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Aphelocheirus sp. (Fig. 2) Material. Specimen GU / R /B/G/3015 (part and counterpart of thorax and abdomen, head only partly visible, legs lacking), stored at the Paleontology laboratory, Department of Geology. H.N.B. Garhwal University, Srinagar Garhwal, Uttarakhand, India Type locality and horizon. Lower Eocene, Palana Formation, Gurha opencast lignite mine, Bikaner district, Rajasthan, India. Description. Body ca. 13.2 mm long, 10.5 mm wide. Head very poorly preserved. Thorax 4.6 mm long, 7.1 mm wide, a median furrow on mesosternum (Fig. 2, white arrow) and metasternum; pronotum with rounded margin; insertions of hind coxae well visible (Fig. 2, yellow arrows). Abdomen well preserved, rounded and flat, 8.8 mm long, 10.0 mm wide, with strong lateral spines on nearly all segments (Fig. 2, blue arrow); posterior margins of segments darkened; presence of two symmetrical plates at apex; broad rounded structures visible in ventral view, with very small white rounded spots inside (respiratory ‘rosettes’ with small openings) (Fig. 2, red arrowhead); two elliptical structures appressed to the rosettes of 2nd sternite (Fig. 2, white arrowhead); sternites IV and V with rounded traces medially along posterior margins; sternite VI very narrow (Fig. 2, red arrow)., Published as part of PATEL, RAMAN, RANA, RAJENDRA SINGH, NEL, ANDRÉ & ALI, ASHIF, 2023, The oldest aquatic aphelocheirid bug (Heteroptera, Nepomorpha) from the lower Eocene of India, pp. 250-254 in Palaeoentomology 6 (3) on page 251, DOI: 10.11646/palaeoentomology.6.3.7, http://zenodo.org/record/8073064

PATEL, RAMAN, RANA, RAJENDRA SINGH, NEL, ANDRÉ, ALI, ASHIF (2023): The oldest aquatic aphelocheirid bug (Heteroptera, Nepomorpha) from the lower Eocene of India. Palaeoentomology 6 (3): 250-254, DOI: 10.11646/palaeoentomology.6.3.7, URL: http://dx.doi.org/10.11646/palaeoentomology.6.3.7

Subgenus Aphelocheirus Westwood, 1833 Type species. Naucoris aestivalis Fabricius, 1794; by original designation., Published as part of PATEL, RAMAN, RANA, RAJENDRA SINGH, NEL, ANDRÉ & ALI, ASHIF, 2023, The oldest aquatic aphelocheirid bug (Heteroptera, Nepomorpha) from the lower Eocene of India, pp. 250-254 in Palaeoentomology 6 (3) on page 251, DOI: 10.11646/palaeoentomology.6.3.7, http://zenodo.org/record/8073064, {"references":["Westwood, J. O. (1833) On the connecting links between the Geocorisae and Hydrocorisae of Latreille, or the land and water bug tribes. Magazine of Natural History, 6, 228 - 229.","Fabricius, J. C. (1794) Entomologia systematica emendata et aucta, secundum classes, ordines, genera, specis adjectis synonymis, locis, observationibus, descriptionibus. Vol. 4. Proft, Hafniae, 572 pp. https: // doi. org / 10.5962 / bhl. title. 125869"]}

KIREJTSHUK, ALEXANDER G., PATEL, RAMAN, RANA, RAJENDRA SINGH, PROKIN, ALEXANDER, NEL, ANDRÉ, JÄCH, MANFRED A. (2023): Discovery of the oldest known elmid larva (Coleoptera, Elmidae) from the Lower Eocene of Rajasthan (India, Palana Formation). Palaeoentomology 6 (3): 235-241, DOI: 10.11646/palaeoentomology.6.3.5, URL: http://dx.doi.org/10.11646/palaeoentomology.6.3.5

Elmidae genus and species indetermined (Fig. 3) Material. Specimen GU / R /B/G 3008 (a nearly complete larva), stored at Palaeontology laboratory, Department of Geology, H.N.B. Garhwal University, Srinagar Garhwal, Uttarakhand, India Type locality and horizon. Lower Eocene, Palana Formation, Gurha opencast lignite mine, Bikaner district, Rajasthan, India. General remarks. The characters observed in this larva are all diagnostic of Elmidae (Fig. 3): Head with clustered stemmata on each side; frontal suture V-shaped, epicranial suture short; antenna shorter than head, with three antennomeres; labrum transverse and short; abdomen long, nine-segmented, segment IX long, with short ventral operculum in apical position, tuft of retractile tracheal anal gills present. Description. Thorax and abdomen laterally compressed, but head dorsoventrally compressed; legs only partly preserved. Body ca. 5.70 mm long, elongate. Thorax and abdomen equally high. Thorax and abdominal segments I–V apparently somewhat expanded and subflattened, probably during fossilization, abdominal segments VI–IX apparently not deformed. Thorax and abdomen with traces of stigmata. Thoracic and abdominal integument rather sclerotized, almost as sclerotized as epicranium, apparently all segments finely and densely granulate, microsetae not visible. Posterior edges of abdominal segments I–VIII apparently finely serrate (serration partly traceable on upper parts of sides of abdominal segments III, IV and VIII). Prothorax ca. 1.8 times as long as mesothorax and 1.6 times as long as metathorax. Epicranium turned about 90° around body axis, apparently widest at middle (but dorsoventrally compressed, particularly posteriorly, and appearing widest at base), apparently somewhat narrowing basally along retracted part of head, subtruncate at frons, mandibles subtriangular and short, heavily sclerotized and visible through epicranial cuticle, ocular area slightly traceable but heavily sclerotized. Median part of epicranium destroyed along epicranial sutures and partly missing. Right antenna moderately long, visible between anterior edge of frons and ocular area. Prothorax larger (longer and apparently wider) than meso- and metathorax, dorsal surface (pronotum) longer than ventral one, with outlined, comparatively wide pro- and mesocoxae, and also two moderately thick metafemora (besides, one profemur and other sclerites of legs apparently partly traceable, as well as some remnants of mouthparts (apparently detached maxilla) or proleg sclerites. Abdominal segments I–VIII approximately subequal in length and also to meso- and metathorax; segment IX about as long as segments VI–VIII together, and nearly twice as long as prothorax, in distal third subconical and sharply acuminate at apex; segment IX with several gill filaments protruding from the ventral operculum., Published as part of KIREJTSHUK, ALEXANDER G., PATEL, RAMAN, RANA, RAJENDRA SINGH, PROKIN, ALEXANDER, NEL, ANDRÉ & JÄCH, MANFRED A., 2023, Discovery of the oldest known elmid larva (Coleoptera, Elmidae) from the Lower Eocene of Rajasthan (India, Palana Formation), pp. 235-241 in Palaeoentomology 6 (3) on pages 237-239, DOI: 10.11646/palaeoentomology.6.3.5, http://zenodo.org/record/8073044

Order Blattodea Brunner von Wattenwyl, 1882 (Figs 2���3) Material. Specimens GU/ R /B/G/3009 (tegmen); GU/ R /B/G/3004 (incomplete tegmen and incomplete hind wing); deposited in Department of Geology, HNB Garhwal University Srinagar Uttarakhand, India. Horizon and Locality. Carbonaceous and maroon shale beds of the Palana Formation (early Eocene), Gurha opencast lignite mine Bikaner Rajasthan. Descriptions. Specimen (GU/ R /B/G/3009) (Fig. 2). Incomplete tegmen with postero-apical part missing; original coloration not preserved; wing 24.8 mm long, about 8.2 mm wide; ScP ends on anterior margin, 8.8 mm from wing base, with weak anterior branches; R ends at wing apex, with numerous distally forked anterior branches, all parallel; area between R and anterior wing margin 2.6 mm wide; RA and RP not well differentiated; median area rather reduced, with few branches of M; CuA with numerous parallel branches covering a broad area; CuP+PCu strongly arched and concave; veins of postcubital-anal area all parallel and ending into CuP+PCu. Specimen (GU/ R /B/G/3004) (Fig. 3). Distal halves of a tegmen and a hind wing, darkened (original color); fragment of tegmen 16 mm long, about 5.5 mm wide (Fig. 3A); numerous anterior branches of R and area between R and anterior wing margin broad, ca. 2.3 mm wide (Fig. 3A); fragment of hind wing 6.7 mm long with numerous branches of main veins (Fig. 3B) and a part of anal fan (Fig. 3C), partly folded below rest of wing so that cubital branches seem not to be parallel to anal fan., Published as part of Patel, Raman, Rana, Rajendra Singh & Nel, Andre, 2021, First two cockroaches from the early Eocene of western Rajasthan, India (Insecta Blattodea), pp. 445-450 in Zootaxa 4927 (3) on pages 447-448, DOI: 10.11646/zootaxa.4927.3.8, http://zenodo.org/record/4542398

Background: The NuPulseCV intravascular ventricular assist system (iVAS) provides extended duration ambulatory counterpulsation via a durable pump placed through the distal subclavian artery. Methods: We performed a prospective, single-arm, multicenter, US Food and Drug Administration-approved feasibility trial of iVAS therapy as a bridge to transplant or decision following the FIH (First-In-Human) trial. Results: Forty-seven patients were enrolled, and 45 patients (median 61 years old, 37 males, and 30 listed on United Network of Organ Sharing) received iVAS support for median 44 (25–87) days. There were no intraoperative complications. Success was defined as survival or transplant on iVAS therapy free from disabling stroke. Outcome success at 30 days (the primary end point of this study) and at 6 months was 89% and 80%, respectively. During 6 months of iVAS support, 2 patients died and 2 patients experienced disabling neurological dysfunction. Six-minute walk distance, 2-minute step test, and Kansas City Cardiomyopathy Questionnaire score improved during 4-week iVAS support. Conclusions: This feasibility trial demonstrated promising short-term outcomes of iVAS therapy with improved functional capacity and quality of life during the therapy. Registration: URL: http://www.clinicaltrials.gov . Unique identifier: NCT02645539.

Summary of Objectives This is a single-arm, non-randomized study designed to assess the preliminary safety and clinical performance of a novel ambulatory counterpulsation device. The device is an intra-aortic, counterpulsation blood pump delivered via axillary artery. The system includes a skin interface device facilitating patient ambulation and an external, portable drive unit allowing increased mobility and independence. This study will assess potential benefits to patients who have advanced heart failure and require additional circulatory support. This study will evaluate human factors, the clinical safety of the device, device failures, whether the device performs its intended purpose, patient characteristics that may impact device performance, and device use outside of the hospital. Methods Following a First-in-Human study of 14 patients, this feasibility study will enroll up to 86 implanted patients in up to 20 investigational sites for a total of 100 patients on device. To date, 71 of 100 patients have been implanted across 14 of 16 participating institutions. Endpoints The primary endpoint of this study is to assess survival to transplant or stroke-free survival at 30 days. The following secondary endpoints will also be evaluated at 30 days: number of patients who deteriorate requiring escalation of inotropic support and/or additional mechanical circulatory support; incidence of serious device-related adverse events; incidence of procedure-related adverse events; incidence of all adverse events; change in NYHA class from baseline; change in quality of life from baseline as measured by Kansas City Cardiomyopathy Questionnaire (KCCQ) - global assessment; change in Seattle Heart Failure Model Prognosis Score; change in six minute walk test and two minute step test from baseline. Subjects supported with the device past 30 days will continue to be followed and evaluated in the study until transplantation, device explant, alternative mechanical circulatory support or death. A Pivotal Trial with this device is expected to begin by the second quarter of 2020.

Thousands of ventricular assist devices (VADs) currently provide circulatory support to patients worldwide, and dozens of heart pump designs for adults and pediatric patients are under various stages of development in preparation for translation to clinical use. The successful bench-to-bedside development of a VAD involves a structured evaluation of possible system states, including human interaction with the device and auxiliary component usage in the hospital or home environment. In this study, we review the literature and present the current landscape of preclinical design and assessment, decision support tools and procedures, and patient-centered therapy. Gaps of knowledge are identified. The study findings support the need for more attention to user-centered design approaches for medical devices, such as mechanical circulatory assist systems, that specifically involve detailed qualitative and quantitative assessments of human-device interaction to mitigate risk and failure.

Purpose The intravascular ventricular assist system (iVAS) is a minimally invasive, ambulatory, counterpulsation heart assist system that is inserted through the subclavian artery and sits in the descending aorta. It has been evaluated in a feasibility trial with expanded indications to include patients who were a bridge to decision (BTD). The objective was to evaluate the role of iVAS as a BTD device. Methods As part of a multicenter US FDA approved feasibility trial, 13 of 44 patients were implanted with iVAS as a BTD. Patients were in advanced congestive heart failure (CHF), did not have an irreversible contraindication to transplant, and were not listed at the time of implantation. Results Four patients were bridge to candidacy (BTC) due to substance abuse - three received a transplant and one is still in a probationary period. Two patients were Jehovah's Witnesses who needed their anemia and end organ function to improve prior to escalation of therapy. Both had comorbidities that precluded transplant and they received a left ventricular assist device (LVAD). One patient was implanted for recovery but the anatomy of his aorta proved incompatible with an iVAS and he received a LVAD. Two patients were initially too frail to receive a LVAD or transplant - one improved and received a transplant and the other is ongoing as a BTC. Two patients received an iVAS for intractable angina. One patient had transplant arteriopathy but also had severe peripheral vascular disease that precluded transplant. The iVAS was explanted after a year and symptom improvement. The other patient had nonrevascularizable coronary disease and had relief of his angina but died suddenly at home from an unknown cause. Two patients had cardiogenic shock after myocardial infarction and were supported for over 6 months. The average duration of iVAS support was 129 ± 101 days. At the time of iVAS implant, 8/13 patients had contraindications to LVAD. At 6 months, 11/13 had been successfully supported with iVAS and reached the intended goal. Conclusion The utility and versatility of the iVAS as a BTD was demonstrated in this trial. Outcomes were excellent in very challenging patients, many with contraindications for LVADs. The iVAS allowed a variety of patients time to improve their physical condition and transplant candidacy and is an important adjunct in treating complex advanced CHF patients.