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Introduction and aimsVeno-arterial extracorporeal membrane oxygenation (VA-ECMO) is an increasingly utilized therapeutic choice in patients with cardiogenic shock, however, high complication rate often counteracts with its beneficial cardiopulmonary effects. The assessment of left ventricular (LV) function in key in the management of this population, however, the most commonly used measures of LV performance are substantially load-dependent. Non-invasive myocardial work is a novel LV functional measure which may overcome this limitation and estimate LV function independent of the significantly altered loading conditions of VA-ECMO therapy. The Usefulness of Myocardial Work IndeX in ExtraCorporeal Membrane Oxygenation Patients (MIX-ECMO) study aims to examine the prognostic role of non-invasive myocardial work in VA-ECMO-supported patients.MethodsThe MIX-ECMO is a multicentric, prospective, observational study. We aim to enroll 110 patients 48–72 h after the initiation of VA-ECMO support. The patients will undergo a detailed echocardiographic examination and a central echocardiography core laboratory will quantify conventional LV functional measures and non-invasive myocardial work parameters. The primary endpoint will be failure to wean at 30 days as a composite of cardiovascular mortality, need for long-term mechanical circulatory support or heart transplantation at 30 days, and besides that other secondary objectives will also be investigated. Detailed clinical data will also be collected to compare LV functional measures to parameters with established prognostic role and also to the Survival After Veno-arterial-ECMO (SAVE) score.ConclusionsThe MIX-ECMO study will be the first to determine if non-invasive myocardial work has added prognostic value in patients receiving VA-ECMO support.

Key Clinical Message This article outlines a surgical protocol designed for people living with dementia (PLWD). It proposes that simultaneous resection and reconstruction of skin cancer can minimizes the need for initial care. The method outlined involves primary closure via a cervicofacial rotation flap technique and the use of monofilament resorbable sutures.

Objective To assess the predictive value of four cardiovascular (CV) risk algorithms for identifying high-risk psoriatic arthritis (PsA) patients.Methods Evaluation of patients with PsA enrolled in the Spanish prospective project CARdiovascular in RheuMAtology. Baseline data of 669 PsA patients with no history of CV events at the baseline visit, who were followed in rheumatology outpatient clinics at tertiary centres for 7.5 years, were retrospectively analysed to test the performance of the Systematic Coronary Risk Assessment (SCORE), the modified version (mSCORE) European Alliance of Rheumatology Associations (EULAR) 2015/2016, the SCORE2 algorithm (the updated and improved version of SCORE) and the QRESEARCH risk estimator version 3 (QRISK3).Results Over 4790 years of follow-up, there were 34 CV events, resulting in a linearised rate of 7.10 per 1000 person-years (95% CI 4.92 to 9.92). The four CV risk scales showed strong correlations and all showed significant associations with CV events (p

Using the photometric population prediction method {\bf Red Dragon}, we characterize the Red Sequence (RS) and Blue Cloud (BC) of DES galaxies in the COSMOS field. Red Dragon (RD) uses a redshift-evolving, error-corrected Gaussian mixture model to detail the distribution of photometric colors, smoothly parameterizing the two populations with relative weights, mean colors, intrinsic scatters, and inter-color correlations. This resulting fit of RS and BC yields RS membership probabilities $P_{\rm RS}$ for each galaxy. Even when training on only DES main bands $griz$, RD selects the quiescent population (defined here as galaxies with $\lg {\rm sSFR \cdot yr} < -11$) with $\gtrsim 90\%$ balanced accuracy out to $z=2$; augmenting with extended photometry from VIRCAM improves this accuracy to $\sim 95\%$ out to $z=3$. We measure redshift evolution of sSFR and galactic age in several stellar mass bins, finding that the BC is consistently more star-forming (by $\gtrsim 1~{\rm dex}$) and typically younger (by $\gtrsim 1~{\rm Gyr}$) than the RS (up to $z \sim 1.4$). This characterization of both RS and BC as functions of redshift and stellar mass improves our understanding of both populations and opens the door to more precise galaxy population characterization in future deep optical and IR systems.

Large bone defect regeneration remains a major challenge for orthopedic surgeons. Tissue engineering approaches are therefore emerging in order to overcome this limitation. However, these processes can alter some of essential native tissue properties such as intermolecular crosslinks of collagen triple helices, which are known for their essential role in tissue structure and function. We assessed the persistence of extracellular matrix (ECM) properties in human fascia lata (HFL) and periosteum (HP) after tissue engineering processes such as decellularization and sterilization. Harvested from cadaveric donors (N = 3), samples from each HFL and HP were decellularized following five different chemical protocols with and without detergents (D1-D4 and D5, respectively). D1 to D4 consisted of different combinations of Triton, Sodium dodecyl sulfate and Deoxyribonuclease, while D5 is routinely used in the institutional tissue bank. Decellularized HFL tissues were further gamma-irradiated (minimum 25 kGy) in order to study the impact of sterilization on the ECM. Polarized light microscopy (PLM) was used to estimate the thickness and density of collagen fibers. Tissue hydration and content of hydroxyproline, enzymatic crosslinks, and non-enzymatic crosslinks (pentosidine) were semi-quantified with Raman spectroscopy. ELISA was also used to analyze the maintenance of the decorin (DCN), an important small leucine rich proteoglycan for fibrillogenesis. Among the decellularization protocols, detergent-free treatments tended to further disorganize HFL samples, as more thin fibers (+53.7%) and less thick ones (−32.6%) were recorded, as well as less collagen enzymatic crosslinks (−25.2%, p = 0.19) and a significant decrease of DCN (p = 0.036). GAG content was significantly reduced in both tissue types after all decellularization protocols. On the other hand, HP samples were more sensitive to the D1 detergent-based treatments, with more disrupted collagen organization and greater, though not significant loss of enzymatic crosslinks (−37.4%, p = 0.137). Irradiation of D5 HFL samples, led to a further and significant loss in the content of enzymatic crosslinks (−29.4%, p = 0.037) than what was observed with the decellularization process. Overall, the results suggest that the decellularization processes did not significantly alter the matrix. However, the addition of a gamma-irradiation is deleterious to the collagen structural integrity of the tissue.

Using the first three years of data from the Dark Energy Survey (DES), we use ratios of small-scale galaxy-galaxy lensing measurements around the same lens sample to constrain source redshift uncertainties, intrinsic alignments and other systematics or nuisance parameters of our model. Instead of using a simple geometric approach for the ratios as has been done in the past, we use the full modeling of the galaxy-galaxy lensing measurements, including the corresponding integration over the power spectrum and the contributions from intrinsic alignments and lens magnification. We perform extensive testing of the small-scale shear-ratio (SR) modeling by studying the impact of different effects such as the inclusion of baryonic physics, nonlinear biasing, halo occupation distribution descriptions and lens magnification, among others, and using realistic N-body simulations of the DES data. We validate the robustness of our constraints in the data by using two independent lens samples with different galaxy properties, and by deriving constraints using the corresponding large-scale ratios for which the modeling is simpler. The results applied to the DES Y3 data demonstrate how the ratios provide significant improvements in constraining power for several nuisance parameters in our model, especially on source redshift calibration and intrinsic alignments. For source redshifts, SR improves the constraints from the prior by up to 38% in some redshift bins. Such improvements, and especially the constraints it provides on intrinsic alignments, translate to tighter cosmological constraints when shear ratios are combined with cosmic shear and other 2pt functions. In particular, for the DES Y3 data, SR improves S8 constraints from cosmic shear by up to 31%, and for the full combination of probes (3×2pt) by up to 10%. The shear ratios presented in this work are used as an additional likelihood for cosmic shear, 2×2pt and the full 3×2pt in the fiducial DES Y3 cosmological analysis.

We quantify evolution in the cluster-scale stellar mass-halo mass (SMHM) relation's parameters using 2323 clusters and brightest central galaxies (BCGs) over the redshift range 0.03 ≤ z ≤ 0.60. The precision on the inferred SMHM parameters is improved by including the magnitude gap (m gap) between the BCG and fourth-brightest cluster member (M14) as a third parameter in the SMHM relation. At fixed halo mass, accounting for m gap, through a stretch parameter, reduces the SMHM relation's intrinsic scatter. To explore this redshift range, we use clusters, BCGs, and cluster members identified using the Sloan Digital Sky Survey C4 and redMaPPer cluster catalogs and the Dark Energy Survey redMaPPer catalog. Through this joint analysis, we detect no systematic differences in BCG stellar mass, m gap, and cluster mass (inferred from richness) between the data sets. We utilize the Pareto function to quantify each parameter's evolution. We confirm prior findings of negative evolution in the SMHM relation's slope (3.5σ), and detect negative evolution in the stretch parameter (4.0σ) and positive evolution in the offset parameter (5.8σ). This observed evolution, combined with the absence of BCG growth, when stellar mass is measured within 50 kpc, suggests that this evolution results from changes in the cluster's m gap. For this to occur, late-term growth must be in the intracluster light surrounding the BCG. We also compare the observed results to IllustrisTNG 300-1 cosmological hydrodynamic simulations and find modest qualitative agreement. However, the simulations lack the evolutionary features detected in the real data.

Purpose Exploratory study to evaluate the association of different phenotypes of right ventricular (RV) involvement and mortality in the intensive care unit (ICU) in patients with acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19). Methods Post-hoc analysis of longitudinal data from the multicenter ECHO-COVID observational study in ICU patients who underwent at least two echocardiography examinations. Echocardiography phenotypes were acute cor pulmonale (ACP, RV cavity dilatation with paradoxical septal motion), RV failure (RVF, RV cavity dilatation and systemic venous congestion), and RV dysfunction (tricuspid annular plane systolic excursion [less than or equal to] 16 mm). Accelerated failure time model and multistate model were used for analysis. Results Of 281 patients who underwent 948 echocardiography studies during ICU stay, 189 (67%) were found to have at least 1 type of RV involvements during one or several examinations: ACP (105/281, 37.4%), RVF (140/256, 54.7%) and/or RV dysfunction (74/255, 29%). Patients with all examinations displaying ACP had survival time shortened by 0.479 [0.284-0.803] times when compared to patients with all examinations depicting no ACP (P = 0.005). RVF showed a trend towards shortened survival time by a factor of 0.642 [0.405-1.018] (P = 0.059), whereas the impact of RV dysfunction on survival time was inconclusive (P = 0.451). Multistate analysis showed that patients might transit in and out of RV involvement, and those who exhibited ACP in their last critical care echocardiography (CCE) examination had the highest risk of mortality (hazard ratio (HR) 3.25 [2.38-4.45], P < 0.001). Conclusion RV involvement is prevalent in patients ventilated for COVID-19 ARDS. Different phenotypes of RV involvement might lead to different ICU mortality, with ACP having the worst outcome., Author(s): Stephen Huang [sup.1], Antoine Vieillard-Baron [sup.2] [sup.3], Bruno Evrard [sup.4], Gwenaël Prat [sup.5], Michelle S. Chew [sup.6], Martin Balik [sup.7], Fernando Clau-Terré [sup.8], Daniel De Backer [sup.9], Armand Mekontso [...]

Abstract Background The aim of this work is to share the authors’ experience and assist therapeutic decision-making in the management of Lemierre syndrome (LS). This is a retrospective descriptive study carried out in the stomatology, maxillofacial surgery, and ENT departments of the teaching hospital of Treichville (Abidjan, Côte d’Ivoire). LS cases managed from 2013 to 2023 were included in the study. Results Eight patients were enrolled (six men and two women). Internal jugular vein thrombosis was unilateral in 7 cases and bilateral in one. No germs were found in four patients. In one patient, a bacterial co-infection was responsible for the thrombosis. Surgical debridement was systematically performed in cases of necrosis. Anticoagulation was justified in three patients. No deaths were observed. Conclusion This work describes the epidemiological, clinical, therapeutic, and evolutionary aspects of LS. The management of LS should not be improvised. The choice of surgical debridement and anticoagulation depends on specific situations.

Abstract Adaptative objects based on shape-memory materials are expected to significantly impact numerous technological sectors including optics and photonics. In this work, we demonstrate the manufacturing of shape-memory optical fibers from the thermal stretching of additively manufactured preforms. First, we show how standard commercially-available thermoplastics can be used to produce long continuously-structured microfilaments with shape-memory abilities. Shape recovery as well as programmability performances of such elongated objects are assessed. Next, we open the way for light-guiding multicomponent fiber architectures that are able to switch from temporary configurations back to user-defined programmed shapes. In particular, we show that distinct designs of fabricated optical fibers can maintain efficient light transmission upon completion of multiple temperature-triggered bending/straightening cycles. Such fibers are also programmed into more complex shapes including coils or near 180 ° curvatures for delivering laser light around obstacles. Finally, a shape-memory exposed-core fiber is employed in fiber evanescent wave spectroscopy experiments to optimize the performance of the sensing scheme. We strongly expect that such actuatable fibers with light-guiding abilities will trigger exciting progress of unprecedented smart devices in the areas of photonics, electronics, or robotics.

Abstract Clear cell Renal Cell Carcinoma (ccRCC) is one of the most prevalent kidney cancers, which is often asymptomatic and thus discovered at a metastatic state (mRCC). mRCC are highly heterogeneous tumors composed of subclonal populations that lead to poor treatment response rate. Several recent works explored the potential of ccRCC tumoroids culture derived from patients. However, these models were produced following a scaffold-based method using collagen I or Matrigel that exhibit lot variability and whose complexity could induce treatment response modifications and phenotypic alterations. Following the observation that ccRCC tumoroids can create their own niche by secreting extracellular matrix components, we developed the first scaffold-free tumoroid model of ccRCC tumors. Tumoroids from mice as well as from human tumors were generated with high success rate (≥90%) using a magnetic suspension method and standard culture media. Immunofluorescence analysis revealed their self-organization capacities to maintain multiple tumor-resident cell types, including endothelial progenitor cells. Transcriptomic analysis showed the reproducibility of the method highlighting that the majority of gene expression patterns was conserved in tumoroids compared to their matching tumor tissue. Moreover, this model enables to evaluate drug effects and invasiveness of renal cancer cells in a 3D context, providing a robust preclinical tool for drug screening and biomarker assessment in line with alternative ex vivo methods like tumor tissue slice culture or in vivo xenograft models.

Although extreme El Niño events (EENEs) have always impacted hydrological anomalies and sediment transport in South America, their intensification by global warming and their association with changes in human activities and land cover after humid periods may lead to the acceleration of sediment transfers in river systems and dam reservoirs. This situation may threaten soil and water resources in arid and semiarid regions highly dependent on water originating from large dams. In this study, we investigated the sediment sequence accumulated in the Poechos Reservoir (northern Peru) and provided a retrospective reconstruction of the interactions of El Niño–Southern Oscillation (ENSO), agricultural practices and vegetation cover changes with sediment dynamics (1978–2019). To this end, a sediment core was dated and characterized by physical and chemical analyses (e.g., scanner tomography, X-ray fluorescence, particle size analysis) to estimate the evolution of sedimentation rates and changes in sediment sources during the last 5 decades. Sediment tracing results indicated the occurrence of changes in sediment sources associated with positive and negative phases of the Eastern Pacific index with a greater contribution of the lowland dry-forest area in comparison to that of the Andean area to sediment during the El Niño events (mean contribution of 76 %; up to 90 % during the coastal El Niño events (CENEs) of 2016–2017). This source contribution was mostly controlled by the stationary rainfall occurring during the EENEs in the lowland dry-forest area characterized by a low vegetation cover. Overall, after an extreme phase of ENSO, like after the EENE 1982–1983, the normal discharges and persistent sediment supplies from the middle- and upper-catchment parts led to river aggradation and the storage of substantial amounts of sediment in alluvial plains. In the absence of a significant EENE between 1983 and 1997, the large volume of sediment stored in the alluvial plains was exported by the EENE 1997–1998 resulting in an increase in sedimentation rate of 140 % after 1997 with a significant aggradation of the deltaic zone of the reservoir. In addition to the impact of extreme climate events on sediment dynamics, the development of agriculture along the riverine system after an extreme phase of ENSO increased the availability of sediments in the main channel of the rivers, easily transported by the next EENE. This study suggests that intensification of human activities associated with a higher frequency of extreme rainfall events amplified the quantity of sediment transported by the river system, which will significantly decrease the lifespan of the reservoir, which is essential to meeting the freshwater demands of the farmers and the populations living in this arid and semiarid region.

Twelve years after the nuclear accident that occurred at the Fukushima Dai-ichi Nuclear Power Plant (FDNPP) in March 2011, radiocesium contamination (with a large dominance of 137Cs, with a 30-year half-life) remains a major concern in various municipalities of north-eastern Japan. The Japanese authorities completed an unprecedented soil decontamination programme in residential and cultivated areas affected by the main radioactive plume (8953 km2). They implemented a complex remediation programme scheme to remediate soils that are fundamental to life on Earth, relying on different decision rules depending on the waste type, its contamination level and its region of origin, after delineating different zones exposed to contrasted radiation rates. The central objective was not to expose local inhabitants to radioactive doses exceeding 1 mSv yr−1 in addition to the natural levels. At the onset of the full reopening of the Difficult-to-Return Zone (DTRZ) in spring 2023, the current review provides an update of a previous synthesis published in 2019 (Evrard et al., 2019). Although this ambitious soil remediation and reconstruction programme has almost been completed in the 12 municipalities of Fukushima Prefecture in which an evacuation order was imposed in at least one neighbourhood in 2011, from the 147 443 inhabitants who lived there before the accident, only 29.9 % of them had returned by 2020. Waste generated by decontamination and tsunami cleaning/demolition work is planned to have been fully transported to (interim) storage facilities by the end of 2023. The cost of the operations conducted between 2011 and 2020 for the so-called “nuclear recovery” operations (including decontamination) was estimated by the Board of Audit of Japan in 2023 as JPY 6122.3 billion (∼ EUR 44 billion). Decontamination of cropland was shown to have impacted soil fertility, and potassium fertilisation is recommended to limit the transfer of residual radiocesium to new crops. In forests that cover 71 % of the surface area of Fukushima Prefecture and that were not targeted by remediation, radiocesium is now found in the upper mineral layer of the soil in a quasi-equilibrium state. Nevertheless, 137Cs concentrations in forest products (including wood for heating and construction, wild plants, wildlife game, mushrooms) often keep exceeding the threshold values authorised in Japan, which prohibits their exploitation in the area affected by the main plume. Radionuclides from forests were shown to be exported in dissolved and particle-bound forms to downstream river systems and floodplains, although multiple monitoring records showed the continuous decrease in radiocesium concentrations in both river water and sediment across the main plume between 2011 and 2021. Fish contamination is now generally found to be below the threshold limits although reputational damage remains a major concern for local fishing communities. The remobilisation of radiocesium from sediment accumulated in reservoirs of the region is also of potential concern as it may lead to secondary contamination of fish or irrigation waters supplied to decontaminated fields. Overall, this synthesis demonstrates the need to continue monitoring post-accidental radiocesium transfer in these environments and to keep sharing data in order to refine our predictive understanding of radiocesium mobility and consolidate the tools available to model contaminant transfer in ecosystems. In forests in particular, novel countermeasures and wood uses remain to be developed and tested. Furthermore, the hydrologic connectivity between soils under different ecosystems greatly influences long-term radiocesium transport. The consequences of extreme phenomena (e.g. typhoons, forest fires) that may become more frequent in the future as a result of global change in these contaminated environments should be further anticipated.

Abstract Background Except in a few retrospective studies mainly including patients under chemotherapy, information regarding the impact of immunosuppressive therapy on the prognosis of patients admitted to the intensive care unit (ICU) for septic shock is scarce. Accordingly, the PACIFIC study aimed to asses if immunosuppressive therapy is associated with an increased mortality in patients admitted to the ICU for septic shock. Methods This was a retrospective epidemiological multicentre study. Eight high enroller centres in septic shock randomised controlled trials (RCTs) participated in the study. Patients in the “exposed” group were selected from the screen failure logs of seven recent RCTs and excluded because of immunosuppressive treatment. The “non-exposed” patients were those included in the placebo arm of the same RCTs. A multivariate logistic regression model was used to estimate the risk of death. Results Among the 433 patients enrolled, 103 were included in the “exposed” group and 330 in the “non-exposed” group. Reason for immunosuppressive therapy included organ transplantation (n = 45 [44%]) or systemic disease (n = 58 [56%]). ICU mortality rate was 24% in the “exposed” group and 25% in the “non-exposed” group (p = 0.9). Neither in univariate nor in multivariate analysis immunosuppressive therapy was associated with a higher ICU mortality (OR: 0.95; [95% CI 0.56–1.58]: p = 0.86 and 1.13 [95% CI 0.61–2.05]: p = 0.69, respectively) or 3-month mortality (OR: 1.13; [95% CI 0.69–1.82]: p = 0.62 and OR: 1.36 [95% CI 0.78–2.37]: p = 0.28, respectively). Conclusions In this study, long-term immunosuppressive therapy excluding chemotherapy was not associated with significantly higher or lower ICU and 3-month mortality in patients admitted to the ICU for septic shock.