Stroke outcomes following durable left ventricular assist device implant in patients bridged with micro-axial flow pump: Insights from a large registry.

BACKGROUND: Stroke after durable left ventricular assist device (d-LVAD) implantation portends high mortality. The incidence of ischemic and hemorrhagic stroke and the impact on stroke outcomes of temporary mechanical circulatory support (tMCS) management among patients requiring bridge to d-LVAD with micro-axial flow-pump (mAFP, Abiomed) is unsettled. METHODS: Consecutive patients, who underwent d-LVAD implantation after being bridged with mAFP at 19 institutions, were retrospectively included. The incidence of early ischemic and hemorrhagic stroke after d-LVAD implantation (<60 days) and association of pre-d-LVAD characteristics and peri-procedural management with a specific focus on tMCS strategies were studied. RESULTS: Among 341 patients, who underwent d-LVAD implantation after mAFP implantation (male gender 83.6%, age 58 [48-65] years, mAFP 5.0/5.5 72.4%), the early ischemic stroke incidence was 10.8% and early hemorrhagic stroke 2.9%. The tMCS characteristics (type of mAFP device and access, support duration, upgrade from intra-aortic balloon pump, ECMELLA, ECMELLA at d-LVAD implantation, hemolysis, and bleeding) were not associated with ischemic stroke after d-LVAD implant. Conversely, the device model (mAFP 2.5/CP vs. mAFP 5.0/5.5: HR 5.6, 95%CI 1.4-22.7, p = 0.015), hemolysis on mAFP support (HR 10.5, 95% CI 1.3-85.3, p = 0.028) and ECMELLA at d-LVAD implantation (HR 5.0, 95% CI 1.4-18.7, p = 0.016) were associated with increased risk of hemorrhagic stroke after d-LVAD implantation. Both early ischemic (HR 2.7, 95% CI 1.9-4.5, p < 0.001) and hemorrhagic (HR 3.43, 95% CI 1.49-7.88, p = 0.004) stroke were associated with increased 1-year mortality. CONCLUSIONS: Among patients undergoing d-LVAD implantation following mAFP support, tMCS characteristics do not impact ischemic stroke occurrence, while several factors are associated with hemorrhagic stroke suggesting a proactive treatment target to reduce this complication.

Alike but genetically divergent: The resurrection of Urotrygon asterias (Jordan & Gilbert, 1883) from its closest relatives, the Munda and the Blotched stingray.

The genus Urotrygon comprises small- to medium-sized endemic round rays on the American continent and has undergone several synonymization processes. Here, we used an integrative taxonomic approach, including meristic, morphometric, and mtDNA analyses, to resolve the particularly intricate relationship among Urotrygon munda Gill, 1863, Urotrygon chilensis (Günther, 1872), and Urotrygon asterias (Jordan & Gilbert, 1883). The latter species is currently a synonym of U. munda but is also considered the U. chilensis "northern morphotype." These taxonomic entities have historically been confounded, mainly due to their phenotypical resemblance along their geographic distribution in the eastern Pacific. We assessed 78 specimens (43 "northern" and 30 "southern morphotypes" of U. chilensis, as well as 5 U. munda) using 19 external variables for taxonomic and morphometric analysis. Distinct meristic patterns, including pectoral and pelvic ceratotrichia, vertebrae number, and thorn distribution along the dorsal midline, were observed in the series-type specimens of the three taxonomic entities. Our multivariate morphometric analyses consistently differentiated the three groups as distinct taxonomic entities, with an overall classification accuracy of 66.7%. The meristic results also provided reliable information distinguishing the three entities. Based on the nicotinamide adenine dinucleotide (NADH2) and cytochrome oxidase subunit I (COI) genes, our phylogenetic analysis were consistent with the morphometric and meristic data, supporting these three entities as distinct species having their own evolutionary lineages. Our comprehensive approach confidently demonstrated that the northern U. chilensis morphotype matched and corresponded to the description of the Starry round ray, U. asterias, confirming its taxonomic resurrection as a valid species distinct from U. chilensis and U. munda. The geographic distribution of U. asterias spans from the tropical west coast of Mexico (including the Gulf of California) to Costa Rica, revealing that microevolutionary processes have well-defined population clades within this range. Furthermore, U. chilensis is unequivocally established as the sole Urotrygon species occurring south of the Guayaquil marine ecoregion. In addition, the public COI and NADH2 sequences available for Urotrygon hosted in the ad hoc online databases were found to be misidentified, emphasizing the need for rigorous taxonomic scrutiny in this group. Finally, our research underscores the significance of an integrative approach that combines morphometric, meristic, and molecular techniques with historical data to disentangle the complexities of closely related taxa.

A priority nursery area for the conservation of the scalloped hammerhead shark Sphyrna lewini in Mexico.

This study describes the genetic diversity and level of genetic differentiation of the scalloped hammerhead shark Sphyrna lewini from eight putative nursery areas in the Mexican Pacific Ocean, using the mtDNA control region. Genetic analyses revealed a particular spatial divergence between La Reforma and all the remaining sites, with five exclusive haplotypes and the highest genetic diversity. This pattern may be interpreted as the signature of regional female philopatry, relatively to a particular female-mediated gene flow for La Reforma, which shows a strong subdivision in the Gulf of California.

Design of a Fully Integrated Inductive Coupling System: A Discrete Approach Towards Sensing Ventricular Pressure.

In this paper, an alternative strategy for the design of a bidirectional inductive power transfer (IPT) module, intended for the continuous monitoring of cardiac pressure, is presented. This new integrated implantable medical device (IMD) was designed including a precise ventricular pressure sensor, where the available implanting room is restricted to a 1.8 × 1.8 cm2 area. This work considers a robust magnetic coupling between an external reading coil and the implantable module: a three-dimensional inductor and a touch mode capacitive pressure sensor (TMCPS) set. In this approach, the coupling modules were modelled as RCL circuits tuned at a 13.56 MHz frequency. The analytical design was validated by means of Comsol Multiphysics, CoventorWare, and ANSYS HFSS software tools. A power transmission efficiency (PTE) of 94% was achieved through a 3.5 cm-thick biological tissue, based on high magnitudes for the inductance (L) and quality factor (Q) components. A specific absorption rate (SAR) of less than 1.6 W/Kg was attained, which suggests that this IPT system can be implemented in a safe way, according to IEEE C95.1 safety guidelines. The set of inductor and capacitor integrated arrays were designed over a very thin polyimide film, where the 3D coil was 18 mm in diameter and approximately 50% reduced in size, considering any conventional counterpart. Finally, this new approach for the IMD was under development using low-cost thin film manufacturing technologies for flexible electronics. Meanwhile, as an alternative test, this novel system was fabricated using a discrete printed circuit board (PCB) approach, where preliminary electromagnetic characterization demonstrates the viability of this bidirectional IPT design.

The Neogene fossil record of Aetomylaeus (Elasmobranchii, Myliobatidae) from the southeastern Pacific.

The presence of eagle rays of the genus Aetomylaeus in the Neogene of the Temperate Pacific coast of South America (TPSA) still is ambiguous, although the fossil record of elasmobranch fishes (sharks, rays, and skates) from this area is quite good. Here, we present the first unmistakable fossil remains of Aetomylaeus from the Neogene of the TPSA. The material comprises 13 dental plates from one site in Peru and six localities in Chile ranging in age from Miocene to Pliocene and was compared with dental plates of extant species. Our study reveals that the number of tooth rows and the shape of lateral teeth in extant species are seemingly very variable and need to be established before fossil specimens can be confidently identified. Consequently, we do not assign the fossil specimens from the Neogene of the TPSA to any species but leave them as Aetomylaeus. Moreover, we recognized that only the shape of medial teeth provides reliable diagnostic characters in our material, whereas the shape and number of lateral teeth are highly variable, similar to the condition seen in extant species.

Role of membrane pore polymerization conditions for pH responsive behavior, catalytic metal nanoparticle synthesis, and PCB degradation.

This article describes the effects of changing monomer and cross-linker concentrations on the mass gain, water permeability, Pd-Fe nanoparticle (NP) loading, and the rate of degradation of 3,3',4,4',5-pentachlorobiphenyl (PCB 126) of pore functionalized polyvinylidene fluoride (PVDF) membranes. In this study, monomer (acrylic acid (AA)) and cross-linker (N, N'- methylene-bis (acrylamide)) concentrations were varied from 10 to 20 wt% of polymer solution and 0.5-2 mol% of monomer concentration, respectively. Results showed that responsive behavior of membrane could be tuned in terms of water permeability over a range of 270-1 L m-2 h-1 bar-1, which is a function of water pH. The NP size on the membrane surface was found in the range of 16-23 nm. With increasing cross-linker density the percentage of smaller NPs (< 10 nm) increases due to smaller mesh size formation during in-situ polymerization of membrane. NP loading was found to vary from 0.21 to 0.94 mg per cm2 of membrane area depending on the variation of available carboxyl groups in membrane pore domain. The NPs functionalized membranes were then tested for use as a platform for the degradation of PCB 126. The observed batch reaction rate (Kobs) for PCB 126 degradation for per mg of catalyst loading was found 0.08-0.1 h-1. Degradation study in convective flow mode shows 98.6% PCB 126 is degraded at a residence time of 46.2 s. The corresponding surface area normalized reaction rate (K sa ) is found about two times higher than K sa of batch degradation; suggesting elimination of the effect of diffusion resistance for degradation of PCB 126 in convective flow mode operation. These Pd-Fe-PAA-PVDF membranes and nanoparticles are characterized by TGA, contact angle measurement, surface zeta potential, XRD, SEM, XPS, FIB, TEM and other techniques reveal the details about the membrane surface, pores and nanoparticles size, shape and size-distribution. Statistical analysis based on experimental results allows us to depict responsive behavior of functionalized membrane. In our best knowledge this paper first time reports detail study on responsive behavior of pore functionalized membrane in terms of permeability, NPs size, metal loading and its effect on PCB 126 degradation in a quantified approach.

Design and Simulation of an Integrated Wireless Capacitive Sensors Array for Measuring Ventricular Pressure.

This paper reports the novel design of a touch mode capacitive pressure sensor (TMCPS) system with a wireless approach for a full-range continuous monitoring of ventricular pressure. The system consists of two modules: an implantable set and an external reading device. The implantable set, restricted to a 2 × 2 cm² area, consists of a TMCPS array connected with a dual-layer coil, for making a reliable resonant circuit for communication with the external device. The capacitive array is modelled considering the small deflection regime for achieving a dynamic and full 5⁻300 mmHg pressure range. In this design, the two inductive-coupled modules are calculated considering proper electromagnetic alignment, based on two planar coils and considering the following: 13.56 MHz frequency to avoid tissue damage and three types of biological tissue as core (skin, fat and muscle). The system was validated with the Comsol Multiphysics and CoventorWare softwares; showing a 90% power transmission efficiency at a 3.5 cm distance between coils. The implantable module includes aluminum- and polyimide-based devices, which allows ergonomic, robust, reproducible, and technologically feasible integrated sensors. In addition, the module shows a simplified and low cost design approach based on PolyMEMS INAOE® technology, featured by low-temperature processing.

First observations on captive hatching and incubation period of the yellow-nose skate Dipturus chilensis (Rajiformes: Rajidae), from the South-Eastern Pacific Ocean.

Twelve egg capsules laid in captivity by three females of Dipturus chilensis were incubated in the laboratory. After 252 ± 9.4 days, 10 skates successfully hatched, with a mean total length, disc length, and disc width of 17.2, 7.4, and 11.4 cm, respectively. This is the first report of captive hatching of D. chilensis and its corresponding incubation period.

Effects of Plyometric Training on Neuromuscular Performance in Youth Basketball Players: A Pilot Study on the Influence of Drill Randomization.

The aim of this single-blind randomized controlled trial was to compare the effects of plyometric jump training (PJT), with (RG) and without (NRG) between-session drill randomization, on performance measures (i.e., jumping and sprinting abilities, change of direction speed, and technical performance) in youth male basketball players (age, 10.2 ± 1.7 years), assigned to either the NRG (n = 7), RG (n = 6), or control group (n = 6). Before and after the intervention, countermovement jump, 20-cm drop jump, 30-m sprint (with or without ball dribbling), and change-of-direction speed tests were completed. The PJT was applied twice per week for seven weeks. The only difference between PJT groups was the order of drill execution. An ANOVA was used to detect differences between study groups. The analyses revealed significant main effects of time (all p<.01; d = 0.64-0.89) and group x time interaction (all p<.05; d=0.31-51) for all examined variables. Post hoc analyses revealed moderate-large significant improvements for the RG (countermovement jump: 18.8%, d = 0.6; 20-cm drop jump: 23.9%, d = 0.80; 30-m sprint: 11.6%, d = 1.13; 30-m sprint with ball dribbling: 9.3%, d = 0.54; change of direction speed test: 14.6%, d = 1.82). In contrast, post hoc analyses revealed only small improvements for the NRG (20-cm drop jump: 14.1%, d = 0.36; 30-m sprint: 6.8%, d = 0.45; 30-m sprint with ball dribbling: 8.8%, d = 0.35; change of direction speed test: 10.5%, d = 0.49). Application of PJT without randomization is effective for improving physical and technical qualities. However, PJT could be more beneficial when executed with between-session randomization of drills.

Mucolipidosis type IV protein TRPML1-dependent lysosome formation.

Lysosomes are dynamic organelles that undergo cycles of fusion and fission with themselves and with other organelles. Following fusion with late endosomes to form hybrid organelles, lysosomes are reformed as discrete organelles. This lysosome reformation or formation is a poorly understood process that has not been systematically analyzed and that lacks known regulators. In this study, we quantitatively define the multiple steps of lysosome formation and identify the first regulator of this process.

Navigating linguistic barriers: a case for and against medical Spanish certification for medical students in border states.

Limited English proficiency poses a significant barrier to health care, particularly in US border states, exacerbated by a nationwide shortage of interpreters. This growing disparity in language-concordant care underscores the need for solutions like integrating Medical Spanish Certification (MSC) into medical school curricula, a topic of considerable debate. Various arguments exist for and against including MSC in medical education, especially considering the increasing Hispanic/Latino patient population. This paper aims to present a balanced perspective on officially including MSC in medical school curricula. After discussing the various arguments, the authors suggest a balanced approach that addresses the challenges while leveraging the potential benefits of MSC in medical education.

Internet-enabled lab-on-a-chip technology for education.

Despite many interventions, science education remains highly inequitable throughout the world. Internet-enabled experimental learning has the potential to reach underserved communities and increase the diversity of the scientific workforce. Here, we demonstrate the use of lab-on-a-chip (LoC) technologies to expose Latinx life science undergraduate students to introductory concepts of computer programming by taking advantage of open-loop cloud-integrated LoCs. We developed a context-aware curriculum to train students at over 8000 km from the experimental site. Through this curriculum, the students completed an assignment testing bacteria contamination in water using LoCs. We showed that this approach was sufficient to reduce the students' fear of programming and increase their interest in continuing careers with a computer science component. Altogether, we conclude that LoC-based internet-enabled learning can become a powerful tool to train Latinx students and increase the diversity in STEM.

Peripartum Cardiomyopathy: A Case Report of Mortality From a Rare and Potentially Fatal Condition.

Peripartum cardiomyopathy (PPCM) poses a significant challenge in maternal health, characterized by heart failure with reduced ejection fraction during late pregnancy or early postpartum. Despite advances in understanding PPCM, it remains life-threatening with substantial maternal morbidity and mortality. This article reviews the epidemiology, etiology, diagnostic challenges, management strategies, and outcomes associated with PPCM. A case report of a 29-year-old woman with PPCM is presented, emphasizing the importance of early recognition and tailored management. The patient's presentation was marked by atypical symptoms, including dysuria, lumbar pain, persistent fever, and oral intake intolerance. Despite aggressive medical intervention, the patient experienced a tragic outcome, succumbing to cardiopulmonary arrest within 48 h of admission. This case underscores the challenges in diagnosing and managing PPCM, particularly when presenting with nonspecific symptoms and emphasizes the urgent need for improved diagnostic criteria and therapeutic interventions to mitigate adverse outcomes in affected individuals.

Design of Acetaldehyde Gas Sensor Based on Piezoelectric Multilayer Microelectromechanical System Resonator.

Acetaldehyde is a volatile organic compound that can cause damage at the cellular and genomic levels. The monitoring of acetaldehyde gas at low concentrations requires fast-response and low-cost sensors. Herein, we propose the design of an acetaldehyde gas sensor based on a low-cost Microelectromechanical System (MEMS) process. This sensor is formed by a single-clamped piezoelectric multilayer resonator (3000 × 1000 × 52.2 µm) with a simple operating principle and easy signal processing. This resonator uses a zinc oxide piezoelectric layer (1 µm thick) and a sensing film of titanium oxide (1 µm thick). In addition, the resonator uses a support layer of 304 stainless steel (50 µm thick) and two aluminum layers (100 nm thick). Analytical and Finite-Element Method (FEM) models are developed to predict the mechanical behavior of the gas sensor, considering the influence of the different layers of the resonator. The analytical results agree well with respect to the FEM model results. The gas sensor has a first bending frequency of 4722.4 Hz and a sensitivity of 8.22 kHz/g. A minimum detectable concentration of acetaldehyde of 102 ppm can be detected with the proposed sensor. This gas sensor has a linear behavior to detect different acetaldehyde concentrations using the frequency shifts of its multilayer resonator. The gas sensor design offers advantages such as small size, a light weight, and cost-efficient fabrication.

A feedback-driven IoT microfluidic, electrophysiology, and imaging platform for brain organoid studies.

The analysis of tissue cultures, particularly brain organoids, takes a high degree of coordination, measurement, and monitoring. We have developed an automated research platform enabling independent devices to achieve collaborative objectives for feedback-driven cell culture studies. Unified by an Internet of Things (IoT) architecture, our approach enables continuous, communicative interactions among various sensing and actuation devices, achieving precisely timed control of in vitro biological experiments. The framework integrates microfluidics, electrophysiology, and imaging devices to maintain cerebral cortex organoids and monitor their neuronal activity. The organoids are cultured in custom, 3D-printed chambers attached to commercial microelectrode arrays for electrophysiology monitoring. Periodic feeding is achieved using programmable microfluidic pumps. We developed computer vision fluid volume estimations of aspirated media, achieving high accuracy, and used feedback to rectify deviations in microfluidic perfusion during media feeding/aspiration cycles. We validated the system with a 7-day study of mouse cerebral cortex organoids, comparing manual and automated protocols. The automated experimental samples maintained robust neural activity throughout the experiment, comparable with the control samples. The automated system enabled hourly electrophysiology recordings that revealed dramatic temporal changes in neuron firing rates not observed in once-a-day recordings.

Modulation of neuronal activity in cortical organoids with bioelectronic delivery of ions and neurotransmitters.

Precise modulation of brain activity is fundamental for the proper establishment and maturation of the cerebral cortex. To this end, cortical organoids are promising tools to study circuit formation and the underpinnings of neurodevelopmental disease. However, the ability to manipulate neuronal activity with high temporal resolution in brain organoids remains limited. To overcome this challenge, we introduce a bioelectronic approach to control cortical organoid activity with the selective delivery of ions and neurotransmitters. Using this approach, we sequentially increased and decreased neuronal activity in brain organoids with the bioelectronic delivery of potassium ions (K+) and γ-aminobutyric acid (GABA), respectively, while simultaneously monitoring network activity. This works highlights bioelectronic ion pumps as tools for high-resolution temporal control of brain organoid activity toward precise pharmacological studies that can improve our understanding of neuronal function.

A new parasitic copepod species of Tautochondria (Siphonostomatoida: Hyponeoidae), found in the narrowmouthed catshark Schroederichthys bivius from the Strait of Magellan.

Hyponeoidae is a copepod family that is rare around the world, with only three species described until now. Recently, a hyponeoid copepod was found in the narrowmouthed catshark, Schroederichthys bivius, from Chile, which has not been formally described. The objective of this study is to describe morphologically a new species of Hyponeoidae, from samples of the Strait of Magellan, Southern Chile. Also, a genetic analysis, based on the COI gene, was used to determine the relatedness of the new hyponeoid species to other copepods from Siphonostomatoida, which were available in the GenBank platform. The new species belongs to the genus Tautochondria and is here described as T. magellanica n. sp. This species differs from T. dolichoura mainly in the presence of long process at each side of the buccal cone, the absence of lobes on the head and short processes on the genital complex. According to the genetic sequences, T. magellanica n. sp. was not closely related to any other species. Therefore, this result confirms that Hyponeoidae is a separate family. However, the relatedness to other genera in Siphonostomatoida is still unknown.

Patient-related effects of primary nursing : Protocol of a pilot randomized controlled trial.

BACKGROUND: Since January 2022, a primary nursing system called process-responsible nursing (PP) has substituted the standard room care system in an intensive care unit (ICU) at our institution. The process of the development and implementation of PP is already being evaluated in a separate study as an actual analysis prior to implementation, as well as after 6 and 12 months. AIM: This pilot randomized controlled trial (RCT) aims to test the feasibility of an RCT. For this purpose, the duration of delirium, among other things, will be compared in the project ICU with the results of standard care in another ICU at the university hospital. As secondary aims, the incidence of delirium, anxiety, the satisfaction of relatives, and the effects of PP on nurses will be assessed. METHODS: It is planned to recruit about 400-500 patients over a period of one year. They will be allocated to PP or standard care. Delirium will be assessed using the Confusion Assessment Method for Intensive Care Units by specifically trained nurses three times a day. Anxiety in patients, the satisfaction of relatives, and the effects of PP on nurses will be evaluated using the numeric rating scale, a standardized questionnaire, and a focus group interview, respectively. EXPECTED RESULTS: The primary hypothesis is that compared to usual care PP reduces the duration of delirium by at least 8 h. Additional hypotheses are that PP reduces anxiety in patients and increases the satisfaction of relatives.

Open-loop lab-on-a-chip technology enables remote computer science training in Latinx life sciences students.

Despite many interventions, science education remains highly inequitable throughout the world. Among all life sciences fields, Bioinformatics and Computational Biology suffer from the strongest underrepresentation of racial and gender minorities. Internet-enabled project-based learning (PBL) has the potential to reach underserved communities and increase the diversity of the scientific workforce. Here, we demonstrate the use of lab-on-a-chip (LoC) technologies to train Latinx life science undergraduate students in concepts of computer programming by taking advantage of open-loop cloud-integrated LoCs. We developed a context-aware curriculum to train students at over 8,000 km from the experimental site. We showed that this approach was sufficient to develop programming skills and increase the interest of students in continuing careers in Bioinformatics. Altogether, we conclude that LoC-based Internet-enabled PBL can become a powerful tool to train Latinx students and increase the diversity in STEM.