unexplained sudden death (+2); QRS duration [<95 ms] = +1; maximum wall thickness (mm) [≥17] = +1. A cumulative QRS‐HCM score ≥2 supports the diagnostic certainty of true HCM with a sensitivity of 79%, specificity of 99%, negative predictive value (NPV) of 55%, and positive predictive value (PPV) of 99%. Conclusion: The QRS duration in patient with HCM is significantly shorter compared with patients with HHD‐related LVH. QRS duration can be used as a diagnosis marker to distinguish between HCM and HHD. The D‐HCM score is a novel, simple, and accurate diagnosis tool for HCM patients with mild to moderate phenotypes. [ABSTRACT FROM AUTHOR]

Background: Skin biorevitalization involves multiple intradermal injections to enhance skin quality, but precise dermal targeting can be challenging due to variations in skin thickness smaller, less painful needles with fewer skin reactions are attractive options. Aims: This study evaluates a new Micro‐Needle device's performance and safety in comparison with the classic needle used in skin biorevitalization. Patients/Methods: Subjects with facial and neck skin aging were enrolled. Safety outcomes, including immediate and local tolerability, were assessed. Performance outcomes measured skin radiance, wrinkles and photoaging grade, hydration, subepidermal low echogenic band, dermis thickness, and skin elasticity. Both subjects and investigators recorded Global Aesthetic Improvement Scale scores. Results: Micro‐Needle injections demonstrated superior performance compared to the classic needle, influenced by the specific skin zones and thickness. Micro‐Needle was superior for skin wrinkles at D49 for periorbital zone and nasolabial folds by −14.5% (p = 0.01) and −15% (p = 0.004), respectively, and for neck by 9.6% (p = 0.0008). The Nanosoft device showed a faster improvement for skin hydration at D42 for the cheek zone (p = 0.04) and at D75 for the neck area (p = 0.01); and for skin radiance at D75 (p = 0.03) and at D120 (p = 0.0098). Ex vivo studies confirmed the Micro‐Needle's accuracy in product placement in the dermis. Adverse events were milder with Micro‐Needle and no serious adverse events occurred. Conclusions: Both needles significantly improved skin quality, but Micro‐Needle enhanced the outcomes of skin biorevitalization procedures, particularly in terms of skin wrinkle reduction, elasticity, and overall skin hydration. [ABSTRACT FROM AUTHOR]

A 40‐year‐old man, newly diagnosed with cardiac sarcoidosis (CS) presented with symptomatic ventricular tachycardia three days after starting steroid‐based immunosuppressive therapy (IT). There was no clear guideline indication for implantable cardioverter‐defibrillator (ICD) before the initiation of IT. Shortly after ICD implantation and the initiation of anti‐arrhythmic drugs, recurring ventricular arrhythmias required titration of the anti‐arrhythmic drug therapy. One‐year follow‐up assessment showed no significant arrhythmias and complete PET scan FDG uptake suppression. This case, along with recent publications, suggests transient pro‐arrhythmic effects of steroids in patients with CS, which are not appropriately addressed in the current guidelines. We believe ICD implantation should be considered in clinically manifest CS before initiating IT, particularly in cases with heterogeneous and/or extensive FDG uptake on PET scans. [ABSTRACT FROM AUTHOR]

Three‐hourly data from two satellite rainfall estimates products, PERSIANN and TMPA, are analysed to document the seasonal patterns of diurnal rainfall distribution over the Congo Basin and neighbouring areas. PERSIANN data for 2001–2017, at a one‐hour time‐scale, are further used to identify rain cells (≥4 mm·h−1) in an attempt to explain the diurnal rainfall variations. Over land areas, an afternoon rainfall maximum is clearly shown, but over much of the region only a minor part of the rains (20%–30%) falls in the wettest 3‐h period. Substantial rains (often 50%–60%) occur in the evening and at night, as a progressively delayed peak from east to west, but a seasonal change is found in the meridional propagation of the peak diurnal rainfall, in a south‐westerly direction in January, and a north‐westerly direction in July. Rain cells have prominent genesis areas west of high terrain, but can develop over most regions, with a peak genesis time slightly ahead the diurnal phase of the rains. The size, mean lifetime and mean rainfall intensity of the rain cells are strongly related to each other and display a semi‐annual cycle not fully in phase with the seasonal cycle of the rains. The mean rain cell propagation speed (6.7 m·s−1) is much lower than in previous studies, which focused on mesoscale convective systems. Rain cells which have a longer lifetime move much faster, the mean speed of those lasting less than 6 h being half that of those lasting at least 24 h. Most (86%) of the mobile rain cells propagate westward, but the meridional component of their propagation shows an annual cycle (southward in austral summer, northward in boreal summer) which matches the mid‐tropospheric winds and explains the seasonal changes in the diurnal rainfall peak. [ABSTRACT FROM AUTHOR]

Chronic conditions associated with aging have proven difficult to prevent or treat. Senescence is a cell fate defined by loss of proliferative capacity and the development of a pro‐inflammatory senescence‐associated secretory phenotype comprised of cytokines/chemokines, proteases, and other factors that promotes age‐related diseases. Specifically, an increase in senescent peripheral blood mononuclear cells (PBMCs), including T cells, is associated with conditions like frailty, rheumatoid arthritis, and bone loss. However, it is unknown if the percentage of senescent PBMCs associated with age‐associated orthopedic decline could be used for potential diagnostic or prognostic use in orthopedics. Here, we report senescent cell detection using the fluorescent compound C12FDG to quantify PBMCs senescence across a large cohort of healthy and osteoarthritic patients. There is an increase in the percent of circulating C12FDG+ PBMCs that is commensurate with increases in age and senescence‐related serum biomarkers. Interestingly, C12FDG+ PBMCs and T cells also were found to be elevated in patients with mild to moderate osteoarthritis, a progressive joint disease that is strongly associated with inflammation. The percent of C12FDG+ PBMCs and age‐related serum biomarkers were decreased in a small subgroup of study participants taking the senolytic drug fisetin. These results demonstrate quantifiable measurements in a large group of participants that could create a composite score of healthy aging sensitive enough to detect changes following senolytic therapy and may predict age‐related orthopedic decline. Detection of peripheral senescence in PBMCs and subsets using C12FDG may be clinically useful for quantifying cellular senescence and determining how and if it plays a pathological role in osteoarthritic progression. [ABSTRACT FROM AUTHOR]

In this study, a reversible pressure‐sensing material with high sensitivity is presented. Mixed β‐diketonate complexes of Tb3+ and Eu3+ [(Ln)(acac)3phen] are synthesized with phenanthroline as an ancillary ligand. The organic ligands provide the antenna effect to make the Ln3+ complex excitable at 405 nm. Eu3+ emission results from efficient energy transfer (ET) from Tb3+. Under 405 nm excitation, the emission intensity of Tb3+ decreases whereas the emission intensity of Eu3+ increases with pressure, making this complex a potential pressure sensor based on luminescent‐intensity‐ratio (LIR) up to 700 MPa. This study then discusses the application of this Tb3+/Eu3+ complex for pressure sensing depending on measurement conditions. The addition of the optically neutral ion Y3+ to the system can reduce the impact of pressure‐induced structural defects on the emission, thus improving the reversibility of the LIR variation as a function of pressure. Therefore, a self‐calibrating, reliable, and reversible pressure‐sensing material is proposed here, with remarkable pressure sensitivity compared to a peak shift‐based pressure sensor. [ABSTRACT FROM AUTHOR]

This study examines the diurnal to interannual variations of the stratiform cloud cover in May–October (1971–2019) from a 3‐hourly station database and from ERA5 reanalyses over western equatorial Africa (WEA). The main diurnal variations of the local‐scale fraction and genus of stratiform clouds are synthesized into three canonical diurnal types (i.e., "clear," "clear afternoon," "cloudy" days). The interannual variations of frequencies of the three diurnal types during the cloudiest months (JJAS) are mostly associated with two main mechanisms: a meridional shallow overturning cell associating more "cloudy" and less "clear" and "clear afternoon" days to anomalous southerlies below 900 hPa over and around WEA, anomalous ascent around 5°–7°N, anomalous northerlies between 875 and 700 hPa, and anomalous subsidence over the equatorial Atlantic. This circulation is strongly related to interannual variations of the equatorial Atlantic upwelling (i.e., more clouds when the upwelling is strong) associated with a meridional shift of the Intertropical Convergence Zone over the Tropical Atlantic and adjacent continents. The second mechanism operates mostly in the zonal direction and involves again the coupled ocean–atmosphere system over the equatorial Atlantic, but also the remote El Niño–Southern Oscillation (ENSO). An anomalously cold equatorial Atlantic drives increased low‐level westerlies toward the Congo Basin. Warm ENSO events promote broad warm and easterly anomalies in the middle and upper troposphere, which increase the local static stability, and thus the local stratiform cloud cover over WEA. The present study suggests new mechanisms responsible for interannual variations of stratiform clouds in WEA, thus providing avenues of future research regarding the stability of the stratiform cloud deck under the ongoing differential warming of tropical ocean and land masses. [ABSTRACT FROM AUTHOR]

Background: In patients with refractory atrial fibrillation (AF), atrioventricular nodal (AVN) ablation and permanent pacemaker implantation is recommended. The Micra Transcatheter Pacing System (Micra) is a single chamber leadless pacemaker (LPM) and thus offers the possibility of AV node (AVN) ablation in the same procedure. Pacing threshold (PT) elevation after radiofrequency (RF) ablation is a potential complication. Methods: We conducted a single center retrospective cohort study. Patients implanted with a Micra (n = 84) and concomitant or delayed AVN ablation (n = 12) from 2014 to 2022 were included. Two cases of acute Micra PT elevation immediately following RF AVN ablation required device retrieval and implantation of a new Micra. Procedural characteristics and electrophysiological parameters were analyzed, and a computer model was performed to determine factors responsible for acute PT elevations. Results: A total of 84 patients were included. Mean age was 74 ± 10 and 48% were women. Twelve patients (14%) underwent AVN ablation. Two patients had acute PT elevation requiring device retrieval despite no direct contact of the ablation catheter with the Micra. Computer modeling shows that significant dissipated power due to electrical field coupling can occur at the tip or ring electrode if the catheter is not kept at a safe distance (≥35 mm) from the Micra when a maximum power of 100 W is delivered. Conclusion: Concurrent AVN ablation and Micra implantation is safe in most patients. To prevent acute PT elevation, keeping a safe distance of ≥35 mm from the tip and ring electrodes of the Micra and using lower power output may prevent this complication. [ABSTRACT FROM AUTHOR]

Objective: To explore barriers to care continuity among formerly incarcerated persons with HIV and/or hepatitis C. Data Sources and Study Setting: We draw on data from semi‐structured interviews conducted in 2018–2019 with 30 formerly incarcerated persons and 10 care providers. Data were collected across two clinics in Baltimore, Maryland, and Washington, D.C. Study Design: We recruited participants using a combination of nonprobability sampling techniques. Participants completed closed‐ended questionnaires and took part in semi‐structured interviews related to treatment barriers and incentives. Data Collection/Extraction Methods: Interviews were transcribed using Express Scribe software and transcriptions were open coded using NVivo 12 software. An iterative process was used to relate and build upon emergent themes in interviews. Principal Findings: Our study illuminates both internal and external barriers to care continuity. The most common external barriers were system navigation and housing instability. Internal barriers consisted of overlapping issues related to mental health, substance use, and feelings of shame and/or denial. Conclusion: An overarching theme is that formerly incarcerated persons with HIV and/or HCV are grappling with numerous challenges that can threaten their health and health care. These barriers are cumulative, intersecting, and reciprocal. [ABSTRACT FROM AUTHOR]

Symptomatic thrombus formation due to a permanent pacemaker (PM) lead is a rare complication. It could be associated with serious outcome and should be suspected in patients who present with unexplained right heart failure, dyspnea, or syncope following dual‐chamber PM implantation. A timely decision to perform an echocardiographic examination, followed by medical, thrombolytic, or surgical treatment can be necessary. We describe the case of an 84‐year‐old man who presented with syncope and hypotension a few days after PM implantation. A transesophageal echocardiography revealed a mobile mass in the right atrium attached to the pacemaker lead. Intravenous heparin allowed a complete resolution of the thrombus. [ABSTRACT FROM AUTHOR]

Relative Caribbean‐North American plate motion is partitioned over the trench and intra‐Caribbean plate faults that bound large scale tectonic blocks. Quantifying the kinematic evolution of this tectonic corridor is challenging because much of the region is submarine. We present an extensive regional paleomagnetic data set (1,330 cores from 136 sampling locations) from Eocene and younger rocks of the northern Lesser Antilles, the Virgin Islands, and Puerto Rico, and use a statistical bootstrapping approach to quantify vertical axis block rotations. Our results show that the Puerto Rico–Virgin Island (PRVI) block and the Northern Lesser Antilles (NoLA) block formed two coherently rotating domains that both underwent at least 45° counterclockwise rotation since the Eocene. The first ∼20° occurred in tandem in late Eocene and Oligocene time, after which the blocks were separated in the Miocene by the opening of the Anegada Passage. The last 25° of rotation of the PRVI block ended in the middle Miocene, whereas the NoLA block rotated slower, until the latest Miocene. The boundary between the NoLA block and a non‐rotated Southern Lesser Antilles was likely the Monserrat‐Harvers fault zone. These results require hundreds of kilometers of intra‐Caribbean motions with oroclinal bending of the trench or forearc sliver motion along the curved plate boundary as endmembers. These data invite a critical re‐evaluation of the kinematic reconstruction of Caribbean‐North American plate motion. The consequent changes in paleogeography may provide a new view on the enigmatic eastern Caribbean paleo‐biogeography and the Paleogene dispersal of South American mammals toward the Greater Antilles. Key Points: Since the late Eocene the Puerto Rico‐Northern Lesser Antilles block underwent ≃45° of counterclockwise rotationDuring the Miocene the opening of the Anegada Passage split this block in two and accommodated part of their differential rotation rateOur results imply intraplate motion of a forearc sliver over 500 km with profound effects on Paleogene Caribbean paleogeography [ABSTRACT FROM AUTHOR]

Background: Toxic dilated cardiomyopathy (T‐DCM) due to substance abuse is now recognized as a potential cause of severe left ventricular dysfunction. The burden of ventricular arrhythmias (VA) and the role of a prophylactic implantable cardioverter‐defibrillator (ICD) are not well documented in this population. We aim to assess the usefulness of ICD implantation in a T‐DCM cohort. Methods: Patients younger than 65 years with a left ventricular ejection fraction (LVEF) < 35% followed at a tertiary center heart failure (HF) clinic between January 2003 and August 2019 were screened for inclusion. The diagnosis of T‐DCM was confirmed after excluding other etiologies, and substance abuse was established according to the DSM‐5 criteria. The composite primary endpoints were arrhythmic syncope, sudden cardiac death (SCD), or death of unknown cause. The secondary endpoints were the occurrence of sustained VA and/or appropriate therapies in ICD carriers. Results: Thirty‐eight patients were identified, and an ICD was implanted in 19 (50%) of these patients, only one for secondary prevention. The primary outcome was similar between the two groups (ICD vs. non‐ICD; p = 1.00). After a mean follow‐up of 33 ± 36 months, only two VA episodes were reported in the ICD group. Three patients received inappropriate ICD therapies. One ICD implantation was complicated with cardiac tamponade. Twenty‐three patients (61%) had an LVEF ≥35% at 12 months. Conclusion: VA are infrequent in the T‐DCM population. The prophylactic ICD benefit was not observed in our cohort. The ideal timing for potential prophylactic ICD implantation in this population needs further studies. [ABSTRACT FROM AUTHOR]

Introduction: Superior vena cava (SVC) tear is the most lethal complication during transvenous lead extraction (TLE) with a mortality rate as high as 50%. Treatment involves aggressive attempts to maintain cardiac output and immediate sternotomy to localize and repair the vascular tear. Occlusion balloons have been developed to provisionally occlude the lacerated SVC and to provide hemodynamic stability allowing time for surgery. In case of mediastinal hematoma without hemodynamic instability, the strategy remains unclear. Methods and Results: We describe two cases of SVC tear during TLE. The first case was a 60‐year‐old man who presented with a right ventricular single‐chamber defibrillator lead fracture and innominate vein stenosis. The RV lead was removed using a laser sheath causing a mediastinal hematoma with no active bleeding during surgical exploration few hours later. The second case was a 28‐year‐old man that presented with a right atrial (RA) lead fracture and RV lead insulation failure in a dual‐chamber defibrillator (ICD). Conclusion: Both the RA and RV leads were removed with mechanical sheaths, and a mediastinal hematoma was medically managed. [ABSTRACT FROM AUTHOR]

Variants of filamin C (FLNC) have been identified as rare genetic substrate for hypertrophic cardiomyopathy (HCM). Data on the clinical course of FLNC‐related HCM are conflicting with some studies suggesting mild phenotypes whereas other studies have reported more severe outcomes. In this study, we present a novel FLNC variant (Ile1937Asn) that was identified in a large family of French‐Canadian descent with excellent segregation data. FLNC‐Ile1937Asn is a novel missense variant characterized by full penetrance and poor clinical outcomes. End stage heart failure requiring transplantation occurred in 43% and sudden cardiac death in 29% of affected family members. Other particular features of FLNC‐Ile1937Asn include an early disease onset (mean age of 19 years) and the development of a marked atrial myopathy (severe biatrial dilatation with remodeling and multiple complex atrial arrhythmias) that was present in all gene carriers. The FLNC‐Ile1937Asn variant is a novel, pathogenic mutation resulting in a severe form of HCM with full disease penetrance. The variant is associated with a high proportion of end‐stage heart failure, heart transplantation, and disease‐related mortality. Close follow‐up and appropriate risk stratification of affected individuals at specialized heart centers is recommended. [ABSTRACT FROM AUTHOR]

Background: Atrial fibrillation (AF) is common in patients with reduced left ventricle ejection fraction (RLVEF). The impact of concomitant surgical atrial fibrillation ablation (SAFA) in patients with RLVEF is uncertain. The purpose of this study was to assess the outcomes of concomitant SAFA in patients with RLVEF undergoing heart surgery on heart failure (HF) rehospitalization and mortality.Methods: Using a local registry and electronic health records linked with provincial civil register survival data from July 2002 to April 2019, we analyzed treatment and outcomes in a cohort of patients with AF and HF defined by left ventricle ejection fraction (LVEF) ≤40%. Health records were used to collect treatment and International Classification of Diseases (ICD 10) codes to determine outcomes. A negative binomial model was used to compare outcomes such as all-cause mortality and rehospitalization for heart failure.Results: The cohort included 682 patients with RLVEF and AF who underwent coronary artery bypass graft and/or valve surgery. A total of 196 patients (29%) underwent concomitant SAFA. After matching, 132 patients with concomitant SAFA were compared to 159 patients who did not undergo concomitant SAFA. At 6.0 ± 3.7 years of follow-up, concomitant SAFA was not associated with lower all-cause mortality (p = .9861) and reduction in rehospitalizations for heart failure decompensation (p = .31) compared to patients who did not have concomitant SAFA performed. Postoperatively, concomitant SAFA might be associated with less vasopressor and mechanical support use (p = .01).Conclusions: Concomitant SAFA during index cardiac surgery is safe but does not reduce mortality or rehospitalizations for HF. The effects of concomitant SAFA in the context of RLVEF need to be better studied with prospective trials. [ABSTRACT FROM AUTHOR]

This study presents an extensive geochemical data set of 23 samples from St. Barthélemy Island, which belongs to the extinct branch of the Lesser Antilles arc and is currently exposed in the northern part of the subduction forearc. Samples were selected to represent all lithologies and main periods of magmatism, that is, Middle‐Late Eocene, Early Oligocene and Late Oligocene. They show enrichment in light rare earth element/medium rare earth element, large ion lithophile elements (Rb and Ba) and isotopic characteristics, suggesting mixing between the mantle and a subduction component (oceanic crust + sediments). Trace element ratios suggest that primary magmas were generated in a normal mid‐oceanic ridge basalt‐type mantle‐wedge that underwent 8%–18% partial melting in the spinel‐stability field. The sediment contribution was low (0.1%–1%) irrespective of the age of the samples. This is similar to what is observed for the northern Lesser Antilles active branch. St. Barthélemy Island shares strong similarities with St. Martin Island, located on the same extinct arc branch, which suggests a similar geodynamic evolution. Oligocene samples displayed an increase in incompatible elements in the magma source, suggesting an increase in sediment melts, which could be correlated with a drastic change in the tectonic regime at that time, characterized by stretching perpendicular to the trench and subsequent basin opening. On Δ7/4Pb versus 206Pb/204Pb, the samples showed a similar trend for both active and extinct islands of the northern Lesser Antilles, suggesting negligible changes in the nature of the magma sources. Plain Language Summary: Subduction zones, and subduction‐related processes, are responsible for the recycling of oceanic crust and sediments deep down into the mantle, the formation of continental crust and ultimately have a profound influence on both climate and tectonics. Present‐day arcs formed above subduction zones are exceptional natural laboratories for studying arc‐related processes and testing models depicting the Earth's evolution through times. To understand subduction‐related processes, we collected 23 volcanic samples from St. Barthélemy Island (Lesser Antilles Arc, West French Indies) spanning from Eocene to late Oligocene. Geochemical analyzes (major and trace elements and Pb, Sr, Nd, Hf isotopes) can be used to constrain magma genesis at depth, the interactions between the various components involved and their variability over time. Analyzes show that the magmas were formed by 8%–18% partial melting of the mantle wedge with 0.1%–1% of sediment contribution. However, the Oligocene samples are characterized by increased sediment melting in the magma source, which we relate to a change in the tectonic regime and stretching perpendicular to the arc trench. A comparison with lavas from the Greater Antilles arc (Cuba) indicates sources and processes close to those active in the Lesser Antilles. Key Points: Saint Barthélemy volcanics were formed by 8%–18% partial melting of an N‐MORB type mantle mixed with less than 1% of sediment meltsGeochemical variation during the Early Oligocene is related to a sediment melt increase linked to a drastic change in the tectonic regimeThe extinct and active branches of the northern segment of the Lesser Antilles Arc display similar geochemical characteristics [ABSTRACT FROM AUTHOR]

We evaluate and partially challenge the household leverage view of the Great Recession. In the data, employment and consumption declined more in U.S. states where household debt declined more. We study a model of a monetary union composed of many regions in which liquidity constraints shape the response of employment and consumption to changes in debt. We estimate the model with Bayesian methods combining state and aggregate data. Changes in household credit explain 40% of the differential rise and fall of employment across states, but a small fraction of the aggregate employment decline in 2007–2010. Nevertheless, since household deleveraging was gradual, credit shocks greatly slowed the recovery. [ABSTRACT FROM AUTHOR]

Transvenous lead extraction (TLE) is used for lead infection, lead debulking, venous recanalization and device upgrades. Lead extraction is performed using specialized tools including locking stylets, mechanical or rotating sheaths, femoral snares or laser sheaths. The most feared complications associated with lead extraction are bleeding, vascular tear, cardiac avulsion and tamponade. Despite technological progress, the incidence of major procedural complications including death remains slightly above 1%. This case depicts an asymptomatic left common carotid artery (LCCA) to left innominate vein arteriovenous fistula (AVF) after laser‐assisted TLE successfully treated with an endovascular covered stent. [ABSTRACT FROM AUTHOR]

Introduction: Inadvertent implantation from the subclavian/axillary arteries is uncommon and has been rarely reported. Complications are frequent, mainly driven by thromboembolic events. Lead extraction, depending on the dwell time may be challenging and associated with thromboembolic events Case Report: We report the case of an 87‐year‐old man who had involuntarily pacemaker lead implanted into the left ventricle through the left subclavian artery. An extraction procedure was performed with surgical dissection to the artery and simple traction of the probe without complication. Conclusion: Percutaneous lead extraction using surgical dissection is a therapeutic option for less than one year old left ventricle inadvertent lead implantation. [ABSTRACT FROM AUTHOR]

Objectives: Parasite selection pressures have driven the evolution of numerous behavioral defenses in host species, but recent studies revealed individual variation in their expression. As little is known about the factors causing heterogeneity among individuals in infection‐avoidance behaviors, we investigated in woolly monkeys (Lagothrix lagotricha poeppigii) the influence of several environmental and individual characteristics on the tendency to avoid food contaminated by soil and by their own and conspecifics' feces. Materials and methods: We conducted feeding tests on 40 semi‐free ranging individuals rescued from the pet trade. Using generalized linear mixed models, we investigated the effect of season, sex, age, dominance rank, and exposure to non‐natural living conditions on feeding decisions. Results: Woolly monkeys did not avoid soil‐contaminated food and equally avoided food contaminated by their own and conspecifics' feces. Individuals varied greatly in their level of fecal avoidance. Only females exhibited strong avoidance of fecally contaminated food, but adapted their behavior to food availability, highlighting the trade‐off between nutritional intake and parasite avoidance. Additionally, low‐ranking females, less competitive over food resources, exhibited lower avoidance than dominant ones. Juveniles were more cautious than adults, possibly to compensate for a higher parasite susceptibility. Finally, we reported an unknown effect of exposure to non‐natural living conditions on behavioral defenses, as animals kept as household pets for an extended period apparently lost their ability to avoid fecally contaminated food. Conclusion: We argue that striving to understand variation in infection‐avoidance behaviors in natural populations is crucial to predict disease spread and inform conservation policies. [ABSTRACT FROM AUTHOR]

A new data set combining thermobarometry, geo‐thermochronology, chronostratigraphic, and structural analyses highlights the tectono‐thermal evolution of the St. Martin granodiorite from its emplacement to its surface exposure. The described vertical motions in this part of the upper plate of the Lesser Antilles subduction zone since 30 Myrs are linked to the migration of the Lesser Antilles volcanic arc toward the plate interior. Results suggest that the St. Martin granodioritic pluton emplaced at 4–5 km depth and underwent a four‐step history: (a) 30–27 Ma, emplacement along N20–40° transtensive structures oblique to the trench followed by, (b) 27–24 Ma, rapid post‐emplacement cooling and exhumation (∼0.6 mm/yr) controlled by perpendicular to the trench N45° trending structures, (c) 24–9 Ma, slow subsidence (0.01 mm/yr) and development of carbonate platforms associated to tectonic quiescence, westward migration of the arc, and subsequent cooling of the crust, (d) 9 Ma to present‐day, exhumation (∼0.25 mm/yr) and uplift of Neogene carbonate platforms mainly along N45° faults that likely accommodate the progressive trench curvature since 30 Ma. Pecube forward modeling using this scenario reproduces both the observed present‐day geometry and thermochronometric ages. A similar sequence of events is observed in the Virgin Islands. Along with our new data, this suggests a southward migration of the deformation associated with the opening of the Anegada Trough. Key Points: The tectono‐thermal history of the St. Martin Oligocene granodiorite is reconstructedExhumation occurred during two periods: between 27 and 24 Ma and since 9 Ma, along N45° trending normal faultsRegionally, exhumation rates suggest a southward migration of the deformation associated with the opening of the Anegada Trough [ABSTRACT FROM AUTHOR]

Based on 2D seismic profiles, multibeam and seabed grab cores acquired during the Garanti cruise in 2017, 1–5 km wide seabed giant polygons were identified in the Grenada basin, covering a total area of ∼55,000 km2, which is the largest area of outcropping polygonal faults (PF) ever found on Earth so far. They represent the top part of an active 700–1,200 m thick underlying polygonal fault system (PFS) formed due to the volumetric contraction of clay‐ and smectite‐rich sediments, initiated in the sub‐surface at the transition between the Early to Middle Pliocene. The short axes of the best‐fit ellipses obtained from a graphical center‐to‐center method were interpreted as the local orientation of a preferential contraction perpendicular to the creep deformation of slope sediments. In the North Grenada Basin, the polygons are relatively regular, but their short axes seem to be parallel to a N40°E extension recently evidenced in the forearc, possibly extending in the backarc, but not shown in the study area. They are most probably related to a progressive burial due to a homogeneous subsidence. In the South Grenada Basin, the polygons are more elongated and their axes are progressively rotating southeastward toward the depocenter, indicating a creep deformation toward the center of the basin created by a differential subsidence. Seabed polygons and underlying PF could thus be indicative of the deformation regime of shallow sediments related to main slopes controlled by two different basin architectures. Key Points: Seabed giant polygons in the Grenada Basin cover the largest area (55,000 km2) ever found on EarthThe short axis of best‐fit ellipses of polygons may represent the orientation of the creep deformation of slope sedimentsThe north and south tectonic domains in the Grenada Basin are marked by major differences in the shape and orientation of seabed polygons [ABSTRACT FROM AUTHOR]

The West Indies are a natural laboratory for the study of biogeography and evolution, especially for mammals. The modality of their arrival in the Caribbean islands is a highly controversial issue, and palaeontological evidence remains particularly elusive. Lower Oligocene deposits of Puerto Rico (c. 29.5 Ma) have recently yielded the oldest archipelago rodents, with teeth of two chinchilloid caviomorphs of South American origin. Here we report the discovery of additional dental remains from the same level, testifying to the occurrence of another rodent group. Their morphology is singular but otherwise characteristic of North/Central American geomyin geomorphs (including extant kangaroo rats, pocket mice, and pocket gophers), and leads us to propose here a new taxon: Caribeomys merzeraudi gen. et sp. nov. The evidence of geomorphs in the West Indies challenges the view that all extinct and extant Antillean rodents derived from South American sources. The morphological singularity of this Puerto Rican geomorph also suggests an early split of this insular lineage from coeval mainland counterparts, and its dispersal towards the West Indies sometime around the Eocene–Oligocene transition. This unexpected rodent adds to the few cases of Antillean terrestrial vertebrates of North American origins, such as solenodonotan eulipotyphlans. In the absence of subaerial land connections between both landmasses, an overwater dispersal may explain mid‐Palaeogene colonization of the West Indies by geomorph rodents. [ABSTRACT FROM AUTHOR]

The Eocene tectonic evolution of the easternmost Caribbean Plate (CP) boundary, that is the Lesser Antilles subduction zone (LASZ), is debated. Recents works shed light on a peculiar period of tectonic duality in the arc/back-arc regions. A compressional-to-transpressional regime occurred in the north, while rifting and seafloor spreading occurred in Grenada basin to the south. The mechanism for this strong spatial variation and its evolution through time has yet to be established. Here, using 3-D subduction mechanical models, we evaluate whether the change in the trench-curvature radius at the northeast corner of the CP could have modulated the duality. We assume asymmetrical CP boundaries at the north (from east to west: oblique subduction to strike-slip) and at the south (subduction-transform edge propagator-like behavior). Regardless of the imposed trench curvature, the southern half of our modeled CP undergoes a NW-to-W-oriented extension due to the tendency of the southernmost part of the South-America oceanic slab to rollback. In contrast, the tectonic regime in the northeast corner of the CP depends on the trench-curvature radius. A low radius promotes transtension-to-transpression, with a NE-oriented compressive component of the principal stress. A high radius largely reduces the compressive component and promotes an extensional regime similar to that in the south. We thus propose that an initially low-curvature radius of the NE-LASZ triggered the tectonic N-S duality in the Eocene and led to an ephemeral period of transpression/compression at the north. However, an additional mechanism might have been required to locally enhance compression. [ABSTRACT FROM AUTHOR]

Objectives: It is critical to assess competency of medical students and residents in emergency medicine (EM) during undergraduate and graduate medical education. However, very few valid tools exist to assess both technical and nontechnical skills in the specific context of EM. Three Acute Care Assessment Tools (ACAT 1, 2, and 3) have been previously developed for three acute care conditions: cardiac arrest (1), coma (2), and acute respiratory failure (3). This study aimed to evaluate the reproducibility of the tools. Methods: The tool was tested using recorded videos of simulation sessions of fourth year medical students and first year residents in EM. Raters independently reviewed the videos two times in a 3‐month interval, and interrater and intrarater reliability using intraclass correlation (ICC) was calculated. Secondary endpoints included the completeness rate and relevance of the ACAT. Results: Sixty‐two sessions were recorded and 48 videos analyzed (18 for CA and 15 for both respiratory failure and coma. The learners were residents in 32 (66%) of videos. Interrater reliability was excellent (ICC >0.9 for all three contexts) and so was the intrarater reliability (>0.88), both upon first review (month 0, M0) and at 3 months (M3). The usability of the ACAT was good, with a completeness of the items that ranged from 96% to 100%. Only one item of the ACAT 1 had a relevance of 27%, as it could not be completed in 13 scenarios out of 18. Conclusions: The results demonstrate educators can evaluate students similarly utilizing video recordings of simulated medical scenario. The excellent completeness of the rated items advocated for good usability. The three ACATs can be utilized to assess for completeness of predefined tasks in three acute care broad scenario in a competency‐based medical education framework. [ABSTRACT FROM AUTHOR]

My goal in these comments is to set the stage for Azar and Vives (2020) by briefly discussing the common ownership literature in the context of the literature on financial structure and product market competition. The other idea is based on the insights of Modigliani and Miller (1958) and Coase (1960): under efficient bargaining, maximizing shareholder value is equivalent to maximizing total firm value. The assumption is that the firm is influenced by its own shareholders, but the nature or identity of the shareholders of other firms in its industry do not matter. Shareholders receive the firm's profits but managers have a preference for scale. [Extracted from the article]

New Findings: What is the role of SCN5A‐C683R?SCN5A‐C683R is a novel variant associated with an uncommon phenotype of adrenaline‐triggered ventricular arrhythmia in the absence of a distinct ECG phenotype.What is the main finding and its importance?Functional studies demonstrated that NaV1.5/C683R results in a mixed electrophysiological phenotype with gain‐of‐function (GOF) and loss‐of‐function (LOF) properties compared with NaV1.5/wild type. Gain‐of‐function properties are characterized by a significant increase of the maximal current density and a hyperpolarizing shift of the steady‐state activation. The LOF effect of NaV1.5/C683R is characterized by increased closed‐state inactivation. Electrophysiological properties and clinical manifestation of SCN5A‐C683R are different from long‐QT‐3 or Brugada syndrome and might represent a distinct inherited arrhythmia syndrome. Mutations of SCN5Ahave been identified as the genetic substrate of various inherited arrhythmia syndromes, including long‐QT‐3 and Brugada syndrome. We recently identified a novel SCN5A variant (C683R) in two genetically unrelated families. The index patients of both families experienced adrenaline‐triggered ventricular arrhythmia with cardiac arrest but did not show a specific ECG phenotype, raising the hypothesis that SCN5A‐C683R might be a susceptibility variant and the genetic substrate of distinct inherited arrhythmia. We conducted functional cellular studies to characterize the electrophysiological properties of NaV1.5/C683R in order to explore the potential pathogenicity of this novel variant. The C683R variant was engineered by site‐directed mutagenesis. NaV1.5/wild type (WT) and NaV1.5/C683R were expressed in tsA201 cells. Electrophysiological characterization of C683R was performed using the whole‐cell patch‐clamp technique. Adrenergic stimulation was mimicked by exposure to the protein kinase A activator 8‐CPT‐cAMP. The impact of β‐blockers was tested by exposing NaV1.5/WT and NaV1.5/C683R currents to propranolol and nadolol. C683R resulted in a co‐association of gain‐of‐function and loss‐of‐function properties of NaV1.5. Gain‐of‐function properties were characterized by a significant increase of the maximal NaV1.5 current density compared with NaV1.5/WT (861 ± 309 vs. 627 ± 489 pA/pF; P < 0.05, n ≥ 9) that was potentiated in NaV1.5/C683R with 8‐CPT‐cAMP stimulation (869 ± 287 vs. 607 ± 320 pA/pF; P < 0.05, n ≥ 12). C683R also resulted in a significant hyperpolarizing shift in the voltage of steady‐state activation (−65.4 ± 3.0 vs. −57.2 ± 4.8 mV; P < 0.001), resulting in an increased window current compared with WT. The loss‐of‐function effect of NaV1.5/C683R was characterized by significantly increased closed‐state inactivation compared with NaV1.5/WT (P < 0.05). C683R is a novel SCN5A variant resulting in a co‐association of gain‐of‐function and loss‐of‐function properties of the cardiac sodium channel NaV1.5. The phenotype is characterized by adrenaline‐triggered ventricular arrhythmias. Electrophysiological properties and clinical manifestations are different from long‐QT‐3 or Brugada syndrome and might represent a distinct inherited arrhythmia syndrome. [ABSTRACT FROM AUTHOR]

Oblique collision of buoyant provinces against subduction zones frequently results in individualizing and rotating regional‐scale blocks. In contrast, the collision of the Bahamas Bank against the Northeastern Caribbean Plate increased the margin convexity triggering forearc fragmentation into small‐scale blocks. This deformation results in a prominent sequence of V‐shaped basins that widens trenchward separated by elevated spurs, in the Northern Lesser Antilles (NLA, i.e., Guadeloupe to Virgin Island). In absence of deep structure imaging, various competing models were proposed to account for this Basins‐and‐Spurs System. However, high‐resolution bathymetric and deep multichannel seismic data acquired during cruises ANTITHESIS 1‐3, reveal a drastically different tectonic evolution of the NLA Forearc. During Eocene‐Oligocene time, the Caribbean Northeastern Boundary accommodated the Bahamas Bank collision and the subsequent margin convex bending by major left‐lateral strike‐slip faults systems in the Greater Antilles and by trench‐parallel extension along N40°–90°‐trending normal faults in the NLA. Block rotations, forearc fracturing, and V‐shaped valleys opening went along with this tectonic phase, which ends up with tectonic uplifts and an earliest‐middle Miocene regional emersion phase. Post middle Miocene regional subsidence and tectonic extension in the forearc are partly accommodated along the newly imaged N300°‐trending, 200‐km‐long normal Tintamarre Faults Zone. This drastic subsidence phase reveals vigorous margin basal erosion, which likely generated the synchronous westward migration of the volcanic arc. Thus, unlike widely accepted previous theoretical models, the NE‐SW faulting and the prominent V‐shaped valleys result from a past and sealed tectonic phase related to the margin bending and subsequent blocks rotation. Key Points: The N. Lesser Antilles has undergone Eocene‐Oligocene NW‐SE extention and post mid Miocene NE‐SW extension separated by a regional emersionFault‐bounded V‐Shaped valleys result from past and sealed NW‐SE extention due to Bahamas Bank collision, margin bending, and blocks rotationDrastic post mid Miocene subsidence and synchronous westward migration of the volcanic arc reveal vigorous subduction‐related margin erosion [ABSTRACT FROM AUTHOR]

Twiddler syndrome is an uncommon yet dangerous phenomenon usually resulting in lead displacement with loss of capture of cardiac implantable electronic devices. In this case report, we present an interesting case of Twiddler syndrome without lead dislodgment which was detected by an alert triggered by an increase in impedance on remote monitoring. [ABSTRACT FROM AUTHOR]

Background: Monitoring of cardiac implantable electronic devices was highly impacted by the COVID‐19 pandemic considering the high volume of in‐person visits for regular follow‐up. Recent recommendations highlight the important role of remote monitoring to prevent exposure to the virus. This study compared remote monitoring of implantable cardioverter defibrillators (ICDs) in patients whose in‐person annual visit was substituted for a remote monitoring session with patients who were already scheduled for a remote monitoring session. Methods: This was a cross‐sectional observational study of 329 consecutive patients between 20 March and 24 April 2020. Group 1 included 131 patients whose in‐person annual visit was substituted for a remote monitoring session. Group 2 included 198 patients who underwent a remote monitoring session as scheduled in their usual device follow‐up. The time interval since the last in‐person visit was 13.3 ± 3.2 months in group 1 and 5.9 ± 1.7 months in group 2 (P <.01). Results: In group 1, 15 patients (11.5%) experienced a clinical event compared to 15 patients (7.6%) in group 2 (P =.25). Nineteen patients (14.5%) required a physician intervention in group 1 compared to 19 patients (9.6%) in group 2 (P =.22). Two patients (1.5%) in group 1 and four patients (2.0%) in group 2 required an early in‐person follow‐up visit during the pandemic (P >.99). Conclusion: Remote monitoring of ICDs is useful to identify clinical events and allows physicians to treat patients appropriately during the COVID‐19 pandemic regardless of the time interval since their last in‐person visit. It reduces significantly in‐person visit for regular follow‐up. [ABSTRACT FROM AUTHOR]

Introduction: The Medtronic Attain Stability Quad lead is a quadripolar left ventricular (LV) lead with an active fixation helix assembly designed to fixate the lead within the coronary sinus and pace nonapical regions of the LV. The primary objective of this study was to determine the safety and effectiveness of this novel active fixation quadripolar LV lead. Methods: Patients with standard indications for cardiac resynchronization therapy (CRT) were enrolled. All patients were followed at 3 and 6 months post‐implant and every 6 months thereafter until study closure. Pacing capture thresholds (PCTs) were measured at implant and each follow‐up and adverse events (AEs) were recorded upon occurrence. Results: Of the 440 patients who underwent implant procedures, placement of the Attain Stability Quad lead was successful in 426 (96.8%). LV lead‐related complications occurred in 10 patients (2.3%), including LV lead dislodgement in three patients (0.7%). The percentage of patients with at least one LV pacing vector with a PCT ≤2.5 V at a 6‐month follow‐up was 96.3%. The LV lead was successfully fixated to the prespecified pacing location in 97.4% of cases. Conclusions: This large, multinational study of the Attain Stability Quad lead demonstrated a high rate of implant success with a low complication rate. The active fixation mechanism allowed precise placement of the pacing electrodes at the desired target region with good PCTs and a very low dislodgement rate. [ABSTRACT FROM AUTHOR]

Financial distress is more likely to happen in bad times. The present value of distress costs therefore depends on risk premia. We estimate this value using risk-adjusted default probabilities derived from corporate bond spreads. For a BBB-rated firm, our benchmark calculations show that the NPV of distress is 4.5% of predistress value. In contrast, a valuation that ignores risk premia generates an NPV of 1.4%. We show that marginal distress costs can be as large as the marginal tax benefits of debt derived by Graham (2000) . Thus, distress risk premia can help explain why firms appear to use debt conservatively. [ABSTRACT FROM AUTHOR]

An intercomparison of seven gridded rainfall products incorporating satellite data (ARC, CHIRPS, CMORPH, PERSIANN, TAPEER, TARCAT, TMPA) is carried out over Central Africa, by evaluating them against three observed datasets: (a) the WaTFor database, consisting of 293 (monthly records) and 154 (daily records) rain‐gauge stations collected from global datasets, national meteorological services and monitoring projects, (b) the WorldClim v2 gridded database, and (c) a set of stations expanded from the FAOCLIM network, these two latter sets describing climate normals. All products fairly well reproduce the mean rainfall regimes and the spatial patterns of mean annual rainfall, although with some discrepancies in the east–west gradient. A systematic positive bias is found in the CMORPH product. Despite its lower spatial resolution, TAPEER shows reasonable skills. When considering daily rainfall amounts, TMPA shows best skills, followed by CMORPH, but over the central part of the Democratic Republic of the Congo, TARCAT is amongst the best products. Skills ranking is however different at the interannual time‐scale, with CHIRPS and TMPA performing best, though PERSIANN has comparable skills when only fully independent stations are used as reference. A preliminary study of Southern Hemisphere dry season variability, from the example of Kinshasa, shows that it is a difficult variable to capture with satellite‐based rainfall products. Users should still be careful when using any product in the most data‐sparse regions, especially for trend assessment. [ABSTRACT FROM AUTHOR]

People of all backgrounds are susceptible to bone and cartilage damage, and these injuries can be debilitating. Current treatments for bone and cartilage injuries are less than optimal, and we are interested in developing new approaches to treat these diseases, specifically using human muscle‐derived stem cells (hMDSCs). Our lab previously demonstrated that sex differences exist between male and female murine MDSCs; thus, this paper sought to investigate whether sex differences also exist in hMDSCs. In the present study, we characterized the chondrogenic and osteogenic sex differences of hMDSCs in vitro and in vivo. We performed in vitro osteogenic and chondrogenic differentiation using hMDSC pellet cultures. As demonstrated by microCT, histology, and immunohistochemistry, male hMDSCs were more chondrogenic and osteogenic than their female counterparts in vitro. No differences were observed based on the sex of hMDSCs in osteogenic and chondrogenic gene expression and cell surface markers. For our in vivo study, we transduced hMDSCs with lenti‐BMP2/GFP and transplanted these cells into critical‐sized calvarial defects in mice. MicroCT results revealed that male hMDSCs regenerated more bone at 2 weeks and demonstrated higher bone density at 4 and 6 weeks than female hMDSCs. Histology demonstrated that both male and female hMDSCs regenerated functional bone. Clinical relevance: These studies reinforce that stem cells isolated from male and female patients differ in function, and we should disclose the sex of cells used in future studies. Considering sex differences of hMDSCs may help to improve cell‐based therapies for autologous cell treatment of bone and cartilage damage. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:1339–1349, 2019. [ABSTRACT FROM AUTHOR]

Hip arthroscopy is one of the most rapidly growing and evolving orthopaedic subspecialties. With the recent dramatic increase in the volume of hip arthroscopy performed there has been an increase in the number of symptomatic patients following arthroscopy for femoroacetabular impingement. Imaging has a key role in determining the need for revision surgery and in preoperative planning. Although the revision rate for hip arthroscopy is 3-9%, little has been published about the imaging findings associated with unsatisfactory treatment outcomes. This review discusses the significance of pre-existing osteoarthritis and underlying hip dysplasia and describes the causes of persistent symptoms. Recent literature on extra articular impingement and causes of microinstability are presented. Post-operative appearances are described focussing on the clinically relevant imaging findings. The challenges of evaluating the labrum after repair and specific findings associated with anchor failure and iatrogenic chondrolabral injury are discussed. The purpose of this article is to review the causes of unsatisfactory treatment outcomes after hip arthroscopy, role of imaging and indications for revision arthroscopy. [ABSTRACT FROM AUTHOR]

Background: This study aimed to determine the failure rate of a combination of the PERC and the YEARS rules for the diagnosis of pulmonary embolism (PE) in the emergency department (ED). Methods: We performed a retrospective analysis of two European cohorts of emergency patients with low gestalt clinical probability of PE (PROPER and PERCEPIC). All patients we included were managed using a conventional strategy (D‐dimer test, followed, if positive, by computed tomographic pulmonary angiogram (CTPA). We tested a diagnostic strategy that combined PERC and YEARS to rule out PE. The primary endpoint was a thromboembolic event diagnosed in the ED or at 3‐months follow‐up. Secondary endpoints included a thromboembolic event at baseline in the ED and a CTPA in the ED. Ninety‐five percent confidence intervals (CIs) of proportions were calculated with the use of Wilson's continuity correction. Results: We analyzed 1,951 patients (mean ± SD age = 47 ± 18 years, 56% women) with an overall proportion of patients with PE of 3.5%. Both PERC and YEARS strategies were associated with 11 missed PE in the ED: failure rate 0.57 (95% CI = 0.32–1.02). At 3‐month follow‐up, the overall failure rate was 0.83% (95% CI = 0.51–1.35). Among the 503 patients who underwent a CTPA (26%), the use of the PERC–YEARS combination would have ruled out PE without CTPA in 249 patients (50% [95%CI = 45%–54%], absolute reduction 13% (95% CI = 11%–14%]). Conclusion: The combination of PERC then YEARS was associated with a low risk of PE diagnostic failure and would have resulted in a relative reduction of almost half of CTPA. [ABSTRACT FROM AUTHOR]

The article offers information on how the U.S. markets started to lose their competitive edge starting around 2000. It mentions that monthly cellphone plans and Internet access are much cheaper in Europe compared to the U.S., as are flights. It states that antitrust enforcement stays active in Europe, with cases against Google that leads in over $7.7 billion in fines.

The upper plate deformation pattern reflects the mechanical behavior of subduction zones. Here we focus on the consequences of the entrance of a buoyant bank into the Caribbean subduction zone during the Eocene by studying the oldest exposed rocks belonging to the Lesser Antilles volcanic arc. Using a novel geochronological data set, we show that the volcanic arc activity on the island of St. Barthelemy spanned over the mid‐Eocene to early Miocene with a westward migration of the tectono‐volcanic activity, which is comparable to what has already been observed on other volcanic islands in the Lesser Antilles. The kinematics analysis allows us to identify a switch in the stress field from pure to radial extension at the Oligo‐Miocene hinge with a subhorizontal σ3 that has a mean trend of N20°. A three‐step restoration of the regional deformation indicates that this switch from pure parallel‐to‐the‐trench extension to radial extension may reflect a strain partitioning initiation affecting the upper Caribbean Plate in response to trench bending that followed the entrance of the Bahamas Bank into the subduction zone. We show that the northern end of the Lesser Antilles arc shows a tectono‐volcanic evolution which is similar to the southern one. The north‐south dichotomy in the perpendicular‐to‐the‐trench extension, 15% in the north versus 30% in the south, may reflect different slab ends that are highly curved to the north (restraining the extension in the upper plate) versus a tear to the south (allowing a larger amount of extension within the upper plate). Key Points: The extinct Lesser Antilles arc shows a westward migration of the tectono‐magmatic activity during the middle Eocene‐Miocene periodPaleostress inversions reveal that the stress regime evolved from pure to radial extension over the Eocene‐Lower Miocene time spanThis switch in the upper plate strain pattern accommodates the bending of the trench that followed the Bahamas Bank collision [ABSTRACT FROM AUTHOR]

Introduction: Implantable cardioverter-defibrillator (ICD) DF-4 connectors have been introduced to facilitate defibrillator lead connection and to reduce the size of device header. There are limited data regarding the overall performance of those leads and no comparison between different ICD DF-4 leads.Methods: This is a cohort study of consecutive patients implanted with ICD DF-4 lead system at one University Centre between October 2010 and February 2015. A historical control group of patients with ICDDF-1 lead implantation was used for comparison. The following ICDDF-4 leadswere evaluated: St. Jude Medical Durata 7122Q (St. Jude Medical, St. Paul, MN, USA), Medtronic Sprint Quattro Secure 6935 M (Medtronic Inc., Minneapolis, MN, USA), Boston Scientific Endotak Reliance 4-Site 0293 (Boston Scientific, Marlborough, MA, USA), and Boston Scientific Reliance 4-Front 0693. This study evaluated the acute and mid-term performances of those leads as well as complications.Results: A total of 812 patients (age 63± 12 years, 80% male, left ventricular ejection fraction 31±12%) underwent implantation of an ICD DF-4 lead. Acute and follow-up R-wave sensing and threshold were excellent. Compared to implantation, intrinsic R waves were higher at follow-up for Boston Scientific and Medtronic leads, and pacing lead impedances were lower for all leads at first follow-up (P<0.001). The number of lead dislodgement or failure was similar between allleads. The estimated lead survival rates at 3 years were 95.6% for Boston Scientific Endotak 4-Site, 97.1% for Boston Scientific 4-Front, 97.7% for Medtronic Sprint Quattro, and 97.5% for St. Jude Durata (P = 0.553).Conclusion: All ICD DF-4 leads had excellent acute and mid-term electrical performances. Longer follow-up will be necessary to confirm their sustained performance. [ABSTRACT FROM AUTHOR]

We analyze trading speed and fragmentation in asset markets. In our model, trading venues make technological investments and compete for investors who choose where and how much to trade. Faster venues charge higher fees and attract speed‐sensitive investors. Competition among venues increases investor participation, trading volume, and allocative efficiency, but entry and fragmentation can be excessive, and speeds are generically inefficient. Regulations that protect transaction prices (e.g., Securities and Exchange Commission trade‐through rule) lead to greater fragmentation. Our model sheds light on the experience of European and U.S. markets since the implementation of Markets in Financial Instruments Directive and Regulation National Markets System. [ABSTRACT FROM AUTHOR]

ABSTRACT: Mean diurnal rainfall regimes over Eastern Africa (also referred to as the Greater Horn of Africa) are studied based on 3‐hourly data from the TRMM 3B42 data set, averaged over a 17‐year period (1998–2014). The consistency with long‐term mean raingauge data, available for partly independent periods, varies from good (Sudan, Ethiopia, Eritrea and Somalia) to very good (Kenya, Tanzania and Uganda). Over sea (Indian Ocean and Red Sea), the diurnal rainfall distribution is quite uniform; however, a morning peak dominates and there is evidence of offshore phase propagation south of the equator. Over land, both rainfall frequency and rainfall amounts show a dominant afternoon maximum (1500–1800 East African Time, i.e. GMT + 3). However, many inland regions show a delayed rainfall maximum (evening, night‐time or morning). The evening to night‐time maximum found over some land areas is associated with a phase propagation from areas showing an afternoon peak. This occurs west of high ground areas (Sudan and parts of the Great Lakes region) and in belts parallel to the seashores (Eritrea, northeastern Ethiopia, Somalia and eastern Kenya). The latter provide indirect evidence that sea breeze effects can be detected at unexpectedly great distances from the coast (up to 300–400 km) in parts of Eastern Africa. A remarkable ring of early afternoon (1500) maxima is found around most lakes, although some east–west asymmetries occur. Over the lakes, a morning or late night maximum is mostly found. It is generally inversely related to the distance to the shorelines for the larger lakes, but over the mid‐size lakes it is replaced by or competes with a late afternoon to evening maximum. [ABSTRACT FROM AUTHOR]

Musculoskeletal injuries that disrupt the structure and function of diarthrodial joints can cause permanent biomechanical alterations and lead to a more severe, chronic condition. Despite advancements that have been made to restore tissue function and delay the need for joint replacement, there are currently no disease-modifying therapies for osteoarthritis (OA). To reduce the risk of OA, innovative preventive medicine approaches have been developed over the last decade to treat the underlying pathology. Several biological approaches are promising treatment modalities for various stages of OA owing to their minimally invasive nature and actively dynamic physiological mechanisms that attenuate tissue degradation and inflammatory responses. Individualized growth factor and cytokine therapies, tissue-engineered biomaterials, and cell-based therapies have revolutionary potential for orthopedic applications; however, the paucity of standardization and categorization of biological components and their counterparts has made it difficult to determine their clinical and biological efficacy. Cell-based therapies and tissue-engineered biologics have become lucrative in sports medicine and orthopedics; nonetheless, there is a continued effort to produce a biological treatment modality tailored to target intra-articular structures that recapitulates tissue function. Advanced development of these biological treatment modalities will potentially optimize tissue healing, regeneration, and joint preservation strategies. Therefore, the purpose of this paper is to review current concepts on several biological treatment approaches for OA. [ABSTRACT FROM AUTHOR]

In this study, we investigate the Lesser Antilles forearc basin, focusing on the late Pliocene to Pleistocene sedimentary archives in order to track the occurrence of extreme events triggered by enhanced subduction-related tectono-volcanic activity. We identify late Piacenzian deposits covering a major regional erosional surface, displaying sedimentary dykes and large marine boulders embedded in a mixed continental-marine matrix, characteristic of tsunamites. We interpret this episode of platform emersion and the successive cataclysmic deposits as resulting from enhanced tectonic activity at the interface of the subduction zone, synchronous with the initiation of the Lesser Antilles volcanic arc. We then discuss the implications in terms of the mechanical behaviour of the Lesser Antilles subduction zone. [ABSTRACT FROM AUTHOR]

Contact-Force Catheters Contact-force (CF) catheters appear to be more effective compared to standard ablation catheters for complex radiofrequency ablation including atrial fibrillation (AF) ablation when optimal CF >10 g is achieved. Some have suggested that this technology could also improve procedural safety. We report 2 cases of atrioesophageal fistulae (AEF), a rare but catastrophic complication of AF ablation. These are to our knowledge the first cases of AEF described after using CF catheters. [ABSTRACT FROM AUTHOR]