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ABSTRACTSmall-scale fisheries provide nutrients to hundreds of millions of people worldwide, with yields dependent on the condition of marine habitats such as coral reefs. Small-scale fisheries are a particularly important food source in societies with nutrient deficiencies and where unhealthy food alternatives are widely available. Using data from coral reef surveys around two islands in French Polynesia (Moorea and Raiatea), we show how the availability of nutrients to fisheries changed in relation to the condition of coral habitat. Fish biomass and nutrient availability were highest when coral cover was low around both islands, driven predominantly by abundant herbivorous reef fish. We also investigated the importance of fish in people’s diets, to determine if fish consumption was aligned with available fisheries resources on local reefs and if nutrient intakes from fish could be explained by people’s socioeconomic background. People ate a higher diversity of reef fish in Raiatea, however nutrient intakes from fish were higher in Moorea. Most people ate more fish than meat on both islands, however fish consumption declined over generations. People from fishing households had higher nutrient intakes from reef and pelagic fish, and people from farming households had higher intakes from reef fish. Preference for eating reef fish over pelagic fish was also associated with higher total nutrient intakes. Promoting traditional diets rich in fish could be key to meeting people’s nutritional needs in French Polynesia while reducing diet-related health issues linked to the overconsumption of fat. French and Tahitian versions of the Abstract are available in Supplementary Material.

Abstract Despite advancements in understanding the pathophysiology of Multiple Myeloma (MM), the cause of rapid progressing disease in a subset of patients is still unclear. MM’s progression is facilitated by complex interactions with the surrounding bone marrow (BM) cells, forming a microenvironment that supports tumor growth and drug resistance. Understanding the immune microenvironment is key to identifying factors that promote rapid progression of MM. To accomplish this, we performed a multi-center single-cell RNA sequencing (scRNA-seq) study on 102,207 cells from 48 CD138- BM samples collected at the time of disease diagnosis from 18 patients with either rapid progressing (progression-free survival (PFS) 4 years) disease. Comparative analysis of data from three centers demonstrated similar transcriptome profiles and cell type distributions, indicating subtle technical variation in scRNA-seq, opening avenues for an expanded multicenter trial. Rapid progressors depicted significantly higher enrichment of GZMK + and TIGIT + exhausted CD8+ T-cells (P = 0.022) along with decreased expression of cytolytic markers (PRF1, GZMB, GNLY). We also observed a significantly higher enrichment of M2 tolerogenic macrophages in rapid progressors and activation of pro-proliferative signaling pathways, such as BAFF, CCL, and IL16. On the other hand, non-progressive patients depicted higher enrichment for immature B Cells (i.e., Pre/Pro B cells), with elevated expression for markers of B cell development (IGLL1, SOX4, DNTT). This multi-center study identifies the enrichment of various pro-tumorigenic cell populations and pathways in those with rapid progressing disease and further validates the robustness of scRNA-seq data generated at different study centers.

Abstract Functional implications of left ventricular (LV) morphological characterization in congenital heart disease are not widely explored. This study qualitatively and quantitatively assessed LV shape associations with a) LV function and b) thoracic aortic morphology in patients with aortic coarctation (CoA) with/without bicuspid aortic valve (BAV), and healthy controls. A statistical shape modelling framework was employed to analyse three-dimensional (3D) LV shapes from cardiac magnetic resonance (CMR) data in isolated CoA (n = 25), CoA + BAV (n = 30), isolated BAV (n = 30), and healthy controls (n = 25). Average 3D templates and deformations were computed. Correlations between shape data and CMR-derived morphometric parameters (i.e., sphericity, conicity) or global and apical strain values were assessed to elucidate possible functional implications. The relationship between LV shape features and arch architecture was also explored. The LV template was shorter and more spherical in CoA patients. Sphericity was overall associated with global and apical radial (p = 0.001, R2 = 0.09; p

En los primeros meses del año 2020, la Organización Mundial de la Salud le otorgó oficialmente categoría de pandemia global al Coronavirus, o COVID-19, un virus prácticamente desconocido para el común de las personas hasta apenas unos meses antes. Expandida a una vertiginosa velocidad hasta alcanzar cada rincón del planeta, la pandemia produjo profundos efectos en diferentes latitudes y en distintos aspectos de las interacciones humanas, incluyendo las relaciones cívico-militares. El hemisferio americano no estuvo ajeno a esa transformación, y su esfera política registró importantes impactos. En ese marco, el presente trabajo analiza la evolución de los roles militares en América y contempla las implicancias posibles para el futuro regional, en relación con los temas del control cívico-militar, la gobernanza democrática y el fortalecimiento institucional.

Objectives To assess the effectiveness of injectable tissue pulmonary valve compared with standard pulmonary valve in patients requiring pulmonary valve replacement surgery.Design A multicentre, single-blind, parallel two-group randomised controlled trial. Participants were blind to their allocation. Follow-up continued for 6 months. Randomised allocations were generated by a computer using block randomisation, stratified by centre.Setting Two National Health Service secondary care centres in the UK.Participants People aged 12–80 years requiring pulmonary valve replacement.Interventions Participants were randomly allocated (1:1 ratio) to injectable pulmonary valve replacement (IPVR) without cardiopulmonary bypass (CPB) or standard pulmonary valve replacement (SPVR) with CPB.Primary and secondary outcome measures The primary outcome was chest drainage volume over the first 24 hours after surgery. Secondary outcomes included in-hospital clinical outcomes; valve and heart function 6 months postsurgery and health-related quality of life 6 weeks and 6 months postsurgery.Results Nineteen participants agreed to take part. Eleven were allocated to IPVR and eight to SPVR. The trial was stopped before the target sample size of 60 participants was reached due to challenges in recruitment. The primary analysis includes all randomised participants; there were no withdrawals. Chest drain volume 24 hours after surgery was on average 277.6 mL lower with IPVR (IPVR mean 340.0 mL; SPVR mean 633.8 mL; mean difference, −277.6; 95% CI, −484.0 to −71.2; p=0.005). There were no statistically significant differences in time to readiness for extubation (p=0.476), time to fitness for discharge (p=0.577) and time to first discharge from the intensive care unit (p=0.209). Six participants with IPVR required CPB. Safety profiles and quality of life scores were similar.Conclusions IPVR reduced chest drain volume despite >50% of participants requiring CPB. There was no evidence of any other benefit of IPVR.Trial registration number ISRCTN23538073.

Abstract Ultrasound (US) has been shown to stimulate brain circuits, however, the ability to excite peripheral nerves with US remains controversial. To the best of our knowledge, there is still no in vivo neural recording study that has applied US stimulation to a nerve isolated from surrounding tissue to confirm direct activation effects. Here, we show that US cannot excite an isolated mammalian sciatic nerve in an in vivo preparation, even at high pressures (relative to levels recommended in the FDA guidance for diagnostic ultrasound) and for a wide range of parameters, including different pulse patterns and center frequencies. US can, however, reliably inhibit nerve activity whereby greater suppression is correlated with increases in nerve temperature. By prohibiting the nerve temperature from increasing during US application, we did not observe suppressive effects. Overall, these findings demonstrate that US can reliably inhibit nerve activity through a thermal mechanism that has potential for various health disorders, though future studies are needed to evaluate the long-term safety of therapeutic ultrasound applications.

Caseous mitral annular calcification (CMAC), sometimes called liquefaction necrosis of mitral annular calcification (MAC), is a rare variant of MAC, a chronic degenerative process that progresses with age. It is a degenerative abnormality of the fibrous tissue and typically involves the posterior annulus, appearing as a smooth mass with no flow or acoustic shadow artefacts. It can be differentiated from other cardiac masses by CT and MRI. Whilst benign in nature, it is associated with a range of pathologies, such as mitral valve dysfunction, arrhythmias, and systemic embolisation. Given the risk of systemic embolisation, surgery may be appropriate, but there is no clear consensus in the literature in patients who are asymptomatic. This case highlights a case of CMAC presenting with a retinal artery occlusion, and was managed conservatively. Background The mitral annulus is a key component of the mitral valve, ensuring appropriate function by facilitating complete closure of the leaflets during systole. With age, MAC can occur, potentially resulting in mitral valve dysfunction, infective endocarditis, and arrhythmias. CMAC is a rare variant of MAC, typically involving the posterior annulus. Whilst benign, the risk of complications, such as systemic embolisation, may indicate a surgical approach to management, even in patients who are asymptomatic. Case Presentation A 60-year-old female, presenting with sudden loss of vision in the lower part of her left eye due to a branch retinal artery embolus, was admitted from ophthalmology services. An outpatient transthoracic echocardiogram showed an abnormal mass on the posterior annulus of the mitral valve. Transoesophageal echocardiography identified a calcified posterior aspect of the mitral annulus with normal leaflet mobility and trivial regurgitation, and an echogenic mass attached to the ventricular aspect of the mitral annulus (at the level of posteromedial commissure), 9x4 mm in size. A cardiac CT showed a caseous mitral valve with evidence of rupture of the calcified shell. Discussion with the surgical multidisciplinary team resulted in a conservative approach, with follow-up echo for monitoring. Conclusion Whilst a benign and rare variant of MAC, CMAC is associated with a range of pathologies, including mitral valve disease, arrhythmias, and systemic embolisation. Currently, there is no standardised management approach for CMAC. Surgery is currently recommended in the context of already known surgically indicated pathologies, such as severe mitral valve disease or systemic embolisation. However, this conservatively-managed patient has had no further complications with stable echocardiographic appearance on repeat echo 3 months following initial exam.

Background: The coronavirus disease-2019 (COVID-19) pandemic significantly affected management of cardiovascular disease around the world. The effect of the pandemic on volume of cardiovascular diagnostic procedures is not known. Objectives: This study sought to evaluate the effects of the early phase of the COVID-19 pandemic on cardiovascular diagnostic procedures and safety practices in Asia. Methods: The International Atomic Energy Agency conducted a worldwide survey to assess changes in cardiovascular procedure volume and safety practices caused by COVID-19. Testing volumes were reported for March 2020 and April 2020 and were compared to those from March 2019. Data from 180 centers across 33 Asian countries were grouped into 4 subregions for comparison. Results: Procedure volumes decreased by 47% from March 2019 to March 2020, showing recovery from March 2020 to April 2020 in Eastern Asia, particularly in China. The majority of centers cancelled outpatient activities and increased time per study. Practice changes included implementing physical distancing and restricting visitors. Although COVID testing was not commonly performed, it was conducted in one-third of facilities in Eastern Asia. The most severe reductions in procedure volumes were observed in lower-income countries, where volumes decreased 81% from March 2019 to April 2020. Conclusions: The COVID-19 pandemic in Asia caused significant reductions in cardiovascular diagnostic procedures, particularly in low-income countries. Further studies on effects of COVID-19 on cardiovascular outcomes and changes in care delivery are warranted.

BackgroundMyocardial infarction induces elevation of progenitor cells in the circulation, a reparative response inhibited by type-2 diabetes.ObjectivesDetermine if myocardial infarct severity and diabetes interactively influence the migratory activity of CD34+/CXCR4+ progenitor cells and if the migratory test predicts cardiac outcomes.Materials and methodsA longitudinal study was conducted on patients with or without diabetes with a STEMI or NSTEMI. CD34+/CXCR4+ cells were measured in the peripheral blood using flow cytometry, and migratory activity was tested in vitro on cells isolated from samples collected on days 0 and 4 post-infarct. Cardiac function was assessed at three months using cardiac MRI.ResultsOf 1,149 patients screened, 71 (6.3%) were eligible and consented. Fifty had STEMI (16 with diabetes) and 21 NSTEMI (8 with diabetes). The proportion of CD34+/CXCR4+ cells within blood mononuclear cells was 1.96 times higher after STEMI compared with NSTEMI (GMR = 1.96, 95% CI 0.87, 4.37) and 1.55 times higher in patients with diabetes compared to patients without diabetes (GMR = 1.55, 95% CI 0.77, 3.13). In the latter, STEMI was associated with a 2.42-times higher proportion of migrated CD34 + /CXCR4 + cells compared with NSTEMI (GMR = 2.42, 95% CI 0.66, 8.81). In patients with diabetes, the association was the opposite, with a 55% reduction in the proportion of migrated CD34+/CXCR4+ cells. No statistically significant associations were observed between the frequency in peripheral blood or in vitro migration capacity of CD34+/CXCR4+ cells and MRI outcomes.ConclusionWe document the interaction between infarct and diabetes on the migratory activity of CD34+/CXCR4+ cells. The test did not predict functional outcomes in the studied cohort.

Hawkweeds (Pilosella spp.) have become a severe and rapidly invading weed in pasture lands and forest meadows of New Zealand. Detection of hawkweed infestations is essential for eradication and resource management at private and government levels. This study explores the potential of machine learning (ML) algorithms for detecting mouse-ear hawkweed (Pilosella officinarum) foliage and flowers from Unmanned Aerial Vehicle (UAV)-acquired multispectral (MS) images at various spatial resolutions. The performances of different ML algorithms, namely eXtreme Gradient Boosting (XGB), Support Vector Machine (SVM), Random Forest (RF), and K-nearest neighbours (KNN), were analysed in their capacity to detect hawkweed foliage and flowers using MS imagery. The imagery was obtained at numerous spatial resolutions from a highly infested study site located in the McKenzie Region of the South Island of New Zealand in January 2021. The spatial resolution of 0.65 cm/pixel (acquired at a flying height of 15 m above ground level) produced the highest overall testing and validation accuracy of 100% using the RF, KNN, and XGB models for detecting hawkweed flowers. In hawkweed foliage detection at the same resolution, the RF and XGB models achieved highest testing accuracy of 97%, while other models (KNN and SVM) achieved an overall model testing accuracy of 96% and 72%, respectively. The XGB model achieved the highest overall validation accuracy of 98%, while the other models (RF, KNN, and SVM) produced validation accuracies of 97%, 97%, and 80%, respectively. This proposed methodology may facilitate non-invasive detection efforts of mouse-ear hawkweed flowers and foliage in other naturalised areas, enabling land managers to optimise the use of UAV remote sensing technologies for better resource allocation.

The emergence of COVID-19 (SARS-CoV-2) led to distancing measures which acutely affected healthcare infrastructure, leading to limited in-person clinical visits and an increased number of virtual appointments. This study aimed to examine the effects this had on adults with hydrocephalus by describing the lived experiences of a cohort of patients at an outpatient hydrocephalus clinic. Between early May and early July of 2020, remote structured interviews were conducted with participants. Interviews were in-depth and open-ended, allowing participants to reflect and expand on the effects of the social distancing mandate on their well-being and quality of care. Three themes emerged: (1) impacts of changes in treatment provision, (2) impacts of changes in mitigating activities, and (3) impacts of changes on personal well-being. The comprehensive understanding of lived experiences may inform the future provision of healthcare services and social policy. Improved approaches to remote care telemedicine have the potential to facilitate high-quality care.

Abstract Background Diabetic foot ulcers (DFU) are a common problem in longstanding diabetes. However, mortality outcomes in Australian patients with DFU are still unclear. Methods All patients with DFU presenting for the first time to the Multi-Disciplinary Foot Clinic (MDFC) at Royal Darwin Hospital, Northern Territory Australia, between January 2003 and June 2015 were included in this study. These patients were followed until 2017, or death. Individual patient data was extracted from hospital and primary care information systems. Kaplan-Meier survival curves were developed. The association between various risk factors and mortality was analysed using Cox regression. Results In total 666 subjects were screened, and 513 were included in the final analysis. Of these subjects, 247 were Indigenous and 266 were non-Indigenous. The median follow-up period was 5.8 years (IQR, 3.1–9.8). The mean age at inclusion was 59.9 ± 12.3 years and 62.8% were males. The majority (93.6%) had type 2 diabetes and the median diabetes duration was 7 years (IQR, 3–12). There were 199 deaths, with a 5-year-mortality rate of 24.6%, and a 10-year-mortality rate of 45.4%. The mean age at death was 64.6 ± 11.8 years. In a multivariate analysis, the following variables were associated with mortality (adjusted HR, 95% CI): age 1.04 (1.02–1.05, P

Aim: This study sought to evaluate the feasibility and effectiveness of TAVI for treatment of aortic stenosis in the ACHD population. Methods and results: Review of 802 patients that underwent TAVI from January 2008 to November 2019. 13 ACHD patients with different underlying congenital anatomy were identified (isolated bicuspid aortic valve was excluded and not defined as ACHD). The main endpoints were: paravalvular aortic regurgitation> grade 2 post-procedure, and all-cause 30-day mortality. Periprocedural and post-procedural complications were defined according to the UK TAVI registry. Median age was 66.7 years (range 29–84 years). Eleven patients had severe aortic stenosis (AS), 1 had both severe AS and severe aortic regurgitation (AR) and 1 had severe AR. Median hospital stay was 9 days (range 6–28 days). One patient required a pacemaker post-TAVI. No mortality or paravalvular AR > grade 2 at 30-days. Twelve patients had a reduction in NYHA class on their first post TAVI follow-up. Conclusion: TAVI is viable option as an alternative to surgery for ACHD patients. Further experience with the use of TAVI in the ACHD patients is required to assess long-term outcomes in this unique group of patients.

BackgroundHypertension is a major cause of preventable disability and death globally and affects more than one in four adults in England. Unwarranted variation is variation in access, quality, outcome or value which is unexplained by differences in the condition or patient characteristics and which reduces quality and efficiency. Distinguishing unwarranted from variation due to clinical, organisational or patient factors can be challenging. We carried out this study to explore inter-practice variation in the diagnosis and management of hypertension in the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) network database, a large, representative surveillance database.Methods and findingWe carried out a cross-sectional study using primary care data extracted from the electronic health records of 1,271,419 adults registered at RCGP RSC general practices on 31st December 2016. Logistic regression was used to indirectly standardise practice-level hypertension prevalence and control against the RCGP RSC population, adjusted for age, gender, ethnicity, deprivation, co-morbidity, NHS region and practice size. Inter-practice variation was demonstrated using funnel plots with 95% and 99.8% control limits. The prevalence of detected hypertension was 18.4% (95% CI 18.4-18.5), n = 234,165. Uncontrolled hypertension was present in 146,553 of 196,052 individuals, 25.2% (25.1-25.4), in whom blood pressure had been recorded in the previous year. Hypertension management varied markedly between practices with a three-fold difference in prevalence, 13.5-38.4%, and a four-fold difference in the proportion of uncontrolled hypertension, 11.8-47.9%. Despite adjustment for sociodemographic and practice characteristics funnel plots demonstrated marked over-dispersion.ConclusionsSubstantial variation in the prevalence of diagnosed hypertension and the management of hypertension was only partially explained by characteristics captured within a routine dataset. The over-dispersion suggests variation is not fully explained by these factors and that context, behaviour and processes of care delivery may contribute to variation. Routine data sources in isolation to not provide sufficient contextual data to diagnose the causes of variation.

Introduction: Hypertension is associated with stiffening of blood vessels, reduced arterial lumen and reduced cerebral blood flow; however, it is not known how lower cerebral blood flow relates to arterial structure or impacts on wave dynamics. We hypothesise increased backward wave energy and faster wave speed in the hypertensive internal carotid artery as an indication of increased resistance to flow. Methods: Normotensive, controlled and uncontrolled hypertensive participants were recruited (daytime ambulatory BP < 135/85 mmHg and >135/85 mmHg, respectively; n = 11 per group). Wave intensity analysis was performed on left internal carotid and ascending aorta phase-contrast magnetic resonance angiography. Results: While ascending aortic wave speed increased significantly in the uncontrolled hypertensive compared to normotensive (p < 0.001) and controlled hypertensive participants (p = 0.038), no significant difference was observed in the internal carotid. Carotid forward and backward wave intensity increased in uncontrolled hypertensives compared to normotensives (p = 0.036 and p = 0.033, respectively), and backward wave energy increased in the controlled hypertensives compared to normotensives (p = 0.041). There was no significant difference between uncontrolled and controlled hypertensives. Figure 1Analysis of the phase contrast MR angiography data. A) Magnitude image B) Phase image of the internal carotid arteries C) Magnitude image and D) Phase image of the ascending aorta E) example of log(Area)-Velocity loop. Red line indicates the slope from which wave speed is calculated in early systole F) Example of the wave Intensity components, where blue is the forward wave energy, red is the backward wave energy and black is the net wave intensity. Conclusion: Wave intensity in the internal carotid artery is altered in uncontrolled hypertension. This is partly rescued when blood pressure is controlled by medication, although greater backward wave energy persists. This supports the hypothesis of increased resistance to flow in the cerebral circulation of the hypertensives. Whilst increased aortic wave speed confirmed an expected increase in stiffness, this was not observed in the internal carotid. This might suggest a protective mechanism in the cerebral circulation, in conjunction with the effect of vessel tortuosity.

Následující článek popisuje některé chirurgické zákroky, které se používají za účelem zvyšování sportovního výkonu, a přináší diskusi o některých možných zákrocích, které by mohly být pro tyto účely používány v budoucnosti. U mnoha atletů ve sportovních odvětvích, ve kterých je zásadním předpokladem úspěchu zrak, se provádějí elektivní oční chirurgické zákroky. Vyvstává tím etická otázka, zda je morálně přijatelné provádět zákroky za účelem rozvoje schopností, které přesahují normu, jako je například přesnost zraku 20/10. Nezbytná jsou kritéria pro stanovení morálnosti těchto zákroků, zvláště pak pokud je chirurgický zákrok volitelný, který není motivován terapeutickými potřebami, nýbrž snahou zvýšit výkon a vytvořit schopnosti přesahující normu. Jednou věcí je podstoupit korektivní chirurgický zákrok pro vlastní pohodlí nebo za účelem zpomalení postupu zhoršování, naprosto jinou věcí je pak tento zákrok za účelem dosažení dokonalého zraku jako je 20/10. Přijmeme-li tento spíše neškodný oční chirurgický zákrok a uvážíme-li pokroky v oblasti minimálně invazivních chirurgických metod, přísná opatření proti používání steroidů a stále rostoucí finanční impulsy pro sportovce, je pouze otázkou času, kdy už půjde o to, aby sportovci podstupovali elektivní chirurgické zákroky za tím účelem, aby se stali většími, silnějšími nebo rychlejšími. Elektivní chirurgie se v oblasti zvyšování výkonu rozšíří. Vyvstává tím množství morálních problémů, a proto musíme seriózně začít hledat kritéria, pomocí nichž bude možno morálnost tohoto typu elektivní chirurgie posuzovat, a povzbuzovat sportovní instituce, aby proaktivně vytvářely příslušné strategie. Konečně je zde diskuse o tom, zda lze řešení hledat v transhumanismu, v pragmatickém přístupu nebo v návratu k esencialistickému pohledu na lidskou povahu. The following article describes some surgeries used to enhance athletic performance along with discussion of possible ones that could be used in the upcoming years for this purpose. Elective eye surgery is used by numerous athletes in sports where sight is an essential aspect of success. This raises the ethical question of whether it is morally acceptable to perform enhancement surgery for the purpose of developing capabilities that are superior to normal, such as 20/10 vision. Criteria to determine the morality of these actions is necessary, especially when the surgery is optional and is motivated not by therapeutic needs but to enhance performance and to create an ability above and beyond the norm. It is one thing to have corrective surgery for convenience’s sake or to slow down deterioration, but it is quite another to do it to create superior vision, such as 20/10. With the acceptance of this rather benign eye surgery and due to the advances in minimally invasive surgical techniques, the crackdown on steroid usage, and the growing financial incentives for athletes, it is only a matter of time before this evolves into athletes having elective surgeries to become bigger, stronger, or faster. Elective surgery will expand in its usage to enhance performance. This raises a plethora of moral issues, therefore there must be serious pursuit of criteria to evaluate the morality of this type of elective surgery and encouragement of athletic institutions to be proactive in policy making. Finally, there is discussion on whether a solution can begin to be found in transhumanism, in a pragmatic approach or in returning to an essentialist view of human nature.

Current laboratory research in the field of abdominal aortic aneurysm (AAA) disease often utilizes small animal experimental models induced by genetic manipulation or chemical application. This has led to the use and development of multiple high-resolution molecular imaging modalities capable of tracking disease progression, quantifying the role of inflammation, and evaluating the effects of potential therapeutics. In vivo imaging reduces the number of research animals used, provides molecular and cellular information, and allows for longitudinal studies, a necessity when tracking vessel expansion in a single animal. This review outlines developments of both established and emerging molecular imaging techniques used to study AAA disease. Beyond the typical modalities used for anatomical imaging, which include ultrasound (US) and computed tomography (CT), previous molecular imaging efforts have used magnetic resonance (MR), near-infrared fluorescence (NIRF), bioluminescence, single-photon emission computed tomography (SPECT), and positron emission tomography (PET). Mouse and rat AAA models will hopefully provide insight into potential disease mechanisms, and the development of advanced molecular imaging techniques, if clinically useful, may have translational potential. These efforts could help improve the management of aneurysms and better evaluate the therapeutic potential of new treatments for human AAA disease.