Transaortic Extraction of Left Ventricular Thrombus.

Background: Left ventricular thrombi may complicate acute myocardial infarction, and anticoagulation is the mainstay of management. Surgical thrombectomy may be considered in some patients with a perceived high risk for thromboembolism if there is another indication for urgent cardiac surgery.

Case Summary: A 43-year-old diabetic man presented with a non-ST-segment elevation myocardial infarction and an acute left ventricular thrombus.

Percutaneous Management of Left Ventricular Perforation Causing Late Cardiac Tamponade After Transcatheter Aortic Valve Implantation.

Background: We present a case of left ventricular perforation and delayed cardiac tamponade after transcatheter aortic valve implantation (TAVI) managed percutaneously. This report describes a novel technique for management of left ventricular perforation after TAVI.

Case Summary: We performed elective transfemoral TAVI in a frail 85-year-old lady.

Transcatheter Aortic Valve Replacement With the Navitor System: Real-World United Kingdom Experience.

The Navitor transcatheter heart valve (THV) is the latest iteration of the Portico self-expanding valve system. Early prospective studies have shown promising outcomes, however, there is a lack of complementary 'real-world' data. This study aimed to assess early safety and efficacy outcomes of the Navitor THV using registry data from 6 high-volume United Kingdom transcatheter aortic valve replacement (TAVR) centers.

Balloon Aortic Valvuloplasty with or without Percutaneous Coronary Intervention in the Transcatheter Aortic Valve Replacement Era.

Introduction: The role of balloon aortic valvuloplasty (BAV) in the era of transcatheter aortic valve replacement remains a topic of debate. We sought to study the safety and feasibility of combined BAV and percutaneous coronary intervention (BAV-PCI).

Methods: Between November 2009 and July 2020, all patients undergoing BAV were identified and divided into three groups: combined BAV-PCI (group A), BAV with significant unrevascularised CAD (group B), and BAV without significant CAD (group C).

Anthelmintic resistance and homeostatic plasticity (Brugia malayi).

Homeostatic plasticity refers to the capacity of excitable cells to regulate their activity to make compensatory adjustments to long-lasting stimulation. It is found across the spectrum of vertebrate and invertebrate species and is driven by changes in cytosolic calcium; it has not been explored in parasitic nematodes when treated with therapeutic drugs. Here we have studied the adaptation of Brugia malayi to exposure to the anthelmintic, levamisole that activates muscle AChR ion-channels.

Increased shear in the North Atlantic upper-level jet stream over the past four decades.

Earth's equator-to-pole temperature gradient drives westerly mid-latitude jet streams through thermal wind balance. In the upper atmosphere, anthropogenic climate change is strengthening this meridional temperature gradient by cooling the polar lower stratosphere and warming the tropical upper troposphere, acting to strengthen the upper-level jet stream. In contrast, in the lower atmosphere, Arctic amplification of global warming is weakening the meridional temperature gradient, acting to weaken the upper-level jet stream.

Rapid Aspirin Desensitization is Safe and Feasible in Patients With Stable and Unstable Coronary Artery Disease: A Single-Center Experience.

Aims: There are limited data on aspirin (ASA) desensitization for patients with coronary disease. We present our experience with a rapid nurse-led oral desensitization regimen in patients with aspirin sensitivity undergoing coronary angiography.

Methods: This single-center retrospective observational study includes patients with a history of ASA sensitivity undergoing coronary angiography with intent to perform percutaneous coronary intervention (PCI).

Optical Coherence Tomography Evaluation of Coronary Dissection and Intramural Hematoma.

Image series shows an extensive intramural hematoma causing luminal compression corresponding to the angiographic stenosis. Although intramural hematomas are identifiable on intravascular ultrasound, OCT offers superior characterization and exclusion of alternate diagnoses, such as plaque erosion.

"Getting Under the Hood" of Neuronal Signaling in .

is a powerful model to study the neural and biochemical basis of behavior. It combines a small, completely mapped nervous system, powerful genetic tools, and a transparent cuticle, allowing Ca imaging without the need for dissection. However, these approaches remain one step removed from direct pharmacological and physiological characterization of individual neurons.

Outcomes after culprit-only percutaneous coronary intervention for multivessel disease during ST-segment elevation myocardial infarction: a comparison of registry and clinical trial outcomes.

Background: The PRAMI and CvLPRIT trials support preventive percutaneous coronary intervention (PCI) for multivessel coronary disease found during ST-segment elevation myocardial infarction (STEMI). We assess our real-world experience of the management of multivessel disease identified during primary PCI (PPCI) in a large UK regional centre.

Patients And Methods: All STEMI patients who underwent culprit-only PPCI during the study period (August 2011 to August 2013) were retrospectively assessed for eligibility to each trial.

Transradial Secondary Access to Guide Valve Implantation and Manage Peripheral Vascular Complications During Transcatheter Aortic Valve Implantation.

Background: Vascular complications from transfemoral (TF) secondary access during transcatheter aortic valve implantation (TAVI) are common. We compare our experience of transradial (TR) versus transfemoral secondary access during TAVI and describe techniques for performing iliofemoral arterial intervention from the transradial approach.

Methods: All TAVI procedures with a single secondary access were included.

On-farm storage of livestock vaccines may be a risk to vaccine efficacy: a study of the performance of on-farm refrigerators to maintain the correct storage temperature.

Background: Livestock vaccines (LV) are often stored on-farm, in a refrigerator (fridge), prior to use and little is documented about the storage conditions during this period. As the quality of a vaccine can be impaired by storage at an incorrect temperature, the present study aimed to evaluate the on-farm performance of farm fridges to maintain the correct storage temperature. From January to August 2014, temperature data loggers were placed on selected farms fridges used to store LV (n = 20) in South-West England.

Incomplete host immunity favors the evolution of virulence in an emergent pathogen.

Immune memory evolved to protect hosts from reinfection, but incomplete responses that allow future reinfection may inadvertently select for more-harmful pathogens. We present empirical and modeling evidence that incomplete immunity promotes the evolution of higher virulence in a natural host-pathogen system. We performed sequential infections of house finches with strains of various levels of virulence.

Note: A self-calibrating wide range electrometer for in-cloud measurements.

Charge is observed in clouds of all forms, which may influence their development and properties. In-cloud charge measurements require a wide dynamic range, extending from charge in aerosols and dusts to that present in thunderstorms. Unexpectedly large charge densities (>200 pC m) have recently been detected in layer clouds using balloon-carried linear electrometers.

The evolution of pathogen virulence: Effects of transitions between host types.

Much of evolutionary epidemiology theory is derived from a perspective in which all hosts, and all parasites, are epidemiologically equivalent. This stands in contrast to the well-documented existence of the numerous processes generating heterogeneity among hosts and parasites that can profoundly influence evolutionary/epidemiological dynamics. Age-related immunological changes, inequities in nutritional status, and interactions between parasites via coinfection are just a few of the many factors that generate heterogeneity among hosts in the ways they express susceptibility to, and respond to infection by, a focal pathogen.

Coronary access following TAVI - Selective coronary engagement using balloon-assisted tracking of a guide catheter extension.

performing percutaneous coronary intervention (PCI) following transcatheter aortic valve implantation (TAVI) will become more frequent with the increasing use of TAVI in lower surgical risk populations. The ideal management strategy for coronary artery disease (CAD) in the setting of TAVI is not well defined and CAD is often left untreated prior to TAVI. Engaging the coronary ostia through the TAVI side cells can be challenging; techniques for rapid coronary cannulation, especially in the acute setting, need to be developed.

Measuring the growth rate of UK dairy heifers to improve future productivity.

Sub-optimal heifer growth is associated with higher disease rates and reduced future performance and longevity in the dairy herd. This report describes a system for measuring heifer growth from birth to first calving that was used on commercial dairy farms in South West England, in order to gather benchmarking data to feed back to farmers. Weights (n = 8443) were collected from 20 farms.

Direct transfemoral transcatheter aortic valve implantation without balloon pre-dilatation using the Edwards Sapien XT valve.

Objectives: To evaluate the feasibility and safety of direct transcatheter aortic valve implantation (TAVI) by the transfemoral approach without balloon pre-dilatation using the Edwards SapienXT valve.

Background: TAVI is established in selected high-risk patients with severe aortic stenosis. Balloon aortic valvuloplasty (BAV) is recommended prior to valve implantation, but may contribute to procedural risk.

The Index of Microcirculatory Resistance Postpercutaneous Coronary Intervention Predicts Left Ventricular Recovery in Patients With Thrombolyzed ST-Segment Elevation Myocardial Infarction.

Background: The index of microcirculatory resistance (IMR), an invasive measure of microvascular function, has been shown to correlate with clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI). The aim of this study is to evaluate the predictive value of IMR on left ventricular recovery in patients undergoing a pharmacoinvasive strategy for STEMI.

Methods: The index of microcirculatory resistance was assessed following percutaneous coronary intervention (PCI) in 31 patients with STEMI who were initially managed with thrombolysis.

Genomic Profiling of Penile Squamous Cell Carcinoma Reveals New Opportunities for Targeted Therapy.

Penile squamous cell carcinoma (PeSCCA) is a rare malignancy for which there are limited treatment options due to a poor understanding of the molecular alterations underlying disease development and progression. Therefore, we performed comprehensive, targeted next-generation sequencing to identify relevant somatic genomic alterations in a retrospective cohort of 60 fixed tumor samples from 43 PeSCCA cases (including 14 matched primary/metastasis pairs). We identified a median of two relevant somatic mutations and one high-level copy-number alteration per sample (range, 0-5 and 0-6, respectively).