Phosphine Generation Pathways on Rocky Planets.

The possibility of life in the venusian clouds was proposed in the 1960s, and recently this hypothesis has been revived with the potential detection of phosphine (PH3) in Venus' atmosphere. These observations may have detected ∼5-20 ppb phosphine on Venus (Greaves et al., 2020), which raises questions about venusian atmospheric/geochemical processes and suggests that this phosphine could possibly be generated by biological processes. In such a claim, it is essential to understand the abiotic phosphorus chemistry that may occur under Venus-relevant conditions, particularly those processes that may result in phosphine generation. Here, we discuss two related abiotic routes for phosphine generation within the atmosphere of Venus. Based on our assessment, corrosion of large impactors as they ablate near Venus' cloud layer, and the presence of reduced phosphorus compounds in the subcloud layer could result in production of phosphine and may explain the phosphine detected in Venus' atmosphere or on other rocky planets. We end on a cautionary note: although there may be life in the clouds of Venus, the detection of a simple, single gas, phosphine, is likely not a decisive indicator.

Cryosurgery for Atrial Fibrillation: Physiologic Basis for Creating Optimal Cryolesions.

BACKGROUND: Although cryosurgery has been used to treat cardiac arrhythmias for nearly 5 decades, the mechanism of action and the surgical technique that produces optimal cryolesions for the treatment of atrial fibrillation are still poorly understood. This has resulted in surgical outcomes that can be improved by a better understanding the mechanisms of cryothermia ablation and the proper surgical techniques that take advantage of those mechanisms. METHODS: The cryobiology underlying cryosurgical ablation is described, as are the nuances of cryosurgical techniques that ensure the reliable creation of contiguous, uniformly transmural atrial cryolesions. The oft-misunderstood "2-minute rule" for the application of cryothermia is clarified in detail, along with its variations that depend on target myocardial temperature. RESULTS: The creation of optimal cryolesions depends on cryoprobe temperature, the temperature of the target myocardium, the duration of cryothermia application, and the presence or absence of a "heat sink" or "cooling sink" created by intracavitary blood circulation. Cryothermia kills myocardial cells during both the freezing and thawing phases of cryoablation cycle. The critical lethal temperature for myocardium is -30°C. The slower the target tissue thaws, the higher the percentage of cell death. CONCLUSIONS: The availability of cryosurgical techniques has revolutionized the surgical treatment of atrial fibrillation. By utilizing modern cryosurgical devices and adhering to the technical principles described, surgeons can now perform surgical procedures for atrial fibrillation that are quicker, safer, and as effective as the standard Maze-III/IV procedure.

Caveats to Exogenous Organic Delivery from Ablation, Dilution, and Thermal Degradation.

A hypothesis in prebiotic chemistry argues that organics were delivered to the early Earth in abundance by meteoritic sources. This study tests that hypothesis by measuring how the transfer of organic matter to the surface of Earth is affected by energy-dissipation processes such as ablation and airbursts. Exogenous delivery has been relied upon as a source of primordial material, but it must stand to reason that other avenues (i.e., hydrothermal vents, electric discharge) played a bigger role in the formation of life as we know it on Earth if exogenous material was unable to deliver significant quantities of organics. For this study, we look at various properties of meteors such as initial velocity and mass of the object, and atmospheric composition to see how meteors with different initial velocities and masses ablate. We find that large meteors do not slow down fast enough and thus impact the surface, vaporizing their components; fast meteors with low masses are vaporized during entry; and meteors with low velocities and high initial masses reach the surface. For those objects that survive to reach the surface, about 60 to >99% of the mass is lost by ablation. Large meteors that fragment are also shown to spread out over increasingly larger areas with increasing mass, and small meteors (~1 mm) are subjected to intense thermal heating, potentially degrading intrinsic organics. These findings are generally true across most atmospheric compositions. These findings provide several caveats to extraterrestrial delivery models that—while a viable point source of organics—likely did not supply as much prebiotic material as an effective endogenous production route.

The addition of hemiarch replacement to aortic root surgery does not affect safety.

OBJECTIVES: A hemiarch reconstruction, using deep hypothermic circulatory arrest, is the conventional approach for proximal aortic arch reconstruction, but it carries risks of neurologic events and coagulopathy. The addition of a hemiarch reconstruction to an aortic root replacement may prevent future aortic arch pathology. Outcomes of this approach at a tertiary care institution were examined to determine whether the addition of a hemiarch reconstruction to an aortic root replacement conferred any additional risk. METHODS: A total of 384 patients underwent an aortic root replacement between April 2004 and June 2012. Of them, 177 (46%) had hemiarch replacement. Propensity score matching yielded 133 pairs of patients receiving hemiarch and non-hemiarch. RESULTS: Sinus segment diameter was similar between groups; ascending aortic diameter was greater in the hemiarch group (median 50 vs 44 mm; P < .001). The hemiarch group had longer perfusion (median 186 vs 120.5 minutes; P < .001) and crossclamp times (median 140 vs 104 minutes; P < .001); median circulatory arrest was 13 minutes. There was no difference, hemiarch versus no hemiarch, in 30-day mortality (3.0% vs 1.5%; P = .41), stroke (2.3% vs 4.5%; P = .31), reoperation for bleeding (11% vs 10%; P = .84), or overall survival (5-year 88.0% [95% confidence interval, 81.9-94.0] vs 91.4% [95% confidence interval, 85.8-96.9], P = .24). CONCLUSIONS: In this series, aortic root replacement ± hemiarch reconstruction had low mortality. Addition of hemiarch replacement extended perfusion times but not at the expense of safety. Hemiarch reconstruction should be performed when the aortic root aneurysm extends into the distal ascending aorta.

Pulseless electrical activity in cardiac arrest: electrocardiographic presentations and management considerations based on the electrocardiogram.

Pulseless electrical activity (PEA), a cardiac arrest rhythm scenario with an associated poor prognosis, is defined as cardiac electrical activity without a palpable pulse. Considering both outpatient and inpatient cardiac arrest presentations, PEA as a rhythm group has been increasing over the past 10 to 20 years with a corresponding decrease in the "shockable" rhythms, such as pulseless ventricular tachycardia and ventricular fibrillation. This review focuses on electrocardiographic findings encountered in PEA cardiac arrest presentations with an emphasis on recognition of patients with a potential opportunity for successful resuscitation.