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A 72-year-old woman presented with acute symptoms of congestive heart failure exacerbation and cardiogenic shock secondary to flow alarms in her HeartMate II left ventricular assist device (LVAD) placed in 2013. Her rapid deterioration required venoarterial extracorporeal membrane oxygenation placement with subsequent cardiac catheterization. A computed tomography scan corroborated 90% stenosis of the LVAD outflow graft with mural thrombus causing cardiogenic shock. A multidisciplinary team proceeded with endovascular treatment of the LVAD outflow obstruction via realignment with percutaneous angioplasty and placement of covered stent grafts. After in-hospital recovery, she was discharged to a rehabilitation facility.

Abstract Acute heart failure and cardiogenic shock are a major cause of morbidity and mortality in patients who have had recent cardiac surgery, myocardial infarct or pulmonary hypertension. The use of percutaneous mechanical circulatory support (MCS) devices before organ failure occurs can improve outcomes in these patients. Imaging plays a key role in identifying appropriate positioning of MCS devices for supporting ventricle function. These devices can be used for left ventricle, right ventricle or biventricular support. Fluoroscopy, angiography and echocardiography are used for implanting these devices. Radiographs and CT can identify both intra- and extra-cardiac complications. The cardiothoracic imager will see increasing use of these devices and familiarity with their normal appearance and complications is important. Critical relevance statement Chest radiographs and CT are useful for assessing the position of the mechanical cardiac support device used for treatment of acute heart failure. CT can identify cardiac and extra-cardiac complications associated with these devices. Graphical abstract Key points IABP upper/distal marker should be 2–3 cm distal to the ostia of the left subclavian artery. Inlet of Impella CP should be 3.5 cm below the aortic valve. The Impella 5.5 does not have a pigtail portion. The inlet should be about 5 cm below the aortic annulus. Impella RP inlet port should be in the right atrium or inferior vena cava, the pigtail portion should be positioned in the main pulmonary artery. Protek Duo inflow is in the right atrium or right ventricle. The outflow is in the main pulmonary artery.

Anurans (frogs and toads) are the most vocal amphibians. In most species, only males produce advertisement calls for defending territories and attracting mates. Female vocalizations are the exceptions among frogs, however in the African clawed frog (Xenopus laevis) both males and females produce distinct vocalizations. The matched filter hypothesis predicts a correspondence between peripheral auditory tuning of receivers and properties of species-specific acoustic signals, but few studies have assessed this relationship between the sexes. Measuring hearing sensitivity with a binaural recording of distortion product otoacoustic emissions, we have found that the ears of the males of this species are tuned to the dominant frequency of the female's calls, whereas the ears of the females are tuned close to the dominant frequency of the male's calls. Our findings provide support for the matched filter hypothesis extended to include male-female calling. This unique example of reciprocal matched filtering ensures that males and females communicate effectively in high levels of background noise, each sex being most sensitive to the frequencies of the other sex's calls.

In the United States, current endovascular repair of proximal arch pathology is limited by patient anatomy, and the availability of Food and Drug Administration (FDA) approved devices. Through the first FDA-authorized Compassionate Use (CU) of a modified scalloped Terumo RelayPro Plus, we describe an endovascular repair of a type Ia endoleak, in a patient with bovine arch anatomy, with distal arch aneurysmal degeneration after an open type A dissection repair and failed conventional TEVAR. Further investigation is warranted to determine whether the increased effective seal zone provided by a scalloped thoracic endograft decreased the risk of type Ia endoleak and subsequent dissection-related aneurysmal degeneration in the aortic arch.

Through the rise of global commodity chains, consumer demand in China and the USA has given rise to the extraction of natural resources in the Congo Basin. The Chinese market for high-valued animal products such as elephant ivory and pangolin scales has encouraged poaching, exploitation and trafficking of these goods in Africa. Chinese demand for other African commodities, however, remains less well known. Using data across a 15-year period (2001–2015), we analysed the relationship between Chinese timber imports and tree-cover loss in the Congo Basin. Tree-cover loss was measured via remote sensing and the value of imports was obtained from official trade statistics. Results indicate that the total accumulated export of wood from Congo Basin countries to China doubled between 2001 and 2015, with 50% of exports originating from Cameroon and the Republic of Congo. We found a positive relationship between measures of Chinese logging and the loss of tree cover in the Congo Basin. Further investigation of the timber products market showed that US demand for Chinese-made furniture was positively correlated with Chinese timber imports from the Congo Basin. These findings suggest that US demand for furniture encourages Chinese economic actors to harvest timber from Congo Basin forests. Our results help to illuminate the complex environmental and economic drivers surrounding trade and deforestation and can help inform consumers about more sustainable ways to purchase wood products from one of the world's preeminent biodiversity hotspots.

Abstract Effective communication requires a match among signal characteristics, environmental conditions, and receptor tuning and decoding. The degree of matching, however, can vary, among others due to different selective pressures affecting the communication components. For evolutionary novelties, strong selective pressures are likely to act upon the signal and receptor to promote a tight match among them. We test this prediction by exploring the coupling between the acoustic signals and auditory sensitivity in Liolaemus chiliensis, the Weeping lizard, the only one of more than 285 Liolaemus species that vocalizes. Individuals emit distress calls that convey information of predation risk to conspecifics, which may respond with antipredator behaviors upon hearing calls. Specifically, we explored the match between spectral characteristics of the distress calls and the tympanic sensitivities of two populations separated by more than 700 km, for which previous data suggested variation in their distress calls. We found that populations differed in signal and receptor characteristics and that this signal variation was explained by population differences in body size. No precise match occurred between the communication components studied, and populations differed in the degree of such correspondence. We suggest that this difference in matching between populations relates to evolutionary processes affecting the Weeping lizard distress calls.

Males of the coqui treefrog, Eleutherodactylus coqui, produce a distinct two-note 'co-qui' advertisement call from sunset to midnight throughout most of the year. Previous work established that both the spectrotemporal aspects of the call and the frequency of highest inner-ear sensitivity change with altitude above sea level. These variations are such that the frequency of the emitted co-note closely matches the frequency to which the inner ear is most sensitive. Given this parallel variation, we expected that the call-evoked behavioural response of male coqui treefrogs would also show an altitude dependence, and hypothesized that males would produce their most robust acoustical territorial response to advertisement calls that match calls from their own altitude. We tested this hypothesis in the field by studying the vocal response behaviour of coquis to playbacks of synthetic, altitude-dependent conspecific calls, and indeed found that the most robust vocal responses were obtained using stimuli closely matching the calls from the same altitude.

This article analyzes the activities of Southeast Asian civil society organizations (CSOs) with regard to citizens' online freedom of expression (digital rights) against the backdrop of China's increasing digital investments in the region through its Digital Silk Road (DSR) concept. CSO behavior relating to citizens' digital rights contributes to the on-the-ground, agency-driven perspective among countries that are targets of Chinese digital infrastructure investments. This perspective is underrepresented in the literature surrounding China's contemporary global rise. Focusing specifically on Indonesia, Malaysia, and the Philippines—three countries that rank as "high" recipients of Beijing's media influence (one form of digital technology influence)—this article sheds light on two phenomena. First, the Southeast Asian CSO landscape currently focuses on pressing issues threatening freedom of expression in national and regional spaces, such as national government surveillance, misinformation campaigns, and internet shutdowns, more so than the "digital Chinese threat." Second, although pushback against the threats to Southeast Asians' digital rights often has connections to China's digital technologies, the reality that digital repression techniques are organized and executed by Southeast Asian governmental regimes (and not by Chinese actors) generates contradictions that run counter to the democratic ideals espoused by these countries and align more closely with the Chinese states' views relating to information organization and control. [ABSTRACT FROM AUTHOR]

Animal acoustic communication often takes the form of complex sequences, made up of multiple distinct acoustic units. Apart from the well-known example of birdsong, other animals such as insects, amphibians, and mammals (including bats, rodents, primates, and cetaceans) also generate complex acoustic sequences. Occasionally, such as with birdsong, the adaptive role of these sequences seems clear (e.g. mate attraction and territorial defence). More often however, researchers have only begun to characterise - let alone understand - the significance and meaning of acoustic sequences. Hypotheses abound, but there is little agreement as to how sequences should be defined and analysed. Our review aims to outline suitable methods for testing these hypotheses, and to describe the major limitations to our current and near-future knowledge on questions of acoustic sequences. This review and prospectus is the result of a collaborative effort between 43 scientists from the fields of animal behaviour, ecology and evolution, signal processing, machine learning, quantitative linguistics, and information theory, who gathered for a 2013 workshop entitled, 'Analysing vocal sequences in animals'. Our goal is to present not just a review of the state of the art, but to propose a methodological framework that summarises what we suggest are the best practices for research in this field, across taxa and across disciplines. We also provide a tutorial-style introduction to some of the most promising algorithmic approaches for analysing sequences. We divide our review into three sections: identifying the distinct units of an acoustic sequence, describing the different ways that information can be contained within a sequence, and analysing the structure of that sequence. Each of these sections is further subdivided to address the key questions and approaches in that area. We propose a uniform, systematic, and comprehensive approach to studying sequences, with the goal of clarifying research terms used in different fields, and facilitating collaboration and comparative studies. Allowing greater interdisciplinary collaboration will facilitate the investigation of many important questions in the evolution of communication and sociality.

Aging is the gradual decline in physical and physiological functioning leading to increased susceptibility to stressors and chronic illnesses, including cardiovascular disease. With an aging global population, in which 1 in 6 individuals will be older than 60 years by 2030, interventional cardiologists are increasingly involved in providing complex care for older individuals. Although procedural aspects remain their main clinical focus, interventionalists frequently encounter age-associated risks that influence eligibility for invasive care, decision making during the intervention, procedural adverse events, and long-term management decisions. The unprecedented growth in transcatheter interventions, especially for structural heart diseases at extremes of age, have pushed age-related risks and implications for cardiovascular care to the forefront. In this JACC state-of-the-art review, the authors provide a comprehensive overview of the aging process as it relates to cardiovascular interventions, with special emphasis on the difference between chronological and biological aging. The authors also address key considerations to improve health outcomes for older patients during and after their invasive cardiovascular care. The role of "gerotherapeutics" in interventional cardiology, technological innovation in measuring biological aging, and the integration of patient-centered outcomes in the older adult population are also discussed. [Display omitted] • Chronological age measures the linear passage of time from birth until old age. • Biological age reflects the pathophysiological changes that occur over time. • Understanding biological aging is critical for interventional cardiology care in older adults. [ABSTRACT FROM AUTHOR]

Hadley Narins,1 Kent Chevli,1,2 Richard Gilbert,2 Michael Duff,1,2 Andrew Toenniessen,2 Yan Hu31Department of Urology, State University of New York at Buffalo Medical School, Buffalo, NY, USA; 2Western New York Urology Associates, Cheektowaga, NY, USA; 3Department of Pathology, State University of New York at Buffalo Medical School, Buffalo, NY, USAAbstract: Spermatocytic seminoma (SS) is a rare entity, accounting for 2%–12% of all seminomas; amongst those, fewer than 10% are bilateral. These may occur synchronously or metachranously. We report here a case of bilateral SS in a 63-year-old patient, who initially presented with bilateral testicular masses. In our search of the literature, this represents the fifth documented case of synchronous, bilateral SS.Keywords: spermatocytic seminoma, bilateral seminoma, testicular, urology, scrotal swelling

Examined the relationship between body mass index (BMI) of adolescents and their perceived-weight status and self-concept. Results based on 17,318 females and 15,878 males indicate that substantial numbers of teenage females perceive themselves as overweight when BMI values suggest they are not. Males reported reasonably accurate weight perceptions. (RJM)