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Some patients with obstructive hypertrophic cardiomyopathy may remain limited after surgical relief of the subaortic obstruction. In this report, we describe experience in surgical management of patients with advanced diastolic heart failure symptoms after adequate transaortic septal myectomy for obstructive hypertrophic cardiomyopathy.

We identified adult patients who presented with heart failure symptoms after previous transaortic septal myectomy for obstructive hypertrophic cardiomyopathy and underwent repeat sternotomy for transapical myectomy to enlarge a small left ventricular cavity. Functional recovery after hospital dismissal was assessed through a questionnaire-based survey.

Six patients with previous septal myectomy presented with New York Heart Association functional class III symptoms. Preoperative transthoracic Doppler echocardiography confirmed adequate relief of subaortic outflow tract obstruction with only trivial or mild mitral valve regurgitation; left atrial volume index was increaseeration due to excessive myocardial hypertrophy. Repeat transapical myectomy can enlarge the left ventricular chamber and augment the diastolic volume, which results in improved physical capacity and patient-perceived functional status.This protocol uses the Tg4 Nr4a3-Tocky mouse model to recalibrate T cell activation thresholds and reveals the role that immune checkpoints play in controlling T cell activation. The example approach here uses flow cytometry to characterize quantitative and qualitative changes in splenic CD4+ T cells reactivated in the presence of anti-PD1 immunotherapy. The protocol is optimized for studying anti-PD1 pathway blockade only. The protocol is not compatible with cellular fixation, and T cells should be analyzed immediately after staining. For complete details on the use and execution of this protocol, please refer to Elliot et al. (2021).Electron microscopy (EM) is considered the gold standard for studying macroautophagy and mitophagy, essential cellular processes for brain health. Here, we present a protocol using EM to analyze autophagosomes and mitophagosomes in the mouse amygdala. We describe the preparation of brain sections, followed by staining and EM imaging. We then detail the steps to identify and analyze autophagosome-like and mitophagosome-like structures. This protocol can be easily adapted to analyze autophagosomes and mitophagosomes in other mouse brain regions. For complete details on the use and execution of this protocol, please refer to Duan et al. (2021).LUTIs (Long Undecoded Transcript Isoforms) are 5'-extended and poorly translated mRNAs that can downregulate transcription from promoters more proximal to a gene's coding sequence (CDS). In this protocol, polyA RNA is extracted from budding yeast cells undergoing highly synchronized meiosis. Using a combination of long-read direct RNA sequencing and transcript leader sequencing (TL-seq), meiosis-specific LUTIs are systematically identified. Following identification, TL-seq is used to quantify the abundance of both LUTI and the more canonical gene-proximal (PROX) transcripts. For complete details on the use and execution of this protocol, please refer to Tresenrider et al. (2021).Studies of animals native to high altitude can provide valuable insight into physiological mechanisms and evolution of performance in challenging environments. We investigated how mechanisms controlling cardiovascular function may have evolved in deer mice (Peromyscus maniculatus) native to high altitude. High-altitude deer mice and low-altitude white-footed mice (P. leucopus) were bred in captivity at sea level, and first-generation lab progeny were raised to adulthood and acclimated to normoxia or hypoxia. We then used pharmacological agents to examine the capacity for adrenergic receptor stimulation to modulate heart rate (f H) and mean arterial pressure (P mean) in anaesthetized mice, and used cardiac pressure-volume catheters to evaluate the contractility of the left ventricle. We found that highlanders had a consistently greater capacity to increase f H via pharmacological stimulation of β1-adrenergic receptors than lowlanders. Also, whereas hypoxia acclimation reduced the capacity for increasing P mean in response to α-adrenergic stimulation in lowlanders, highlanders exhibited no plasticity in this capacity. These differences in highlanders may help augment cardiac output during locomotion or cold stress, and may preserve their capacity for α-mediated vasoconstriction to more effectively redistribute blood flow to active tissues. Highlanders did not exhibit any differences in some measures of cardiac contractility (maximum pressure derivative, dP/dtmax, or end-systolic elastance, Ees), but ejection fraction was highest in highlanders after hypoxia acclimation. selleck products Overall, our results suggest that evolved changes in sensitivity to adrenergic stimulation of cardiovascular function may help deer mice cope with the cold and hypoxic conditions at high altitude.The automatic segmentation of ears in wheat canopy images is an important step to measure ear density or extract relevant plant traits separately for the different organs. Recent deep learning algorithms appear as promising tools to accurately detect ears in a wide diversity of conditions. However, they remain complicated to implement and necessitate a huge training database. This paper is aimed at proposing an easy and quick to train and robust alternative to segment wheat ears from heading to maturity growth stage. The tested method was based on superpixel classification exploiting features from RGB and multispectral cameras. Three classifiers were trained with wheat images acquired from heading to maturity on two cultivars at different levels of fertilizer. The best classifier, the support vector machine (SVM), yielded satisfactory segmentation and reached 94% accuracy. However, the segmentation at the pixel level could not be assessed only by the superpixel classification accuracy. For this reason, a second assessment method was proposed to consider the entire process. A simple graphical tool was developed to annotate pixels. The strategy was to annotate a few pixels per image to be able to quickly annotate the entire image set, and thus account for very diverse conditions. Results showed a lesser segmentation score (F1-score) for the heading and flowering stages and for the zero nitrogen input object. The methodology appeared appropriate for further work on the growth dynamics of the different wheat organs and in the frame of other segmentation challenges.Flame-retardant and thermal management structures have attracted great attention due to the requirement of high-temperature exposure in industrial, aerospace, and thermal power fields, but the development of protective fire-retardant structures with complex shapes to fit arbitrary surfaces is still challenging. Herein, we reported a rotation-blade casting-assisted 3D printing process to fabricate nacre-inspired structures with exceptional mechanical and flame-retardant properties, and the related fundamental mechanisms are studied. 3-(Trimethoxysilyl)propyl methacrylate (TMSPMA) modified boron nitride nanoplatelets (BNs) were aligned by rotation-blade casting during the 3D printing process to build the "brick and mortar" architecture. The 3D printed structures are more lightweight, while having higher fracture toughness than the natural nacre, which is attributed to the crack deflection, aligned BN (a-BNs) bridging, and pull-outs reinforced structures by the covalent bonding between TMSPMA grafted a-BNs and polymer matrix. Thermal conductivity is enhanced by 25.5 times compared with pure polymer and 5.8 times of anisotropy due to the interconnection of a-BNs. 3D printed heat-exchange structures with vertically aligned BNs in complex shapes were demonstrated for efficient thermal control of high-power light-emitting diodes. 3D printed helmet and armor with a-BNs show exceptional mechanical and fire-retardant properties, demonstrating integrated mechanical and thermal protection.Sodium metal anodes (SMAs) suffer from extremely low reversibility (1 μm with addition of FEC upon the threshold value. A highly crystalline and much thinner (~40 nm) solid-electrolyte interphase (SEI) is consequently observed to uniformly wrap the Na surface, in contrast to the severely corroded Na as retrieved from the blank electrolyte. The potence of FEC is further demonstrated in a series of "corrosive solvents" such as ethyl acetate (EA), trimethyl phosphate (TMP), and acetonitrile (AN), enabling highly reversible SMAs in the otherwise unusable solvent systems.To adapt one's behavior, in a timely manner, to an environment that changes in many different aspects, one must be sensitive to uncertainty about each aspect of the environment. Although the medial prefrontal cortex has been implicated in the representation and reduction of a variety of uncertainties, it is unknown whether different types of uncertainty are distinguished by distinct neuronal populations. To investigate how the prefrontal cortex distinguishes between different types of uncertainty, we recorded neuronal activities from the medial and lateral prefrontal cortices of monkeys performing a visual feedback-based action-learning task in which uncertainty of coming feedback and that of context change varied asynchronously. We found that the activities of two groups of prefrontal cells represented the two different types of uncertainty. These results suggest that different types of uncertainty are represented by distinct neural populations in the prefrontal cortex.Left hemispheric cerebral stroke can cause apraxia, a motor cognitive disorder characterized by deficits of higher-order motor skills such as the failure to accurately produce meaningful gestures. This disorder provides unique insights into the anatomical and cognitive architecture of the human praxis system. The present study aimed to map the structural brain network that is damaged in apraxia. We assessed the ability to perform meaningful gestures with the hand in 101 patients with chronic left hemisphere stroke. Structural white matter fibre damage was directly assessed by diffusion tensor imaging and fractional anisotropy mapping. We used multivariate topographical inference on tract-based fractional anisotropy topographies to identify white matter disconnection associated with apraxia. We found relevant pathological white matter alterations in a densely connected fronto-temporo-parietal network of short and long association fibres. Hence, the findings suggest that heterogeneous topographical results in previous lesion mapping studies might not only result from differences in study design, but also from the general methodological limitations of univariate topographical mapping in uncovering the structural praxis network. A striking role of middle and superior temporal lobe disconnection, including temporo-temporal short association fibres, was found, suggesting strong involvement of the temporal lobe in the praxis network. Further, the results stressed the importance of subcortical disconnections for the emergence of apractic symptoms. Our study provides a fine-grain view into the structural connectivity of the human praxis network and suggests a potential value of disconnection measures in the clinical prediction of behavioural post-stroke outcome.