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We present a computational study of isochoric heating in multi-layered (ML) targets at ultra-high intensity laser irradiation ( ∼ 10 20 W c m − 2 ). Previous studies have shown enhanced ion heating at interfaces, but at the cost of large temperature gradients. Here, we study ML targets to spread this enhanced interface heating to the entirety of the target and find heating parameters at which the temperature distribution is more homogeneous than at a single interface while still exceeding the mean temperature of a non-layered target. Further, we identify a limiting process of pressure oscillations that causes the layers to alternate between expanding and being compressed and leads to lower ion temperatures. Based on that, we derive an analytical model estimating the oscillation period to find target conditions that optimize heating and temperature homogeneity. This model can also be used to infer the electron energy from the oscillation period which can be measured e.g. by XFEL probing.

Acquired pulmonary artery branch stenosis without main pulmonary artery involvement due to external compression by neoplasia has been described in human and veterinary medicine. Over time, this can result in right ventricular hypertension and right-sided heart failure. Endovascular stenting offers quick relief from signs, while the underlying cause is addressed. Here, we present a dog with severe right pulmonary artery compression caused by a chemodectoma, which was treated with two, overlapping, self-expanding vascular stents and chemotherapy. The patient experienced immediate symptomatic relief, progressive stent expansion over time, and has been free of clinical symptoms for 5 months post implantation.

Abstract Background Cardiovascular diseases with increased right ventricular (RV) afterload induce RV diastolic and systolic dysfunction, and myocardial fibrosis in humans. Studies in dogs with pulmonary stenosis (PS) evaluating RV diastolic function and markers of myocardial fibrosis are lacking. Hypothesis/Objectives Dogs with PS have echocardiographic evidence of RV diastolic and systolic dysfunction and increased serum concentrations of galectin‐3 (Gal‐3), a surrogate biomarker for myocardial fibrosis. Animals Forty client‐owned dogs (10 controls, 30 with PS). Methods Prospective study. All dogs had systemic blood pressure measurement, serum biochemical analysis, echocardiography, and measurement of serum Gal‐3 concentration performed. Results Variables of RV diastolic function were obtained in 39/40 dogs. Trans‐tricuspid flow velocity in early diastole to trans‐tricuspid flow velocity in late diastole ratios (RV E/A) were lower (P

The purpose of this study was to assess the effect of flipping the classroom on final exam scores in a terminal general education college mathematics course for a diverse student population. We employed a quasiexperimental design. Seven instructors collectively taught 13 sections of each pedagogy (flipped/traditional). Six hundred thirty-two students participated. Common final exams were graded concurrently. Mixed-model analyses were performed. Students in flipped sections scored 5.1 percentage points higher on average than those in traditional sections (p = 0.02) when controlling for math SAT and financial aid status, an improvement of 7.8 points among Black students (p < 0.01) and 1.0 points among Whites (p = 0.67). The estimated average difference between White and Black students, conditional on covariates, was 5.2 percentage points in traditional sections (p < 0.01) and -1.6 in flipped sections (p = 0.39). The 6.8-point difference in achievement gap between pedagogies was statistically significant (p < 0.01). Flipping the classroom was associated with improved student performance, particularly among Black students.

The creation of accurate elevation models (topography) from stereo images are critical for a large variety of geospatial activities, including the production of digital orthomosaics, change detection, landing site analysis, geologic mapping, rover traverse planning, and spectral analysis. The United Stated Geological Survey, Astrogeology Science Center, continues to transition the supported planetary sensor models to the Community Sensor Model (CSM) standard. This paper describes the current state of use for this photogrammetric standard, supported sensor model types, and qualitatively compares derived topography between SOCET SET and SOCET GXP (®BAE Systems) using HiRISE stereo images of Mars. Our transition to the CSM standard will ensure an uninterrupted capability to make these valuable products for Mars and many other extraterrestrial planets and moons.

Background: Thoracic outlet syndrome (TOS) is a rare condition caused by compression of the neurovascular structures within the thoracic outlet. Different classifications of TOS exist depending on the neurovascular structure being compressed: neurogenic, venous, or arterial. Any of these forms can present independently or coexist with one other. TOS symptoms are sometimes precipitated by the presence of boney abnormalities that often require surgical intervention for ultimate resolution. This retrospective review will examine the presentations and outcomes of patients with TOS whose cause was a boney abnormality. Methods: A total of 73 patients who underwent thoracic outlet surgery between 2016 and 2021 were retrospectively reviewed via electronic medical records. Twelve (16%) patients demonstrated boney abnormalities on presentation causing their symptoms. The patients with boney abnormalities were analyzed based on venous, arterial, or neurogenic TOS diagnosis. Results: Of the 12 patients with boney abnormalities, 5 were classified as venous TOS, 6 patients as neurogenic TOS, and 1 as arterial TOS. The boney abnormalities were as follows: venous TOS: three clavicular fractures, one nonfused congenital clavicle, and one residual rib; neurogenic TOS: three fractured first ribs, one fractured clavicle, and two cervical ribs; and arterial TOS: fused first and second rib with bilateral cervical ribs and arterial compression. Postoperatively, there were no artery, vein, or nerve injuries. Five patients had a pneumothorax treated over night with a chest tube, and one patient had a superficial wound infection. The median hospital stay was 1 day. All patients completed physical therapy after surgery. All patients have symptom resolution at follow-up. Conclusions: Patients with boney abnormalities constitute about one-fifth of patients who can present with all three forms of TOS: neurogenic, arterial, and venous, and some will have more than one of these presentations. Results in patients undergoing surgery with boney abnormalities causing thoracic outlet syndrome are excellent with symptom resolution and without substantial complications.

Acquired pulmonary artery branch stenosis without main pulmonary artery involvement due to external compression by neoplasia has been described in human and veterinary medicine. Over time, this can result in right ventricular hypertension and right-sided heart failure. Endovascular stenting offers quick relief from signs, while the underlying cause is addressed. Here, we present a dog with severe right pulmonary artery compression caused by a chemodectoma, which was treated with two, overlapping, self-expanding vascular stents and chemotherapy. The patient experienced immediate symptomatic relief, progressive stent expansion over time, and has been free of clinical symptoms for 5 months post implantation. [ABSTRACT FROM AUTHOR]

Abstract Background Arterial thromboembolism is a sequela of hypertrophic cardiomyopathy (HCM) in cats related to left atrial (LA) enlargement and dysfunction. Hypothesis Pimobendan improves LA transport function in cats. Animals Twenty‐two client‐owned cats with HCM and 11 healthy cats. Methods Prospective, double‐blind, randomized, placebo‐controlled clinical cohort study. Cats were randomized to receive either pimobendan (0.25 mg/kg PO q12h) or placebo for 4 to 7 days. Nineteen echocardiographic variables of LA size and function were evaluated. Statistical comparisons included t tests, analysis of variance, and multivariable analyses. Results Peak velocity of left auricular appendage flow (LAapp peak; mean ± SD, 0.85 ± 0.20 vs 0.71 ± 0.22 m/s; P = .01), maximum LA volume (P = .03), LA total emptying volume (P = .03), peak velocity of late diastolic transmitral flow (A peak velocity; 0.77 ± 0.12 vs 0.62 ± 0.17 m/s; P = .05), and A velocity time integral (A VTI; 3.05 ± 0.69 vs 3.37 ± 0.49; P = .05) were increased after pimobendan. Mean change after pimobendan was larger in cats with HCM compared to healthy cats for LA fractional shortening (2.1% vs −2.1%; P = .05), A VTI (0.58 vs 0.01 cm; P = .01), LAapp peak (0.20 vs 0.02 m/s; P = .02), LA kinetic energy (3.51 vs −0.10 kdynes‐cm; P = .05), and LA ejection force (1.93 vs −0.07 kdynes; P = .01) in the multivariable model. The stronger effect of pimobendan in cats with HCM was independent of LA size. Conclusions and Clinical Importance We identified positive, albeit minor, effects of pimobendan on LA function in cats with HCM. Whether or not treatment with pimobendan decreases the risk of cardiogenic embolism deserves further study.

Abstract Background Although older adults encompass almost half of patients with advanced chronic kidney disease, it remains unclear which long-term hemodialysis vascular access type, arteriovenous fistula or arteriovenous graft, is optimal with respect to effectiveness and patient satisfaction. Clinical outcomes based on the initial AV access type have not been evaluated in randomized controlled trials. This pilot study tested the feasibility of randomizing older adults with advanced kidney disease to initial arteriovenous fistula versus graft vascular access surgery. Methods Patients 65 years or older with pre-dialysis chronic kidney disease or incident end-stage kidney disease and no prior arteriovenous vascular access intervention were randomized in a 1:1 ratio to undergo surgical placement of a fistula or a graft after providing informed consent. Trial feasibility was evaluated as (i) recruitment of ≥ 70% of eligible participants, (ii) ≥ 50 to 70% of participants undergo placement of index arteriovenous access within 90 to 180 days of enrollment, respectively, (iii) ≥ 80% adherence to study-related assessments, and (iv) ≥ 70% of participants who underwent index arteriovenous access placement will have a follow-up duration of ≥ 12 months after index surgery date. Results Between September 2018 and October 2019, 81% (44/54) of eligible participants consented and were enrolled in the study; 11 had pre-dialysis chronic kidney disease, and 33 had incident or prevalent end-stage kidney disease. After randomization, 100% (21/21) assigned to arteriovenous fistula surgery and 78% (18/23) assigned to arteriovenous graft surgery underwent index arteriovenous access placement within a median (1st, 3rd quartile) of 5.0 (1.0, 14.0) days and 13.0 (5.0, 44.3) days, respectively, after referral to vascular surgery. The completion rates for study-specific assessments ranged between 40.0 and 88.6%. At median follow-up of 215.0 days, 5 participants expired, 7 completed 12 months of follow-up, and 29 are actively being followed. Assessments of grip strength, functional independence, and vascular access satisfaction were completed by > 85% of patients who reached pre-specified post-operative assessment time point. Conclusions Results from this study reveal it is feasible to enroll and randomize older adults with advanced kidney disease to one of two different arteriovenous vascular access placement surgeries. The study can progress with minor protocol adjustments to a multisite clinical trial. Trial registration Clinical Trials ID, NCT03545113 .

Abstract Background Endothelial colony forming cells (ECFCs) may be useful therapeutically in conditions with poor blood supply, such as distal limb wounds in the horse. Encapsulation of ECFCs into injectable hydrogel microspheres may ensure cell survival and cell localization to improve neovascularization and healing. Autologous ECFCs were isolated from 6 horses, labeled with quantum nanodots (QD), and a subset were encapsulated in poly(ethylene) glycol fibrinogen microspheres (PEG-Fb MS). Full-thickness dermal wounds were created on each distal limb and injected with empty PEG-Fb MS, serum, ECFCs, or ECFCs encapsulated into PEG- Fb MS (ECFC/MS). Analysis included wound surface area (WSA), granulation tissue scoring (GS), thermography, collagen density staining, and immunohistochemical staining for endothelial and inflammatory cells. The purpose of this study was to track cell location and evaluate wound vascularization and inflammatory response after injection of ECFC/MS or naked ECFCs in equine distal limb wounds. Results ECFCs were found near and within newly formed blood vessels up to 3 weeks after injection. ECFC and ECFC/MS groups had the greatest blood vessel quantity at week 1 in the wound periphery. Wounds treated with ECFCs and ECFC/MS had the lowest density of neutrophils and macrophages at week 4. There were no significant effects of ECFC or ECFC/MS treatment on other measured parameters. Conclusions Injection of microsphere encapsulated ECFCs was practical for clinical use and well-tolerated. The positive ECFC treatment effects on blood vessel density and wound inflammation warrant further investigation.

Many women experience depressive symptoms after birth, and rates among African Americans are as high as 40 percent. Spirituality and religiosity are valued in African American communities, but their relevance to new mothers has not been empirically tested. We examined effects of religiosity and spirituality on trajectories of depressive symptoms during the year following childbirth. Data were collected by the Eunice Kennedy Shriver NICHD Community and Child Health Network (CCHN) focused on maternal-child health disparities. The sample consisted of 702 low SES African American predominantly Christian women. Participants were interviewed in their homes throughout the year following a birth. Spirituality and religiosity each independently predicted changes in depressive symptoms with low levels predicting increases over time. Effects of religiosity were mediated by a woman's spirituality. Religiosity and spirituality functioned as significant, interrelated protective factors in this study which provides novel insight about lower income African American women following birth.

Background: It is unclear whether surgical placement of an arteriovenous (AV) fistula (AVF) confers substantial clinical benefits over an AV graft (AVG) in older adults with end-stage kidney disease (ESKD). We report vascular access outcomes of a pilot clinical trial. Study Design: Pilot randomized parallel-group open-label trial. Setting & Participants: Patients 65 years and older with ESKD and no prior AV access receiving maintenance hemodialysis through a tunneled central venous catheter referred for AV access placement by their treating nephrologist. Intervention: Participants were randomly assigned in a 1:1 ratio to surgical placement of an AVG or AVF. Outcomes: Index AV access primary failure, successful cannulation, adjuvant interventions and infections. Results: Of 122 older adults receiving hemodialysis and no prior AV access surgery, 24% died before (n = 18) or were too sick for (n = 11) referral for a permanent AV access. Of 46 eligible patients, 36 (78%) consented and were randomly assigned to AVG (n = 18) and AVF (n = 18) placement, of whom 13 (72%) and 16 (89%) underwent index AV access surgical placement, respectively. At a median follow-up of 321.0 days, primary AV access failure was noted in 31% in each group. The proportion of patients with successful cannulation was 62% (8 of 13) in the AVG and 50% (8 of 16) in the AVF group; median times to successful cannulation were 75.0 and 113.5 days, respectively. Endovascular procedures were recorded in 38% and 44%, and surgical reinterventions, in 23% and 25%, respectively. AV access infection was seen in 3 (23%) and 2 (13%) patients, respectively. Limitations: Small sample size precludes statistical inference. Conclusions: Almost one-quarter of older adults with incident ESKD and a central venous catheter as primary access were not referred for AV access placement due to medical reasons. Based on these limited results, there is little reason to favor either an AVF or AVG in this population until results from a larger randomized clinical trial become available. Funding: Government funding to an author (Dr Murea is supported by National Institutes of Health∖National Institute on Aging grant 1R03 AG060178-01). Trial Registration: NCT03545113.

Many discoveries of active surface processes on Mars have been made due to the availability of repeat high-resolution images from the High Resolution Imaging Science Experiment (HiRISE) onboard the Mars Reconnaissance Orbiter. HiRISE stereo images are used to make digital terrain models (DTMs) and orthorectified images (orthoimages). HiRISE DTMs and orthoimage time series have been crucial for advancing the study of active processes such as recurring slope lineae, dune migration, gully activity, and polar processes. We describe the process of making HiRISE DTMs, orthoimage time series, DTM mosaics, and the difference of DTMs, specifically using the ISIS/SOCET Set workflow. HiRISE DTMs are produced at a 1 and 2 m ground sample distance, with a corresponding estimated vertical precision of tens of cm and ∼1 m, respectively. To date, more than 6000 stereo pairs have been acquired by HiRISE and, of these, more than 800 DTMs and 2700 orthoimages have been produced and made available to the public via the Planetary Data System. The intended audiences of this paper are producers, as well as users, of HiRISE DTMs and orthoimages. We discuss the factors that determine the effective resolution, as well as the quality, precision, and accuracy of HiRISE DTMs, and provide examples of their use in time series analyses of active surface processes on Mars.

The article reflects on the presidency of L.J. Randolph Jr. at the American Council on the Teaching of Foreign Languages (ACTFL), emphasizing his work in promoting professional engagement in language education. Topics discussed include teacher recruitment and retention, the ACTFL Black Language Educators (ABLE) Institute, and opportunities for professional development, including the upcoming ACTFL convention.

Case summary An 8-year-old spayed female domestic shorthair cat was presented for a recheck evaluation of hypertrophic cardiomyopathy and chronic kidney disease. Three years prior to presentation, the patient was diagnosed with obstructive hypertrophic cardiomyopathy and started on atenolol. The left ventricular outflow tract obstruction subsequently resolved. Biochemical analysis a week prior to presentation demonstrated severe azotemia. Transthoracic echocardiograph revealed pericardial effusion, pleural effusion, severe left ventricular concentric hypertrophy, severe left atrial enlargement and continuous left-to-right flow through the interatrial septum near the fossa ovalis. The patient was euthanized owing to poor prognosis, and gross examination at necropsy revealed a valve-incompetent patent foramen ovale secondary to severe left atrial dilation. Relevance and novel information To our knowledge, this is the first report of an acquired left-to-right shunt through a valve-incompetent foramen ovale in a cat with hypertrophic cardiomyopathy. Severe left atrial dilation was suspected to cause interatrial shunting through the valve-incompetent foramen ovale, and this finding may be relevant to echocardiographic evaluations in other cats.

Objective: This study describes the pharmacokinetics of parent pimobendan (PIM) and its active metabolite, o-desmethyl-pimobendan (ODMP), after oral and rectal administration of pimobendan to healthy dogs.Animals: A total of eight healthy privately owned dogs were used in this study.Procedures: The dogs received a single dose (0.5 mg/kg) of a commercially available pimobendan tablet per os (PO). Twelve blood samples were collected over a 12-h period for pharmacokinetic analysis. After a 24-h washout period, the dogs received the same dose of pimobendan solution per rectum (PR), and samples were obtained at the same time for analysis.Results: For PIM, PO vs. PR, respectively, the mean maximum plasma concentration (Cmax, ng/ml) was 49.1 ± 28.7 vs. 10.1 ± 2, the time to reach a maximum concentration (Tmax, h) was 2.1 ± 0.9 vs. 1 ± 0.4, the disappearance half-life (t1/2, h) was 1.8 ± 0.8 vs. 2.2 ± 0.6, and the area under the concentration–time curve (AUC, ng*h/ml) was 148.4 ± 71.6 vs. 31.1 ± 11.9, with relative bioavailability (F, %) of 25 ± 8. For ODMP, PO vs. PR, respectively, Cmax was 30.9 ± 10.4 vs. 8.8 ± 4.8, Tmax was 3.2 ± 1.6 vs. 1.7 ± 1.1, and t1/2 was 5.0 ± 2.7 vs. 8.3 ± 4.8, with AUC of 167.8 ± 36.2 vs. 50.1 ± 19.2 and F of 28 ± 6. The differences between PO and PR were significant (P < 0.03) for AUC and Cmax for both PIM and ODMP.Conclusions and Clinical Relevance: The pharmacokinetics of PIM and ODMP were described following PO and PR administration. The findings suggest that pimobendan PR might achieve effective concentrations and, as such, warrant future studies of clinical effectiveness in treating dogs with congestive heart failure and which are unable to receive medication PO.

Nearly half of all mild brain injury sufferers experience long-term cognitive impairment, so an important goal in rehabilitation is to address their multiple cognitive deficits to help them return to prior levels of functioning. Cognitive training, or the use of repeated mental exercises to enhance cognition, is one remediation method for brain injury. The primary purpose of this hypothesis-generating pilot study was to explore the statistical and clinical significance of cognitive changes and transfer of training to real-life functioning following 60 h of Brain Booster, a clinician-delivered cognitive training program, for six patients with mild traumatic brain injury (TBI) or non-traumatic acquired brain injury (ABI). The secondary purpose was to explore changes in functional connectivity and neural correlates of cognitive test gains following the training. We used a multiple case study design to document significant changes in cognitive test scores, overall IQ score, and symptom ratings; and we used magnetic resonance imaging (MRI) to explore trends in functional network connectivity and neural correlates of cognitive change. All cognitive test scores showed improvement with statistically significant changes on five of the seven measures (long-term memory, processing speed, reasoning, auditory processing, and overall IQ score). The mean change in IQ score was 20 points, from a mean of 108 to a mean of 128. Five themes emerged from the qualitative data analysis including improvements in cognition, mood, social identity, performance, and Instrumental Activities of Daily Living (IADLs). With MRI, we documented significant region-to-region changes in connectivity following cognitive training including those involving the cerebellum and cerebellar networks. We also found significant correlations between changes in IQ score and change in white matter integrity of bilateral corticospinal tracts (CST) and the left uncinate fasciculus. This study adds to the growing body of literature examining the effects of cognitive training for mild TBI and ABI, and to the collection of research on the benefits of cognitive training in general.Clinical Trial Registration:www.ClinicalTrials.gov, identifier NCT02918994.

An 8-year-old intact female Chihuahua was presented for evaluation and possible occlusion of a previously diagnosed patent ductus arteriosus (PDA). Transthoracic echocardiography revealed left ventricular and left atrial enlargement, enlargement of the main pulmonary artery, and a PDA with bidirectional shunting. Tricuspid regurgitant velocities suggested moderate pulmonary hypertension. The PDA was occluded with an Amplatz® Canine Duct Occluder using a transarterial approach on the following day. No immediate complications were observed other than an acute decrease in left ventricular systolic function. One day after the PDA occlusion transthoracic echocardiography revealed no residual ductal flow, but there was spontaneous echocardiographic contrast in the left ventricle. The patient was discharged with sildenafil, pimobendan, and clopidogrel. Five weeks later when the patient was presented for a recheck examination, the previously documented spontaneous echocardiographic contrast was no longer present. Finding spontaneous echocardiographic contrast in the dog has not previously been reported in association with PDA occlusion.

Abstract Background Endothelial progenitor cells (EPCs) contribute to neovascularization and vascular repair in vivo and are attractive for clinical use in ischemic disease. Tracking of stem and progenitor cells is essential to determine engraftment after administration. Semiconductor quantum dots (QD) are promising for cell labeling due to their ease of uptake by many cell lines and their continued presence after many cell generations. The purpose of this study was to evaluate function and growth of equine EPCs after QD labeling. Additionally, this study evaluated the duration of QD label retention and mechanisms of QD label loss. Results Endothelial colony forming cells (ECFCs) from adult horses (N = 3) were employed for this study, with QD labeled and unlabeled ECFCs tested from each horse. Cell proliferation of ECFCs labeled with QD at 20 nM was quantified by comparing the number of cell doublings per day (NCD) and the population doubling time (PDT) in labeled and unlabeled cells. Function of labeled and unlabeled ECFCs was assessed by comparing uptake of acetylated low-density lipoprotein (DiO-Ac-LDL) and tubule formation on growth factor containing matrix. Cell proliferation was not impacted by QD labeling; both NCD (p = 0. 95) and PDT (P = 0. 91) did not differ between unlabeled and QD labeled cells. Function of ECFCs assessed by DiO-Ac-LDL and tubule formation was also not different between unlabeled and QD labeled cells (P = 0. 33 and P = 0. 52, respectively). ECFCs retained their QD labeling over 7 passages with both 5 nM and 20 nM label concentrations. Reduction in label intensity was observed over time, and the mechanism was determined to be cell division. Conclusions Equine ECFCs are effectively labeled with QD, and QD concentrations up to 20 nM do not affect cell growth or function. QD label loss is a result of cell division. The use of QD labeling with equine EPCs may be an ideal way to track engraftment of EPCs for in vivo applications.