For donation after circulatory death, procurement is performed after the heart has arrested. This technique has been employed and adopted by clinicians to overcome the shortage of available hearts for transplant. Warm ischemia time plays a pivotal role in the survival outcome of the heart recipients. We describe a fast and safe technique to flush the heart during recovery from circulatory death donors in order to shorten the warm ischemia time.

The blue shark Prionace glauca is a top predator with one of the widest geographic distributions of any shark species, yet classified as critically endangered in the Mediterranean Sea, and Near Threatened globally. Previous genetic studies did not reject the null hypothesis of a single global population across the worldwide species range. Blue shark situation was proposed as a possible archetype of the ‘grey zone of population differentiation’, coined to designate cases where population structure may be too recent or too faint to be detected using a limited set of markers. Here, blue shark samples collected throughout its global range were sequenced using a specific ddRAD method (DArTseq; Georges et al. 2018), which recovered 37,655 genome-wide single nucleotide polymorphisms (SNPs). Two main groups emerged, with Mediterranean Sea and Northern Atlantic samples significantly differentiated from the Indo-west Pacific samples. Significant pairwise FST values indicated further genetic differentiation within the Atlantic Ocean, and between the Atlantic Ocean and the Mediterranean Sea. Reconstruction of recent demographic history suggested the divergence between northern and southern oceanic populations emerged about 500 generations ago and revealed a drastic reduction in effective population size from a large ancestral population. Our results illustrate the power of high-density genome scans to detect population structure and reconstruct demographic history in highly migratory marine species. As the management of the blue shark fishery, either as target or as bycatch, does not account for this delineation, we strongly recommend that the results presented here be considered in future stock assessment and management plans.

The idea of lacunary statistical convergence sequences, which is a development of statistical convergence, is examined and expanded in this study on L − fuzzy normed spaces, which is a generalization of fuzzy spaces. On L − fuzzy normed spaces, the definitions of lacunary statistical Cauchy and completeness, as well as associated theorems, are provided. The link between lacunary statistical Cauchyness and lacunary statistical boundedness with regard to L − fuzzy norm is also shown.

The purpose of this paper is to give a necessary and sufficient condition for the existence and non-existence of global solutions of the following semilinear parabolic equations \[ u_{t}=\Delta u+\psi(t)f(u),\,\,\mbox{ in }\Omega\times (0,t^{*}), \] under the Dirichlet boundary condition on a bounded domain. In fact, this has remained as an open problem for a few decades, even for the case $f(u)=u^{p}$. As a matter of fact, we prove:\\ \[ \begin{aligned} &\mbox{there is no global solution for any initial data if and only if }\\ &\mbox{the function } f \mbox{ satisfies}\\ &\hspace{20mm}\int_{0}^{\infty}\psi(t)\frac{f\left(\epsilon \,\left\| S(t)u_{0}\right\|_{\infty}\right)}{\left\| S(t)u_{0}\right\|_{\infty}}dt=\infty\\ &\mbox{for every }\,\epsilon>0\,\mbox{ and nonnegative nontrivial initial data }\,u_{0}\in C_{0}(\Omega). \end{aligned} \] Here, $(S(t))_{t\geq 0}$ is the heat semigroup with the Dirichlet boundary condition.

This work is about the goldbach conjecture . Here i have attempted to disprove it using different methods, just to brief it it involves ramanujan's derivation of riemanns's zeta function. I would request you to kindly review and let me know the feedback. Thank you

In this paper, we are concerned with an integral system $$ \left\{ \begin{aligned} &u(x)= W_{\beta,\gamma}(u^{p-1}v)(x), \ u>0 \ \text{in} \ R^{n},\\ &v(x)=I_{\alpha}(u^{p})(x), \ v>0 \ \text{in} \ R^{n}, \end{aligned} \right. $$ where $p>0,$ $0<\alpha, \beta\gamma1$. Base on the integrability of positive solutions, we obtain some Liouville theorems and the decay rates of positive solutions at infinity. In addition, we use the properties of the contraction map and the shrinking map to prove that $u$ is Lipschitz continuous. In particular, the Serrin type condition is established, which plays an important role to classify the positive solutions.

The geometrical structures, stabilities and electronic properties of bimetallic mononuclear LinClK(0,+1) (n=1-6) clusters were studied within the density functional theory. From the ground state geometries, the Cl atom prefers the apex position and the K atom is at either side position or at surface. The dissociation energy, second order energy difference and GapHL (HOMO-LUMO gap) points out that LinClK(n=2,4,6) and the LinClK+(n=1,3,5) clusters are more stable. According to their ionization energies, the clusters can be classified as superalkalis, but the systematic study signifying that noticeable ionisation energy difference appears between the smallest bimetallic mononuclear superalkali compound (LiClK) and rest of superalkali species. Upon ionisation, the detached electron is from K atom. The delocalised electrons except the LiClK+ point out that the clusters are hyperlithiated clusters. The delocalization type of 3c/2e is responsible from the higher stability of the closed shell clusters.

A portion of the west of Mexico City is a densely populated area located in an abrupt topography, whose volcano-sedimentary materials increase the likelihood of landslides. This study uses Seismic Refraction Tomography (SRT) and Ambient Noise Tomography (ANT) methods to estimate the extent of landslide-prone materials at a test site. We exploited the geometry of a quadrangular array of surface sources and receivers to generate a Vp tomography image of the bedrock and surface-wave group-velocity tomographies of SRTand ANT in the frequency range of 6 to 26 Hz. We found that the best velocities correlation between the two methods is an average frequency of 24 Hz. The results show the areas of low velocity associated with materials that have lost their resistance due to the increase in pore pressure (Vs < 100 m/s) and the areas where eventually more landslides will occur (120 < Vs < 200 m/s) if mitigation work is not carried out. The most stable zones correspond to materials with velocity values greater than 250 m/s that overlap a substratum at an average depth of 8 m. In the case of a high risk of landslide, when it is not advisable to perform active source experiments, ANT can provide good results to determine the extension of the sliding materials.

The initial oleogelation process (microstructuring) as well as the formulation are determinant to obtain the desired characteristics in oleogels with potential application in the industry. The microstructuring process in oleogels has been extensively studied by means of techniques highly sensitive to thermal variations, such as differential scanning calorimetry (DSC). However, there are other readily available techniques and equipment that can be employed to perform similar evaluations. Non-isothermal nucleation kinetics by spectrophotometric methods can be used as alternatives to basic crystallization studies in oleogels. Therefore, in this research a comparison of both techniques is presented, highlighting their similarities, advantages and limitations, in the study of the microstructure of oleogels. Oleogels were obtained with a minimum concentration of gelator and another saturated one, using vegetable oils of different degrees of saturation. The crystallization profiles of the oleogels were obtained by DSC, a non-isothermal nucleation kinetics was performed from the molten system and the final microstructure was evaluated by optical microscopy. The Fisher-Turnbull and Avrami model was used to evaluate the behavior during microstructuring. A gap was observed during the crystallization process by DSC which can be evaluated by spectrophotometry. Differences in the microstructuring process were found in both methods due to the temperature ramp used and formulation variables. The results obtained by spectrophotometry indicate that it can be a good alternative, easily accessible in oleogel crystallization studies, when high sensitivity or very specific thermal parameters are not required.

Rahul Naithani, MD, DM1; Nitin Dayal, MD21Division of Hematology & Bone Marrow Transplantation, 2Lab MedicineMax Superspeciality Hospital, DelhiWord Count: 182Figure: 1Dr Rahul Naithani declares that he has no conflict of interest. Dr Nitin Dayal declares that he has no conflict of interest.

Background and Purpose：Hypoxia, as a risk factor for pulmonary hypertension (PH), was an inducing factor for pulmonary artery endothelial cells (PAECs) injury and inflammation. Pyroptosis induced cell death along with the maturation and secretion of the inflammatory mediators. However, the correlation among pyroptosis, PAECs injury and inflammation remain unknown. Here, we explored, in detail, the effect of hypoxia on pyroptosis of PAECs. Experimental approach：Using RNA-seq sequencing method, we screened differentially expressed genes in pulmonary artery in SU5416-induced hypoxia PH model. Next, we verified the role and mechanism of the differentially expressed gene GPR146 in PAECs by immunohistochemistry, immunofluorescence, CCK8, western blotting, realtime PCR, and LDH release experiments. Key Results: Our results showed that GPR146 was highly expressed in PH human lung tissue and Sugen5416/hypoxia (SuHx) induced rat PAH lung tissues. Meanwhile, our data suggested the expression of pyroptosis-related proteins was remarkably increased under hypoxia both in vivo and in vitro, which were inhibited by silencing GPR146. Moreover, inhibiting NLRP3 or caspase-1 effectively suppressed cleavage of caspase-1, production of interleukin (IL)-1β and IL-18 in PAECs by hypoxia and overexpression of GPR146. Conclusion and Implications: Our results indicated that GPR146 induced pyroptosis and inflammatory responses through the NLRP3/caspase-1 signaling axis, triggering endothelial injury and vascular remodeling. Hypoxia could promote PAECs pyroptosis through upregulation of GPR146 to affect the progression of PH, which might provide novel targets for treatment of PH.

Title: Percutaneous Lead Extraction in Patients with Large Vegetations: Limiting our Aspirations.Robert D. Schaller, DO11The Section of Cardiac Electrophysiology, Cardiovascular Division, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PennsylvaniaFunding: This work was supported in part by the Mark Marchlinski EP Research & Education FundKey words: Lead extraction, vegetation, pulmonary embolism, thrombus, aspirationDisclosures: NoneWord count: 1547Transvenous lead extraction (TLE) in the 1960’s involved orthopedic-style pulley systems that joined the exposed portion of the lead to progressively heavier weights hanging from the bed. Sustained tension on the lead was maintained until the patient experienced discomfort, ventricular arrhythmias, or noticeable resistance developed, and was maintained for minutes to days. The location of the lead within the chest was monitored with daily chest radiographs and the ensuingbang of the weight hitting the floor of the intensive care unit signified case conclusion; at which point the patient was assessed. Complications were erratic and included lead laceration and possible migration, injury to the tricuspid valve (TV), myocardial avulsion, tamponade, and death.1 Due to the immature nature of the procedure at that time, it was relegated to infectious indications including lead-related endocarditis, at that time referred to as “catheter fever”.Contemporary TLE has evolved into a highly refined practice with a multitude of tools and predictable results, and procedural indications that now span infection, venous occlusion, management of redundant leads, and access to magnetic resonance imaging.2Procedural imaging with computed tomography (CT) and real-time ultrasound-based tools have similarly changed the TLE experience with identification of adhesions, thrombi, vegetations, and complications.3 Large lead-related masses have historically caused angst due to the possibility of being sheared off by the extraction sheath and embolizing to the lung, and still represent a relative contraindication to percutaneous TLE.2In this issue of the Journal of Cardiovascular Electrophysiology , Giacopelli, et al.4 present the outcomes of 25 consecutive patients (mean age 64 years, 68% male) including 5 with pacemakers, 10 with implantable cardioverter-defibrillators, and 10 with cardiac resynchronization therapy devices, who underwent TLE with vegetations ≥10 mm on transesophageal echocardiography (TEE). Contrast-enhanced CT was performed before and after TLE with 18 (72%) patients showing subclinical pulmonary embolism (PE). Vegetation size (median of 17.5 mm and maximum of 30 mm) did not differ in those with and without PE (20.0 mm vs. 14.0 mm, p=0.116). Complete TLE success was achieved in all patients with 76% requiring advanced tools and 2 needing femoral snaring, and there were no significant procedural complications. In the group with pre-TLE PE, a post-TLE scan confirmed the presence of PE in only 14/18 (78%) and there were no patients with new PE formation. During a median follow-up period of 19.4 months, no re-infection of the new implanted systems was reported and there were 5 deaths (20%); with no differences between the groups. The authors concluded that subclinical PE was common in this clinical scenario but did not influence the complexity or safety of the procedure.Several aspects of this paper warrant comment. No data are reported on the size or location of the PEs nor the time between the first and second CT. It is possible that small PEs would not be identified on subsequent studies days after antibiotics had already been started. Patients also received acute and chronic anticoagulation if PE was identified, which in the setting of vegetations, is generally not indicated and could potentially lead to bleeding. The authors did not provide information regarding infectious pathogens or the timing of culture clearance, which could influence treatment. Additionally, it is unclear which patients received new CIED systems including the type and timing of reimplantation, which might influence subsequent infectious risk. A vascular occlusion balloon was not used in any patients in this report. While this tool is associated with a reduced risk of death in the setting of a superior vena cava laceration when used properly, it has also been shown to be thrombogenic during long dwell times,5 and use could impact post-operative CTs in future studies. Despite utilizing transthoracic echocardiography during TLE, neither TEE nor intracardiac echocardiography were used intraoperatively and thus no information regarding the precise location of the vegetations within the heart is known. Importantly, no information regarding the characteristics of the vegetations other than size was reported.Not all lead-related masses are created equal with two distinct sub-types previously described.6 The first is composed of thickened endocardium and fibrous tissue covering the leads and ultimately forming into connective tissue. These masses, commonly found on leads behind the TV, are caused by a vortical flow pattern leading to low shear stress on the lead surface and provoking neointimal hyperplasia,7 and range from small fibrous strands to large, smooth organized thrombus (Figure, left column). Despite their sterile nature, TLE in the setting of a large, mature thrombus could result in embolization and obstruction of the pulmonary artery resulting in symptomatic PE. The second type, frequently seen in the setting of infective endocarditis, is composed of inflammatory cells, platelets, adhesion molecules, fresh fibrin, and bacteria binding to coagulum and forming vegetations. They are typically longer, more likely to be multi-lobular, and commonly span several chambers of the heart (Figure, right column). These vegetations that are typically acute, with friable finger-like projections, characteristically break apart upon being sheared off during TLE, with reports showing low risk of symptomatic PE.8 Vegetations that are lobular, however, have been associated with worse outcomes.9Despite acute procedural success in the setting of lead-related vegetations, mortality rates at 1 year approach 25%.10 Indeed, despite successful TLE in this report, 20% of patients were dead at 1.5 years. Although complete understanding of the mechanism of these poor outcomes remains unknown, septic emboli, lung abscesses, and infected lead “ghosts” have been implicated.11 Vegetation removal prior to TLE has thus represented an appealing therapeutic option with reports of successful percutaneous aspiration prior to TLE showing promising results, albeit with unknown long-term benefit.12,13 Although the lack of new PEs after TLE in this report does not directly support the effort, cost, and added risk of such a strategy, “debulking” of infectious burden remains a tempting complementary treatment. Importantly, the acute safety of TLE with large vegetations in this study should not be extrapolated to chronic, large lead-related masses, which are more like to cause acute PE if embolized. While aspiration of these sterile masses prior to TLE is appealing from a procedural outcome perspective, their morphologic characteristics, and the imperfect, but evolving, aspiration sheaths currently available are limiting, and requires consideration of surgical extraction. Further advancements in aspiration catheter technology and the development of right ventricular outflow track filters might influence future management.TLE continues to represent the gold standard for the management of lead-related infection.2 Due to the extensive work of the pathfinders in the vanguard of procedural development, the sound of crashing weights has been supplanted by those that power advancing sheaths. Yet despite the safe and predictable nature of modern-day TLE, the sobering long-term mortality of patients with infectious indications remains out of proportion to acute procedural success. While infectious “debulking” continues to represent the most attractive and practical complementary option to address this incongruity, future studies should concentrate both on identification of mass characteristics that suggest success, as well as determining if long-term benefits exist above and beyond lead removal. However, if improvement in clinical outcomes that warrant this added cost and effort are not identified, we should likely limit our aspirations.

A biopharmaceutical grade poloxamer designed with less hydrophobic contaminants and shown to resolve growth issues for mammalian cell lines was implemented in a commercial biopharmaceutical process and expected to improve protection of cells from hydrodynamic stress [[1]](#ref-0001). However, contrary to expected results, the cell growth and resultant titer further declined. This was not consistent with prior reports in literature [[2]](#ref-0002), which demonstrated that these hydrophobic contaminants present in P188 poloxamer contributed to low performance due to inefficiency in protecting cells from shear stress. An analytical screening tool as well as a novel, high shear stress bioreactor model was developed and used to determine that an overall higher poloxamer average molecular weight was actually the root cause of poor growth in this SP2/0 production cell line. This demonstrates an increased SP2/0 sensitivity to subtle differences in poloxamer molecular weight distribution.

Selection on quantitative traits by divergent climatic conditions can lead to substantial trait variation across a species range. In the context of rapidly changing environments, however, it is equally important to understand selection on trait plasticity. To evaluate the role of selection in driving divergences in traits and their associated plasticity within a widespread species, we compared molecular and quantitative trait variation in Populus fremontii (Fremont cottonwood) populations throughout Arizona. Using SNP data and genotypes from 16 populations reciprocally planted in three common gardens, we first performed QST-FST analyses to detect selection on traits and trait plasticity. We then explored the mechanistic basis of selection using trait-climate and plasticity-climate regressions. Three major findings emerged: 1) There was significant genetic variation in traits expressed in each of the common gardens and in the phenotypic plasticity of traits across gardens. 2) Based on QST-FST comparisons, there was evidence of selection in all traits measured; however, this result varied from no effect in one garden to highly significant in another, indicating that detection of past selection is environmentally dependent. We also found strong evidence of divergent selection on plasticity across environments for two traits. 3) Traits and/or their plasticity were often correlated with population source climate (R2 up to 0.77 and 0.66, respectively). This suggests that steep climate gradients across the Southwest have played a major role in shaping the evolution of divergent phenotypic responses in populations and genotypes now experiencing climate change.

In this paper I shall focus on proving the Inequality, π((x + 1)) − π(x^ 2) ≥ 1 provided some range of x. Our proof is merely relied on basic calculus. Specifically speaking we will use basic properties of definite integrals to prove this inequality.

1. Ombrotrophic peatbogs provide valuable records of environmental change on long timescales but are rarely preserved in an undamaged state near the major centres of industrial activity. Holcroft Moss is a rare example of an intact lowland peatbog in NW England, which provides a valuable opportunity to trace industrial impacts on vegetation in a sensitive environmental archive in close proximity to the early industrialising cities of Manchester and Liverpool. 2. We reconstructed the environmental changes of a Holcroft Moss before and after the Industrial Revolution using a high-resolution record of pollen, non-pollen palynomorphs, microcharcoal, peat composition (organic content, ash-free bulk density) and heavy metal content constrained by a radiocarbon and SCP (spheroidal carbonaceous particle) chronology. We examine the relationship between abiotic and biotic environmental tracers using principal components analysis and evaluate the role of local and regional climatic and anthropogenic drivers using canonical redundancy analysis and partitioning of variation. 3. Results show significant changes in bog vegetation composition during the last 700 years. From the 14th to 18th centuries AD, atmospheric climate variability and local agro-pastoral disturbance (grazing and fires) were the main drivers of vegetation change. From the mid-18th century onwards, the intensification of regional coal-fired industry contributed to increases in atmospheric pollutants such as dust, heavy metals and acid deposition that severely impacted vegetation, driving the decline of Sphagnum. Grasses subsequently rose to dominance in the 20th century associated especially with cumulative nitrogen deposition. Although atmospheric pollution significantly decreased after the Industrial Revolution, vegetation has not returned to previous pre-industrial conditions, reflecting the ongoing impact of external press drivers which pose challenges for conservation and restoration. 4. Synthesis. Palaeoecological studies are needed to reveal the long-term history of vegetation degradation and to offer guidelines for restoration and conservation practices.

Mucopolysaccharidosis type VI (MPS VI) is a lysosomal storage disorder associated with pathogenic variants in the ARSB gene. Herein, we present a novel type of ARSB mutations, which is an insertion of the LHFPL2 gene fragment derived from unequal non-allelic homologous recombination between these two genes. The 52 kb insertion, containing the LHPL2 exon 3, was identified in reverse complement orientation deep in the intron 4 of ARSB using whole genome sequencing. Subsequent RNA analysis determined its deleterious effect, which is premature transcription termination. Two mobile genetic elements of the L1 class with high sequence similarity were identified in both genes at the site of recombination and their close spatial proximity is suggested to favor structural rearrangements in this locus. The recombination was identified in compound heterozygous state with the nonsense variant c.966G>A (p.Trp322*) in patient with an early-onset form of MPS VI. Almost complete absence of the full-length ARSB mRNA isoform expression from both alleles correlates well with a severe phenotype of the patient. The results of our study expand mutational spectrum of the ARSB gene towards complex structural variants and novel molecular-genetic mechanisms.

In the past decade, on account of computer-aided prosthetic manufacturing techniques, subperiosteal implants were introduced as a safe option for patients with compromised alveolar ridges. We present 3 years follow-up of a complete maxillary rehabilitation by subperiosteal implants in a young patient after an endosseous implant treatment failure.

We report a rare case of right ventricular angioleiomyoma in a 35-years old man diagnosed by multimodality imaging, including echocardiography, cardiac magnetic resonance imaging (CMR), Positron emissions tomography (PET) and Computer tomography angiography (CTA). The imaging results were finally confirmed by surgery. We present the clinical value of multimodality imaging in diagnosing cardiac angioleiomyoma.

Acute fatty liver disease of pregnancy (AFLP) is a rare condition associated with other common liver manifestations such as hemolysis, elevated liver enzymes, and low platelets syndrome (HELLP). We present a 27-year-old pregnant woman who developed hepatic encephalopathy and DIC after being diagnosed with Acute fatty liver disease of pregnancy.

A 64-year-old edentulous woman with a mandibular fracture received a subperiosteal implant for fracture fixation and dental rehabilitation. Unfortunately, the ball abutments were covered by soft tissue because they were too short. Therefore, we designed a connector to lengthen the attachment and achieve adequate stability and retention for the overdenture.

A novel nonlinear higher order difference equation is introduced in this paper. The difference equation has the form x_(n+1)=1+A x_n/(x_(n-m)^k ) with A and initial conditions are positive real numbers, m,k ∈ {2, 3, 4, · · · }. The dynamics of the proposed equation are studied. Some new results on the periodicity, semicycles, boundedness and global asymptotically stability of solutions of the proposed difference equation are established.

Title Page Title: Letter to the Editor: ” Role of matrix metalloproteinases in mitral valve regurgitation: Association between the of MMP‐1, MMP‐9, TIMP‐1, and TIMP‐2 expression, degree of mitral valve insufficiency, and pathologic etiology ”.Article type : Letter to the editor.

On Time Surgery Start: Is Standardization The Answer?Olufunke Folasade Dada MD, Tanaya Sparkle M.B.B.S.University of Toledo Medical Center, Anesthesiology Department,3000 Arlington Avenue, Toledo, Ohio, USACorresponding Author: Dr. Tanaya Sparkle, M.B.B.S.Address for correspondence:University of Toledo Medical Center, Anesthesiology Department,3000 Arlington Avenue, Toledo, Ohio - 43614E-mail: [email protected]: 419-383-3531