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Emergent Transcatheter Tricuspid Edge-to-Edge Repair for Right Ventricular Shock from Tricuspid Regurgitation in Hypertrophic Cardiomyopathy
No full textBackground
Transcatheter tricuspid edge-to-edge repair (T-TEER) is an emerging technology used to treat severe tricuspid regurgitation (TR). The pivotal trials demonstrating the safety and efficacy of T-TEER exclude patients with severely reduced left ventricular function (≤20%).
Case Summary
We demonstrate the use of T-TEER in a patient with end-stage hypertrophic cardiomyopathy who suffered acute, torrential TR and subsequently developed cardiogenic shock as a complication of high-risk transvenous lead extraction. Why Beyond the Guidelines Currently, there are no guidelines addressing the nonsurgical emergent management of acute TR.
Discussion
The TriClip system (Abbott) may have certain advantages when used in managing acute primary TR compared with other valve repair and/or replacement approaches.
Take-Home Message
TriClip can be considered for urgent use to correct severe TR in hemodynamically unstable patients who are not surgical candidates
Program: Virginia Academy of Science 103rd Annual Meeting, 2025
No full textFull program of the 103rd Annual Meeting of the Virginia Academy of Science. Held at the University of Virginia, Charlottesville, Virginia on May 22, 2025
Mission Engineering Competencies Workshop Report: Roles, Responsibilities, and Skills
No full textThis report summarizes the findings of a two-day Old Dominion University Mission Engineering Workshop involving the U.S. Navy, U.S. Marine Corps, U.S. Air Force, National Aeronautics and Space Administration, the University of New South Wales, and Old Dominion University, focused on defining the roles, competencies, and skills essential to Mission Engineering. It presents a structured competency framework and offers recommendations to guide workforce development, training, and cross-agency collaboration in support of complex, mission-driven systems
Sensitivity Analysis of the 197 MHz Prototype Crab Cavity for EIC
No full textThe Electron-Ion Collider at BNL requires several crabbing systems that will be operating at 197 MHz and 394 MHz to compensate for the loss of luminosity due to the large crossing angle of the colliding beams. Two 197 MHz crab cavity cryomodules containing two cavities each will be installed in the Hadron Storage Ring (HSR) at the IP6 interaction region. Due to its large size compared to previously developed crabbing cavities, the 197 MHz crabbing cavity system was identified as one of the critical rf systems in the EIC. Therefore, a cavity has been designed including the ancillaries, and is in the fabrication process, in-house at Jefferson Lab. This cavity will be used to verify the required performance of the first 197 MHz crabbing cavity. Detailed tolerance analysis has been carried out considering cavity operating frequency and HOMs. This paper presents the results from the study in comparison with the achieved tolerances during the fabrication of cavity components
Predicting Cardiovascular Mortality in Hampton Roads using Social Determinants of Health
No full textBackground: In Virginia’s Hampton Roads (HR) region, minority populations experience notably higher mortality rates than white populations. Despite abundant research on the association between social determinants of health (SDOH) and cardiovascular mortality rates at the state and national levels, there is a lack of research examining this association in the HR region.
Objective: The main objective of this study is to train and validate a geospatial-temporal predictive model to examine the association between SDOH and cardiovascular mortality, in the HR region.
Methods: Utilizing a longitudinal dataset (2010–2021) from the Virginia Department of Health and the U.S. Census Bureau, we trained a geospatial-temporal negative binomial regression model to predict cardiovascular mortality. Standardized SDOH variables – such as affordability index, median income, low educational attainment, Townsend index, and low birthweight – were used as fixed-effects, while census tract and year were treated as random-effects. The model was trained on 2010–2019 dataset and validated using 2020–2021 dataset, with accuracy evaluated through root mean square error (RMSE). ArcGIS maps were generated to compare the observed versus and predicted distributions of cardiovascular mortality.
Results: Low educational attainment, Townsend index, and low birthweight were significant predictors of cardiovascular mortality (RMSE = 6.27). Correlations among the SDOH variables ranged from .003 (low) to .474 (moderate) for the model.
Conclusion: This study highlights the influence of SDOH on health disparities, demonstrating their effectiveness in predicting cardiovascular mortality. The results point to the necessity for targeted public health interventions focusing on education, income inequality, and maternal health
Point Cloud-Based Diffusion Models for the Electron-Ion Collider
No full textAt high-energy collider experiments, generative models can be used for a wide range of tasks, including fast detector simulations, unfolding, searches of physics beyond the Standard Model, and inference tasks. In particular, it has been demonstrated that score-based diffusion models can generate high-fidelity and accurate samples of jets or collider events. This work expands on previous generative models in three distinct ways. First, our model is trained to generate entire collider events, including all particle species with complete kinematic information. We quantify how well the model learns event-wide constraints such as the conservation of momentum and discrete quantum numbers. We focus on the events at the future Electron-Ion Collider, but we expect that our results can be extended to proton-proton and heavy-ion collisions. Second, previous generative models often relied on image-based techniques. The sparsity of the data can negatively affect the fidelity and sampling time of the model. We address these issues using point clouds and a novel architecture combining edge creation with transformer modules called Point Edge Transformers. Third, we adapt the foundation model OmniLearn, to generate full collider events. This approach may indicate a transition toward adapting and fine-tuning foundation models for downstream tasks instead of training new models from scratch
Evaluation of CardioMEMS and Kidney Function Preservation in Heart Failure Patients with CKD: A Two-Year Cohort Analysis.
No full textSurface Currents in the Mid-Atlantic Bight: The Role of the Gulf Stream Versus Wind
No full textSurface currents of the Mid-Atlantic Bight (MAB) were studied using high frequency radar (HFR) observations at 6 km resolution during a five-year period (2020-2024). The study\u27s focus on the role of the Gulf Stream (GS) contrasts with most past studies that focused on the seasonal wind-driven currents. Empirical Orthogonal Function (EOF) analyses of the daily HFR currents were conducted with and without the GS, revealing modes of current variability linked to the seasonal wind pattern and storms versus modes linked to GS variability. The remote impact of the GS on coastal currents is complex, with different impacts seen on different parts of the MAB. For example, unusual GS meanders that move close to the coast impact flow variability near the shelf-break front, while other locations may be influenced by the strength of the GS and shift in the mean position of the GS. In general, it was found that monthly wind may be responsible for about 50-80% of the surface current variability over the entire MAB, while the GS position and speed is correlated with the offshore component of the coastal currents and linked to about 10-30% of the current variability. There are also large interannual variations, so that during some years the GS impact on the coast is larger than during other years. Comparison between geostrophic velocity derived from altimeter data and the HFR surface currents shows the influence of the GS path on the offshore currents, however, close to the coast the currents are wind-and river-driven, so that geostrophic currents obtained from altimeter are not reliable. Therefore, combining altimeter and HFR data will provide a better current field than each data set alone. The study demonstrates the usefulness of the HFR data to study coastal dynamics and links between the coast and open ocean variability
Changes in Cardiovascular Risk Factors and Health Care Expenditures Among Patients Prescribed Semaglutide
No full textImportance Semaglutide, a glucagon-like peptide-1 receptor agonist, has demonstrated substantial weight reduction and cardiovascular benefits in clinical trials. However, its association with clinical outcomes and health care expenditures remains underexplored.
Objective To evaluate changes in cardiovascular risk factors and health care expenditures among patients prescribed semaglutide across multicenter cohorts.
Design, Setting, and Participants This retrospective cohort study included 23 522 adults (≥18 years) who received an initial semaglutide prescription between January 1, 2018, and January 1, 2025, at Sentara Healthcare and between January 1, 2018, and May 1, 2025, at Yale New Haven Health System.
Exposure The first prescription of semaglutide identified at the ingredient level, stratified by type 2 diabetes status.
Main outcomes and measures Primary outcomes included changes in weight (% baseline), blood pressure (BP), total cholesterol, and hemoglobin A₁c. Secondary outcomes assessed health care expenditures using Medicare-based cost estimates. A staggered difference-in-differences design compared outcomes of patients after the first semaglutide prescription with those of patients who had not yet received their prescription during the same period.
Results The study cohort included 23 522 patients (mean [SD] age at initiation of semaglutide, 56.2 [12.9] years; 66.7% female; 68.6% with diabetes). In the overall cohort, initiation of semaglutide was significantly associated with a -3.8% (95% CI, -3.9% to -3.7%) reduction in weight at 13 to 24 months, with a -5.1% (95% CI, -5.5% to -4.7%) reduction in weight among patients without diabetes. Significant reductions in diastolic BP (-1.5 mm Hg; 95% CI, -1.7 to -1.4 mm Hg), systolic BP (-1.1 mm Hg; 95% CI, -1.4 to -0.8 mm Hg), and total cholesterol (-12.8 mg/dL; 95% CI, -14.3 to -11.4 mg/dL) were also observed. Hemoglobin A₁c reductions were greater among patients with diabetes (-0.3%; 95% CI, -0.3% to -0.2%) compared with patients without diabetes (-0.1%; 95% CI, -0.2% to -0.01%). Imputed health care expenditures, excluding the cost of semaglutide, increased by 68-$92 per month) during the 13- to 24-month period, which was associated with inpatient stays shifting to more expensive circulatory and metabolic diagnoses.
Conclusions and relevance In this cohort study of adults prescribed semaglutide, initiation was associated with reductions in weight and cardiovascular risk factors but increases in health care expenditures, excluding semaglutide costs. These findings suggest potential clinical benefits in routine practice, while highlighting the need to evaluate the long-term impact of semaglutide on economic outcomes
A Multispecies, Multisite Assessment of Coral Thermal Tolerances in American Samoa, Using Acute Heat Stress Assays
No full textReef-building corals are being impacted by increasing seawater temperatures, with marine heatwaves leading to mass bleaching events and extensive mortality. However, corals can display variation in thermal tolerance, both within and among species. In this study, we sampled four coral species (Acropora hyacinthus, Montipora grisea, Pocillopora verrucosa, and Porites lobata) from two sites on Tutuila, American Samoa, with contrasting environmental regimes but similar Maximum Monthly Means (MMM). Coral fragments were subjected to short-term acute heat stress experiments using the Coral Bleaching Automated Stress System (CBASS). PAM Fluorometry was used to measure the symbiont’s effective quantum yield (Fv/Fm) following heat stress and calculate colony-level ED50s (Effective Dose temperature at which Fv/Fm declined by 50% relative to initial values), interpreted as a thermal threshold of corals. Thermal thresholds primarily varied among species, with M. grisea and P. verrucosa displaying the lowest ED50s (36.29°C and 36.47°C respectively) of the assayed corals. P. lobata from both sites had the highest ED50s (37.07°C and 36.79°C), aligning with previous findings that massive Porites spp. often display higher resilience to environmental stress relative to other species. Importantly, these ED50s are 7.5– 8.5°C above the historical MMMs for the area, which are among the highest relative ED50s measured to date across assayed Indo-Pacific sites. Overall, our approach demonstrates the value of acute thermal assays as a time- and cost-effective approach to determining coral thermal performances and identifying corals for potential use in conservation and restoration efforts