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1. Very-high-energy γ-Ray Emission from Young Massive Star Clusters in the Large Magellanic Cloud

Author: F. Aharonian, F. Ait Benkhali, J. Aschersleben, H. Ashkar, M. Backes, V. Barbosa Martins, R. Batzofin, Y. Becherini, D. Berge, K. Bernlöhr, M. Böttcher, J. Bolmont, M. de Bony de Lavergne, J. Borowska, R. Brose, A. Brown, F. Brun, B. Bruno, C. Burger-Scheidlin, S. Casanova, J. Celic, M. Cerruti, T. Chand, S. Chandra, A. Chen, J. Chibueze, O. Chibueze, G. Cotter, P. Cristofari, J. Devin, A. Djannati-Ataï, J. Djuvsland, A. Dmytriiev, K. Egberts, S. Einecke, K. Feijen, M. Filipovic, G. Fontaine, S. Funk, S. Gabici, Y. A. Gallant, J. F. Glicenstein, J. Glombitza, G. Grolleron, L. Haerer, B. Heß, J. A. Hinton, W. Hofmann, T. L. Holch, D. Horns, Zhiqiu Huang, M. Jamrozy, F. Jankowsky, I. Jung-Richardt, E. Kasai, K. Katarzyński, R. Khatoon, B. Khélifi, W. Kluźniak, Nu. Komin, K. Kosack, D. Kostunin, A. Kundu, R. G. Lang, S. Le Stum, A. Lemière, M. Lemoine-Goumard, J.-P. Lenain, F. Leuschner, J. Mackey, V. Marandon, G. Martí-Devesa, R. Marx, A. Mehta, A. Mitchell, R. Moderski, M. O. Moghadam, L. Mohrmann, A. Montanari, E. Moulin, M. de Naurois, J. Niemiec, S. Ohm, L. Olivera-Nieto, E. de Ona Wilhelmi, M. Ostrowski, S. Panny, U. Pensec, G. Peron, G. Pühlhofer, A. Quirrenbach, S. Ravikularaman, M. Regeard, A. Reimer, O. Reimer, H. Ren, M. Renaud, B. Reville, F. Rieger, G. Rowell, B. Rudak, E. Ruiz-Velasco, K. Sabri, V. Sahakian, H. Salzmann, A. Santangelo, M. Sasaki, J. Schäfer, F. Schüssler, H. M. Schutte, H. Sol, S. Spencer, Ł. Stawarz, S. Steinmassl, C. Steppa, K. Streil, I. Sushch, A. M. Taylor, R. Terrier, M. Tsirou, N. Tsuji, C. van Eldik, M. Vecchi, C. Venter, J. Vink, S. J. Wagner, R. White, A. Wierzcholska, M. Zacharias, A. A. Zdziarski, A. Zech, N. Żywucka, and H.E.S.S. Collaboration
Subjects: Young star clusters, Massive stars, Large Magellanic Cloud, Gamma-ray astronomy, Astrophysics, QB460-466
Abstract: The Tarantula Nebula in the Large Magellanic Cloud is known for its high star formation activity. At its center lies the young massive star cluster R136, providing a significant amount of the energy that makes the nebula shine so brightly at many wavelengths. Recently, young massive star clusters have been suggested to also efficiently produce very high-energy cosmic rays, potentially beyond PeV energies. Here, we report the detection of very-high-energy γ -ray emission from the direction of R136 with the High Energy Stereoscopic System, achieved through a multicomponent, likelihood-based modeling of the data. This supports the hypothesis that R136 is indeed a very powerful cosmic-ray accelerator. Moreover, from the same analysis, we provide an updated measurement of the γ -ray emission from 30 Dor C, the only superbubble detected at TeV energies presently. The γ -ray luminosity above 0.5 TeV of both sources is (2–3) × 10 ^35 erg s ^−1 . This exceeds by more than a factor of 2 the luminosity of HESS J1646−458, which is associated with the most massive young star cluster in the Milky Way, Westerlund 1. Furthermore, the γ -ray emission from each source is extended with a significance of >3 σ and a Gaussian width of about 30 pc. For 30 Dor C, a connection between the γ -ray emission and the nonthermal X-ray emission appears likely. Different interpretations of the γ -ray signal from R136 are discussed.
Published: 2024
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2. The Vanishing of the Primary Emission Region in PKS 1510–089

Author: F. Aharonian, F. Ait Benkhali, J. Aschersleben, H. Ashkar, M. Backes, V. Barbosa Martins, J. Barnard, R. Batzofin, Y. Becherini, D. Berge, K. Bernlöhr, B. Bi, M. de Bony de Lavergne, M. Böttcher, C. Boisson, J. Bolmont, J. Borowska, M. Bouyahiaoui, F. Bradascio, M. Breuhaus, R. Brose, A. M. Brown, F. Brun, B. Bruno, T. Bulik, C. Burger-Scheidlin, S. Caroff, S. Casanova, R. Cecil, J. Celic, M. Cerruti, T. Chand, S. Chandra, A. Chen, J. Chibueze, O. Chibueze, G. Cotter, J. Damascene Mbarubucyeye, I. D. Davids, A. Djannati-Ataï, A. Dmytriiev, V. Doroshenko, K. Egberts, S. Einecke, J.-P. Ernenwein, S. Fegan, G. Fontaine, M. Füßling, S. Funk, S. Gabici, S. Ghafourizadeh, G. Giavitto, D. Glawion, J. F. Glicenstein, P. Goswami, G. Grolleron, L. Haerer, W. Hofmann, T. L. Holch, M. Holler, D. Horns, M. Jamrozy, F. Jankowsky, V. Joshi, I. Jung-Richardt, E. Kasai, K. Katarzyński, R. Khatoon, B. Khélifi, W. Kluźniak, Nu. Komin, K. Kosack, D. Kostunin, R. G. Lang, S. Le Stum, F. Leitl, A. Lemière, J.-P. Lenain, F. Leuschner, A. Luashvili, J. Mackey, V. Marandon, P. Marchegiani, G. Martí-Devesa, R. Marx, A. Mehta, M. Meyer, A. Mitchell, R. Moderski, L. Mohrmann, A. Montanari, E. Moulin, M. de Naurois, J. Niemiec, A. Priyana Noel, P. O’Brien, S. Ohm, L. Olivera-Nieto, E. de Ona Wilhelmi, M. Ostrowski, S. Panny, M. Panter, G. Peron, D. A. Prokhorov, G. Pühlhofer, M. Punch, A. Quirrenbach, P. Reichherzer, A. Reimer, O. Reimer, H. Ren, F. Rieger, G. Rowell, B. Rudak, H. Rueda Ricarte, E. Ruiz-Velasco, V. Sahakian, H. Salzmann, D. A. Sanchez, A. Santangelo, M. Sasaki, F. Schüssler, H. M. Schutte, U. Schwanke, J. N. S. Shapopi, H. Sol, A. Specovius, S. Spencer, Ł. Stawarz, R. Steenkamp, S. Steinmassl, C. Steppa, I. Sushch, H. Suzuki, T. Takahashi, T. Tanaka, R. Terrier, N. Tsuji, C. van Eldik, B. van Soelen, M. Vecchi, J. Veh, J. Vink, T. Wach, S. J. Wagner, A. Wierzcholska, M. Zacharias, D. Zargaryan, A. A. Zdziarski, A. Zech, S. Zouari, N. Żywucka, D. A. H. Buckley, J. Cooper, D. Groenewald, and H.E.S.S. Collaboration
Subjects: Blazars, Relativistic jets, Non-thermal radiation sources, Flat-spectrum radio quasars, Gamma-ray sources, Spectropolarimetry, Astrophysics, QB460-466
Abstract: In 2021 July, PKS 1510−089 exhibited a significant flux drop in the high-energy γ -ray (by a factor 10) and optical (by a factor 5) bands and remained in this low state throughout 2022. Similarly, the optical polarization in the source vanished, resulting in the optical spectrum being fully explained through the steady flux of the accretion disk and the broad-line region. Unlike the aforementioned bands, the very-high-energy γ -ray and X-ray fluxes did not exhibit a significant flux drop from year to year. This suggests that the steady-state very-high-energy γ -ray and X-ray fluxes originate from a different emission region than the vanished parts of the high-energy γ -ray and optical jet fluxes. The latter component has disappeared through either a swing of the jet away from the line of sight or a significant drop in the photon production efficiency of the jet close to the black hole. Either change could become visible in high-resolution radio images.
Published: 2023
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3. Constraints on the Intergalactic Magnetic Field Using Fermi-LAT and H.E.S.S. Blazar Observations

Author: F. Aharonian, J. Aschersleben, M. Backes, V. Barbosa Martins, R. Batzofin, Y. Becherini, D. Berge, B. Bi, M. Bouyahiaoui, M. Breuhaus, R. Brose, F. Brun, B. Bruno, T. Bulik, C. Burger-Scheidlin, T. Bylund, S. Caroff, S. Casanova, J. Celic, M. Cerruti, T. Chand, S. Chandra, A. Chen, J. Chibueze, O. Chibueze, G. Cotter, M. de Bony, K. Egberts, J.-P. Ernenwein, G. Fichet de Clairfontaine, M. Filipovic, G. Fontaine, M. Füssling, S. Funk, S. Gabici, S. Ghafourizadeh, G. Giavitto, D. Glawion, J. F. Glicenstein, P. Goswami, M.-H. Grondin, L. Haerer, T. L. Holch, M. Holler, D. Horns, M. Jamrozy, F. Jankowsky, V. Joshi, I. Jung-Richardt, E. Kasai, K. Katarzyński, R. Khatoon, B. Khélifi, W. Kluźniak, Nu. Komin, K. Kosack, D. Kostunin, R. G. Lang, S. Le Stum, F. Leitl, A. Lemière, J.-P. Lenain, F. Leuschner, T. Lohse, A. Luashvili, I. Lypova, J. Mackey, D. Malyshev, V. Marandon, P. Marchegiani, A. Marcowith, G. Martí-Devesa, R. Marx, M. Meyer, A. Mitchell, R. Moderski, L. Mohrmann, A. Montanari, E. Moulin, J. Muller, T. Murach, K. Nakashima, J. Niemiec, S. Ohm, L. Olivera-Nieto, E. de Ona Wilhelmi, S. Panny, M. Panter, R. D. Parsons, G. Peron, D. A. Prokhorov, H. Prokoph, G. Pühlhofer, M. Punch, A. Quirrenbach, P. Reichherzer, A. Reimer, O. Reimer, B. Reville, F. Rieger, G. Rowell, B. Rudak, E. Ruiz-Velasco, V. Sahakian, D. A. Sanchez, M. Sasaki, F. Schüssler, H. M. Schutte, U. Schwanke, J. N. S. Shapopi, H. Sol, S. Spencer, S. Steinmassl, H. Suzuki, T. Takahashi, T. Tanaka, A. M. Taylor, R. Terrier, C. Thorpe-Morgan, M. Tsirou, N. Tsuji, Y. Uchiyama, C. van Eldik, J. Veh, C. Venter, S. J. Wagner, R. White, A. Wierzcholska, Yu Wun Wong, M. Zacharias, D. Zargaryan, A. A. Zdziarski, S. Zouari, N. Żywucka, H.E.S.S. Collaboration, and Fermi-LAT Collaboration
Subjects: Active galaxies, High energy astrophysics, Extragalactic magnetic fields, Astrophysics, QB460-466
Abstract: Magnetic fields in galaxies and galaxy clusters are believed to be the result of the amplification of intergalactic seed fields during the formation of large-scale structures in the universe. However, the origin, strength, and morphology of this intergalactic magnetic field (IGMF) remain unknown. Lower limits on (or indirect detection of) the IGMF can be obtained from observations of high-energy gamma rays from distant blazars. Gamma rays interact with the extragalactic background light to produce electron−positron pairs, which can subsequently initiate electromagnetic cascades. The gamma-ray signature of the cascade depends on the IGMF since it deflects the pairs. Here we report on a new search for this cascade emission using a combined data set from the Fermi Large Area Telescope and the High Energy Stereoscopic System. Using state-of-the-art Monte Carlo predictions for the cascade signal, our results place a lower limit on the IGMF of B > 7.1 × 10 ^−16 G for a coherence length of 1 Mpc even when blazar duty cycles as short as 10 yr are assumed. This improves on previous lower limits by a factor of 2. For longer duty cycles of 10 ^4 (10 ^7 ) yr, IGMF strengths below 1.8 × 10 ^−14 G (3.9 × 10 ^−14 G) are excluded, which rules out specific models for IGMF generation in the early universe.
Published: 2023
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4. H.E.S.S. Follow-up Observations of GRB 221009A

Author: F. Aharonian, F. Ait Benkhali, J. Aschersleben, H. Ashkar, M. Backes, A. Baktash, V. Barbosa Martins, R. Batzofin, Y. Becherini, D. Berge, K. Bernlöhr, B. Bi, M. Böttcher, C. Boisson, J. Bolmont, M. de Bony de Lavergne, J. Borowska, M. Bouyahiaoui, F. Bradascio, M. Breuhaus, R. Brose, F. Brun, B. Bruno, T. Bulik, C. Burger-Scheidlin, S. Caroff, S. Casanova, J. Celic, M. Cerruti, T. Chand, S. Chandra, A. Chen, J. Chibueze, O. Chibueze, G. Cotter, S. Dai, J. Damascene Mbarubucyeye, J. Devin, A. Djannati-Ataï, A. Dmytriiev, V. Doroshenko, K. Egberts, S. Einecke, J.-P. Ernenwein, S. Fegan, G. Fichet de Clairfontaine, M. Filipovic, G. Fontaine, M. Füßling, S. Funk, S. Gabici, S. Ghafourizadeh, G. Giavitto, D. Glawion, J. F. Glicenstein, P. Goswami, G. Grolleron, M.-H. Grondin, J. A. Hinton, T. L. Holch, M. Holler, D. Horns, Zhiqiu Huang, M. Jamrozy, F. Jankowsky, V. Joshi, I. Jung-Richardt, E. Kasai, K. Katarzyński, R. Khatoon, B. Khélifi, W. Kluźniak, Nu. Komin, R. Konno, K. Kosack, D. Kostunin, R. G. Lang, S. Le Stum, F. Leitl, A. Lemière, M. Lemoine-Goumard, J.-P. Lenain, F. Leuschner, T. Lohse, I. Lypova, J. Mackey, D. Malyshev, V. Marandon, P. Marchegiani, A. Marcowith, G. Martí-Devesa, R. Marx, M. Meyer, A. Mitchell, L. Mohrmann, A. Montanari, E. Moulin, T. Murach, K. Nakashima, M. de Naurois, J. Niemiec, A. Priyana Noel, P. O’Brien, S. Ohm, L. Olivera-Nieto, E. de Ona Wilhelmi, M. Ostrowski, S. Panny, M. Panter, R. D. Parsons, G. Peron, D. A. Prokhorov, H. Prokoph, G. Pühlhofer, M. Punch, A. Quirrenbach, P. Reichherzer, A. Reimer, O. Reimer, H. Ren, M. Renaud, B. Reville, F. Rieger, G. Rowell, B. Rudak, E. Ruiz-Velasco, V. Sahakian, H. Salzmann, A. Santangelo, M. Sasaki, J. Schäfer, F. Schüssler, H. M. Schutte, U. Schwanke, J. N. S. Shapopi, A. Specovius, S. Spencer, Ł. Stawarz, R. Steenkamp, S. Steinmassl, C. Steppa, I. Sushch, H. Suzuki, T. Takahashi, T. Tanaka, R. Terrier, N. Tsuji, Y. Uchiyama, M. Vecchi, C. Venter, J. Vink, S. J. Wagner, R. White, A. Wierzcholska, Yu Wun Wong, M. Zacharias, D. Zargaryan, A. A. Zdziarski, A. Zech, S. J. Zhu, N. Żywucka, and H.E.S.S. Collaboration
Subjects: Gamma-rays, Gamma-ray bursts, Non-thermal radiation sources, High-energy cosmic radiation, Astrophysics, QB460-466
Abstract: GRB 221009A is the brightest gamma-ray burst (GRB) ever detected. To probe the very-high-energy (VHE; >100 GeV) emission, the High Energy Stereoscopic System (H.E.S.S.) began observations 53 hr after the triggering event, when the brightness of the moonlight no longer precluded observations. We derive differential and integral upper limits using H.E.S.S. data from the third, fourth, and ninth nights after the initial GRB detection, after applying atmospheric corrections. The combined observations yield an integral energy flux upper limit of ${{\rm{\Phi }}}_{\mathrm{UL}}^{95 \% }=9.7\times {10}^{-12}\,\mathrm{erg}\,{\mathrm{cm}}^{-2}\,{{\rm{s}}}^{-1}$ above E _thr = 650 GeV. The constraints derived from the H.E.S.S. observations complement the available multiwavelength data. The radio to X-ray data are consistent with synchrotron emission from a single electron population, with the peak in the spectral energy distribution occurring above the X-ray band. Compared to the VHE-bright GRB 190829A, the upper limits for GRB 221009A imply a smaller gamma-ray to X-ray flux ratio in the afterglow. Even in the absence of a detection, the H.E.S.S. upper limits thus contribute to the multiwavelength picture of GRB 221009A, effectively ruling out an IC-dominated scenario.
Published: 2023
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5. Multiwavelength Observations of the Blazar PKS 0735+178 in Spatial and Temporal Coincidence with an Astrophysical Neutrino Candidate IceCube-211208A

Author: A. Acharyya, C. B. Adams, A. Archer, P. Bangale, J. T. Bartkoske, P. Batista, W. Benbow, A. Brill, J. H. Buckley, J. L. Christiansen, A. J. Chromey, M. Errando, A. Falcone, Q. Feng, G. M. Foote, L. Fortson, A. Furniss, G. Gallagher, W. Hanlon, D. Hanna, O. Hervet, C. E. Hinrichs, J. Hoang, J. Holder, T. B. Humensky, W. Jin, P. Kaaret, M. Kertzman, M. Kherlakian, D. Kieda, T. K. Kleiner, N. Korzoun, S. Kumar, M. J. Lang, M. Lundy, G. Maier, C. E McGrath, M. J. Millard, J. Millis, C. L. Mooney, P. Moriarty, R. Mukherjee, S. O’Brien, R. A. Ong, M. Pohl, E. Pueschel, J. Quinn, K. Ragan, P. T. Reynolds, D. Ribeiro, E. Roache, I. Sadeh, A. C. Sadun, L. Saha, M. Santander, G. H. Sembroski, R. Shang, M. Splettstoesser, A. Kaushik Talluri, J. V. Tucci, V. V. Vassiliev, A. Weinstein, D. A. Williams, S. L. Wong, J. Woo, The VERITAS Collaboration, F. Aharonian, J. Aschersleben, M. Backes, V. Barbosa Martins, R. Batzofin, Y. Becherini, D. Berge, K. Bernlöhr, B. Bi, M. Böttcher, C. Boisson, J. Bolmont, M. de Bony de Lavergne, J. Borowska, M. Bouyahiaoui, F. Bradascio, M. Breuhaus, R. Brose, F. Brun, B. Bruno, T. Bulik, C. Burger-Scheidlin, S. Caroff, S. Casanova, R. Cecil, J. Celic, M. Cerruti, T. Chand, S. Chandra, A. Chen, J. Chibueze, O. Chibueze, G. Cotter, S. Dai, J. Damascene Mbarubucyeye, A. Djannati-Ataï, A. Dmytriiev, V. Doroshenko, S. Einecke, J.-P. Ernenwein, G. Fichet de Clairfontaine, M. Filipovic, G. Fontaine, M. Füßling, S. Funk, S. Gabici, S. Ghafourizadeh, G. Giavitto, D. Glawion, J. F. Glicenstein, P. Goswami, G. Grolleron, L. Haerer, J. A. Hinton, T. L. Holch, M. Holler, D. Horns, M. Jamrozy, F. Jankowsky, V. Joshi, I. Jung-Richardt, E. Kasai, K. Katarzyński, R. Khatoon, B. Khélifi, S. Klepser, W. Kluźniak, K. Kosack, D. Kostunin, R. G. Lang, S. Le Stum, A. Lemière, J.-P. Lenain, F. Leuschner, T. Lohse, A. Luashvili, I. Lypova, J. Mackey, D. Malyshev, V. Marandon, P. Marchegiani, A. Marcowith, G. Martí-Devesa, R. Marx, A. Mitchell, R. Moderski, L. Mohrmann, A. Montanari, E. Moulin, T. Murach, K. Nakashima, J. Niemiec, A. Priyana Noel, P. O’Brien, L. Olivera-Nieto, E. de Ona Wilhelmi, M. Ostrowski, S. Panny, M. Panter, G. Peron, D. A. Prokhorov, G. Pühlhofer, M. Punch, A. Quirrenbach, P. Reichherzer, A. Reimer, O. Reimer, H. Ren, M. Renaud, F. Rieger, B. Rudak, E. Ruiz-Velasco, V. Sahakian, A. Santangelo, M. Sasaki, J. Schäfer, F. Schüssler, H. M. Schutte, U. Schwanke, J. N. S. Shapopi, A. Specovius, S. Spencer, Ł. Stawarz, R. Steenkamp, S. Steinmassl, I. Sushch, H. Suzuki, T. Takahashi, T. Tanaka, R. Terrier, C. van Eldik, M. Vecchi, J. Veh, C. Venter, J. Vink, R. White, A. Wierzcholska, Yu Wun Wong, M. Zacharias, D. Zargaryan, A. A. Zdziarski, A. Zech, S. Zouari, N. Żywucka, The H.E.S.S. Collaboration, and K. Mori
Subjects: Active galactic nuclei, Blazars, Neutrino astronomy, Gamma-ray astronomy, Astrophysics, QB460-466
Abstract: We report on multiwavelength target-of-opportunity observations of the blazar PKS 0735+178, located 2.°2 away from the best-fit position of the IceCube neutrino event IceCube-211208A detected on 2021 December 8. The source was in a high-flux state in the optical, ultraviolet, X-ray, and GeV γ -ray bands around the time of the neutrino event, exhibiting daily variability in the soft X-ray flux. The X-ray data from Swift-XRT and NuSTAR characterize the transition between the low-energy and high-energy components of the broadband spectral energy distribution (SED), and the γ -ray data from Fermi-LAT, VERITAS, and H.E.S.S. require a spectral cutoff near 100 GeV. Both the X-ray and γ -ray measurements provide strong constraints on the leptonic and hadronic models. We analytically explore a synchrotron self-Compton model, an external Compton model, and a lepto-hadronic model. Models that are entirely based on internal photon fields face serious difficulties in matching the observed SED. The existence of an external photon field in the source would instead explain the observed γ -ray spectral cutoff in both the leptonic and lepto-hadronic models and allow a proton jet power that marginally agrees with the Eddington limit in the lepto-hadronic model. We show a numerical lepto-hadronic model with external target photons that reproduces the observed SED and is reasonably consistent with the neutrino event despite requiring a high jet power.
Published: 2023
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6. Novel Reaction Scheme for the Selective Oxidation of O-xylene to Phthalic Anhydride

Author: R. Marx, H.J. Woelk, G. Mestl, and T. Turek
Subjects: Chemical engineering, TP155-156, Computer engineering. Computer hardware, TK7885-7895
Abstract: Abstract preview not available - see full-text PDF article.
Published: 2011
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7. Linearized Model Predictive Control with Offset-freeness for Trajectory Tracking on Inland Vessels.

Author: Johannes R. Marx, Robert Damerius, and Torsten Jeinsch
Published: 2023
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8. Model Predictive Control of Vessels with Azimuth Drives in Maneuvering Situations.

Author: Johannes R. Marx, Martin Kurowski, and Torsten Jeinsch
Published: 2022
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9. Crystal structure and optical properties of Cd–Zn–pyrrolidine dithiocarbamate metal–organic frameworks

Author: Karthikeyan, N., primary, Nirmal, R. Marx, additional, and Akilan, R., additional
Published: 2023
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10. Association between bariatric surgery and outcomes in chronic myeloid leukemia

Author: Fadi G. Haddad, Hagop M. Kantarjian, Aram Bidikian, Elias J. Jabbour, Nicholas J. Short, Jing Ning, Lianchun Xiao, Naveen Pemmaraju, Courtney D. DiNardo, Tapan M. Kadia, Kayleigh R. Marx, Guillermo Garcia‐Manero, Farhad Ravandi, Koji Sasaki, and Ghayas C. Issa
Subjects: Cancer Research, Oncology
Published: 2023

11. Recommendations for the Use of Echocardiography in the Evaluation of Rheumatic Heart Disease: A Report from the American Society of Echocardiography

Author: Natesa G. Pandian, Jin Kyung Kim, Jose Antonio Arias-Godinez, Gerald R. Marx, Hector I. Michelena, Jagdish Chander Mohan, Kofoworola O. Ogunyankin, Ricardo E. Ronderos, Leyla Elif Sade, Anita Sadeghpour, Shantanu P. Sengupta, Robert J. Siegel, Xianhong Shu, Amiliana M. Soesanto, Lissa Sugeng, Ashwin Venkateshvaran, Marcelo Luiz Campos Vieira, and Stephen H. Little
Subjects: Radiology, Nuclear Medicine and imaging, Cardiology and Cardiovascular Medicine
Published: 2023

12. Value of 3D-echocardiography to improve prediction of mitral valve reoperation in patients with congenital mitral valve disease

Author: Nora Lang, Steven J. Staffa, David Zurakowski, Francesca Sperotto, Melinda Shea, Christopher W. Baird, Sitaram Emani, Pedro J. del Nido, and Gerald R. Marx
Abstract: BACKGROUNDCongenital mitral valve disease (CMVD) presents major challenges in medical and surgical management. Data on predictors of mitral valve (MV) reoperation and value of 3D echocardiography (3DE) in this context are currently limited. Aim of our study was to identify predictors of MV reoperation and to investigate the value of 3DE in risk stratification.METHODSAll children RESULTSOver the course of the study period, 206 children underwent MV reconstruction for CMVD: 105 had mitral stenosis (MS), 75 had mitral regurgitation (MR), and 26 had mixed disease (MD). Of them, 64 (31%) required a MV-reoperation. At multivariable analysis, age P=0.006) and 2D-VCRA (AUC=0.969 vs AUC=0.720,P=0.012), respectively. Decision-tree analysis found that a CONCLUSIONSAge CLINICAL PERSPECTIVESWhat is new?In congenital mitral valve (MV) disease patients undergoing MV reconstruction, changes in 3D effective orifice area (3D-EOA) and 3D vena contracta regurgitant area (3D-VCRA) were found to be independent predictors of MV reoperation.Changes in 3D effective orifice area (3D-EOA) and 3D vena contracta regurgitant area (3D-VCRA) had significantly higher predictive value compared to 2D-echocardiography parameters, i.e. changes in mean gradient, 2D-VCRA and moderate or greater postoperative 2D mitral regurgitation.Decision tree analysis identified cut-off points in changes of 3D-EOA and 3D-VCRA to predict MV reoperation.What are the clinical implications?Changes in 3D-EOA and 3D-VCRA can be measured in the operating room to consider return to bypass, or at discharge, to help inform need for early follow-up and MV reoperation.3DE-based decision tree predictive algorithms may help in risk stratification and serve as a support tool to facilitate clinical decision-making.
Published: 2023

13. A comparison between the apical and subcostal view for three-dimensional echocardiographic assessment of right ventricular volumes in pediatric patients

Author: Alessandra M. Ferraro, Kristin Bonello, Lynn A. Sleeper, Minmin Lu, Melinda Shea, Gerald R. Marx, Andrew J. Powell, Tal Geva, and David M. Harrild
Subjects: Cardiology and Cardiovascular Medicine
Abstract: BackgroundAccurate measurement of ventricular volumes is an important clinical imaging goal. Three-dimensional echocardiography (3DEcho) is used increasingly as it is more available and less costly than cardiac magnetic resonance (CMR). For the right ventricle (RV), the current practice is to acquire 3DEcho volumes from the apical view. However, in some patients the RV may be better seen from the subcostal view. Therefore, this study compared RV volume measurements from the apical vs. the subcostal view, using CMR as a reference standard.MethodsPatients ResultsForty-seven patients were included in the analysis (age range 10 months to 16 years). The ICC was moderate to excellent for all volume comparisons to CMR (subcostal vs. CMR: end-diastolic volume 0.93, end-systolic volume 0.81; apical vs. CMR: end-diastolic volume 0.94, end-systolic volume 0.74).The 3DEcho mean % error vs. CMR for end-systolic volume was 25% for subcostal and 31% for apical; for end-diastolic volume it was 15% for subcostal and 16% for apical. The % error was not significantly different between apical vs. subcostal views for end-systolic and end-diastolic volume measurements.ConclusionsFor apical and subcostal views, 3DEcho-derived ventricular volumes agree well with CMR. Neither echo view has a consistently smaller error when compared to CMR volumes. Accordingly, the subcostal view can be used as an alternative to the apical view when acquiring 3DEcho volumes in pediatric patients, particularly when the image quality from this window is superior.
Published: 2023

14. Anomalous Left Coronary Artery Arising from the Pulmonary Artery (ALCAPA): The Critically Important Role of Color Flow Doppler in Identifying a Rare Intramural Course

Author: David J. Harrison, David A. Kane, Sitaram M. Emani, Stephen P. Sanders, Thomas A. Miller, and Gerald R. Marx
Subjects: General Medicine
Published: 2022

15. A MeerKAT, e-MERLIN, HESS, and Swift search for persistent and transient emission associated with three localized FRBs

Author: J O Chibueze, M Caleb, L Spitler, H Ashkar, F Schüssler, B W Stappers, C Venter, I Heywood, A M S Richards, D R A Williams, M Kramer, R Beswick, M C Bezuidenhout, R P Breton, L N Driessen, F Jankowski, E F Keane, M Malenta, M Mickaliger, V Morello, H Qiu, K Rajwade, S Sanidas, M Surnis, T W Scragg, C R H Walker, N Wrigley, H E S S Collaboration: F Aharonian, F Ait Benkhali, E O Angüner, M Backes, V Baghmanyan, V Barbosa Martins, R Batzofin, Y Becherini, D Berge, M Böttcher, C Boisson, J Bolmont, M de Bony de Lavergne, M Breuhaus, R Brose, F Brun, T Bulik, F Cangemi, S Caroff, S Casanova, J Catalano, M Cerruti, T Chand, A Chen, O U Chibueze, G Cotter, P Cristofari, J Damascene Mbarubucyeye, J Devin, A Djannati-Ataï, A Dmytriiev, K Egberts, J-P Ernenwein, A Fiasson, G Fichet de Clairfontaine, G Fontaine, S Funk, S Gabici, S Ghafourizadeh, G Giavitto, D Glawion, M-H Grondin, M Hörbe, C Hoischen, T L Holch, Zhiqiu Huang, M Jamrozy, F Jankowsky, V Joshi, I Jung-Richardt, E Kasai, K Katarzyński, U Katz, B Khélifi, W Kluźniak, Nu Komin, K Kosack, D Kostunin, A Lemière, J-P Lenain, F Leuschner, T Lohse, A Luashvili, I Lypova, J Mackey, D Malyshev, V Marandon, P Marchegiani, A Marcowith, G Martí-Devesa, R Marx, A Mitchell, R Moderski, L Mohrmann, E Moulin, J Muller, K Nakashima, M de Naurois, A Nayerhoda, J Niemiec, A Priyana Noel, P O’Brien, S Ohm, L Olivera-Nieto, E de Ona Wilhelmi, M Ostrowski, S Panny, R D Parsons, S Pita, V Poireau, D A Prokhorov, H Prokoph, G Pühlhofer, A Quirrenbach, P Reichherzer, A Reimer, O Reimer, G Rowell, B Rudak, E Ruiz-Velasco, V Sahakian, S Sailer, H Salzmann, D A Sanchez, A Santangelo, M Sasaki, H M Schutte, U Schwanke, J N S Shapopi, A Specovius, S Spencer, R Steenkamp, S Steinmassl, T Takahashi, T Tanaka, C Thorpe-Morgan, N Tsuji, C van Eldik, J Veh, J Vink, S J Wagner, A Wierzcholska, Yu Wun Wong, A Yusafzai, M Zacharias, D Zargaryan, A A Zdziarski, A Zech, S J Zhu, S Zouari, N Żywucka, High Energy Astrophys. & Astropart. Phys (API, FNWI), Centre de Physique des Particules de Marseille (CPPM), Aix Marseille Université (AMU)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), AstroParticule et Cosmologie (APC (UMR_7164)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Observatoire de Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Laboratoire Univers et Théories (LUTH (UMR_8102)), Institut national des sciences de l'Univers (INSU - CNRS)-Observatoire de Paris, Laboratoire de Physique Nucléaire et de Hautes Énergies (LPNHE (UMR_7585)), Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Laboratoire d'Annecy de Physique des Particules (LAPP), Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Centre National de la Recherche Scientifique (CNRS), Université de Bordeaux (UB), Laboratoire Univers et Particules de Montpellier (LUPM), and Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)
Subjects: radio continuum: galaxies, High Energy Astrophysical Phenomena (astro-ph.HE), ) fast radio burst [(transients], FOS: Physical sciences, Astronomy and Astrophysics, radiation mechanisms: non-thermal, non-thermal [radiation mechanisms], Astrophysics - Astrophysics of Galaxies, galaxies [radio continuum], fast radio bursts, Space and Planetary Science, [SDU]Sciences of the Universe [physics], Astrophysics of Galaxies (astro-ph.GA), (transients:) fast radio burst, ddc:520, Astrophysics - High Energy Astrophysical Phenomena
Abstract: Monthly notices of the Royal Astronomical Society 515(1), 1365 - 1379 (2022). doi:10.1093/mnras/stac1601, We report on a search for persistent radio emission from the one-off fast radio burst (FRB) 20190714A, as well as from two repeating FRBs, 20190711A and 20171019A, using the MeerKAT radio telescope. For FRB 20171019A, we also conducted simultaneous observations with the High-Energy Stereoscopic System (H.E.S.S.) in very high-energy gamma rays and searched for signals in the ultraviolet, optical, and X-ray bands. For this FRB, we obtain a UV flux upper limit of |$1.39 \times 10^{-16}~{\rm erg\, cm^{-2}\, s^{-1}}$|Å^−1, X-ray limit of |$\sim 6.6 \times 10^{-14}~{\rm erg\, cm^{-2}\, s^{-1}}$| and a limit on the very high energy gamma-ray flux |$\Phi (E\gt 120\, {\rm GeV}) \lt 1.7\times 10^{-12}\, \mathrm{erg\, cm^{-2}\, s^{-1}}$|⁠. We obtain a radio upper limit of ∼15 |$\mu$|Jy beam^−1 for persistent emission at the locations of both FRBs 20190711A and 20171019A with MeerKAT. However, we detected an almost unresolved (ratio of integrated flux to peak flux is ∼1.7 beam) radio emission, where the synthesized beam size was ∼ 8 arcsec size with a peak brightness of |$\sim 53\, \mu$|Jy beam^−1 at MeerKAT and |$\sim 86\, \mu$|Jy beam^−1 at e-MERLIN, possibly associated with FRB 20190714A at z = 0.2365. This represents the first detection of persistent continuum radio emission potentially associated with a (as-yet) non-repeating FRB. If the association is confirmed, one of the strongest remaining distinction between repeaters and non-repeaters would no longer be applicable. A parallel search for repeat bursts from these FRBs revealed no new detections down to a fluence of 0.08 Jy ms for a 1 ms duration burst., Published by Oxford Univ. Press, Oxford
Published: 2023
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16. Dynamic Annular Modeling of the Unrepaired Complete Atrioventricular Canal Annulus

Author: John M. Simpson, Jing Huang, Christian Herz, Hannah H. Nam, Gabor Fichtinger, Patrick V. Dinh, Alison M. Pouch, Meryl S. Cohen, Andras Lasso, Ahmed H. Aly, Saleha Kabir, Andrew C. Glatz, Adriana Posada, David M. Harrild, Matthew A. Jolley, and Gerald R. Marx
Subjects: Male, Pulmonary and Respiratory Medicine, Echocardiography, Three-Dimensional, Regurgitation (circulation), Article, Mitral valve, Humans, Medicine, Mitral Valve Annulus, cardiovascular diseases, Cardiac Surgical Procedures, Retrospective Studies, Annulus (mycology), Atrioventricular valve, Cardiac cycle, business.industry, Heart Septal Defects, Infant, Anatomy, equipment and supplies, medicine.disease, medicine.anatomical_structure, Child, Preschool, cardiovascular system, Atrioventricular canal, Female, Surgery, Cardiology and Cardiovascular Medicine, business, Mitral valve regurgitation, Echocardiography, Transesophageal
Abstract: BACKGROUND: Repair of complete atrioventricular canal (CAVC) is often complicated by atrioventricular valve regurgitation, particularly of the left-sided valve. Understanding the three-dimensional (3D) structure of the atrioventricular canal annulus prior to repair may help to inform optimized repair. However, the 3D shape and movement of the CAVC annulus has yet to be quantified nor has it been rigorously compared to a normal mitral valve annulus. METHODS: The complete annuli of 43 patients with CAVC were modeled in 4 cardiac phases using transthoracic 3D echocardiograms and custom code. The annular structure was compared to the annuli of 20 normal pediatric mitral valves using 3D metrics and statistical shape analysis (Procrustes analysis). RESULTS: The unrepaired CAVC annulus varied in shape significantly throughout the cardiac cycle. Procrustes analysis visually demonstrated that the average normalized CAVC annular shape is more planar than the normal mitral annulus. Quantitatively, the annular height to valve width ratio of the native left CAVC atrioventricular valve was significantly lower than that of a normal mitral valve in all systolic phases(p
Published: 2022

17. Restriction of Atrial Septal Defect Leads to Growth of Hypoplastic Ventricle in Patients with Borderline Right or Left Heart

Author: Pedro J. del Nido, Gerald R. Marx, Jae Gun Kwak, Breanna L. Piekarski, and Sitaram M. Emani
Subjects: Heart Septal Defects, Ventricular, Pulmonary and Respiratory Medicine, congenital, hereditary, and neonatal diseases and abnormalities, medicine.medical_specialty, Heart Ventricles, medicine.medical_treatment, Constriction, Pathologic, 030204 cardiovascular system & hematology, Heart Septal Defects, Atrial, Atrial septal defects, Fontan procedure, 03 medical and health sciences, 0302 clinical medicine, Double outlet right ventricle, medicine.artery, Internal medicine, medicine, Humans, cardiovascular diseases, Pulmonary vein stenosis, Retrospective Studies, business.industry, Infant, General Medicine, Stroke volume, medicine.disease, Pulmonary hypertension, Treatment Outcome, medicine.anatomical_structure, 030228 respiratory system, Ventricle, Pulmonary artery, cardiovascular system, Cardiology, Surgery, Cardiology and Cardiovascular Medicine, business
Abstract: Patients with borderline hypoplastic right or left ventricle and VSD may be candidates for either single ventricle palliation or staged ventricular recruitment (SVR) followed by eventual biventricular conversion. Components of SVR include restriction of atrial septal defects (ASD) without ventricular septal defects (VSD) closure and addition of accessory pulmonary blood flow. This study evaluated the impact of ASD restriction on ventricular growth and function. We retrospectively reviewed patients with borderline ventricular hypoplasia and VSD who underwent a staged ventricular recruitment (SVR) procedure from 2012 to June 2019. Pre- and post-recruitment MRI and echocardiogram data were compared and analyzed. We excluded cases in which we intentionally restricted VSD with simultaneous ASD restriction. Forty-six patients (41 with right-dominant ventricle, 25 with risk factors for Fontan procedure) underwent SVR at a median age of 15.1 months' (interquartile range (IQR), 7.2-37.2 months'). The median indexed ventricular end-diastolic volume, end-systolic volume, and stroke volume according to cardiac MRI significantly increased at median 11.0 months' (IQR:7.8~14.1 months') after recruitment. Among them, except 2 operative mortalities after SVR, 26 patients underwent bi-ventricular repair (56.5% including one and a half ventricle repair) at a median of 8.0 months' (IQR: 6.2-12.2 months') after recruitment. Fifteen patients await biventricular completion, and 3 patients underwent single ventricle palliation. Pulmonary blood flow (Qp) tended to increase after recruitment regardless of type of pulmonary blood flow modification without statistical significance. Six patients died at a median duration of 6.5 months' (IQR: 2.9-11.7) after SVR; 3 patients died after biventricular completion, 2 after recruitment, and 1 after returning to single ventricle palliation. All of them were considered poor Fontan candidates due to severe atrioventricular valve regurgitation, pulmonary hypertension, pulmonary vein stenosis, or airway stenosis. Restriction of the atrial septum leads to the growth of hypoplastic ventricle in patients with ventricular septal defects who undergo SVR regardless of the preoperative characteristics, and eventual biventricular repair can be performed in a subgroup of these patients. Future work is necessary to optimize timing of SVR and method of accessory pulmonary blood flow.
Published: 2022

18. Staged ventricular recruitment and biventricular conversion following single-ventricle palliation in unbalanced atrioventricular canal defects

Author: Nicholas A. Oh, Ilias P. Doulamis, Alvise Guariento, Breanna Piekarski, Gerald R. Marx, Pedro J. del Nido, and Sitaram M. Emani
Subjects: Pulmonary and Respiratory Medicine, single ventricle palliationunbalanced atrioventricular canal defectbiventricular repair, Surgery, Congenital: Single Ventricle, Cardiology and Cardiovascular Medicine
Abstract: OBJECTIVE: Restoration of biventricular circulation is an alternative management strategy in unbalanced atrioventricular canal defects (uAVCDs), especially in patients with risk factors for single-ventricle palliation (SVP) failure. When ventricular volume is inadequate for biventricular circulation, recruitment procedures may accommodate its growth. In this study, we review our uAVCD experience with biventricular conversion (BIVC) after prior SVP. METHODS: This is a single-institution, retrospective cohort study of uAVCD patients who underwent BIVC after SVP, with staged recruitment (staged) or primary BIVC (direct) between 2003 to 2018. Mortality, unplanned reinterventions, imaging, and catheterization data were analyzed. RESULTS: Sixty-five patients underwent BIVC from SVP (17 stage 1, 42 bidirectional Glenn, and 6 Fontan). Decision for conversion was based on poor SVP candidacy (n = 43) or 2 adequately sized ventricles (n = 22). Of the 65 patients, 20 patients underwent recruitment before conversion. The staged group had more severe ventricular hypoplasia than the direct group, reflected in prestaging end-diastolic volume z scores (–4.0 vs –2.6; P
Published: 2022

19. 1844. Mortality associated with Stenotrophomonas maltophilia bloodstream infection in patients with leukemia

Author: Samuel L Aitken, Joslyn Rudoni, Kayleigh R Marx, Frank P Tverdek, Samuel A Shelburne, and Pablo C Okhuysen
Subjects: Infectious Diseases, Oncology
Abstract: Background Patients with leukemia are disproportionately vulnerable to infections caused by S. maltophilia and mortality approaches 100% in patients with hemorrhagic pneumonia. Trimethoprim-sulfamethoxazole (SXT) is the drug of choice for treatment of infections caused by S. maltophilia however allergies, toxicity, and resistance may preclude its use. We sought to characterize clinical outcomes of patients with leukemia and S. maltophilia bloodstream infection (BSI). Methods Patients with leukemia are disproportionately vulnerable to infections caused by S. maltophilia and mortality approaches 100% in patients with hemorrhagic pneumonia. Trimethoprim-sulfamethoxazole (SXT) is the drug of choice for treatment of infections caused by S. maltophilia however allergies, toxicity, and resistance may preclude its use. We sought to characterize clinical outcomes of patients with leukemia and S. maltophilia bloodstream infection (BSI). Results Ninety-six patients with leukemia and S. maltophilia BSI were identified. The most common diagnosis was acute myeloid leukemia (60%); 31% had prior stem cell transplant. The most common single identified source was respiratory (31%) followed by central venous catheter (CVC, 26%). A single clear source was unable to be identified in 33%.Overall 14-day mortality was 31%. After excluding eleven patients who died within 24 hours, most patients received SXT (72%), followed by ceftazidime (40%), tigecycline (TGC, 40%), and minocycline (26%). SXT was associated with reduced mortality (hazard ratio [HR] 0.15, 95% confidence interval [CI] 0.05 – 0.44, p < 0.01) while TGC was associated with increased mortality (HR 3.13, 95% CI 1.00 – 9.73, p = 0.05). All patients who died were neutropenic at baseline and none had a CVC infection. Conclusion S. maltophilia BSI is associated with high mortality in patients with leukemia, particularly those with neutropenia at baseline. CVC infection alone was not associated with mortality. SXT is associated with reduced mortality relative to other antimicrobials. Alternative agents should be used with caution in these vulnerable patients. Disclosures Samuel L. Aitken, PharmD, MPH, Entasis Therapeutics: Advisor/Consultant|GlaxoSmithKline: Advisor/Consultant|Melinta: Grant/Research Support|Shionogi: Advisor/Consultant Pablo C. Okhuysen, MD, AstraZeneca: Stocks/Bonds|Beam Therapeutics: Stocks/Bonds|Biontech: Stocks/Bonds|Deinove: Grant/Research Support|Ferring: Advisor/Consultant|Glaxo Smith Kleine: Stocks/Bonds|Johnson and Johnson: Stocks/Bonds|Melinta: Grant/Research Support|Merck Sharp & Dohme Corp: Grant/Research Support|Moderna: Stocks/Bonds|Napo Pharmaceuticals: Advisor/Consultant|Napo Pharmaceuticals: Grant/Research Support|Novavax: Stocks/Bonds|Pfizer: Stocks/Bonds|Summit: Advisor/Consultant|Summit: Grant/Research Support.
Published: 2022

20. Case report: Active clinical manifestation of endocardial fibroelastosis in adolescence in a patient with mitral and aortic obstruction–histologic presence of endothelial-to-mesenchymal transformation

Author: Daniel Diaz-Gil, Chrystalle Katte Carreon, Natalia Silva-Gomez, Alan E. Benheim, Sitaram M. Emani, Pedro J. del Nido, Gerald R. Marx, and Ingeborg Friehs
Subjects: Cardiology and Cardiovascular Medicine
Abstract: This is the first description of active clinical manifestation of endocardial fibroelastosis (EFE) and remodeling of the endocardium via endothelial-to-mesenchymal transformation (EndMT) in an adolescent with Shone’s variant hypoplastic left heart complex (HLHC) and a genetic heterozygous ABL1 variant. While EFE has not been typically associated HLHC or Shone’s syndrome, in this patient flow alterations in the left ventricle (LV), combined with genetic alterations of intrinsic EndMT pathways led to active clinical manifestation of EFE in adolescence. This case emphasizes that new therapies for EFE might need to focus on molecular factors influenced by intrinsic and extrinsic stimuli of EndMT.
Published: 2022

21. Incidence of adverse effects in patients receiving ponatinib with concomitant azole antifungals

Author: Kayleigh R. Marx, Caitlin R. Rausch, Alexandra R. Lovell, Nicholas J. Short, Shilpa Paul, Nitin Jain, Jenessa Lee, J. Michael Savoy, Farhad Ravandi, and Elias Jabbour
Subjects: Cancer Research, Oncology, Hematology
Abstract: Ponatinib plus Hyper-CVAD yields a five-year overall survival of 73% in patients with Philadelphia-positive acute lymphoblastic leukemia. Ponatinib dose intensity is associated with increased incidence of adverse effects (AEs), including vascular events. Ponatinib combined with azole antifungals may further increase the risk of AEs due to increased ponatinib exposure. We reviewed 53 patients who received ponatinib with intensive (
Published: 2022

22. Modeling Mitral Valve Leaflets from Three-Dimensional Ultrasound.

Author: Robert J. Schneider, William C. Burke, Gerald R. Marx, Pedro J. del Nido, and Robert D. Howe
Published: 2011
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23. Patient-Specific Mitral Leaflet Segmentation from 4D Ultrasound.

Author: Robert J. Schneider, Neil A. Tenenholtz, Douglas P. Perrin, Gerald R. Marx, Pedro J. del Nido, and Robert D. Howe
Published: 2011
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24. Mitral Annulus Segmentation from Three-Dimensional Ultrasound.

Author: Robert J. Schneider, Douglas P. Perrin, Nikolay V. Vasilyev, Gerald R. Marx, Pedro J. del Nido, and Robert D. Howe
Published: 2009
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25. Congenital aortic and truncal valve reconstruction using the Ozaki technique: Short-term clinical results

Author: Pedro J. del Nido, Lynn A. Sleeper, Gerald R. Marx, Brenda Cooney, Mariana Chávez, and Christopher W. Baird
Subjects: Adult, Male, Reoperation, Pulmonary and Respiratory Medicine, Aortic valve, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Persistent truncus arteriosus, Regurgitation (circulation), 030204 cardiovascular system & hematology, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Valve replacement, Aortic valve replacement, Humans, Medicine, Cardiac Surgical Procedures, Child, Retrospective Studies, Body surface area, business.industry, Infant, Newborn, Infant, medicine.disease, Aortic Valve Disease, Surgery, Stenosis, Catheter, medicine.anatomical_structure, 030228 respiratory system, Echocardiography, Aortic Valve, Child, Preschool, cardiovascular system, Female, Cardiology and Cardiovascular Medicine, business
Abstract: Objectives Aortic valve reconstruction (AVRec) with neocuspidization or the Ozaki procedure with complete cusp replacement for aortic valve disease has excellent mid-term results in adults. Limited results of AVRec in pediatric patients have been reported. We report our early outcomes of the Ozaki procedure for congenital aortic and truncal valve disease. Methods A retrospective analysis was performed on all 57 patients with congenital aortic and truncal valve disease who had a 3-leaflet Ozaki procedure at a single institution from August 2015 to February 2019. Outcome measures included mortality, surgical or catheter-based reinterventions, and echocardiographic measurements. Results Twenty-four patients had aortic regurgitation (AR), 6 had aortic stenosis (AS), and 27 patients had AS/AR. Two patients had quadricuspid valves, 26 had tricuspid, 20 had bicuspid, and 9 had unicusp aortic valves. Four patients had truncus arteriosus. Thirty-four patients had previous aortic valve repairs and 5 had replacements. Preoperative echocardiography mean annular diameter was 20.90 ± 4.98 cm and peak gradient for patients with AS/AR was 53.62 ± 22.20 mm Hg. Autologous, Photofix, and CardioCel bovine pericardia were used in 20, 35, and 2 patients. Eight patients required aortic root enlargement and 20 had sinus enlargement. Fifty-one patients had concomitant procedures. Median intensive care unit and hospital length of stay were 1.87 and 6.38 days. There were no hospital mortalities or early conversions to valve replacement. At discharge, 98% of patients had mild or less regurgitation and peak aortic gradient was 16.9 ± 9.5 mm Hg. Two patients underwent aortic valve replacement. At median follow-up of 8.1 months, 96% and 91% of patients had less than moderate regurgitation and stenosis, respectively. Conclusions The AVRec procedure has acceptable short-term results and should be considered for valve reconstruction in pediatric patients with congenital aortic and truncal valve disease. Longer-term follow-up is necessary to determine the optimal patch material and late valve function and continued annular growth.
Published: 2021

26. Photodegradation studies of pure and cobalt doped zinc oxide nanoparticles

Author: Natarajan, Karthikeyan, primary, R, Marx Nirmal, additional, G, Sathishkumar, additional, and R, Akilan, additional
Published: 2022
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27. Aortic elongation and bronchial splint for late bronchial complication after neonatal arch reconstruction

Author: Russell W. Jennings, Christopher W. Baird, Gerald R. Marx, and Peter Chiu
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, business.industry, medicine.medical_treatment, Congenital: Aorta: Case Report, Medicine, Surgery, Arch, business, Complication, Splint (medicine)
Published: 2021

28. Application of convolutional artificial neural networks to echocardiograms for differentiating congenital heart diseases in a pediatric population.

Author: Douglas P. Perrin, Alejandra Bueno, Andrea Rodriguez, Gerald R. Marx, and Pedro J. del Nido
Published: 2017
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29. Resynchronizing Right and Left Ventricles With Right Bundle Branch Block in the Congenital Heart Disease Population

Author: Rahul H. Rathod, Edward T. O’Leary, Michelle Gurvitz, Douglas Y. Mah, Gerald R. Marx, David M. Harrild, Francis Fynn-Thompson, and Diego Porras
Subjects: Adult, medicine.medical_specialty, Adolescent, genetic structures, Heart disease, Heart Ventricles, medicine.medical_treatment, Bundle-Branch Block, Population, Cardiac resynchronization therapy, Left Ventricles, 030204 cardiovascular system & hematology, Single Center, Cardiac Resynchronization Therapy, Electrocardiography, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, 030212 general & internal medicine, Child, education, education.field_of_study, business.industry, Infant, Middle Aged, Right bundle branch block, medicine.disease, Patient population, Echocardiography, Child, Preschool, cardiovascular system, Cardiology, business
Abstract: This study describes a single center experience with the use of cardiac resynchronization therapy (CRT) in a difficult patient population, including single systemic right ventricles (RVs), subpulmonary RVs, and left ventricles (LVs) with right bundle branch block (RBBB).CRT remains challenging in the congenital heart disease population.Consecutive patients undergoing resynchronization of single RVs, subpulmonary RVs, or LVs in the setting of RBBB were identified between 2016 and 2019. Patients who had CRT performed for complete heart block or had3 months of follow-up were excluded. Patients underwent pre-procedural advanced imaging by echocardiogram, computed tomography, or cardiac magnetic resonance to assess ventricular function and synchrony; intraoperative mapping was performed to identify optimal lead placement.All patients undergoing resynchronization presented with at least moderate systolic ventricular dysfunction in the setting of intrinsic atrioventricular nodal conduction and RBBB. Seven patients were identified. Two patients underwent CRT of a single RV, 3 with subpulmonary RVs and 2 with systemic LVs. The median age at CRT was 5 years (range 0.6 to 48 years). The median follow-up was 9 months (range 3 to 18 months). The median baseline QRS duration was 180 ms (range 115 to 260ms). Post-CRT, the QRS duration decreased by a median of 34% (range 19% to 38%). All patients had improvement in their systolic ventricular function.Targeted resynchronization in systemic and subpulmonary RVs can be used to improve ventricular function and heart failure in the congenital heart disease population. Similar techniques can be applied to successfully treat patients with LV dysfunction and RBBB and improve their long-term outcomes.
Published: 2020

30. Residual Lesion Severity Predicts Midterm Outcomes After Congenital Aortic Valve Repair

Author: Aditya Sengupta, Kimberlee Gauvreau, Gerald R. Marx, Steven D. Colan, Jane W. Newburger, Christopher W. Baird, Pedro J. del Nido, and Meena Nathan
Subjects: Pulmonary and Respiratory Medicine, Surgery, Cardiology and Cardiovascular Medicine
Abstract: We sought to validate the technical performance score (TPS) as a predictor of midterm outcomes after congenital aortic valve repair.This was a single-center, retrospective review of consecutive patients who underwent aortic valve repair between January 1, 2011, and December 31, 2019. Predischarge echocardiograms were used to assign a TPS for each index operation as class 1, no aortic valve residua; class 2, minor aortic valve residua; or class 3, major aortic valve residua or predischarge reintervention for major residua. The primary outcome was postdischarge (late) unplanned aortic valve reintervention. Secondary outcomes included late mortality and at least moderate aortic regurgitation or stenosis at the latest follow-up or before the earliest reintervention. Associations between TPS and outcomes were assessed using competing risk, Cox proportional hazards, or logistic regression models, adjusting for preoperative patient- and procedure-related covariates.Of 507 patients, there were 110 (21.7%) reinterventions, 22 (4.3%) deaths, and 67 (13.2%) cases of at least moderate aortic regurgitation or stenosis at the latest follow-up or earliest reintervention. On multivariable analysis, class 3 patients had a greater risk of reintervention (subdistribution hazard ratio, 2.6; 95% CI, 1.3-5.1; P = .005) and mortality (hazard ratio, 5.3; 95% CI. 1.1-25.2; P = .038) compared with class 1 patients. Adjusting for duration of follow-up, class 3 patients also had a greater risk of at least moderate aortic regurgitation or stenosis at the latest follow-up or earliest reintervention (odds ratio, 7.7; 95% CI, 2.5-24.2; P.001) vs class 1 patients.Patients with major residua after congenital aortic valve repair have significantly worse midterm outcomes compared with those with no residua, warranting closer follow-up.
Published: 2022

31. Contemporary Challenges in Academic Health Science Center Financial Management

Author: Jeffrey R. Balser, Edward R. Marx, and John F. Manning
Published: 2022

32. Anatomic and Quantitative 3D Echocardiographic Predictors for Risk Stratification and Improved Management of Congenital Mitral Valve Disease

Author: N. Lang, S. Staffa, D. Zurakowski, C. Baird, S. Emani, M. Shea, P. J. Del Nido, and G. R. Marx
Published: 2022

33. Cherenkov Telescope Array : the World’s largest VHE gamma-ray observatory

Author: Roberta Zanin, H. Abdalla, H. Abe, S. Abe, A. Abusleme, F. Acero, A. Acharyya, V. Acin Portella, K. Ackley, R. Adam, C. Adams, S.S. Adhikari, I. Aguado Ruesga, I. Agudo, R. Aguilera, A. Aguirre Santaella, F. Aharonian, A. Alberdi, R. Alfaro, J. Alfaro, C. Alispach, R. Aloisio, R. Alves Batista, J.P. Amans, L. Amati, E. Amato, L. Ambrogi, G. Ambrosi, M. Ambrosio, R. Ammendola, J. Anderson, M. Anduze, E.O. Anguner, L.A. Antonelli, V. Antonuccio, P. Antoranz, R. Anutarawiramkul, J. Aragunde Gutierrez, C. Aramo, A. Araudo, M. Araya, A. Arbet Engels, C. Arcaro, V. Arendt, C. Armand, T. Armstrong, F. Arqueros, L. Arrabito, B. Arsioli, M. Artero, K. Asano, Y. Ascasibar, J. Aschersleben, M. Ashley, P. Attina, P. Aubert, C. B. Singh, D. Baack, A. Babic, M. Backes, V. Baena, S. Bajtlik, A. Baktash, C. Balazs, M. Balbo, O. Ballester, J. Ballet, B. Balmaverde, A. Bamba, R. Bandiera, A. Baquero Larriva, P. Barai, C. Barbier, V. Barbosa Martins, M. Barcelo, M. Barkov, M. Barnard, L. Baroncelli, U. Barres de Almeida, J.A. Barrio, D. Bastieri, P.I. Batista, I. Batkovic, C. Bauer, R. Bautista González, J. Baxter, U. Becciani, J. Becerra González, Y. Becherini, G. Beck, J. Becker Tjus, W. Bednarek, A. Belfiore, L. Bellizzi, R. Belmont, W. Benbow, D. Berge, E. Bernardini, M.I. Bernardos, K. Bernlöhr, A. Berti, M. Berton, B. Bertucci, V. Beshley, N. Bhatt, S. Bhattacharyya, W. Bhattacharyya, B. Y. Bi, G. Bicknell, N. Biederbeck, C. Bigongiari, A. Biland, R. Bird, E. Bissaldi, J. Biteau, M. Bitossi, O. Blanch, M. Blank, J. Blazek, J. Bobin, C. Boccato, F. Bocchino, C. Boehm, M. Bohacova, C. Boisson, J. Boix, J.P. Bolle, J. Bolmont, G. Bonanno, C. Bonavolontà, L. Bonneau Arbeletche, G. Bonnoli, P. Bordas, J. Borkowski, R. Bose, D. Bose, Z. Bosnjak, E. Bottacini, Markus Böttcher, M.T. Botticella, C. Boutonnet, F. Bouyjou, V. Bozhilov, E. Bozzo, L. Brahimi, C. Braiding, S. Brau Nogue, S. Breen, J. Bregeon, M. Breuhaus, A. Brill, W. Brisken, E. Brocato, A.M. Brown, K. Brügge, P. Brun, F. Brun, L. Brunetti, G. Brunetti, P. Bruno, A. Bruno, A. Bruzzese, N. Bucciantini, J. H. Buckley, R. Bühler, A. Bulgarelli, T. Bulik, M. Bünning, M. Bunse, M. Burton, A. Burtovoi, M. Buscemi, S. Buschjager, G. Busetto, J. Buss, K. Byrum, A. Caccianiga, F. Cadoux, A. Calanducci, C. Calderon, J. Calvo Tovar, R. A. Cameron, P. Campana, R. Canestrari, F. Cangemi, B. Cantlay, M. Capalbi, M. Capasso, M. Cappi, A. Caproni, R. Capuzzo Dolcetta, P. Caraveo, V. Cárdenas, L. Cardiel, M. Cardillo, C. Carlile, S. Caroff, R. Carosi, A. Carosi, E. Carquin, M. Carrere, J.M. Casandjian, S. Casanova, F. Cassol, F. Catalani, O. Catalano, D. Cauz, A. Ceccanti, C. Celestino Silva, K. Cerny, M. Cerruti, E. Chabanne, P. Chadwick, Y. Chai, P. Chambery, C. Champion, S. Chaty, A. Chen, K. Cheng, M. Chernyakova, G. Chiaro, A. Chiavassa, M. Chikawa, V.R. Chitnis, J. Chudoba, L. Chytka, S. Cikota, A. Circiello, P. Clark, M. Colak, E. Colombo, S. Colonges, A. Comastri, A. Compagnino, V. Conforti, E. Congiu, R. Coniglione, J. Conrad, F. Conte, J.L. Contreras, P. Coppi, R. Cornat, J. Coronado Blazquez, J. Cortina, A. Costa, H. Costantini, G. Cotter, B. Courty, S. Covino, S. Crestan, P. Cristofari, R. Crocker, J. Croston, K. Cubuk, O. Cuevas, X. Cui, G. Cusumano, S. Cutini, G. D'Amico, F. D'Ammando, P. D'Avanzo, P. Da Vela, M. Dadina, S. Dai, M. Dalchenko, M. Dall'Ora, M.K. Daniel, J. Dauguet, I. Davids, J. Davies, B. Dawson, A. De Angelis, A.E. de Araujo Carvalho, M. de Bony de Lavergne, G. De Cesare, F. de Frondat, I. de la Calle, E. de Gouveia Dal Pino, B. De Lotto, A. De Luca, D. De Martino, M. de Naurois, E. de Ona Wilhelmi, F. De Palma Persio, N. De Simone, V. de Souza Valle, E. Delagnes, G. Deleglise Reznicek, C. Delgado, A.G. Delgado Giler, J. Delgado Mengual Valle, Domenico Della Volpe, D. Depaoli, J. Devin, T. Di Girolamo, C. Di Giulio Pierro, L. Di Venere, C. Díaz, C. Dib, S. Diebold, S. Digel, A. Djannati Atai, J. Djuvsland, A. Dmytriiev, K. Docher, A. Domínguez, D. Dominis Prester, A. Donini, D. Dorner, M. Doro, Rita Cassia dos Anjos, J.L. Dournaux, T. Downes, G. Drake, H. Drass, D. Dravins, C. Duangchan, A. Duara, G. Dubus, L. Ducci, C. Duffy, D. Dumora, K. Dundas Mora, A. Durkalec, V.V. Dwarkadas, J. Ebr, C. Eckner, J. Eder, E. Edy, K. Egberts, S. Einecke, C. Eleftheriadis, D. Elsässer, G. Emery, D. Emmanoulopoulos, J.P. Ernenwein, M. Errando, P. Escarate, J. Escudero, C. Espinoza, S. Ettori, A. Eungwanichayapant, P. Evans, C. Evoli, M. Fairbairn, D. Falceta Goncalves, A. Falcone, V. Fallah Ramazanı, R. Falomo, K. Farakos, G. Fasola, A. Fattorini, Y. Favre, R. Fedora, E. Fedorova, K. Feijen, Q. Feng, G. Ferrand, G. Ferrara, O. Ferreira, M. Fesquet, E. Fiandrini, A. Fiasson, M. Filipovic, D. Fink, J.P. Finley, V. Fioretti, D.F.G. Fiorillo, M. Fiorini, S. Flis, H. Flores, L. Foffano, C. Fohr, M.V. Fonseca, L. Font, G. Fontaine, O. Fornieri, P. Fortin, L. Fortson, N. Fouque, B. Fraga, A. Franceschini, F.J. Franco, L. Freixas Coromina, L. Fresnillo, D. Fugazza, Y. Fujita, S. Fukami, Y. Fukazawa, D. Fulla, S. Funk, A. Furniss, S. Gabici, D. Gaggero, G. Galanti, P. Galdemard, Y. A. Gallant, D. Galloway, S. Gallozzi, V. Gammaldi, R. Garcia, L. E. García-Muñoz, E. Garcia Lopez, F. Gargano, C. Gargano, S. Garozzo, D. Gascon, T. Gasparetto, D. Gasparrini, H. Gasparyan, M. Gaug, N. Geffroy, A. Gent, S. Germani, A. Ghalumyan, A. Ghedina, G. Ghirlanda, F. Gianotti, S. Giarrusso, M. Giarrusso, G. Giavitto, B. Giebels, N. Giglietto, V. Gika, F. Gillardo, R. Gimenes, F. Giordano, E. Giro, M. Giroletti, Andrea Giuliani, M. Gjaja, J.F. Glicenstein, P. Gliwny, H. Goksu, P. Goldoni, J.L. Gomez, M.M. Gonzalez, Juan Manuel Gonzalez, K.S. Gothe, D. Gotz Coelho, T. Grabarczyk, R. Graciani, P. Grandi, G. Grasseau, D. Grasso, D. Green, J. Green, T. Greenshaw, P. Grespan, A. Grillo, M.H. Grondin, J. Grube, V. Guarino, B. Guest, O. Gueta, M. Günduz, S. Gunji, G. Gyuk, J. Hackfeld, D. Hadasch, L. Hagge, A. Hahn, J.E. Hajlaoui, A. Halim, P. Hamal, W. Hanlon, Y. Harada, M.J. Hardcastle, M. Harvey Collado, T. Haubold, A. Haupt, M. Havelka, K. Hayashi, M. Hayashida, H. He, L. Heckmann, M. Heller, F. Henault, Gilles Henri, G. Hermann, S. Hernández Cadena, J. Herrera Llorente, O. Hervet, J. Hinton, A. Hiramatsu, K. Hirotani, B. Hnatyk, R. Hnatyk, J.K. Hoang, D. H.H. Hoffmann, C. Hoischen, J. Holder, M. Holler, B. Hona, D. Horan, Dieter Horns, P. Horvath, J. Houles, M. Hrabovsky, D. Hrupec, Y. Huang, J.‑M. Huet, G. Hughes, G. Hull, T.B. Humensky, M. Hütten, M. Iarlori, J.M. Illa, R. Imazawa, T. Inada, F. Incardona, A. Ingallinera, S. Inoue, T. Inoue, Y. Inoue, F. Iocco, K. Ioka, M. Ionica, S. Iovenitti, A. Iriarte, K. Ishio, W. Ishizaki, Y. Iwamura, J. Jacquemier, M. Jacquemont, M. Jamrozy, P. Janecek, F. Jankowsky, A. JardinBlicq, C. Jarnot, P. Jean Martínez, L. Jocou, N. Jordana, M. Josselin, I. JungRichardt, F.J.P.A. Junqueira, C. Juramy Gilles, P. Kaaret, L.H.S. Kadowaki, M. Kagaya, R. Kankanyan, D. Kantzas, V. Karas, A. Karastergiou, S. Karkar, J. Kasperek, H. Katagiri, J. Kataoka, K. Katarzynski, S. Katsuda, N. Kawanaka, D. Kazanas, D. Kerszberg, B. Khélifi, M.C. Kherlakian, T.P. Kian, D.B. Kieda, T. Kihm, S. Kim, S. Kisaka, R. Kissmann, R. Kleijwegt, G. Kluge, W. Kluźniak, J. Knapp, A. Kobakhidze, Y. Kobayashi, B. Koch, J. Kocot, K. Kohri, N. Komin, A. Kong, K. Kosack, F. Krack, M. Krause, F. Krennrich, H. Kubo, V. N. Kudryavtsev, S. Kunwar, J. Kushida, P. Kushwaha, Barbera Parola, G. La Rosa, R. Lahmann, A. Lamastra, M. Landoni, D. Landriu, R.G. Lang, J. Lapington, P. Laporte, P. Lason, J. Lasuik, J. Lazendic Galloway, T. Le Flour, P. Le Sidaner, S. Leach, S.H. Lee, W.H. Lee, S. Lee Oliveira, A. Lemiere, M. Lemoine Goumard, J.P. Lenain, F. Leone, V. Leray, G. Leto, F. Leuschner, R. Lindemann, E. Lindfors, L. Linhoff, I. Liodakis, A. Lipniacka, M. Lobo, Thomas Lohse, S. Lombardi, A. Lopez, M. Lopez, R. Lopez Coto, F. Louis, M. Louys, F. Lucarelli, H. Ludwig Boudi, P.L. Luque Escamilla, M.C. Maccarone, E. Mach, A.J. Maciejewski, J. Mackey, P. Maeght, C. Maggio, G. Maier, P. Majumdar, M. Makariev, M. Mallamaci, R. Malta Nunes de Almeida, D. Malyshev, D. Mandat, G. Maneva, M. Manganaro, P. Manigot, K. Mannheim, N. Maragos, D. Marano, M. Marconi, A. Marcowith, M. Marculewicz, B. Marcun, J. Marin, N. Marinello, P. Marinos, S. Markoff, P. Marquez, G. Marsella, J. M. Martin, P. G. Martin, M. Martinez, G. Martinez, O. Martinez, H. Martinez Huerta, C. Marty, R. Marx, N. Masetti, P. Massimino, H. Matsumoto, N. Matthews, G. Maurin, W. Max Moerbeck, N. Maxted, M.N. Mazziotta, S.M. Mazzola, J.D. Mbarubucyeye, L. Mc Comb, I. McHardy, S. McKeague, S. McMuldroch, E. Medina, D. Medina Miranda, A. Melandri, C. Melioli, D. Melkumyan, S. Menchiari, S. Mereghetti, G. Merino Arevalo, E. Mestre, J.L. Meunier, T. Meures, S. Micanovic, M. Miceli, M. Michailidis, J. Michalowski, T. Miener, I. Mievre, J. D. Miller, T. Mineo, M. Minev, J.M. Miranda, A. Mitchell, T. Mizuno, B. A. Mode, R. Moderski, L. Mohrmann, E. Molinari, T. Montaruli, I. Monteiro, C. Moore, A. Moralejo, D. Morcuende Parrilla, E. Moretti, K. Mori, P. Moriarty, K. Morik, P. Morris, A. Morselli, K. Mosshammer, R. Mukherjee, J. Muller, C. Mundell, J. Mundet, T. Murach, A. Muraczewski, H. Muraishi, I. Musella, A. Musumarra, A. Nagai, S. Nagataki, T. Naito, T. Nakamori, K. Nakashima, K. Nakayama, N. Nakhjiri, G. Naletto, D. Naumann, L. Nava, M.A. Nawaz, H. Ndiyavala, D. Neise, L. Nellen, R. Nemmen, N. Neyroud, K. Ngernphat, T. Nguyen Trung, L. Nicastro, L. Nickel, J. Niemiec, D. Nieto, C. Nigro, M. Nikołajuk, D. Ninci, K. Noda, Y. Nogami, S. Nolan, R. P. Norris, D. Nosek, M. Nöthe, V. Novotny, S. Nozaki, F. Nunio, P. O'Brien, K. Obara, Y. Ohira, M. Ohishi, S. Ohm, T. Oka, N. Okazaki, A. Okumura, C. Oliver, G. Olivera, B. Olmi, M. Orienti, R. Orito, M. Orlandini, E. Orlando, J.P. Osborne, M. Ostrowski, N. Otte, E. Ovcharov, E. Owen, I. Oya, A. Ozieblo, M. Padovani, A. Pagliaro, A. Paizis, M. Palatiello, M. Palatka, E. Palazzi, J.‑L. Panazol, D. Paneque, S. Panny, Francesca Romana Pantaleo, M. Panter, M. Paolillo, A. Papitto, A. Paravac, J.M. Paredes, G. Pareschi, N. Parmiggiani, R.D. Parsons, P. Paśko, S. R. Patel, B. Patricelli, L. Pavletic, S. Pavy, A. Peer, M. Pecimotika, M.G. Pellegriti, P. Peñil Del Campo, A. Pepato, S. Perard, C. Perennes, M. Peresano, A. Perez Aguilera, J. Perez Romero, M.A. Perez Torres, M. Persic, P. O. Petrucci, O. Petruk, B. Peyaud, K. Pfrang, E. Pian, P. Piatteli, E. Pietropaolo, R. Pillera, D. Pimentel, F. Pintore, C. Pio Garcia, G. Pirola, F. Piron, S. Pita, M. Pohl, V. Poireau, A. Pollo, M. Polo, C. Pongkitivanichkul, J. Porthault, J. Powell, D. Pozo, R.R. Prado, E. Prandini, J. Prast, K. Pressard, G. Principe, N. Produit, D. Prokhorov, H. Prokoph, H. Przybilski, E. Pueschel, G. Pühlhofer, I. Puljak, M.L. Pumo, M. Punch, F. Queiroz, J. Quinn, A. Quirrenbach, P.J. Rajda, R. Rando, S. Razzaque, S. Recchia, P. Reichherzer, O. Reimer, A. Reisenegger, Q. Remy, M. Renaud, T. Reposeur, B. Reville, J.M. Reymond, J. Reynolds, D. Ribeiro, M. Ribo, G. Richards, J. Rico, F. Rieger, L. Riitano, M. Riquelme, D. Riquelme, S. Rivoire, V. Rizi, E. Roache, M. Roche, J. Rodriguez, G. Rodriguez Fernandez, J.C. Rodriguez Ramirez, J.J. Rodriguez Vazquez, G. Rojas, P. Romano, G. Romeo Lobato, C. Romoli, M. Roncadelli, J. Rosado, A. Rosales de Leon, G. Rowell, A. Rugliancich, J.E. Ruiz del Mazo, C. Rulten, C. Russell, F. Russo Hatlen, S. Safi Harb, L. Saha, V. Sahakian, S. Sailer, T. Saito, N. Sakaki, S. Sakurai, G. Salina, H. Salzmann, D. Sanchez, H. Sandaker, A. Sandoval, P. Sangiorgi, M. Sanguillon, H. Sano, M. Santander, A. Santangelo, R. Santos Lima, A. Sanuy, L. Sapozhnikov, T. Saric, S. Sarkar, H. Sasaki, N. Sasaki, Y. Sato, F.G. Saturni, M. Sawada, J. Schaefer, A. Scherer, J. Scherpenberg, P. Schipani, B. Schleicher, J. Schmoll, M. Schneider, H. Schoorlemmer, P. Schovanek, F. Schussler, B. Schwab, U. Schwanke, J. Schwarz, E. Sciacca, S. Scuderi, M. Seglar Arroyo, I. Seitenzahl, D. Semikoz, O. Sergijenko, J.E. Serna Franco, Karol Seweryn, V. Sguera, A. Shalchi, R.Y. Shang, P. Sharma, L. Sidoli, J. Sieiro, H. Siejkowski, A. Sillanpaa, B.B. Singh, K.K. Singh, A. Sinha, C. Siqueira, J. Sitarek, P. Sizun, V. Sliusar, D. Sobczynska, R.W. Sobrinho, H. Sol, G. Sottile, H. Spackman, S. Spencer, G. Spengler, D. Spiga, W. Springer, A. Stamerra, S. Stanic, R. Starling, Ł. Stawarz, Stanislav Stefanik, C. Stegmann, A. Steiner, S. Steinmassl, C. Stella, R. Sternberger, M. Sterzel, C. Stevens, B. Stevenson, T. Stolarczyk, G. Stratta, U. Straumann, J. Striskovic, M. Strzys, R. Stuik, M. Suchenek, Y. Sunada, Tiina Suomijarvi, T. Suric, H. Suzuki, P. Swierk, T. Szepieniec, K. Tachihara, G. Tagliaferri, H. Tajima, N. Tajima, D. Tak, H. Takahashi, M. Takahashi, J. Takata, R. Takeishi, T. Tam, M. Tanaka, T. Tanaka, S. Tanaka, M. Tavani, F. Tavecchio, T. Tavernier, A. Russ Taylor, L.A. Tejedor, P. Temnikov, K. Terauchi, J.C. Terrazas, R. Terrier, T. Terzic, M. Teshima, D. Thibaut, F. Thocquenne, W. Tian, L. Tibaldo, A. Tiengo, M. Tluczykont, C.J. Todero Peixoto, K. Toma, L. Tomankova, J. Tomastik, M. Tornikoski, D.F. Torres, E. Torresi, G. Tosti, L. Tosti, N. Tothill, F. Toussenel, G. Tovmassian, C. Trichard, M. Trifoglio, A. Trois, S. Truzzi, A. Tsiahina, B. Turk, A. Tutone, Y. Uchiyama, P. Utayarat, L. Vaclavek, M. Vacula, V. Vagelli, F. Vagnetti, J.A. Valdivia, M. Valentino, A. Valio, B. Vallage, P. Vallania Quispe, A.M. van den Berg, W. van Driel, C. van Eldik, C. van Rensburg, Brian van Soelen, J. Vandenbroucke, G. Vasileiadis, V. Vassiliev, M. Vazquez Acosta, M. Vecchi, A. Vega, J. Veh, P. Veitch, C. Venter, S. Ventura, S. Vercellone, V. Verguilov, G. Verna, S. Vernetto, V. Verzi, G.P. Vettolani, C. Veyssiere, I. Viale, A. Viana, N. Viaux, J. Vignatti, C.F. Vigorito, J. Villanueva, V. Vitale, V. Vittorini, V. Vodeb, N. Vogel, V. Voisin, S. Vorobiov, M. Vrastil, T. Vuillaume, S.J. Wagner, P. Wagner, K. Wakazono, S.P. Wakely, M. Ward, D. Warren, J. Watson, M. Wechakama, P. Wegner, A. Weinstein, C. Weniger, F. Werner, H. Wetteskind, M. L. White, A. Wierzcholska, S. Wiesand, R. Wijers, M. Wilkinson, M. Will, J. Williams, T. J. Williamson, A. Wolter, Y.W. Wong, M. Wood, T. Yamamoto, H. Yamamoto, Y. Yamane, R. Yamazaki, S. Yanagita, L. Yang, S. Yoo, T. Yoshida, T. Yoshikoshi, P. Yu, A. Yusafzai, Michael Zacharias, B. Zaldivar, L. Zampieri, R. Zanin, R. Zanmar Sanchez, D. Zaric, M. Zavrtanik, D. Zavrtanik, Andrzej Zdziarski, A. Zech, H. Zechlin, A. Zenin, A. Zerwekh, K. Ziętara, A. Zink, J. Ziolkowski, M. Zivec, A. Zmija, Współautorami artykułu są członkowie CTA Observatory, CTA Consortium i LST Collaboration w liczbie 1139, Astronomy, Research unit Nuclear & Hadron Physics, and Research unit Astroparticle Physics
Subjects: Physics, Observatory, Gamma ray, Astronomy
Abstract: Very-high Energy (VHE) gamma-ray astroparticle physics is a relatively young field, and observations over the past decade have surprisingly revealed almost two hundred VHE emitters which appear to act as cosmic particle accelerators. These sources are an important component of the Universe, influencing the evolution of stars and galaxies. At the same time, they also act as a probe of physics in the most extreme environments known - such as in supernova explosions, and around or after the merging of black holes and neutron stars. However, the existing experiments have provided exciting glimpses, but often falling short of supplying the full answer. A deeper understanding of the TeV sky requires a significant improvement in sensitivity at TeV energies, a wider energy coverage from tens of GeV to hundreds of TeV and a much better angular and energy resolution with respect to the currently running facilities. The next generation gamma-ray observatory, the Cherenkov Telescope Array Observatory (CTAO), is the answer to this need. In this talk I will present this upcoming observatory from its design to the construction, and its potential science exploitation. CTAO will allow the entire astronomical community to explore a new discovery space that will likely lead to paradigm-changing breakthroughs. In particular, CTA has an unprecedented sensitivity to short (sub-minute) timescale phenomena, placing it as a key instrument in the future of multi-messenger and multi-wavelength time domain astronomy. I will conclude the talk presenting the first scientific results obtained by the LST-1, the prototype of one CTAO telescope type - the Large-Sized Telescope, that is currently under commission., PoS: Proceedings of Science, 395, ISSN:1824-8039, Proceedings of 37th International Cosmic Ray Conference (ICRC2021)
Published: 2022

34. Endocardial Fibroelastosis Recurrence: Comparing Single Ventricle Palliation versus Biventricular Repair

Author: D. Diaz-Gil, B. L. Piekarski, G. R. Marx, P. J. Del Nido, S. Emani, and I. Friehs
Published: 2022

35. Real-time image-based rigid registration of three-dimensional ultrasound.

Author: Robert J. Schneider, Douglas P. Perrin, Nikolay V. Vasilyev, Gerald R. Marx, Pedro J. del Nido, and Robert D. Howe
Published: 2012
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36. Mitral annulus segmentation from four-dimensional ultrasound using a valve state predictor and constrained optical flow.

Author: Robert J. Schneider, Douglas P. Perrin, Nikolay V. Vasilyev, Gerald R. Marx, Pedro J. del Nido, and Robert D. Howe
Published: 2012
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37. Photodegradation studies of pure and cobalt doped zinc oxide nanoparticles.

Author: Natarajan, Karthikeyan, R, Marx Nirmal, G, Sathishkumar, and R, Akilan
Subjects: *ZINC oxide, *MALACHITE green, *X-ray powder diffraction, *PHOTODEGRADATION, *COBALT, *SCANNING electron microscopes
Abstract: Pure and cobalt (Co)-doped zinc oxide (ZnO) nanoparticles were synthesised by co-precipitation method. Various characterisation studies such as powder X-ray diffraction, scanning electron microscope (SEM) and UV-visible spectra were carried out to investigate their structural and optical characteristics. The absorbance spectrum shows the red shift for the Co-doped ZnO nanoparticles and also decrease in their band gap due to increase in dopant concentration. The SEM analysis reveals that the pure ZnO has spherical-shaped morphology and Co-doped samples have hexagonal-shaped nanorods and nanoflowers. Photo catalytic activity of pure and Co-doped Zinc oxide was analysed using Malachite Green and Chrysodine Y dyes under UV irradiation, and it shows good photo catalytic behaviour. [ABSTRACT FROM AUTHOR]
Published: 2023
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38. Mitral Annulus Segmentation From 3D Ultrasound Using Graph Cuts.

Author: Robert J. Schneider, Douglas P. Perrin, Nikolay V. Vasilyev, Gerald R. Marx, Pedro J. del Nido, and Robert D. Howe
Published: 2010
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39. Fast block flow tracking of atrial septal defects in 4D echocardiography.

Author: Marius George Linguraru, Nikolay V. Vasilyev, Gerald R. Marx, Wayne Tworetzky, Pedro J. del Nido, and Robert D. Howe
Published: 2008
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40. Abstract 13570: Quantitative 3D Echocardiographic Predictors for Risk Stratification and Improved Management of Congenital Mitral Valve Disease

Author: Nora Lang, Steven Staffa, David Zurakowski, Christopher W Baird, Sitaram Emani, Melinda H Shea, Pedro J Del Nido, and Gerald R Marx
Subjects: Physiology (medical), Cardiology and Cardiovascular Medicine
Abstract: Background: Congenital mitral valve disease (CMVD) presents major challenges regarding medical and surgical management. Three dimensional echocardiography (3DE) allows precise delineation of area tracing from cross-sectional planes for more precise measurements and outcome analysis. However, there are no available data to inform clinicians on how 3DE can help guide management. We hypothesized that quantitative 3DE measurements can provide improved risk stratification and guide management of CMVD. Methods and Results: Demographic, procedural and outcome data were obtained for all 183 children who underwent MV reconstruction for CMVD from 2002 to 2017. 92 patients had mitral stenosis (MS), 68 mitral regurgitation (MR), and 23 mixed disease (MD). 13 patients (7%) died. MD patients had higher rates of mortality, reoperation, and valve replacement. Quantitative 3DE measurements of the effective orifice area (EOA) and vena contracta regurgitant area (VCRA) were determined preoperatively and before discharge. Changes from baseline in EOA and VCRA were significant independent predictors of reoperation with excellent area under the curve (AUC) values (EOA: AUC = 0.888; VCRA: AUC = 0.962; both P Conclusions: Reconstructive surgery for CMVD can be performed with good outcomes. 3DE EOA and VCRA aids in postoperative clinical and surgical management. Further, 3DE is more predictive of patient outcomes than 2DE measurements of MG. Thus, we now incorporate 3DE EOA and VCRA into clinical decision making.
Published: 2021

41. Abstract 9566: Quantification of Valve Regurgitation in the Pediatric Population Using 3-Dimensional Echocardiography: Feasibility and Comparison With Cardiac Magnetic Resonance Imaging

Author: Joseph D Kuebler, Melinda H Shea, Minmin Lu, Lynn A Sleeper, David M Harrild, Ashwin Prakash, and Gerald R Marx
Subjects: Physiology (medical), Cardiology and Cardiovascular Medicine
Abstract: Introduction: Valvar regurgitation in pediatric patients is commonly assessed by cardiac magnetic resonance (CMR). This modality is associated with increased cost and need for anesthesia in young patients when compared to echocardiography. 3-dimensional echocardiography (3DE) can measure ventricular volumes and calculate the regurgitation fraction (RF) by comparison of stroke volumes - similar to CMR. Given the potential advantages of 3DE in children, this study sought to compare the quantification of single valvar regurgitation using 3DE versus CMR as the gold standard. Methods: Pediatric patients ≤18 years of age were included in the study. Patients were excluded if they had more than mild regurgitation of an additional valve, significant shunt, or suboptimal imaging windows. Full volume data sets were obtained sub-costally using a Philips IE33 or EPIQ CVx machine (X5 or X7 ultrasound probe). 3DE volumes were analyzed using 4D Cardioview (Tomtec Imaging Systems) and compared with ventricular volumes and RF obtained by CMR. Inter- and intra-observer reliability were assessed for 3DE ventricular volumes and RF. Results: 34 patients had volumes obtained by 3DE and CMR with two patients having pairs of studies performed on different dates. The median age was 8.7 (IQR; 3.9-12.3) years. 12 studies (33%) were obtained under sedation. Primary valve involvement was: mitral-12 (33%), tricuspid-9 (25%), pulmonary-1 (3%), and aortic-14 (39%). Agreement between 3DE and CMR ventricular volumes by intraclass correlation coefficient (ICC) was excellent (ICC>0.90). Agreement for the regurgitant fraction was good (ICC 0.80 (95% CI; 0.68, 0.88)). Ventricular volume ratios obtained by MRI and 3DE were strongly correlated; Spearman r = 0.92 (95% CI; 0.85-0.96). Inter-observer reliability was excellent for ventricular volumes and moderate for RF (ICC 0.63 (95% CI; 0.23, 0.85)). Intra-observer reliability was excellent for ventricular volumes and RF (ICC≥0.97). Conclusions: Assessment of single valvar regurgitation using 3DE compares favorably with CMR in pediatric patients. The shorter time for image acquisition and lower cost will allow for standard application of 3DE to measure single valve regurgitation in this population, particularly on a serial basis.
Published: 2021

42. Single-Leaflet Aortic Valve Reconstruction Utilizing the Ozaki Technique in Patients With Congenital Aortic Valve Disease

Author: Supreet P Marathe, Christopher W. Baird, Mariana Chávez, Gerald R. Marx, Kevin G. Friedman, Eric N. Feins, Pedro J. del Nido, and Lynn A. Sleeper
Subjects: Pulmonary and Respiratory Medicine, Aortic valve, medicine.medical_specialty, medicine.medical_treatment, Aortic Valve Insufficiency, Aortic valve repair, Valve replacement, medicine.artery, medicine, Endocarditis, Humans, Animals, cardiovascular diseases, Child, Retrospective Studies, Body surface area, business.industry, General Medicine, medicine.disease, Aortic Valve Disease, Surgery, medicine.anatomical_structure, Treatment Outcome, Aortic Valve, Pulmonary artery, cardiovascular system, End-diastolic volume, Cattle, Unicuspid, Cardiology and Cardiovascular Medicine, business, Pericardium
Abstract: Evaluate outcomes of single leaflet aortic valve reconstruction using Ozaki sizer and template. Single institute retrospective analysis between August 2015 and August 2019. Thirty-three patients, median age 9.3 years and weight 29.2 kg underwent single leaflet Ozaki repair. Preoperative indications were: AR (n = 17), AS (n = 3) or AS/AR (n = 13). Baseline anatomy was unicuspid (n = 15), bicuspid (n = 9) or tricuspid (n = 9). Two patients had endocarditis. Prior interventions included balloon valvuloplasty (n = 22) and aortic valve repair (n = 9). Pre-op average native annulus diameter was 19.6 mm and peak echo gradient was 36 mm Hg. Autologous pericardium, Photofix and CardioCel bovine pericardium were used in 26, 5, and 2 patients. Non-coronary sinus enlargement was required in 3 and aortic root reduction in 9 patients. Single leaflet reconstruction was done for the right coronary cusp (n = 25), non-coronary cusp in (n = 6) and left coronary cusp (n = 2). Additional procedures were done in 30 patients. Median ICU and hospital LOS were 2.1 and 6.3 days. There were no early re-interventions or conversions to valve replacement and one unrelated mortality.en At discharge, all patients hadmoderate AR and/or AS with average peak gradients of 15 mm Hg. The median follow-up was 1.1 year, (IQR 0.7-1.8 years). Freedom from ≥ moderate AR and AS at 2 years was 76% and 86%. One patient required surgical re-intervention for severe AR 1.5 years after surgery for inflammatory infiltrate with calcification and fibrosis. Single-leaflet aortic valve leaflet reconstruction utilizing the Ozaki technique has promising early results and can be considered in patients when there are acceptable native leaflets.
Published: 2021

43. TeV Emission of Galactic Plane Sources with HAWC and H.E.S.S

Author: Nicola Omodei, Sebastian Panny, A. Sandoval, Q. Piel, S. Raab, Arturo Iriarte, Kirsty Feijen, R. D. Parsons, Michael Newbold, J. Zorn, Michael Schneider, Fernando Garfias, D. Huber, Christo Venter, Jacek Niemiec, Arnaud Mares, Frank M. Rieger, Thomas Weisgarber, A. Dmytriiev, Olaf Reimer, A. Zech, E. Ruiz-Velasco, Thomas Bylund, Y. A. Gallant, David Sánchez, R. López-Coto, Jorge Cotzomi, Jacques Muller, H. León Vargas, Alison Peisker, Justine Devin, Thomas Murach, P. Morris, Harm Schoorlemmer, Jonathan Mackey, Andrea Albert, Samuel Zouari, Pascal Vincent, M. Zacharias, Stefan Ohm, S. Pita, Tadayuki Takahashi, Gilgamesh Luis-Raya, A. Yusafzai, Andreas Quirrenbach, Samuel Timothy Spencer, Stefano Gabici, Regis Terrier, Victor Doroshenko, L. Nellen, Włodek Kluźniak, R. Noriega-Papaqui, E. Kasai, C. Moore, L. Oakes, J. Bolmont, Michal Ostrowski, J.-P. Lenain, Pooja Surajbali, William H. Lee, L. Olivera-Nieto, E. Moulin, Tomasz Bulik, Rhiannon Turner, Lente Dreyer, O. Martinez, Stefan Klepser, Alessandro Montanari, D. J. van der Walt, Fernando Ureña-Mena, J. P. Harding, César Alvarez, Michael DuVernois, A.M. Taylor, J. C. Arteaga-Velézquez, Connor Duffy, Davit Zargaryan, R. J. White, Stefan Funk, Alicja Wierzcholska, Dmitriy Kostunin, J. Damascene Mbarubucyeye, R. Rauth, Maria Magdalena González, Kristi Engel, A. Galván-Gámez, Christoph Deil, Krzysztof Katarzynski, F. Eichhorn, Mohanraj Senniappan, E. Moreno, Michael Punch, Axel Donath, B. Hona, A. W. Chen, S. Steinmassl, Sami Caroff, Domenico Tiziani, D. Malyshev, Catherine Boisson, M. Panter, Mora Durocher, U. Katz, Pedro Miranda-Romagnoli, C. Arcaro, H. Zhou, Michael Backes, S. Coutiño de León, Ernesto Belmont-Moreno, M. de Bony de Lavergne, R. Brose, Petra Hüntemeyer, C. Levy, Francois Brun, R. J. Tuffs, B. Bi, Andreas Specovius, Joachim Hahn, K. P. Arunbabu, Riaan Steenkamp, Gavin Rowell, P. Reichherzer, James E. M. Watson, M. Bryan, E. de Oña Wilhelmi, Łukasz Stawarz, C. van Rensburg, Pierre Brun, Brenda Dingus, V. Marandon, J. A. Morales-Soto, M. Büchele, H. Prokoph, C. De León, A. Marcowith, V. Baghmanyan, J. Schäfer, Nu. Komin, Tim Holch, Q. Remy, H. M. Schutte, Isak Delberth Davids, A. Fiasson, Jean-Pierre Ernenwein, Hassan Abdalla, S. Hernandez, Jim Hinton, V. Sahakian, E. De la Fuente, F. Werner, Mischa Breuhaus, Luis Villaseñor, Yu Wun Wong, Hambeleleni Ndiyavala, D. Avila Rojas, G. Lamanna, K. S. Caballero-Mora, Roberta Zanin, G. Emery, Halim Ashkar, Fabian Leuschner, Heiko Salzmann, A. S. Seyffert, Kwok Lung Fan, M. Hörbe, T. Tavernier, Nissim Illich Fraija, P. T. O'Brien, Johannes Veh, S. Sailer, Dmitry Khangulyan, Gilles Maurin, S. J. Fegan, A. Djannati-Ataï, D. Jankowsky, J. Dyks, Celine Armand, M. Füßling, R. Marx, Dieter Horns, M. Tluczykont, F. Ait Benkhali, J. F. Glicenstein, M. U. Nisa, Marek Jamrozy, Clemens Hoischen, A. A. Zdziarski, A. Jardin-Blicq, E. O. Angüner, R. Diaz Hernandez, N. Shafi, Natalia Żywucka, M. de Naurois, Andrea Santangelo, K. Malone, Gwenael Giacinti, L. Sun, M.-H. Grondin, D. Garcia, M. Seglar-Arroyo, B. Khélifi, A. J. Smith, T. Capistrán, B. van Soelen, G. Hermann, Anna Barnacka, D. Gottschall, Anne Lemiere, B. Rudak, Markus Böttcher, K. Tollefson, Jhilik Majumdar, Helene Sol, T. Chand, C. Brisbois, Andreas Zmija, Tom Armstrong, Elijah Willox, Carlo Romoli, Alison Mitchell, R. Torres-Escobedo, Atreyee Sinha, Manuel Meyer, I. Martinez-Castellanos, Zorawar Wadiasingh, A. Priyana Noel, V. Barbosa Martins, C. van Eldik, M. Lemoine-Goumard, M. Tsirou, Michael Kreter, Anna Lia Longinotti, F. Schüssler, Dezhi Huang, Jose Andres Garcia-Gonzalez, Werner Hofmann, Monica Barnard, Juan Carlos Diaz-Velez, V. Poireau, Jimmy N.S. Shapopi, K. Nakashima, José Serna-Franco, G. Peron, Garret Cotter, Jacco Vink, A. Carraminana, Umberto Cotti, Jim Davies, M. A. Kastendieck, Thomas Lohse, K. Kosack, Paolo Marchegiani, Konrad Bernlöhr, Heinrich J. Völk, Sabrina Casanova, Catalina Espinoza, M. Renaud, D. Berge, G. Vasileiadis, F. Salesa Greus, I. Jung-Richardt, Kleopas Shiningayamwe, Gilles Fontaine, J. T. Linnemann, Lenka Tomankova, M. Mostafá, G. Fichet de Clairfontaine, R. Konno, Gianluca Giavitto, V. Joshi, B. Peyaud, G. Pühlhofer, J. A. Goodman, H. Odaka, A. Reimer, R. W. Ellsworth, R. W. Springer, M. Curyło, F. Hueyotl-Zahuantitla, E. G. Pérez-Pérez, Y. Pérez Araujo, A. Nayerhoda, Christian Stegmann, Stefan Wagner, Yasunobu Uchiyama, David Kieda, L. Mohrmann, Misao Sasaki, Markus Holler, Felix Jankowsky, Felix Aharonian, D. Glawion, Jesús Martínez-Castro, Segev BenZvi, Constantin Steppa, L. Giunti, D. A. Prokhorov, Ullrich Schwanke, L. Rinchiuso, J. A. Matthews, Ibrahim Torres, Rachel Simoni, A. Carosi, K. Egberts, S. Chandra, Ruben Alfaro, Sabrina Einecke, Iryna Lypova, Daniel Rosa-Gonzalez, Yvonne Becherini, M. Fernández Alonso, L. Dirson, G. Martí-Devesa, C. Trichard, Sylvia Zhu, P. J. Meintjes, J. H. E. Thiersen, Marion Spir-Jacob, Maria Haupt, C. D. Rho, Rafal Moderski, Centre de Physique des Particules de Marseille (CPPM), Aix Marseille Université (AMU)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), Laboratoire d'Annecy de Physique des Particules (LAPP), Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Centre National de la Recherche Scientifique (CNRS), Laboratoire de Physique Nucléaire et de Hautes Énergies (LPNHE (UMR_7585)), Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), AstroParticule et Cosmologie (APC (UMR_7164)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Observatoire de Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Laboratoire Leprince-Ringuet (LLR), Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-École polytechnique (X)-Centre National de la Recherche Scientifique (CNRS), Laboratoire Univers et Particules de Montpellier (LUPM), Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre d'Etudes Nucléaires de Bordeaux Gradignan (CENBG), Université Sciences et Technologies - Bordeaux 1 (UB)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), Gravitation and Astroparticle Physics Amsterdam, High Energy Astrophys. & Astropart. Phys (API, FNWI), Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), Centre National de la Recherche Scientifique (CNRS)-École polytechnique (X)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université Montpellier 2 - Sciences et Techniques (UM2), Université Sciences et Technologies - Bordeaux 1-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), Collaboration, H.E.S.S., and Collaboration, HAWC
Subjects: High-energy astronomy, media_common.quotation_subject, Astrophysics::High Energy Astrophysical Phenomena, FOS: Physical sciences, IACT, Field of view, 030226 pharmacology & pharmacy, 01 natural sciences, 03 medical and health sciences, 0302 clinical medicine, Observatory, 0103 physical sciences, High Energy Stereoscopic System, 010303 astronomy & astrophysics, Instrumentation and Methods for Astrophysics (astro-ph.IM), Cherenkov radiation, media_common, Physics, [PHYS]Physics [physics], Astrophysics::Instrumentation and Methods for Astrophysics, Astronomy, Astronomy and Astrophysics, Galactic plane, Space and Planetary Science, Sky, Astrophysics - Instrumentation and Methods for Astrophysics, [PHYS.ASTR]Physics [physics]/Astrophysics [astro-ph], High energy astrophysics
Abstract: International audience; The High Altitude Water Cherenkov (HAWC) observatory and the High Energy Stereoscopic System (H.E.S.S.) are two leading instruments in the ground-based very-high-energy γ-ray domain. HAWC employs the water Cherenkov detection (WCD) technique, while H.E.S.S. is an array of Imaging Atmospheric Cherenkov Telescopes (IACTs). The two facilities therefore differ in multiple aspects, including their observation strategy, the size of their field of view, and their angular resolution, leading to different analysis approaches. Until now, it has been unclear if the results of observations by both types of instruments are consistent: several of the recently discovered HAWC sources have been followed up by IACTs, resulting in a confirmed detection only in a minority of cases. With this paper, we go further and try to resolve the tensions between previous results by performing a new analysis of the H.E.S.S. Galactic plane survey data, applying an analysis technique comparable between H.E.S.S. and HAWC. Events above 1 TeV are selected for both data sets, the point-spread function of H.E.S.S. is broadened to approach that of HAWC, and a similar background estimation method is used. This is the first detailed comparison of the Galactic plane observed by both instruments. H.E.S.S. can confirm the γ-ray emission of four HAWC sources among seven previously undetected by IACTs, while the three others have measured fluxes below the sensitivity of the H.E.S.S. data set. Remaining differences in the overall γ-ray flux can be explained by the systematic uncertainties. Therefore, we confirm a consistent view of the γ-ray sky between WCD and IACT techniques.
Published: 2021

44. Management of Congenitally Corrected Transposition of the Great Arteries With Intact Ventricular Septum: Anatomic Repair or Palliative Treatment?

Author: Christopher W. Baird, Breanna L. Piekarski, Gerald R. Marx, Ali Hage, Sitaram M. Emani, Hujun Cui, and Pedro J. del Nido
Subjects: medicine.medical_specialty, Palliative treatment, business.industry, Transposition of Great Vessels, Palliative Care, Ventricular Septum, 030204 cardiovascular system & hematology, Congenitally Corrected Transposition of the Great Arteries, Cardiac surgery, Surgery, 03 medical and health sciences, Treatment Outcome, 0302 clinical medicine, Congenitally corrected transposition, 030228 respiratory system, Great arteries, medicine, Humans, Cardiology and Cardiovascular Medicine, business
Abstract: Background: Management of the congenitally corrected transposition of the great arteries (ccTGA) with intact ventricular septum (IVS) is controversial and includes either anatomic repair with systemic left ventricle (morphological left ventricle) or maintenance of a systemic right ventricle (morphological right ventricle). The purpose of this study was to describe outcomes of ccTGA-IVS with either strategy. Methods: A single-institution, retrospective review of all patients with a diagnosis of ccTGA-IVS who either underwent double switch operation (DSO) or managed with systemic morphological right ventricle (no-DSO). The composite end points included death, heart transplantation, or development of significant systemic ventricular dysfunction or atrioventricular valve regurgitation. Results: Between January 1980 and October 2019, 128 patients with ccTGA-IVS underwent primary treatment at a single institution (91 no-DSO and 37 DSO). Mean age at initial presentation was younger in the DSO compared with the no-DSO cohort (2.1 versus 18.2 years; P P =0.039). Among patients with initial age at presentation ≤5 years, DSO was associated with 0.16× the hazard compared with no-DSO (hazard ratio, 0.16 [95% CI, 0.04–0.62]; P =0.008). Pacemaker implantation was not associated with increased hazard of the composite outcome. Conclusions: Systemic ventricular dysfunction is a late complication of ccTGA-IVS regardless of the strategy pursued. Compared with those undergoing anatomic repair, patients with systemic morphological right ventricle may have lower long-term freedom from cardiovascular complications.
Published: 2021

45. Dehiscence of patch augmentation of a left-sided atrioventricular valve related to strenuous isometric exercise: Case report and failure analysis

Author: Christopher W. Baird, Peter E. Hammer, Gerald R. Marx, and Pedro J. del Nido
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, Atrioventricular valve, business.industry, Mitral Valve Insufficiency, Isometric exercise, 030204 cardiovascular system & hematology, Dehiscence, Left sided, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, 030228 respiratory system, Internal medicine, Mitral valve, medicine, Cardiology, Humans, Mitral Valve, Surgery, Cardiology and Cardiovascular Medicine, business, Exercise
Published: 2018

46. The Association of Age and Repair Modification with Outcome after Cone Repair for Ebstein's Malformation

Author: Antonia Schulz, Supreet P Marathe, Lynn A. Sleeper, Mariana Chávez, Gerald R. Marx, Christopher W. Baird, Pedro J. del Nido, and Sitaram M. Emani
Subjects: Pulmonary and Respiratory Medicine, Adult, medicine.medical_specialty, Adolescent, 030204 cardiovascular system & hematology, law.invention, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Age groups, law, Pulmonary Valve Replacement, medicine, Cardiopulmonary bypass, Humans, Single institution, Child, Papillary muscle, Retrospective Studies, Tricuspid valve, business.industry, Infant, Newborn, Infant, General Medicine, Middle Aged, Tricuspid Valve Insufficiency, Surgery, Ebstein Anomaly, medicine.anatomical_structure, Treatment Outcome, 030228 respiratory system, Child, Preschool, Native tissue, Tricuspid Valve, Cardiology and Cardiovascular Medicine, business, Repair/Modification
Abstract: Cone repair (CR) uses native tissue for tricuspid valve (TV) repair and provides potential for growth. Results after CR were investigated in different age groups including several surgical modifications. Single institution retrospective analysis of all CR excluding neonatal procedures. Endpoints included TV reoperation, late tricuspid regurgitation (TR) and death. Between April 2006 and August 2019, 157 patients underwent CR at a median age of 11.7 years (range, 0.3-57.2). 20% (n=32) of patients had previous surgery. Repair modifications included atrial reduction (n=111,71%), right ventricular plication (n=85,55%), leaflet augmentation (n=36,23%), papillary muscle repositioning (n=50,32%), ring annuloplasty (n=70,45%). Early re-operation for recurrent TR occurred in 11 patients. Median follow-up time was 4.3 years (range, 9d-12.3y). There was no significant association between age at repair and time to TV reoperation (p=0.25). However, age4 years at CR was identified as the most discriminating binary age threshold for the patients with TV reoperation (25.0% in4y group vs 9.3% in the ≥4y group). Placement of an annuloplasty ring was protective against ≥moderate TR (OR=0.39, 95% CI 0.16-0.95, p=0.039). Freedom from late TV re-operation was 94.1% at 7 years. Survival was 97.9% at 6 years. Repair after age 18 years was associated with mortality in early follow-up (p=0.037). Mid-term results for CR are favorable in children and adults. Time to TV reoperation may be shorter when CR is performed before age four years, but this result requires confirmation in a larger sample. An annuloplasty ring should be considered when appropriate.
Published: 2021

47. Revealing x-ray and gamma ray temporal and spectral similarities in the GRB 190829A afterglow

Author: K. Egberts, Davit Zargaryan, Axel Donath, A. W. Chen, G. Pühlhofer, M. de Bony de Lavergne, V. Poireau, P. T. O'Brien, P. A. Evans, Riaan Steenkamp, A. Lemiere, F. Eichhorn, Nu. Komin, J. Schäfer, Włodek Kluźniak, A. S. Seyffert, N. Shafi, Natalia Żywucka, Sebastian Panny, R. J. White, Domenico Tiziani, D. Malyshev, T. Chand, Jhilik Majumdar, V. Baghmanyan, Clemens Hoischen, A. A. Zdziarski, Jacco Vink, Alison Mitchell, Joachim Hahn, M. Füßling, C. van Eldik, J.F. Glicenstein, Lei Sun, P. Reichherzer, Jim Davies, A. Carosi, Zorawar Wadiasingh, Q. Remy, Anna Barnacka, A. Djannati-Ataï, A. Montanari, E. Moulin, M. de Naurois, Alexandre Marcowith, Arnaud Mares, Christoph Deil, Sabrina Casanova, Christo Venter, G. Peron, Garret Cotter, M. Hörbe, Dmitriy Kostunin, E. Ruiz-Velasco, Mohanraj Senniappan, Thomas Bylund, E. O. Angüner, S. Raab, Tadayuki Takahashi, F. Brun, R. J. Tuffs, B. Bi, H. Prokoph, C. van Rensburg, A. Zech, J. Muller, Monica Barnard, B. Peyaud, Kirsty Feijen, R. Rauth, Pierre Brun, Victor Doroshenko, Michael Punch, E. Kasai, Konrad Bernlöhr, M. Curyło, Stefano Gabici, Gianluca Giavitto, Frank M. Rieger, Michael Backes, Stefan Klepser, J.-P. Ernenwein, A. Dmytriiev, Mischa Breuhaus, J. Dyks, G. Emery, L. Olivera-Nieto, Tim Holch, S. Fegan, Samuel Zouari, M.-H. Grondin, L. Mohrmann, Stefan Ohm, I. Jung-Richardt, Markus Böttcher, K. Kosack, A. Reimer, G. Hermann, Marek Jamrozy, Regis Terrier, S. Pita, Markus Holler, Felix Jankowsky, Armelle Jardin-Blicq, E. de Ona Wilhelmi, A.M. Taylor, Carlo Romoli, J. Damascene Mbarubucyeye, Hester Schutte, Dieter Horns, Jonathan Mackey, Tom Armstrong, Helene Sol, Sylvia Zhu, P. J. Meintjes, Hambeleleni Ndiyavala, G. Fontaine, H. Odaka, Felix Aharonian, V. Barbosa Martins, Andreas Specovius, Michal Ostrowski, Johannes Veh, D. J. van der Walt, Yu Wun Wong, L. Oakes, C. Moore, J. Bolmont, D. Jankowsky, M. Seglar-Arroyo, Paolo Marchegiani, Rachel Simoni, R. Marx, S. Steinmassl, D. Glawion, Łukasz Stawarz, Manuel Meyer, Tomasz Bulik, Lente Dreyer, Andreas Quirrenbach, Sabrina Einecke, Iryna Lypova, Constantin Steppa, D. A. Prokhorov, M. Zacharias, Christopher J. Duffy, A. Wierzcholska, M. Tluczykont, Christian Stegmann, Stefan Wagner, Yasunobu Uchiyama, F. Schüssler, Yvonne Becherini, Jimmy N.S. Shapopi, C. Levy, Werner Hofmann, G. Lamanna, M. A. Kastendieck, James E. M. Watson, Ullrich Schwanke, G. Vasileiadis, Isak Delberth Davids, Misao Sasaki, Bruno Khelifi, M. Büchele, M. Lemoine-Goumard, J. Zorn, Elisabetta Bissaldi, Roberta Zanin, F. Ait Benkhali, L. Rinchiuso, M. Scalici, Y. A. Gallant, J. Devin, Jim Hinton, D. Berge, V. Sahakian, F. Werner, Andrea Santangelo, Stefan Funk, S. Sailer, Dmitry Khangulyan, Michael Kreter, Jacek Niemiec, D. A. Sanchez, A. Priyana Noel, C. Arcaro, Fabian Leuschner, J. H. E. Thiersen, M. Panter, U. Katz, K. Nakashima, Olaf Reimer, G. Martí-Devesa, H. Ashkar, Q. Piel, P. Morris, Gavin Rowell, M. Bryan, Kleopas Shiningayamwe, A. Yusafzai, Thomas Murach, G. Maurin, Maria Haupt, Heinrich J. Völk, M. Renaud, R. D. Parsons, Samuel Timothy Spencer, Lenka Tomankova, T. Tam, G. Fichet de Clairfontaine, A. Sinha, J.-P. Lenain, D. Huber, Rafal Moderski, S. Caroff, B. van Soelen, S. Chandra, R. Konno, L. Dirson, M. Tsirou, B. Rudak, V. Joshi, Thomas Lohse, L. Giunti, A. Nayerhoda, Hassan Abdalla, A. Fiasson, M. Spir-Jacob, V. Marandon, K. Katarzyński, P. Vincent, T. Tavernier, K. L. Page, Heiko Salzmann, Celine Armand, Catherine Boisson, Centre de Physique des Particules de Marseille (CPPM), Aix Marseille Université (AMU)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), Laboratoire d'Annecy de Physique des Particules (LAPP), Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Centre National de la Recherche Scientifique (CNRS), Institut de Recherches sur les lois Fondamentales de l'Univers (IRFU), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay, Laboratoire Univers et Théories (LUTH (UMR_8102)), Institut national des sciences de l'Univers (INSU - CNRS)-Observatoire de Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Laboratoire de Physique Nucléaire et de Hautes Énergies (LPNHE (UMR_7585)), Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), AstroParticule et Cosmologie (APC (UMR_7164)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Observatoire de Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Laboratoire Leprince-Ringuet (LLR), Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-École polytechnique (X)-Centre National de la Recherche Scientifique (CNRS), Laboratoire Univers et Particules de Montpellier (LUPM), Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre d'Etudes Nucléaires de Bordeaux Gradignan (CENBG), Université Sciences et Technologies - Bordeaux 1 (UB)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), H.E.S.S., Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Diderot - Paris 7 (UPD7), Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), Centre National de la Recherche Scientifique (CNRS)-École polytechnique (X)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3), Université Montpellier 2 - Sciences et Techniques (UM2)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Université Sciences et Technologies - Bordeaux 1-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), Gravitation and Astroparticle Physics Amsterdam, High Energy Astrophys. & Astropart. Phys (API, FNWI), H.E.S.S. Collaboration, and Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université Montpellier 2 - Sciences et Techniques (UM2)
Subjects: Photon, Astrophysics::High Energy Astrophysical Phenomena, FOS: Physical sciences, Astrophysics, Astrophysics::Cosmology and Extragalactic Astrophysics, gamma ray: burst, 01 natural sciences, Luminosity, HESS, 0103 physical sciences, High Energy Stereoscopic System, 010303 astronomy & astrophysics, High Energy Astrophysical Phenomena (astro-ph.HE), Physics, energy: high, Multidisciplinary, X-ray: energy spectrum, 010308 nuclear & particles physics, photon, Gamma ray, trigger, Light curve, redshift, Redshift, Afterglow, collapse, gamma ray: VHE, HESS - Abteilung Hinton, spectral, Astrophysics - High Energy Astrophysical Phenomena, Gamma-ray burst, [PHYS.ASTR]Physics [physics]/Astrophysics [astro-ph], absorption
Abstract: An intrinsic gamma-ray burst afterglow Long gamma-ray bursts (GRBs) are emitted by relativistic jets generated during the collapse of a massive star in a distant galaxy. The GRB itself lasts only a few seconds but is followed by an afterglow that can persist for hours or days. The H.E.S.S. Collaboration observed the afterglow of GRB 190829A, a nearby long GRB. The proximity of this burst allowed it to be detected at tera–electron volt energies that would otherwise be absorbed in the intergalactic medium. By analyzing the spectrum and light curve at x-ray and gamma-ray wavelengths, the authors show that the afterglow cannot be explained by standard models. Science , abe8560, this issue p. 1081
Published: 2021

48. Swarm Learning for decentralized and confidential clinical machine learning

Author: Warnat-Herresthal, S. Schultze, H. Shastry, K.L. Manamohan, S. Mukherjee, S. Garg, V. Sarveswara, R. Händler, K. Pickkers, P. Aziz, N.A. Ktena, S. Tran, F. Bitzer, M. Ossowski, S. Casadei, N. Herr, C. Petersheim, D. Behrends, U. Kern, F. Fehlmann, T. Schommers, P. Lehmann, C. Augustin, M. Rybniker, J. Altmüller, J. Mishra, N. Bernardes, J.P. Krämer, B. Bonaguro, L. Schulte-Schrepping, J. De Domenico, E. Siever, C. Kraut, M. Desai, M. Monnet, B. Saridaki, M. Siegel, C.M. Drews, A. Nuesch-Germano, M. Theis, H. Heyckendorf, J. Schreiber, S. Kim-Hellmuth, S. Balfanz, P. Eggermann, T. Boor, P. Hausmann, R. Kuhn, H. Isfort, S. Stingl, J.C. Schmalzing, G. Kuhl, C.K. Röhrig, R. Marx, G. Uhlig, S. Dahl, E. Müller-Wieland, D. Dreher, M. Marx, N. Nattermann, J. Skowasch, D. Kurth, I. Keller, A. Bals, R. Nürnberg, P. Rieß, O. Rosenstiel, P. Netea, M.G. Theis, F. Mukherjee, S. Backes, M. Aschenbrenner, A.C. Ulas, T. Angelov, A. Bartholomäus, A. Becker, A. Bezdan, D. Blumert, C. Bonifacio, E. Bork, P. Boyke, B. Blum, H. Clavel, T. Colome-Tatche, M. Cornberg, M. De La Rosa Velázquez, I.A. Diefenbach, A. Dilthey, A. Fischer, N. Förstner, K. Franzenburg, S. Frick, J.-S. Gabernet, G. Gagneur, J. Ganzenmueller, T. Gauder, M. Geißert, J. Goesmann, A. Göpel, S. Grundhoff, A. Grundmann, H. Hain, T. Hanses, F. Hehr, U. Heimbach, A. Hoeper, M. Horn, F. Hübschmann, D. Hummel, M. Iftner, T. Iftner, A. Illig, T. Janssen, S. Kalinowski, J. Kallies, R. Kehr, B. Keppler, O.T. Klein, C. Knop, M. Kohlbacher, O. Köhrer, K. Korbel, J. Kremsner, P.G. Kühnert, D. Landthaler, M. Li, Y. Ludwig, K.U. Makarewicz, O. Marz, M. McHardy, A.C. Mertes, C. Münchhoff, M. Nahnsen, S. Nöthen, M. Ntoumi, F. Overmann, J. Peter, S. Pfeffer, K. Pink, I. Poetsch, A.R. Protzer, U. Pühler, A. Rajewsky, N. Ralser, M. Reiche, K. Ripke, S. da Rocha, U.N. Saliba, A.-E. Sander, L.E. Sawitzki, B. Scheithauer, S. Schiffer, P. Schmid-Burgk, J. Schneider, W. Schulte, E.-C. Sczyrba, A. Sharaf, M.L. Singh, Y. Sonnabend, M. Stegle, O. Stoye, J. Vehreschild, J. Velavan, T.P. Vogel, J. Volland, S. von Kleist, M. Walker, A. Walter, J. Wieczorek, D. Winkler, S. Ziebuhr, J. Breteler, M.M.B. Giamarellos-Bourboulis, E.J. Kox, M. Becker, M. Cheran, S. Woodacre, M.S. Goh, E.L. Schultze, J.L. COVID-19 Aachen Study (COVAS) Deutsche COVID-19 Omics Initiative (DeCOI)
Abstract: Fast and reliable detection of patients with severe and heterogeneous illnesses is a major goal of precision medicine1,2. Patients with leukaemia can be identified using machine learning on the basis of their blood transcriptomes3. However, there is an increasing divide between what is technically possible and what is allowed, because of privacy legislation4,5. Here, to facilitate the integration of any medical data from any data owner worldwide without violating privacy laws, we introduce Swarm Learning—a decentralized machine-learning approach that unites edge computing, blockchain-based peer-to-peer networking and coordination while maintaining confidentiality without the need for a central coordinator, thereby going beyond federated learning. To illustrate the feasibility of using Swarm Learning to develop disease classifiers using distributed data, we chose four use cases of heterogeneous diseases (COVID-19, tuberculosis, leukaemia and lung pathologies). With more than 16,400 blood transcriptomes derived from 127 clinical studies with non-uniform distributions of cases and controls and substantial study biases, as well as more than 95,000 chest X-ray images, we show that Swarm Learning classifiers outperform those developed at individual sites. In addition, Swarm Learning completely fulfils local confidentiality regulations by design. We believe that this approach will notably accelerate the introduction of precision medicine. © 2021, The Author(s).
Published: 2021

49. Three-Dimensional Transesophageal Echocardiography in Congenital Heart Disease

Author: Gerald R. Marx and Pierre C. Wong
Subjects: medicine.medical_specialty, Interventional cardiology, Heart disease, business.industry, Color flow doppler, Three dimensional echocardiography, Diagnostic evaluation, medicine.disease, Adult age, Atrial septal defects, Cardiac surgery, Internal medicine, Cardiology, Medicine, business, human activities
Abstract: Over the past two decades, real-time three-dimensional echocardiography has emerged as an important new technique in echocardiography for the diagnosis and evaluation of both acquired and congenital heart disease. In recent years, three-dimensional transesophageal echocardiography (3D TEE) probes have become available. While these probes were designed primarily for use in the adult age group, they have also been utilized effectively in older children and adolescents. These probes are capable of real-time 3D TEE imaging and color flow Doppler, providing excellent spatial detail of selected acquired and congenital heart defects. Thus, 3D TEE serves an important and ever-increasing role for preoperative diagnostic evaluation, interventional cardiology procedures, and cardiac surgery. This chapter describes the technique of 3D TEE imaging as well as some of its most common applications for congenital heart disease evaluation.
Published: 2021

50. A multicenter study of three-dimensional echocardiographic evaluation of normal pediatric left ventricular volumes and function

Author: Pei-Ni Jone, Tim Colen, Benjamin H. Goot, Gerald R. Marx, Zhaoxing Pan, Alessandra M. Ferraro, Nee S. Khoo, David M. Harrild, Lisa Le, Sachie Shigemitsu, and Anitha Parthiban
Subjects: Adolescent, Intraclass correlation, Heart Ventricles, Left, Echocardiography, Three-Dimensional, 030204 cardiovascular system & hematology, left ventricular volume, Pediatrics, Ventricular Function, Left, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, left ventricular function, 0302 clinical medicine, Cardiac magnetic resonance imaging, medicine, three-dimensional echocardiography, Humans, Ventricular Function, Radiology, Nuclear Medicine and imaging, normal data, Child, Child, Preschool, Infant, Infant, Newborn, Reproducibility of Results, Stroke Volume, Preschool, Body surface area, Ejection fraction, medicine.diagnostic_test, business.industry, Three dimensional echocardiography, Stroke volume, Repeatability, Newborn, Multicenter study, Echocardiography, Three-Dimensional, Cardiology and Cardiovascular Medicine, business, Nuclear medicine
Abstract: Background: Three-dimensional echocardiography (3DE) evaluation of left ventricular (LV) volume and function in pediatrics compares favorably with cardiac magnetic resonance imaging. The aim of this study was to establish from a multicenter, normal pediatric z-score values of 3DE left ventricular volumes and function. Methods: Six hundred and ninety-eight healthy children (ages 0 to 18 years) were recruited from five centers. LV 3DE was acquired from the 4-chamber view. A vendor independent software analyzed end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), and ejection fraction (EF) using semi-automated quantification. Body surface area (BSA) based z-scores were generated. Intraobserver and interobserver variability were calculated using intraclass correlation (ICC) and repeatability coefficient (RC). Results: Z-scores were generated for ESV, EDV, and SV. The ICC for intraobserver variability for EDV, ESV, and SV were 0.99, 0.99, and 0.99 respectively. The ICC for interobserver variability for EDV, ESV, and SV were 0.98, 0.94, and 0.98 respectively. The RC for intraobserver and interobserver variability for LV EF was 4.39% (95% CI: 3.01, 5.59) and interobserver was 7.08% (95%CI: 5.51, 8.42). Conclusions: We report pediatric Z-scores for normal LV volumes using the semi-automated method from five centers, enhancing its generalizability. 3DE evaluation of LV volumes and EF in pediatric patients is highly reproducible.
Published: 2021

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