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Augmented reality (AR) visualization of 3D rotational angiography (3DRA) provides 3D representations of cardiac structures with full visualization of the procedural environment. The purpose of this study was to evaluate the feasibility of converting 3DRAs of congenital heart disease patients to AR models, highlight the workflow for 3DRA optimization for AR visualization, and assess physicians' perceptions of their use. This single-center study prospectively evaluated 30 retrospectively-acquired 3DRAs that were converted to AR, compared to Computer Models (CM). Median patient age 6.5 years (0.24–38.8) and weight 20.6 kg (3.4–107.0). AR and CM quality were graded highly. RV pacing was associated with higher quality of both model types (p = 0.02). Visualization and identification of structures were graded as "very easy" in 81.1% (n = 73) and 67.8% (n = 61) of AR and CM, respectively. Fifty-nine (66%) grades 'Agreed' or 'Strongly Agreed' that AR models provided superior appreciation of 3D relationships; AR was found to be least beneficial in visualization of aortic arch obstruction. AR models were thought to be helpful in identifying pathology and assisting in interventional planning in 85 assessments (94.4%). There was significant potential seen in the opportunity for patient/family counseling and trainee/staff education with AR models. It is feasible to convert 3D models of 3DRAs into AR models, which are of similar image quality as compared to CM. AR models provided additional benefits to visualization of 3D relationships in most anatomies. Future directions include integration of interventional simulation, peri-procedural counseling of patients and families, and education of trainees and staff with AR models. [ABSTRACT FROM AUTHOR]

Introduction: Transthoracic (TTE) follow up guidelines after PFO device closure are vague. The primary goal of this study was to perform a literature search to characterize the timing of complications that occur after PFO device placement to determine the utility of long‐term routine TTE. Methods: A search was performed in Medline (PubMed) with English language and publication date (2000–2023) filters were applied. Studies were included if they reported on patients who underwent a PFO device closure. Studies were excluded if they only reported on ASD device closure patients, were meta‐analysis or review papers, or did not report any outcomes for the PFO device procedure. Results: A total of 305 articles met the criteria (observational cohort study, n = 196; case study, n = 99; and randomized control study, n = 10). Age at the time of PFO device closure was 47.5 ± 9.3 years. The incidence of complications was 6.9% (3358/48 348). Maximum range of follow‐up was 0–17 years. The plurality of complications was due to arrhythmias (46.3%, 1554/3358), followed by residual shunts (29.7%, 999/3358). The majority of complications occurred ≤6 months post‐device placement (57.8%, 1941/3358). Only 0.8% (27/3358) of complications took place >5 years. All patients with complications >5 years of device placement were presented with clinical symptoms related to their complications. Conclusion: The incidence of patients presenting with PFO‐reported complications beyond 5 years post‐procedure diminished. The utility of routine TTE beyond 5 years post‐PFO after device placement should be further assessed. [ABSTRACT FROM AUTHOR]

Inter-basin water transfers are implemented to counter the uneven geographical distribution of natural water sources. This paper's novelty consists of providing a system-dynamics framework to evaluate inter-basin water transfers based on integrated water governance. The Big Karun Basin, Iran, has long been of interest to water managers due to its discharge potential. It houses several water-transfer projects that are under operation or under study for possible future implementation. This study implements system dynamics modeling (SDM) in the Big Karun Basin considering existing inter-basin water transfers. This study's results estimate an average annual 8 to 10 billion cubic meters of water are transferred from the Karun River to the Persian Gulf. Part of this flow can be used to meet some of the water demands in Iran's central and eastern basins subject to social and environmental assessment of impacts. SDM modeling was also implemented accounting for the existing water transfers plus the under-study water transfers. This study's results indicate the firm energy from hydropower produced by the Big Karun Basin system would decrease by 28% relative to existing water transfer conditions. This issue raises concerns given the Big Karun Basin contribution to electricity production Iran. The water supply to several sectors would be marginally impacted by future water tranfers, yet water quality would be compromised in some instances. Therefore, the Big Karun Basin water system was simulated considering inter-basin water governance based on hedging rules for the under-study water transfers. Results indicate the minimum drinking and industrial demands could be met. In addition, the firm energy from hydropower produced by the Big Karun Basin system would decline by 12% relative to existing water-transfer conditions and the vulnerability of the water system would decline in terms of required quality for downstream demands and water users in comparison with the full-transfer water condition. [ABSTRACT FROM AUTHOR]

This document provides a concise summary of a study on the use of implanted haemodynamic monitoring (IHM) in adults with subaortic right ventricles (sRV) who have congenital heart disease. The study explores the novel uses of IHM, including monitoring pulmonary artery pressures for heart transplant referral and management after a ventricular assist device. The study found that IHM had multiple uses and could potentially reduce the need for repeat cardiac catheterizations. The document also provides supplemental tables and references related to the study, which can be useful for researchers and healthcare professionals in the field. [Extracted from the article]

Patch augmentation of the right ventricular outflow tract (RVOT) and pulmonary artery (PA) arterioplasty are relatively common procedures in the surgical treatment of patients with congenital heart disease. To date, several patch materials have been applied with no agreed upon clinical standard. Each patch type has unique performance characteristics, cost, and availability. There are limited data describing the various advantages and disadvantages of different patch materials. We performed a review of studies describing the clinical performance of various RVOT and PA patch materials and found a limited but growing body of literature. Short-term clinical performance has been reported for a multitude of patch types, but comparisons are limited by inconsistent study design and scarce histologic data. Standard clinical criteria for assessment of patch efficacy and criteria for intervention need to be applied across patch types. The field is progressing with improvements in outcomes due to newer patch technologies focused on reducing antigenicity and promoting neotissue formation which may have the ability to grow, remodel, and repair. [ABSTRACT FROM AUTHOR]

The aim of the study was to determine the variables associated with high-quality (HQ) versus low-quality (LQ) three-dimensional rotational angiography (3DRA) and create guides for optimization of approach to 3DRA in congenital cardiac catheterization (CCC). CCC has adopted 3DRA as a mainstay, but there has not been systematic analysis of approach to and factors associated with HQ 3DRA. This was a single-center, retrospective study of 3DRAs using Canon Infinix-I platform. Reconstructions were graded by 3 interventionalists. Quality was dichotomized into HQ and LQ. Univariable analyses and multivariable logistic regression models were performed. From 8/2016 to 12/2018, 208 3DRAs were performed in 195 CCCs; median age 7 years (2, 16), weight 23 kg (12, 57). The majority of 3DRAs were performed in patients with biventricular physiology (N = 137, 66%) and in pulsatile sites (N = 144, 69%). HQ 3DRA (N = 182, 88%) was associated with greater total injection volume [2.20 mL/kg (1.44, 3.29) vs. 1.62 mL/kg (1.10, 1.98), p = 0.005] and more dilute contrast solution [60% (50, 100) vs. 100% (60, 100), p = 0.007], but not with contrast volume administered (p = 0.2) on univariable analysis. On multivariable logistic regression, HQ 3DRA was significantly associated with patient weight [OR 0.97 (95% CI (0.94, 0.99), p = 0.018], total injection volume [OR 1.04 (95% CI 1.01, 1.07) p = 0.011], and percent contrast solution [OR 0.97 (95% CI 0.95, 1.00), p = 0.022]. These data resulted in creation of scatter plots and a novel 3DRA Nomogram for estimating the probability of HQ 3DRA. This is the first study to create evidence-based contrast dose guides and nomogram for 3DRA in CCC. HQ 3DRA was associated with lower weight, higher total injection volumes, and more dilute contrast solution. [ABSTRACT FROM AUTHOR]

Rivers play an important role in water supply, waterway transport, and riverine species habitations. The underwater depth of a river channel is a fundamental geometric element and a key input to studies for the aforementioned and other applications. Traditional in-situ field surveys for flow depth measurements would incur high costs and encounter technical and/or logistical difficulties, particularly for river channels of large extents, very shallow channels, and remote, inaccessible channels. Recent advances in satellite remote sensing of inland water bodies like rivers, streams, and creeks have allowed mapping flow depth in an inexpensive, convenient, and efficient manner. The purpose of this paper is to demonstrate the retrieval of river flow depth from high-resolution (1.2 m) WorldView-3 satellite imagery. The depth retrieval methods are based on the ratio of top-of-atmosphere reflectance between two pairing wavelength bands of multispectral imagery. The originality of the methods lies in using analytical relationships without resorting to ground data of river flow depth for calibration, which improves from previous studies of remote sensing of river flow depth. The methods are successfully applied to mapping the underwater bathymetry of a 26 km reach of the Nicolet River in Quebec, Canada. This study shows the importance of geometric and radiometric corrections to the satellite images. The obtained flow depths using the ratio of reflectance of the red band (630–690 nm) to that of the green band (510–580 nm), among the eight bands in the visible spectrum, agree best with in-situ measurements. This study is perhaps the first use of the analytical approach for mapping river bathymetry. It is feasible to implement the approach to other river channels, with a good potential to reduce the costs and increase the efficiency of mapping river bathymetries. [ABSTRACT FROM AUTHOR]

The management of large-scale water resources systems requires including of different stakeholders and users from municipal, agricultural, industrial and environmental sectors. This has baffled the process of decision making for integrated water resource systems. In such systems, the interactions between various stakeholders must be carefully taken into account with the goal of aggregating interests around the sustainability concept. In this study, first, the integrated water resources systems of Big Karun Watershed, Iran, have been modeled using the system dynamics approach. The system dynamics model represents the interactions between different components of the system, including water transfer projects, dams, urban, industry, agriculture and fish farming, and environmental demands. Vensim software has been used for the system dynamics modeling. Vensim simulates the dynamics behavior of the sub-systems and overall performance of the system by comparing the current operation policies with the future management scenarios. A wide range of performance indices, such as quantitative and qualitative water stress, income, cost, and productivity, have been used here to represent different aspects of sustainability goals. Finally, the performance of the systems has been evaluated by developing a sustainability index using distributed zoning model in order to identify proper management policies for this watershed. The results indicate that downstream users demand cannot be fully met by solely considering inter-basin water transfer and agricultural development projects. The sustainable and integrated management of the whole system ties into enhancement in both infrastructure systems and the operation of the whole system. It is expected that the sustainability of the basin improves if a water market schema exists and the gained money would be used to enhance the efficiency of existing irrigation networks. [ABSTRACT FROM AUTHOR]

Decreasing flood damages in a basin and achieving sustainable development reveal the necessity of integrated management of flood. Integrated flood management requires the co-implementation of both structural and non-structural flood mitigation strategies. Watershed management, building dams and levees, and increasing channel capacity are considered among structural measures. While, flood forecasting, developing flood early warning systems, and establishing reservoir operation rules can fall into the non-structural measures group. The main goal of this study is to reveal the importance of co-implementation of structural and non-structural measures for managing the flood in the whole system. Structural measures are divided here into two main groups (1) dams and (2) watershed management, and non-structural measures focus more on reoperation of the system of reservoirs. The system dynamics (SD) approach has been used to model the integration of a series of structural and non-structural flood control measures for the Karkheh Basin, Iran. The performance of the developed model is evaluated based on historical floods, including the recent 2019 flooding event in this basin, and the performance of flood mitigation strategies is evaluated facing these flood events. Results indicate that both structural and non-structural solutions should be considered in flood management portfolios simultaneously, and none solely can be the silver bullet. The magnitude of a 200-year flood can be reduced from 7956 to 3021 m3/s, if integrated structural and non-structural strategies would be considered in Karkheh Basin. This study identifies the key role of structural and non-structural measures for integrated flood management in Karkheh Basin, which and provides effective information for appropriate and timely operation and decision making in the future. [ABSTRACT FROM AUTHOR]

Decreasing flood damages in a basin and achieving sustainable development reveal the necessity of integrated management of flood. Integrated flood management requires the co-implementation of both structural and non-structural flood mitigation strategies. Watershed management, building dams and levees, and increasing channel capacity are considered among structural measures. While, flood forecasting, developing flood early warning systems, and establishing reservoir operation rules can fall into the non-structural measures group. The main goal of this study is to reveal the importance of co-implementation of structural and non-structural measures for managing the flood in the whole system. Structural measures are divided here into two main groups (1) dams and (2) watershed management, and non-structural measures focus more on reoperation of the system of reservoirs. The system dynamics (SD) approach has been used to model the integration of a series of structural and non-structural flood control measures for the Karkheh Basin, Iran. The performance of the developed model is evaluated based on historical floods, including the recent 2019 flooding event in this basin, and the performance of flood mitigation strategies is evaluated facing these flood events. Results indicate that both structural and non-structural solutions should be considered in flood management portfolios simultaneously, and none solely can be the silver bullet. The magnitude of a 200-year flood can be reduced from 7956 to 3021 m3/s, if integrated structural and non-structural strategies would be considered in Karkheh Basin. This study identifies the key role of structural and non-structural measures for integrated flood management in Karkheh Basin, which and provides effective information for appropriate and timely operation and decision making in the future. [ABSTRACT FROM AUTHOR]

Introduction: A 2-year-old female with hypoplastic left heart syndrome (HLHS)-variant, a complex congenital heart defect (CHD) characterized by the underdevelopment of the left ventricle, presented with complications following single ventricle palliation. Diagnostic work-up revealed elevated Fontan pathway pressures, as well as significant dilation of the inferior Fontan pathway with inefficient swirling flow and hepatic venous reflux. Due to the frail condition of the patient, the clinical team considered an endovascular revision of the Fontan pathway. In this work, we performed a computational fluid dynamics (CFD) analysis informed by data on anatomy, flow, and pressure to investigate the hemodynamic effect of the endovascular Fontan revision. Methods: A patient-specific anatomical model of the Fontan pathway was constructed from magnetic resonance imaging (MRI) data using the cardiovascular modeling software CardiovasculaR Integrated Modeling and SimulatiON (CRIMSON). We first created and calibrated a pre-intervention 3D-0D multi-scale model of the patient's circulation using fluid-structure interaction (FSI) analyses and custom lumped parameter models (LPMs), including the Fontan pathway, the single ventricle, arterial and venous systemic, and pulmonary circulations. Model parameters were iteratively tuned until simulation results matched clinical data on flow and pressure. Following calibration of the pre-intervention model, a custom bifurcated endograft was introduced into the anatomical model to virtually assess post-intervention hemodynamics. Results: The pre-intervention model successfully reproduced the clinical hemodynamic data on regional flow splits, pressures, and hepatic venous reflux. The proposed endovascular repair model revealed increases of mean and pulse pressure at the inferior vena cava (IVC) of 6 and 29%, respectively. Inflows at the superior vena cava (SVC) and IVC were each reduced by 5%, whereas outflows at the left pulmonary artery (LPA) and right pulmonary artery (RPA) increased by 4%. Hepatic venous reflux increased by 6%. Conclusion: Our computational analysis indicated that the proposed endovascular revision would lead to unfavorable hemodynamic conditions. For these reasons, the clinical team decided to forgo the proposed endovascular repair and to reassess the management of this patient. This study confirms the relevance of CFD modeling as a beneficial tool in surgical planning for single ventricle CHD patients. [ABSTRACT FROM AUTHOR]

Children with hypoplastic left heart syndrome (HLHS) must undergo multiple surgical stages to reconstruct the anatomy to a sustainable single ventricle system. Stage I palliation, or the Norwood procedure, provides circulation to both pulmonary and systemic vasculature. The aorta is reconstructed and attached to the right ventricle and a fraction of systemic flow is redirected to the pulmonary arteries (PAs) through a systemic-to-PA shunt. Despite abundant hemodynamic data available 4–5 months after Norwood palliation, data is very scarce immediately following stage I. This data is critical in determining post-operative success. In this work, we combined population data and computational fluid dynamics (CFD) to characterize hemodynamics immediately following stage I (post-stage I) and prior to stage II palliation (pre-stage II). A patient-specific model was constructed as a baseline geometry, which was then scaled to reflect population-based morphological data at both time-points. Population-based hemodynamic data was then used to calibrate each model to reproduce blood flow representative of HLHS patients. The post-stage I simulation produced a PA pressure of 22 mmHg and high-frequency oscillations within the flow field indicating highly disturbed hemodynamics. Despite PA mean pressure dropping to 14 mmHg, the pre-stage II model also produced high-frequency flow components and PA wall shear stress increases. These suboptimal conditions may be necessary to ensure adequate PA flow throughout the pre-stage II period, as the shunt becomes relatively smaller compared to the patient's somatic growth. In the future, CFD can be used to optimize shunt design and minimize these suboptimal conditions. [ABSTRACT FROM AUTHOR]

3D visualization technologies have evolved to become a mainstay in the management of congenital heart disease (CHD) with a growing presence within multiple facets. Printed and virtual 3D models allow for a more comprehensive approach to educating trainees and care team members. Computational fluid dynamics can take 3D modeling to the next level, by predicting post-procedural outcomes and helping to determine surgical approach. 3D printing and extended reality are developing resources for pre-procedural planning and intra-procedural guidance with the potential to revolutionize decision-making and procedural success. Challenges still remain within existing technologies and their applications to the CHD field. Addressing these gaps, both by those within and outside of CHD, will transform education and patient care within our field. [ABSTRACT FROM AUTHOR]

There is no better representation of the need for personalization of care than the breadth and complexity of congenital heart disease. Advanced imaging modalities are now standard of care in the field, and the advancements being made to three-dimensional visualization technologies are growing as a means of pre-procedural preparation. Incorporating emerging modeling approaches, such as computational fluid dynamics, will push the limits of our ability to predict outcomes, and this information may be both obtained and utilized during a single procedure in the future. Artificial intelligence and customized devices may soon surface as realistic tools for the care of patients with congenital heart disease, as they are showing growing evidence of feasibility within other fields. This review illustrates the great strides that have been made and the persistent challenges that exist within the field of congenital interventional cardiology, a field which must continue to innovate and push the limits to achieve personalization of the interventions it provides. [ABSTRACT FROM AUTHOR]

Abstract: Aim: Chronic periodontitis (CP) is a multifactorial disease and the most common type of periodontitis mainly caused by microbial plaque. CP can be brought on by, and progresses with, insufficient oral hygiene, and environmental and genetic susceptibilities. The aim of the present study was to investigate the association between interleukin (IL)‐2 (T‐330G), IL‐16 (T‐295C), and IL‐17 (A‐7383G) gene polymorphisms and the susceptibility to CP in an Iranian population. Methods: Ninety‐nine cases diagnosed with CP and 75 matched healthy controls engaged in the present study. 3 cc peripheral blood samples were obtained for DNA isolation. Genotype analysis was performed using restriction fragment length polymorphism polymerase chain reaction. Genotype distribution and allele frequencies within groups were compared using χ2‐test, and logistic regression analysis was used to recognize the independent relation between the disease and the absence or presence of alleles. Results: There was no polymorphism in IL‐2 (T‐330G) among our patients, and the TT genotype was present in both study groups. Moreover, none of the studied genotypes and alleles of IL‐16 (T‐295C) and IL‐17 (A‐7383G) was significantly associated with CP. Conclusion: The present study demonstrated no association between IL‐2 (T‐330G), IL‐16 (T‐295C), and IL‐17 (A‐7383G) genotypes and CP in an Iranian population. [ABSTRACT FROM AUTHOR]

Background Debriefing after pediatric rapid response team activations (RRT-As) in a tertiary care children's hospital was identified to occur only sporadically. The lack of routine debriefing after RRT-As was identified as a missed learning opportunity. Objective We implemented a formal debriefing program and assessed staff attitudes toward and experiences with debriefing after pediatric RRT-As. Methods Real-time feedback for pediatrics residents captured clinical and debriefing data for each RRT-A from July 2014 to June 2016. The debriefing on physiology, team communication, and anticipation of clinical deterioration was introduced in July 2015. To assess debriefing perceptions, residents, intensive care fellows, nurses, and respiratory therapists participated in anonymous preintervention and postintervention surveys. We also developed a workshop to teach residents how to lead debriefing. Results Debriefing after RRT-As increased from 26% preintervention to 46% postintervention (P < .0001). A total of 43 of 76 pediatrics residents (57%) attended at least 1 of 4 debriefing workshops. Both preintervention and postintervention, more than 80% (70 of 78 preintervention and 54 of 65 postintervention) of health professionals surveyed strongly agreed or agreed that there was a benefit to debriefing after RRT-As. Postintervention, 65% (26 of 40) of respondents strongly agreed or agreed that debriefing improved their understanding of the RRT-A process. The rate of debriefing was sustained at 46% (6 months after the end of the study period). Conclusions Debriefing frequency after pediatric RRT-As significantly increased with the introduction of a formal debriefing program. A majority of health professionals and trainees reported this practice was a valuable experience. [ABSTRACT FROM AUTHOR]

An 8‐year‐old boy with tetralogy of Fallot, pulmonary atresia, and major aortopulmonary collaterals status post complete repair including a fenestrated ventricular septal defect patch presented to the catheterization laboratory for fenestration closure. During the procedure, the catheterization wire was found to have an unusual intracardiac loop and was unable to be straightened within the heart. Three‐dimensional transesophageal echocardiography revealed the wire was looped around a right ventricular papillary muscle. The wire was readjusted, and the fenestration was successfully closed. Three‐dimensional imaging was essential in unambiguously defining the catheter course and assisting in fenestration closure. [ABSTRACT FROM AUTHOR]

Background: Periodontal disease has a multifactorial etiology. A combination of microbial agents and environmental, habitual, systemic, and genetic risk factors is responsible for the development of periodontal disease. Host immune response causes the destruction of tooth-supporting structure and eventual tooth loss. This study aimed to assess the correlation of interleukin 6 (IL-6) -174-GC and IL-6-572-GC gene polymorphisms with periodontal disease in an Iranian population. Materials and Methods: This case-control analytical study was conducted on 129 subjects presenting to the laboratory of Taleghani Hospital. Subjects underwent clinical and periodontal examinations and divided into five groups of healthy, gingivitis and mild, moderate and severe periodontitis. Blood samples (2 ml) were obtained. Genomic DNA was extracted manually using the salting-out method. IL-6 sequence amplification was performed using polymerase chain reaction with three thermal protocols. Digested products were analyzed by electrophoresis through 2% agarose gel using Gel Red staining. Data were analyzed using Chi-square, Kruskal-Wallis, and Mann-Whitney tests, and P < 0.05 was considered significant. Results: The frequency of GG polymorphism at IL-6-174 and IL-6-572 genomic regions was 51.2% and 71.3%, respectively. The frequency of IL-6-572-GG polymorphism was significantly greater than that of IL-6-572-GC polymorphism (P< 0.001). Comparison of the mean and maximum pocket depth and clinical attachment level, as well as bleeding on probing percentage, revealed significant differences between the healthy controls and periodontitis patients (P < 0.001 ).The frequency percentages of GC and GG polymorphisms were almost equal in the healthy, gingivitis, and periodontitis groups. In other words, the frequency of the two polymorphisms was not significantly different between the health and disease states (P = 0.065 for IL-6-572 and P = 0.63 for IL-6-174). Conclusion: This study found no association between IL-6-l74 and IL-6-572 gene polymorphisms and periodontitis in the studied population. [ABSTRACT FROM AUTHOR]

Cardiopulmonary bypass (CPB) can be a potential cause of morbidity in patients for several reasons, including significantly higher gaseous microemboli (GME) formation than extracorporeal life support (ECLS) and physiological circulation, diverted blood flow from the patient via an open purge line of the arterial filter, and pressure drop across the oxygenator that is used in the circuit. Using a combined oxygenator and arterial filter may minimize these harmful factors and can effectively reduce the chances for postoperative morbidity. This study investigated the new QUADROX-i Neonatal Oxygenator (D-72145, Maquet, Hirrlingen, Germany) with an integrated arterial filter in terms of the hemodynamic properties and ability to clear GME in response to hypothermic versus normothermic conditions, open versus closed arterial filter purge line, and varying flow rates in a simulated CPB circuit identical to that of the clinical setting. A flow probe, pressure transducer, and Emboli Detection and Classification (EDAC) quantifier transducer were placed upstream and downstream to the oxygenator to measure changes in each parameter. The circuit was primed with fresh human blood with an hematocrit (Hct) of 26% diluted with Ringer’s lactate solution. Five milliliters of air were injected proximal to the venous cardiotomy reservoir, under non-pulsatile perfusion, with flow rates of 500 ml/min, 750 ml/min, and 1000 ml/min. A total of 8 air bolus injections were made at each individual set of conditions for a total of 96 injections. Results showed that the QUADROX-i Neonatal Oxygenator with an integrated filter has excellent hemodynamic properties with extremely low pressure drops and blood flow diverted from the patient, as well as high rates of GME capturing. The arterial filter purge line has a significant effect on the degree of blood flow diverted from the patient (p < 0.001), but does not affect pressure drop across the oxygenator. [ABSTRACT FROM AUTHOR]

Presents a study which aimed to explain further a model of the political process in the U.S. that may be contained within the Amacher-Boyes approach and to point out its empirical implications. Measurement of a politician's independence and the characteristics of the polity; Implication of an alternative measure of independence for the importance of polity and political cycle phenomena in senatorial behavior; Regression results for alternative measure of senatorial independence.

Purpose: Ectodermal dysplasias are characterized by developmental abnormalities in ectodermal structures. Hypohidrotic ectodermal dysplasias (HED) are the most common subtype. They are most commonly inherited via X-linked recessive routes. We report on a novel ectodysplasin-A (EDA) mutation that is expected to be involved in pathogenesis of HED. Methods: Hypohidrotic ectodermal dysplasia genes, including EDA, EDAR and EDARADD, were analyzed using next-generation sequencing (NGS). The detected mutation on the EDA gene was confirmed in the patient and his mother using Sanger sequencing. Results: The patient presented with adontia, absence of gum development, hyperthermia and hypohidrosis. Our genetic analysis of the patient revealed a novel frameshift hemizygous mutation (c.898_924 + 8del35ins4CTTA) on the EDA gene. The patient's mother showed a mild HED phenotype. Direct sequencing of the EDA gene in the region where her son had the mutation showed the same mutation in a heterozygous state. Conclusion: We identified a novel frameshift mutation in the EDA gene in an Iranian patient affected by X-linked HED. The difference between our patient's symptoms and those recorded for some previous subjects may be due to the differences in the mutations involved. [ABSTRACT FROM AUTHOR]

Transcatheter stent implantation for SVC obstruction following OHT has been well described, particularly in pediatric patients. This study describes a large single‐center pediatric heart transplant experience that investigates the risk factors for SVC stenosis requiring stent implantation and its associated outcomes. All pediatric OHTs between January 1, 2000, and December 12, 2016, were examined for risk factors. Twelve of 349 (3.4%) OHTs required SVC stent implantation. Patients who required stents were younger (2.5 years vs 10.0 years, P = 0.0097), weighed less (8.6 kg vs 26.0 kg, P = 0.0024), and were more likely to have had CHD (83% vs 32%, P = 0.001) or previous SCPA (58% vs 18%, P = 0.002). Bicaval anastomosis was not associated with subsequent SVC stent implantation. Symptoms included SVC syndrome and chylous effusions. All 12 patients had evidence of significant SVC obstruction by both echocardiographic Doppler interrogation and transcatheter angiography. There were no acute procedural complications; however, reinterventions were common (four of 12 patients) and occurred at a mean of 5.7 ± 3.6 months poststent implantation. In conclusion, transcatheter SVC stent implantation is safe and effective after OHT. There were significant associations between SVC stent implantation and younger age, smaller weight, CHD, and history of SCPA, but not with bicaval anastomosis or donor‐recipient weight ratio. [ABSTRACT FROM AUTHOR]