Sensitivity analysis of geometrical parameters to study haemodynamics and thrombus formation in the left atrial appendage.

PubMed

García-Isla, Guadalupe; Olivares, Andy Luis; Silva, Etelvino; Nuñez-Garcia, Marta; Butakoff, Constantine; Sanchez-Quintana, Damian; G Morales, Hernán; Freixa, Xavier; Noailly, Jérôme; De Potter, Tom; Camara, Oscar

2018-05-08

The left atrial appendage (LAA) is a complex and heterogeneous protruding structure of the left atrium (LA). In atrial fibrillation patients, it is the location where 90% of the thrombi are formed. However, the role of the LAA in thrombus formation is not fully known yet. The main goal of this work is to perform a sensitivity analysis to identify the most relevant LA and LAA morphological parameters in atrial blood flow dynamics. Simulations were run on synthetic ellipsoidal left atria models where different parameters were individually studied: pulmonary veins and mitral valve dimensions; LAA shape; and LA volume. Our computational analysis confirmed the relation between large LAA ostia, low blood flow velocities and thrombus formation. Additionally, we found that pulmonary vein configuration exerted a critical influence on LAA blood flow patterns. These findings contribute to a better understanding of the LAA and to support clinical decisions for atrial fibrillation patients. Copyright © 2018 John Wiley & Sons, Ltd.

The effect of different atrioventricular delays on left atrium and left atrial appendage function in patients with DDD pacemaker.

PubMed

Kanadaşı, Mehmet; Caylı, Murat; Sahin, Durmuş Yıldıray; Sen, Ömer; Koç, Mevlüt; Usal, Ayhan; Batur, Mustafa Kemal; Demirtaş, Mustafa

2011-07-01

Although it has been known that optimization of atrioventricular delay (AVD) has favorable effect on the left ventricular functions in patients with DDD pacemaker, the effect of different AVDs on left atrium (LA) and left atrial appendage (LAA) functions has not been exactly evaluated. The aim of the present study was to assess the effect of different AVDs on LA and LAA functions in DDD pacemaker implanted patients with atrioventricular block. Forty-eight patients with DDD pacemaker were enrolled into the study. Patients were divided into two groups according to the echocardiographic diastolic function: Group I (normal diastolic function) and Group II (diastolic dysfunction). LAA emptying velocity on pulsed wave Doppler and LAA late systolic wave velocity by using tissue Doppler were recorded. Patients were paced for five successive continuous pacing periods of 10 minutes duration using five selective AVDs (80-250 ms). Significant effect on LA and LAA functions has not been observed by the setting of AVD in Group I. However, when the AVD was gradually shortened form 150 ms to 80 ms, LA and LAA functions gradually decreased in Group II patients. When AVD increased to 200 ms, LA and LAA functions were improved. Further increase in AVD resulted in decreased LA and LAA functions. Setting of AVD has not significant effect on the LA and LAA functions in patients with normal diastolic function, but moderate prolongation of AVD in physiological limits improved LA and LAA functions in DDD pacemaker implanted patients with diastolic dysfunction. © 2011, Wiley Periodicals, Inc.

Vitamin-C delivery from CoCr alloy surfaces using polymer-free and polymer-based platforms for cardiovascular stent applications.

PubMed

Thiruppathi, Eagappanath; Mani, Gopinath

2014-06-03

Antiproliferative drugs such as paclitaxel and sirolimus are delivered from stents to inhibit the growth of smooth muscle cells (SMCs) for preventing neointimal hyperplasia. However, these drugs delay the growth of endothelial cells (ECs) as well and cause late stent thrombosis. We recently demonstrated the use of Vitamin-C (l-ascorbic acid, l-AA) over paclitaxel and sirolimus for inhibiting SMCs growth and promoting EC growth simultaneously. In this study, we have investigated the delivery of l-AA from CoCr alloy surfaces for potential use in stents. A polymer-free phosphoric acid (PA) platform and a polymer-based poly(lactic-co-glycolic acid) (PLGA) platform were used for coating l-AA onto CoCr surfaces. For the PA platform, FTIR confirmed that the PA was coated on CoCr, while the AFM showed that the PA coating on the CoCr surface was homogeneous. The successful deposition of l-AA on PA-coated CoCr was also confirmed by FTIR. The uniform distribution of l-AA crystals on PA-coated CoCr was shown by SEM, optical profilometer, and AFM. The drug release studies showed that l-AA (276 μg/cm(2)) was burst released from the PA platform by 1 h. For the PLGA platform, SEM showed that the l-AA incorporated polymer films were smoothly and uniformly coated on CoCr. FTIR showed that l-AA was incorporated into the bulk of the PLGA film. DSC showed that the l-AA was present in an amorphous form and formed an intermolecular bonding interaction with PLGA. The drug release studies showed that l-AA was sustained released from the PLGA coated CoCr for up to 24 h. The SEM, FTIR, and DSC characterizations of samples collected post drug release shed light on the mechanism of l-AA release from PLGA coated CoCr. Thus, this study demonstrated the delivery of l-AA from biomaterial surfaces for potential applications in stents and other implantable medical devices.

Left atrial appendage segmentation and quantitative assisted diagnosis of atrial fibrillation based on fusion of temporal-spatial information.

PubMed

Jin, Cheng; Feng, Jianjiang; Wang, Lei; Yu, Heng; Liu, Jiang; Lu, Jiwen; Zhou, Jie

2018-05-01

In this paper, we present an approach for left atrial appendage (LAA) multi-phase fast segmentation and quantitative assisted diagnosis of atrial fibrillation (AF) based on 4D-CT data. We take full advantage of the temporal dimension information to segment the living, flailed LAA based on a parametric max-flow method and graph-cut approach to build 3-D model of each phase. To assist the diagnosis of AF, we calculate the volumes of 3-D models, and then generate a "volume-phase" curve to calculate the important dynamic metrics: ejection fraction, filling flux, and emptying flux of the LAA's blood by volume. This approach demonstrates more precise results than the conventional approaches that calculate metrics by area, and allows for the quick analysis of LAA-volume pattern changes of in a cardiac cycle. It may also provide insight into the individual differences in the lesions of the LAA. Furthermore, we apply support vector machines (SVMs) to achieve a quantitative auto-diagnosis of the AF by exploiting seven features from volume change ratios of the LAA, and perform multivariate logistic regression analysis for the risk of LAA thrombosis. The 100 cases utilized in this research were taken from the Philips 256-iCT. The experimental results demonstrate that our approach can construct the 3-D LAA geometries robustly compared to manual annotations, and reasonably infer that the LAA undergoes filling, emptying and re-filling, re-emptying in a cardiac cycle. This research provides a potential for exploring various physiological functions of the LAA and quantitatively estimating the risk of stroke in patients with AF. Copyright © 2018 Elsevier Ltd. All rights reserved.

Evaluation of the Obesity Genes FTO and MC4R for Contribution to the Risk of Large Artery Atherosclerotic Stroke in a Chinese Population

PubMed Central

Song, Zhi; Qiu, Lingling; Hu, Zhongyang; Liu, Jia; Liu, Ding; Hou, Deren

2016-01-01

Background Obesity is a well-established risk factor for large artery atherosclerotic (LAA) stroke. The aim of the study was to explore whether obesity genes, such as MC4R and FTO, contribute to LAA stroke risk in the Chinese Han population. Methods 322 LAA stroke patients and 473 controls were recruited. Gene polymorphism of MC4R (rs17782313) and FTO (rs8050136 and rs9939609) were genotyped. Results No differences were observed in genotype frequencies of variants of FTO (rs8050136 and rs9939609) or MC4R (rs17782313) between LAA stroke patients and control subjects. However, rs17782313 of the MC4R gene was associated with LAA stroke susceptibility in smokers (rs17782313: p = 0.020, OR (95s% CI) = 1.55 (1.07–2.23)) in the stratified analysis. Furthermore, multifactor dimensionality reduction analysis revealed that the combination of MC4R variant (rs17782313), hypertension and smoking habit was significantly associated with increased risk of LAA stroke (p < 0.0001, OR (95s% CI) = 6.57 (4.79–9.01)). Conclusion Our study indicated that the synergistic effects of MC4R variants, hypertension, and smoking habit contribute significantly to the risk of LAA stroke in the Chinese Han population. The finding revealed that obesity gene MC4R contribute to the risk of LAA stroke via a synergistic mechanism, which will provide new insight into the genetic architecture of LAA stroke. PMID:27701175

Evaluation of the Obesity Genes FTO and MC4R for Contribution to the Risk of Large Artery Atherosclerotic Stroke in a Chinese Population.

PubMed

Song, Zhi; Qiu, Lingling; Hu, Zhongyang; Liu, Jia; Liu, Ding; Hou, Deren

2016-01-01

Obesity is a well-established risk factor for large artery atherosclerotic (LAA) stroke. The aim of the study was to explore whether obesity genes, such as MC4R and FTO, contribute to LAA stroke risk in the Chinese Han population. 322 LAA stroke patients and 473 controls were recruited. Gene polymorphism of MC4R (rs17782313) and FTO (rs8050136 and rs9939609) were genotyped. No differences were observed in genotype frequencies of variants of FTO (rs8050136 and rs9939609) or MC4R (rs17782313) between LAA stroke patients and control subjects. However, rs17782313 of the MC4R gene was associated with LAA stroke susceptibility in smokers (rs17782313: p = 0.020, OR (95% CI) = 1.55 (1.07-2.23)) in the stratified analysis. Furthermore, multifactor dimensionality reduction analysis revealed that the combination of MC4R variant (rs17782313), hypertension and smoking habit was significantly associated with increased risk of LAA stroke (p < 0.0001, OR (95% CI) = 6.57 (4.79-9.01)). Our study indicated that the synergistic effects of MC4R variants, hypertension, and smoking habit contribute significantly to the risk of LAA stroke in the Chinese Han population. The finding revealed that obesity gene MC4R contribute to the risk of LAA stroke via a synergistic mechanism, which will provide new insight into the genetic architecture of LAA stroke. © 2016 The Author(s) Published by S. Karger GmbH, Freiburg.

Development of digital phantoms based on a finite element model to simulate low-attenuation areas in CT imaging for pulmonary emphysema quantification.

PubMed

Diciotti, Stefano; Nobis, Alessandro; Ciulli, Stefano; Landini, Nicholas; Mascalchi, Mario; Sverzellati, Nicola; Innocenti, Bernardo

2017-09-01

To develop an innovative finite element (FE) model of lung parenchyma which simulates pulmonary emphysema on CT imaging. The model is aimed to generate a set of digital phantoms of low-attenuation areas (LAA) images with different grades of emphysema severity. Four individual parameter configurations simulating different grades of emphysema severity were utilized to generate 40 FE models using ten randomizations for each setting. We compared two measures of emphysema severity (relative area (RA) and the exponent D of the cumulative distribution function of LAA clusters size) between the simulated LAA images and those computed directly on the models output (considered as reference). The LAA images obtained from our model output can simulate CT-LAA images in subjects with different grades of emphysema severity. Both RA and D computed on simulated LAA images were underestimated as compared to those calculated on the models output, suggesting that measurements in CT imaging may not be accurate in the assessment of real emphysema extent. Our model is able to mimic the cluster size distribution of LAA on CT imaging of subjects with pulmonary emphysema. The model could be useful to generate standard test images and to design physical phantoms of LAA images for the assessment of the accuracy of indexes for the radiologic quantitation of emphysema.

Correlation of right atrial appendage velocity with left atrial appendage velocity and brain natriuretic Peptide.

PubMed

Kim, Bu-Kyung; Heo, Jung-Ho; Lee, Jae-Woo; Kim, Hyun-Soo; Choi, Byung-Joo; Cha, Tae-Joon

2012-03-01

Left atrial appendage (LAA) anatomy and function have been well characterized both in healthy and diseased people, whereas relatively little attention has been focused on the right atrial appendage (RAA). We sought to evaluate RAA flow velocity and to compare these parameters with LAA indices and with a study of biomarkers, such as brain natriuretic peptide, among patients with sinus rhythm (SR) and atrial fibrillation (AF). In a series of 79 consecutive patients referred for transesophageal echocardiography, 43 patients (23 with AF and 20 controls) were evaluated. AF was associated with a decrease in flow velocity for both LAA and RAA [LAA velocity-SR vs. AF: 61 ± 22 vs. 29 ± 18 m/sec (p < 0.01), RAA velocity-SR vs. AF: 46 ± 20 vs. 19 ± 8 m/sec (p < 0.01)]. Based on simple linear regression analysis, LAA velocity and RAA velocity were positively correlated, and RAA velocity was inversely correlated with brain natriuretic peptide (BNP). AF was associated with decreased RAA and LAA flow velocities. RAA velocity was found to be positively correlated with LAA velocity and negatively correlated with BNP. The plasma BNP concentration may serve as a determinant of LAA and RAA functions.

The left atrial appendage: from embryology to prevention of thromboembolism.

PubMed

Patti, Giuseppe; Pengo, Vittorio; Marcucci, Rossella; Cirillo, Plinio; Renda, Giulia; Santilli, Francesca; Calabrò, Paolo; De Caterina, Alberto Ranieri; Cavallari, Ilaria; Ricottini, Elisabetta; Parato, Vito Maurizio; Zoppellaro, Giacomo; Di Gioia, Giuseppe; Sedati, Pietro; Cicchitti, Vincenzo; Davì, Giovanni; Golia, Enrica; Pariggiano, Ivana; Simeone, Paola; Abbate, Rosanna; Prisco, Domenico; Zimarino, Marco; Sofi, Francesco; Andreotti, Felicita; De Caterina, Raffaele

2017-03-21

The left atrial appendage (LAA) is the main source of thromboembolism in patients with non-valvular atrial fibrillation (AF). As such, the LAA can be the target of specific occluding device therapies. Optimal management of patients with AF includes a comprehensive knowledge of the many aspects related to LAA structure and thrombosis. Here we provide baseline notions on the anatomy and function of the LAA, and then focus on current imaging tools for the identification of anatomical varieties. We also describe pathogenetic mechanisms of LAA thrombosis in AF patients, and examine the available evidence on treatment strategies for LAA thrombosis, including the use of non-vitamin K antagonist oral anticoagulants and interventional approaches. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

Low levels of exposure to libby amphibole asbestos and localized pleural thickening.

PubMed

Christensen, Krista Yorita; Bateson, Thomas F; Kopylev, Leonid

2013-11-01

To explore the relationship between low levels of exposure to Libby amphibole asbestos (LAA) and pleural abnormalities, specifically localized pleural thickening (LPT). Three studies presenting the risks associated with quantitative LAA exposure estimates were reviewed, paying particular attention to lower exposure ranges. Studies reviewed were conducted among workers exposed to LAA at mining and milling operations in Libby, Montana, at a vermiculite processing facility in Marysville, Ohio, and community residents exposed to LAA from a vermiculite processing facility in Minneapolis, Minnesota. Pleural abnormalities were evaluated using radiographs. Despite differences in study populations and design, each study found that cumulative inhalation LAA exposure was associated with increased risk of LPT even at low levels of exposure. Inhalation exposure to LAA is associated with increased risk of LPT even at the lowest levels of exposure in each study.

Generative statistical modeling of left atrial appendage appearance to substantiate clinical paradigms for stroke risk stratification

NASA Astrophysics Data System (ADS)

Sanatkhani, Soroosh; Menon, Prahlad G.

2018-03-01

Left atrial appendage (LAA) is the source of 91% of the thrombi in patients with atrial arrhythmias ( 2.3 million US adults), turning this region into a potential threat for stroke. LAA geometries have been clinically categorized into four appearance groups viz. Cauliflower, Cactus, Chicken-Wing and WindSock, based on visual appearance in 3D volume visualizations of contrast-enhanced computed tomography (CT) imaging, and have further been correlated with stroke risk by considering clinical mortality statistics. However, such classification from visual appearance is limited by human subjectivity and is not sophisticated enough to address all the characteristics of the geometries. Quantification of LAA geometry metrics can reveal a more repeatable and reliable estimate on the characteristics of the LAA which correspond with stasis risk, and in-turn cardioembolic risk. We present an approach to quantify the appearance of the LAA in patients in atrial fibrillation (AF) using a weighted set of baseline eigen-modes of LAA appearance variation, as a means to objectify classification of patient-specific LAAs into the four accepted clinical appearance groups. Clinical images of 16 patients (4 per LAA appearance category) with atrial fibrillation (AF) were identified and visualized as volume images. All the volume images were rigidly reoriented in order to be spatially co-registered, normalized in terms of intensity, resampled and finally reshaped appropriately to carry out principal component analysis (PCA), in order to parametrize the LAA region's appearance based on principal components (PCs/eigen mode) of greyscale appearance, generating 16 eigen-modes of appearance variation. Our pilot studies show that the most dominant LAA appearance (i.e. reconstructable using the fewest eigen-modes) resembles the Chicken-Wing class, which is known to have the lowest stroke risk per clinical mortality statistics. Our findings indicate the possibility that LAA geometries with high

Left atrial appendage dimensions predict the risk of stroke/TIA in patients with atrial fibrillation.

PubMed

Beinart, Roy; Heist, E Kevin; Newell, John B; Holmvang, Godtfred; Ruskin, Jeremy N; Mansour, Moussa

2011-01-01

Risk of Stroke/TIA in Patients With Atrial Fibrillation. Most strokes in patients with atrial fibrillation (AF) arise from thrombus formation in left atrial appendage (LAA). Our aim was to identify LAA features associated with a higher stroke risk in patients with AF using magnetic resonance imaging and angiography (MRI/MRA). The study included 144 patients with nonvalvular AF who were not receiving warfarin and who underwent MRI/MRA prior to catheter ablation for AF. LAA volume, LAA depth, short and long axes of LAA neck, and numbers of lobes were measured. Of the 144 patients, 18 had a prior stroke or transient ischemic attack (TIA) (13 and 5, respectively). Compared with patients who had no history of stroke/TIA, these patients were older, had higher prevalence of hypertension and hyperlipidemia and had higher LAA volume (22.9 ± 9.6 cm(3) vs. 14.5 ± 7.1 cm(3) , P < 0.001). Their LAA depth (3.76 ± 0.9 cm vs. 3.21 ± 0.8 cm, P = 0.006) and the long and short axes of the LAA neck (3.12 ± 0.7 cm vs. 2.08 ± 0.7 cm, P < 0.001; 2.06 ± 0.5 cm vs. 1.37 ± 0.4 cm, P < 0.001, respectively) were larger. Using stepwise logistic regression model, the only statistically significant multivariable predictors of events were age (OR = 1.21 per year, 95% CI 1.06-1.38, P = 0.004), aspirin use (OR = 0.039, 95% CI 0.005-0.28, P = 0.001), and LAA neck dimensions (short axis × long axis) (OR = 3.59 per cm(2) , 95% CI 1.93-6.69, P < 0.001). LAA dimensions predict strokes/TIAs in patients with AF. LAA assessment by MRI/MRA can potentially be used as an adjunctive tool for risk stratification for embolic events in AF patients. © 2010 Wiley Periodicals, Inc.

PPARG gene C161T CT/TT associated with lower blood lipid levels and ischemic stroke from large-artery atherosclerosis in a Han population in Guangdong.

PubMed

Wei, Wei-Min; Wu, Xiao-Yan; Li, Shu-Ting; Shen, QingYu

2016-07-01

Peroxisome proliferator-activated receptor gamma (PPARG) is a transcription factor involved in atherosclerosis and related diseases. In this study, we aimed to investigate whether PPARG C161T was associated with lipid levels and large-artery atherosclerosis (LAA) ischemic stroke in a Han Chinese population in Guangdong province. The genotype PPARG C161T in 149 LAA ischemic stroke patients and 125 healthy controls was examined by polymerase chain reaction-restriction fragment length polymorphism (RFLP) assay. Associations with LAA ischemic stroke were analyzed for PPARG C161T genotype, total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C), and a logistic regression analysis was performed to identify risk factors for LAA ischemic stroke. The frequency of CC was higher than that of CT + TT and was significantly associated with LAA ischemic stroke. In both the LAA and control groups, TC and LDL-C levels were significantly higher in the CC type than the CT + TT, but TG and HDL-C levels were comparable. The only verified independent risk factors for LAA ischemic stroke were ischemic heart disease (OR: 2.784, 95% CI: 1.377-5.632; p = 0.004) and systolic blood pressure (OR: 1.014, 95% CI: 1.001-1.026; p = 0.029); the PPARG C161T allele was not independently associated with an increased risk of LAA ischemic stroke (OR = 0.697, 95% CI: 0.372-1.305; p = 0.260). In this Han population, PPARG C161T CT/TT was associated with LAA ischemic stroke and lower levels of blood TC and LDL-C, but was not an independent risk factor for LAA ischemic stroke.

Growth differentiation factor 15 is associated with left atrial/left atrial appendage thrombus in patients with nonvalvular atrial fibrillation.

PubMed

Hu, Xiao Feng; Zhan, Rui; Xu, Shanhu; Wang, Junjun; Wu, Jiong; Liu, Xiaoli; Li, Yaguo; Chen, Linhui

2018-01-01

There is evidence suggesting that growth differentiation factor 15 (GDF-15) appears to be associated with stroke in patients with atrial fibrillation (AF). AF-related thromboembolic stroke is predominantly attributed to the thrombus from the left atrium (LA) or left atrial appendage (LAA). GDF-15 is related to LA/LAA thrombus in nonvalvular AF (NVAF) patients. A total of 894 patients with NVAF without anticoagulation therapy were included in this study. All patients routinely underwent transesophageal echocardiography for detection of LA/LAA thrombus. GDF-15 was measured by enzyme-linked immunosorbent assay. Logistic regression models were used to test for association. LA/LAA thrombus was detected by transesophageal echocardiography in 69 (7.72%) patients with AF. The GDF-15 levels in the patients with LA/LAA thrombus were significantly higher than those without LA/LAA thrombus (log 10 GDF-15: 2.989 ± 0.023 ng/L vs 2.831 ± 0.007 ng/L; P < 0.001). Logistic regression analysis showed that GDF-15 was an independent risk factor for LA/LAA thrombus (odds ratio [per quarter]: 1.799, 95% confidence interval: 1.381-2.344, P < 0.001) after adjusting for potential clinical risk factors. The optimal cutoff point for GDF-15 predicting LA/LAA thrombus was 809.9 ng/L (sensitivity, 75.3%; specificity, 61.5%), determined by ROC curve. The area under the curve was 0.709 (95% confidence interval: 0.644-0.770, P < 0.001). Elevated GDF-15 indicated a significantly increased risk for LA/LAA thrombus in NVAF patients. Thus, GDF-15 might be a potentially useful adjunct in discriminating LA/LAA thrombus in NVAF patients. © 2018 Wiley Periodicals, Inc.

32 CFR Appendix I to Part 154 - Overseas Investigations

Code of Federal Regulations, 2014 CFR

2014-07-01

... conducted for post-adjudicative purposes. Hereafter they are referred to as LAA and Post-adjudicative cases... describes LAA cases. b. Post-adjudication investigation. A Personnel Security Investigation (PSI) predicated... purpose of the investigation is for an LAA or post-adjudication on a Subject overseas, much, if not all of...

Left atrial appendage function in prediction of paroxysmal atrial fibrilation in patients with untreated hypertension.

PubMed

Tenekecioglu, Erhan; Agca, Fahriye Vatansever; Karaagac, Kemal; Ozluk, Ozlem Arican; Peker, Tezcan; Kuzeytemiz, Mustafa; Senturk, Muhammed; Yılmaz, Mustafa

2014-01-01

Abstract The onset of AF results in a significant increase in mortality rates and morbidity in hypertensive patients and this rhythm disorder exposes patients to a significantly increased risk of cerebral or peripheral embolisms. Tissue Doppler imaging was found to be useful in early detection of myocardial dysfunction in several diseases. It was shown that tissue Doppler analysis of the walls of the left atrial appendage (LAA) can give accurate information about the function of the LAA in hypertensive patients. In this study, we aimed to investigate and identify the specific predictive parameters for the onset of AF in patients with hypertension with tissue Doppler imaging of LAA. We studied age and sex matched 57 untreated hypertensive patients with paroxysmal atrial fibrillation (PAF) and 27 untreated hypertensive subjects without PAF. With transthoracic echocardiography, diastolic mitral A-velocity and LA maximal volume index which reflects reservoir function of left atrium was measured, with transesophageal echocardiography, LAA emptying velocity (LAA-PW D2) and tissue Doppler contracting velocity of LAA (LAA-TDI-D2) were measured. LA maximal volume index of the groups (22.28 ± 3.59 mL/m(2) in Group 1 versus 20.37 ± 3.97 mL/m(2) in Group 2, p = 0.07) and diastolic mitral A-velocity [0.93 (0.59-1.84) m/s in patients with PAF versus 0.90 (0.62-1.76) m/s in patients without PAF, p = 0.26] was not significantly different between study groups, during TEE, LAA-PW D2 (0.31 ± 0.04 m/s in Group 1 versus 0.33 ± 0.03 m/s in Group 2, p = 0.034) and LAA-TDI-D2 (0.18 ± 0.04 m/s in Group 1 versus 0.21 ± 0.05 m/s in Group 2, p = 0.014) were significantly decreased in Group 1. In this study, we found that in hypertensive PAF patients despite normal global LA functions, LAA contracting function was deteriorated. Tissue Doppler analysis of LAA is clinically usefull approach to detect the risk of developing PAF in

The impact of surgical left atrial appendage amputation/ligation on stroke prevention in patients undergoing off-pump coronary artery bypass grafting.

PubMed

Endo, Daisuke; Kato, Tomoko S; Iwamura, Tai; Oishi, Atsumi; Yokoyama, Yasutaka; Kuwaki, Kenji; Inaba, Hirotaka; Amano, Atsushi

2017-06-01

Stroke is a major adverse event in patients developing atrial fibrillation (AF) after cardiac surgery. Surgical left atrial appendage amputation/ligation (LAA-A/L) during off-pump coronary artery bypass grafting (OPCAB) is routinely performed in our institution. We analyzed 578 consecutive patients (mean age 69 years, male 82%) undergoing OPCAB with or without concomitant LAA-A/L from 2011 to 2014 at our institution in a prospective observational manner. The safety and efficacy of the concomitant LAA-A/L on preventing early (<30 days) and overall postoperative stroke were examined. A total of 193 patients (33.4%) underwent LAA-A/L, consisting of amputation in 154 and ligation in 39 patients (80 and 20% of the cases, respectively). Preoperative characteristics, operative time, requirement of blood transfusion, and 30-day mortality were not significantly different between those with and without LAA-A/L. The incidences of postoperative AF and early and overall stroke were not significantly different between the groups in the analysis based on a total cohort. In a subanalysis of patients without LAA-A/L, early and overall stroke occurred more frequently in those developing postoperative AF than those without AF (2.8 vs. 0%; p = 0.005, 6.2 vs. 1.5%; p = 0.017, respectively), while in patients receiving LAA-A/L, stroke incidences did not differ between those with and without AF. Multivariate logistic regression showed postoperative AF without LAA-A/L as the only independent positive predictor of overall stroke (OR 3.69, p = 0.03). Concomitant LAA-A/L with OPCAB can safely prevent postoperative stroke occurrence in case patients develop AF, the most common arrhythmia associated with stroke.

Black Carbon, Dust and Organic Matter at South Cascade Glacier in Washington State, USA: A Comprehensive Characterization of Temporal (1865-2014) and Spatial Variability

NASA Astrophysics Data System (ADS)

Kaspari, S.; Pittenger, D.; Swick, M.; Skiles, M.; Perez, A.; Sethi, H.; Sevier, E.

2017-12-01

Rising temperatures are a widely recognized cause of glacial retreat in Washington, however light absorbing aerosols (LAA, including black carbon (BC), dust and organic matter) can also contribute to increased melt by reducing snow albedo. We present updated results of BC and dust variability at South Cascade (SOCAS) glacier spanning 1865-1994 using a 158 m ice core. Peak BC deposition occurred between 1940-1958, when median BC concentrations were 25 times higher than background levels. Post 1958 BC concentrations decrease, followed by an increase post 1980 associated with melt consolidation and/or trans-Pacific aerosol transport. Dust deposition at SOCAS is dominated by local sources. Albedo reductions from LAA are dominated by dust deposition, except during high BC deposition events from wildfires, and during the 1940-1958 period when BC contributes equally to albedo reductions. Results from a 2014 field campaign that included collection of 3 shallow ice cores, surface snow, and snow albedo measurements allow the 1865-1994 ice core record to be extended toward present, and spatial variability in LAA to be characterized. Snow albedo transects were measured using a spectrometer. BC concentrations were measured using a Single Particle Soot Photometer (SP2). Gravimetric filtration was used to determine the total LAA, and a thermal gravimetric technique was used to partition the LAA between dust and organic matter. The organic matter was partitioned into organic and elemental carbon using a thermal optical method. These methods allow LAA abundances be measured, but to partition the contribution of the LAA to albedo reductions requires characterization of LAA optical properties. This was accomplished using a Hyperspectral Imaging Microscope Spectrometer method that allows particle reflectance to be measured at 138 nm2 pixel resolution. By combining these methods, we provide a comprehensive characterization of spatial and temporal LAA variability at SOCAS.

Left Atrial Appendage Electrical Isolation and Concomitant Device Occlusion to Treat Persistent Atrial Fibrillation: A First-in-Human Safety, Feasibility, and Efficacy Study.

PubMed

Panikker, Sandeep; Jarman, Julian W E; Virmani, Renu; Kutys, Robert; Haldar, Shouvik; Lim, Eric; Butcher, Charles; Khan, Habib; Mantziari, Lilian; Nicol, Edward; Foran, John P; Markides, Vias; Wong, Tom

2016-07-01

Left atrial appendage (LAA) electric isolation is reported to improve persistent atrial fibrillation (AF) ablation outcomes. However, loss of LAA mechanical function may increase thromboembolic risk. Concomitant LAA electric isolation and occlusion as part of conventional AF ablation has never been tested in humans. We therefore evaluated the feasibility, safety, and efficacy of LAA electric isolation and occlusion in patients undergoing long-standing persistent AF ablation. Patients with long-standing persistent AF (age, 68±7 years; left atrium diameter, 46±3 mm; and AF duration, 25±15 months) underwent AF ablation, LAA electric isolation, and occlusion. Outcomes were compared with a balanced (1:2 ratio) control group who had AF ablation alone. Among 22 patients who underwent ablation, LAA electric isolation was possible in 20. Intraprocedural LAA reconnection occurred in 17 of 20 (85%) patients, predominantly at anterior and superior locations. All were reisolated. LAA occlusion was successful in all 20 patients. There were no major periprocedural complications. Imaging at 45 days and 9 months confirmed satisfactory device position and excluded pericardial effusion. One of twenty (5%) patients had a gap of ≥5 mm requiring anticoagulation. Nineteen of twenty (95%) patients stopped warfarin at 3 months. Without antiarrhythmic drugs, freedom from AF at 12 months after a single procedure was significantly higher in the study group (19/20, 95%) than in the control group (25/40, 63%), P=0.036. Freedom from atrial arrhythmias was demonstrated in 12 of 20 (60%) and 18 of 20 (90%) patients after 1 and ≤2 procedures (mean, 1.3), respectively. Persistent AF ablation, LAA electric isolation, and mechanical occlusion can be performed concomitantly. This technique may improve the success of persistent AF ablation while obviating the need for chronic anticoagulation. URL: https://clinicaltrials.gov. Unique identifier: NCT02028130. © 2016 American Heart Association, Inc.

Left Atrial Appendage Morphology and Embolic Stroke of Undetermined Source: A Cross-Sectional Multicenter Pilot Study.

PubMed

Yaghi, Shadi; Chang, Andrew D; Hung, Peter; Mac Grory, Brian; Collins, Scott; Gupta, Ajay; Reynolds, Jacques; Finn, Caitlin B; Hemendinger, Morgan; Cutting, Shawna M; McTaggart, Ryan A; Jayaraman, Mahesh; Leasure, Audrey; Sansing, Lauren; Panda, Nikhil; Song, Christopher; Chu, Antony; Merkler, Alexander; Gialdini, Gino; Sheth, Kevin N; Kamel, Hooman; Elkind, Mitchell S V; Greer, David; Furie, Karen; Atalay, Michael

2018-06-01

The left atrial appendage (LAA) is the main source of thrombus in atrial fibrillation, and there is an association between non-chicken wing (NCW) LAA morphology and stroke. We hypothesized that the prevalence of NCW LAA morphology would be higher among patients with cardioembolic (CE) stroke and embolic stroke of undetermined source (ESUS) than among those with noncardioembolic stroke (NCS). This multicenter retrospective pilot study included consecutive patients with ischemic stroke from 3 comprehensive stroke centers who previously underwent a qualifying chest computed tomography (CT) to assess LAA morphology. Patients underwent inpatient diagnostic evaluation for ischemic stroke, and stroke subtype was determined based on ESUS criteria. LAA morphology was determined using clinically performed contrast enhanced thin-slice chest CT by investigators blinded to stroke subtype. The primary predictor was NCW LAA morphology and the outcome was stroke subtype (CE, ESUS, NCS). We identified 172 patients with ischemic stroke who had a clinical chest CT performed. Mean age was 70.1 ± 14.3 years and 51.7% were male. Compared with patients with NCS, the prevalence of NCW LAA morphology was higher in patients with CE stroke (58.7% versus 46.3%, P = .1) and ESUS (58.8% versus 46.3%, P = .2), but this difference did not achieve statistical significance. The prevalence of NCW LAA morphology may be similar in patients with ESUS and CE, and may be higher than that in those with NCS. Larger studies are needed to confirm these associations. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Genetic overlap between diagnostic subtypes of ischemic stroke.

PubMed

Holliday, Elizabeth G; Traylor, Matthew; Malik, Rainer; Bevan, Steve; Falcone, Guido; Hopewell, Jemma C; Cheng, Yu-Ching; Cotlarciuc, Ioana; Bis, Joshua C; Boerwinkle, Eric; Boncoraglio, Giorgio B; Clarke, Robert; Cole, John W; Fornage, Myriam; Furie, Karen L; Ikram, M Arfan; Jannes, Jim; Kittner, Steven J; Lincz, Lisa F; Maguire, Jane M; Meschia, James F; Mosley, Thomas H; Nalls, Mike A; Oldmeadow, Christopher; Parati, Eugenio A; Psaty, Bruce M; Rothwell, Peter M; Seshadri, Sudha; Scott, Rodney J; Sharma, Pankaj; Sudlow, Cathie; Wiggins, Kerri L; Worrall, Bradford B; Rosand, Jonathan; Mitchell, Braxton D; Dichgans, Martin; Markus, Hugh S; Levi, Christopher; Attia, John; Wray, Naomi R

2015-03-01

Despite moderate heritability, the phenotypic heterogeneity of ischemic stroke has hampered gene discovery, motivating analyses of diagnostic subtypes with reduced sample sizes. We assessed evidence for a shared genetic basis among the 3 major subtypes: large artery atherosclerosis (LAA), cardioembolism, and small vessel disease (SVD), to inform potential cross-subtype analyses. Analyses used genome-wide summary data for 12 389 ischemic stroke cases (including 2167 LAA, 2405 cardioembolism, and 1854 SVD) and 62 004 controls from the Metastroke consortium. For 4561 cases and 7094 controls, individual-level genotype data were also available. Genetic correlations between subtypes were estimated using linear mixed models and polygenic profile scores. Meta-analysis of a combined LAA-SVD phenotype (4021 cases and 51 976 controls) was performed to identify shared risk alleles. High genetic correlation was identified between LAA and SVD using linear mixed models (rg=0.96, SE=0.47, P=9×10(-4)) and profile scores (rg=0.72; 95% confidence interval, 0.52-0.93). Between LAA and cardioembolism and SVD and cardioembolism, correlation was moderate using linear mixed models but not significantly different from zero for profile scoring. Joint meta-analysis of LAA and SVD identified strong association (P=1×10(-7)) for single nucleotide polymorphisms near the opioid receptor μ1 (OPRM1) gene. Our results suggest that LAA and SVD, which have been hitherto treated as genetically distinct, may share a substantial genetic component. Combined analyses of LAA and SVD may increase power to identify small-effect alleles influencing shared pathophysiological processes. © 2015 American Heart Association, Inc.

Improvement of a snow albedo parameterization in the Snow-Atmosphere-Soil Transfer model: evaluation of impacts of aerosol on seasonal snow cover

NASA Astrophysics Data System (ADS)

Zhong, Efang; Li, Qian; Sun, Shufen; Chen, Wen; Chen, Shangfeng; Nath, Debashis

2017-11-01

The presence of light-absorbing aerosols (LAA) in snow profoundly influence the surface energy balance and water budget. However, most snow-process schemes in land-surface and climate models currently do not take this into consideration. To better represent the snow process and to evaluate the impacts of LAA on snow, this study presents an improved snow albedo parameterization in the Snow-Atmosphere-Soil Transfer (SAST) model, which includes the impacts of LAA on snow. Specifically, the Snow, Ice and Aerosol Radiation (SNICAR) model is incorporated into the SAST model with an LAA mass stratigraphy scheme. The new coupled model is validated against in-situ measurements at the Swamp Angel Study Plot (SASP), Colorado, USA. Results show that the snow albedo and snow depth are better reproduced than those in the original SAST, particularly during the period of snow ablation. Furthermore, the impacts of LAA on snow are estimated in the coupled model through case comparisons of the snowpack, with or without LAA. The LAA particles directly absorb extra solar radiation, which accelerates the growth rate of the snow grain size. Meanwhile, these larger snow particles favor more radiative absorption. The average total radiative forcing of the LAA at the SASP is 47.5 W m-2. This extra radiative absorption enhances the snowmelt rate. As a result, the peak runoff time and "snow all gone" day have shifted 18 and 19.5 days earlier, respectively, which could further impose substantial impacts on the hydrologic cycle and atmospheric processes.

Preclinical assessment of a modified Occlutech left atrial appendage closure device in a canine model.

PubMed

Kim, Jung-Sun; Lee, Seul-Gee; Bong, Sung-Kyung; Park, Se-Il; Hong, Sung-Yu; Shin, Sanghoon; Shim, Chi Young; Hong, Geu-Ru; Choi, Donghoon; Jang, Yangsoo; Park, Jai-Wun

2016-10-15

LAA occlusion has a similar stroke prevention efficacy compared to anticoagulation treatment for non-valvular atrial fibrillation. The objective of this study was to assess the feasibility and safety of a modified Occlutech® left atrial appendage (LAA) closure device in a canine model. The device was implanted in 10 dogs (33±1kg) using fluoroscopy and transesophageal echocardiography (TEE) guidance. The modified Occlutech® LAA occlusion device was compared with the current version, the Watchman device, and the Amplazter cardiac plug (ACP). LAA occlusion and anchoring to the LAA were evaluated. All dogs were assessed using angiography, TEE, and a gross anatomy examination. The 10 LAA occlusion devices were to be implanted into 10 dogs (5 modified Occlutech devices, 3 current version of Occlutech devices, 1 Watchman, and 1 ACP). LAA implantation was not performed in one dog due to transeptal puncture failure. The three current version of Occlutech devices were embolized immediately after implantation, so three modified devices of the same size were implanted securely without embolization. The mean implant size was 20.1±2.0mm. The devices chosen were a mean of 23.3±10.6% larger than the measured landing zone diameters. Post-implant angiography and TEE revealed well-positioned devices without pericardial effusion or impingement on surrounding structures. The results of this acute animal study suggested that a modified Occlutech® LAA occlusion device was feasible and had greater anchoring performance in canines. Additional large clinical studies are needed to evaluate safety and efficacy. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Genetic Control of Fruit Vitamin C Contents1

PubMed Central

Davey, Mark W.; Kenis, Katrien; Keulemans, Johan

2006-01-01

An F1 progeny derived from a cross between the apple (Malus x domestica) cultivars Telamon and Braeburn was used to identify quantitative trait loci (QTL) linked to the vitamin C (l-ascorbate [l-AA]) contents of fruit skin and flesh (cortex) tissues. We identified up to three highly significant QTLs for both the mean l-AA and the mean total l-AA contents of fruit flesh on both parental genetic linkage maps, confirming the quantitative nature of these traits. These QTLs account for up to a maximum of 60% of the total population variation observed in the progeny, and with a maximal individual contribution of 31% per QTL. QTLs common to both parents were identified on linkage groups (LGs) 6, 10, and 11 of the Malus reference map, while each parent also had additional unique QTLs on other LGs. Interestingly, one strong QTL on LG-17 of the Telamon linkage map colocalized with a highly significant QTL associated with flesh browning, and a minor QTL for dehydroascorbate content, supporting earlier work that links fruit l-AA contents with the susceptibility of hardfruit to postharvest browning. We also found significant minor QTLs for skin l-AA and total l-AA (l-AA + dehydroascorbate) contents in Telamon. Currently, little is known about the genetic determinants underlying tissue l-AA homeostasis, but the presence of major, highly significant QTL in both these apple genotypes under field conditions suggests the existence of common control mechanisms, allelic heterozygosity, and helps outline strategies and the potential for the molecular breeding of these traits. PMID:16844833

Prevention of laboratory animal allergy.

PubMed

Fisher, R; Saunders, W B; Murray, S J; Stave, G M

1998-07-01

Laboratory animal allergy (LAA) is a significant occupational hazard for workers in a number of research settings, including the pharmaceutical industry. Prevention of allergy and asthma is important because the illness can affect health and career. In a major pharmaceutical company, in an effort to prevent LAA, a comprehensive program to reduce exposure to environmental allergens was developed. The program included education, engineering controls, administrative controls, use of personal protective equipment, and medical surveillance. A prospective survey of five years of data was completed to determine the effect of the program on the prevalence and incidence of LAA. After instituting this program, we found that the prevalence of LAA ranged from 12%-22% and that the incidence was reduced to zero during the last two years of observation. We concluded that LAA is preventable through the implementation of a comprehensive effort to reduce exposure to allergens.

Algorithm of pulmonary emphysema extraction using thoracic 3-D CT images

NASA Astrophysics Data System (ADS)

Saita, Shinsuke; Kubo, Mitsuru; Kawata, Yoshiki; Niki, Noboru; Nakano, Yasutaka; Ohmatsu, Hironobu; Tominaga, Keigo; Eguchi, Kenji; Moriyama, Noriyuki

2008-03-01

Emphysema patients have the tendency to increase due to aging and smoking. Emphysematous disease destroys alveolus and to repair is impossible, thus early detection is essential. CT value of lung tissue decreases due to the destruction of lung structure. This CT value becomes lower than the normal lung- low density absorption region or referred to as Low Attenuation Area (LAA). So far, the conventional way of extracting LAA by simple thresholding has been proposed. However, the CT value of CT image fluctuates due to the measurement conditions, with various bias components such as inspiration, expiration and congestion. It is therefore necessary to consider these bias components in the extraction of LAA. We removed these bias components and we proposed LAA extraction algorithm. This algorithm has been applied to the phantom image. Then, by using the low dose CT(normal: 30 cases, obstructive lung disease: 26 cases), we extracted early stage LAA and quantitatively analyzed lung lobes using lung structure.

First in vivo evaluation of a flexible self-apposing left atrial appendage closure device in the canine model.

PubMed

Cheng, Yanping; Conditt, Gerard; Yi, Genghua; Tellez, Armando; Corcoran, Michael; Rousselle, Serge; Kaluza, Greg L; Granada, Juan F

2015-07-01

Aimed to evaluate the feasibility of deployment and healing response of a novel transcatheter left atrial appendage (LAA) occlusion device in the canine model LAA occlusion is proposed to reduce the risk of stroke in atrial fibrillation patients Transseptal puncture and device deployment was guided under fluoroscopy and transesophageal echocardiography (TEE) in five dogs. First, a distal cylindrical bulb occluder was released and secured to the appendage wall with hooks. Subsequently, a proximal sail was unfolded, covering the LAA ostium. Rotational angiography, TEE, and histology outcomes were assessed 30 days following implantation Pre-operative TEE revealed the mean diameter of the LAA ostium to be 17.2 ± 1.6 mm with a depth of 18.5 ± 1.7 mm. The landing zone for the distal bulb was measured to be 12.8 ± 1.3 mm. The mean bulb diameter at implant was 16.8 ± 1.8 mm. Post-operative TEE showed adequate positioning and successful LAA occlusion with all implanted devices. Pericardial effusion requiring pericardiocentesis was seen in one animal following device implantation. At 30 days, TEE revealed full occlusion of all LAA ostia with the exception of a minimal peri-device leak (<3 mm) observed in one animal. No pericardial effusion or device-related thrombus formation was found at termination. Histological analysis confirmed circumferential occlusion of all appendages and complete neointimal coverage on the luminal aspect of the occluder The percutaneous delivery of a novel self-positioning LAA occlusion device is feasible and safe in a canine model. At 30 days, all devices displayed complete healing and occlusion of the LAA without any device related adverse events. © 2015 Wiley Periodicals, Inc.

Impacts of absorbing aerosol deposition on snowpack and hydrologic cycle in the Rocky Mountain region using variable-resolution CESM (VR-CESM)

NASA Astrophysics Data System (ADS)

Wu, C.; Liu, X.; Lin, Z.; Rahimi-Esfarjani, S. R.; Lu, Z.

2017-12-01

Deposition of light-absorbing aerosols (LAAs) including black carbon (BC) and dust onto snow surface has been suggested to reduce the snow albedo, and modulate the snowpack and consequent hydrologic cycle. In this study we use the variable-resolution Community Earth System Model (VR-CESM) to quantify the impacts of LAAs deposition onto snow in the Rocky Mountain region (RMR) during the period of 1981-2005. We first evaluate the model simulation of LAA concentrations both in the atmosphere and in snow, and then investigate the snowpack and runoff changes induced by LAAs-in-snow. The model simulates similar magnitudes of surface atmospheric dust concentrations as observations, but underestimates surface atmospheric BC concentrations by about a factor of two. Despite of this, the magnitude of BC-in-snow concentrations is overall comparable to observations. Regional mean surface radiative effect (SRE) due to LAAs-in-snow reaches up to 0.6-1.7 W m-2 in spring, and dust contributes to about 21-43% of total SRE. Maximum surface air temperature increase due to the LLA's SRE is around 0.9-1.1oC. Snow water equivalent and snow cover fraction reduce by around 2-50 mm and 0.05-0.2, respectively in the two regions around the mountains (Eastern Snake River Plain and Southwestern Wyoming) due to positive snow-albedo feedbacks. During the snow melting period, LAAs accelerate the hydrologic cycle with runoff increased by 7%-42% in April-May and reduced by 2-23% in June-July in the mountainous regions. Under the influence of LAAs-in-snow, Southern Rockies experience the most significant reduction of runoff by about 15% in the later stage of snow melt (i.e., June-July). Our results highlight the potentially important role of LAAs-in-snow in the historical and future changes of snowpack in the RMR.

A low-dose, dual-phase cardiovascular CT protocol to assess left atrial appendage anatomy and exclude thrombus prior to left atrial intervention.

PubMed

Lazoura, Olga; Ismail, Tevfik F; Pavitt, Christopher; Lindsay, Alistair; Sriharan, Mona; Rubens, Michael; Padley, Simon; Duncan, Alison; Wong, Tom; Nicol, Edward

2016-02-01

Assessment of the left atrial appendage (LAA) for thrombus and anatomy is important prior to atrial fibrillation (AF) ablation and LAA exclusion. The use of cardiovascular CT (CCT) to detect LAA thrombus has been limited by the high incidence of pseudothrombus on single-pass studies. We evaluated the diagnostic accuracy of a two-phase protocol incorporating a limited low-dose delayed contrast-enhanced examination of the LAA, compared with a single-pass study for LAA morphological assessment, and transesophageal echocardiography (TEE) for the exclusion of thrombus. Consecutive patients (n = 122) undergoing left atrial interventions for AF were assessed. All had a two-phase CCT protocol (first-past scan plus a limited, 60-s delayed scan of the LAA) and TEE. Sensitivity, specificity, diagnostic accuracy, positive (PPV) and negative predictive values (NPV) were calculated for the detection of true thrombus on first-pass and delayed scans, using TEE as the gold standard. Overall, 20/122 (16.4 %) patients had filling defects on the first-pass study. All affected the full delineation of the LAA morphology; 17/20 (85 %) were confirmed as pseudo-filling defects. Three (15 %) were seen on late-pass and confirmed as true thrombi on TEE; a significant improvement in diagnostic performance relative to a single-pass scan (McNemar Chi-square 17, p < 0.001). The sensitivity, specificity, diagnostic accuracy, PPV and NPV was 100, 85.7, 86.1, 15.0 and 100 % respectively for first-pass scans, and 100 % for all parameters for the delayed scans. The median (range) additional radiation dose for the delayed scan was 0.4 (0.2-0.6) mSv. A low-dose delayed scan significantly improves the identification of true LAA anatomy and thrombus in patients undergoing LA intervention.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Busch, Albert; Kiel, Tilman; Heupel, Wolfgang-M.

Lamins, which form the nuclear lamina, not only constitute an important determinant of nuclear architecture, but additionally play essential roles in many nuclear functions. Mutations in A-type lamins cause a wide range of human genetic disorders (laminopathies). The importance of lamin A (LaA) in the spatial arrangement of nuclear pore complexes (NPCs) prompted us to study the role of LaA mutants in nuclear protein transport. Two mutants, causing prenatal skin disease restrictive dermopathy (RD) and the premature aging disease Hutchinson Gilford progeria syndrome, were used for expression in HeLa cells to investigate their impact on the subcellular localization of NPC-associatedmore » proteins and nuclear protein import. Furthermore, dynamics of the LaA mutants within the nuclear lamina were studied. We observed affected localization of NPC-associated proteins, diminished lamina dynamics for both LaA mutants and reduced nuclear import of representative cargo molecules. Intriguingly, both LaA mutants displayed similar effects on nuclear morphology and functions, despite their differences in disease severity. Reduced nuclear protein import was also seen in RD fibroblasts and impaired lamina dynamics for the nucleoporin Nup153. Our data thus represent the first study of a direct link between LaA mutant expression and reduced nuclear protein import.« less

Efficacy of anticoagulation in resolving left atrial and left atrial appendage thrombi: A transesophageal echocardiographic study

NASA Technical Reports Server (NTRS)

Jaber, W. A.; Prior, D. L.; Thamilarasan, M.; Grimm, R. A.; Thomas, J. D.; Klein, A. L.; Asher, C. R.

2000-01-01

BACKGROUND: Transesophageal echocardiography (TEE) is the gold standard for evaluation of the left atrium and the left atrial appendage (LAA) for the presence of thrombi. Anticoagulation is conventionally used for patients with atrial fibrillation to prevent embolization of atrial thrombi. The mechanism of benefit and effectiveness of thrombi resolution with anticoagulation is not well defined. METHODS AND RESULTS: We used a TEE database of 9058 consecutive studies performed between January 1996 and November 1998 to identify all patients with thrombi reported in the left atrium and/or LAA. One hundred seventy-four patients with thrombi in the left atrial cavity (LAC) and LAA were identified (1.9% of transesophageal studies performed). The incidence of LAA thrombi was 6.6 times higher than LAC thrombi (151 vs 23, respectively). Almost all LAC thrombi were visualized on transthoracic echocardiography (90.5%). Mitral valve pathology was associated with LAC location of thrombi (P <.0001), whereas atrial fibrillation or flutter was present in most patients with LAA location of thrombi. Anticoagulation of 47 +/- 18 days was associated with thrombus resolution in 80.1% of the patients on follow-up TEE. Further anticoagulation resulted in limited additional benefit. CONCLUSIONS: LAC thrombi are rare and are usually associated with mitral valve pathology. Transthoracic echocardiography is effective in identifying these thrombi. LAA thrombi occur predominantly in patients with atrial fibrillation or flutter. Short-term anticoagulation achieves a high rate of resolution of LAA and LAC thrombi but does not obviate the need for follow-up TEE.

Effects of ventricular rate and regularity on the velocity and magnitude of left atrial appendage flow in atrial fibrillation

PubMed Central

Obel, O A; Luddington, L; Maarouf, N; Aytemir, K; Ekwall, C; Malik, M; Camm, A J

2005-01-01

Objective: To prospectively determine whether ventricular rate and regularity are significant determinants of the velocity and magnitude of left atrial appendage (LAA) flow. Design and patients: 12 patients with atrial fibrillation (AF), high degree atrioventricular block, and indwelling permanent pacemakers were studied. Setting: Cardiology department of a tertiary referral centre. Interventions: Pacing was triggered by an external programmable transcutaneous device. Patients were paced at 60, 120, and 150 beats/min in both regular and irregular rhythm. LAA flow velocity and magnitude were assessed with transoesophageal Doppler echocardiography. Main outcome measures: Peak and mean LAA inflow and outflow velocity, and time-velocity interval (TVI) of LAA flow. Results: Increasing ventricular rate was associated with significantly lower peak inflow (p < 0.01), peak outflow (p < 0.05), mean inflow (p < 0.01), and mean outflow (p < 0.05) velocities and with a lower TVI of LAA filling and emptying velocities (p < 0.01). This effect was noted at rates of 60 beats/min compared with both 120 and 150 beats/min. At a pacing rate of 120 beats/min there was a significantly higher total TVI when pacing at a regular than at an irregular rhythm (40.16 (14.6) cm v 30.74 (10.9) cm, p < 0.05). Conclusions: In this study, LAA filling velocities in patients in AF were significantly influenced by paced ventricular rate and to a much lesser extent ventricular rhythm. These results suggest that rapid ventricular rates may predispose to stasis in the LAA in AF. PMID:15894771

Development of Host Crystals for Ce(+3) Blue and Blue-Green Solid-State Lasers.

DTIC Science & Technology

1982-07-01

oxides ............ 9 Syntheses of LaA1O3 and Lal-xScxO3 . . . . . . . . . . . . . .. . . . . . 10 Syntheses of Oxides from Oxalates ...oxidation of Ce+ 3 . The crystal growth of LaA1O3 has been reported from the melt, hydrothermally , and both LaA103 and Th0 2 from fluxes. ’Va Fa...temperature and/or flux composition may be necessary to produce this oxide. Syntheses of Oxides from Oxalates Syntheses of oxides by the oxidative

[New technology for prevention of embolic events in atrial fibrillation: a systematic review on percutaneous endovascular left atrial appendage closure].

PubMed

Danna, Paolo; Sagone, Antonio; Proietti, Riccardo; Arensi, Andrea; Viecca, Maurizio; Santangeli, Pasquale; Di Biase, Luigi; Natale, Andrea

2012-09-01

Atrial fibrillation (AF) is the most common cardiac arrhythmia. The mortality rate of patients with AF is doubled as compared to non-fibrillating controls. The most relevant complication of AF is a major increase in the risk of stroke. The gold standard in reducing cerebrovascular events in AF is warfarin therapy, which is not free from contraindications and limitations. The left atrial appendage (LAA) is the main source of emboli causing stroke in AF. LAA closure is a seducing approach to stroke risk reduction in AF without anticoagulation. Since 1949, heart surgeons have performed LAA closure or amputation in patients with AF. Percutaneous endovascular LAA closure is a new, less invasive, technique to reach the goal. Several devices have been used to perform this intervention, and the results of published trials are encouraging in terms of effectiveness and relative safety of this attractive technique. In this review we examine the published trials and data on percutaneous LAA closure, with particular attention to the risks and benefits of this procedure.

Experimental IR and Raman spectra and quantum chemical studies of molecular structures, conformers and vibrational characteristics of L-ascorbic acid and its anion and cation

NASA Astrophysics Data System (ADS)

Yadav, R. A.; Rani, P.; Kumar, M.; Singh, R.; Singh, Priyanka; Singh, N. P.

2011-12-01

IR and spectra of the L-ascorbic acid ( L-AA) also known as vitamin C have been recorded in the region 4000-50 cm -1. In order to make vibrational assignments of the observed IR and Raman bands computations were carried out by employing the RHF and DFT methods to calculate the molecular geometries and harmonic vibrational frequencies along with other related parameters for the neutral L-AA and its singly charged anionic ( L-AA -) and cationic ( L-AA +) species. Significant changes have been found for different characteristics of a number of vibrational modes. The four ν(O-H) modes of the L-AA molecule are found in the order ν(O 9-H 10) > ν(O 19-H 20) > ν(O 7-H 8) > ν(O 14-H 15) which could be due to complexity of hydrogen bonding in the lactone ring and the side chain. The C dbnd O stretching wavenumber ( ν46) decreases by 151 cm -1 in going from the neutral to the anionic species whereas it increases by 151 cm -1 in going from the anionic to the cationic species. The anionic radicals have less kinetic stabilities and high chemical reactivity as compared to the neutral molecule. It is found that the cationic radical of L-AA is kinetically least stable and chemically most reactive as compared to its neutral and anionic species.

Development and analysis of a finite element model to simulate pulmonary emphysema in CT imaging.

PubMed

Diciotti, Stefano; Nobis, Alessandro; Ciulli, Stefano; Landini, Nicholas; Mascalchi, Mario; Sverzellati, Nicola; Innocenti, Bernardo

2015-01-01

In CT imaging, pulmonary emphysema appears as lung regions with Low-Attenuation Areas (LAA). In this study we propose a finite element (FE) model of lung parenchyma, based on a 2-D grid of beam elements, which simulates pulmonary emphysema related to smoking in CT imaging. Simulated LAA images were generated through space sampling of the model output. We employed two measurements of emphysema extent: Relative Area (RA) and the exponent D of the cumulative distribution function of LAA clusters size. The model has been used to compare RA and D computed on the simulated LAA images with those computed on the models output. Different mesh element sizes and various model parameters, simulating different physiological/pathological conditions, have been considered and analyzed. A proper mesh element size has been determined as the best trade-off between reliable results and reasonable computational cost. Both RA and D computed on simulated LAA images were underestimated with respect to those calculated on the models output. Such underestimations were larger for RA (≈ -44 ÷ -26%) as compared to those for D (≈ -16 ÷ -2%). Our FE model could be useful to generate standard test images and to design realistic physical phantoms of LAA images for the assessment of the accuracy of descriptors for quantifying emphysema in CT imaging.

Atypical cleavage of protonated N-fatty acyl amino acids derived from aspartic acid evidenced by sequential MS3 experiments.

PubMed

Boukerche, Toufik Taalibi; Alves, Sandra; Le Faouder, Pauline; Warnet, Anna; Bertrand-Michel, Justine; Bouchekara, Mohamed; Belbachir, Mohammed; Tabet, Jean-Claude

2016-12-01

Lipidomics calls for information on detected lipids and conjugates whose structural elucidation by mass spectrometry requires to rationalization of their gas phase dissociations toward collision-induced dissociation (CID) processes. This study focused on activated dissociations of two lipoamino acid (LAA) systems composed of N-palmitoyl acyl coupled with aspartic and glutamic acid mono ethyl esters (as LAA (*D) and LAA (*E) ). Although in MS/MS, their CID spectra show similar trends, e.g., release of water and ethanol, the [(LAA (*D/*E) +H)-C 2 H 5 OH] + product ions dissociate via distinct pathways in sequential MS 3 experiments. The formation of all the product ions is rationalized by charge-promoted cleavages often involving stepwise processes with ion isomerization into ion-dipole prior to dissociation. The latter explains the maleic anhydride or ketene neutral losses from N-palmitoyl acyl aspartate and glutamate anhydride fragment ions, respectively. Consequently, protonated palmitoyl acid amide is generated from LAA (*D), whereas LAA (*E) leads to the [*E+H-H 2 O] + anhydride. The former releases ammonia to provide acylium, which gives the C n H (2n-1) and C n H (2n-3) carbenium series. This should offer structural information, e.g., to locate either unsaturation(s) or alkyl group branching present on the various fatty acyl moieties of lipo-aspartic acid in further studies based on MS n experiments.

Is Dynamic Cerebral Autoregulation Bilaterally Impaired after Unilateral Acute Ischemic Stroke?

PubMed

Xiong, Li; Tian, Ge; Lin, Wenhua; Wang, Wei; Wang, Lijuan; Leung, Thomas; Mok, Vincent; Liu, Jia; Chen, Xiangyan; Wong, Ka Sing

2017-05-01

Whether dynamic cerebral autoregulation (dCA) is impaired focally in the affected hemisphere or bilaterally in both the affected and nonaffected hemispheres after ischemic stroke remains controversial. We therefore investigated the pattern of dCA in acute ischemic stroke patients with different subtypes. Sixty acute ischemic stroke patients with unilateral anterior circulation infarct [30 with large artery atherosclerosis (LAA), 13 with small vessel disease (SVD), and 17 with coexisting LAA and SVD] and 16 healthy controls were enrolled. Spontaneous arterial blood pressure and cerebral blood flow velocity fluctuations in both bilateral middle cerebral arteries using transcranial Doppler were recorded over 10 minutes. Transfer function analysis was applied to obtain autoregulatory parameters, autoregulation index (ARI), phase difference (PD), and gain. PD was significantly lower on both the ipsilateral and contralateral sides in the LAA group (ipsilateral, 30.74 degrees; contralateral, 29.17 degrees) and the coexisting LAA and SVD group (20.23 degrees; 13.10 degrees) than that in healthy controls (left side, 51.66 degrees; right side, 58.48 degrees) (all P < .05), but there were no significant differences between the 2 sides when compared with each other in all groups. However, in the coexisting LAA and SVD group, phase on both sides was significantly lower when compared with that in the LAA and SVD groups, respectively. The results of ARI were consistent with the findings in PD. The results indicate that dCA is bilaterally impaired in acute ischemic patients with LAA, and the coexisting SVD may aggravate the bilateral impairment of dCA. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Comparison of three instruments for measuring patient anxiety in a coronary care unit.

PubMed

Elliott, D

1993-09-01

This paper compares the State-Trait Anxiety Inventory (STAI), Hospital Anxiety and Depression Scale (HAD Scale) and a Linear Analogue Anxiety Scale (LAAS) for evaluating anxiety in patients with acute ischaemic heart disease. The instruments were examined for correlation, reliability and internal consistency. Strong associations were demonstrated at pre-test between the STAI and the other scales. Moderate coefficients between HAD-A and HAD-D/LAAS were also apparent. Lower correlations were found at post-test than at pre-test. At post-test, strong inter-correlations occurred for STAI/LAAS. The HAD Scale demonstrated high test-retest reliability, while the STAI and LAAS were moderate in their reliability in this sample. The adequate correlation between the instruments suggest that each is a valid and appropriate measure of anxiety in this clinical sample.

Cost-Effectiveness of Percutaneous Closure of the Left Atrial Appendage in Atrial Fibrillation Based on Results From PROTECT AF Versus PREVAIL.

PubMed

Freeman, James V; Hutton, David W; Barnes, Geoffrey D; Zhu, Ruo P; Owens, Douglas K; Garber, Alan M; Go, Alan S; Hlatky, Mark A; Heidenreich, Paul A; Wang, Paul J; Al-Ahmad, Amin; Turakhia, Mintu P

2016-06-01

Randomized trials of left atrial appendage (LAA) closure with the Watchman device have shown varying results, and its cost effectiveness compared with anticoagulation has not been evaluated using all available contemporary trial data. We used a Markov decision model to estimate lifetime quality-adjusted survival, costs, and cost effectiveness of LAA closure with Watchman, compared directly with warfarin and indirectly with dabigatran, using data from the long-term (mean 3.8 year) follow-up of Percutaneous Closure of the Left Atrial Appendage Versus Warfarin Therapy for Prevention of Stroke in Patients With Atrial Fibrillation (PROTECT AF) and Prospective Randomized Evaluation of the Watchman LAA Closure Device in Patients With Atrial Fibrillation (PREVAIL) randomized trials. Using data from PROTECT AF, the incremental cost-effectiveness ratios compared with warfarin and dabigatran were $20 486 and $23 422 per quality-adjusted life year, respectively. Using data from PREVAIL, LAA closure was dominated by warfarin and dabigatran, meaning that it was less effective (8.44, 8.54, and 8.59 quality-adjusted life years, respectively) and more costly. At a willingness-to-pay threshold of $50 000 per quality-adjusted life year, LAA closure was cost effective 90% and 9% of the time under PROTECT AF and PREVAIL assumptions, respectively. These results were sensitive to the rates of ischemic stroke and intracranial hemorrhage for LAA closure and medical anticoagulation. Using data from the PROTECT AF trial, LAA closure with the Watchman device was cost effective; using PREVAIL trial data, Watchman was more costly and less effective than warfarin and dabigatran. PROTECT AF enrolled more patients and has substantially longer follow-up time, allowing greater statistical certainty with the cost-effectiveness results. However, longer-term trial results and postmarketing surveillance of major adverse events will be vital to determining the value of the Watchman in clinical

Pathophysiologic correlates of thromboembolism in nonvalvular atrial fibrillation: I. Reduced flow velocity in the left atrial appendage (The Stroke Prevention in Atrial Fibrillation [SPAF-III] study).

PubMed

Goldman, M E; Pearce, L A; Hart, R G; Zabalgoitia, M; Asinger, R W; Safford, R; Halperin, J L

1999-12-01

Stroke associated with atrial fibrillation (AF) is mainly due to embolism of thrombus formed during stasis of blood in the left atrial appendage (LAA). Pathophysiologic correlates of appendage flow velocity as assessed by transesophageal echocardiography (TEE) in patients with AF have not been defined. To evaluate the hypothesis that reduced velocity is associated with spontaneous echocardiographic contrast and thrombus in the LAA and with clinical embolic events, we measured LAA flow velocity by TEE in 721 patients with nonvalvular AF entering the Stroke Prevention in Atrial Fibrillation (SPAF-III) study. Patient features, TEE findings, and subsequent cardioembolic events were correlated with velocity by multivariate analysis. Patients in AF during TEE displayed lower peak antegrade (emptying) flow velocity (Anu(p)) than those with intermittent AF in sinus rhythm during TEE (33 cm/s vs 61 cm/s, respectively, P <.0001). Anu(p) < 20 cm/s was associated with dense spontaneous echocardiographic contrast (P <.001), appendage thrombus (P <.01), and subsequent cardioembolic events (P <.01). Independent predictors of Anu(p) < 20 cm/s included age (P =.009), systolic blood pressure (P <.001), sustained AF (P =.01), ischemic heart disease (P =.01), and left atrial area (P =.04). Multivariate analysis found both Anu(p) <20 cm/s (relative risk 2.6, P =.02) and clinical risk factors (relative risk 3.3, P =.002) independently associated with LAA thrombus. LAA Anu(p) is reduced in AF and associated with spontaneous echocardiographic contrast, appendage thrombus, and cardioembolic stroke. Systolic hypertension and aortic atherosclerosis, independent clinical predictors of stroke in patients with AF, also correlated with LAA Anu(p). Our results support the role of reduced LAA Anu(p) in the generation of stasis, thrombus formation, and embolism in patients with AF, although other mechanisms also contribute to stroke.

Influence of renal function on the association between homocysteine level and risk of ischemic stroke.

PubMed

Cheng, Yao; Kong, Fan-Zhen; Dong, Xiao-Feng; Xu, Qin-Rong; Gui, Qian; Wang, Wei; Feng, Hong-Xuan; Luo, Wei-Feng; Gao, Zong-En; Wu, Guan-Hui

2017-01-01

We examined whether the association between total homocysteine (tHCY) and risk of ischemic stroke (IS) varies depending on renal function to gain insight into why tHCY-lowering vitamins do not reduce the incidence of cardiovascular disease in clinical trials. We analyzed data from 542 IS patients with large artery atherosclerosis (LAA) or small artery occlusion (SAO) after stratification by estimated glomerular filtration rate (eGFR) to evaluate renal function. We found that tHCY level was positively associated with the occurrence of IS in both LAA (OR: 1.159, 95% CI: 1.074-1.252, P <0.001) and SAO (OR: 1.143, 95% CI: 1.064-1.228, P <0.001) patients and in LAA (OR: 1.135, 95% CI: 1.047-1.230, P =0.002) and SAO (OR: 1.159, 95% CI: 1.060-1.268, P =0.001) subgroups with normal renal function but not in LAA or SAO subgroups with renal insufficiency. eGFR level was positively associated with IS in LAA (OR: 1.022, 95% CI: 1.010-1.034, P <0.001) and SAO (OR: 1.024, 1.012-1.037, P <0.001) subgroups with normal renal function but was negatively associated with IS in LAA (OR: 0.875, 95% CI: 0.829-0.925, P <0.001) and SAO (OR: 0.890, 95% CI: 0.850-0.932, P <0.001) subgroups with renal insufficiency. Folic acid level was negatively associated with IS in LAA (OR: 0.734, 95% CI: 0.606-0.889, P =0.002) and SAO (OR: 0.861, 95% CI: 0.767-0.967, P =0.012) subgroups with renal insufficiency. Therefore, renal function as evaluated by eGFR exerts a significant influence on the association between tHCY and risk of IS.

Left Atrial Appendage Exclusion for Atrial Fibrillation

PubMed Central

Syed, Faisal F.; DeSimone, Christopher V.; Friedman, Paul A.; Asirvatham, Samuel J.

2015-01-01

SYNOPSIS Percutaneous left atrial appendage (LAA) closure is increasingly being used as a treatment strategy to prevent stroke in patients with atrial fibrillation (AF) who have contraindications to anticoagulants. A number of approaches and devices have been developed in the last few years, each with their own unique set of advantages and disadvantages. We review the published studies on surgical and percutaneous approaches to LAA closure; focusing on stroke mechanisms in AF, LAA structure and function relevant to stroke prevention, practical differences in procedural approach, and clinical considerations surrounding management. PMID:25443240

Ranging airport pseudolite for local area augmentation using the global positioning system

NASA Astrophysics Data System (ADS)

Bartone, Chris Gregory

The Local Area Augmentation System (LAAS) is being developed to support precision approach and landing operations in and about the local area surrounding an airport. The LAAS Program is currently under development by the Federal Aviation Administration (FAA) with Minimum Aviation System Performance Standards for the LAAS being developed by RTCA, Incorporated. The LAAS uses differential Global Positioning System (DGPS) and includes one or more airport pseudolites (APL) to increase the availability for certain installations. This dissertation addresses the addition of a differentially corrected, ranging APL into a LAAS. Prior to this work, no ranging APL has been integrated into a prototype LAAS and demonstrated in a real-time flight environment showing that an increase in LAAS availability is feasible. The APL requirements resulted in a prototype APL transmitting and receiving subsystem with a coarse-acquisition (C/A) code format that could be operated at any frequency within the L1± 10.0 MHz band. To investigate the major APL error the developmental approach was performed in two phases. Phase I implemented an APL operating at a center frequency off-L1 and concentrated on multipath limiting. The Phase II on-L1 APL architecture implemented a unique pulsing, automatic gain control (AGC) and GPS Blanker technique in the common reception path to maximize APL signal tracking and minimize electromagnetic interference to DGPS. To minimize ground multipath for the APL geometry, which is more severe than for GPS, a multipath limiting antenna (MLA) was designed, fabricated, and tested within a 4-month period. The implementation of this MLA concept was a first for APL applications and also contributed to the successful multipath limiting of ground multipath at the DGPS LAAS Ground Station. This effort successfully demonstrated that ground multipath can be limited (with low variance and no long-term bias) for the APL geometry and that suitable precision approach performance

Amphiphilic naproxen prodrugs: differential scanning calorimetry study on their interaction with phospholipid bilayers.

PubMed

Giuffrida, Maria Chiara; Pignatello, Rosario; Castelli, Francesco; Sarpietro, Maria Grazia

2017-09-01

Naproxen, a nonsteroid anti-inflammatory drug studied for Alzheimer's disease, was conjugated with lipoamino acids (LAA) directly or through a diethylamine (EDA) spacer to improve the drug lipophilicity and the interaction with phospholipid bilayers. The interaction of naproxen and its prodrugs with biomembrane models consisting of dimyristoylphosphatidylcholine multilamellar vesicles was studied by differential scanning calorimetry. The transfer of prodrugs from a lipophilic carrier to a biomembrane model was also studied. Naproxen conjugation to lipoamino acids improves its interaction with biomembrane models and affects the transfer from a lipophilic carrier to biomembrane model. LAA portion may localize between the phospholipid chains; the entity of the interaction depends not only on the presence of the spacer but also on the LAA chain length. Variation of LAA portion can modulate the naproxen prodrugs affinity towards the biological membrane as well as towards the lipophilic carrier. © 2017 Royal Pharmaceutical Society.

Journal Article: Low Levels of Exposure to Libby Amphibole Asbestos and Localized Pleural Thickening

EPA Science Inventory

Libby Amphibole asbestos (LAA) is a mixture of amphibole fibers present in ore from the vermiculite mine near Libby, MT (1). Workers and community residents were exposed to LAA at the mining operations in Libby, MT (2, 3), as well as at vermiculite processing facilities in Marys...

The effect of transient balloon occlusion of the mitral valve on left atrial appendage blood flow velocity and spontaneous echo contrast.

PubMed

Wang, J; Chung Ann Choo, D; Zhang, X; Yang, Q; Xian, T; Lu, D; Jiang, S

2000-07-01

Spontaneous echo contrast (SEC) is a phenomenon that is commonly seen in areas of blood stasis. It is a slowly moving, cloud-like swirling pattern of "smoke" or increased echogenicity recorded on echocardiography. SEC is commonly seen in the left atrium of patients with mitral stenosis or atrial fibrillation. The presence of SEC has been shown to be a marker of increased thromboembolic risk. By using transesophageal echocardiography during percutaneous balloon mitral valvotomy (PBMV), the study investigated the relationship between SEC and varying left atrial appendage (LAA) blood flow velocity in the human heart. Thirty-five patients with rheumatic mitral stenosis underwent percutaneous balloon mitral valvotomy with intraoperative transesophageal echocardiography monitoring. We alternatively measured LAA velocities and observed the left atrium for various grades of SEC (0 = none to 4 = severe) before and after each balloon inflation. Left atrial appendage maximal ejection velocity was reduced from 35 +/- 14 to 6 +/- 2 mm/s at peak balloon inflation and increased to 40 +/- 16 mm/s after balloon deflation. In comparison with the values before balloon inflation and after balloon deflation, LAA velocities were significantly lower (p < 0.001). New or increased SEC grade was observed during 54 of 61 (88%) inflations and unchanged in 7 (12%) inflations at peak balloon inflation. Spontaneous echo contrast became lower in grade after 55 balloon deflations (90%), completely disappeared after 18 deflations (30%), and remained unchanged after 6 deflations (10%). The mean time to achieve maximal SEC grade (2.5 +/- 1.2 s) coincided with the mean time to trough LAA velocities (2.3 +/- 1.1 s) after balloon inflation. Upon deflation, the mean time to lowest SEC grade (2.9 +/- 1.8 s) coincided with mean time to achieve maximal LAA velocities (2.7 +/- 1.6 s). During balloon inflation, the severity of SEC was enhanced with corresponding reduction in LAA flow velocity. Upon balloon

Periprocedural intracardiac echocardiography for left atrial appendage closure: a dual-center experience.

PubMed

Berti, Sergio; Paradossi, Umberto; Meucci, Francesco; Trianni, Giuseppe; Tzikas, Apostolos; Rezzaghi, Marco; Stolkova, Miroslava; Palmieri, Cataldo; Mori, Fabio; Santoro, Gennaro

2014-09-01

This dual-center study sought to demonstrate the utility and safety of intracardiac echocardiography (ICE) in providing adequate imaging guidance as an alternative to transesophageal echocardiography (TEE) during Amplatzer Cardiac Plug device implantation. Over 90% of intracardiac thrombi in atrial fibrillation originate from the left atrial appendage (LAA). Patients with contraindications to anticoagulation are potential candidates for LAA percutaneous occlusion. TEE is typically used to guide implantation. ICE-guided percutaneous LAA closure was performed in 121 patients to evaluate the following tasks typically achieved by TEE: assessment of the LAA dimension for device sizing; guidance of transseptal puncture; verification of the delivery sheath position; confirmation of location and stability of the device before and after release and continuous monitoring to detect procedural complications. In 51 consecutive patients, we compared the measurements obtained by ICE and fluoroscopy to choose the size of the device. The device was successfully implanted in 117 patients, yielding a technical success rate of 96.7%. Procedural success was achieved in 113 cases (93.4%). Four major adverse events (3 cardiac tamponades and 1 in-hospital transient ischemic attack) occurred. There was significant correlation in the measurements for device sizing assessed by angiography and ICE (r = 0.94, p < 0.0001). ICE imaging was able to perform the tasks typically provided by TEE during implantation of the Amplatzer Cardiac Plug device for LAA occlusion. Therefore, we provide evidence that the use of ICE offered accurate measurements of LAA dimension in order to select the correct device sizes. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Size-based emphysema cluster analysis on low attenuation area in 3D volumetric CT: comparison with pulmonary functional test

NASA Astrophysics Data System (ADS)

Lee, Minho; Kim, Namkug; Lee, Sang Min; Seo, Joon Beom; Oh, Sang Young

2015-03-01

To quantify low attenuation area (LAA) of emphysematous regions according to cluster size in 3D volumetric CT data of chronic obstructive pulmonary disease (COPD) patients and to compare these indices with their pulmonary functional test (PFT). Sixty patients with COPD were scanned by a more than 16-multi detector row CT scanner (Siemens Sensation 16 and 64) within 0.75mm collimation. Based on these LAA masks, a length scale analysis to estimate each emphysema LAA's size was performed as follows. At first, Gaussian low pass filter from 30mm to 1mm kernel size with 1mm interval on the mask was performed from large to small size, iteratively. Centroid voxels resistant to the each filter were selected and dilated by the size of the kernel, which was regarded as the specific size emphysema mask. The slopes of area and number of size based LAA (slope of semi-log plot) were analyzed and compared with PFT. PFT parameters including DLco, FEV1, and FEV1/FVC were significantly (all p-value< 0.002) correlated with the slopes (r-values; -0.73, 0.54, 0.69, respectively) and EI (r-values; -0.84, -0.60, -0.68, respectively). In addition, the D independently contributed regression for FEV1 and FEV1/FVC (adjust R sq. of regression study: EI only, 0.70, 0.45; EI and D, 0.71, 0.51, respectively). By the size based LAA segmentation and analysis, we evaluated the Ds of area, number, and distribution of size based LAA, which would be independent factors for predictor of PFT parameters.

Cost-Effectiveness of Percutaneous Closure of the Left Atrial Appendage in Atrial Fibrillation Based on Results from PROTECT AF vs. PREVAIL

PubMed Central

Freeman, James V.; Hutton, David W.; Barnes, Geoffrey D.; Zhu, Ruo P.; Owens, Douglas K.; Garber, Alan M.; Go, Alan S.; Hlatky, Mark A.; Heidenreich, Paul A.; Wang, Paul J.; Al-Ahmad, Amin; Turakhia, Mintu P.

2016-01-01

Background Randomized trials of left atrial appendage (LAA) closure with the Watchman device have shown varying results, and its cost-effectiveness compared to anticoagulation has not been evaluated using all available contemporary trial data. Methods and Results We used a Markov decision model to estimate lifetime quality-adjusted survival, costs, and cost-effectiveness of LAA closure with Watchman, compared directly with warfarin and indirectly with dabigatran, using data from the long-term (mean 3.8 year) follow-up of PROTECT AF and PREVAIL randomized trials. Using data from PROTECT AF, the incremental cost-effectiveness ratios (ICER) compared to warfarin and dabigatran were $20,486 and $23,422 per quality adjusted life year (QALY), respectively. Using data from PREVAIL, LAA closure was dominated by warfarin and dabigatran, meaning that it was less effective (8.44, 8.54, and 8.59 QALYs, respectively) and more costly. At a willingness-to-pay-threshold of $50,000 per QALY, LAA closure was cost-effective 90% and 9% of the time under PROTECT AF and PREVAIL assumptions, respectively. These results were sensitive to the rates of ischemic stroke and intracranial hemorrhage for LAA closure and medical anticoagulation. Conclusions Using data from the PROTECT AF trial, LAA closure with the Watchman device was cost-effective; using PREVAIL trial data, Watchman was more costly and less effective than warfarin and dabigatran. PROTECT AF enrolled more patients and has substantially longer follow-up time, allowing greater statistical certainty with the cost-effectiveness results. However, longer term trial results and post-marketing surveillance of major adverse events will be vital to determining the value of the Watchman in clinical practice. PMID:27307517

Impacts of absorbing aerosol deposition on snowpack and hydrologic cycle in the Rocky Mountain region based on variable-resolution CESM (VR-CESM) simulations

NASA Astrophysics Data System (ADS)

Wu, Chenglai; Liu, Xiaohong; Lin, Zhaohui; Rahimi-Esfarjani, Stefan R.; Lu, Zheng

2018-01-01

The deposition of light-absorbing aerosols (LAAs), such as black carbon (BC) and dust, onto snow cover has been suggested to reduce the snow albedo and modulate the snowpack and consequent hydrologic cycle. In this study we use the variable-resolution Community Earth System Model (VR-CESM) with a regionally refined high-resolution (0.125°) grid to quantify the impacts of LAAs in snow in the Rocky Mountain region during the period 1981-2005. We first evaluate the model simulation of LAA concentrations both near the surface and in snow and then investigate the snowpack and runoff changes induced by LAAs in snow. The model simulates similar magnitudes of near-surface atmospheric dust concentrations as observations in the Rocky Mountain region. Although the model underestimates near-surface atmospheric BC concentrations, the model overestimates BC-in-snow concentrations by 35 % on average. The regional mean surface radiative effect (SRE) due to LAAs in snow reaches up to 0.6-1.7 W m-2 in spring, and dust contributes to about 21-42 % of total SRE. Due to positive snow albedo feedbacks induced by the LAA SRE, snow water equivalent is reduced by 2-50 mm and snow cover fraction by 5-20 % in the two regions around the mountains (eastern Snake River Plain and southwestern Wyoming), corresponding to an increase in surface air temperature by 0.9-1.1 °C. During the snow melting period, LAAs accelerate the hydrologic cycle with monthly runoff increases of 0.15-1.00 mm day-1 in April-May and reductions of 0.04-0.18 mm day-1 in June-July in the mountainous regions. Of all the mountainous regions, the Southern Rockies experience the largest reduction of total runoff by 15 % during the later stage of snowmelt (i.e., June and July). Compared to previous studies based on field observations, our estimation of dust-induced SRE is generally 1 order of magnitude smaller in the Southern Rockies, which is ascribed to the omission of larger dust particles (with the diameter > 10 µm) in

Identification of Left Atrial Appendage Thrombi in Patients With Persistent and Long-Standing Persistent Atrial Fibrillation Using Intra-Cardiac Echocardiography and Cardiac Computed Tomography.

PubMed

Ikegami, Yukinori; Tanimoto, Kojiro; Inagawa, Kohei; Shiraishi, Yasuyuki; Fuse, Jun; Sakamoto, Munehisa; Momiyama, Yukihiko; Takatsuki, Seiji

2017-12-25

Intracardiac echocardiography (ICE) and cardiac computed tomography (CCT), in addition to standard transesophageal echocardiography (TEE), have been used to identify left atrial (LA) thrombi prior to ablation for atrial fibrillation (AF). The clinical advantages of this, however, remain unclear. This study therefore investigated the advantages of additional pre-procedural LA appendage (LAA) thrombus evaluation using ICE and the clinical value of CCT in persistent and long-standing persistent AF.Methods and Results:We analyzed data from 108 consecutive patients with persistent and long-standing persistent AF who were scheduled to undergo AF ablation. TEE was performed within 24 h prior to ablation. ICE was performed for 97 patients in whom a thrombus was not detected on TEE. CCT was performed in 95 patients. Thrombus or sludge was detected on TEE in 11 patients (10.3%), for whom ablation was cancelled. Four additional patients were diagnosed with LAA thrombus on ICE. When TEE and ICE were used as the reference for thrombus detection, the sensitivity, specificity, positive predictive value, and negative predictive value of CCT for identifying contrast defects in the LAA were 100%, 81.0%, 40.7%, and 100%, respectively. ICE combined with TEE increased the detection rate of LAA thrombi in patients with persistent and long-standing persistent AF. Moreover, CCT had high sensitivity and negative predictive value for LAA thrombus detection.

Resolution of massive left atrial appendage thrombi with rivaroxaban before balloon mitral commissurotomy in severe mitral stenosis: A case report and literature review.

PubMed

Li, Yuechun; Lin, Jiafeng; Peng, Chen

2016-12-01

Data on nonvitamin K antagonist oral anticoagulant being used for the treatment of LAA thrombi are limited only in nonvalvular atrial fibrillation. There are no data on the antithrombotic efficacy and safety of nonvitamin K antagonist oral anticoagulant in the resolution of left atrial appendage (LAA) thrombi in patients with rheumatic mitral stenosis. A 49-year-old woman with known rheumatic mitral stenosis and atrial fibrillation was referred for percutaneous transvenous mitral commissurotomy because of progressive dyspnea on exertion over a period of 3 months. Transesophageal echocardiography (TEE) demonstrated a large LAA thrombus protruding into left atria cavity before the procedure. Direct factor Xa (FXa) inhibitor rivaroxaban (20 mg/d) was started for the patient. After 3 weeks of rivaroxaban treatment TEE showed a relevantly decreased thrombus size, and a complete thrombus resolution was achieved after 5 weeks of anticoagulant therapy with the FXa inhibitor. To the best of our knowledge, this is the first documented case of large LAA thrombus resolution with nonvitamin K antagonist oral anticoagulant in severe mitral stenosis, and in which percutaneous transvenous mitral commissurotomy was performed subsequently. The report indicated that rivaroxaban could be a therapeutic option for mitral stenosis patients with LAA thrombus. Further study is required before the routine use of rivaroxaban in patients with rheumatic mitral stenosis and atrial fibrillation.

Clinical illness and outcomes in Nigerian children with late-appearing anaemia after artemisinin-based combination treatments of uncomplicated falciparum malaria.

PubMed

Sowunmi, Akintunde; Akano, Kazeem; Ayede, Adejumoke I; Ntadom, Godwin; Aderoyeje, Temitope; Adewoye, Elsie O; Fatunmbi, Bayo

2016-06-01

Late-appearing anaemia (LAA) following treatment with artemisinins for severe malaria has been reported and well described, but there are limited clinical and parasitological data on LAA in African children with uncomplicated falciparum malaria following oral artemisinin-based combination therapies (ACTs). This was an open label study with the main objectives of evaluating the clinical features, the risk factors for, the temporal changes in haematocrit and the outcomes of a LAA in malarious children treated with artesunate-amodiaquine (AA), artemether-lumefantrine (AL) or dihydroartemisinin-piperaquine (DHP). The diagnosis of LAA was made using the criteria: clearance of parasitaemia, fever and other symptoms within 1 week of commencing treatment; adequate clinical and parasitological response at 4-6 weeks after treatment began; haematocrit ≥30 % 1 and/or 2 weeks after treatment began; and haematocrit <30 %, parasite negativity by microscopy and polymerase chain reaction and absence of concomitant illness 3-6 weeks after treatment began. LAA occurred in 84 of 609 children, was mild, moderate or severe in 77, 6 or 1 child, respectively and was relatively asymptomatic. Mean time elapsing from commencement of treatment to LAA was 27.1 days (95 % CI 25.3-28.9). In a multivariate analysis, an age <3 years (adjusted odd ratio [AOR] = 2.6, 95 % CI 1.3-5.2, P = 0.005), fever 1 day after treatment began (AOR = 3.8, 95 % CI 1.8-8.2, P < 0.0001), haematocrit <25 % at presentation (AOR = 2.2, 95 % CI 1.3-3.7, P = 0.003), haematocrit <30 % 1 day after treatment began (AOR = 2.1, 95 % CI 1.0-4.3, P = 0.04), parasite reduction ratio >10(4) 2 days after treatment began (AOR = 2.1, 95 % CI 1.1-3.9, P = 0.03) and spleen enlargement at presentation (AOR = 2.0, 95 % CI 1.1-3.9, P < 0.0001) were independent predictors of LAA. During 6 weeks of follow-up, uneventful recovery from anaemia occurred in 56 children [mean recovery

[Characteristics of electrophysiology and effects of ouabain on transient outward potassium current and L-type calcium current of left atrium posterior wall in rabbits].

PubMed

Wang, Teng; Huang, Cong-xin; Jiang, Hong; Tang, Qi-zhu; Yang, Bo; Li, Geng-shan

2009-12-01

To investigate the properties of electrophysiology and effects of ouabain upon transient outward potassium current (I(to)) and L-type calcium current (I(Ca-L)) of left atrium posterior wall (LAPW) and left atrium appendage tissue (LAA)in rabbit so as to provide the scientific explanations that LAPW and ouabain can enhance atrial fibrillation (AF) vulnerability through increasing electrophysiological heterogeneity and electrical remodeling of different regions of left atrium in rabbits. Atrial myocytes from LAPWs and LAAs of rabbits on an in vitro heart perfusion system were obtained by enzymatic dissociation. The whole-cell patch-clamp technique was used to assess the effects of ouabain upon I(to) and I(Ca-L). The current-voltage (I-V) curves of I(to) and I(Ca-L) in LAPW and LAA myocytes were fitted before and after ouabain administration. (1) With holding potential +50 mV and commanding potential +50 mV, the current densities of LAPW I(to) decreased slightly less than that of LAA I(to) in control groups (P > 0.05). After ouabain administration, the current densities of LAPW I(to) were significantly larger than that of LAA I(to) [(10.97 +/- 0.58) pA/pF vs (9.39 +/- 0.83) pA/pF, P < 0.05]. The I-V curve of LAPW I(to) was slightly lowered to I-V curve of LAA I(to) in control groups. But with perfusion of ouabain, the I-V curve of LAPW I(to) opposed to I-V curve of LAA I(to) significantly changed from the bottom to the top with the same upward direction. (2) With the voltage clamp protocol of I(Ca-L), the current densities of LAPW I(Ca-L) markedly decreased compared with that of LAA I(Ca-L) in control groups (P < 0.05). With the addition of ouabain, the peak of amplitude of LAPW I(Ca-L) at +20 mV obviously increased to that of LAA I(Ca-L) [(-11.13 +/- 0.99) pA/pF vs (-8.86 +/- 0.51) pA/pF, P < 0.01]. In the control groups, the I-V curve of LAPW I(Ca-L) was shifted to the bottom of all I-V curves of I(Ca-L). Through the effects of ouabain, the I-V curve of LAPW I

Left atrial appendage obliteration in atrial fibrillation patients undergoing bioprosthetic mitral valve replacement.

PubMed

Min, X P; Zhu, T Y; Han, J; Li, Y; Meng, X

2016-02-01

Left atrial appendage (LAA) obliteration is a proven stroke-preventive measure for patients with nonvalvular atrial fibrillation (AF). However, the efficacy of LAA obliteration for patients with AF after bioprosthetic mitral valve replacement (MVR) remains unclear. This study aimed to estimate the efficacy of LAA obliteration in preventing embolism and to investigate the predictors of thromboembolism after bioprosthetic MVR. We retrospectively studied 173 AF subjects with bioprosthetic MVR; among them, 81 subjects underwent LAA obliteration using an endocardial running suture method. The main outcome measure was the occurrence of thrombosis events (TEs). The mean follow-up time was 40 ± 17 months. AF rhythm was observed in 136 patients postoperatively. The incidence rate of TEs was 13.97 % for postoperative AF subjects; a dilated left atrium (LA; > 49.5 mm) was identified as an independent risk factor of TEs (OR = 10.619, 95 % CI = 2.754-40.94, p = 0.001). For postoperative AF patients with or without LAA, the incidence rate of TEs was 15.8 % (9/57) and 12.7 % (10/79; p = 0.603), respectively. The incidence rate of TEs was 2.7 % (1/36) and 4.2 % (2/48) for the subgroup patients with a left atrial diameter of < 49.5 mm, and 38.1 % (8/21) and 25.8 % (8/31) for those with a left atrial diameter of > 49.5 mm (p = 0.346). Surgical LAA obliteration in patients with valvular AF undergoing bioprosthetic MVR did not reduce TEs, even when the CHA2DS2-VASc score (a score for estimating the risk of stroke in AF) was ≥ 2 points.

Echocardiographic Risk Factors for Stroke and Outcomes in Patients With Atrial Fibrillation Anticoagulated With Apixaban or Warfarin.

PubMed

Vinereanu, Dragos; Lopes, Renato D; Mulder, Hillary; Gersh, Bernard J; Hanna, Michael; de Barros E Silva, Pedro G M; Atar, Dan; Wallentin, Lars; Granger, Christopher B; Alexander, John H

2017-12-01

Few data exist on the long-term outcomes of patients with spontaneous echo contrast (SEC), left atrial/left atrial appendage (LA/LAA) thrombus, and complex aortic plaque (CAP), in patients with atrial fibrillation receiving oral anticoagulation. We explored the relationship between these 3 echocardiographic findings and clinical outcomes, and the comparative efficacy and safety of apixaban and warfarin for each finding. Patients from the ARISTOTLE trial (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation) with SEC, LA/LAA thrombus, or CAP diagnosed by either transthoracic or transesophageal echocardiography were compared with patients with none of these findings on transesophageal echocardiography. A total of 1251 patients were included: 217 had SEC, 127 had LA/LAA thrombus, 241 had CAP, and 746 had none. The rates of stroke/systemic embolism were not significantly different among patients with and without these echocardiographic findings (hazard ratio, 0.96; 95% confidence interval, 0.25-3.60 for SEC; hazard ratio, 1.27; 95% confidence interval, 0.23-6.86 for LA/LAA thrombus; hazard ratio, 2.21; 95% confidence interval, 0.71-6.85 for CAP). Rates of ischemic stroke, myocardial infarction, cardiovascular death, and all-cause death were also not different between patients with and without these findings. For patients with either SEC or CAP, there was no evidence of a differential effect of apixaban over warfarin. For patients with LA/LAA thrombus, there was also no significant interaction, with the exception of all-cause death and any bleeding where there was a greater benefit of apixaban compared with warfarin among patients with no LA/LAA thrombus. In anticoagulated patients with atrial fibrillation and risk factors for stroke, echocardiographic findings do not seem to add to the risk of thromboembolic events. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00412984. © 2017 American Heart Association, Inc.

Dynamics of Lamin-A Processing Following Precursor Accumulation

PubMed Central

Liu, Qian; Kim, Dae In; Syme, Janet; LuValle, Phyllis; Burke, Brian; Roux, Kyle J.

2010-01-01

Lamin A (LaA) is a component of the nuclear lamina, an intermediate filament meshwork that underlies the inner nuclear membrane (INM) of the nuclear envelope (NE). Newly synthesized prelamin A (PreA) undergoes extensive processing involving C-terminal farnesylation followed by proteolysis yielding non-farnesylated mature lamin A. Different inhibitors of these processing events are currently used therapeutically. Hutchinson-Gilford Progeria Syndrome (HGPS) is most commonly caused by mutations leading to an accumulation of a farnesylated LaA isoform, prompting a clinical trial using farnesyltransferase inhibitors (FTI) to reduce this modification. At therapeutic levels, HIV protease inhibitors (PI) can unexpectedly inhibit the final processing step in PreA maturation. We have examined the dynamics of LaA processing and associated cellular effects during PI or FTI treatment and following inhibitor washout. While PI reversibility was rapid, with respect to both LaA maturation and associated cellular phenotype, recovery from FTI treatment was more gradual. FTI reversibility is influenced by both cell type and rate of proliferation. These results suggest a less static lamin network than has previously been observed. PMID:20526372

Thromboembolism after WATCHMANTM in a clopidogrel non-responder: A case for concern?

PubMed

Venkataraman, Ganesh; Bliden, Kevin P; Tantry, Udaya S; Gurbel, Paul A

2017-11-11

Atrial fibrillation (AF) is associated with an increased risk of stroke and thromboembolism (TE). The WATCHMAN TM left atrial appendage (LAA) closure device is indicated to reduce the risk of TE from the LAA in patients with non-valvular AF. Here, we present a case of a patient with device-related thrombus who suffered a TE event two months after WATCHMAN TM LAA closure and two weeks after switching from aspirin plus warfarin to aspirin plus clopidogrel therapy. Laboratory investigation identified the patient to be hypercoagulable and to be a non-responder to clopidogrel therapy. We discuss the potential role of platelet function testing to prevent device-related thrombi. © 2017 Wiley Periodicals, Inc.

Left Atrial Appendage Eccentricity and Irregularity Are Associated With Residual Leaks After Percutaneous Closure.

PubMed

Rajwani, Adil; Shirazi, Masoumeh G; Disney, Patrick J S; Wong, Dennis T L; Teo, Karen S L; Delacroix, Sinny; Chokka, Ramesh G; Young, Glenn D; Worthley, Stephen G

2015-12-01

Predictors of residual leak following percutaneous LAA closure were evaluated. Left atrial appendage (LAA) closure aims to exclude this structure from the circulation, typically using a circular occluder. A noncircular orifice is frequently encountered however, and fibrous remodeling of the LAA in atrial fibrillation may restrict orifice deformation. Noncircularity may thus be implicated in the occurrence of residual leak despite an appropriately oversized device. Pre-procedural multislice computerized tomography was used to quantify LAA orifice eccentricity and irregularity. Univariate predictors of residual leak were identified with respect to the orifice, device, and relevant clinical variables, with the nature of any correlations then further evaluated. Eccentricity and irregularity indexes of the orifice in 31 individuals were correlated with residual leak even where the device was appropriately oversized. An eccentricity index of 0.15 predicted a residual leak with 85% sensitivity and 59% specificity. An irregularity index of 0.05 predicted a significant residual leak ≥3 mm with 100% sensitivity and 86% specificity. Orifice size, device size, degree of device oversize, left atrial volume, and pulmonary artery pressure were not predictors of residual leak. Eccentricity and irregularity of the LAA orifice are implicated in residual leak after percutaneous closure even where there is appropriate device over-size. Irregularity index in particular is a novel predictor of residual leak, supporting a closer consideration of orifice morphology before closure. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Risk factors associated with airway allergic diseases from exposure to laboratory animal allergens among veterinarians.

PubMed

Krakowiak, Anna; Wiszniewska, Marta; Krawczyk, Patrycja; Szulc, Bogdan; Wittczak, Tomasz; Walusiak, Jolanta; Pałczynski, Cezary

2007-05-01

Investigate the risk factors for the development of occupational airway allergy (OAA) from exposure to laboratory animal allergens (LAA) among Polish veterinarians. Two hundred veterinarians responded to the questionnaire and were subjected to skin prick test (SPT) to common allergens and LAA (rat, mouse, hamster, guinea pig, rabbit). Evaluation of total serum IgE level and specific IgE against occupational allergens was performed. In addition, bronchial hyperreactivity (BHR) and peak expiratory flow rate (PEFR) were measured before and after specific challenge testing (SCT) only in the subjects with work-related symptoms suggestive of occupational asthma (OA). The prevalence of asthmatic and ocular symptoms was statistically more prevalent in the group of veterinarians sensitised to LAA versus non-sensitised subjects. The most frequent occupational allergens of skin and serum reactivity were LAA (44.5 and 31.5%, respectively). In 41 (20.5%) and in 22 (11%) subjects out of 200 veterinarians, serum specific IgE to natural rubber latex (NRL) allergens and disinfectants was also found. Serum sensitisation to cat allergens and daily contact with laboratory animals (LA) increased the risk for developing isolated occupational rhinitis. Furthermore, working time of more than 10 years and daily contact with LA were also significant risk factors for the development of OAA. Measuring PEFR and BHR before and after SCT is a useful method to confirm the presence of OA. Allergy to LAA is an important health problem among veterinary medicine practitioners in Poland.

Finalizing the Libby Action Plan Research Program | Science ...

EPA Pesticide Factsheets

Libby, Montana is the location of a former vermiculite mine that operated from 1923 to 1990. The vermiculite ore from the mine co-existed with amphibole asbestos, referred to as Libby Amphibole Asbestos (LAA). Combined with the cessation of the asbestos mining and processing operations, there has been significant progress in reducing the exposure to LAA in Libby, Montana. In 2009, the U.S Environmental Protection Agency (EPA) jointly with the Department of Health and Human Services (DHHS) declared a public health emergency in Libby due to observed asbestos-related health effects in the region. As part of this effort, the EPA led a cross-agency research program that conducted analytical, toxicological, and epidemiological research on the health effects of asbestos at the Libby Asbestos Superfund Site (Libby Site) in Libby, Montana. The Libby Action Plan (LAP) was initiated in 2007 to support the site-specific risk assessment for the Libby Site. The goal of the LAP research program was to explore the health effects of LAA, and determine toxicity information specific to LAA in order to accurately inform a human health risk assessment at the Libby Site. LAP research informed data gaps related to the health effects of exposure to LAA, particularly related to specific mechanisms of fiber dosimetry and toxicity (e.g., inflammatory responses), as well as investigated disease progression in exposed populations and advanced asbestos analytical techniques. This work incl

Quantitative computed tomography of the lungs and airways in healthy nonsmoking adults.

PubMed

Zach, Jordan Alexander; Newell, John D; Schroeder, Joyce; Murphy, James R; Curran-Everett, Douglas; Hoffman, Eric A; Westgate, Philip M; Han, MeiLan K; Silverman, Edwin K; Crapo, James D; Lynch, David A

2012-10-01

The purposes of this study were to evaluate the reference range of quantitative computed tomography (QCT) measures of lung attenuation and airway parameter measurements in healthy nonsmoking adults and to identify sources of variation in those measures and possible means to adjust for them. Within the COPDGene study, 92 healthy non-Hispanic white nonsmokers (29 men, 63 women; mean [SD] age, 62.7 [9.0] years; mean [SD] body mass index [BMI], 28.1 [5.1] kg/m(2)) underwent volumetric computed tomography (CT) at full inspiration and at the end of a normal expiration. On QCT analysis (Pulmonary Workstation 2, VIDA Diagnostics), inspiratory low-attenuation areas were defined as lung tissue with attenuation values -950 Hounsfield units or less on inspiratory CT (LAA(I-950)). Expiratory low-attenuation areas were defined as lung tissue -856 Hounsfield units or less on expiratory CT (LAA(E-856)). We used simple linear regression to determine the impact of age and sex on QCT parameters and multiple regression to assess the additional impact of total lung capacity and functional residual capacity measured by CT (TLC(CT) and FRC(CT)), scanner type, and mean tracheal air attenuation. Airways were evaluated using measures of airway wall thickness, inner luminal area, wall area percentage (WA%), and standardized thickness of an airway with inner perimeter of 10 mm (Pi10). Mean (SD) %LAA(I-950) was 2.0% (2.7%), and mean (SD) %LAA(E-856) was 9.2% (6.8%). Mean (SD) %LAA(I-950) was 3.6% (3.2%) in men, compared with 1.3% (2.0%) in women (P < 0.001). The %LAA(I-950) did not change significantly with age (P = 0.08) or BMI (P = 0.52). %LAA(E-856) did not show any independent relationship with age (P = 0.33), sex (P = 0.70), or BMI (P = 0.32). On multivariate analysis, %LAA(I-950) showed a direct relationship to TLC(CT) (P = 0.002) and an inverse relationship to mean tracheal air attenuation (P = 0.003), and %LAA(E-856) was related to age (P = 0.001), FRC(CT) (P = 0.007), and scanner type

[Stroke. are there any difference between patients with or without patent foramen ovale in left atrial appendage systolic function?].

PubMed

Contreras, Alejandro E; Perrote, Federico; Concari, Ignacio; Brenna, Eduardo J; Lucero, Cecilia

2012-01-01

The aim of this study was to evaluate the systolic function of the left atrial appendage (LAA) in a group with and without patent foramen ovale (PFO) who suffered ischemic cerebrovascular events. Between September 2010 and October 2011, 17 patients were referred for transesophageal echocardiography (TEE) after suffering a stroke. PFO was defined as the passage of at least one bubble through atrial septum with bubble test. We compared systolic velocity in the appendage between patients with and without PFO and a control group. Were 8 women and 9 men, mean age 54.1 ± 19.5 years and 8 patients were under 55 years of age. All patients had suffered a ischemic cerebrovascular events, 41.2% had stroke, 52.9% transient ischemic attack and amaurosis fugax 5.9%. In the assessment of TEE, 11.8% had atrial septal aneurysm and 35.3% PFO. Mean LAA systolic velocity was 66.3 ± 20.3 cm / sec. There was no difference in systolic velocity of the LAA between patients with and without PFO (67.5 ± 11.8 cm / sec vs 65.7 ± 24.3 cm / sec respectively, p = 0.87). The control group of 8 patients, 5 women and 3 men, mean age 39.5 ± 18 years, had a LAA systolic velocity of 77.6 ± 28.9 cm / sec, no significant differences with ischemic patients. There were no differences in systolic function of the LAA between patients with and without PFO with ischemic cerebrovascular event.

[Recent and upcoming randomized trials for left atrial appendage occlusion : Need for a definite assessment of the situation].

PubMed

Skurk, Carsten; Hartung, Johannes Jakob; Landmesser, Ulf

2017-12-01

Atrial fibrillation (AF) is the most common arrhythmia affecting more than 1.6 million patients in Germany. Based on demographic developments, an the number is expected to increase. Embolic strokes in AF patients are particularly severe, and individualized new oral anticoagulant (NOAC) therapy reduces the incidence of stroke in these patients by approximately 70%. Besides vitamin K antagonists, the NOACs rivaroxaban, dabigatran, apixaban, and edoxaban have been introduced into clinical practice; however, major bleeding still occurs at a rate of 2-3% per year. Moreover, randomized studies and real-life registries suggest that >20% of patients with AF and an indication for anticoagulation cannot tolerate chronic oral anticoagulant therapy. Therefore, an alternative method for stroke prevention in AF patients has been developed, i. e., catheter-based exclusion of the left atrial appendage (LAA), a location that is prone for thrombus formation in these patients. The randomized trials of catheter-based LAA occlusion have compared this interventional therapy with vitamin K antagonists. In the future, however, LAA exclusion needs to be compared with NOAC therapy. Moreover, percutaneous LAA exclusion in clinical practice is mostly offered to patients ineligible for long-term oral anticoagulation or with high bleeding risk. However, no controlled, randomized trial data exist for this patient population. These data are needed for appropriate clinical judgment and optimal clinical management. Ongoing studies and scientific questions that are important to define the future for catheter-based LAA closure are discussed in this review.

A Comparative Study between the Effect of Combined Local Anesthetic and Low-dose Ketamine with Local Anesthetic on Postoperative Complications after Impacted Third Molar Surgery.

PubMed

Kumar, Anuj; Kale, Tejraj Pundalik

2015-12-01

Postoperative pain, swelling and trismus are the most common outcome after third molar surgery. Many methods have been tried to improve postoperative comfort after surgery. Ketamine is a phencyclidine derivative that induces a state of dissociative anesthesia. It is a noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist and has a distinct suppression effect on central nervous system (CNS) sensitization. Ketamine in a subanesthetic dose is set to produce analgesic and anti-inflammatory effect. Sixty patients, between the age group of 18 and 38 years, undergoing the extraction of impacted mandibular third molar, reporting to the department of oral and maxillofacial surgery were included in the study. Patients were divided randomly into two groups: local anesthetic alone (LAA) and local anesthetic and ketamine (LAK). Statistical analysis was performed using the Mann-Whitney U/unpaired--t-test and Wilcoxon signed-rank test. There was a significant difference in mouth opening in the LAA and LAK group in the immediate postoperative period. There was a significant difference between the two groups after 1 hour (LAA: 2.37; LAK: 1.40), and 4 hours (LAA: 2.37; LAK: 1.40). There was a significant difference in terms of facial swelling in the immediate postoperative period and day 1 between the LAA and LAK group. Use of subanesthetic dose of ketamine is not only safe but also valuable in reducing patient morbidity after third molar surgery. Combination of a local anesthetic and subanesthetic dose of ketamine during surgical extraction of third molars provides good postoperative analgesia with less swelling and significantly less trismus.

Percutaneous left atrial appendage occlusion: Effect of device positioning on outcome.

PubMed

Wolfrum, Mathias; Attinger-Toller, Adrian; Shakir, Samera; Gloekler, Steffen; Seifert, Burkhardt; Moschovitis, Aris; Khattab, Ahmed; Maisano, Francesco; Meier, Bernhard; Nietlispach, Fabian

2016-10-01

The study in patients with percutaneous left atrial appendage (LAA) occlusion investigates clinical outcomes according to the position of the Amplatzer Cardiac Plug (ACP) disc. The ACP consists of a disc and an anchoring lobe. The disc is meant to cover the ostium of the LAA, but frequently retracts partially or completely into the neck of the LAA. It is not known whether a retracted disc affects outcome. Outcomes of 169 consecutive patients (age 73.1 ± 10.4 years; 76% male) with successful LAA closure were analyzed according to the position of the ACP disc: group A had complete coverage of the LAA ostium; in group B the disc prolapsed partially or completely into the LAA-neck. Transesophageal echocardiography was performed 1-6 months after ACP implantation. The safety endpoint was the composite of clinically significant pericardial effusion, device embolization, procedure-related stroke/transient ischemic attack (TIA), major bleeding, or device thrombus. The efficacy endpoint was the composite of death, neurological events (ischemic and hemorrhagic stroke, TIA), or systemic embolism during follow-up. Group A comprised 76 patients (age 73.0 ± 9.9 years; 74% male) and group B 93 patients (age 73.3 ± 10.9 years; 79% male). Mean CHA 2 DS 2 -Vasc score and HASBLED score were 4.2 ± 1.7 (group A 4.3 ± 1.6; group B 4.2 ± 1.8) and 2.9 ± 1.1 (group A 2.9 ± 1.0; group B 3.0 ± 1.2), respectively. Mean follow-up of the study population was 13.0 ± 10.4 months. Overall, the composite safety and efficacy endpoints occurred in 20 (12%) and 6 patients (4%), respectively. There was no significant difference between groups A and B in the occurrence of the safety endpoint (13% vs. 11%, P = 0.64), or the efficacy endpoint (4% vs. 3%, P = 1.0). No evidence for a difference in the occurrence of the safety and efficacy endpoint was found between patients with complete vs. incomplete ACP disc coverage of the LAA ostium. The risk of

A study on quantifying COPD severity by combining pulmonary function tests and CT image analysis

NASA Astrophysics Data System (ADS)

Nimura, Yukitaka; Kitasaka, Takayuki; Honma, Hirotoshi; Takabatake, Hirotsugu; Mori, Masaki; Natori, Hiroshi; Mori, Kensaku

2011-03-01

This paper describes a novel method that can evaluate chronic obstructive pulmonary disease (COPD) severity by combining measurements of pulmonary function tests and measurements obtained from CT image analysis. There is no cure for COPD. However, with regular medical care and consistent patient compliance with treatments and lifestyle changes, the symptoms of COPD can be minimized and progression of the disease can be slowed. Therefore, many diagnosis methods based on CT image analysis have been proposed for quantifying COPD. Most of diagnosis methods for COPD extract the lesions as low-attenuation areas (LAA) by thresholding and evaluate the COPD severity by calculating the LAA in the lung (LAA%). However, COPD is usually the result of a combination of two conditions, emphysema and chronic obstructive bronchitis. Therefore, the previous methods based on only LAA% do not work well. The proposed method utilizes both of information including the measurements of pulmonary function tests and the results of the chest CT image analysis to evaluate the COPD severity. In this paper, we utilize a multi-class AdaBoost to combine both of information and classify the COPD severity into five stages automatically. The experimental results revealed that the accuracy rate of the proposed method was 88.9% (resubstitution scheme) and 64.4% (leave-one-out scheme).

[Combined left atrial appendage percutaneous closure and atrial fibrillation ablation: a single center experience].

PubMed

Pelissero, Elisa; Giuggia, Marco; Todaro, Maria Chiara; Trapani, Giuseppe; Giordano, Benedetta; Senatore, Gaetano

2017-12-01

We evaluated long-term safety and efficacy of concomitant left atrial appendage (LAA) closure and atrial fibrillation (AF) ablation. From February 2013 to June 2017, all patients referred for AF ablation and LAA closure (group 1) were enrolled in the study and compared with a matched control group undergoing AF ablation only (group 2). Pulmonary vein isolation was achieved in all cases with radiofrequency or cryoballoon. LAA was occluded with Watchman or Amplatzer Cardiac Plug or Amulet (ACP) devices. All patients were treated with oral anticoagulation therapy for at least 3 months after the procedure ("blanking period"), and then switched to dual antiplatelet therapy with aspirin and clopidogrel for other 3 months, and then to single antiplatelet therapy with aspirin in case of LAA closure, while group 2 was treated with long-term oral anticoagulation therapy according to CHA2DS2-VASc score. Follow-up was performed with transesophageal echocardiography and clinical visit at 3, 6 and 12 months after the procedure. AF burden was evaluated by loop recorder or pacemaker interrogation in all patients. Overall, 42 patients were enrolled, 21 in each group. Mean age was 66.86 ± 10.35 years in group 1 vs 68.42 ± 10.61 in group 2 (p=NS); mean CHA2DS2-VASc score was 2.8 ± 1.22 in group 1 vs 2.01 ± 0.93 in group 2 (p=NS), mean HAS-BLED score was 3.2 ± 0.83 in group 1 vs 3.1 ± 0.95 in group 2 (p=NS). Persistent AF was present in 80% of patients in group 1 and in 85% in group 2. LAA closure was successful in all cases (14 Watchman, 7 ACP devices). Procedural and fluoroscopy times were shorter in group 2 (68 ± 17 vs 52 ± 15 min, p <0.05; 23 ± 5 vs 18 ± 3 min, p <0.05, respectively). No procedural complications were observed in group 2, while in group 1 one case of self-terminating pericardial effusion and one arteriovenous fistula were observed. At a mean follow-up of 14.93 ± 10.05 months, complete seal of LAA was documented in all patients, with neither dislocations

Epicardial clip occlusion of the left atrial appendage during cardiac surgery provides optimal surgical results and long-term stability.

PubMed

Kurfirst, Vojtech; Mokrácek, Aleš; Canádyová, Júlia; Frána, Radim; Zeman, Petr

2017-07-01

Occlusion of the left atrial appendage (LAA) has become an integral and important part of the surgical treatment of atrial fibrillation. Different methods of surgical occlusion of the LAA have been associated with varying levels of short- and long-term success for closure. The purpose of this study was to evaluate long-term results of epicardial placement and endocardial occlusion in patients undergoing cardiac operative procedures. A total of 101 patients (average age 65.7 years) undergoing cardiac operative procedures with the epicardial AtriClip Exclusion System of the LAA were enrolled in the study. The AtriClip was placed via a sternotomy or a thoracotomy or from a thoracoscopic approach. Postoperative variables, such as thromboembolic events, clip stability and endocardial leakage around the device, were examined by transoesophageal echocardiography (TEE) and/or computed tomography. Perioperative clip implantation was achieved in 98% of patients. TEE and/or computed tomography conducted during the follow-up period, comprising 1873 patient-months with a mean duration of 18 ± 11 months, revealed no clip migration, no leakage around the device and no clot formation near the remnant cul-de-sac. During the follow-up period, 4 of the cardiac patients experienced transitory ischaemic attacks, whereas no patient experienced a cerebrovascular attack. The Epicardial AtriClip Exclusion System of the LAA appears to be a feasable and safe operative method with a high success rate. Long-term follow-up confirmed clip stability, complete occlussion of the LAA and absence of any atrial fibrilation-related thromboembolic events. These results need to be confirmed by a larger, multicentre study. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Verapamil eliminates the hierarchical nature of activation frequencies from the pulmonary veins to the atria during paroxysmal atrial fibrillation.

PubMed

Kushiyama, Yasunori; Osaka, Toshiyuki; Yokoyama, Eriko; Hasebe, Hideyuki; Kuroda, Yusuke; Kamiya, Kaichiro; Kodama, Itsuo

2010-05-01

There is evidence that verapamil promotes the persistence of paroxysmal atrial fibrillation (AF). Little is known about the underlying mechanisms. The purpose of this study was to determine the effect of verapamil on dominant frequencies (DFs) in the pulmonary veins (PVs) and atria during paroxysmal AF with reference to its potential arrhythmogenicity. Forty-three patients with paroxysmal AF were studied. Bipolar electrograms were recorded simultaneously during AF from the right atrial free wall (RAFW), coronary sinus (CS) and three PVs, or two PVs and the left atrial appendage (LAA). The DFs were obtained by fast Fourier transform analysis before and after infusion of verapamil (0.1 mg/kg, intravenously). At baseline, the maximum DF among the PVs (6.9 +/- 0.9 Hz) was significantly higher than the DF in the RAFW (6.2 +/- 0.7 Hz), CS (5.7 +/- 0.5 Hz), or LAA (5.9 +/- 0.7 Hz) (P<.01); there was a substantial PV-to-atrial DF gradient (RAFW 0.7 +/- 0.9, CS 1.1 +/- 0.7, LAA 0.7 +/- 0.9 Hz). Verapamil increased the atrial DF to 6.9 +/- 0.8, 6.6 +/- 0.7, and 7.2 +/- 1.0 Hz in the RAFW, CS, and LAA, respectively (P<.0001) but did not affect the maximum PV DF (7.1 +/- 0.7 Hz). The PV-to-atrial DF gradient was eliminated after verapamil (RAFW 0.2 +/- 0.8, CS 0.5 +/- 0.6, LAA -0.4 +/- 0.8 Hz; P<.01 vs. baseline). Verapamil increases the activation frequency in the atria but not in the PVs, eliminating the PV-to-atrial DF gradient during paroxysmal AF. Copyright 2010 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Increased myosin heavy chain-beta with atrial expression of ventricular light chain-2 in canine cardiomyopathy.

PubMed

Fuller, Geraldine A; Bicer, Sabahattin; Hamlin, Robert L; Yamaguchi, Mamoru; Reiser, Peter J

2007-10-01

Dilated cardiomyopathy is a naturally occurring disease in humans and dogs. Human studies have shown increased levels of myosin heavy chain (MHC)-beta in failing ventricles and the left atria (LA) and of ventricular light chain (VLC)-2 in the right atria in dilated cardiomyopathy. This study evaluates the levels of MHC-beta in all heart chambers in prolonged canine right ventricular pacing. In addition, we determined whether levels of VLC2 were altered in these hearts. Failing hearts demonstrated significantly increased levels of MHC-beta in the right atria, right atrial appendage, LA, left atrial appendage (LAA), and right ventricle compared with controls. Significant levels of VLC2 were detected in the right atria of paced hearts. Differences in MHC-beta expression were observed between the LA and the LAA of paced and control dogs. MHC-beta expression was significantly greater in the LA of paced and control dogs compared with their respective LAA. The cardiac myosin isoform shifts in this study were similar to those observed in end-stage human heart failure and more severe than those reported in less prolonged pacing models, supporting the use of this model for further study of end-stage human heart failure. The observation of consistent differences between sampling sites, especially LA versus LAA, indicates the need for rigorous sampling consistency in future studies.

Development and initial validation of a measure of attachment security in late adulthood.

PubMed

Lopez, Frederick G; Ramos, Katherine; Kim, Mijin

2018-05-10

Attachment theory-guided studies of older adults have generally relied on self-report measures that were validated on young adult samples and that focus on fears of rejection by romantic partners and on experiences of chronic discomfort with romantic intimacy as the key indicators of adult attachment security. These assessment characteristics raise important questions as to whether these measures are appropriate for use with older adults. Unlike their younger adult counterparts, older adults may face distinctive life stage-related threats to their attachment security such as declining health and autonomy, spousal loss, and increased dependence on younger family members for instrumental and emotional support. In response to these concerns, we conducted two independent studies aimed at developing and validating a novel measure of attachment security in older adults-the Late Adulthood Attachment Scale (LAAS). In study one (N = 287), exploratory structural equation modeling (ESEM) methods were used to identify and support a 2-factor structure (Fearful Avoidance, Secure Engagement) underlying LAAS scores. In study two (N = 417), ESEM and regression analyses confirmed the 2-factor structure and demonstrated the ability of LAAS scores to predict participants' well-being over a 3-month interval (n = 93). Findings from both studies support the psychometric adequacy of the LAAS as an alternative measure of attachment security for use with older adult samples. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

FLT3-regulated antigens as targets for leukemia-reactive cytotoxic T lymphocytes

PubMed Central

Brackertz, B; Conrad, H; Daniel, J; Kast, B; Krönig, H; Busch, D H; Adamski, J; Peschel, C; Bernhard, H

2011-01-01

The FMS-like tyrosine kinase 3 (FLT3) is highly expressed in acute myeloid leukemia (AML). Internal tandem duplications (ITD) of the juxtamembrane domain lead to the constitutive activation of the FLT3 kinase inducing the activation of multiple genes, which may result in the expression of leukemia-associated antigens (LAAs). We analyzed the regulation of LAA in FLT3-wild-type (WT)- and FLT3-ITD+ myeloid cells to identify potential targets for antigen-specific immunotherapy for AML patients. Antigens, such as PR-3, RHAMM, Survivin, WT-1 and PRAME, were upregulated by constitutively active FLT3-ITD as well as FLT3-WT activated by FLT3 ligand (FL). Cytotoxic T-cell (CTL) clones against PR-3, RHAMM, Survivin and an AML-directed CTL clone recognized AML cell lines and primary AML blasts expressing FLT3-ITD, as well as FLT3-WT+ myeloid dendritic cells in the presence of FL. Downregulation of FLT3 led to the abolishment of CTL recognition. Comparing our findings concerning LAA upregulation by the FLT3 kinase with those already made for the Bcr-Abl kinase, we found analogies in the LAA expression pattern. Antigens upregulated by both FLT3 and Bcr-Abl may be promising targets for the development of immunotherapeutical approaches against myeloid leukemia of different origin. PMID:22829124

Left Atrial Appendage Closure in Atrial Fibrillation: A World without Anticoagulation?

PubMed Central

Contractor, Tahmeed; Khasnis, Atul

2011-01-01

Atrial Fibrillation (AF) is a common arrhythmia with an incidence that is as high as 10% in the elderly population. Given the large proportion of strokes caused by AF as well as the associated morbidity and mortality, reducing stroke burden is the most important part of AF management. While warfarin significantly reduces the risk of AF-related stroke, perceived bleeding risks and compliance limit its widespread use in the high-risk AF population. The left atrial appendage is believed to be the “culprit” for thrombogenesis in nonvalvular AF and is a new therapeutic target for stroke prevention. The purpose of this review is to explore the evolving field of percutaneous LAA occlusion. After briefly highlighting the risk of stroke with AF, problems with warfarin, and the role of the LAA in clot formation, this article discusses the feasibility and efficacy of various devices which have been developed for percutaneous LAA occlusion. PMID:21559225

Land application of mine water causes minimal uranium loss offsite in the wet-dry tropics: Ranger Uranium Mine, Northern Territory, Australia.

PubMed

Mumtaz, Saqib; Streten, Claire; Parry, David L; McGuinness, Keith A; Lu, Ping; Gibb, Karen S

2015-11-01

Ranger Uranium Mine (RUM) is situated in the wet-dry tropics of Northern Australia. Land application (irrigation) of stockpile (ore and waste) runoff water to natural woodland on the mine lease is a key part of water management at the mine. Consequently, the soil in these Land Application Areas (LAAs) presents a range of uranium (U) and other metals concentrations. Knowledge of seasonal and temporal changes in soil U and physicochemical parameters at RUM LAAs is important to develop suitable management and rehabilitation strategies. Therefore, soil samples were collected from low, medium, high and very high U sites at RUM LAAs for two consecutive years and the effect of time and season on soil physicochemical parameters particularly U and other major solutes applied in irrigation water was measured. Concentrations of some of the solutes applied in the irrigation water such as sulphur (S), iron (Fe) and calcium (Ca) showed significant seasonal and temporal changes. Soil S, Fe and Ca concentration decreased from year 1 to year 2 and from dry to wet seasons during both years. Soil U followed the same pattern except that we recorded an increase in soil U concentrations at most of the RUM LAAs after year 2 wet season compared to year 2 dry season. Thus, these sites did not show a considerable decrease in soil U concentration from year 1 to year 2. Sites which contained elevated U after wet season 2 also had higher moisture content which suggests that pooling of U containing rainwater at these sites may be responsible for elevated U. Thus, U may be redistributed within RUM LAAs due to surface water movement. The study also suggested that a decrease in U concentrations in LAA soils at very high U (>900 mg kg(-1)) sites is most likely due to transport of particulate matter bound U by surface runoff and U may not be lost from the surface soil due to vertical movement through the soil profile. Uranium attached to particulate matter may reduce its potential for environmental

Left atrial appendages from adult hearts contain a reservoir of diverse cardiac progenitor cells.

PubMed

Leinonen, Jussi V; Emanuelov, Avishag K; Platt, Yardanna; Helman, Yaron; Feinberg, Yael; Lotan, Chaim; Beeri, Ronen

2013-01-01

There is strong evidence supporting the claim that endogenous cardiac progenitor cells (CPCs) are key players in cardiac regeneration, but the anatomic source and phenotype of the master cardiac progenitors remains uncertain. Our aim was to investigate the different cardiac stem cell populations in the left atrial appendage (LAA) and their fates. We investigated the CPC content and profile of adult murine LAAs using immunohistochemistry and flow cytometry. We demonstrate that the LAA contains a large number of CPCs relative to other areas of the heart, representing over 20% of the total cell number. We grew two distinct CPC populations from the LAA by varying the degree of proteolysis. These differed by their histological location, surface marker profiles and growth dynamics. Specifically, CD45(pos) cells grew with milder proteolysis, while CD45(neg) cells grew mainly with more intense proteolysis. Both cell types could be induced to differentiate into cells with cardiomyocyte markers and organelles, albeit by different protocols. Many CD45(pos) cells expressed CD45 initially and rapidly lost its expression while differentiating. Our results demonstrate that the left atrial appendage plays a role as a reservoir of multiple types of progenitor cells in murine adult hearts. Two different types of CPCs were isolated, differing in their epicardial-myocardial localization. Considering studies demonstrating layer-specific origins of different cardiac progenitor cells, our findings may shed light on possible pathways to study and utilize the diversity of endogenous progenitor cells in the adult heart.

[Quantitative Measurements on the Blood Flow Fields of Left Atrial Appendage using Vector Flow Mapping in Patients with Nonvalvular Atrial Fibrillation].

PubMed

Cai, Yu-Yan; Wei, Xin; Zhang, Xiao-Ling; Liu, Gu-Yue; Li, Xi; Tang, Hong

2018-01-01

To quantify the hemodynamic characteristics of patients with nonvalvular atrial fibrillation. Twenty patients with paroxysmal atrial fibrillation and 15 patients with persistent atrial fibrillation enrolled in this study,while 12 patients with sinus rhythms served as controls. The hemodynamic characteristics of the patients in left atrial appendage were measured by transesophageal echocardiography (TEE) and vector flow mapping (VFM) using indicators such as vectors,vortex and energy loss (EL). ① Significant differences appeared between the patients with atrial fibrillation and the controls in heart rate,size of left atrium,size of left atrial appendage (LAA),and velocities of LAA filling and emptying. ② Regular vectors in LAA in early systole and late diastole were found in the patients with paroxysmal atrial fibrillation and the controls; whereas,irregular vectors with direction alternating were visualized in the whole cardiac cycle in the patients with persistent atrial fibrillation. ③ Small vortexes were observed at the opening of the left atrial appendage in late diastole in the patients with paroxysmal atrial fibrillation and the controls. ④ Peak EL values occurred in early systole and late diastole in the patients with paroxysmal atrial fibrillation and the controls. But the patients with persistent atrial fibrillation had increased EL values over the whole cardiac cycle. VFM can visualize and quantify the hemodynamics of LAA in patients with different heart rhythms. It may provide a new method for assessing atrial fibrillation. CopyrightCopyright© by Editorial Board of Journal of Sichuan University (Medical Science Edition).

Computed tomography measurement of the left atrial appendage for optimal sizing of the Watchman device.

PubMed

Xu, Bo; Betancor, Jorge; Sato, Kimi; Harb, Serge; Abdur Rehman, Karim; Patel, Kunal; Kumar, Arnav; Cremer, Paul C; Jaber, Wael; Rodriguez, L Leonardo; Schoenhagen, Paul; Wazni, Oussama

Percutaneous left atrial appendage (LAA) occlusion is an emerging treatment option for patients with non-valvular atrial fibrillation who cannot tolerate oral anticoagulation. The Watchman device (Boston Scientific Corporation, Natick, MA, USA) is deployed at the ostium of the LAA, and an appropriately sized device is critical for successful occlusion. However, standardized imaging protocols for device sizing have not been established. We investigated the clinical utility of a standardized imaging protocol, with pre-procedural multi-detector cardiac computed tomography (MDCT), and intra-procedural transesophageal echocardiography (TEE), for Watchman device sizing. Patients who underwent Watchman device implantation between 2010 and 2016 at our center, and who had pre-procedural MDCT and intra-procedural TEE were included. MDCT measurements (CTmax, CTmin, CTmean), and TEE measurement (TEEmax) of the LAA ostium were determined for each case, and correlated with the final size of the Watchman device implanted. Demographic data and clinical outcomes were collected. The study included 80 patients (mean age: 75 ± 9.6 years; male: 68%; mean CHA2DS2-VASc score: 4.5 ± 1.4). CTmax of the LAA ostium correlated strongly with the final deployed Watchman device size (Spearman's rho: 0.81, p < 0.001), while TEEmax of the LAA ostium showed only moderate correlation with the final deployed Watchman device size (Spearman's rho: 0.61, p < 0.001). Implantation success rate was 100%. At a mean duration of follow-up of 197 days, there were no device-related complications (device embolization, cardiac perforation and pericardial tamponade). At follow-up, the vast majority of patients (76 patients; 95%) had either no or trivial (≤3 mm) residual peri-device leak on TEE. A standardized imaging protocol for assessment of Watchman device implantation incorporating pre-procedural MDCT and intra-procedural TEE, was associated with excellent procedural outcomes at a mean duration

Vaccine specific immune response to an inactivated oral cholera vaccine and EPI vaccines in a high and low arsenic area in Bangladeshi children.

PubMed

Saha, Amit; Chowdhury, Mohiul I; Nazim, Mohammad; Alam, Mohammad Murshid; Ahmed, Tanvir; Hossain, Mohammad Bakhtiar; Hore, Samar Kumar; Sultana, Gazi Nurun Nahar; Svennerholm, Ann-Mari; Qadri, Firdausi

2013-01-11

Immune responses to the inactivated oral whole cell cholera toxin B (CTB) subunit cholera vaccine, Dukoral(®), as well as three childhood vaccines in the national immunization system were compared in children living in high and low arsenic contaminated areas in Bangladesh. In addition, serum complement factors C3 and C4 levels were evaluated among children in the two areas. VACCINATIONS: Toddlers (2-5 years) were orally immunized with two doses of Dukoral 14 days apart. Study participants had also received diphtheria, tetanus and measles vaccines according to the Expanded Program on Immunization (EPI) in Bangladesh. The mean level of arsenic in the urine specimens in the children of the high arsenic area (HAA, Shahrasti, Chandpur) was 291.8μg/L while the level was 6.60μg/L in the low arsenic area (LAA, Mirpur, Dhaka). Cholera specific vibriocidal antibody responses were significantly increased in the HAA (87%, P<0.001) and the LAA (75%, P<0.001) children after vaccination with Dukoral, but no differences were found between the two groups. Levels of CTB specific IgA and IgG antibodies were comparable between the two groups, whereas LPS specific IgA and IgG were higher in the LAA group, although response rates were comparable. Diphtheria and tetanus vaccine specific IgG responses were significantly higher in the HAA compared to the LAA group (P<0.001, P=0.048 respectively), whereas there were no differences in the measles specific IgG responses between the groups. Complement C3 and C4 levels in sera were higher in participants from the HAA than the LAA groups (P<0.001, P=0.049 respectively). The study demonstrates that the oral cholera vaccine as well as the EPI vaccines studied are immunogenic in children in high and low arsenic areas in Bangladesh. The results are encouraging for the potential use of cholera vaccines as well as the EPI vaccines in arsenic endemic areas. Copyright © 2012 Elsevier Ltd. All rights reserved.

Thermal stability of L-ascorbic acid and ascorbic acid oxidase in broccoli (Brassica oleracea var. italica).

PubMed

Munyaka, Ann Wambui; Makule, Edna Edward; Oey, Indrawati; Van Loey, Ann; Hendrickx, Marc

2010-05-01

The thermal stability of vitamin C (including l-ascorbic acid [l-AA] and dehydroascorbic acid [DHAA]) in crushed broccoli was evaluated in the temperature range of 30 to 90 degrees C whereas that of ascorbic acid oxidase (AAO) was evaluated in the temperature range of 20 to 95 degrees C. Thermal treatments (for 15 min) of crushed broccoli at 30 to 60 degrees C resulted in conversion of l-AA to DHAA whereas treatments at 70 to 90 degrees C retained vitamin C as l-AA. These observations indicated that enzymes (for example, AAO) could play a major role in the initial phase (that is, oxidation of l-AA to DHAA) of vitamin C degradation in broccoli. Consequently, a study to evaluate the temperature-time conditions that could result in AAO inactivation in broccoli was carried out. In this study, higher AAO activity was observed in broccoli florets than stalks. During thermal treatments for 10 min, AAO in broccoli florets and stalks was stable until around 50 degrees C. A 10-min thermal treatment at 80 degrees C almost completely inactivated AAO in broccoli. AAO inactivation followed 1st order kinetics in the temperature range of 55 to 65 degrees C. Based on this study, a thermal treatment above 70 degrees C is recommended for crushed vegetable products to prevent oxidation of l-AA to DHAA, the onset of vitamin C degradation. The results reported in this study are applicable for both domestic and industrial processing of vegetables into products such as juices, soups, and purees. In this report, we have demonstrated that processing crushed broccoli in a temperature range of 30 to 60 degrees C could result in the conversion of l-ascorbic acid to dehydroascorbic (DHAA), a very important reaction in regard to vitamin C degradation because DHAA could be easily converted to other compounds that do not have the biological activity of vitamin C.

Left Atrial Appendages from Adult Hearts Contain a Reservoir of Diverse Cardiac Progenitor Cells

PubMed Central

Platt, Yardanna; Helman, Yaron; Feinberg, Yael; Lotan, Chaim; Beeri, Ronen

2013-01-01

Aims There is strong evidence supporting the claim that endogenous cardiac progenitor cells (CPCs) are key players in cardiac regeneration, but the anatomic source and phenotype of the master cardiac progenitors remains uncertain. Our aim was to investigate the different cardiac stem cell populations in the left atrial appendage (LAA) and their fates. Methods and Results We investigated the CPC content and profile of adult murine LAAs using immunohistochemistry and flow cytometry. We demonstrate that the LAA contains a large number of CPCs relative to other areas of the heart, representing over 20% of the total cell number. We grew two distinct CPC populations from the LAA by varying the degree of proteolysis. These differed by their histological location, surface marker profiles and growth dynamics. Specifically, CD45pos cells grew with milder proteolysis, while CD45neg cells grew mainly with more intense proteolysis. Both cell types could be induced to differentiate into cells with cardiomyocyte markers and organelles, albeit by different protocols. Many CD45pos cells expressed CD45 initially and rapidly lost its expression while differentiating. Conclusions Our results demonstrate that the left atrial appendage plays a role as a reservoir of multiple types of progenitor cells in murine adult hearts. Two different types of CPCs were isolated, differing in their epicardial-myocardial localization. Considering studies demonstrating layer-specific origins of different cardiac progenitor cells, our findings may shed light on possible pathways to study and utilize the diversity of endogenous progenitor cells in the adult heart. PMID:23555001

Limb ischemia, an alarm signal to a thromboembolic cascade - renal infarction and nephrectomy followed by surgical suppression of the left atrial appendage.

PubMed

Caraşca, Cosmin; Borda, Angela; Incze, Alexandru; Caraşca, Emilian; Frigy, Attila; Suciu, HoraŢiu

2016-01-01

We present the case of a 55-year-old male with mild hypertension and brief episodes of paroxysmal self-limiting atrial fibrillation (AF) since 2010. Despite a small cardioembolic risk score, CHA2DS2-Vasc=1 (Congestive heart failure, Hypertension, Age=75, Diabetes melitus, prior Stroke), the patient is effectively anticoagulated using acenocumarol. In December 2014, he showed signs of plantar transitory ischemia, for which he did not address the doctor. In early January 2015, he urgently presented at the hospital with left renal pain, caused by a renal infarction, diagnosed by computed tomography (CT) angiography. Left nephrectomy was performed with pathological confirmation. He was discharged with effective anticoagulation treatment. Within the next two weeks, he suffered a transitory ischemic event and a stroke, associated with right sided hemiparesis. On admission, AF was found and converted to sinus rhythm with effective anticoagulation - international normalized ratio (INR) of 2.12. Transthoracic echocardiography detected no pathological findings. Transesophageal echocardiography showed an expended left atrial appendage (LAA) with a slow blood flow (0.2 m÷s) and spontaneous echocontrast. Considering these clinical circumstances, surgical LAA suppression was decided on as a last therapeutic resort. Postoperative evolution was favorable; the patient is still free of ischemic events, one year post-intervention. Some morphological and hemodynamic characteristics of LAA may add additional thromboembolic risk factors, not included in scores. Removing them by surgical LAA suppression may decrease the risk of cardioembolic events. Intraoperative presence of thrombus makes it an indisputable proof.

Left atrial appendage closure: a new technique for clinical practice.

PubMed

John Camm, A; Colombo, Antonio; Corbucci, Giorgio; Padeletti, Luigi

2014-03-01

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. It is associated with increased risk for stroke mainly due to cardiac embolism from the left atrial appendage (LAA). Occlusion of the LAA by means of a device represents a valid alternative to oral anticoagulation, mainly in patients who cannot tolerate this therapy because of a high bleeding risk. Recent data on the endocardial device WATCHMAN show encouraging results for this patient population in terms of stroke risk reduction compared to the expected rate as well as in terms of implant success. This article reviews all relevant publications related to the main surgical and transcatheter devices used for LAA closure (LAAC). PROTECT-AF, the first prospective randomized trial conducted on this technique, showed that LAA occlusion using the WATCHMAN was noninferior to warfarin for a combined end-point in patients with nonvalvular AF. There is a lack of large-scale randomized trials on long-term stroke risk in patients submitted to LAAC. Most studies are relatively small and focus on the comparison of different surgical techniques with regard to complete/incomplete closure success. More recently, PROTECT-AF long-term results (4-year follow-up) demonstrated that LAAC was statistically superior to warfarin in terms of efficacy. This review concludes that it is now appropriate to consider these techniques for patients with AF who are at high risk for stroke for whom effective conventional or novel anticoagulant therapy is not available or who present problems in managing drug treatment. Copyright © 2014 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Left atrial appendage closure with the Watchman device in patients with a contraindication for oral anticoagulation: the ASAP study (ASA Plavix Feasibility Study With Watchman Left Atrial Appendage Closure Technology).

PubMed

Reddy, Vivek Y; Möbius-Winkler, Sven; Miller, Marc A; Neuzil, Petr; Schuler, Gerhard; Wiebe, Jens; Sick, Peter; Sievert, Horst

2013-06-25

The purpose of this study was to assess the safety and efficacy of left atrial appendage (LAA) closure in nonvalvular atrial fibrillation (AF) patients ineligible for warfarin therapy. The PROTECT AF (Watchman Left Atrial Appendage System for Embolic Protection in Patients With Atrial Fibrillation) trial demonstrated that LAA closure with the Watchman device (Boston Scientific, Natick, Massachusetts) was noninferior to warfarin therapy. However, the PROTECT AF trial only included patients who were candidates for warfarin, and even patients randomly assigned to the LAA closure arm received concomitant warfarin for 6 weeks after Watchman implantation. A multicenter, prospective, nonrandomized study was conducted of LAA closure with the Watchman device in 150 patients with nonvalvular AF and CHADS₂ (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, and prior stroke or transient ischemic attack) score ≥1, who were considered ineligible for warfarin. The primary efficacy endpoint was the combined events of ischemic stroke, hemorrhagic stroke, systemic embolism, and cardiovascular/unexplained death. The mean CHADS₂ score and CHA₂DS₂-VASc (CHADS₂ score plus 2 points for age ≥75 years and 1 point for vascular disease, age 65 to 74 years, or female sex) score were 2.8 ± 1.2 and 4.4 ± 1.7, respectively. History of hemorrhagic/bleeding tendencies (93%) was the most common reason for warfarin ineligibility. Mean duration of follow-up was 14.4 ± 8.6 months. Serious procedure- or device-related safety events occurred in 8.7% of patients (13 of 150 patients). All-cause stroke or systemic embolism occurred in 4 patients (2.3% per year): ischemic stroke in 3 patients (1.7% per year) and hemorrhagic stroke in 1 patient (0.6% per year). This ischemic stroke rate was less than that expected (7.3% per year) based on the CHADS₂ scores of the patient cohort. LAA closure with the Watchman device can be safely performed without a warfarin

Mediterranean Diet in patients with acute ischemic stroke: Relationships between Mediterranean Diet score, diagnostic subtype, and stroke severity index.

PubMed

Tuttolomondo, Antonino; Casuccio, Alessandra; Buttà, Carmelo; Pecoraro, Rosaria; Di Raimondo, Domenico; Della Corte, Vittoriano; Arnao, Valentina; Clemente, Giuseppe; Maida, Carlo; Simonetta, Irene; Miceli, Giuseppe; Lucifora, Benedetto; Cirrincione, Anna; Di Bona, Danilo; Corpora, Francesca; Maugeri, Rosario; Iacopino, Domenico Gerardo; Pinto, Antonio

2015-11-01

Adherence to a Mediterranean Diet appears to reduce the risk of cardiovascular disease, cancer, Alzheimer's disease, and Parkinson's disease, as well as the risk of death due to cardiovascular disease. No study has addressed the association between diagnostic subtype of stroke and its severity and adherence to a Mediterranean Diet in subjects with acute ischemic stroke. To evaluate the association between Mediterranean Diet adherence, TOAST subtype, and stroke severity by means of a retrospective study. The type of acute ischemic stroke was classified according to the TOAST criteria. All patients admitted to our ward with acute ischemic stroke completed a 137-item validated food-frequency questionnaire adapted to the Sicilian population. A scale indicating the degree of adherence to the traditional Mediterranean Diet was used (Me-Di score: range 0-9). 198 subjects with acute ischemic stroke and 100 control subjects without stroke. Stroke subjects had a lower mean Mediterranean Diet score compared to 100 controls without stroke. We observed a significant positive correlation between Me-Di score and SSS score, whereas we observed a negative relationship between Me-Di score and NIHSS and Rankin scores. Subjects with atherosclerotic (LAAS) stroke subtype had a lower mean Me-Di score compared to subjects with other subtypes. Multinomial logistic regression analysis in a simple model showed a negative relationship between MeDi score and LAAS subtype vs. lacunar subtype (and LAAS vs. cardio-embolic subtype). Patients with lower adherence to a Mediterranean Diet are more likely to have an atherosclerotic (LAAS) stroke, a worse clinical presentation of ischemic stroke at admission and a higher Rankin score at discharge. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Tomosynthesis for the early detection of pulmonary emphysema: diagnostic performance compared with chest radiography, using multidetector computed tomography as reference.

PubMed

Yamada, Yoshitake; Jinzaki, Masahiro; Hashimoto, Masahiro; Shiomi, Eisuke; Abe, Takayuki; Kuribayashi, Sachio; Ogawa, Kenji

2013-08-01

To compare the diagnostic performance of tomosynthesis with that of chest radiography for the detection of pulmonary emphysema, using multidetector computed tomography (MDCT) as reference. Forty-eight patients with and 63 without pulmonary emphysema underwent chest MDCT, tomosynthesis and radiography on the same day. Two blinded radiologists independently evaluated the tomosynthesis images and radiographs for the presence of pulmonary emphysema. Axial and coronal MDCT images served as the reference standard and the percentage lung volume with attenuation values of -950 HU or lower (LAA-950) was evaluated to determine the extent of emphysema. Receiver-operating characteristic (ROC) analysis and generalised estimating equations model were used. ROC analysis revealed significantly better performance (P < 0.0001) of tomosynthesis than radiography for the detection of pulmonary emphysema. The average sensitivity, specificity, positive predictive value and negative predictive value of tomosynthesis were 0.875, 0.968, 0.955 and 0.910, respectively, whereas the values for radiography were 0.479, 0.913, 0.815 and 0.697, respectively. For both tomosynthesis and radiography, the sensitivity increased with increasing LAA-950. The diagnostic performance of tomosynthesis was significantly superior to that of radiography for the detection of pulmonary emphysema. In both tomosynthesis and radiography, the sensitivity was affected by the LAA-950. • Tomosynthesis showed significantly better diagnostic performance for pulmonary emphysema than radiography. • Interobserver agreement for tomosynthesis was significantly higher than that for radiography. • Sensitivity increased with increasing LAA -950 in both tomosynthesis and radiography. • Tomosynthesis imparts a similar radiation dose to two projection chest radiography. • Radiation dose and cost of tomosynthesis are lower than those of MDCT.

Functional Image-Guided Radiotherapy Planning in Respiratory-Gated Intensity-Modulated Radiotherapy for Lung Cancer Patients With Chronic Obstructive Pulmonary Disease

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kimura, Tomoki, E-mail: tkkimura@hiroshima-u.ac.jp; Nishibuchi, Ikuno; Murakami, Yuji

2012-03-15

Purpose: To investigate the incorporation of functional lung image-derived low attenuation area (LAA) based on four-dimensional computed tomography (4D-CT) into respiratory-gated intensity-modulated radiotherapy (IMRT) or volumetric modulated arc therapy (VMAT) in treatment planning for lung cancer patients with chronic obstructive pulmonary disease (COPD). Methods and Materials: Eight lung cancer patients with COPD were the subjects of this study. LAA was generated from 4D-CT data sets according to CT values of less than than -860 Hounsfield units (HU) as a threshold. The functional lung image was defined as the area where LAA was excluded from the image of the total lung.more » Two respiratory-gated radiotherapy plans (70 Gy/35 fractions) were designed and compared in each patient as follows: Plan A was an anatomical IMRT or VMAT plan based on the total lung; Plan F was a functional IMRT or VMAT plan based on the functional lung. Dosimetric parameters (percentage of total lung volume irradiated with {>=}20 Gy [V20], and mean dose of total lung [MLD]) of the two plans were compared. Results: V20 was lower in Plan F than in Plan A (mean 1.5%, p = 0.025 in IMRT, mean 1.6%, p = 0.044 in VMAT) achieved by a reduction in MLD (mean 0.23 Gy, p = 0.083 in IMRT, mean 0.5 Gy, p = 0.042 in VMAT). No differences were noted in target volume coverage and organ-at-risk doses. Conclusions: Functional IGRT planning based on LAA in respiratory-guided IMRT or VMAT appears to be effective in preserving a functional lung in lung cancer patients with COPD.« less

Efficacy and safety of percutaneous left atrial appendage closure to prevent thromboembolic events in atrial fibrillation patients with high stroke and bleeding risk.

PubMed

Seeger, Julia; Bothner, Carlo; Dahme, Tillman; Gonska, Birgid; Scharnbeck, Dominik; Markovic, Sinisa; Rottbauer, Wolfgang; Wöhrle, Jochen

2016-03-01

The randomized PROTECT AF trial demonstrated non-inferiority of left atrial appendage (LAA) closure to oral anticoagulation with warfarin. Current guidelines give a class IIb recommendation for LAA closure. We evaluated the efficacy and safety of LAA closure in a consecutive series of non-valvular atrial fibrillation patients with contraindications to long-term oral anticoagulation or at high bleeding risk. 101 consecutive non-valvular atrial fibrillation patients (age 74.7 ± 7.5 years) at high risk for stroke (CHA2DS2-VASc Score 4.4 ± 1.6) and high bleeding risk (HAS-BLED Score 4.2 ± 1.3) received LAA closure with either the Watchman closure device (n = 38) or the Amplatzer cardiac plug (n = 63). Dual antiplatelet therapy with aspirin and clopidogrel was recommended for 3-6 months after device implantation, followed by long-term antiplatelet therapy with aspirin. No anticoagulation was given after device implantation. Mean follow-up was 400 days. One patient (1 %) experienced a transient ischemic attack, and two patients (2 %) suffered from ischemic stroke. While on recommended antiplatelet therapy, bleeding occurred in 12/101 patients (12 %). Bleeding was significantly reduced with 3 compared with 6 months dual antiplatelet therapy (3.0 vs. 16.2 %, p < 0.05) while ischemic or thrombotic events were similar. Left atrial appendage closure in patients with non-valvular atrial fibrillation and high risk for stroke and bleeding events effectively prevented stroke and reduced cerebral ischemic events compared to expected stroke rate according to CHA2DS2-VASc Score. Dual antiplatelet therapy for 3 months reduced the rate of bleeding events compared to 6 months therapy with no increase of thrombotic events.

Artemisinin and Artemisia annua leaves alleviate Eimeria tenella infection by facilitating apoptosis of host cells and suppressing inflammatory response.

PubMed

Jiao, JinYing; Yang, YunQiao; Liu, MingJiang; Li, JinGui; Cui, Yi; Yin, ShaoJie; Tao, JianPing

2018-04-30

Evasion strategies of intracellular parasites by hijacking cellular pathways, are necessary to ensure successful survival and replication. Eimeria tenella (E. tenella) has the ability to circumvent apoptosis of infected cells through increased expression of the transcriptional factor NF-κB and the anti-apoptotic factor Bcl-x L during the development of second generation schizonts. Artemisinin (ART) and its original plant, the dried leaves of Artemisia annua (LAA) have been shown to be effective against avian coccidiosis, however, the underlying mechanism remains unclear. We showed that E. tenella infection promoted the expression of anti-apoptotic protein Bcl-2 and inhibited the expression of pro-apoptotic proteins Bax and cleaved caspase-3 at 60 h post infection (PI), with a higher ratio of Bcl-2 to Bax. Nevertheless, the expression trends of Bcl-2, Bax and caspase-3 were reversed at 120 h and 192 h PI. ART treatment significantly abrogated Bcl-2 expression, whereas it promoted the expression levels of Bax and cleaved caspase-3 at the three time points above. Additionally, ART remarkably suppressed the increased mRNA expressions of NF-κB and interleukin-17A in ceca during infection by E. tenella. Compared with the ART treatment, LAA treatment exerted more improvements in clinical symptoms, promoting apoptosis and suppressing inflammatory response. These alterations caused by ART and LAA treatments were consistent with the reduced clinical diarrhea and pathological improvements in chicken ceca. Collectively, these results indicate that the inhibitory effects of ART or LAA on E. tenella infection may work through facilitating the apoptosis of infected host cells and inhibiting the inflammatory response. Copyright © 2018 Elsevier B.V. All rights reserved.

Progress of dendritic cell-based cancer vaccines for patients with hematological malignancies.

PubMed

Ni, Ming; Hoffmann, Jean-Marc; Schmitt, Michael; Schmitt, Anita

2016-09-01

Dendritic cells (DCs) are the most professional antigen-presenting cells eliciting cellular and humoral immune responses against cancer cells by expressing these antigens on MHC class I/II complexes to T cells. Therefore, they have been employed in many clinical trials as cancer vaccines for patients with cancer. This review focuses on the use of DCs in leukemia patients expressing leukemia-associated antigens (LAAs). The contribution of both stimulating vs. tolerogenic DCs as well as of other factors to the milieu of anti-leukemia immune responses are discussed. Several DC vaccination strategies like leukemia lysate, proteins and peptides have been developed. Next generation DC vaccines comprise transduction of DCs with retroviral vectors encoding for LAAs, cytokines and costimulatory molecules as well as transfection of DCs with naked RNA encoding for LAAs. Published as well as ongoing clinical trials are reported and critically reviewed. Future results will demonstrate whether next-generation DCs are really superior to conventional pulsing with peptide, protein or tumor lysate. However, currently available methods based on nucleic acid transfection/transduction are tempting in terms of material production costs and time for clinical application according to good manufacturing practice (GMP).

Transcatheter closure of the left atrial appendage: initial experience with the WATCHMAN device

PubMed Central

Ding, Jiandong; Zhu, Jian; Lu, Jing; Ding, Xiuxia; Zhang, Xiaoli; Lu, Wenbin; Ao, Mingqiang; Ma, Genshan

2015-01-01

Background: Atrial fibrillation (AF) is the most commonly encountered clinical arrhythmia, accounting for approximately one third of hospitalizations for cardiac rhythm disturbance. In patients with non-valvular AF, approximately 90% of thrombi are thought to arise from the left atrial appendage (LAA). Anticoagulation with warfarin has been the mainstay of therapy to reduce stroke risk in these patients; however, it is not without its complications including bleeding and drug interactions. Percutaneous left atrial appendage closure can be an alternative to warfarin treatment in patients with AF at high risk for thromboembolic events and/or bleeding complications. Methods: Patients with atrial fibrillation and CHADSVASc score ≥ 2, not eligible for anticoagulation, were submitted to left atrial appendage closure using the WATCHMAN device. The procedure was performed under general anaesthesia, and was guided by fluoroscopy and transoesophageal echocardiography. Results: Percutaneous LAA closure with the WATCHMAN device was performed in all patients. At 45-day follow-up no recurrent major adverse events and especially no thromboembolic events occurred. Conclusions: Transcatheter closure of the LAA with the WATCHMAN device is generally safe and feasible. Long-term follow-up will further reveal the risk and benefits of this therapy. PMID:26629008

Relationship between diminution of small pulmonary vessels and emphysema in chronic obstructive pulmonary disease.

PubMed

Mashimo, Shuko; Chubachi, Shotaro; Tsutsumi, Akihiro; Kameyama, Naofumi; Sasaki, Mamoru; Jinzaki, Masahiro; Nakamura, Hidetoshi; Asano, Koichiro; Reilly, John J; Betsuyaku, Tomoko

To investigate the relationship between small pulmonary vessels and extent of emphysema on CT in individual lungs with chronic obstructive pulmonary disease (COPD). Forty-nine patients were included. The percentage of cross-sectional area of vessels <5mm 2 (%CSA <5) and extent of emphysema were assessed. Less than half of the COPD patients demonstrated an inverse correlation between %CSA <5 and percentage of low attenuation area (LAA%). In the remaining patients, %CSA <5 was homogeneously distributed. Not all patients with COPD demonstrated an inverse correlation of the distributions between %CSA <5 and LAA% in individual lungs. Copyright © 2017 Elsevier Inc. All rights reserved.

Prospective randomized evaluation of the Watchman Left Atrial Appendage Closure device in patients with atrial fibrillation versus long-term warfarin therapy: the PREVAIL trial.

PubMed

Holmes, David R; Kar, Saibal; Price, Matthew J; Whisenant, Brian; Sievert, Horst; Doshi, Shephal K; Huber, Kenneth; Reddy, Vivek Y

2014-07-08

In the PROTECT AF (Watchman Left Atrial Appendage Closure Technology for Embolic Protection in Patients With Atrial Fibrillation) trial that evaluated patients with nonvalvular atrial fibrillation (NVAF), left atrial appendage (LAA) occlusion was noninferior to warfarin for stroke prevention, but a periprocedural safety hazard was identified. The goal of this study was to assess the safety and efficacy of LAA occlusion for stroke prevention in patients with NVAF compared with long-term warfarin therapy. This randomized trial further assessed the efficacy and safety of the Watchman device. Patients with NVAF who had a CHADS2 (congestive heart failure, hypertension, age >75 years, diabetes mellitus, and previous stroke/transient ischemic attack) score ≥2 or 1 and another risk factor were eligible. Patients were randomly assigned (in a 2:1 ratio) to undergo LAA occlusion and subsequent discontinuation of warfarin (intervention group, n = 269) or receive chronic warfarin therapy (control group, n = 138). Two efficacy and 1 safety coprimary endpoints were assessed. At 18 months, the rate of the first coprimary efficacy endpoint (composite of stroke, systemic embolism [SE], and cardiovascular/unexplained death) was 0.064 in the device group versus 0.063 in the control group (rate ratio 1.07 [95% credible interval (CrI): 0.57 to 1.89]) and did not achieve the prespecified criteria noninferiority (upper boundary of 95% CrI ≥1.75). The rate for the second coprimary efficacy endpoint (stroke or SE >7 days' postrandomization) was 0.0253 versus 0.0200 (risk difference 0.0053 [95% CrI: -0.0190 to 0.0273]), achieving noninferiority. Early safety events occurred in 2.2% of the Watchman arm, significantly lower than in PROTECT AF, satisfying the pre-specified safety performance goal. Using a broader, more inclusive definition of adverse effects, these still were lower in PREVAIL (Watchman LAA Closure Device in Patients With Atrial Fibrillation Versus Long Term Warfarin Therapy

Prospective randomized evaluation of the watchman left atrial appendage closure device in patients with atrial fibrillation versus long-term warfarin therapy: The PREVAIL trial.

PubMed

Belgaid, Djouhar Roufeida; Khan, Zara; Zaidi, Mariam; Hobbs, Adrian

2016-09-15

Assessing the safety and effectiveness of left atrial appendage (LAA) (pouch found in the upper chambers of the heart) occlusion, using the Watchman device compared to long term warfarin therapy (drug that reduces clot formation), in preventing the risk of stroke in patients with atrial fibrillation (most common type of irregular heart beat). 90% of strokes in atrial fibrillation arise from clots forming in this pouch. By mechanically blocking it using the device less clots are suggested to be formed. This is an alternative to taking warfarin especially in patients who cannot take it. 50 sites in the United States enrolled 407 participants. After being randomly allocated, the device group had 269 participants and warfarin group (comparator)had 138 participants. Patients with atrial fibrillation and at high risk of stroke were randomly allocated a group after they were deemed eligible. Patients in the device group had to take warfarin and aspirin for 45days till the complete closure of the LAA. The oral anticoagulant was followed by dual antiplatelet therapy until 6months and then ASA. Patients in the warfarin group have to take it for life and were continually monitored. The study ran for 26months. The trial assessed the rate of adverse events using three endpoints: The PREVAIL trial was not designed to show superiority, but non-inferiority. It met the safety endpoint and one efficacy endpoint for the watchman device compared to long term warfarin for overall efficacy of the device. The results established that LAA occlusion is not worse than warfarin intake for the prevention of stroke more than 1week after randomization. Compared to previous trials, the safety of the device has also improved. LAA occlusion is a reasonable alternative to chronic warfarin therapy in stroke prevention for patients with atrial fibrillation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Percutaneous closure of the left atrial appendage for prevention of thromboembolism in atrial fibrillation for patients with contraindication to or failure of oral anticoagulation: a single-center experience.

PubMed

Faustino, Ana; Paiva, Luís; Providência, Rui; Trigo, Joana; Botelho, Ana; Costa, Marco; Leitão-Marques, António

2013-06-01

In non-valvular atrial fibrillation 90% of thrombi originate in the left atrial appendage (LAA). Percutaneous LAA closure has been shown to be non-inferior to warfarin for prevention of thromboembolism. To evaluate the initial experience of a single center in percutaneous LAA closure in patients with high thromboembolic risk and in whom oral anticoagulation was impractical or contraindicated or had failed. Patients with non-valvular atrial fibrillation and CHADS2 score ≥2 in whom oral anticoagulation was impractical or contraindicated or had failed underwent percutaneous LAA closure according to the standard technique. After the procedure, dual antiplatelet therapy was maintained for one month, followed by single antiplatelet therapy indefinitely. Patients were followed by clinical assessment and transthoracic and transesophageal echocardiography. The procedure was performed in 22 of the 23 selected patients (95.7%), mean age 70±9 years, CHADS2 score 3.2±0.9 and CHA2DS2-VASC score 4.7±1.4. Intraprocedural device replacement was necessary only in the first patient, due to oversizing. The following periprocedural complications were observed: one femoral pseudoaneurysm, three femoral hematomas and two minor oropharyngeal bleeds, resolved by local hemostatic measures. During a 12±8 month follow-up a mild peri-device flow and a thrombus adhering to the device, resolved under with enoxaparin therapy, were identified. The rate of transient ischemic attack (TIA)/stroke was lower than expected according to the CHADS2 score (0 vs. 6.7±2.2%). In our initial experience, this procedure proved to be a feasible, safe and effective alternative for atrial fibrillation patients in whom oral anticoagulation is not an option. Only relatively minor complications were observed, with a lower than expected TIA/stroke rate. Copyright © 2012 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

Coherex WAVECREST I Left Atrial Appendage Occlusion Study

ClinicalTrials.gov

2015-01-13

Non-valvular Paroxysmal, Persistent, or Permanent Atrial Fibrillation; LAA Anatomy Amenable to Treatment by Percutaneous Technique; Anticoagulation Indication for Potential Thrombus Formation in the Left Atrium

Thrombophilia-Related Complications in the Treatment of a Left Atrial Appendage Thrombus: A Case Report

PubMed Central

Parato, Vito Maurizio; Scarano, Michele; Labanti, Benedetto

2014-01-01

Trans-esophageal echocardiography (TEE) revealed a left atrial appendage (LAA) thrombus in an 84-year-old woman with nonvalvular atrial fibrillation not known before our evaluation. In her medical history, there were hypertension, dyslipidemia and a previous pulmonary embolism. She was taking warfarin at time of our evaluation and presented signs and symptoms of heart failure. Together with heart failure treatment, intravenous anticoagulation with unfractionated heparin was initiated. Treatment was complicated by additional right lower limb embolic event and the LAA thrombus remained unchanged. Testing revealed heterozygosity for both the factor V Leiden and the methylenetetrahydrofolate reductase C677T mutations inducing resistance to activated protein C. The patient refused transcatheter closure of the left atrial appendage. PMID:28465906

76 FR 13597 - Request for an Extension of a Currently Approved Information Collection; County Committee Elections

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-14

... individual with farming interest in the Local Administrative Area (LAA) (eligible voters). Estimated Number... technological collection techniques or other forms of information technology. All responses received in response...

On optimal improvements of classical iterative schemes for Z-matrices

NASA Astrophysics Data System (ADS)

Noutsos, D.; Tzoumas, M.

2006-04-01

Many researchers have considered preconditioners, applied to linear systems, whose matrix coefficient is a Z- or an M-matrix, that make the associated Jacobi and Gauss-Seidel methods converge asymptotically faster than the unpreconditioned ones. Such preconditioners are chosen so that they eliminate the off-diagonal elements of the same column or the elements of the first upper diagonal [Milaszewicz, LAA 93 (1987) 161-170], Gunawardena et al. [LAA 154-156 (1991) 123-143]. In this work we generalize the previous preconditioners to obtain optimal methods. "Good" Jacobi and Gauss-Seidel algorithms are given and preconditioners, that eliminate more than one entry per row, are also proposed and analyzed. Moreover, the behavior of the above preconditioners to the Krylov subspace methods is studied.

Computed tomography quantification of emphysema in people living with HIV and uninfected controls.

PubMed

Ronit, Andreas; Kristensen, Thomas; Hoseth, Vilde S; Abou-Kassem, Dalia; Kühl, Tobias; Benfield, Thomas; Gerstoft, Jan; Afzal, Shoaib; Nordestgaard, Børge G; Lundgren, Jens D; Vestbo, Jørgen; Kofoed, Klaus F; Nielsen, Susanne Dam

2018-06-07

People living with HIV (PLWH) may be more susceptible to the development of emphysema than uninfected individuals. We assessed prevalence and risk factors for emphysema in PLWH and uninfected controls. Spirometry and chest computed tomography scans were obtained in PLWH from the Copenhagen comorbidity in HIV infection (COCOMO) Study and in uninfected controls from the Copenhagen General Population Study (CGPS) who were aged above 40 years. Emphysema was quantified using low attenuation area below -950 Hounsfield units (%LAA-950), the 15 th percentile density index (PD15) and assessed by semi-quantitative visual scales. Of 742 PLWH, 21.2% and 4.7% had emphysema according to the %LAA-950 threshold with cut-offs at 5% and 10%, respectively. Of 470 uninfected controls, these numbers were 24.3% (p=0.23) and 4.0% (p=0.68). HIV was not associated with emphysema (adjusted odds ratio 1.25 [95%CI: 0.68-2.36] for %LAA-950>10%), by PD15, or by visually assessed emphysema. We found no interaction between HIV and cumulative smoking. Breathlessness and sputum production were more common in PLWH with emphysema, and emphysema seemed to be more prevalent in PLWH with airflow limitation. HIV was therefore not independently associated with emphysema but the clinical impact of emphysema was greater in PLWH than in uninfected controls. Copyright ©ERS 2018.

Device Interventions for Stroke Prevention in Atrial Fibrillation

MedlinePlus

... complex LAA are not suitable because of the design of the LARIAT. The above information is correct ... days before the procedure and replaced with enoxaparin shots (injections). What to Expect the Day of the ...

Evaluation of lipid peroxidation and antioxidant defense mechanisms in the bone of rats in conditions of separate and combined administration of vanadium (V) and magnesium (Mg).

PubMed

Ścibior, Agnieszka; Gołębiowska, Dorota; Adamczyk, Agnieszka; Kurus, Joanna; Staniszewska, Magdalena; Sadok, Ilona

2018-03-25

The impact of vanadium (V) and magnesium (Mg) applied as sodium metavanadate (SMV, 0.125 mg V/ml) and magnesium sulfate (MS, 0.06 mg Mg/ml) on oxidative stress markers in bone of male Wistar rats was investigated. Some of them were also measured in the liver, e.g. l-ascorbic acid (hepatic L-AA). Additionally, relationships between selected indices determined in bone were examined. SMV alone (Group II) did not significantly alter the level of TBARS and the activity of SOD, compared with the control (Group I), but it slightly reduced the GR activity (by 13%) and the L-AA level (by 15.5%). It also markedly lowered the activity of CAT and GPx (by 34% and 29%), and to some degree elevated the activity of GST (by 16%) and the hepatic L-AA level (by 119%). MS alone (Group III) decreased the TBARS level (by 49%), slightly lowered the L-AA concentration (by 14%), and reduced the SOD, GPx, and GR activities (by 31%, 40%, and 28%), but did not change the activity of CAT, compared with the control. Additionally, it elevated the GST activity (by 56%) and the hepatic L-AA level (by 40%). In turn, the SMV + MS combination (Group IV) reduced the TBARS level (by 38%) and the SOD, CAT, GPx, and GR activities (by 61%, 58%, 72%, and 40%) but elevated the GST activity (by 66%), compared with the control. The activity of SOD and GPx in the rats in Group IV was also reduced, compared with Group II (by 61% and 61%) and Group III (by 44% and 54%). In turn, the activities of CAT and GR were decreased, compared with Group III (by 55%) and Group II (by 31%), and the L-AA level was lowered, in comparison with Groups II and III (by 53% and 54%). Further, the concentration of V in the bone of rats in Groups II and IV increased, whereas the concentration of Mg decreased, compared with Groups I and III, in which the V and Mg levels dropped and were not altered, respectively, compared with Group I. The total content of Fe in the bone of rats in Groups II and IV increased, compared with

Whole-brain functional connectivity during acquisition of novel grammar: Distinct functional networks depend on language learning abilities.

PubMed

Kepinska, Olga; de Rover, Mischa; Caspers, Johanneke; Schiller, Niels O

2017-03-01

In an effort to advance the understanding of brain function and organisation accompanying second language learning, we investigate the neural substrates of novel grammar learning in a group of healthy adults, consisting of participants with high and average language analytical abilities (LAA). By means of an Independent Components Analysis, a data-driven approach to functional connectivity of the brain, the fMRI data collected during a grammar-learning task were decomposed into maps representing separate cognitive processes. These included the default mode, task-positive, working memory, visual, cerebellar and emotional networks. We further tested for differences within the components, representing individual differences between the High and Average LAA learners. We found high analytical abilities to be coupled with stronger contributions to the task-positive network from areas adjacent to bilateral Broca's region, stronger connectivity within the working memory network and within the emotional network. Average LAA participants displayed stronger engagement within the task-positive network from areas adjacent to the right-hemisphere homologue of Broca's region and typical to lower level processing (visual word recognition), and increased connectivity within the default mode network. The significance of each of the identified networks for the grammar learning process is presented next to a discussion on the established markers of inter-individual learners' differences. We conclude that in terms of functional connectivity, the engagement of brain's networks during grammar acquisition is coupled with one's language learning abilities. Copyright © 2016 Elsevier B.V. All rights reserved.

A region-specific quantitative profile of autonomic innervation of the canine left atrium and pulmonary veins.

PubMed

Gao, Chong-han; Wang, Fei; Jiang, Rong; Zhang, Jin; Mou, Huamin; Yin, Yue-hui

2011-07-05

The aim of the present study was to determine and quantify the cardiac autonomic innervation of the canine atria and pulmonary vein. Tissue specimens were taken from the canine pulmonary veins (PVs), posterior left atrium (PLA), left atrial roof (LAR), anterior left atrium (ALA), interatrial septum (IAS), and left atrial appendage (LAA) respectively for immunohistochemical analysis and nerve density determination. Both sympathetic and parasympathetic nerve densities decreased in the order: PLA>PV>IAS>LAR>ALA>LAA. For sympathetic nerve, multiple comparisons between any two regions showed a significant difference (P<0.05-P<0.01) except for PV vs. PLA, IAS vs. LAR, and LAR vs. ALA; for parasympathetic nerve, all the differences between any pair of regions were statistically significant (P<0.05-P<0.01) with the exception of PV vs. PLA, IAS vs. LAR, LAR vs. ALA, and ALA vs. LAA. For both nerve types, there was a decreasing gradient of nerve densities from the external to internal layer (P<0.001, for each comparisons). Nerve density at the ostia for either nerve type was significantly higher than at the distal segments of PVs (P<0.001). In summary, the LA and PVs are innervated by sympathetic and parasympathetic nerves in a regionally heterogeneous way, which may be important for the pathophysiological investigation and ablation therapy of atrial fibrillation (AF). Copyright © 2011 Elsevier B.V. All rights reserved.

Economic Analysis of Local Area Augmentation System and Alternative Architectures

DOT National Transportation Integrated Search

1996-01-01

The objective of this study has been to perform an economic comparison by conducting a cost-benefit analsyis (CBA) of the five Local Area Augementation System (LAAS) and alternative architectures. The five architectures chosen by the FAA for the stud...

Journal Article: Localized Pleural Thickening: Smoking and Exposure to Libby Vermiculite

EPA Science Inventory

There is limited research on the combined effects of smoking and asbestos exposure on risk of localized pleural thickening (LPT). This analysis uses data from the Marysville cohort of workers occupationally exposed to Libby amphibole asbestos (LAA). Workers were interviewed to ...

CT based 3D printing is superior to transesophageal echocardiography for pre-procedure planning in left atrial appendage device closure.

PubMed

Obasare, Edinrin; Mainigi, Sumeet K; Morris, D Lynn; Slipczuk, Leandro; Goykhman, Igor; Friend, Evan; Ziccardi, Mary Rodriguez; Pressman, Gregg S

2018-05-01

Accurate assessment of the left atrial appendage (LAA) is important for pre-procedure planning when utilizing device closure for stroke reduction. Sizing is traditionally done with transesophageal echocardiography (TEE) but this is not always precise. Three-dimensional (3D) printing of the LAA may be more accurate. 24 patients underwent Watchman device (WD) implantation (71 ± 11 years, 42% female). All had complete 2-dimensional TEE. Fourteen also had cardiac computed tomography (CCT) with 3D printing to produce a latex model of the LAA for pre-procedure planning. Device implantation was unsuccessful in 2 cases (one with and one without a 3D model). The model correlated perfectly with implanted device size (R 2  = 1; p < 0.001), while TEE-predicted size showed inferior correlation (R 2  = 0.34; 95% CI 0.23-0.98, p = 0.03). Fisher's exact test showed the model better predicted final WD size than TEE (100 vs. 60%, p = 0.02). Use of the model was associated with reduced procedure time (70 ± 20 vs. 107 ± 53 min, p = 0.03), anesthesia time (134 ± 31 vs. 182 ± 61 min, p = 0.03), and fluoroscopy time (11 ± 4 vs. 20 ± 13 min, p = 0.02). Absence of peri-device leak was also more likely when the model was used (92 vs. 56%, p = 0.04). There were trends towards reduced trans-septal puncture to catheter removal time (50 ± 20 vs. 73 ± 36 min, p = 0.07), number of device deployments (1.3 ± 0.5 vs. 2.0 ± 1.2, p = 0.08), and number of devices used (1.3 ± 0.5 vs. 1.9 ± 0.9, p = 0.07). Patient specific models of the LAA improve precision in closure device sizing. Use of the printed model allowed rapid and intuitive location of the best landing zone for the device.

Pulmonary vein activity does not predict the outcome of catheter ablation for persistent atrial fibrillation: A long-term multicenter prospective study.

PubMed

Prabhu, Sandeep; Kalla, Manish; Peck, Kah Y; Voskoboinik, Aleksandr; McLellan, Alex J A; Pathik, Bupesh; Nalliah, Chrishan J; Wong, Geoff R; Sugumar, Hariharan; Azzopardi, Sonia M; Lee, Geoffrey; Ling, Liang-Han; Kalman, Jonathan M; Kistler, Peter M

2018-03-02

Pulmonary vein (PV) isolation (PVI) remains the cornerstone of catheter ablation (CA) in persistent atrial fibrillation (AF) (PeAF), although less successful than for paroxysmal AF. Whether rapid or fibrillatory (PV AF) PV firing may identify patients with PeAF more likely to benefit from a PV-based ablation approach is unclear. The purpose of this study was to determine the relationship between the PV cycle length (PVCL) and the PV AF outcome after CA. Before ablation, the multipolar catheter was placed in each PV and the left atrial appendage (LAA) for 100 consecutive cycles. The presence of PV AF, the average PVCL of all 4 veins (PV 4VAverage ), the fastest vein average (PV FVAverage ), the fastest cycle length (PV Fast ) both individually and relative to the average LAA cycle length were calculated. The ablation strategy included PVI and posterior wall isolation with a minimum of 12 months follow-up. A total of 123 patients underwent CA (age 62 ± 9.1 years; CHA 2 DS 2 -VASC score 1.6 ± 1.1; left ventricular ejection fraction 48% ± 13%; left atrial area 31 ± 8.7 cm 2 ; AF duration 16 ± 17 months). PVI was achieved in 100% of patients. Multiprocedure success (MPS; freedom from AF/atrial tachycardia episodes lasting >30 seconds) was achieved in 76% of patients at 24 ± 8.1 months of follow-up after 1.2 ± 0.4 procedures. PV activity was not associated with MPS either absolutely (PV 4VAverage [MPS no vs yes: 178 ± 27 ms vs 177 ± 24 ms; P = .92], PV FVAverage [P = .69], or PV Fast [P = .82]) or as a ratio relative to the LAA cycle length (PV 4VAverage /LAA 1.05 ± 0.11 vs 1.06 ± 0.21; P = .87). The presence of PV AF (31% vs 47%; P = .13) did not predict MPS. The rapidity of PV firing or presence of fibrillation within the PV was not predictive of outcome of CA for PeAF. PV activity does not identify patients most likely to benefit from a PV-based ablation strategy. Copyright © 2018 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Classification of the height and flexibility of the medial longitudinal arch of the foot.

PubMed

Nilsson, Mette Kjærgaard; Friis, Rikke; Michaelsen, Maria Skjoldahl; Jakobsen, Patrick Abildgaard; Nielsen, Rasmus Oestergaard

2012-02-17

The risk of developing injuries during standing work may vary between persons with different foot types. High arched and low arched feet, as well as rigid and flexible feet, are considered to have different injury profiles, while those with normal arches may sustain fewer injuries. However, the cut-off values for maximum values (subtalar position during weight-bearing) and range of motion (ROM) values (difference between subtalar neutral and subtalar resting position in a weight-bearing condition) for the medial longitudinal arch (MLA) are largely unknown. The purpose of this study was to identify cut-off values for maximum values and ROM of the MLA of the foot during static tests and to identify factors influencing foot posture. The participants consisted of 254 volunteers from Central and Northern Denmark (198 m/56 f; age 39.0 ± 11.7 years; BMI 27.3 ± 4.7 kg/m2). Navicular height (NH), longitudinal arch angle (LAA) and Feiss line (FL) were measured for either the left or the right foot in a subtalar neutral position and subtalar resting position. Maximum values and ROM were calculated for each test. The 95% and 68% prediction intervals were used as cut-off limits. Multiple regression analysis was used to detect influencing factors on foot posture. The 68% cut-off values for maximum MLA values and MLA ROM for NH were 3.6 to 5.5 cm and 0.6 to 1.8 cm, respectively, without taking into account the influence of other variables. Normal maximum LAA values were between 131 and 152° and normal LAA ROM was between -1 and 13°. Normal maximum FL values were between -2.6 and -1.2 cm and normal FL ROM was between -0.1 and 0.9 cm. Results from the multivariate linear regression revealed an association between foot size with FL, LAA, and navicular drop. The cut-off values presented in this study can be used to categorize people performing standing work into groups of different foot arch types. The results of this study are important for investigating a possible link between

Numerical tsunami hazard assessment of the submarine volcano Kick 'em Jenny in high resolution are

NASA Astrophysics Data System (ADS)

Dondin, Frédéric; Dorville, Jean-Francois Marc; Robertson, Richard E. A.

2016-04-01

Landslide-generated tsunami are infrequent phenomena that can be potentially highly hazardous for population located in the near-field domain of the source. The Lesser Antilles volcanic arc is a curved 800 km chain of volcanic islands. At least 53 flank collapse episodes have been recognized along the arc. Several of these collapses have been associated with underwater voluminous deposits (volume > 1 km3). Due to their momentum these events were likely capable of generating regional tsunami. However no clear field evidence of tsunami associated with these voluminous events have been reported but the occurrence of such an episode nowadays would certainly have catastrophic consequences. Kick 'em Jenny (KeJ) is the only active submarine volcano of the Lesser Antilles Arc (LAA), with a current edifice volume estimated to 1.5 km3. It is the southernmost edifice of the LAA with recognized associated volcanic landslide deposits. The volcano appears to have undergone three episodes of flank failure. Numerical simulations of one of these episodes associated with a collapse volume of ca. 4.4 km3 and considering a single pulse collapse revealed that this episode would have produced a regional tsunami with amplitude of 30 m. In the present study we applied a detailed hazard assessment on KeJ submarine volcano (KeJ) form its collapse to its waves impact on high resolution coastal area of selected island of the LAA in order to highlight needs to improve alert system and risk mitigation. We present the assessment process of tsunami hazard related to shoreline surface elevation (i.e. run-up) and flood dynamic (i.e. duration, height, speed...) at the coast of LAA island in the case of a potential flank collapse scenario at KeJ. After quantification of potential initial volumes of collapse material using relative slope instability analysis (RSIA, VolcanoFit 2.0 & SSAP 4.5) based on seven geomechanical models, the tsunami source have been simulate by St-Venant equations-based code

Left atrial appendage closure followed by 6 weeks of antithrombotic therapy: a prospective single-center experience.

PubMed

Chun, K R Julian; Bordignon, Stefano; Urban, Verena; Perrotta, Laura; Dugo, Daniela; Fürnkranz, Alexander; Nowak, Bernd; Schmidt, Boris

2013-12-01

Currently, 2 different left atrial appendage (LAA) closure systems are available for stroke prevention in nonvalvular atrial fibrillation but comparative data are lacking. To prospectively compare procedural data and patient outcome for 2 contemporary LAA closure systems and to investigate an alternative antithrombotic treatment regimen in high-risk patients. Patients with nonvalvular atrial fibrillation, with high risk for stroke, and who either had contraindication or were not willing to accept oral anticoagulation were prospectively enrolled. Watchman (Boston Scientific, Natick, MA; group A) or Amplatzer Cardiac Plug (St Jude Medical, Minneapolis, MN; group B) devices were implanted. All patients received antithrombotic therapy for 6 weeks. After repeat transesophageal echocardiography, patients were switched to aspirin. Eighty patients were enrolled. There was no statistical difference in patient characteristics in groups A and B: CHA2DS2VASC score: 4.1 ± 1.5 versus 4.5 ± 1.8; HASBLED score: 3.1 ± 1.1 versus 3.1 ± 1.1, respectively. LAA closure was achieved in 78 of 80 patients (98%) (group A: 38 of 40 [95%] vs group B: 40 of 40 [100%]). There was no difference in procedure time (group A: 48 ± 16 minutes vs group B: 47 ± 15 minutes; P = .69) and fluoroscopy time (group A: 6.0 ± 4.7 minutes vs group B: 7.3 ± 4.4 minutes; P = .25). Major complications included 1 air embolism and delayed tamponade in each group. After 6 weeks, 1 device dislodgment and 4 device-related thrombi were detected. Ninety-four percent of the patients (73 of 77) were switched to aspirin after 6 weeks. During a median follow-up of 364 days (Q1-Q3: 283-539 days), no systemic embolism occurred, but 3 patients died (heart failure: n = 2; bleeding: n = 1). Implantation of both LAA closure devices can be performed with high success rates in high-risk patients. Postprocedural 6 weeks antithrombotic therapy followed by aspirin therapy needs to be confirmed in a larger study. Copyright �

Glycomacropeptide in children with phenylketonuria: does its phenylalanine content affect blood phenylalanine control?

PubMed

Daly, A; Evans, S; Chahal, S; Santra, S; MacDonald, A

2017-08-01

In phenylketonuria (PKU), there are no data available for children with respect to evaluating casein glycomacropeptide (CGMP) as an alternative to phenylalanine-free protein substitutes [Phe-free L-amino acid (AA)]. CGMP contains a residual amount of phenylalanine, which may alter blood phenylalanine control. In a prospective 6-month pilot study, we investigated the effect on blood phenylalanine control of CGMP-amino acid (CGMP-AA) protein substitute in 22 PKU subjects (13 boys, nine girls), median age (range) 11 years (6-16 years). Twelve received CGMP-AA and nine received Phe-free L-AA, (1 CGMP-AA withdrawal). Subjects partially or wholly replaced Phe-free L-AA with CGMP-AA. If blood phenylalanine exceeded the target range, the CGMP-AA dose was reduced and replaced with Phe-free L-amino acids. The control group remained on Phe-free L-AAs. Phenylalanine, tyrosine and Phe : Tyr ratio concentrations were compared with the results for the previous year. In the CGMP-AA group, there was a significant increase in blood phenylalanine concentrations (pre-study, 275 μmol L -1 ; CGMP-AA, 317 μmol L -1 ; P = 0.02), a decrease in tyrosine concentrations (pre-study, 50 μmol L -1 ; CGMP-AA, 40 μmol L -1 ; P = 0.03) and an increase in Phe : Tyr ratios (pre-study, Phe : Tyr 4.9:1; CGMP-AA, Phe : Tyr 8:1; P = 0.02). In the control group there was a non-significant fall in phenylalanine concentrations (pre-study 325μmol/L: study 280μmol/L [p = 0.9], and no significant changes for tyrosine or phe/tyr ratios [p = 0.9]. Children taking the CGMP-AA found it more acceptable to L-AA. Blood phenylalanine control declined with CGMP-AA but, by titrating the dose of CGMP-AA, blood phenylalanine control remained within target range. The additional intake of phenylalanine may have contributed to the change in blood phenylalanine concentration. CGMP-AA use requires careful monitoring in children. © 2017 The British Dietetic Association Ltd.

Materials Data on LaAs (SG:225) by Materials Project

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kristin Persson

Computed materials data using density functional theory calculations. These calculations determine the electronic structure of bulk materials by solving approximations to the Schrodinger equation. For more information, see https://materialsproject.org/docs/calculations

Crosstalk between Diverse Synthetic Protein Degradation Tags in Escherichia coli.

PubMed

Butzin, Nicholas C; Mather, William H

2018-01-19

Recently, a synthetic circuit in E. coli demonstrated that two proteins engineered with LAA tags targeted to the native protease ClpXP are susceptible to crosstalk due to competition for degradation between proteins. To understand proteolytic crosstalk beyond the single protease regime, we investigated in E. coli a set of synthetic circuits designed to probe the dynamics of existing and novel degradation tags fused to fluorescent proteins. These circuits were tested using both microplate reader and single-cell assays. We first quantified the degradation rates of each tag in isolation. We then tested if there was crosstalk between two distinguishable fluorescent proteins engineered with identical or different degradation tags. We demonstrated that proteolytic crosstalk was indeed not limited to the LAA degradation tag, but was also apparent between other diverse tags, supporting the complexity of the E. coli protein degradation system.

In Situ Observations of Snow Metamorphosis Acceleration Induced by Dust and Black Carbon

NASA Astrophysics Data System (ADS)

Schneider, A. M.; Flanner, M.

2017-12-01

Previous studies demonstrate the dependence of shortwave infrared (SWIR) reflectance on snow specific surface area (SSA) and others examine the direct darkening effect dust and black carbon (BC) deposition has on snow and ice-covered surfaces. The extent to which these light absorbing aerosols (LAAs) accelerate snow metamorphosis, however, is challenging to assess in situ as measurement techniques easily disturb snowpack. Here, we use two Near-Infrared Emitting Reflectance Domes (NERDs) to measure 1300 and 1550nm bidirectional reflectance factors (BRFs) of natural snow and experimental plots with added dust and BC. We obtain NERD measurements and subsequently collect and transport snow samples to the nearby U.S. Army Corps of Engineers' Cold Regions Research and Engineering Lab for micro computed tomography (micro-CT) analysis. Snow 1300 (1550) nm BRFs evolve from 0.6 (0.15) in fresh snow to 0.2 (0.03) after metamorphosis. Hourly-scale time evolving snow surface BRFs and SSA estimates from micro-CT reveal more rapid SWIR darkening and snow metamorphosis in contaminated versus natural plots. Cloudiness and high wind speeds can completely obscure these results if LAAs mobilize before absorbing enough radiant energy. These findings verify experimentally that dust and BC deposition can accelerate snow metamorphosis and enhance snow albedo feedback in sunny, calm weather conditions. Although quantifying the enhancement of snow albedo feedback induced by LAAs requires further surface temperature, solar irradiance, and impurity concentration measurements, this study provides experimental verification of positive feedback occurring where dust and BC accelerate snow metamorphosis.

Heating Rate of Light Absorbing Aerosols: Time-Resolved Measurements, the Role of Clouds, and Source Identification.

PubMed

Ferrero, Luca; Močnik, Griša; Cogliati, Sergio; Gregorič, Asta; Colombo, Roberto; Bolzacchini, Ezio

2018-03-20

Light absorbing aerosols (LAA) absorb sunlight and heat the atmosphere. This work presents a novel methodology to experimentally quantify the heating rate (HR) induced by LAA into an atmospheric layer. Multiwavelength aerosol absorption measurements were coupled with spectral measurements of the direct, diffuse and surface reflected radiation to obtain highly time-resolved measurements of HR apportioned in the context of LAA species (black carbon, BC; brown carbon, BrC; dust), sources (fossil fuel, FF; biomass burning, BB), and as a function of cloudiness. One year of continuous and time-resolved measurements (5 min) of HR were performed in the Po Valley. We experimentally determined (1) the seasonal behavior of HR (winter 1.83 ± 0.02 K day -1 ; summer 1.04 ± 0.01 K day -1 ); (2) the daily cycle of HR (asymmetric, with higher values in the morning than in the afternoon); (3) the HR in different sky conditions (from 1.75 ± 0.03 K day -1 in clear sky to 0.43 ± 0.01 K day -1 in complete overcast); (4) the apportionment to different sources: HR FF (0.74 ± 0.01 K day -1 ) and HR BB (0.46 ± 0.01 K day -1 ); and (4) the HR of BrC (HR BrC : 0.15 ± 0.01 K day -1 , 12.5 ± 0.6% of the total) and that of BC (HR BC : 1.05 ± 0.02 K day -1 ; 87.5 ± 0.6% of the total).

78 FR 67365 - Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-12

... reduce the risk of life-threatening bleeding events in patients with non-valvular atrial fibrillation who... premarket approval application regarding the Boston Scientific WATCHMAN Left Atrial Appendage (LAA) Closure... placed in the left atrial appendage. This device is intended to prevent thrombus embolization from the...

Finalizing the Libby Action Plan Research Program

EPA Science Inventory

Libby, Montana is the location of a former vermiculite mine that operated from 1923 to 1990. The vermiculite ore from the mine co-existed with amphibole asbestos, referred to as Libby Amphibole Asbestos (LAA). Combined with the cessation of the asbestos mining and processing oper...

Functional, textural and sensory properties of dry pasta supplemented with lyophilized tomato matrix or with durum wheat bran extracts produced by supercritical carbon dioxide or ultrasound.

PubMed

Pasqualone, Antonella; Gambacorta, Giuseppe; Summo, Carmine; Caponio, Francesco; Di Miceli, Giuseppe; Flagella, Zina; Marrese, Pier Paolo; Piro, Gabriella; Perrotta, Carla; De Bellis, Luigi; Lenucci, Marcello Salvatore

2016-12-15

A study was carried out to produce functional pasta by adding bran aqueous extract (BW) and bran oleoresin (BO) obtained using ultrasound and supercritical CO2, respectively, or a powdery lyophilized tomato matrix (LT). The bioactive compounds, hydrophilic and lipophilic antioxidant activity (HAA and LAA) in vitro, were evaluated. BW supplementation did not improve antioxidant activity, whilst LT pasta showed unconventional taste and odor. BO pasta had good levels of tocochromanols (2551μg/100g pasta f.w.) and carotenoids (40.2μg/100g pasta f.w.), and the highest HAA and LAA. The oleoresin altered starch swelling and gluten network, as evidenced by scanning electron microscopy, therefore BO pasta had structural characteristics poor compared with the control (4.8% vs. 3.2% cooking loss), although this difference did not affect significantly overall sensory judgment (74 vs. 79 for BO and control, respectively). BO supplementation was most effective for increasing antioxidant activity without jeopardizing pasta quality. Copyright © 2016 Elsevier Ltd. All rights reserved.

An Authorization Logic with Explicit Time

DTIC Science & Technology

2008-02-02

that η-logic can be used in specifying the behavior of systems with time-dependent authorization policies. In such cases, the logic can be used to...10(4):265– 310, November 1992. [26] Christopher Lesniewski-Laas, Bryan Ford, Jacob Strauss, M. Frans Kaashoek, and Robert Morris. Alpaca : extensible

New methodology to assess activity status of occlusal caries in primary teeth using laser fluorescence device.

PubMed

Braga, Mariana Minatel; de Benedetto, Monique Saveriano; Imparato, Jose Carlos Pettorossi; Mendes, Fausto Medeiros

2010-01-01

An in vivo study was conducted to verify the ability of laser fluorescence (LF) to assess the activity status of occlusal caries in primary teeth, using different air-drying times. Occlusal sites (707) were examined using LF (DIAGNOdent) after air-drying for 3 s and 15 s, and the difference between readings (DIF15 s-3 s) was calculated. For concurrent validation of LF, visual criteria-Nyvad (NY) and Lesion Activity Assessment associated with the International Caries Detection and Assessment System (LAA-ICDAS)-were the reference standards for lesion activity. Histological exam using a pH-indicator dye (0.1% methyl red) was performed in 46 exfoliated/extracted teeth for criterion validation. LF readings and DIF15 s-3 s were compared using Kruskall-Wallis and Mann-Whitney tests. Receiver operating characteristic analyses were performed and validity parameters calculated, considering the caries activity assessment. Using NY, active lesions (3 s: 30.0+/-29.3; 15 s: 34.2+/-30.6) presented higher LF readings than inactive lesions (3 s: 17.0+/-16.3; 15 s: 19.2+/-17.3; p<0.05), different from LAA-ICDAS. Active cavitated caries resulted in higher LF readings (3 s: 50.3+/-3.5; 15 s: 54.7+/-30.2) than inactive cavitated caries (3 s: 19.9+/-16.3; 15 s: 22.8+/-16.8). Therefore, LF can distinguish cavitated active and inactive lesions classified by NY, but not by LAA-ICDAS; however, this difference might be related to the visual system rather than to LF. The air-drying time could be an alternative to improve the caries activity assessment; however, longer air-drying time is suggested to be tested subsequently.

Polygenic overlap between kidney function and large artery atherosclerotic stroke

PubMed Central

Holliday, Elizabeth G.; Traylor, Matthew; Malik, Rainer; Bevan, Stephen; Maguire, Jane; Koblar, Simon A.; Sturm, Jonathan; Hankey, Graeme J.; Oldmeadow, Christopher; McEvoy, Mark; Sudlow, Cathie; Rothwell, Peter M.; Coresh, Josef; Hamet, Pavel; Tremblay, Johanne; Turner, Stephen T.; de Andrade, Mariza; Rao, Madhumathi; Schmidt, Reinhold; Crick, Peter A.; Robino, Antonietta; Peralta, Carmen A.; Jukema, J. Wouter; Mitchell, Paul; Rosas, Sylvia E.; Wang, Jie Jin; Scott, Rodney J.; Dichgans, Martin; Mitchell, Braxton D.; Linda Kao, W. H.; Fox, Caroline S.; Levi, Christopher; Attia, John; Markus, Hugh S

2014-01-01

Background and Purpose Epidemiological studies show strong associations between kidney dysfunction and risk of ischaemic stroke, the mechanisms of which are incompletely understood. We investigated whether these associations may reflect shared heritability due to a common polygenic basis and whether this differed for ischaemic stroke subtypes. Methods Polygenic models were derived using GWAS meta-analysis results for three kidney traits: estimated glomerular filtration rate using serum creatinine (eGFRcrea: N=73,998), eGFR using cystatin C (eGFRcys: N=22,937) and urinary albumin to creatinine ratio (UACR: N=31,580). For each, SNPs passing ten P-value thresholds were used to form profile scores in 4,561 ischaemic stroke cases and 7,094 controls from the UK, Germany and Australia. Scores were tested for association with ischaemic stroke and its three aetiological subtypes: large artery atherosclerosis (LAA), cardioembolism (CE) and small vessel disease (SVD). Results Polygenic scores correlating with higher eGFRcrea were associated with reduced risk of LAA, with five scores reaching P<0.05 (peak P=0.004) and all showing the epidemiologically expected direction of effect. A similar pattern was observed for polygenic scores reflecting higher UACR, of which three associated with LAA (peak P=0.01) and all showed the expected directional association. One UACR-based score also associated with SVD (P=0.03). The global pattern of results was unlikely to have occurred by chance (P=0.02). Conclusions This study suggests possible polygenic correlation between renal dysfunction and ischaemic stroke. The shared genetic components may be specific to stroke subtypes, particularly large artery atherosclerotic stroke. Further study of the genetic relationships between these disorders appears merited. PMID:25352485

Lipid profiles and ischemic stroke risk: variations by sex within racial/ethnic groups

PubMed Central

Gezmu, Tefera; Schneider, Dona; Demissie, Kitaw; Lin, Yong; Giordano, Christine; Gizzi, Martin S

2014-01-01

Evidence implicates lipid abnormalities as important but modifiable risk factors for stroke. This study assesses whether hypercholesterolemia can be used to predict the risk for etiologic subtypes of ischemic stroke between sexes within racial/ethnic groups. Data elements related to stroke risk, diagnosis, and outcomes were abstracted from the medical records of 3,290 acute stroke admissions between 2006 and 2010 at a regional stroke center. Sex comparison within racial/ethnic groups revealed that South Asian and Hispanic men had a higher proportion of ischemic stroke than women, while the inverse was true for Whites and African Americans (P=0.0014). All women, except South Asian women, had higher mean plasma total cholesterol and higher blood circulating low-density lipoprotein levels (≥100 mg/dL) than men at the time of their admissions. The incidence of large-artery atherosclerosis (LAA) was more common among women than men, except among Hispanics, where men tended to have higher incidences. A regression analysis that considered patients diagnosed with either LAA or small-artery occlusion etiologic subtype as the outcomes and high-density lipoproteins and triglycerides as predictors showed inconsistent associations between lipid profiles and the incidence of these subtypes between the sexes within racial/ethnic groups. In conclusion, our investigation suggests that women stroke patients may be at increased risk for stroke etiologic subtype LAA than men. Although the higher prevalence of stroke risk factors examined in this study predicts the increase in the incidence of the disease, lack of knowledge/awareness and lack of affordable treatments for stroke risk factors among women and immigrants/non-US-born subpopulations may explain the observed associations. PMID:24940081

Lipid profiles and ischemic stroke risk: variations by sex within racial/ethnic groups.

PubMed

Gezmu, Tefera; Schneider, Dona; Demissie, Kitaw; Lin, Yong; Giordano, Christine; Gizzi, Martin S

2014-01-01

Evidence implicates lipid abnormalities as important but modifiable risk factors for stroke. This study assesses whether hypercholesterolemia can be used to predict the risk for etiologic subtypes of ischemic stroke between sexes within racial/ethnic groups. Data elements related to stroke risk, diagnosis, and outcomes were abstracted from the medical records of 3,290 acute stroke admissions between 2006 and 2010 at a regional stroke center. Sex comparison within racial/ethnic groups revealed that South Asian and Hispanic men had a higher proportion of ischemic stroke than women, while the inverse was true for Whites and African Americans (P=0.0014). All women, except South Asian women, had higher mean plasma total cholesterol and higher blood circulating low-density lipoprotein levels (≥100 mg/dL) than men at the time of their admissions. The incidence of large-artery atherosclerosis (LAA) was more common among women than men, except among Hispanics, where men tended to have higher incidences. A regression analysis that considered patients diagnosed with either LAA or small-artery occlusion etiologic subtype as the outcomes and high-density lipoproteins and triglycerides as predictors showed inconsistent associations between lipid profiles and the incidence of these subtypes between the sexes within racial/ethnic groups. In conclusion, our investigation suggests that women stroke patients may be at increased risk for stroke etiologic subtype LAA than men. Although the higher prevalence of stroke risk factors examined in this study predicts the increase in the incidence of the disease, lack of knowledge/awareness and lack of affordable treatments for stroke risk factors among women and immigrants/non-US-born subpopulations may explain the observed associations.

The Effect of Ascorbic Acid and Garlic Administration on Lead-Induced Neural Damage in Rat Offspring's Hippocampus.

PubMed

Sadeghi, Akram; Ebrahimzadeh Bideskan, Alireza; Alipour, Fatemeh; Fazel, Alireza; Haghir, Hossein

2013-02-01

The aim of this study was to investigate ascorbic acid and garlic protective effects on lead-induced neurotoxicity during rat hippocampus development. 90 pregnant wistar rats were divided randomly into nine groups: 1- Animals received leaded water (L). 2- Rats received leaded water and ascorbic acid (L+AA). 3- Animals received leaded water and garlic juice (L+G). 4-Animals received leaded water, ascorbic acid and garlic juice (L+G+AA). 5- Rats treated with ascorbic acid (AA). 6- Rats treated with garlic juice (G). 7- Rats treated with ascorbic acid and garlic juice (AA+G). 8- Rats treated with tap water plus 0.4 ml/l normal hydrogen chloride (HCl) and 0.5 mg/l Glucose (Sham). 9- Normal group (N). Leaded water (1500 ppm), garlic juice (1 ml/100g/day, gavage) and ascorbic acid (500 mg/kg/day, IP) were used. Finally, blood lead levels (BLL) were measured in both rats and their offspring. The rat offspring brain sections were stained using Toluidine Blue and photographed. Dark neurons (DNs) were counted to compare all groups. BLL significantly increased in L group compared to control and sham groups and decreased in L+G and L+AA groups in comparison to the L group (P<0.05). the number of DNs in the CA1, CA3, and DG of rat offspring hippocampus significantly increased in L group in comparison to control and sham groups (P<0.05) and decreased in L+G and L+AA groups compared to L group (P<0.05). Garlic juice and ascorbic acid administration during pregnancy and lactation may protect lead-induced neural damage in rat offspring hippocampus.

78 FR 26399 - National Endowment for the Arts; Proposed Collection, Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-06

... (PRA95) [44 U.S.C. 3506(c)(A)]. This program helps to ensure that requested data can be provided in the... clearly understood, and the impact of collection requirements on respondents can be properly assessed... Arts Agencies (LAAs). A copy of the current information collection request can be obtained by...

77 FR 41479 - Unblocking of Specially Designated Nationals and Blocked Persons Pursuant to Executive Order 12978

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-13

..., Maria Teresa), c/o INVERSIONES MPS S.A., Bogota, Colombia; c/o PROYECTOS Y SOLUCIONES INMOBILIARIA LTDA... S.A., Quito, Ecuador; c/o INVERSIONES ARA LTDA., Cali, Colombia; c/o DISTRIBUIDORA DE DROGAS LA....A., Bogota, Colombia; c/o DROCARD S.A., Bogota, Colombia; c/o INVERSIONES ESPANOLES FEMCAR S.L...

[Quantitative analysis of emphysema and air trapping at inspiratory and expiratory phase multi-slice spiral CT scan in smokers: correlation with pulmonary function test].

PubMed

Zhang, D; Guan, Y; Fan, L; Xia, Y; Liu, S Y

2018-05-22

Objective: To quantify emphysema and air trapping at inspiratory and expiratory phase multi-slice spiral CT(MSCT) scanning in smokers without respiratory symptoms, and analyze the correlation between the CT quantifiable parameters and lung function parameters. Methods: A total of 72 smokers, who underwent medical examinations from September 2013 to September 2016 in Changzheng Hospital were enrolled in this research and were divided into two groups: 24 smokers with COPD and 48 smokers without COPD.Besides, thirty-nine non-smokers with normal pulmonary function were enrolled as the controls.All subjects underwent double phase MSCT scanning and pulmonary function tests.CT quantifiable parameters of emphysema included the low attenuation area below a threshold of -950 Hounsfield Units (HU)(LAA%(-950)), the lowest 15th percentile of the histogram of end-inspiratory attenuation values (P(15-IN)), the lowest 15th percentile of the histogram of end-expiratory attenuation values (P(15-EX)), relative volume change(RVC) and the expiratory to inspiratory ratio of mean lung density (E/I(MLD)). Pulmonary function parameters included forced expiratory volume in 1 second expressed as percent predicted (FEV(1)%), forced expiratory volume in one second to forced vital capacity ratio (FEV(1)/FVC), residual volume to total lung capacity ratio (RV/TLC) and carbon monoxide diffusion capacity corrected for alveolar volume (DLCO/VA). The differences of CT quantifiable parameters and pulmonary function parameters among the three groups were analyzed by using one-way analysis of variance or Kruskal - Wallis H test.The correlation between CT quantifiable parameters and pulmonary function parameters was analyzed by using Spearman ' s correlation analysis. Results: The differences of LAA%(-950)(the values for the controls, the group of smokers with out COPD and the group of smokers with COPD were 0.5%±0.7%, 0.7%±1.2% and 2.0%±2.4% respectively), P(15-IN)(the values of the three groups were

Primary and Secondary Stroke Prevention Using Left Atrial Appendage Closure with Watchman Devices in Atrial Fibrillation Patients: A Single Center Experience from Mainland China.

PubMed

Chen, Yanhong; Zhang, Yonghua; Huang, Weiping; Huang, Keqiang; Xu, Bei; Su, X I

2017-06-01

Atrial fibrillation (AF) is associated with increased stroke risk resulting from cardiac embolism of the left atrial appendage (LAA). Stroke tends to recur in NVAF patients. Yet safety and feasibility of secondary stroke preventions with LAA closure (LAAC) have not been assessed in detail. This retrospective study was designed to compare the feasibility and safety of LAAC in primary and secondary stroke preventions, in a real-world setting of Chinese patients. From 2014 to 2015, non-valvular AF patients with CHA2DS2-VASc ≥1 were selected for percutaneous LAAC operations. Outcome observations of primary and secondary stroke preventions with Watchman devices were analyzed and compared. Overall, 122 patients were included. LAAC with Watchman devices were attempted in 115 patients, of whom 68 were for primary stroke prevention and 47 were for secondary prevention. Both the CHA2DS2-VASc score and the HASBLED score were significantly higher in the secondary prevention group (4.09 ± 1.06 vs. 1.93 ± 1.09 for CHA2DS2-VASc and 1.83 ± 1.03 vs. 1.26 ± 0.87 for HASBLED, P < 0.01). In both groups LAAC were achieved with high successful rate (98.53% in the primary prevention group and 100% in the secondary prevention group, P > 0.05) and low complication rates. The stroke rates were at a low level in both groups (1.47% in primary prevention group vs. 2.13% in secondary prevention group, P > 0.05). In our initial single-center experience, percutaneous LAA closure was a feasible and safe procedure for both primary and secondary stroke preventions in Chinese patients with nonvalvular AF. © 2017 Wiley Periodicals, Inc.

Air ambulance tasking: mechanism of injury, telephone interrogation or ambulance crew assessment?

PubMed

Wilmer, Ian; Chalk, Graham; Davies, Gareth Edward; Weaver, Anne Elizabeth; Lockey, David John

2015-10-01

The identification of serious injury is critical to the tasking of air ambulances. London's Air Ambulance (LAA) is dispatched by a flight paramedic based on mechanism of injury (MOI), paramedical interrogation of caller (INT) or land ambulance crew request (REQ).This study aimed to demonstrate which of the dispatch methods was most effective (in accuracy and time) in identifying patients with serious injury. A retrospective review of 3 years of data (to December 2010) was undertaken. Appropriate dispatch was defined as the requirement for LAA to escort the patient to hospital or for resuscitation on-scene. Inaccurate dispatch was where LAA was cancelled or left the patient in the care of the land ambulance crew. The χ(2) test was used to calculate p values; with significance adjusted to account for multiple testing. There were 2203 helicopter activations analysed: MOI 18.9% (n=417), INT 62.4% (n=1375) and REQ 18.7% (n=411). Appropriate dispatch rates were MOI 58.7% (245/417), INT 69.7% (959/1375) and REQ 72.2% (297/411). INT and REQ were both significantly more accurate than MOI (p<0.0001). There was no significant difference in accuracy between INT and REQ (p=0.36). Combining MOI and INT remotely identified 80.2% of patients, with an overtriage rate of 32.8%. Mean time to dispatch (in minutes) was MOI 4, INT 8 and REQ 21. Telephone interrogation of the caller by a flight paramedic is as accurate as ground ambulance crew requests, and both are significantly better than MOI in identifying serious injury. Overtriage remains an issue with all methods. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Efficacy and safety of left atrial appendage closure with WATCHMAN in patients with or without contraindication to oral anticoagulation: 1-Year follow-up outcome data of the EWOLUTION trial.

PubMed

Boersma, Lucas V; Ince, Hueseyin; Kische, Stephan; Pokushalov, Evgeny; Schmitz, Thomas; Schmidt, Boris; Gori, Tommaso; Meincke, Felix; Protopopov, Alexey Vladimir; Betts, Timothy; Foley, David; Sievert, Horst; Mazzone, Patrizio; De Potter, Tom; Vireca, Elisa; Stein, Kenneth; Bergmann, Martin W

2017-09-01

Left atrial appendage (LAA) occlusion with WATCHMAN has emerged as viable alternative to vitamin K antagonists in randomized controlled trials. EWOLUTION was designed to provide data in routine practice from a prospective multicenter registry. A total of 1025 patients scheduled for a WATCHMAN implant were prospectively and sequentially enrolled at 47 centers. Indication for LAA closure was based on European Society of Cardiology guidelines. Follow-up and transesophageal echocardiography (TEE) were performed per local practice. The baseline CHA 2 DS 2 -VASc score was 4.5 ± 1.6; the mean age was 73.4 ± 9 years; previous transient ischemic attack/ischemic stroke was present in 312 (30.5%), 155 (15.1%) had previous hemorrhagic stroke, and 320 (31.3%) had a history of major bleeding; and 750 (73%) were deemed unsuitable for oral anticoagulation therapy. WATCHMAN implant succeeded in 1005 (98.5%) of patients, without leaks >5 mm in 1002 (99.7%) with at least 1 TEE follow-up in 875 patients (87%). Antiplatelet therapy was used in 784 (83%), while vitamin K antagonists were used in only 75 (8%). At 1 year, mortality was 98 (9.8%), reflecting the advanced age and comorbidities in this population. Device thrombus was observed in 28 patients at routine TEE (3.7%) and was not correlated with the drug regimen (P = .14). Ischemic stroke rate was 1.1% (relative risk 84% vs estimated historical data); the major bleeding rate was 2.6% and was predominantly (2.3%) nonprocedure/device related. LAA closure with the WATCHMAN device has a high implant and sealing success. This method of stroke risk reduction appears to be safe and effective with an ischemic stroke rate as low as 1.1%, even though 73% of patients had a contraindication to and were not using oral anticoagulation. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Lung ventilation-perfusion imbalance in pulmonary emphysema: assessment with automated V/Q quotient SPECT.

PubMed

Suga, Kazuyoshi; Kawakami, Yasuhiko; Koike, Hiroaki; Iwanaga, Hideyuki; Tokuda, Osamu; Okada, Munemasa; Matsunaga, Naofumi

2010-05-01

Tc-99m-Technegas-MAA single photon emission computed tomography (SPECT)-derived ventilation (V)/perfusion (Q) quotient SPECT was used to assess lung V-Q imbalance in patients with pulmonary emphysema. V/Q quotient SPECT and V/Q profile were automatically built in 38 patients with pulmonary emphysema and 12 controls, and V/Q distribution and V/Q profile parameters were compared. V/Q distribution on V/Q quotient SPECT was correlated with low attenuation areas (LAA) on density-mask computed tomography (CT). Parameters of V/Q profile such as the median, standard deviation (SD), kurtosis and skewness were proposed to objectively evaluate the severity of lung V-Q imbalance. In contrast to uniform V/Q distribution on V/Q quotient SPECT and a sharp peak with symmetrical V/Q distribution on V/Q profile in controls, lung areas showing heterogeneously high or low V/Q and flattened peaks with broadened V/Q distribution were frequently seen in patients with emphysema, including lung areas with only slight LAA. V/Q distribution was also often asymmetric regardless of symmetric LAA. All the proposed parameters of V/Q profile in entire lungs of patients with emphysema showed large variations compared with controls; SD and kurtosis were significantly different from controls (P < 0.0001 and P < 0.001, respectively), and a significant correlation was found between SD and A-aDO2 (P < 0.0001). V/Q quotient SPECT appears to be more sensitive to detect emphysematous lungs compared with morphologic CT in patients with emphysema. SD and kurtosis of V/Q profile can be adequate parameters to assess the severity of lung V-Q imbalance causing gas-exchange impairment in patients with emphysema.

Computed Tomographic Measures of Pulmonary Vascular Morphology in Smokers and Their Clinical Implications

PubMed Central

Estépar, Raúl San José; Kinney, Gregory L.; Black-Shinn, Jennifer L.; Bowler, Russell P.; Kindlmann, Gordon L.; Ross, James C.; Kikinis, Ron; Han, MeiLan K.; Come, Carolyn E.; Diaz, Alejandro A.; Cho, Michael H.; Hersh, Craig P.; Schroeder, Joyce D.; Reilly, John J.; Lynch, David A.; Crapo, James D.; Wells, J. Michael; Dransfield, Mark T.; Hokanson, John E.

2013-01-01

Rationale: Angiographic investigation suggests that pulmonary vascular remodeling in smokers is characterized by distal pruning of the blood vessels. Objectives: Using volumetric computed tomography scans of the chest we sought to quantitatively evaluate this process and assess its clinical associations. Methods: Pulmonary vessels were automatically identified, segmented, and measured. Total blood vessel volume (TBV) and the aggregate vessel volume for vessels less than 5 mm2 (BV5) were calculated for all lobes. The lobe-specific BV5 measures were normalized to the TBV of that lobe and the nonvascular tissue volume (BV5/TissueV) to calculate lobe-specific BV5/TBV and BV5/TissueV ratios. Densitometric measures of emphysema were obtained using a Hounsfield unit threshold of −950 (%LAA-950). Measures of chronic obstructive pulmonary disease severity included single breath measures of diffusing capacity of carbon monoxide, oxygen saturation, the 6-minute-walk distance, St George’s Respiratory Questionnaire total score (SGRQ), and the body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index. Measurements and Main Results: The %LAA-950 was inversely related to all calculated vascular ratios. In multivariate models including age, sex, and %LAA-950, lobe-specific measurements of BV5/TBV were directly related to resting oxygen saturation and inversely associated with both the SGRQ and BODE scores. In similar multivariate adjustment lobe-specific BV5/TissueV ratios were inversely related to resting oxygen saturation, diffusing capacity of carbon monoxide, 6-minute-walk distance, and directly related to the SGRQ and BODE. Conclusions: Smoking-related chronic obstructive pulmonary disease is characterized by distal pruning of the small blood vessels (<5 mm2) and loss of tissue in excess of the vasculature. The magnitude of these changes predicts the clinical severity of disease. PMID:23656466

Distribution and recovery of nitrogen-15-labeled liquid anhydrous ammonia among various soil fractions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Norman, R.J.; Kurtz, L.T.; Stevenson, F.J.

Since liquid anhydrous ammonia (LAA) is a major N fertilizer, information was sought about the proportions of LAA that enter into various combinations in soils. Liquid anhydrous NH/sub 3/, labeled with /sup 15/N was injected into three soils (Drummer, Typic Haplaquoll; Blount, Aeric Ochraqualf; Cisne, Mollic Albaqualf) in the laboratory at a rate equivalent to a field application of 206 kg N ha /sup 1/ in 76.2 cm knife-spacings. At 1, 7, 14, 28, 56, and 112 d after application, fertilizer N present in different soil fractions was determined in five concentric zones with radii of 0 to 1.5, 1.5more » to 3.0, 3.0 to 4.5, 4.5 to 6.0, and 6.0 to 7.0 cm around the point of application. Depending on the soil, from 68 to 83% of the applied /sup 15/N was accounted for as (exchangeable NH/sub 4//sup +/ + NO/sub 3//sup -/ + NO/sub 2//sup -/)-N by the 112th day following application, the remainder being accounted for as clay-fixed NH/sub 4//sup +/ (1.9-4.9%), organic matter-fixed NH/sub 3/ (4.0-6.0%), and biologically immobilized organic N (3.9-9.3%). From 50 to 70% of the organic matter-fixed NH/sub 3/-N was released by hydrolysis with dilute KOH solution as compared to 10 to 15% for the immobilized N. Total recovery of /sup 15/N at 112 d ranged from 77% for the Cisne soil to about 97% for the Drummer and Blount soils. Lateral distributions and transformations of NH/sub 4//sup +/ and NO/sub 3//sup -/ and pH trends after LAA applications were similar to those reported by previous investigators.« less

Non-emphysematous chronic obstructive pulmonary disease is associated with diabetes mellitus.

PubMed

Hersh, Craig P; Make, Barry J; Lynch, David A; Barr, R Graham; Bowler, Russell P; Calverley, Peter M A; Castaldi, Peter J; Cho, Michael H; Coxson, Harvey O; DeMeo, Dawn L; Foreman, Marilyn G; Han, MeiLan K; Harshfield, Benjamin J; Hokanson, John E; Lutz, Sharon; Ramsdell, Joe W; Regan, Elizabeth A; Rennard, Stephen I; Schroeder, Joyce D; Sciurba, Frank C; Steiner, Robert M; Tal-Singer, Ruth; van Beek, Edwin; Silverman, Edwin K; Crapo, James D

2014-10-24

Chronic obstructive pulmonary disease (COPD) has been classically divided into blue bloaters and pink puffers. The utility of these clinical subtypes is unclear. However, the broader distinction between airway-predominant and emphysema-predominant COPD may be clinically relevant. The objective was to define clinical features of emphysema-predominant and non-emphysematous COPD patients. Current and former smokers from the Genetic Epidemiology of COPD Study (COPDGene) had chest computed tomography (CT) scans with quantitative image analysis. Emphysema-predominant COPD was defined by low attenuation area at -950 Hounsfield Units (LAA-950) ≥10%. Non-emphysematous COPD was defined by airflow obstruction with minimal to no emphysema (LAA-950 < 5%). Out of 4197 COPD subjects, 1687 were classified as emphysema-predominant and 1817 as non-emphysematous; 693 had LAA-950 between 5-10% and were not categorized. Subjects with emphysema-predominant COPD were older (65.6 vs 60.6 years, p < 0.0001) with more severe COPD based on airflow obstruction (FEV1 44.5 vs 68.4%, p < 0.0001), greater exercise limitation (6-minute walk distance 1138 vs 1331 ft, p < 0.0001) and reduced quality of life (St. George's Respiratory Questionnaire score 43 vs 31, p < 0.0001). Self-reported diabetes was more frequent in non-emphysematous COPD (OR 2.13, p < 0.001), which was also confirmed using a strict definition of diabetes based on medication use. The association between diabetes and non-emphysematous COPD was replicated in the ECLIPSE study. Non-emphysematous COPD, defined by airflow obstruction with a paucity of emphysema on chest CT scan, is associated with an increased risk of diabetes. COPD patients without emphysema may warrant closer monitoring for diabetes, hypertension, and hyperlipidemia and vice versa. Clinicaltrials.gov identifiers: COPDGene NCT00608764, ECLIPSE NCT00292552.

Ionospheric threats to the integrity of airborne GPS users

NASA Astrophysics Data System (ADS)

Datta-Barua, Seebany

The Global Positioning System (GPS) has both revolutionized and entwined the worlds of aviation and atmospheric science. As the largest and most unpredictable source of GPS positioning error, the ionospheric layer of the atmosphere, if left unchecked, can endanger the safety, or "integrity," of the single frequency airborne user. An augmentation system is a differential-GPS-based navigation system that provides integrity through independent ionospheric monitoring by reference stations. However, the monitor stations are not in general colocated with the user's GPS receiver. The augmentation system must protect users from possible ionosphere density variations occurring between its measurements and the user's. This study analyzes observations from ionospherically active periods to identify what types of ionospheric disturbances may cause threats to user safety if left unmitigated. This work identifies when such disturbances may occur using a geomagnetic measure of activity and then considers two disturbances as case studies. The first case study indicates the need for a non-trivial threat model for the Federal Aviation Administration's Local Area Augmentation System (LAAS) that was not known prior to the work. The second case study uses ground- and space-based data to model an ionospheric disturbance of interest to the Federal Aviation Administration's Wide Area Augmentation System (WAAS). This work is a step in the justification for, and possible future refinement of, one of the WAAS integrity algorithms. For both WAAS and LAAS, integrity threats are basically caused by events that may be occurring but are unobservable. Prior to the data available in this solar cycle, events of such magnitude were not known to be possible. This work serves as evidence that the ionospheric threat models developed for WARS and LAAS are warranted and that they are sufficiently conservative to maintain user integrity even under extreme ionospheric behavior.

CT Metrics of Airway Disease and Emphysema in Severe COPD

PubMed Central

Kim, Woo Jin; Silverman, Edwin K.; Hoffman, Eric; Criner, Gerard J.; Mosenifar, Zab; Sciurba, Frank C.; Make, Barry J.; Carey, Vincent; Estépar, Raúl San José; Diaz, Alejandro; Reilly, John J.; Martinez, Fernando J.; Washko, George R.

2009-01-01

Background: CT scan measures of emphysema and airway disease have been correlated with lung function in cohorts of subjects with a range of COPD severity. The contribution of CT scan-assessed airway disease to objective measures of lung function and respiratory symptoms such as dyspnea in severe emphysema is less clear. Methods: Using data from 338 subjects in the National Emphysema Treatment Trial (NETT) Genetics Ancillary Study, densitometric measures of emphysema using a threshold of −950 Hounsfield units (%LAA-950) and airway wall phenotypes of the wall thickness (WT) and the square root of wall area (SRWA) of a 10-mm luminal perimeter airway were calculated for each subject. Linear regression analysis was performed for outcome variables FEV1 and percent predicted value of FEV1 with CT scan measures of emphysema and airway disease. Results: In univariate analysis, there were significant negative correlations between %LAA-950 and both the WT (r = −0.28, p = 0.0001) and SRWA (r = −0.19, p = 0.0008). Airway wall thickness was weakly but significantly correlated with postbronchodilator FEV1% predicted (R = −0.12, p = 0.02). Multivariate analysis showed significant associations between either WT or SRWA (β = −5.2, p = 0.009; β = −2.6, p = 0.008, respectively) and %LAA-950 (β = −10.6, p = 0.03) with the postbronchodilator FEV1% predicted. Male subjects exhibited significantly thicker airway wall phenotypes (p = 0.007 for WT and p = 0.0006 for SRWA). Conclusions: Airway disease and emphysema detected by CT scanning are inversely related in patients with severe COPD. Airway wall phenotypes were influenced by gender and associated with lung function in subjects with severe emphysema. PMID:19411295

Association of matrix metalloproteinase-3 gene 5A/6A polymorphism with the recurrence of ischemic stroke: A prospective observational study.

PubMed

Huang, Xiaoya; Ye, Qiang; Zhang, Zheng; Huang, Xiangdong; Zhu, Zhenguo; Chen, Yanyan; Li, Jia; Chen, Siyan; Xia, Niange; Mao, Xinlei; Han, Liya; Ye, Zusen

2017-11-01

Studies have demonstrated that matrix metalloproteinase-3 (MMP-3) is involved in the development and progression of atherosclerosis. However, there is no information available on the association of MMP-3 5A/6A polymorphism with recurrent ischemic stroke (IS) in different IS subtypes. We investigated the potential associations between MMP-3 serum level and -1171 5A/6A polymorphism and the recurrence of IS in a Chinese population. Consecutive acute first-ever IS patients were enrolled between August 2008 and October 2013. The genotypes of MMP-3 5A/6A polymorphism were determined using polymerase chain reaction-restriction fragment length polymorphism. IS recurrence was monitored after the index event and multivariate Cox proportional hazards model was constructed to identify factors related to future IS recurrence. A total of 1282 eligible patients were enrolled. During a 2-year follow-up period, 157 (12.25%) patients had recurrent events. MMP-3 level was significantly higher in patients with 5A/6A or 5A/5A genotype (22.72±7.29ng/ul) than in patients with 6A/6A genotype (20.48±7.58ng/ul), P<0.001. No interaction between MMP-3 5A/6A polymorphism and the risk of recurrence in total IS patients was found. The variant 5A/6A+5A/5A genotype and the 5A allele were significantly associated with a high risk of recurrence for large-artery atherosclerosis (LAA) (multivariate-adjusted, P=0.002, 0.001, respectively), but not for small-artery occlusion and cardioembolism. Our finding showed that MMP-3 5A/6A may be a useful biomarker for predicting recurrence for LAA stroke patients and 5A allele carrier may bear a higher risk of recurrence among patients with the subtype of LAA. Copyright © 2017. Published by Elsevier B.V.

A-type Lamins Form Distinct Filamentous Networks with Differential Nuclear Pore Complex Associations.

PubMed

Xie, Wei; Chojnowski, Alexandre; Boudier, Thomas; Lim, John S Y; Ahmed, Sohail; Ser, Zheng; Stewart, Colin; Burke, Brian

2016-10-10

The nuclear lamina is a universal feature of metazoan nuclear envelopes (NEs) [1]. In mammalian cells, it appears as a 10-30 nm filamentous layer at the nuclear face of the inner nuclear membrane (INM) and is composed primarily of A- and B-type lamins, members of the intermediate filament family [2]. While providing structural integrity to the NE, the lamina also represents an important signaling and regulatory platform [3]. Two A-type lamin isoforms, lamins A and C (LaA and LaC), are expressed in most adult human cells. Encoded by a single gene, these proteins are largely identical, diverging only in their C-terminal tail domains. By contrast with that of LaC, the unique LaA tail undergoes extensive processing, including farnesylation and endo-proteolysis [4, 5]. However, functional differences between LaA and LaC are still unclear. Compounding this uncertainty, the structure of the lamina remains ill defined. In this study, we used BioID, an in vivo proximity-labeling method to identify differential interactors of A-type lamins [6]. One of these, Tpr, a nuclear pore complex (NPC) protein, is highlighted by its selective association with LaC. By employing superresolution microscopy, we demonstrate that this Tpr association is mirrored in enhanced interaction of LaC with NPCs. Further superresolution studies visualizing both endogenous A- and B-type lamins have allowed us to construct a nanometer-scale model of the mammalian nuclear lamina. Our data indicate that different A- and B-type lamin species assemble into separate filament networks that together form an extended composite structure at the nuclear periphery providing attachment sites for NPCs, thereby regulating their distribution. Copyright © 2016 Elsevier Ltd. All rights reserved.

Targeting Toll-like receptor 7/8 enhances uptake of apoptotic leukemic cells by monocyte-derived dendritic cells but interferes with subsequent cytokine-induced maturation.

PubMed

van den Ancker, Willemijn; van Luijn, Marvin M; Ruben, Jurjen M; Westers, Theresia M; Bontkes, Hetty J; Ossenkoppele, Gert J; de Gruijl, Tanja D; van de Loosdrecht, Arjan A

2011-01-01

Therapeutic vaccination with dendritic cells (DC) is an emerging investigational therapy for eradication of minimal residual disease in acute myeloid leukemia. Various strategies are being explored in manufacturing DC vaccines ex vivo, e.g., monocyte-derived DC (MoDC) loaded with leukemia-associated antigens (LAA). However, the optimal source of LAA and the choice of DC-activating stimuli are still not well defined. Here, loading with leukemic cell preparations (harboring both unknown and known LAA) was explored in combination with a DC maturation-inducing cytokine cocktail (CC; IL-1β, IL-6, TNF-α, and PGE(2)) and Toll-like receptor ligands (TLR-L) to optimize uptake. Since heat shock induced apoptotic blasts were more efficiently taken up than lysates, we focused on uptake of apoptotic leukemic cells. Uptake of apoptotic blast was further enhanced by the TLR7/8-L R848 (20-30%); in contrast, CC-induced maturation inhibited uptake. CC, and to a lesser extent R848, enhanced the ability of MoDC to migrate and stimulate T cells. Furthermore, class II-associated invariant chain peptide expression was down-modulated after R848- or CC-induced maturation, indicating enhanced processing and presentation of antigenic peptides. To improve both uptake and maturation, leukemic cells and MoDC were co-incubated with R848 for 24 h followed by addition of CC. However, this approach interfered with CC-mediated MoDC maturation as indicated by diminished migratory and T cell stimulatory capacity, and the absence of IL-12 production. Taken together, our data demonstrate that even though R848 improved uptake of apoptotic leukemic cells, the sequential use of R848 and CC is counter-indicated due to its adverse effects on MoDC maturation.

Climate Change and Adaptation Planning on the Los Angeles Aqueduct

NASA Astrophysics Data System (ADS)

Roy, S. B.; Bales, R. C.; Costa-Cabral, M. C.; Chen, L.; Maurer, E. P.; Miller, N. L.; Mills, W. B.

2009-12-01

This study provides an assessment of the potential impacts of climate change on the Eastern Sierra Nevada snowpack and snowmelt timing, using a combination of empirical (i.e., data-based) models, and computer simulation models forced by GCM-projected 21st century climatology (IPCC 2007 AR4 projections). Precipitation from the Eastern Sierra Nevada is one of the main water sources for Los Angeles' more than 4 million people - a source whose future availability is critical to the city's growing population and large economy. Precipitation in the region falls mostly in winter and is stored in the large natural reservoir that is the snowpack. Meltwater from the Eastern Sierra is delivered to the city by the 340-mile long Los Angeles Aqueducts. The analysis is focused on the nature of the impact to the LAA water supplies over the 21st century due to potential climate change, including volume of precipitation, the mix of snowfall and rainfall, shifts in the timing of runoff, interannual variability and multi-year droughts. These impacts further affect the adequacy of seasonal and annual carryover water storage, and potentially water treatment. Most of the snow in the 10,000 km^2 Mono-Owens basins that feed the LAA occurs in a relatively narrow, 10-20 km wide, high-elevation band on the steep slopes of 20 smaller basins whose streams drain into the Owens River and thence LAA. Extending over 240 km in the north-south direction, these basins present special challenges for estimating snowpack amounts and downscaling climate-model data. In addition, there are few meteorological stations and snow measurements in the snow-producing parts of the basins to drive physically based hydrologic modeling.

U.S. EPA, Pesticide Product Label, 20% GRANULAR 2,4-D LOW VOLATILE, 01/14/1994

EPA Pesticide Factsheets

2011-04-14

... 1lI"AiAI '~";PIR'AI UIN wilA '~t5 ,,,sa ... , Vie., 'Y' ,N.,stiaR fI'. Mill" IF .'et,. ... 181, .A" wat.r .5 IIIR iii 'l5&i~l. Itllr ",i.iAI. laa"iAIJ IIF 1"I)I'iAI'''i' ,Fa"W". 'I:'.,h hIA"'. ...

IgE binding to peanut allergens is inhibited by combined D-aspartic and D-glutamic acids

USDA-ARS?s Scientific Manuscript database

D-amino acids (D-aas) are reported to bind to IgE antibodies from people with allergy and asthma. The objectives of this study were to determine if D-aas bind or inhibit IgE binding to peanut allergens, and if they are more effective than L-amino acids (L-aas) in this respect. Several D-aa cocktails...

Left atrial appendage resection can be performed minimally invasively with good clinical and echocardiographic outcomes without any severe risk.

PubMed

Inoue, Takafumi; Suematsu, Yoshihiro

2018-01-22

The adverse effects of left atrial appendage (LAA) closure have not yet been evaluated. This study aimed to prove the safety and low invasiveness of LAA resection through our thoracoscopic stand-alone left atrial appendectomy experience. Eighty-seven patients [mean age 68 ± 9 years, 68 men (78%), mean congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, prior stroke or transient ischaemic attack to thromboembolism, vascular disease, age 65-74 years and sex category (CHA2DS2-VASc) score 2.9 ± 1.6 points] who had undergone thoracoscopic left atrial appendectomy were selected. The operative and clinical data (left atrial diameter, left ventricular diameter of systole/diastole, ejection fraction, brain natriuretic peptide and human atrial natriuretic peptide) were evaluated. All procedures were performed without cardiopulmonary bypass or cardiac arrest. The LAA was resected with an endoscopic linear cutter device. Except for 1 case with severe pleural adhesion, all operations were performed thoracoscopically. The preoperative and postoperative data are as follows: left atrial diameter 43 ± 5 mm and 43 ± 5 mm (P = 0.8); left ventricular diameter of systole/diastole 50 ± 5/35 ± 6 mm and 48 ± 5/34 ± 6 mm (P < 0.01); ejection fraction 57 ± 10% and 56 ± 10% (P = 0.11); brain natriuretic peptide 97 ± 77 pg/ml and 72 ± 65 pg/ml (P < 0.01) and human atrial natriuretic peptide 73 ± 64 pg/ml and 96 ± 67 pg/ml (P = 0.03), respectively. The mean volume of bleeding in the operation was very small (<10 ml). The mean length of postoperative in-hospital stay was 3.8 ± 1.8 days. All the patients were discharged while maintaining their preoperative activities of daily living without major complications. No thrombus or residual stumps were detected during the 3-month postoperative computed tomography follow-up. The perioperative heart

Expectation Maximization and its Application in Modeling, Segmentation and Anomaly Detection

DTIC Science & Technology

2008-05-01

ocomplNc <la!a rrot>lcm,. ",., i’lCOll\\l>lc,c,ICSS of Ihc dala mayan "" IIuc lu missing dala. (J,,,,,,.,ed di,nibu!ions . elc . 0"" such c • ..- is a...Estimation Techniques in Computer Huiyan, Z., Yongfeng, C., Wen, Y. SAR Image Segmentation Using MPM Constrained Stochastic Relaxation. Civil Engineering

Static and dynamic micro deformable mirror characterization by phase-shifting and time-averaged interferometry

NASA Astrophysics Data System (ADS)

Liotard, Arnaud; Zamkotsian, Frédéric

2017-11-01

The micro-opto-electro-mechanical systems (MOEMS), based on mature technologies of micro-electronics, are essential in the design of future astronomical instruments. One of these key-components is the microdeformable mirror for wave-front correction. Very challenging topics like search of exo-planets could greatly benefit from this technology. Design, realization and characterization of micro-Deformable Mirrors are under way at Laboratoire d'Astrophysique de Marseille (LAM) in collaboration with Laboratoire d'Analyse et d'Architecture des Systèmes (LAAS). In order to measure the surface shape and the deformation parameters during operation of these devices, a high-resolution Twyman-Green interferometer has been developed. Measurements have been done on a tiltable micro-mirror (170*100μm2) designed by LAM-LAAS and realized by an American foundry, and also on an OKO deformable mirror (15mm diameter). Static characterization is made by phase shifting interferometry and dynamic measurements have been made by quantitative time-averaged interferometry. The OKO mirror has an actuator stroke of 370+/-10nm for 150V applied and its resonant frequency is 1170+/-50 Hz, and the tiltable mirror has a rotation cut-off frequency of 31+/-3 kHz.

EWOLUTION: Design of a registry to evaluate real-world clinical outcomes in patients with AF and high stroke risk-treated with the WATCHMAN left atrial appendage closure technology.

PubMed

Boersma, Lucas V A; Schmidt, Boris; Betts, Tim R; Sievert, Horst; Tamburino, Corrado; Teiger, Emmanuel; Stein, Kenneth M; Bergmann, Martin W

2016-09-01

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and the rate of ischemic stroke attributed to non-valvular AF is estimated at 5% per year. Several multi-center studies established left atrial appendage closure as a safe and effective alternative to oral anticoagulation, but there is a need for additional real world data. The purpose of this observational, prospective, single-arm, multicenter clinical study is to compile real-world clinical outcome data for WATCHMAN™ LAA (left atrial appendage) Closure Technology. One thousand subjects at up to 70 institutions in Europe, the Middle East, and Russia will be enrolled. Patients will be followed for 2 years after WATCHMAN implantation, according to standard medical practice. Primary endpoints include procedural and long-term data including stroke/embolism, bleeding, and death. This article presents the background of the LAAC device and describes the design of the study. Results for peri-procedural analyses are expected toward the end of 2015; long-term follow-up data are expected in the latter half of 2017. The EWOLUTION study will formally expand knowledge of LAA closure into a broader real world setting. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Diffusion capacity and CT measures of emphysema and airway wall thickness - relation to arterial oxygen tension in COPD patients.

PubMed

Saure, Eirunn Waatevik; Bakke, Per Sigvald; Lind Eagan, Tomas Mikal; Aanerud, Marianne; Jensen, Robert Leroy; Grydeland, Thomas Blix; Johannessen, Ane; Nilsen, Roy Miodini; Thorsen, Einar; Hardie, Jon Andrew

2016-01-01

Decreased diffusing capacity of the lung for carbon monoxide (DLCO) is associated with emphysema. DLCO is also related to decreased arterial oxygen tension (PaO2), but there are limited data on associations between PaO2 and computed tomography (CT) derived measures of emphysema and airway wall thickness. To examine whether CT measures of emphysema and airway wall thickness are associated with level of arterial oxygen tension beyond that provided by measurements of diffusion capacity and spirometry. The study sample consisted of 271 smoking or ex-smoking COPD patients from the Bergen COPD Cohort Study examined in 2007-2008. Emphysema was assessed as percent of low-attenuation areas<-950 Hounsfield units (%LAA), and airway wall thickness as standardised measure at an internal perimeter of 10 mm (AWT-Pi10). Multiple linear regression models were fitted with PaO2 as the outcome variable, and %LAA, AWT-Pi10, DLCO and carbon monoxide transfer coefficient (KCO) as main explanatory variables. The models were adjusted for sex, age, smoking status, and haemoglobin concentration, as well as forced expiratory volume in one second (FEV1). Sixty two per cent of the subjects were men, mean (SD) age was 64 (7) years, mean (SD) FEV1 in percent predicted was 50 (15)%, and mean PaO2 (SD) was 9.3 (1.1) kPa. The adjusted regression coefficient (CI) for PaO2 was -0.32 (-0.04-(-0.019)) per 10% increase in %LAA (p<0.01). When diffusion capacity and FEV1 were added to the model, respectively, the association lost its statistical significance. No relationship between airway wall thickness and PaO2 was found. CT assessment of airway wall thickness is not associated with arterial oxygen tension in COPD patients. Emphysema score measured by chest CT, is related to decreased PaO2, but cannot replace measurements of diffusion capacity in the clinical evaluation of hypoxaemia.

Safety and Procedural Success of Left Atrial Appendage Exclusion With the Lariat Device: A Systematic Review of Published Reports and Analytic Review of the FDA MAUDE Database.

PubMed

Chatterjee, Saurav; Herrmann, Howard C; Wilensky, Robert L; Hirshfeld, John; McCormick, Daniel; Frankel, David S; Yeh, Robert W; Armstrong, Ehrin J; Kumbhani, Dharam J; Giri, Jay

2015-07-01

The Lariat device has received US Food and Drug Administration (FDA) 510(k) clearance for soft-tissue approximation and is being widely used off-label for left atrial appendage (LAA) exclusion. A comprehensive analysis of safety and effectiveness has not been reported. To perform a systematic review of published literature to assess safety and procedural success, defined as successful closure of the LAA during the index procedure, of the Lariat device. We performed a formal analytic review of the FDA MAUDE (Manufacturer and User Facility Device Experience) database to compile adverse event reports from real-world practice with the Lariat. For the systematic review, PubMed, EMBASE, CINAHL, and the Cochrane Library were searched from January 2007 through August 2014 to identify all studies reporting use of the Lariat device in 3 or more patients. The FDA MAUDE database was queried for adverse events reports related to Lariat use. Data were abstracted in duplicate by 2 physician reviewers. Events from published literature were pooled using a generic inverse variance weighting with a random effects model. Cumulative and individual adverse events were also reported using the FDA MAUDE data set. Procedural adverse events and procedural success. In the systematic review, 5 reports of Lariat device use in 309 participants were identified. Specific complications weighted for inverse of variance of individual studies were urgent need for cardiac surgery (2.3%; 7 of 309 procedures) and death (0.3%; 1 of 309 procedures). Procedural success was 90.3% (279 of 309 procedures). In the FDA MAUDE database, there were 35 unique reports of adverse events with use of the Lariat device. Among these, we identified 5 adverse event reports that noted pericardial effusion and death and an additional 23 reported urgent cardiac surgery without mention of death. This review of published reports and case reports identified risks of adverse events with off-label use of the Lariat device for LAA

Serum magnesium but not calcium was associated with hemorrhagic transformation in stroke overall and stroke subtypes: a case-control study in China.

PubMed

Tan, Ge; Yuan, Ruozhen; Wei, ChenChen; Xu, Mangmang; Liu, Ming

2018-05-26

Association between serum calcium and magnesium versus hemorrhagic transformation (HT) remains to be identified. A total of 1212 non-thrombolysis patients with serum calcium and magnesium collected within 24 h from stroke onset were enrolled. Backward stepwise multivariate logistic regression analysis was conducted to investigate association between calcium and magnesium versus HT. Calcium and magnesium were entered into logistic regression analysis in two models, separately: model 1, as continuous variable (per 1-mmol/L increase), and model 2, as four-categorized variable (being collapsed into quartiles). HT occurred in 140 patients (11.6%). Serum calcium was slightly lower in patients with HT than in patient without HT (P = 0.273). But serum magnesium was significantly lower in patients with HT than in patients without HT (P = 0.007). In logistic regression analysis, calcium displayed no association with HT. Magnesium, as either continuous or four-categorized variable, was independently and inversely associated with HT in stroke overall and stroke of large-artery atherosclerosis (LAA). The results demonstrated that serum calcium had no association with HT in patients without thrombolysis after acute ischemic stroke. Serum magnesium in low level was independently associated with increasing HT in stroke overall and particularly in stroke of LAA.

Effects of blanching, acidification, or addition of EDTA on vitamin C and β-carotene stability during mango purée preparation.

PubMed

Guiamba, Isabel R F; Svanberg, Ulf

2016-09-01

The impact of acidification with citric acid, addition of EDTA or water blanching at high temperature, and short time (HTST) conducted at 90°C for 4 min, on the retention of vitamin C (L-AA and DHAA) and β-carotene was studied in mango purée 30 min after crushing. HTST blanching prior to matrix disruption into purée resulted in complete inactivation of polyphenol oxidase (PPO) and minor residual activity (8%) of ascorbic acid oxidase (AAO). The retention of total vitamin C was 100% in blanched purées and in purée with EDTA and about 90% in purées at pH 3.9 and 5.0. Acidification, blanching, and addition of EDTA preserved vitamin C mainly as L-AA, while complete conversion into DHAA was observed in purée at pH 5.0. The retention of all-trans-β-carotene was between 65 and 72%, with the highest value in purée with EDTA and the lowest value in purée of blanched mango. The ratio of 13-cis-β-carotene in fresh mango was 8.2 ± 0.5% that increased significantly after blanching and in purée at pH 5.0.

Designing Comparative Effectiveness Trials of Surgical Ablation for Atrial Fibrillation: Experience of the Cardiothoracic Surgical Trials Network

PubMed Central

Gillinov, A. Marc; Argenziano, Michael; Blackstone, Eugene H.; Iribarne, Alexander; DeRose, Joseph J.; Ailawadi, Gorav; Russo, Mark J.; Ascheim, Deborah D.; Parides, Michael K.; Rodriguez, Evelio; Bouchard, Denis; Taddei-Peters, Wendy C.; Geller, Nancy L.; Acker, Michael A.; Gelijns, Annetine C.

2013-01-01

Background Since the introduction of the cut-and-sew Cox-Maze procedure for atrial fibrillation (AF) there has been substantial innovation in techniques for ablation. Use of alternate energy sources for ablation simplified the procedure and has resulted in dramatic increase in the number of AF patients treated by surgical ablation. Despite its increasingly widespread adoption, there is lack of rigorous clinical evidence to establish this as an effective clinical therapy. Methods and Results This paper describes a comparative effectiveness randomized trial, supported by the Cardiothoracic Surgical Trials Network, of surgical ablation with left atrial appendage (LAA) closure versus LAA closure alone in patients with persistent and longstanding persistent AF undergoing mitral valve surgery. Nested within this trial, is a further randomized comparison of 2 different lesions sets: pulmonary vein isolation and full Maze lesion set. This paper addresses trial design challenges, including how to best characterize the target population, operationalize freedom from AF as a primary endpoint, account for the impact of anti-arrhythmic drugs, and measure and analyze secondary endpoints, such as post-operative AF load. Conclusions This paper concludes by discussing how insights that emerge from this trial may affect surgical practice and guide future research in this area. PMID:21616507

VizieR Online Data Catalog: methoxy radical (CH3O) rotational spectrum (Laas+,

NASA Astrophysics Data System (ADS)

Laas, J. C.; Widicus Weaver, S. L.

2017-08-01

The methoxy radical (CH3O) has recently been detected interstellar medium and may be an important tracer of methanol-related chemistry in cold sources. Despite its importance, the spectral information needed to guide further astronomical searches is limited. We have therefore studied the low-temperature rotational spectrum in the laboratory within the spectral range of 246-303GHz. We have combined these new measurements with results from a number of literature reports to refine the molecular parameters and provide an updated and improved spectral line catalog. We present here the results of the laboratory studies and the refined analysis for the millimeter and submillimeter spectrum of methoxy. (1 data file).

Abstracts of ARI Research Publications, FY 1979

DTIC Science & Technology

1980-11-01

Technical Report 483 ABSTRACTS OF ARI RESEARCH PUBLICATIONS FY 1979 -- C:) U. S . ArmyL.) LAa Research Institute for the Behavioral and Social...U. S . ARMY RESEARCH INSTITUTE FOR THE BEHAVIORAL AND SOCIAL SCIENCES A Field Operating Agency under the Jurisdiction of the Deputy Chief of Staff...PIEIT’S ATALOG NUMBER Technical Report 483 l L~,2 y. (-P- NUZE 4. TITLE (nd Subtfti.) S . TYPE OF REPORT & PERIOD COVERED ABSTRACTS OF ARI RESEARCH

Effects of dietary copper and amino acid density on growth performance, apparent metabolizable energy, and nutrient digestibility in Eimeria acervulina-challenged broilers.

PubMed

Rochell, S J; Usry, J L; Parr, T M; Parsons, C M; Dilger, R N

2017-03-01

The objective of this experiment was to evaluate the influence of copper supplementation in diets varying in amino acid (AA) density on growth performance, apparent metabolizable energy (AMEn), apparent ileal nutrient digestibility (AID), and plasma carotenoids in broilers infected with Eimeria acervulina. Ross 308 male broilers (480 total) were housed in battery cages and allotted to 8 experimental treatments in a factorial arrangement of 2 dietary AA densities [1.00% (LAA) or 1.20% (HAA) digestible Lys], 2 supplemental copper concentrations (zero or 116 mg/kg), and 2 E. acervulina infection states (uninfected or infected). Essential AA ratios relative to digestible Lys were similar in both the LAA and HAA diets, and copper was provided by 200 mg/kg of tribasic copper chloride (58% copper). Chicks received experimental diets from 2 to 21 d post hatch and 6 replicate cages of 10 birds per cage were assigned to each treatment. Broilers were inoculated with zero or 6.3 × 105 sporulated E. acervulina oocysts at 15 d and blood and ileal digesta were collected at 21 days. From 2 to 15 d, body weight gain and G:F of broilers were improved (P < 0.05) with increasing AA density, and an AA density × copper interaction was observed (P < 0.05) for feed intake. Eimeria infection reduced (P < 0.05) plasma carotenoids, growth performance, dietary AMEn, and AID of organic matter, nitrogen, and total AA. There were no interactive effects of dietary treatments with E. acervulina infection on broiler growth performance or dietary AMEn. An AA density × copper supplementation interaction was observed (P < 0.05) for AID of total AA, whereby copper supplementation increased AID of total AA for birds fed the LAA diet and decreased AID of total AA for birds fed the HAA diet. In summary, E. acervulina-induced reductions in nutrient digestibility were dependent on dietary copper and AA status, but changes in digestibility had minimal impact on growth performance of broilers during

Variance in age-specific sex composition of Pacific halibut catches, and comparison of statistical and genetic methods for reconstructing sex ratios

NASA Astrophysics Data System (ADS)

Loher, Timothy; Woods, Monica A.; Jimenez-Hidalgo, Isadora; Hauser, Lorenz

2016-01-01

Declines in size at age of Pacific halibut Hippoglossus stenolepis, in concert with sexually-dimorphic growth and a constant minimum commercial size limit, have led to the expectation that the sex composition of commercial catches should be increasingly female-biased. Sensitivity analyses suggest that variance in sex composition of landings may be the most influential source of uncertainty affecting current understanding of spawning stock biomass. However, there is no reliable way to determine sex at landing because all halibut are eviscerated at sea. In 2014, a statistical method based on survey data was developed to estimate the probability that fish of any given length at age (LAA) would be female, derived from the fundamental observation that large, young fish are likely female whereas small, old fish have a high probability of being male. Here, we examine variability in age-specific sex composition using at-sea commercial and closed-season survey catches, and compare the accuracy of the survey-based LAA technique to genetic markers for reconstructing the sex composition of catches. Sexing by LAA performed best for summer-collected samples, consistent with the hypothesis that the ability to characterize catches can be influenced by seasonal demographic shifts. Additionally, differences between survey and commercial selectivity that allow fishers to harvest larger fish within cohorts may generate important mismatch between survey and commercial datasets. Length-at-age-based estimates ranged from 4.7% underestimation of female proportion to 12.0% overestimation, with mean error of 5.8 ± 1.5%. Ratios determined by genetics were closer to true sample proportions and displayed less variability; estimation to within < 1% of true ratios was limited to genetics. Genetic estimation of female proportions ranged from 4.9% underestimation to 2.5% overestimation, with a mean absolute error of 1.2 ± 1.2%. Males were generally more difficult to assign than females: 6.7% of

Emphysema quantification and lung volumetry in chest X-ray equivalent ultralow dose CT - Intra-individual comparison with standard dose CT.

PubMed

Messerli, Michael; Ottilinger, Thorsten; Warschkow, René; Leschka, Sebastian; Alkadhi, Hatem; Wildermuth, Simon; Bauer, Ralf W

2017-06-01

To determine whether ultralow dose chest CT with tin filtration can be used for emphysema quantification and lung volumetry and to assess differences in emphysema measurements and lung volume between standard dose and ultralow dose CT scans using advanced modeled iterative reconstruction (ADMIRE). 84 consecutive patients from a prospective, IRB-approved single-center study were included and underwent clinically indicated standard dose chest CT (1.7±0.6mSv) and additional single-energy ultralow dose CT (0.14±0.01mSv) at 100kV and fixed tube current at 70mAs with tin filtration in the same session. Forty of the 84 patients (48%) had no emphysema, 44 (52%) had emphysema. One radiologist performed fully automated software-based pulmonary emphysema quantification and lung volumetry of standard and ultralow dose CT with different levels of ADMIRE. Friedman test and Wilcoxon rank sum test were used for multiple comparison of emphysema and lung volume. Lung volumes were compared using the concordance correlation coefficient. The median low-attenuation areas (LAA) using filtered back projection (FBP) in standard dose was 4.4% and decreased to 2.6%, 2.1% and 1.8% using ADMIRE 3, 4, and 5, respectively. The median values of LAA in ultralow dose CT were 5.7%, 4.1% and 2.4% for ADMIRE 3, 4, and 5, respectively. There was no statistically significant difference between LAA in standard dose CT using FBP and ultralow dose using ADMIRE 4 (p=0.358) as well as in standard dose CT using ADMIRE 3 and ultralow dose using ADMIRE 5 (p=0.966). In comparison with standard dose FBP the concordance correlation coefficients of lung volumetry were 1.000, 0.999, and 0.999 for ADMIRE 3, 4, and 5 in standard dose, and 0.972 for ADMIRE 3, 4 and 5 in ultralow dose CT. Ultralow dose CT at chest X-ray equivalent dose levels allows for lung volumetry as well as detection and quantification of emphysema. However, longitudinal emphysema analyses should be performed with the same scan protocol and

Defining the Molecular Actions of Dietary Fatty Acids in Breast Cancer: Selective Modulation of Peroxisome Proliferator-Activated Receptor Gamma

DTIC Science & Technology

2005-05-01

Maximum 200 Words) Stark differences in the actions of lenoleic acid (LAA), an omega-6 fatty acid , and eicosapentaenoic acid (EPA), an omega-3 fatty acid ...AD_ Award Number: W81XWH-04-1-0532 TITLE: Defining the Molecular Actions of Dietary Fatty acids in Breast Cancer: Selective Modulation of Peroxisome...TITLE AND SUBTITLE 5. FUNDING NUMBERS Defining the Molecular Actions of Dietary Fatty acids in W81XWH-04-1-0532 Breast Cancer: Selective Modulation of

Lipoamino acid-based micelles as promising delivery vehicles for monomeric amphotericin B.

PubMed

Serafim, Cláudia; Ferreira, Inês; Rijo, Patrícia; Pinheiro, Lídia; Faustino, Célia; Calado, António; Garcia-Rio, Luis

2016-01-30

Lipoamino acid-based micelles have been developed as delivery vehicles for the hydrophobic drug amphotericin B (AmB). The micellar solubilisation of AmB by a gemini lipoamino acid (LAA) derived from cysteine and its equimolar mixtures with the bile salts sodium cholate (NaC) and sodium deoxycholate (NaDC), as well as the aggregation sate of the drug in the micellar systems, was studied under biomimetic conditions (phosphate buffered-saline, pH 7.4) using UV-vis spectroscopy. Pure surfactant systems and equimolar mixtures were characterized by tensiometry and important parameters were determined, such as critical micelle concentration (CMC), surface tension at the CMC (γCMC), maximum surface excess concentration (Γmax), and minimum area occupied per molecule at the water/air interface (Amin). Rheological behaviour from viscosity measurements at different shear rates was also addressed. Solubilisation capacity was quantified in terms of molar solubilisation ratio (χ), micelle-water partition coefficient (KM) and Gibbs energy of solubilisation (ΔGs°). Formulations of AmB in micellar media were compared in terms of drug loading, encapsulation efficiency, aggregation state of AmB and in vitro antifungal activity against Candida albicans. The LAA-containing micellar systems solubilise AmB in its monomeric and less toxic form and exhibit in vitro antifungal activity comparable to that of the commercial formulation Fungizone. Copyright © 2015 Elsevier B.V. All rights reserved.

SAMHD1 Gene Mutations Are Associated with Cerebral Large-Artery Atherosclerosis

PubMed Central

Xin, Baozhong; Yan, Junpeng; Wu, Ying; Hu, Bo; Liu, Liping; Wang, Yilong; Ahn, Jinwoo; Skowronski, Jacek; Zhang, Zaiqiang; Wang, Yongjun; Wang, Heng

2015-01-01

Background. To investigate whether one or more SAMHD1 gene mutations are associated with cerebrovascular disease in the general population using a Chinese stroke cohort. Methods. Patients with a Chinese Han background (N = 300) diagnosed with either cerebral large-artery atherosclerosis (LAA, n = 100), cerebral small vessel disease (SVD, n = 100), or other stroke-free neurological disorders (control, n = 100) were recruited. Genomic DNA from the whole blood of each patient was isolated, and direct sequencing of the SAMHD1 gene was performed. Both wild type and mutant SAMHD1 proteins identified from the patients were expressed in E. coli and purified; then their dNTPase activities and ability to form stable tetramers were analysed in vitro. Results. Three heterozygous mutations, including two missense mutations c.64C>T (P22S) and c.841G>A (p.E281K) and one splice site mutation c.696+2T>A, were identified in the LAA group with a prevalence of 3%. No mutations were found in the patients with SVD or the controls (p = 0.05). The mutant SAMHD1 proteins were functionally impaired in terms of their catalytic activity as a dNTPase and ability to assemble stable tetramers. Conclusions. Heterozygous SAMHD1 gene mutations might cause genetic predispositions that interact with other risk factors, resulting in increased vulnerability to stroke. PMID:26504826

Postoperative pulmonary hypertensive crisis caused by inverted left atrial appendage after cardiopulmonary bypass surgery for congenital heart disease in a neonate.

PubMed

Zhao, Qifeng; Hu, Xingti

2013-09-01

Postoperative pulmonary hypertensive crisis (PHC) caused by an inverted left atrial appendage (ILAA) is a rare complication following cardiac surgery. We present a case of 23 day-old male infant who developed postoperative PHC attacks after undergoing cardiopulmonary bypass (CPB) surgery for repair of the coactation of aorta. A hyperechogenic left atrial mass was detected via bedside transthoracic echocardiography (TTE), which was identified as an ILAA and corrected following repeat surgery. In this case, both the negative pressure in vent catheter and the long left atrial appendage (LAA) with a narrow base led to an irreversible ILAA. As in this neonate, ILAA had significant influence on the left atrial volume and caused PHC since the ILAA was located on the mitral valve orifice and interfered with the blood flow through the valve. Therefore, we recommend that the vent catheter should be turned off before removing to avoid this potential complication. Additionally, LAA should be carefully inspected after CPB surgery, and intra-operative and post-operative transoesophageal echocardiography (TEE) should be performed to detect ILAA intraoperatively so as to avoid the reoperation. When an ILAA is diagnosed postoperatively, whether conservative treatment or surgery will depend on the balance of benefit and risk for a particular patient. Crown Copyright © 2013. Published by Elsevier B.V. All rights reserved.

Finite Element Solution to the Helmholtz Equation with High Wave Number. Part 1. The h-Version of the FEM

DTIC Science & Technology

1993-11-01

4) between the exact solution and it’s best approximnation on the one and the FE-solution on the other hand. The determining equation for ti. & ielt ...Acknowledgement: The work of the first atitlhor wvas supported by Grant No 517 402 524 3 of the Gerinan Academic Exchange Service (l)AA[)). The work of thle second...methou, mn: A.K. Aziz (ed.), The mathematical foundations of tile finite element, method with applicai.4ons to partial differential equations, Academic

Growth of Ce+3 Doped Oxides by the Traveling Solvent Zone Technique.

DTIC Science & Technology

1983-06-01

ambient 1100 0.05 9 PbTiO3 PbF 2/PbO ambient 1075 0.05 9 In this program, we have evaluated several fluxes for growth of LaA10 3 , LaAll-xMxO3 (M = Sc+ 3...TABLE 2. X-RAY DIFFRACTIN PARAMETERS MEASURED FOR ARC FURNACE SYNTHESIZED LaAIO3 AND LaAl 0 .7Sc0 303 LaAIO3 LaAl 0 .7Sc .303 hkl d(A) d(A) 3.71 3.86

Carotid Artery Distensibility and Hormone Therapy and Menopause: The Los Angeles Atherosclerosis Study (LAAS)

PubMed Central

Shufelt, Chrisandra; Elboudwarej, Omeed; Johnson, B. Delia; Mehta, Puja; Bittner, Vera; Braunstein, Glenn; Berga, Sarah; Stanczyk, Frank; Dwyer, Kathleen; Merz, C. Noel Bairey

2015-01-01

Objective Observational studies suggest that arterial distensibility decreases during menopause; however, the relation to hormone therapy use is controversial. We prospectively studied distensibility and hormone therapy use during different menopause stages. Methods 161 women between 42–61 years of age without cardiovascular disease had carotid artery measurements by ultrasound to calculate the distensibility index at baseline and 3 years later. Menopause stage was classified at each visit as premenopausal, perimenopausal, and postmenopausal. Over 3 years of prospective observation, women were classified as remaining premenopausal, remaining postmenopausal, or transitioning, defined as change from premenopausal-to-perimenopausal, premenopausal-to-postmenopausal, perimenopausal-to-perimenopausal, or perimenopausal-to-postmenopausal. Results Distensibility declined over time in all menopause stages (p<0.0001). Compared to postmenopausal women, premenopausal and transitioning/no hormone therapy women had over twice the decline in distensibility index (p=0.06 and p=0.016, respectively), whereas transitioning/hormone therapy did not differ in distensibility decline (p=0.28). In a multivariate model, change in systolic blood pressure (p<0.0001) and change in pulse pressure (p=0.004) were independent predictors of distensibility index change and served as effect modulators. In the adjusted model, women in the premenopausal and transitioning/no hormone therapy groups had a significantly faster distensibility index decline (p=0.002 and 0.001, respectively) than postmenopausal women, while the transitioning/hormone therapy group did not (p=0.21) Conclusions These findings confirm that menopause transition is associated with reduced vascular compliance. Hormone therapy is associated with better arterial distensibility only during menopause transition. Additional prospective studies are needed to confirm these findings and to determine if hormone therapy use beyond menopause transition is related to distensibility. PMID:26308234

An Operational Fire Hazards Analysis of the C-5

DTIC Science & Technology

1975-02-01

cadmium or lead acid batteries should be installed. (San Antonio A•C) 1. Chine Drain 1) The straight runs of plastic tubing between !MLG wheels should be...JP-5 c. NIL-H-5606, Hydraulic Oil d. NIL-L-7808, Lubricating Oil e. A nonetallic materials such as fabrics, insulation, curtains, plastic panels...14072-1 dat Jan. 8, 1968 "l•ydox (Thermo Formable Plastic ) Self wxtirr-uishin., Test Mcthodc A`S" D-63556T Rhom & 1laas Bul. PL-674B & Itj Sept. 10, 1969

Serum Zinc, Iron, and Copper Concentrations during Typhoid Fever in Man: Effect of Chloramphenicol Therapy

DTIC Science & Technology

1974-11-12

automated colori- exposure. In those volunteers who became clinically metric technique (13, 14). ill and were hospitalized, blood samples were ob- Monkey ...study. Two adult female rhesus monkeys tained for an additional seven days. were inoculated intravenously with 1 x 1010 viable S. Serum zinc, iron, and...on Serum Transferrin and am0 at-Macroglebullfl Concentrations zoo D a ft T r peora laa r mr U ea n b Uoac t o o Control 283 * 7 ml339 :L 13 10 di 120

Food matrix and processing influence on carotenoid bioaccessibility and lipophilic antioxidant activity of fruit juice-based beverages.

PubMed

Rodríguez-Roque, María Janeth; de Ancos, Begoña; Sánchez-Vega, Rogelio; Sánchez-Moreno, Concepción; Cano, M Pilar; Elez-Martínez, Pedro; Martín-Belloso, Olga

2016-01-01

The biological activity of carotenoids depends on their bioaccessibility and solubilization in the gastrointestinal tract. These compounds are poorly dispersed in the aqueous media of the digestive tract due to their lipophilic nature. Thus, it is important to analyze the extent to which some factors, such as the food matrix and food processing, may improve their bioaccessibility. Beverages formulated with a blend of fruit juices and water (WB), milk (MB) or soymilk (SB) were treated by high-intensity pulsed electric fields (HIPEF) (35 kV cm(-1) with 4 μs bipolar pulses at 200 Hz for 1800 μs), high-pressure processing (HPP) (400 MPa at 40 °C for 5 min) or thermal treatment (TT) (90 °C for 1 min) in order to evaluate the influence of food matrix and processing on the bioaccessibility of carotenoids and on the lipophilic antioxidant activity (LAA). The bioaccessibility of these compounds diminished after applying any treatment (HIPEF, HPP and TT), with the exception of cis-violaxanthin + neoxanthin, which increased by 79% in HIPEF and HPP beverages. The lowest carotenoid bioaccessibility was always obtained in TT beverages (losses up to 63%). MB was the best food matrix for improving the bioaccessibility of carotenoids, as well as the LAA. The results demonstrate that treatment and food matrix modulated the bioaccessibility of carotenoids as well as the lipophilic antioxidant potential of beverages. Additionally, HIPEF and HPP could be considered as promising technologies to obtain highly nutritional and functional beverages.

Methionine Regulates mTORC1 via the T1R1/T1R3-PLCβ-Ca2+-ERK1/2 Signal Transduction Process in C2C12 Cells.

PubMed

Zhou, Yuanfei; Ren, Jiao; Song, Tongxing; Peng, Jian; Wei, Hongkui

2016-10-11

The mammalian target of rapamycin complex 1 (mTORC1) integrates amino acid (AA) availability to support protein synthesis and cell growth. Taste receptor type 1 member (T1R) is a G protein-coupled receptor that functions as a direct sensor of extracellular AA availability to regulate mTORC1 through Ca 2+ stimulation and extracellular signal-regulated kinases 1 and 2 (ERK1/2) activation. However, the roles of specific AAs in T1R1/T1R3-regulated mTORC1 are poorly defined. In this study, T1R1 and T1R3 subunits were expressed in C2C12 myotubes, and l-AA sensing was accomplished by T1R1/T1R3 to activate mTORC1. In response to l-AAs, such as serine (Ser), arginine (Arg), threonine (Thr), alanine (Ala), methionine (Met), glutamine (Gln), and glycine (Gly), Met induced mTORC1 activation and promoted protein synthesis. Met also regulated mTORC1 via T1R1/T1R3-PLCβ-Ca 2+ -ERK1/2 signal transduction. Results revealed a new role for Met-regulated mTORC1 via an AA receptor. Further studies should be performed to determine the role of T1R1/T1R3 in mediating extracellular AA to regulate mTOR signaling and to reveal its mechanism.

Peroxisome proliferator-activated receptor-γ in induced sputum is correlated with MMP-9/TIMP-1 imbalance and formation of emphysema in COPD patients.

PubMed

Zhou, Xiao-Ming; Hou, Gang; Gu, Dong-Xue; Wang, Qiu-Yue; Zhao, Li

2017-10-01

The development of chronic obstructive pulmonary disease (COPD) is modulated by the symmetry of matrix metalloproteinases (MMPs) and the counter-acting tissue inhibitors of metalloproteinases (TIMPs). We investigated the interaction between peroxisome proliferator-activated receptor gamma (PPARγ) expression and the imbalance of MMP-9/TIMP-1 in the induced sputum of stable COPD patients. Sixty-six stable COPD patients were enrolled and the induced sputum samples were gathered. The correlation between PPARγ and other index, including MMP-9, TIMP-1, pulmonary function and the index of emphysema-the percentage of low attenuation area (LAA%), was analyzed. PPARγ and TIMP-1 concentrations were decreased and the concentration of MMP-9 and the ratio of MMP9/TIMP1 were enhanced in the induced sputum of COPD patients, compared to the healthy controls. Among COPD patients, those with worse lung function or patients with emphysema exhibited increased MMP-9 expression with decreased TIMP-1 and PPARγ expression. Besides, the concentration of PPARγ of the induced sputum was correlated with the forced expiratory volume in one second percentage (FEV1%) positively and the expression of TIMP-1; while it was negatively correlated with the residual volume (RV), RV/total lung capacity (TLC), LAA%, and MMP-9 expression. Our findings reveal the protective role of PPARγ in the maintenance of the dynamic balance of MMP-9/TIMP-1 in COPD, thus providing evidence on which to base the potential COPD treatment.

Investigation of Ce(3+) Dopant in Appropriate Hosts for Blue Green Lasers.

DTIC Science & Technology

1986-11-25

crystal of La(A10 .8Sc 0 .2 )0 3 doped with 0.01% Ce. During one experiment a small amount of the charge was fused in an iridium crucible. The...from ordering was not observed. Similar results were achieved in Experiment #47 with (LaAlO3 ) 0 .5 (SrZrO 3 )0 5 composition. Small additions of...compositions evaluated, enlarged cubic cells could not be formed by ordering. Small additions of less than 5% of BaZrO 3 or SrZrO 3 to LaAIO 3 produced

Distinct quantitative computed tomography emphysema patterns are associated with physiology and function in smokers.

PubMed

Castaldi, Peter J; San José Estépar, Raúl; Mendoza, Carlos S; Hersh, Craig P; Laird, Nan; Crapo, James D; Lynch, David A; Silverman, Edwin K; Washko, George R

2013-11-01

Emphysema occurs in distinct pathologic patterns, but little is known about the epidemiologic associations of these patterns. Standard quantitative measures of emphysema from computed tomography (CT) do not distinguish between distinct patterns of parenchymal destruction. To study the epidemiologic associations of distinct emphysema patterns with measures of lung-related physiology, function, and health care use in smokers. Using a local histogram-based assessment of lung density, we quantified distinct patterns of low attenuation in 9,313 smokers in the COPDGene Study. To determine if such patterns provide novel insights into chronic obstructive pulmonary disease epidemiology, we tested for their association with measures of physiology, function, and health care use. Compared with percentage of low-attenuation area less than -950 Hounsfield units (%LAA-950), local histogram-based measures of distinct CT low-attenuation patterns are more predictive of measures of lung function, dyspnea, quality of life, and health care use. These patterns are strongly associated with a wide array of measures of respiratory physiology and function, and most of these associations remain highly significant (P < 0.005) after adjusting for %LAA-950. In smokers without evidence of chronic obstructive pulmonary disease, the mild centrilobular disease pattern is associated with lower FEV1 and worse functional status (P < 0.005). Measures of distinct CT emphysema patterns provide novel information about the relationship between emphysema and key measures of physiology, physical function, and health care use. Measures of mild emphysema in smokers with preserved lung function can be extracted from CT scans and are significantly associated with functional measures.

Progressive deficit in isolated pontine infarction: the association with etiological subtype, lesion topography and outcome.

PubMed

Gökçal, Elif; Niftaliyev, Elvin; Baran, Gözde; Deniz, Çiğdem; Asil, Talip

2017-09-01

It is important to predict progressive deficit (PD) in isolated pontine infarction, a relatively common problem of clinical stroke practice. Traditionally, lacunar infarctions are known with their progressive course. However, few studies have analyzed the branch atheromatous disease subtype as a subtype of lacunar infarction, separately. There are also conflicting results regarding the relationship with the topography of lesion and PD. In this study, we classified etiological subtypes and lesion topography in isolated pontine infarction and aimed to investigate the association of etiological subtypes, lesion topography and clinical outcome with PD. We analyzed demographics, laboratory parameters, and risk factors of 120 patients having isolated pontine infarction and admitted within 24 h retrospectively. PD was defined as an increase in the National Institutes of Health Stroke scale ≥2 units in 5 days after onset. Patients were classified as following: large artery disease (LAA), basilar artery branch disease (BABD) and small vessel disease (SVD). Upper, middle and lower pontine infarcts were identified longitudinally. Functional outcome at 3 months was determined according to modified Rankin scores. Of 120 patients, 41.7% of the patients were classified as BABD, 30.8% as SVD and 27.5% as LAA. 23 patients (19.2%) exhibited PD. PD was significantly more frequent in patient with BABD (p 0.006). PD was numerically higher in patients with lower pontine infarction. PD was associated with BABD and poor functional outcome. It is important to discriminate the BABD neuroradiologically from other stroke subtypes to predict PD which is associated with poor functional outcome in patients with isolated pontine infarctions.

Microbubble signal and trial of org in acute stroke treatment (TOAST) classification in ischemic stroke.

PubMed

Lee, Chan-Hyuk; Kang, Hyun Goo; Lee, Ji Sung; Ryu, Han Uk; Jeong, Seul-Ki

2018-07-15

Right-to-left shunt (RLS) through a patent foramen ovale (PFO) is likely associated with ischemic stroke. Many studies have attempted to demonstrate the association between RLS and ischemic stroke. However, information on the association between the degree of RLS and the subtypes of ischemic stroke categorized by the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification is lacking. This was a retrospective study involving 508 patients with ischemic stroke who underwent a transcranial Doppler (TCD) microbubble test between 2013 and 2015. The degree of RLS was divided into 4 grades according to the microbubble signal (MBS) as follows: no MBS, grade 1; MBS < 20, grade 2; MBS > 20, grade 3; curtain sign, grade 4. The degree of RLS and the type of ischemic stroke as classified by TOAST were analyzed and compared with other clinical information and laboratory findings. The higher RLS grade was associated with the cardioembolism (CE) and stroke of undetermined etiology (SUE), and the microbubble signals were inversely related with small vessel disease (SVD). An MBS higher than grade 3 showed a 2.95-fold higher association with SUE than large artery atherosclerosis (LAA), while grade 4 MBS revealed an approximately 8-fold higher association with SUE than LAA. RLS identified by the TCD microbubble test was significantly and independently associated with cryptogenic ischemic stroke (negative evaluation). Subsequent studies are needed to determine the biologic relationship between RLS and ischemic stroke, particularly the cryptogenic subtype of ischemic stroke. Copyright © 2018 Elsevier B.V. All rights reserved.

Diagnostic value of color flow mapping and Doppler echocardiography in the quantification of mitral regurgitation in patients with mitral valve prolapse or rheumatic heart disease.

PubMed

Pinheiro, Aurélio Carvalho; Mancuso, Frederico José Neves; Hemerly, Daniela Fernanda Alli; Kiyose, Alberto Takeshi; Campos, Orlando; de Andrade, José Lázaro; de Paola, Angelo Amato Vicenzo; de Camargo Carvalho, Antonio Carlos; Moises, Valdir Ambrosio

2007-10-01

The objective was to analyze the diagnostic value of the echocardiographic methods used for quantification of mitral regurgitation (MR) in patients with mitral valve prolapse (MVP) or rheumatic heart disease (RHD). The study included 50 patients with MR (mean age of 46.1 years; 35 women), 27 (54%) with RHD and 23 (46%) with MVP. Quantification of the mitral valve regurgitation was obtained by regurgitant orifice area (ROA) and regurgitant volume (RV) by the flow convergence region (FCR) and two-dimensional Doppler echocardiographic methods, regurgitant fraction, jet area (JA), jet area/left atrial area ratio (JA/LAA), and vena contracta (VC). Patients were clinically followed to identify cardiovascular events. Data were analyzed by Pearson, kappa, and receiver operator characteristic curve tests; significance was defined as a P value less than .05. The correlation between the two methods for ROA and RV were r = 0.79 and r = 0.80, respectively, and between these parameters and regurgitant fraction, VC, JA, and JA/LAA varied from r = 0.54 to r = 0.94 (P lt; .05); the agreement varied from kappa = 0.19 to kappa = 0.83. The highest accuracy to identify patients with clinically significant MR (events at follow-up) was 96% for ROA by FCR, 94% for VC, 86% for RV by FCR, and 86% for JA. No method showed a significant difference between MVP and RHD. The methods analyzed had significant correlation and good agreement. ROA by FCR and VC had the best performance to identify severe MR; no significant difference between MVP and RHD was observed.

Quantification of mitral valve regurgitation in dogs with degenerative mitral valve disease by use of the proximal isovelocity surface area method.

PubMed

Gouni, Vassiliki; Serres, François J; Pouchelon, Jean-Louis; Tissier, Renaud; Lefebvre, Hervé P; Nicolle, Audrey P; Sampedrano, Carolina Carlos; Chetboul, Valérie

2007-08-01

To determine the within-day and between-day variability of regurgitant fraction (RF) assessed by use of the proximal isovelocity surface area (PISA) method in awake dogs with degenerative mitral valve disease (MVD), measure RF in dogs with MVD, and assess the correlation between RF and several clinical and Doppler echocardiographic variables. Prospective study. 6 MVD-affected dogs with no clinical signs and 67 dogs with MVD of differing severity (International Small Animal Cardiac Health Council [ISACHC] classification). The 6 dogs were used to determine the repeatability and reproducibility of the PISA method, and RF was then assessed in 67 dogs of various ISACHC classes. Mitral valve regurgitation was also assessed from the maximum area of regurgitant jet signal-to-left atrium area (ARJ/LAA) ratio determined via color Doppler echocardiographic mapping. Within- and between-day coefficients of variation of RF were 8% and 11%, respectively. Regurgitation fraction was significantly correlated with ISACHC classification and heart murmur grade and was higher in ISACHC class III dogs (mean +/- SD, 72.8 +/- 9.5%) than class II (57.9 +/- 20.1%) or I (40.7 +/- 19.2%) dogs. Regurgitation fraction and left atriumto-aorta ratio, fractional shortening, systolic pulmonary arterial pressure, and ARJ/LAA ratio were significantly correlated. Results suggested that RF is a repeatable and reproducible variable for noninvasive quantitative evaluation of mitral valve regurgitation in awake dogs. Regurgitation fraction also correlated well with disease severity. It appears that this Doppler echocardiographic index may be useful in longitudinal studies of MVD in dogs.

Measuring patient anxiety in coronary care. Part 1.

PubMed

Elliott, D

1992-06-01

Patient anxiety is a common problem identified by nurses. However, the difficulty of assessing the level and significance of the anxiety is problematic. This paper discusses the issue of measuring patient anxiety, specifically in Coronary Care. As well as discussing physiological measures, three appropriate psychometric instruments are identified (the State-Trait Anxiety Inventory--STAI; the Hospital Anxiety and Depression Scale--HAD; a Linear Analogue Anxiety Scale--LAAS), along with a review of the relevant literature. Systematic anxiety measurement, and management of maladaptive anxiety would appear to be appropriate and meaningful nursing functions within the provision of holistic patient care in Coronary Care.

Decline in frequency of the 2La chromosomal inversion in Anopheles gambiae (s.s.) in Western Kenya: correlation with increase in ownership of insecticide-treated bed nets.

PubMed

Matoke-Muhia, Damaris; Gimnig, John E; Kamau, Luna; Shililu, Josephat; Bayoh, M Nabie; Walker, Edward D

2016-06-10

The 2La chromosomal inversion, a genetic polymorphism in An. gambiae (sensu stricto) (s.s.), is associated with adaptation to microclimatic differences in humidity and desiccation resistance and mosquito behaviors. Ownership of insecticide-treated bed nets (ITNs) for malaria control has increased markedly in western Kenya in the last 20 years. An increase in the frequency of ITNs indoors could select against house entering or indoor resting of Anopheles mosquitoes. Thus, the frequency of the 2La inversion is postulated to change in An. gambiae (s.s.) with the increase of ITN ownership over time. Anopheles gambiae mosquitoes were sampled between 1994 and 2011 using pyrethrum knockdown, bednet traps and human landing catches (HLC) from Asembo and Seme, western Kenya. The 2La inversion was detected by a PCR assay with primers designed for proximal breakpoints of the 2La/a and 2L+(a)/+(a) chromosomal conformation. Mosquitoes were tested for malaria parasite infection by sporozoite ELISA. The frequency of the 2La chromosomal inversion declined from 100 % of all chromosomes in 1994 to 17 % in 2005 and remained low through 2011 (21 %). ITN ownership increased from 0 to > 90 % of houses in the study area during this interval. The decline in the frequency of the 2La chromosomal inversion was significantly, negatively correlated with year (r = -0.93) and with increase in ITN ownership (r = -0.96). The frequency of the homo- and heterokaryotypes departed significantly from Hardy-Weinberg equilibrium, suggesting that 2La/a karyotype was under selection, earlier in its favor and later, against it. Precipitation and maximum monthly temperature did not vary over time, therefore there was no trend in climate that could account for the decline. There was no significant difference in frequency of the 2La inversion in An. gambiae (s.s.) females sampled indoors or outdoors in HCL in 2011, nor was there an association between the 2La inversion and infection with Plasmodium

Humidity sorption on natural building stone

NASA Astrophysics Data System (ADS)

Franzen, C.; Mirwald, P.

2003-04-01

processes, physical, chemical or biological, depend on the presence of water. Like most porous materials building stone respond on humidity by water uptake. The sorption isotherm represents the equilibrium moisture, specific for each material. The determination of the isotherm for stone of low and small porosity like marble is difficult. With the help of a newly developed water sorption analysis chamber [2], which allows the simultaneous measurement of 11 samples, good results on stone/rock samples have been obtained. Even at marble species with pore volumes lower than 0.4 % isotherms are measured. This analytical method offers new insights in the pore behaviour of low porosity materials. The advantages of this technique which supplements other techniques (e.g. BET, Hg-porosimetry) are: i) the testing agent is identical to the weathering agent, water; ii) the atmospheric parameters at the measurement reflect the natural conditions - thus no changes to the material properties have to be considered; iii) due to the small diameter of the water molecule (~0.28 nm), smaller pores are reached than e.g. with N2 (~0.31 nm). Sorption isotherms of sandstone (Baumberg, Obernkirchen, Groeden), granite (Brixen), and marble (Sterzing, Laas) are presented. Particular as to marbles the resolution is considerably higher. A previously observed negative hysteresis [3] seems an effect due to limited data resolution. [1] Snethlage, R. (1984) Steinkonservierung, Bayer. LA Denkmalpflege, Ah. 22, 203 S. [2] Griesser, U.J., Dillenz, J. (2002) Neuartiges, vollautomatisches Feuchtesorptionsprüfgerät mit hohem Probendurchsatz, Feuchtetag 2002, Weimar, 85-93. [3] Fimmel, R. (1996) Verwitterungsverhalten der alpinen Marmore von Laas und Sterzing, Diss. Univ. Ibk, 116 S.

Distinct Quantitative Computed Tomography Emphysema Patterns Are Associated with Physiology and Function in Smokers

PubMed Central

San José Estépar, Raúl; Mendoza, Carlos S.; Hersh, Craig P.; Laird, Nan; Crapo, James D.; Lynch, David A.; Silverman, Edwin K.; Washko, George R.

2013-01-01

Rationale: Emphysema occurs in distinct pathologic patterns, but little is known about the epidemiologic associations of these patterns. Standard quantitative measures of emphysema from computed tomography (CT) do not distinguish between distinct patterns of parenchymal destruction. Objectives: To study the epidemiologic associations of distinct emphysema patterns with measures of lung-related physiology, function, and health care use in smokers. Methods: Using a local histogram-based assessment of lung density, we quantified distinct patterns of low attenuation in 9,313 smokers in the COPDGene Study. To determine if such patterns provide novel insights into chronic obstructive pulmonary disease epidemiology, we tested for their association with measures of physiology, function, and health care use. Measurements and Main Results: Compared with percentage of low-attenuation area less than −950 Hounsfield units (%LAA-950), local histogram-based measures of distinct CT low-attenuation patterns are more predictive of measures of lung function, dyspnea, quality of life, and health care use. These patterns are strongly associated with a wide array of measures of respiratory physiology and function, and most of these associations remain highly significant (P < 0.005) after adjusting for %LAA-950. In smokers without evidence of chronic obstructive pulmonary disease, the mild centrilobular disease pattern is associated with lower FEV1 and worse functional status (P < 0.005). Conclusions: Measures of distinct CT emphysema patterns provide novel information about the relationship between emphysema and key measures of physiology, physical function, and health care use. Measures of mild emphysema in smokers with preserved lung function can be extracted from CT scans and are significantly associated with functional measures. PMID:23980521

Response of the Cardiovascular System to Vibration and Combined Stresses

DTIC Science & Technology

1983-11-30

D . John B. Charles. Ph.D.Pr Benjamin S. KelleyPh.D. CD JUN1 9 1984J LAA rpubi Ia release U1 trl OD1 uflhimitod. U’= -’ Wenner-Gren Research...and Combined Stresses 4. PeRIVORUING OitG. RECPORT HuMUS FI 7. AUTHORrs) 6. C01YR ACT 04 GRANT NUMBER(#) C. F. Knapp, Ph. D ., J. M. Evans, M.S. D . C...Randall, Ph. D ., J. B. Charles, Ph. D . and F92-3K00 B. S. Kelley, PhD. 9.PERFORMN 10NZTO AI N DRS to. PROGRAM ELEMENT. PROJECT, TASK IWO~~RE ARAITO

Algorithm of pulmonary emphysema extraction using thoracic 3D CT images

NASA Astrophysics Data System (ADS)

Saita, Shinsuke; Kubo, Mitsuru; Kawata, Yoshiki; Niki, Noboru; Nakano, Yasutaka; Ohmatsu, Hironobu; Tominaga, Keigo; Eguchi, Kenji; Moriyama, Noriyuki

2007-03-01

Recently, due to aging and smoking, emphysema patients are increasing. The restoration of alveolus which was destroyed by emphysema is not possible, thus early detection of emphysema is desired. We describe a quantitative algorithm for extracting emphysematous lesions and quantitatively evaluate their distribution patterns using low dose thoracic 3-D CT images. The algorithm identified lung anatomies, and extracted low attenuation area (LAA) as emphysematous lesion candidates. Applying the algorithm to thoracic 3-D CT images and then by follow-up 3-D CT images, we demonstrate its potential effectiveness to assist radiologists and physicians to quantitatively evaluate the emphysematous lesions distribution and their evolution in time interval changes.

Algorithm of pulmonary emphysema extraction using low dose thoracic 3D CT images

NASA Astrophysics Data System (ADS)

Saita, S.; Kubo, M.; Kawata, Y.; Niki, N.; Nakano, Y.; Omatsu, H.; Tominaga, K.; Eguchi, K.; Moriyama, N.

2006-03-01

Recently, due to aging and smoking, emphysema patients are increasing. The restoration of alveolus which was destroyed by emphysema is not possible, thus early detection of emphysema is desired. We describe a quantitative algorithm for extracting emphysematous lesions and quantitatively evaluate their distribution patterns using low dose thoracic 3-D CT images. The algorithm identified lung anatomies, and extracted low attenuation area (LAA) as emphysematous lesion candidates. Applying the algorithm to 100 thoracic 3-D CT images and then by follow-up 3-D CT images, we demonstrate its potential effectiveness to assist radiologists and physicians to quantitatively evaluate the emphysematous lesions distribution and their evolution in time interval changes.

Perception system and functions for autonomous navigation in a natural environment

NASA Technical Reports Server (NTRS)

Chatila, Raja; Devy, Michel; Lacroix, Simon; Herrb, Matthieu

1994-01-01

This paper presents the approach, algorithms, and processes we developed for the perception system of a cross-country autonomous robot. After a presentation of the tele-programming context we favor for intervention robots, we introduce an adaptive navigation approach, well suited for the characteristics of complex natural environments. This approach lead us to develop a heterogeneous perception system that manages several different terrain representatives. The perception functionalities required during navigation are listed, along with the corresponding representations we consider. The main perception processes we developed are presented. They are integrated within an on-board control architecture we developed. First results of an ambitious experiment currently underway at LAAS are then presented.

Therapeutic efficacy and effects of artesunate-amodiaquine and artemether-lumefantrine on malaria-associated anaemia in Nigerian children aged two years and under.

PubMed

Sowunmi, Akintunde; Akano, Kazeem; Ayede, Adejumoke I; Ntadom, Godwin; Adewoye, Elsie O; Fatunmbi, Bayo; Aderoyeje, Temitope

2016-07-06

Artemisinin-based combination therapies are recommended as first-line treatments for uncomplicated falciparum malaria, but there is little evaluation of their efficacy and effects on uncomplicated malaria-associated anaemia in children aged 2 years and under. Parasitological efficacy and effects on malaria-associated anaemia were evaluated in 250 malarious children aged 2 years and under, and efficacy was evaluated in 603 malarious children older than two but younger than 5 years of age following treatment with artesunate-amodiaquine (AA) or artemether-lumefantrine (AL). Kinetics of the disposition of parasitaemia following treatment were evaluated using a non-compartment model. Late-appearing anaemia (LAA) was diagnosed using the following criteria: clearance of parasitaemia, fever and other symptoms occurring within 7 days of starting treatment, adequate clinical and parasitological response on days 28-42, haematocrit (HCT) ≥ 30 % at 1 and/or 2 weeks, a fall in HCT to < 30 % occurring at 3-6 weeks, absence of concomitant illness at 1-6 weeks, and absence of asexual parasitaemia detected using both microscopy and polymerase chain reaction (PCR) at 1-6 weeks. Overall, in children aged 2 years and under, the PCR-corrected parasitological efficacy was 97.2 % (95 % CI 92.8-101.6), which was similar for both treatments. In children older than 2 years, parasitological efficacy was also similar for both treatments, but parasite prevalence 1 day after treatment began was significantly higher, and fever and parasite clearance times were significantly faster in the AA-treated children compared with the AL-treated children. Declines in parasitaemia were monoexponential with an estimated elimination half-time of 1 h. Elimination half-times were similar for both treatments. In children aged 2 years and under who were anaemic at presentation, the mean anaemia recovery time was 12.1 days (95 % CI 10.6-13.6, n = 127), which was similar for both

Chiral capillary electrophoresis with UV-excited fluorescence detection for the enantioselective analysis of 9-fluorenylmethoxycarbonyl-derivatized amino acids.

PubMed

Prior, Amir; Coliva, Giulia; de Jong, Gerhardus J; Somsen, Govert W

2018-05-29

The potential of capillary electrophoresis (CE) with ultraviolet (UV)-excited fluorescence detection for sensitive chiral analysis of amino acids (AAs) was investigated. DL-AAs were derivatized with 9-fluorenylmethoxycarbonyl chloride (FMOC)-Cl to allow their fluorescence detection and enhance enantioseparation. Fluorescence detection was achieved employing optical fibers, leading UV excitation light (< 300 nm) from a Xe-Hg lamp to the capillary window, and fluorescence emission to a spectrograph equipped with a charge-coupled device (CCD). Signal averaging over time and emission wavelength intervals was carried out to improve the signal-to-noise ratio of the FMOC-AAs. A background electrolyte (BGE) of 40 mM sodium tetraborate (pH 9.5), containing 15% isopropanol (v/v), 30 mM sodium dodecyl sulfate (SDS), and 30 mM β-cyclodextrin (β-CD), was found optimal for AA chemo- and enantioseparation. Enantioresolutions of 1.0 or higher were achieved for 16 proteinogenic DL-AAs. Limits of detection (LODs) were in the 10-100-nM range (injected concentration) for the D-AA enantiomers, except for FMOC-D-tryptophan (536 nM) which showed intramolecular fluorescence quenching. Linearity (R 2  > 0.997) and repeatability for peak height (relative standard deviations (RSDs) < 7.0%; n = 5) and electrophoretic mobility (RSDs < 0.6%; n = 5) of individual AA enantiomers were established for chiral analysis of DL-AA mixtures. The applicability of the method was investigated by the analysis of cerebrospinal fluid (CSF). Next to L-AAs, endogenous levels of D-glutamine and D-aspartic acid could be measured in CSF revealing enantiomeric ratios of 0.35 and 19.6%, respectively. This indicates the method's potential for the analysis of low concentrations of D-AAs in presence of abundant L-AAs.

Forearc structure in the Lesser Antilles inferred from depth to the Curie temperature and thermo-mechanical simulations

NASA Astrophysics Data System (ADS)

Gailler, Lydie; Arcay, Diane; Münch, Philippe; Martelet, Guillaume; Thinon, Isabelle; Lebrun, Jean-Frédéric

2017-06-01

Imaging deep active volcanic areas remains a challenge in our understanding of their activity and evolution, especially in subduction zones. Study of magnetic anomalies is appropriate to access such dynamics in depth. The magnetic anomaly pattern of the Lesser Antilles Arc (LAA) subduction is studied through Curie Point Depth (CPD), interpreted as the depth of the 580 °C isotherm, and developed to better assess the deep thermal structure of the arc. The depth of the estimated CPD exhibits a complex topography. Keeping in mind the overall uncertainty associated with this method, a main doming is evidenced below the Guadeloupe archipelago. Its apex is shifted towards the ancient arc, suggesting a very hot state of the fore-arc/arc domain. To better understand the LAA thermal state, we perform 2D thermo-mechanical simulations of the subduction zone. Recalling that magnetite is a serpentinization by-product, we simulate water transfer triggered by slab dehydration to test the assumption of fore-arc serpentinization suggested by the positive magnetic anomaly in the vicinity of the Guadeloupe archipelago. In this area, the subduction-induced arc lithosphere hydration and related weakening trigger a fast heating of the upper plate by basal convective removal. This process of fast arc lithosphere thinning may apply where simultaneously the volcanic arc is split in two and normal convergence is high enough. As serpentinization strongly decreases P-wave velocity, we propose a new interpretation of a published seismic profile below Guadeloupe. The seismic layer previously interpreted as the arc lower crust may rather be a layer of serpentinized mantle, as supported by spatial correlations between gravimetric and magnetic anomalies. Consequently, at the scale of Guadeloupe Island, the fore-arc Moho would be shallower than initially assumed, with a dome shape more consistent with both the extensive deformation active since the Oligocene in the inner fore-arc and the CPD doming.

The effect of parenteral nitrogen and energy intake on electrolyte balance in the preterm infant.

PubMed

Bonsante, F; Iacobelli, S; Chantegret, C; Martin, D; Gouyon, J-B

2011-10-01

Recent guidelines for preterm parenteral nutrition (PN) recommend an earlier and higher intake of amino acids (AA) and energy to avoid postnatal catabolism and approximate normal fetal growth. Few investigations explored how early PN may affect electrolyte and water homeostasis. We performed a prospective observational trial to assess the effect of nutrient intake on electrolyte homeostasis and balance. During 16 months, all infants ≤32 weeks were eligible. In the first week of life, we recorded the following daily: electrolytes (plasma and 8-h urine collection), nutritional intake, urine output, body weight, and we calculated sodium (Na) and potassium (K) balance. Infants were divided, for analysis, into three groups of AA intake: low <1.5 g/kg/day (LAA), medium 1.5-2 g/kg/day (MAA) and high >2 g/kg/day (HAA). A total of 154 infants were included. HAA group presented lower weight loss. Na balance was influenced by urine output and postnatal age, with little contribution of nutrition. Kalemia and K balance were mainly influenced by AA intake. K balance differed among groups: LAA, -2.3 mmol/kg/week; MAA, 1.1 mmol/kg/week; and HAA 2.6 mmol/kg/week (P<0.0001). In the HAA group, plasma and urine K were significantly lower and non-oliguric hyperkalemia was reduced. Na homeostasis was very slightly modified by early nutrition, suggesting that a negative Na balance is obligatory after birth. We showed that AA intake strongly affects K balance, minimize hyperkalemia and reduces weight loss. As K balance is strictly linked to cellular metabolism, we speculate that early nutrition may inhibit cellular catabolism and reduce the contraction of intracellular water compartment.

Five primary sources of organic aerosols in the urban atmosphere of Belgrade (Serbia).

PubMed

Zangrando, Roberta; Barbaro, Elena; Kirchgeorg, Torben; Vecchiato, Marco; Scalabrin, Elisa; Radaelli, Marta; Đorđević, Dragana; Barbante, Carlo; Gambaro, Andrea

2016-11-15

Biomass burning and primary biological aerosol particles (PBAPs) represent important primary sources of organic compounds in the atmosphere. These particles and compounds are able to affect climate and human health. In the present work, using HPLC-orbitrapMS, we determined the atmospheric concentrations of molecular markers such as anhydrosugars and phenolic compounds that are specific for biomass burning, as well as the concentrations of sugars, alcohol sugars and d- and l-amino acids (D-AAs and L-AAs) for studying PBAPs in Belgrade (Serbia) aerosols collected in September-December 2008. In these samples, high levels of all these biomarkers were observed in October. Relative percentages of vanillic (V), syringic compounds (S) and p-coumaric acid (PA), as well as levoglucosan/mannosan (L/M) ratios, helped us discriminate between open fire events and wood combustion for domestic heating during the winter. L-AAs and D-AAs (1% of the total) were observed in Belgrade aerosols mainly in September-October. During open fire events, mean D-AA/L-AA (D/L) ratio values of aspartic acid, threonine, phenylalanine, alanine were significantly higher than mean D/L values of samples unaffected by open fire. High levels of AAs were observed for open biomass burning events. Thanks to four different statistical approaches, we demonstrated that Belgrade aerosols are affected by five sources: a natural source, a source related to fungi spores and degraded material and three other sources linked to biomass burning: biomass combustion in open fields, the combustion of grass and agricultural waste and the combustion of biomass in stoves and industrial plants. The approach employed in this work, involving the determination of specific organic tracers and statistical analysis, proved useful to discriminate among different types of biomass burning events. Copyright © 2016 Elsevier B.V. All rights reserved.

Is CHA2DS2-VASc appropriate for hyperthyroid patients with atrial fibrillation? Implications of adding a transesophageal echocardiography evaluation.

PubMed

de Souza, Marcus Vinicius Leitão; de Fátima Dos Santos Teixeira, Patricia; Vaisman, Mario; Xavier, Sergio Salles

2017-02-01

Anticoagulation remains a controversial issue among hyperthyroid patients with atrial fibrillation (AF). We aimed to evaluate the prevalence of the thrombogenic milieu (TM), detected using transesophageal echocardiography (TEE), among patients with AF related to hyperthyroidism, and to correlate these findings with the clinical embolic risk classification (CHA 2 DS 2 -VASc). CHA 2 DS 2 -VASc score, thyroid hormonal status, time since hyperthyroidism diagnosis, transthoracic echocardiography (TTE) and TEE were assessed in 47 consecutive patients aged between 18 and 65years with AF related to hyperthyroidism. The following TEE parameters defined TM: dense spontaneous echo contrast, thrombi, or left atrial appendage (LAA) blood flow velocities <0.20m/s. Non-classic TM was defined as non-dense SEC plus LAA flow velocity 0.20-0.40m/s. Pulmonary hypertension was present in 39/47 (81.4%) and TM in 22/47 (46.8%) patients. Despite a low CHA 2 DS 2 -VASc score of 0/1, 10 of 19 (52.6%) patients had a TM, whereas 16 of 28 (57.1%) patients with score ≥2 had none. The probability of having a TM did not correlate with CHA 2 DS 2 -VASc scores. On regression binary analysis, hyperthyroidism diagnosed more than 12months previous was independently associated with non-classic TM (p=0.031). Among patients younger than 65years of age with AF related to hyperthyroidism, pulmonary hypertension and TM on TEE were highly prevalent. There was no association between CHA 2 DS 2 -VASc with TEE markers of TM. Thyroid status, especially longer duration of hyperthyroidism might influence thrombogenic abnormalities. TEE adds useful information that may change antithrombotic therapy if otherwise guided solely by clinical risk classification. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Recurrent transient ischaemic attack and early risk of stroke: data from the PROMAPA study.

PubMed

Purroy, Francisco; Jiménez Caballero, Pedro Enrique; Gorospe, Arantza; Torres, María José; Alvarez-Sabin, José; Santamarina, Estevo; Martínez-Sánchez, Patricia; Cánovas, David; Freijo, María José; Egido, Jose Antonio; Ramírez-Moreno, Jose M; Alonso-Arias, Arantza; Rodríguez-Campello, Ana; Casado, Ignacio; Delgado-Mederos, Raquel; Martí-Fàbregas, Joan; Fuentes, Blanca; Silva, Yolanda; Quesada, Helena; Cardona, Pere; Morales, Ana; de la Ossa, Natalia Pérez; García-Pastor, Antonio; Arenillas, Juan F; Segura, Tomas; Jiménez, Carmen; Masjuán, Jaime

2013-06-01

Many guidelines recommend urgent intervention for patients with two or more transient ischaemic attacks (TIAs) within 7 days (multiple TIAs) to reduce the early risk of stroke. To determine whether all patients with multiple TIAs have the same high early risk of stroke. Between April 2008 and December 2009, we included 1255 consecutive patients with a TIA from 30 Spanish stroke centres (PROMAPA study). We prospectively recorded clinical characteristics. We also determined the short-term risk of stroke (at 7 and 90 days). Aetiology was categorised using the TOAST (Trial of Org 10172 in Acute Stroke Treatment) classification. Clinical variables and extracranial vascular imaging were available and assessed in 1137/1255 (90.6%) patients. 7-Day and 90-day stroke risk were 2.6% and 3.8%, respectively. Large-artery atherosclerosis (LAA) was confirmed in 190 (16.7%) patients. Multiple TIAs were seen in 274 (24.1%) patients. Duration <1 h (OR=2.97, 95% CI 2.20 to 4.01, p<0.001), LAA (OR=1.92, 95% CI 1.35 to 2.72, p<0.001) and motor weakness (OR=1.37, 95% CI 1.03 to 1.81, p=0.031) were independent predictors of multiple TIAs. The subsequent risk of stroke in these patients at 7 and 90 days was significantly higher than the risk after a single TIA (5.9% vs 1.5%, p<0.001 and 6.8% vs 3.0%, respectively). In the logistic regression model, among patients with multiple TIAs, no variables remained as independent predictors of stroke recurrence. According to our results, multiple TIAs within 7 days are associated with a greater subsequent risk of stroke than after a single TIA. Nevertheless, we found no independent predictor of stroke recurrence among these patients.

D-amino acids reduce Enterococcus faecalis biofilms in vitro and in the presence of antimicrobials used for root canal treatment.

PubMed

Zilm, Peter S; Butnejski, Victor; Rossi-Fedele, Giampiero; Kidd, Stephen P; Edwards, Suzanne; Vasilev, Krasimir

2017-01-01

Enterococcus faecalis is the most frequent species present in post-treatment disease and plays a significant role in persistent periapical infections following root canal treatment. Its ability to persist in stressful environments is inter alia, due to its ability to form biofilms. The presence of certain D-amino acids (DAAs) has previously been shown to reduce formation of Bacillus subtilis biofilms. The aims of this investigation were to determine if DAAs disrupt biofilms in early and late growth stages for clinical E. faecalis strains and to test their efficacy in disrupting E. faecalis biofilms grown in sub-minimum inhibitory concentrations of commonly used endodontic biocides. From thirty-seven E. faecalis strains, the ten "best" biofilm producers were used to test the ability of a mixture containing D-leucine, D-methionine, D-tyrosine and D-tryptophan to reduce biofilm growth over a period of 24, 72 and 144 hours and when compared to their cognate L-Amino Acids (LAAs). We have previously shown that sub-MIC levels of tetracycline and sodium hypochlorite promotes biofilm growth in clinical strains of E. faecalis. DAAs were therefore tested for their effectiveness to reduce biofilm growth in the presence of sub-minimal concentrations of sodium hypochlorite (NaOCl-0.031%) and Odontocide™ (0.25% w/v), and in the presence of Odontopaste™ (0.25% w/v). DAAs significantly reduced biofilm formation for all strains tested in vitro, while DAAs significantly reduced biofilm formation compared to LAAs. The inhibitory effect of DAAs on biofilm formation was concentration dependent. DAAs were also shown to be effective in reducing E. faecalis biofilms in the presence of Odontopaste™ and sub-MIC levels of NaOCl and Odontocide™. The results suggest that the inclusion of DAAs into current endodontic procedures may reduce E. faecalis biofilms.

High-pressure studies on Ba-doped cobalt perovskites by neutron diffraction

NASA Astrophysics Data System (ADS)

Cao, Huibo; Garlea, Vasile; Wang, Fangwei; Dos Santos, Antonio; Cheng, Zhaohua

2012-02-01

Cobalt perovskite possess rich structural, magnetic and electrical properties depending on the subtle balance of the interactions among the spin, charge, and orbital degrees of freedom. Divalent hole-doped cobalt perovskites LaA^2+CoO3 exhibit structural phase transitions, metal-insulator transitions, and multi-magnetic phase transitions. High-pressure measurement is believed to mimic the size effects of the doped ions. We performed neutron diffraction experiments on selected Ba-doped LaCoO3 under pressures up to 6.3 GPa at SNAP at Spallation Neutron Source of ORNL. This work focuses on the high-pressure effects of the selected Ba-doped samples and the change of the phase diagram with pressure.

Disturbance of light-absorbing aerosols on the albedo in a winter snowpack of Central Tibet.

PubMed

Ming, Jing; Wang, Pengling; Zhao, Shuyu; Chen, Pengfei

2013-08-01

A field observation on the albedo of the snowpack in Central Tibet was conducted in the Nam Co region in the winter of 2011. Snow properties, including grain size and density, were measured in the field, and surface-layer snow samples (down to 5 cm) were collected. The average concentrations of black carbon and dust were 72 ppbm (close to that in the glaciers of Mt. Nyainqentanglha) and 120 ppmm, respectively. Inverse trends were found to exist between the albedo of the snowpack and light-absorbing aerosols (LAAs) as well as grain size growth. Modeling showed that black carbon, dust, and grain growth in the winter snowpack can reduce the broadband albedo by 11%, 28%, and 61%, respectively.

Prediction of the thermal annealing of thick oxide metal-oxide-semiconductor dosimeters irradiated in a harsh radiation environment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ravotti, F.; Glaser, M.; Saigne, F.

Radiation-sensing metal-oxide-semiconductor field-effect transistors produced by the laboratory LAAS-CNRS were exposed to a harsh hadron field that represents the real radiation environment expected at the CERN Large Hadron Collider experiments. The long-term stability of the transistor's I{sub ds}-V{sub gs} characteristic was investigated using the isochronal annealing technique. In this work, devices exposed to high intensity hadron levels ({phi}{>=}10{sup 12} neutrons/cm{sup 2}) show evidences of displacement damages in the I{sub ds}-V{sub gs} annealing behavior. By comparing experimental and simulated results over 14 months, the isochronal annealing method, originally devoted to oxide trapped charge, is shown to enable prediction of the recoverymore » of silicon bulk defects.« less

Low Energy Multi-Stage Atrial Defibrillation Therapy Terminates Atrial Fibrillation with Less Energy than a Single Shock

PubMed Central

Li, Wenwen; Janardhan, Ajit H.; Fedorov, Vadim V.; Sha, Qun; Schuessler, Richard B.; Efimov, Igor R.

2011-01-01

Background Implantable device therapy of atrial fibrillation (AF) is limited by pain from high-energy shocks. We developed a low-energy multi-stage defibrillation therapy and tested it in a canine model of AF. Methods and Results AF was induced by burst pacing during vagus nerve stimulation. Our novel defibrillation therapy consisted of three stages: ST1 (1-4 low energy biphasic shocks), ST2 (6-10 ultra-low energy monophasic shocks), and ST3 (anti-tachycardia pacing). Firstly, ST1 testing compared single or multiple monophasic (MP) and biphasic (BP) shocks. Secondly, several multi-stage therapies were tested: ST1 versus ST1+ST3 versus ST1+ST2+ST3. Thirdly, three shock vectors were compared: superior vena cava to distal coronary sinus (SVC>CSd), proximal coronary sinus to left atrial appendage (CSp>LAA) and right atrial appendage to left atrial appendage (RAA>LAA). The atrial defibrillation threshold (DFT) of 1BP shock was less than 1MP shock (0.55 ± 0.1 versus 1.38 ± 0.31 J; p =0.003). 2-3 BP shocks terminated AF with lower peak voltage than 1BP or 1MP shock and with lower atrial DFT than 4 BP shocks. Compared to ST1 therapy alone, ST1+ST3 lowered the atrial DFT moderately (0.51 ± 0.46 versus 0.95 ± 0.32 J; p = 0.036) while a three-stage therapy, ST1+ST2+ST3, dramatically lowered the atrial DFT (0.19 ± 0.12 J versus 0.95 ± 0.32 J for ST1 alone, p=0.0012). Finally, the three-stage therapy ST1+ST2+ST3 was equally effective for all studied vectors. Conclusions Three-stage electrotherapy significantly reduces the AF defibrillation threshold and opens the door to low energy atrial defibrillation at or below the pain threshold. PMID:21980076

The Evaluation of Interstitial Abnormalities in Group B of the 2011 Global Initiative for Chronic Obstructive Lung Disease (GOLD) Classification of Chronic Obstructive Pulmonary Disease (COPD).

PubMed

Ohgiya, Masahiro; Matsui, Hirotoshi; Tamura, Atsuhisa; Kato, Takafumi; Akagawa, Shinobu; Ohta, Ken

2017-10-15

Objective In 2011, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification categorized chronic obstructive pulmonary disease (COPD) patients into 4 groups. A report demonstrated that the mortality in Group B was higher than that in Group C. Ischemic heart disease and cancer were suggested to be the cause. The aim of the present study was to test the hypothesis that interstitial lung abnormalities (ILAs) are more prevalent in Group B than Group C and that they may be responsible for the higher mortality in Group B. Methods Patients were selected based on their pulmonary function test results. The inclusion criterion was a forced expiratory volume in 1 second (FEV 1 )/forced vital capacity (FVC) of <70% after the inhalation of a bronchodilator. Patients without a smoking history or computed tomography (CT) scan were excluded. The medical records of the patients were retrospectively reviewed, and the selected patients were categorized into Groups A to D. High-resolution CT scans were used to investigate the presence of ILAs and determine the low attenuation area (LAA). Results Among the 349 COPD patients, ILAs were detected in 10.3% of the patients in Group A, 22.5% of the patients in Group B, 5.6% of the patients in Group C, and 23.1% of the patients in Group D. In Group B, the frequency of ILAs was significantly higher and the area affected by the ILAs was significantly greater in comparison to Group C. Among the patterns of interstitial abnormalities, the area of honeycombing in Group B was significantly greater than that in Group C. Furthermore, among the patients in Group B, the LAA in the ILA-positive patients was significantly greater than that in the ILA-negative patients. Conclusion In Group B, the area occupied by ILAs-especially honeycombing-was greater than that in Group C. This contributed to the preserved %FEV 1 and possibly to the poorer prognosis of the patients in Group B.

Growth and properties of rare-earth arsenide InGaAs nanocomposites for terahertz generation

NASA Astrophysics Data System (ADS)

Salas, R.; Guchhait, S.; Sifferman, S. D.; McNicholas, K. M.; Dasika, V. D.; Krivoy, E. M.; Jung, D.; Lee, M. L.; Bank, S. R.

2015-02-01

We explore the electrical, optical, and structural properties of fast photoconductors of In0.53Ga0.47As containing a number of different rare-earth arsenide nanostructures. The rare-earth species provides a route to tailor the properties of the photoconductive materials. LuAs, GdAs, and LaAs nanostructures were embedded into InGaAs in a superlattice structure and compared to the relatively well-studied ErAs:InGaAs system. LaAs:InGaAs was found to have the highest dark resistivities, while GdAs:InGaAs had the lowest carrier lifetimes and highest carrier mobility at moderate depositions. The quality of the InGaAs overgrowth appears to have the most significant effect on the properties of these candidate fast photoconductors.

Introduction to Ada (Trademark), a Higher Order Language. L103 Teacher’s Guide.

DTIC Science & Technology

1984-05-01

I -- co 0 0 Cl) ) Lu Cl .L =) cr. LuL x 0 Lu I - Lu ml C 0 Lu a- 0 L 0 0 % Ci Lu Lu . I -- Lu cz w LuV ) Li- c 0 II- C. a.-, 0 C)) I -- Z I l 0 I - Cl...U. V L3 O-J zz w zz U, 0 w ww CX 0 wU I - LA. w 0 0 cr. U- w 0 (j Laa. z w ww oil co CL - - w a- x U) ’-cc i ... ’S.. 0 a&z V) - U- z C.x.)C. 4 IL** -4...mU rq U- - U >- L 0 LU> 1~~ V) V) UIZ UC 4w (U wI U0UL 1w 0 I - u . 9- c -V)

Corrosion-Control (CC) Program: Pilot Powder Coating Station Service Test.

DTIC Science & Technology

1986-03-14

o CL oU C4 CL00 z ;,S Go 0 m~ CL - C9 uj4 U..~D o . ZC.F Go zz 2 0 I- - c t < m U, cc V V4 cg c ~ D GD...Spray Booth# Curing Oven and A2-58 UNIT TOTAL is_18 A2-1 1WOW - o 0 -1 Q S re. 10 U c Z. 2E E. a.E 8 tE 20 4AU ==- %A a 4 $AO - Lo 48 0 w 0 -IL .. 0.... 0...Laa 00 3-r Q’ IA E zo 0..0 -< 4o C a) Ia - o x c bi. l c *4 ’a a~~* coLo. 0V Ua- 41 w - a V 2 2 .8 h A a U to bo co i ac

Inductive crystal field control in layered metal oxides with correlated electrons

DOE PAGES

Balachandran, P. V.; Cammarata, A.; Nelson-Cheeseman, B. B.; ...

2014-07-25

Here, we show that the NiO 6 crystal field energies can be tailored indirectly via heterovalent A cation ordering in layered (La,A) NiO 4 Ruddlesden-Popper (RP) oxides, where A = Sr, Ca, or Ba, using density functional calculations. We leverage as a driving force the electrostatic interactions between charged [LaO] 1+ and neutral [AO] 0 planes to inductively tune the Ni-O bond distortions, without intentional doping or epitaxial strain, altering the correlated d-orbital energies. We use this strategy to design cation ordered LaCaNiO 4 and LaBaNiO 4 with distortions favoring enhanced Ni e g orbital polarization, and find local electronicmore » structure signatures analogous to those in RP La-cuprates, i.e., parent phases of the high-temperature superconducting oxides.« less

Size variation and collapse of emphysema holes at inspiration and expiration CT scan: evaluation with modified length scale method and image co-registration.

PubMed

Oh, Sang Young; Lee, Minho; Seo, Joon Beom; Kim, Namkug; Lee, Sang Min; Lee, Jae Seung; Oh, Yeon Mok

2017-01-01

A novel approach of size-based emphysema clustering has been developed, and the size variation and collapse of holes in emphysema clusters are evaluated at inspiratory and expiratory computed tomography (CT). Thirty patients were visually evaluated for the size-based emphysema clustering technique and a total of 72 patients were evaluated for analyzing collapse of the emphysema hole in this study. A new approach for the size differentiation of emphysema holes was developed using the length scale, Gaussian low-pass filtering, and iteration approach. Then, the volumetric CT results of the emphysema patients were analyzed using the new method, and deformable registration was carried out between inspiratory and expiratory CT. Blind visual evaluations of EI by two readers had significant correlations with the classification using the size-based emphysema clustering method ( r -values of reader 1: 0.186, 0.890, 0.915, and 0.941; reader 2: 0.540, 0.667, 0.919, and 0.942). The results of collapse of emphysema holes using deformable registration were compared with the pulmonary function test (PFT) parameters using the Pearson's correlation test. The mean extents of low-attenuation area (LAA), E1 (<1.5 mm), E2 (<7 mm), E3 (<15 mm), and E4 (≥15 mm) were 25.9%, 3.0%, 11.4%, 7.6%, and 3.9%, respectively, at the inspiratory CT, and 15.3%, 1.4%, 6.9%, 4.3%, and 2.6%, respectively at the expiratory CT. The extents of LAA, E2, E3, and E4 were found to be significantly correlated with the PFT parameters ( r =-0.53, -0.43, -0.48, and -0.25), with forced expiratory volume in 1 second (FEV 1 ; -0.81, -0.62, -0.75, and -0.40), and with diffusing capacity of the lungs for carbon monoxide (cDLco), respectively. The fraction of emphysema that shifted to the smaller subgroup showed a significant correlation with FEV 1 , cDLco, forced expiratory flow at 25%-75% of forced vital capacity, and residual volume (RV)/total lung capacity ( r =0.56, 0.73, 0.40, and -0.58). A detailed assessment of

DOE Office of Scientific and Technical Information (OSTI.GOV)

Xu, J.; Bugaris, D. E.; Xiao, Z. L.

We report the occurrence of reentrantmetallic behavior in theWeyl semimetal NbP. When the appliedmagnetic field H is above a critical value H-c, a reentrance appears as a peak in the temperature-dependent resistivity rho(xx) (T) at T = T-p, similar to that observed in graphite where it was attributed to local superconductivity. The Tp(H) relationship follows a power-law dependence T-p similar to (H-H-c)(1/nu) where. can be derived from the temperature dependence of the zero-field resistivity rho(0)(T) similar to T-nu. From concurrent measurements of the transverse rho(xx) (T) and Hall rho(xy)(T) magnetoresistivities, we reveal a clear correlation between the rapidly increasing rho(xy)more » (T) and the occurrence of a peak in the rho(xx) (T) curve. Quantitative analysis indicates that the reentrantmetallic behavior arises from the competition of the magnetoconductivity sigma(xx) (T) with an additional component Delta sigma(xx) (T) = kappa(H)sigma(xx)(T) where kappa(H) = [rho(xy)(T)/rho(xx)(T)](2) is the Hall factor. We find that the Hall factor (kappa(H) approximate to 0.4) at peak temperature T-p is nearly field independent, leading to the observed T-p (H) relationship. Furthermore, the reentrant metallic behavior in rho(xx) (T) also is reflected in the behavior of rho(xx) (H) that ranges from nonsaturating at T > 70K to saturation at liquid-helium temperatures. The latter can be explained with the magnetic field dependence of the Hall factor kappa(H) (H). Our paper demonstrates that a semiclassical theory can account for the "anomalies" in the magnetotransport phenomena of NbP without invoking an exotic mechanism.« less

Prime Contractors with Awards Over $25,000 by Name, Location, and Contract Number, Fiscal Year 87. Part 6. HI Desert Eagle Corporation-Kingsley Machine Company, Incorporated.

DTIC Science & Technology

1987-01-01

a a . c - 4 ) ) x’ m~ a4 a. a a J~C 0. ~a.L a. a m ac zz acca > a0 0 a0 a 0o~ a a 7- .CLa - cF 4 0 - HH u H auH. z~ -a a A wa a a~~~ a w .Laa.4 w...FF cc>C ~ ~ ~ ~ F o F ,.FF X1 F F -C F) F F -IC 0~~ 3 F F F3 Lo3F< 4 FF 4 0 F F . F 0 F 4 F * 0 0 OFUF 0 C 0 1 F CZFCi F7 Zl F C ,O D O C F - F F F...8217. ZU)to -At-4 - ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ k OD.-.-- - - - - - -.. -. . .~- - - r ~rwr y vva v- - - .3l f3 . ~ r.- (SOc Cr J m- OD( N t--C m m

Psychosocial Health Status of Persons Seeking Treatment for Exposure to Libby Amphibole Asbestos

PubMed Central

Weinert, Clarann; Hill, Wade G.; Winters, Charlene A.; Kuntz, Sandra W.; Rowse, Kimberly; Hernandez, Tanis; Black, Brad; Cudney, Shirley

2011-01-01

A cross-sectional exploratory study was conducted to describe the psychosocial health status of persons seeking health care for exposure to Libby amphibole asbestos (LAA). Health indicators including depression, stress, acceptance of illness, and satisfaction with access and financial aspects of care were obtained via electronic and paper-pencil survey. The exposure pathway and demographic data were gleaned from the health record. Of the 386 participants, more than one-third (34.5%) demonstrated significant levels of psychological distress. The oldest group of women had the lowest levels of depression and stress and the highest acceptance of illness. Gender, age, and satisfaction with financial resources were significantly related to depression, stress, and acceptance of illness. Satisfaction with access to care was significant only for stress. No differences in depression, stress, and acceptance of illness were found based on residence, exposure pathway, or insurance status. PMID:22007326

Lipid- and sugar-modified endomorphins: novel targets for the treatment of neuropathic pain

PubMed Central

Varamini, Pegah; Toth, Istvan

2013-01-01

Endomorphins are endogenous opioid peptides that cause potent antinociception in rodent models of acute and neuropathic pain with less undesirable side effects than opioid alkaloids. However, endomorphins are poorly suited to clinical applications because of low membrane permeability and a susceptibility to enzymatic degradation. Glycosylation and lipidation have proven to be two of the most robust approaches for the generation of new therapeutic endomorphin derivatives. Conjugation with lipoamino acids (LAA) confers an amphipathic character to the peptide, which improved interaction between the peptide and the lipid bilayer of the cell membranes, increasing permeability. Glycosylation can also improve peptide stability and blood brain barrier (BBB) transport. It is believed that an endocytotic mechanism (transcytosis) is responsible for the systemic delivery of water-soluble glycopeptides. This review discusses the application of glycosylation and lipidation strategies to improve the drug-like properties of endomorphins. Pharmacologically active endomorphin analogs with less adverse effects are also discussed. PMID:24379782

Electrical characterization of reduced graphene oxide (rGO) on organic thin film transistor (OTFT)

NASA Astrophysics Data System (ADS)

Musa, Nurhazwani; Halim, Nurul Farhanah Ab.; Ahmad, Mohd Noor; Zakaria, Zulkhairi; Hashim, Uda

2017-03-01

A green method and eco-friendly solution were used to chemically reduce graphene oxide (GO) to graphene using green reductant. In this study, graphene oxide (GO) were prepared by using Tours method. Then, reduced graphene oxides (rGO) were prepared by using three typical reduction agents: L-ascorbic acid (L-AA), formamidinesulfinic acid (FAS) and sodium sulfite (Na2SO3). The reduced materials were characterized by Fourier transform infrared spectroscopy (FTIR), Thermo gravimetric analysis (TGA) and X-ray diffraction (XRD). Graphene based organic thin film transistor (G-OTFT) was prepared by a spin coating and thermal evaporation technique. The electrical characterization of G-OTFT was analyzed by using semiconductor parameter analyzer (SPA). The G-OTFT devices show p-type semiconducting behaviour. This article focuses on the synthesis and reduction of graphene oxide using three different reductants in order to maximise its electrical conductivity. The rGO product demonstrated a good electrical conductivity performance with highly sensitivity sensor.

Facile synthesis of soluble graphene quantum dots and its improved property in detecting heavy metal ions.

PubMed

Zhou, Chengfeng; Jiang, Wei; Via, Brian K

2014-06-01

An effective approach to produce graphene quantum dots (GQDs) has been developed, which based on the cutting of graphene oxide (GO) powder into smaller pieces and being reduced by a green approach, using sodium polystyrene sulfonate (PSS) as a dispersant and l-ascorbic acid (l-AA) as the reducing agent, which is environmentally friendly. Then the as-prepared GQDs were further used for the detection of heavy metal ions Pb(2+). This kind of GQDs has greater solubility in water and is more biocompatible than GO that has been reduced by hydrazine hydrate. The few-layers of GQDs with defects and residual OH groups were shown to be particularly well suited for the determination of metal ions in the liquid phase using an electrochemical method, in which a remarkably low detection limit of 7×10(-9)M for Pb(2+) was achieved. Copyright © 2014 Elsevier B.V. All rights reserved.

The Effects of Service-Learning on College Students’ Attitudes Toward Older Adults

PubMed Central

Augustin, Frankline; Freshman, Brenda

2016-01-01

The current U.S. healthcare workforce shortage is at crisis levels for providers who specialize in elder care (Harahan, 2011; Kovner, Mezey, & Harrington, 2002). Barriers such as ageism, lack of awareness of the need for workers, and lack of contact with seniors can impact the career choice of young professionals (Gross & Eshbaugh, 2011; Hutchison, Fox, Laas, Matharu, & Urzi, 2010; Lun, 2012). To explore ways to increase the number of students who pursue gerontology and to expand the elder care workforce, the researchers conducted a qualitative content analysis on the impact of service-learning in senior care facilities on students’ attitudes toward older adults. Students with senior contact reported increases in positive perceptions of seniors, discovered their own ageist stereotypes, and developed an interest in a career in elder care. Twenty-one months after the service-learning experience, students were surveyed again with their responses indicating continued positive attitude changes along with professional development demonstrating beneficial long-term effects from the experience. PMID:26679428

High temperature superconductor step-edge Josephson junctions using Ti-Ca-Ba-Cu-O

DOEpatents

Ginley, David S.; Hietala, Vincent M.; Hohenwarter, Gert K. G.; Martens, Jon S.; Plut, Thomas A.; Tigges, Chris P.; Vawter, Gregory A.; Zipperian, Thomas E.

1994-10-25

A process for formulating non-hysteretic and hysteretic Josephson junctions using HTS materials which results in junctions having the ability to operate at high temperatures while maintaining high uniformity and quality. The non-hysteretic Josephson junction is formed by step-etching a LaAlO.sub.3 crystal substrate and then depositing a thin film of TlCaBaCuO on the substrate, covering the step, and forming a grain boundary at the step and a subsequent Josephson junction. Once the non-hysteretic junction is formed the next step to form the hysteretic Josephson junction is to add capacitance to the system. In the current embodiment, this is accomplished by adding a thin dielectric layer, LaA1O.sub.3, followed by a cap layer of a normal metal where the cap layer is formed by first depositing a thin layer of titanium (Ti) followed by a layer of gold (Au). The dielectric layer and the normal metal cap are patterned to the desired geometry.

Solution of fractional kinetic equation by a class of integral transform of pathway type

NASA Astrophysics Data System (ADS)

Kumar, Dilip

2013-04-01

Solutions of fractional kinetic equations are obtained through an integral transform named Pα-transform introduced in this paper. The Pα-transform is a binomial type transform containing many class of transforms including the well known Laplace transform. The paper is motivated by the idea of pathway model introduced by Mathai [Linear Algebra Appl. 396, 317-328 (2005), 10.1016/j.laa.2004.09.022]. The composition of the transform with differential and integral operators are proved along with convolution theorem. As an illustration of applications to the general theory of differential equations, a simple differential equation is solved by the new transform. Being a new transform, the Pα-transform of some elementary functions as well as some generalized special functions such as H-function, G-function, Wright generalized hypergeometric function, generalized hypergeometric function, and Mittag-Leffler function are also obtained. The results for the classical Laplace transform is retrieved by letting α → 1.

Prime Contract Awards by FSC/SVC and Purchasing Office in Excess of $100,000. FY 1993. Part 4. Q101 Dependent Medicare Services - Z300 Main/Restoration Activities

DTIC Science & Technology

1994-03-01

4e A[ -C U) caa -j cn40 -j = L o o t U~ V)0 (4 *OF Laa el 9L cn U 4 COUn Lfl4oe I- lv, *) Ci - W 4 ) u wm.) (.3n 04 LU 0 en 01 c- >- a) N (A3 03 wto...C)1 01 DU cn 0 4Nq PC0 %.W 0 .4 00 1* 0(V)10(000omONW0010 Nw ýwo W4 MW~( ,4..(-4 W to(D cn C.) Ln N. CY CU A -I-0 In Om ce 401NN0 t .. ( -4 en qt0...0D00~00 EYýI - o v %- 1.L DCJ o m m00D-acDl 4-4cvný L 0 (D -it(CVI~ ý Iv f ( v.Or-c u Lj0 ( en () GO o~ 0. UU 41 LU o n y ( -0 V3O E e)Nw0W0 0 (14 -t c

Geographic List of Prime Contract Awards. Oct 91 - Sep 92. FY92. (Norwich Vermont - Melrose Virginia)

DTIC Science & Technology

1993-01-01

4 11 0.:000000000 wo~ 0.000u Woo0 1,000 0 - 0 -j ifw IWcO-I4 1 -4 -4 co 00 co00 NNNN " ( NIB -I."-< ൴ 44< < <(o0(D0(to(D0(o(D0(0 សNC"" is C3 -4 (7...a 0 0 C), CD, a a a 0 0 0 0 a a C. C> (n) C, 10 C> a C> a .0 U) III m I mclco< 11 C.)MMM C,) M C1) M I mc>co<:: Cacao co C43 Coa c Q 0 0 0 10 C. Q Q 0...i LA1)0)0 (-mir-- (c)4c LAA) o a ( De 400 M t-.) --.?-- 1 --4 of a < CON ma 00 o(0 0100 ()a )01C)0m)0000oo0 ;4100 40 <D 004 44 14 0V)CI0000 -4I mm. 1

Size variation and collapse of emphysema holes at inspiration and expiration CT scan: evaluation with modified length scale method and image co-registration

PubMed Central

Oh, Sang Young; Lee, Minho; Seo, Joon Beom; Kim, Namkug; Lee, Sang Min; Lee, Jae Seung; Oh, Yeon Mok

2017-01-01

A novel approach of size-based emphysema clustering has been developed, and the size variation and collapse of holes in emphysema clusters are evaluated at inspiratory and expiratory computed tomography (CT). Thirty patients were visually evaluated for the size-based emphysema clustering technique and a total of 72 patients were evaluated for analyzing collapse of the emphysema hole in this study. A new approach for the size differentiation of emphysema holes was developed using the length scale, Gaussian low-pass filtering, and iteration approach. Then, the volumetric CT results of the emphysema patients were analyzed using the new method, and deformable registration was carried out between inspiratory and expiratory CT. Blind visual evaluations of EI by two readers had significant correlations with the classification using the size-based emphysema clustering method (r-values of reader 1: 0.186, 0.890, 0.915, and 0.941; reader 2: 0.540, 0.667, 0.919, and 0.942). The results of collapse of emphysema holes using deformable registration were compared with the pulmonary function test (PFT) parameters using the Pearson’s correlation test. The mean extents of low-attenuation area (LAA), E1 (<1.5 mm), E2 (<7 mm), E3 (<15 mm), and E4 (≥15 mm) were 25.9%, 3.0%, 11.4%, 7.6%, and 3.9%, respectively, at the inspiratory CT, and 15.3%, 1.4%, 6.9%, 4.3%, and 2.6%, respectively at the expiratory CT. The extents of LAA, E2, E3, and E4 were found to be significantly correlated with the PFT parameters (r=−0.53, −0.43, −0.48, and −0.25), with forced expiratory volume in 1 second (FEV1; −0.81, −0.62, −0.75, and −0.40), and with diffusing capacity of the lungs for carbon monoxide (cDLco), respectively. The fraction of emphysema that shifted to the smaller subgroup showed a significant correlation with FEV1, cDLco, forced expiratory flow at 25%–75% of forced vital capacity, and residual volume (RV)/total lung capacity (r=0.56, 0.73, 0.40, and −0.58). A detailed

An inactivated gE-deleted pseudorabies vaccine provides complete clinical protection and reduces virus shedding against challenge by a Chinese pseudorabies variant.

PubMed

Wang, Jichun; Guo, Rongli; Qiao, Yongfeng; Xu, Mengwei; Wang, Zhisheng; Liu, Yamei; Gu, Yiqi; Liu, Chang; Hou, Jibo

2016-12-07

Since the end of 2011 an outbreak of pseudorabies affected Chinese pig herds that had been vaccinated with the commercial vaccine made of Bartha K61 strain. It is now clear that the outbreak was caused by an emergent PRV variant. Even though vaccines made of PRV Bartha K61 strain can confer certain cross protection against PRV variants based on experimental data, less than optimal clinical protection and virus shedding reduction were observed, making the control or eradication of this disease difficult. An infectious clone of PRV AH02LA strain was constructed to generate a gE deletion mutant PRV(LA-A B ) strain. PRV(LA-A B ) strain can reach a titer of 10 8.43 TCID 50 /mL (50% tissue culture infectious dose) on BHK-21 cells. To evaluate the efficiency of the inactivated vaccine made of PRV(LA-A B ) strain, thirty 3-week-old PRV-negative piglets were divided randomly into six groups for vaccination and challenge test. All five piglets in the challenge control showed typical clinical symptoms of pseudorabies post challenge. Sneezing and nasal discharge were observed in four and three piglets in groups C(vaccinated with inactivated PRV Bartha K61 strain vaccine) and D(vaccinated with live PRV Bartha K61 strain vaccine) respectively. In contrast, piglets in both groups A(vaccinated with inactivated PRV LA-AB strain vaccine) and B(vaccinated with inactivated PRV LA-A B strain vaccine with adjuvant) presented mild or no clinical symptoms. Moreover, viral titers detected via nasal swabs were approximately 100 times lower in group B than in the challenge control, and the duration of virus shedding (3-4 days) was shorter than in either the challenge control (5-10 days) or groups C and D (5-6 days). The infectious clone constructed in this study harbors the whole genome of the PRV variant AH02LA strain. The gE deletion mutant PRV(LA-A B )strain generated from PRV AH02LA strain can reach a high titer on BHK-21 cells. An inactivated vaccine of PRV LA-A B provides clinical

Multi-aircraft dynamics, navigation and operation

NASA Astrophysics Data System (ADS)

Houck, Sharon Wester

-in-the-sky display and being guided by a Category I LAAS, it is technically feasible to reduce the runway spacing to 1100 ft. If a Category I LAAS and an "intelligent auto-pilot" that executes both the approach and emergency escape maneuver are used, the technically achievable required runway spacing is reduced to 750 ft. Both statements presume full aircraft state information, including position, velocity, and attitude, is being reliably passed between aircraft at a rate equal to or greater than one Hz.

Expected geoneutrino signal at JUNO

NASA Astrophysics Data System (ADS)

Strati, Virginia; Baldoncini, Marica; Callegari, Ivan; Mantovani, Fabio; McDonough, William F.; Ricci, Barbara; Xhixha, Gerti

2015-12-01

Constraints on the Earth's composition and on its radiogenic energy budget come from the detection of geoneutrinos. The Kamioka Liquid scintillator Antineutrino Detector (KamLAND) and Borexino experiments recently reported the geoneutrino flux, which reflects the amount and distribution of U and Th inside the Earth. The Jiangmen Underground Neutrino Observatory (JUNO) neutrino experiment, designed as a 20 kton liquid scintillator detector, will be built in an underground laboratory in South China about 53 km from the Yangjiang and Taishan nuclear power plants, each one having a planned thermal power of approximately 18 GW. Given the large detector mass and the intense reactor antineutrino flux, JUNO aims not only to collect high statistics antineutrino signals from reactors but also to address the challenge of discriminating the geoneutrino signal from the reactor background. The predicted geoneutrino signal at JUNO is terrestrial neutrino unit (TNU), based on the existing reference Earth model, with the dominant source of uncertainty coming from the modeling of the compositional variability in the local upper crust that surrounds (out to approximately 500 km) the detector. A special focus is dedicated to the 6° × 4° local crust surrounding the detector which is estimated to contribute for the 44% of the signal. On the basis of a worldwide reference model for reactor antineutrinos, the ratio between reactor antineutrino and geoneutrino signals in the geoneutrino energy window is estimated to be 0.7 considering reactors operating in year 2013 and reaches a value of 8.9 by adding the contribution of the future nuclear power plants. In order to extract useful information about the mantle's composition, a refinement of the abundance and distribution of U and Th in the local crust is required, with particular attention to the geochemical characterization of the accessible upper crust where 47% of the expected geoneutrino signal originates and this region contributes

Water quality and pollution status of Chambal river in National Chambal Sanctuary, Madhya Pradesh.

PubMed

Saksena, D N; Garg, R K; Rao, R J

2008-09-01

The physico-chemical characteristics of Chambal river water in National Chambal sanctuary (Madhya Pradesh) have been studied. The stretch of Chambal river contained in the National Chambal sanctuary (located at 25 degrees 23'-26 degrees 52'N, 76 degrees 28'-79 degrees 15'E) is extending up to 600 km downstream from Kota (Rajasthan) to the confluence of the Chambal with Yamuna river (Etawah). The river flow in Madhya Pradesh spans up to approximately 400 km. Three sampling stations viz., Station A--near Palighat, district Sheopurkalan, Station B--near Rajghat, district Morena and Station C--near Baraighat, district Bhind were established for the collection of water samples during April, 2003 to March, 2004. The water quality parameters namely transparency (12.12-110 cm), colour (transparent-very turbid), turbidity (1-178 TNU), electrical conductivity (145.60-884 microS cm(-1)), total dissolved solids (260-500 mgl(-1)), pH (7.60-9.33), dissolved oxygen (4.86-14.59 mgl(-1)), free carbon dioxide (0-16.5 mgl(-1)), total alkalinity (70-290 mgl(-1)), total hardness (42-140 mgl(-1)), chloride (15.62-80.94 mgl(-1)), nitrate (0.008-0.025 mgl(-1)), nitrite (0.002-0.022 mgl(-1)), sulphate (3.50-45 mgl(-1)), phosphate (0.004-0.050 mgl(-1)), silicate (2.80-13.80 mgl(-1)), biochemical oxygen demand (0.60-5.67 mgl(-1)), chemical oxygen demand (2.40-26.80 mgl(-1)), ammonia (nil-0.56 mgl(-1)), sodium (14.30-54.40 mgl(-1)) and potassium (2.10 mgl(-1)-6.30 mgl(-1)) reflects on the pristine nature of the river in National Chambal sanctuary. On the basis of various parameters studied, Chambal river in this stretch can be placed under the category of oligosaprobic. The water quality analysis, indicated that the riverwater in the sanctuary area is pollution free and can serve as a good habitat for many aquatic animals including endangered species.

High temperature superconductor step-edge Josephson junctions using Ti-Ca-Ba-Cu-O

DOEpatents

Ginley, D.S.; Hietala, V.M.; Hohenwarter, G.K.G.; Martens, J.S.; Plut, T.A.; Tigges, C.P.; Vawter, G.A.; Zipperian, T.E.

1994-10-25

A process is disclosed for formulating non-hysteretic and hysteretic Josephson junctions using HTS materials which results in junctions having the ability to operate at high temperatures while maintaining high uniformity and quality. The non-hysteretic Josephson junction is formed by step-etching a LaAlO[sub 3] crystal substrate and then depositing a thin film of TlCaBaCuO on the substrate, covering the step, and forming a grain boundary at the step and a subsequent Josephson junction. Once the non-hysteretic junction is formed the next step to form the hysteretic Josephson junction is to add capacitance to the system. In the current embodiment, this is accomplished by adding a thin dielectric layer, LaA1O[sub 3], followed by a cap layer of a normal metal where the cap layer is formed by first depositing a thin layer of titanium (Ti) followed by a layer of gold (Au). The dielectric layer and the normal metal cap are patterned to the desired geometry. 8 figs.

Percutaneous left atrial appendage closure vs warfarin for atrial fibrillation: a randomized clinical trial.

PubMed

Reddy, Vivek Y; Sievert, Horst; Halperin, Jonathan; Doshi, Shephal K; Buchbinder, Maurice; Neuzil, Petr; Huber, Kenneth; Whisenant, Brian; Kar, Saibal; Swarup, Vijay; Gordon, Nicole; Holmes, David

2014-11-19

While effective in preventing stroke in patients with atrial fibrillation (AF), warfarin is limited by a narrow therapeutic profile, a need for lifelong coagulation monitoring, and multiple drug and diet interactions. To determine whether a local strategy of mechanical left atrial appendage (LAA) closure was noninferior to warfarin. PROTECT AF was a multicenter, randomized (2:1), unblinded, Bayesian-designed study conducted at 59 hospitals of 707 patients with nonvalvular AF and at least 1 additional stroke risk factor (CHADS2 score ≥1). Enrollment occurred between February 2005 and June 2008 and included 4-year follow-up through October 2012. Noninferiority required a posterior probability greater than 97.5% and superiority a probability of 95% or greater; the noninferiority margin was a rate ratio of 2.0 comparing event rates between treatment groups. Left atrial appendage closure with the device (n = 463) or warfarin (n = 244; target international normalized ratio, 2-3). A composite efficacy end point including stroke, systemic embolism, and cardiovascular/unexplained death, analyzed by intention-to-treat. At a mean (SD) follow-up of 3.8 (1.7) years (2621 patient-years), there were 39 events among 463 patients (8.4%) in the device group for a primary event rate of 2.3 events per 100 patient-years, compared with 34 events among 244 patients (13.9%) for a primary event rate of 3.8 events per 100 patient-years with warfarin (rate ratio, 0.60; 95% credible interval, 0.41-1.05), meeting prespecified criteria for both noninferiority (posterior probability, >99.9%) and superiority (posterior probability, 96.0%). Patients in the device group demonstrated lower rates of both cardiovascular mortality (1.0 events per 100 patient-years for the device group [17/463 patients, 3.7%] vs 2.4 events per 100 patient-years with warfarin [22/244 patients, 9.0%]; hazard ratio [HR], 0.40; 95% CI, 0.21-0.75; P = .005) and all-cause mortality (3.2 events per 100 patient

IgE binding to peanut allergens is inhibited by combined D-aspartic and D-glutamic acids.

PubMed

Chung, Si-Yin; Reed, Shawndrika

2015-01-01

The objective of this study was to determine if D-amino acids (D-aas) bind and inhibit immunoglobulin E (IgE) binding to peanut allergens. D-aas such as D-Asp (aspartic acid), D-Glu (glutamic acid), combined D-[Asp/Glu] and others were each prepared in a cocktail of 9 other D-aas, along with L-amino acids (L-aas) and controls. Each sample was mixed with a pooled plasma from peanut-allergic donors, and tested by ELISA (enzyme-linked immunosorbent assay) and Western blots for IgE binding to peanut allergens. Results showed that D-[Asp/Glu] (4 mg/ml) inhibited IgE binding (75%) while D-Glu, D-Asp and other D-aas had no inhibitory effect. A higher inhibition was seen with D-[Asp/Glu] than with L-[Asp/Glu]. We concluded that IgE was specific for D-[Asp/Glu], not D-Asp or D-Glu, and that D-[Asp/Glu] was more reactive than was L-[Asp/Glu] in IgE inhibition. The finding indicates that D-[Asp/Glu] may have the potential for removing IgE or reducing IgE binding to peanut allergens in vitro. Published by Elsevier Ltd.

Ellipsometric study of YBa2Cu3O(7-x) laser ablated and co-evaporated films

NASA Technical Reports Server (NTRS)

Alterovitz, S. A.; Sieg, R. E.; Warner, J. D.; Stan, M. A.; Vitta, S.

1990-01-01

High temperature superconducting films of YBa2Cu3O(7-x) (YBCO were grown on SrTiO3, LaA1O3, and YSZ substrates using two techniques: excimer laser ablation with in situ annealing and co-evaporation of Y, Cu, and BaF2 with ex-situ annealing. Film thicknesses were typically 5000 A, with predominant c-axis alignment perpendicular to the substrate. Critical temperatures up to Tc(R=O)=90 K were achieved by both techniques. Ellipsometric measurements were taken in the range 1.6 to 4.3 eV using a variable angle spectroscopic ellipsometer. The complex dielectric function of the laser ablated films was reproducible from run to run, and was found to be within 10 percent of that previously reported for (001) oriented single crystals. A dielectric overlayer was observed in these films, with an index of refraction of approximately 1.55 and nearly zero absorption. For the laser ablated films the optical properties were essentially independent of substrate material. The magnitude of the dielectric function obtained for the co-evaported films was much lower than the value reported for single crystals, and was sample dependent.

Arctic Climate during Eocene Hyperthermals: Wet Summers on Ellesmere Island?

NASA Astrophysics Data System (ADS)

Greenwood, D. R.; West, C. K.; Basinger, J. F.

2012-12-01

Previous work has shown that during the late Paleocene to middle Eocene, mesothermal conditions (i.e., MAT ~12-15° C) and high precipitation (MAP > 150cm/yr) characterized Arctic climates - an Arctic rain forest. Recent analyses of Arctic Eocene wood stable isotope chemistry are consistent with the annual and seasonal temperature estimates from leaf physiognomy and nearest living relative analogy from fossil plants, including the lack of freezing winters, but is interpreted as showing that there was a summer peak in precipitation - modern analogs are best sought on the summer-wet east coasts (e.g., China, Japan, South Korea) not the winter-wet west coasts of present-day northern temperate continents (e.g., Pacific northwest of North America). Highly seasonal 'monsoon-type' summer-wet precipitation regimes (i.e., summer precip./winter precip. > 3.0) seem to characterize Eocene hyperthermal conditions in several regions of the earth, including the Arctic and Antarctic, based on both climate model sensitivity experiments and the paleoclimate proxy evidence. The leaf physiognomy proxy previously applied to estimate Arctic Paleogene precipitation was leaf area analysis (LAA), a correlation between mean leaf size in woody dicot vegetation and annual precipitation. New data from modern monsoonal sites, however demonstrates that for deciduous-dicot dominated vegetation, summer precipitation determines mean leaf size, not annual totals, and therefore that under markedly seasonal precipitation and/or light regimes that summer precipitation is being estimated using LAA. Presented here is a new analysis of a leaf macrofloras from 3 separate florules of the Margaret Formation (Split Lake, Stenkul Fiord and Strathcona Fiord) from Ellesmere Island that are placed stratigraphically as early Eocene, and likely fall within Eocene thermal maximum 1 (ETM1; = the 'PETM') or ETM2. These floras are each characterized by a mix of large-leafed and small-leafed dicot taxa, with overall

5-Year Outcomes After Left Atrial Appendage Closure: From the PREVAIL and PROTECT AF Trials.

PubMed

Reddy, Vivek Y; Doshi, Shephal K; Kar, Saibal; Gibson, Douglas N; Price, Matthew J; Huber, Kenneth; Horton, Rodney P; Buchbinder, Maurice; Neuzil, Petr; Gordon, Nicole T; Holmes, David R

2017-12-19

The PROTECT AF (WATCHMAN Left Atrial Appendage System for Embolic Protection in Patients With Atrial Fibrillation) trial demonstrated that left atrial appendage closure (LAAC) with the Watchman device (Boston Scientific, St. Paul, Minnesota) was equivalent to warfarin for preventing stroke in atrial fibrillation, but had a high rate of complications. In a second randomized trial, PREVAIL (Evaluation of the WATCHMAN LAA Closure Device in Patients With Atrial Fibrillation Versus Long Term Warfarin Therapy), the complication rate was low. The warfarin cohort experienced an unexpectedly low ischemic stroke rate, rendering the efficacy endpoints inconclusive. However, these outcomes were based on relatively few patients followed for a relatively short time. The final results of the PREVAIL trial, both alone and as part of a patient-level meta-analysis with the PROTECT AF trial, are reported with patients in both trials followed for 5 years. PREVAIL and PROTECT AF are prospective randomized clinical trials with patients randomized 2:1 to LAAC or warfarin; together, they enrolled 1,114 patients for 4,343 patient-years. Analyses are by intention-to-treat, and rates are events per 100 patient-years. For the PREVAIL trial, the first composite coprimary endpoint of stroke, systemic embolism (SE), or cardiovascular/unexplained death did not achieve noninferiority (posterior probability for noninferiority = 88.4%), whereas the second coprimary endpoint of post-procedure ischemic stroke/SE did achieve noninferiority (posterior probability for noninferiority = 97.5%); the warfarin arm maintained an unusually low ischemic stroke rate (0.73%). In the meta-analysis, the composite endpoint was similar between groups (hazard ratio [HR]: 0.820; p = 0.27), as were all-stroke/SE (HR: 0.961; p = 0.87). The ischemic stroke/SE rate was numerically higher with LAAC, but this difference did not reach statistical significance (HR: 1.71; p = 0.080). However, differences in

Stroke and transient ischemic attack incidence rate in Spain: the IBERICTUS study.

PubMed

Díaz-Guzmán, Jaime; Egido, Jose-A; Gabriel-Sánchez, Rafael; Barberá-Comes, Gloria; Fuentes-Gimeno, Blanca; Fernández-Pérez, Cristina

2012-01-01

In Spain, stroke is a major public health concern, but large population-based studies are scarce and date from the 1990s. We estimated the incidence and in-hospital mortality of stroke through a multicentered population-based stroke register in 5 geographical areas of Spain, i.e. Lugo, Almería, Segovia, Talavera de la Reina and Mallorca, representing north, south, central (×2) and Mediterranean areas of Spain, respectively, the aim and novelty being that all methodologies were standardized, and diagnoses were verified by a neurologist using neuroimaging techniques. The register identified subjects >17 years of age who suffered a first-ever stroke or transient ischemic attack (TIA) between 1 January and 31 December 2006. Stroke and TIA were defined according to the WHO criteria. The Lausanne Stroke Registry definitions were used to classify ischemic stroke subtypes, as follows: (1) large-artery atherosclerosis (LAA); (2) cardioembolism (CE); (3) lacunar stroke or small-artery occlusion (SAO); (4) stroke of other infrequent cause (SIC), and (5) stroke of undetermined cause (UND). We used several complementary data sources such as hospital discharge registers, emergency room registers and primary care surveillance systems. In the 1-year study period, we identified 2,700 first-ever cerebrovascular episodes (53% men; 2,257 strokes + 443 TIA episodes). Brain CT in the acute stage was performed in 99% of cases. Of a total of 2,257 stroke patients, 1,817 (81%) had cerebral infarction, 350 (16%) had intracerebral hemorrhage, 59 (3%) had subarachnoid hemorrhage (SAH) and 31 (1%) had unclassifiable stroke. The overall unadjusted annual incidence for all cerebrovascular events was 187 per 100,000 [95% confidence interval (CI) 180-194; incidence for men: 202, 95% CI 189-210; incidence for women: 187, 95% CI 180-194]. The subtype of ischemic stroke could be determined in 1,779 patients and was classified as LAA in 624 (35%), CE in 352 (20%), SAO in 316 (18%), SIC in 56 (3

Investigation Into The Needs of Part 135 Operators to Access Airports Restricted Under FAR Part 135 Sections 135.213, 135.219 and/or 135.225

NASA Technical Reports Server (NTRS)

Eckert, Clifford A.; Stough, H. P. (Technical Monitor)

2002-01-01

NASA and the FAA have joint interests and responsibilities for developing guidelines and standards for cockpit displays of Flight Information Services (FIS) information and for developing enhancements to the planned FAA Data Link (FISDL) services. NASA and the FAA have established responsibilities in connection with development tasks for enhancements to the FISDL project. This report is the result of NASA Task 2, "Weather Support Concept- Part 135 Operations." The objective of the task was to determine the needs of Part 135 operators as they relate to FAA Part 135 Sections 135.213, 135.219 and 135.225, which pertain to weather reporting requirements at destination airports. This report discusses the results of two questionnaires completed by volunteer Part 135 operators that questioned their operations, their needs for flying to airports without weather reporting compatibilities, and suggestions for modifying FARs 135.213, 135.219 and 135.225. The operators pointed out airports in areas of the CONUS that were needed for IFR operations but lacked weather reporting capabilities and they offered practical suggestions for changes to the FARs. Related to operators's needs, and discussed in this report, were the Fractional Ownership NPRM and the possible impact of GPS WAAS and LAAS approaches.

Comparison of the Chinese ischemic stroke subclassification and Trial of Org 10172 in acute stroke treatment systems in minor stroke.

PubMed

Tan, Sha; Zhang, Lei; Chen, Xiaoyu; Wang, Yanqiang; Lin, Yinyao; Cai, Wei; Shan, Yilong; Qiu, Wei; Hu, Xueqiang; Lu, Zhengqi

2016-09-06

The underlying causes of minor stroke are difficult to assess. Here, we evaluate the reliability of the Chinese Ischemic Stroke Subclassification (CISS) system in patients with minor stroke, and compare it to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) system. A total of 320 patients with minor stroke were retrospectively registered and categorized into different subgroups of the CISS and TOAST by two neurologists. Inter- and intra-rater agreement with the two systems were assessed with kappa statistics. The percentage of undetermined etiology (UE) cases in the CISS system was 77.3 % less than that in the TOAST system, which was statistically significant (P < 0.001). The percentage of large artery atherosclerosis (LAA) in the CISS system was 79.7 % more than that in the TOAST system, which was also statistically significant (P < 0.001). The kappa values for inter-examiner agreement were 0.898 (P = 0.031) and 0.732 (P = 0.022) for the CISS and TOAST systems, respectively. The intra-observer reliability indexes were moderate (0.569 for neurologist A, and 0.487 for neurologist B). The CISS and TOAST systems are both reliable in classifying patients with minor stroke. CISS classified more patients into known etiologic categories without sacrificing reliability.

ABO blood groups: A risk factor for left atrial and left atrial appendage thrombogenic milieu in patients with non-valvular atrial fibrillation.

PubMed

Fu, Yuan; Li, Kuibao; Yang, Xinchun

2017-08-01

Previous studies have identified ABO blood groups as predictors of thromboembolic diseases. In patients with atrial fibrillation (AF), however, potential association between ABO blood groups and the risk of left atrial (LA) and/or left atrial appendage (LAA) thrombogenic milieu (TM) has not been established. This is a retrospective case-control study that included 125 consecutive patients with non-valvular atrial fibrillation (NVAF) plus TM, as evidenced by transesophageal echocardiography (TEE) during a period from1 January 2010 to 31 December 2016. The controls were selected randomly from 1072 NVAF without TM at a 1:2 ratio. Potential association between ABO blood groups and TM was analyzed using multivariate logistic regression analysis. The risk of TM was higher in patients with blood group A (33.6% vs. 20.2% in non-A blood groups, P=0.005). After adjusting for age, sex, oral anticoagulant use, AF type and duration, and relevant functional measures (e.g., NT-pro BNP level, left atrium diameter, and left ventricular ejection fraction), blood group A remained associated with an increased risk of TM (OR=2.99, 95% CI 1.4-6.388, P=0.005). Blood group A is an independent risk factor for TM in NVAF patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

Reduced Serum Level of Interleukin-10 is Associated with Cerebral Infarction: A Case-Control and Meta-Analysis Study.

PubMed

Zhu, Yifei; Yang, Haiqing; Diao, Zengyan; Li, Yi; Yan, Chuanzhu

2016-05-01

IL-10 expression limits inflammation and restricts the size of CNS damage from stroke. In this study, we examined the correlation between cerebral infarction (CI) and serum levels of interleukin-10 (IL-10) using a combination of case-control study and meta-analysis of published data, with an aim of understanding the relevance of serum IL-10 levels to CI development. This study enrolled a total of 169 CI patients admitted to the Second Hospital of Hebei Medical University between May 2011 and November 2014. During the same period, a group of 145 individuals were recruited at the same hospital as healthy controls after thorough physical examination. Serum IL-10 levels were measured by enzyme-linked immunosorbent assay (ELISA). SPSS 19.0 (IBM, 2010, Chicago, IL, USA) and Comprehensive Meta-Analysis 2.0 (CMA 2.0) software were used for data analysis. Serum levels of IL-10 (pg/mL) were significantly lower in CI patients when compared to healthy controls (15.36 ± 3.21 vs. 21.64 ± 5.17, t = 13.12, P < 0.001). In addition, patients with large artery atherosclerosis (LAAS), cardioembolic infarct (CEI), and lacunar infarct (LAC) displayed drastically reduced serum levels of IL-10 (pg/mL) compared to healthy controls (LAAS 14.77 ± 5.21, CEI 15.25 ± 5.10, LAC 16.58 ± 4.92, all P < 0.001). Interestingly, no significant differences were observed in the serum IL-10 levels when pair-wise comparisons were made between these three clinical subtypes of CI (all P > 0.05). Logistic regression analysis indicated that, with the exception of triglyceride (TG) and uric acid (UA) levels (both P > 0.05), the other seven parameters, including fasting blood glucose (FPG), total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), creatinine (Cr), systolic blood pressure (SBP), and diastolic blood pressure (DBP), strongly correlated with CI development (all P < 0.05). Meta-analysis of pooled data from nine case-control studies revealed an inverse correlation between

Intracardiac Echocardiography for Structural Heart and Electrophysiological Interventions.

PubMed

Basman, Craig; Parmar, Yuvrajsinh J; Kronzon, Itzhak

2017-09-06

With an increasing number of interventional procedures performed for structural heart disease and cardiac arrhythmias each year, echocardiographic guidance is necessary for safe and efficient results. The purpose of this review article is to overview the principles of intracardiac echocardiography (ICE) and describes the peri-interventional role of ICE in a variety of structural heart disease and electrophysiological interventions. Both transthoracic (TTE) and transesophageal echocardiography have limitations. ICE provides the advantage of imaging from within the heart, providing shorter image distances and higher resolution. ICE may be performed without sedation and avoids esophageal intubation as with transesophageal echocardiography (TEE). Limitations of ICE include the need for additional venous access with possibility of vascular complications, potentially higher costs, and a learning curve for new operators. Data supports the use of ICE in guiding device closure of interatrial shunts, transseptal puncture, and electrophysiologic procedures. This paper reviews the more recent reports that ICE may be used for primary guidance or as a supplement to TEE in patients undergoing left atrial appendage (LAA) closure, interatrial shunt closure, transaortic valve implantation (TAVI), percutaneous mitral valve repair (PMVR), paravalvular leak (PVL) closure, aortic interventions, transcatheter pulmonary valve replacement (tPVR), ventricular septal defect (VSD), and patent ductus arteriosus (PDA) closure. ICE imaging technology will continue to expand and help improve structural heart and electrophysiology interventions.

Microwave Conductivity of Laser Ablated YBa2Cu3O7-delta Superconducting Films and Its Relation to Microstrip Transmission Line Performance

NASA Technical Reports Server (NTRS)

Bhasin, K. B.; Warner, J. D.; Chorey, C. M.; Ebihara, B. T.; Romanofsky, R. R.; Heinen, V. O.

1990-01-01

We report on the values of the microwave conductivity in the normal (sigma(subN)) and superconducting (sigma*=sigma(sub1)-j sigma(sub2)) states of two laser ablated YBa2CU3O7(sigma) thin films at 35 GHz, in the temperature range from 20 to 300 K. The films 0.7 and 0.4 micrometers) were deposited on LaA10(sub3) by laser ablation. The conductivity was obtained from the microwave power transmitted through the films and assuming a two-fluid model. Values of sigma(subN) approximately 2.3 X 10(exp5) S/m at room temperature for both films, and of sigma(sub1) approximately 6.3 X 10(exp5) and 4.6 X 10(exp5) S/m at temperatures around 80 K were obtained for the 0.7 and 0.4 micrometer films respectively. For sigma(sub2) values of 4.9 X 10(exp6) and 5.4 X 10(exp6) S/m were obtained for the 0.7 and 0.4 micrometer films at 80 K. The expected conductor losses and Q-factor of a superconducting ring resonator were calculated using these conductivity values. The theoretical values were then compared with the experimental results obtained for a resonator fabricated from one of these films.

Mechanical Performance of Two Left Atrial Appendage Occlusion Systems: In Vitro Comparison of Tug Force, Radial Force, Sealing and Deformation.

PubMed

Menne, Matthias F; Schrickel, Jan W; Nickenig, Georg; Al-Kassou, Baravan; Nelles, Dominik; Schmitz-Rode, Thomas; Steinseifer, Ulrich; Sedaghat, Alexander

2018-05-24

The aim of this study was to establish in vitro bench-tests of left atrial appendage occlusion (LAAo) devices regarding tug force, radial force and sealing capacity. Two LAAo devices, namely the WATCHMAN™ and the Occlutech ® , of three different sizes underwent testing in novel dedicated in vitro setups. Radial force was assessed in a commercial radial force tester. At baseline, tug force of the WATCHMAN™ was significantly higher when compared to Occlutech ® for all devices. Repeated resheathing resulted in a reduction of device-diameter in the WATCHMAN™ devices of max. 7.9%, whereas diameters of Occlutech ® occluders remained unchanged. Tug force was not significantly impacted by resheathing in both devices. At baseline, sealing capacity in a bench-test using silicone LAA-models did not differ between the devices. Resheathing lead to an in vitro loss of sealing capacity of the WATCHMAN™ devices, increasing with resheathing and resulting in a max. peridevice leak of 91.1 ± 7.9%. Radial force was higher for the Occlutech ® devices and decreased for WATCHMAN™ occluders after resheathing. The WATCHMAN™ occluder series showed progressive deformation, increased peridevice leakage and decreased radial force after resheathing, presumably as a result of diameter reduction. Tug force of the WATCHMAN™ was not impaired by resheathing and was significantly higher than that of the Occlutech ® device.

Arterial stiffness and cardiac functions in patients with chronic venous disease.

PubMed

Ozpelit, E; Ozpelit, M E; Albayrak, G; Karabay, O; Nesli Sahin, B; Gonencer, J Z; Badak, O

2015-12-01

Although the venous system is in direct continuity with the heart and the arterial system, it is not known whether chronic venous disease (CVD) has any impact on either of these. The aims of this study were to investigate the global functions of the left and right heart, and also arterial stiffness parameters in patients with CVD. Forty-eight patients with primary stage C4-C6 CVD were enrolled into the study. The control group consisted of 39 age/sex and Body Mass Index matched healthy volunteers. All of the patients underwent detailed echocardiographic examination with further focus on Doppler and tissue Doppler (TD) parameters of the left and right ventricle. Arterial stiffness was evaluated via applanation tonometry in each patient. The left atrial area (LAA) and interventricular septum thickness were slightly increased in patients with CVD. Regarding Doppler and tissue Doppler measurements of the LV, all of the parameters were similar among the groups, while RV tissue Doppler systolic velocity and TAPSE were higher in patients with CVD. Among the arterial stiffness parameters, central aortic pressure, augmentation index, and pulse wave velocity were slightly higher in patients with CVD. The results of this study indicated that CVD may be associated with a subclinical disease state in the arterial system and also in the heart. Further studies are needed to confirm this association and to describe the possible mechanisms.

Current Developments on Optical Feedback Interferometry as an All-Optical Sensor for Biomedical Applications

PubMed Central

Perchoux, Julien; Quotb, Adam; Atashkhooei, Reza; Azcona, Francisco J.; Ramírez-Miquet, Evelio E.; Bernal, Olivier; Jha, Ajit; Luna-Arriaga, Antonio; Yanez, Carlos; Caum, Jesus; Bosch, Thierry; Royo, Santiago

2016-01-01

Optical feedback interferometry (OFI) sensors are experiencing a consistent increase in their applications to biosensing due to their contactless nature, low cost and compactness, features that fit very well with current biophotonics research and market trends. The present paper is a review of the work in progress at UPC-CD6 and LAAS-CNRS related to the application of OFI to different aspects of biosensing, both in vivo and ex vivo. This work is intended to present the variety of opportunities and potential applications related to OFI that are available in the field. The activities presented are divided into two main sensing strategies: The measurement of optical path changes and the monitoring of flows, which correspond to sensing strategies linked to the reconstruction of changes of amplitude from the interferometric signal, and to classical Doppler frequency measurements, respectively. For optical path change measurements, measurements of transient pulses, usual in biosensing, together with the measurement of large displacements applied to designing palliative care instrumentation for Parkinson disease are discussed. Regarding the Doppler-based approach, progress in flow-related signal processing and applications in real-time monitoring of non-steady flows, human blood flow monitoring and OFI pressure myograph sensing will be presented. In all cases, experimental setups are discussed and results presented, showing the versatility of the technique. The described applications show the wide capabilities in biosensing of the OFI sensor, showing it as an enabler of low-cost, all-optical, high accuracy biomedical applications. PMID:27187406

Current Developments on Optical Feedback Interferometry as an All-Optical Sensor for Biomedical Applications.

PubMed

Perchoux, Julien; Quotb, Adam; Atashkhooei, Reza; Azcona, Francisco J; Ramírez-Miquet, Evelio E; Bernal, Olivier; Jha, Ajit; Luna-Arriaga, Antonio; Yanez, Carlos; Caum, Jesus; Bosch, Thierry; Royo, Santiago

2016-05-13

Optical feedback interferometry (OFI) sensors are experiencing a consistent increase in their applications to biosensing due to their contactless nature, low cost and compactness, features that fit very well with current biophotonics research and market trends. The present paper is a review of the work in progress at UPC-CD6 and LAAS-CNRS related to the application of OFI to different aspects of biosensing, both in vivo and ex vivo. This work is intended to present the variety of opportunities and potential applications related to OFI that are available in the field. The activities presented are divided into two main sensing strategies: The measurement of optical path changes and the monitoring of flows, which correspond to sensing strategies linked to the reconstruction of changes of amplitude from the interferometric signal, and to classical Doppler frequency measurements, respectively. For optical path change measurements, measurements of transient pulses, usual in biosensing, together with the measurement of large displacements applied to designing palliative care instrumentation for Parkinson disease are discussed. Regarding the Doppler-based approach, progress in flow-related signal processing and applications in real-time monitoring of non-steady flows, human blood flow monitoring and OFI pressure myograph sensing will be presented. In all cases, experimental setups are discussed and results presented, showing the versatility of the technique. The described applications show the wide capabilities in biosensing of the OFI sensor, showing it as an enabler of low-cost, all-optical, high accuracy biomedical applications.

Ab initio and DFT study of hydrogen bond interactions between ascorbic acid and dimethylsulfoxide based on FT-IR and FT-Raman spectra

NASA Astrophysics Data System (ADS)

Niazazari, Naser; Zatikyan, Ashkhen L.; Markarian, Shiraz A.

2013-06-01

The hydrogen bonding of 1:1 complexes formed between L-ascorbic acid (LAA) and dimethylsulfoxide (DMSO) has been studied by means of ab initio and density functional theory (DFT) calculations. Solutions of L-ascorbic acid (AA) in dimethylsulfoxide (DMSO) have been studied by means of both FT-IR (4000-220 cm-1) and FT-Raman spectroscopy. Ab initio Hartree-Fock (HF) and DFT methods have been used to determine the structure and energies of stable conformers of various types of L-AA/DMSO complexes in gas phase and solution. The basis sets 6-31++G∗∗ and 6-311+G∗ were used to describe the structure, energy, charges and vibrational frequencies of interacting complexes in the gas phase. The optimized geometric parameters and interaction energies for various complexes at different theories have been estimated. Binding energies have been corrected for basis set superposition error (BSSE) and harmonic vibrational frequencies of the structures have been calculated to obtain the stable forms of the complexes. The self-consistent reaction field (SCRF) has been used to calculate the effect of DMSO as the solvent on the geometry, energy and charges of complexes. The solvent effect has been studied using the Onsager models. It is shown that the polarity of the solvent plays an important role on the structures and relative stabilities of different complexes. The results obtained show that there is a satisfactory correlation between experimental and theoretical predictions.

Incidence of non-pulmonary cancer and lung cancer by amount of emphysema and airway wall thickness: a community-based cohort.

PubMed

Aamli Gagnat, Ane; Gjerdevik, Miriam; Gallefoss, Frode; Coxson, Harvey O; Gulsvik, Amund; Bakke, Per

2017-05-01

There is limited knowledge about the prognostic value of quantitative computed tomography (CT) measures of emphysema and airway wall thickness in cancer.The aim of this study was to investigate if using CT to quantitatively assess the amount of emphysema and airway wall thickness independently predicts the subsequent incidence of non-pulmonary cancer and lung cancer.In the GenKOLS study of 2003-2005, 947 ever-smokers performed spirometry and underwent CT examination. The main predictors were the amount of emphysema measured by the percentage of low attenuation areas (%LAA) on CT and standardised measures of airway wall thickness (AWT-PI10). Cancer data from 2003-2013 were obtained from the Norwegian Cancer Register. The hazard ratio associated with emphysema and airway wall thickness was assessed using Cox proportional hazards regression for cancer diagnoses.During 10 years of follow-up, non-pulmonary cancer was diagnosed in 11% of the subjects with LAA <3%, in 19% of subjects with LAA 3-10%, and in 17% of subjects with LAA ≥10%. Corresponding numbers for lung cancer were 2%, 3% and 11%, respectively. After adjustment, the baseline amount of emphysema remained a significant predictor of the incidence of non-pulmonary cancer and lung cancer. Airway wall thickness did not predict cancer independently.This study offers a strong argument that emphysema is an independent risk factor for both non-pulmonary cancer and lung cancer. Copyright ©ERS 2017.

VHDL-AMS modelling and simulation of a planar electrostatic micromotor

NASA Astrophysics Data System (ADS)

Endemaño, A.; Fourniols, J. Y.; Camon, H.; Marchese, A.; Muratet, S.; Bony, F.; Dunnigan, M.; Desmulliez, M. P. Y.; Overton, G.

2003-09-01

System level simulation results of a planar electrostatic micromotor, based on analytical models of the static and dynamic torque behaviours, are presented. A planar variable capacitance (VC) electrostatic micromotor designed, fabricated and tested at LAAS (Toulouse) in 1995 is simulated using the high level language VHDL-AMS (VHSIC (very high speed integrated circuits) hardware description language-analog mixed signal). The analytical torque model is obtained by first calculating the overlaps and capacitances between different electrodes based on a conformal mapping transformation. Capacitance values in the order of 10-16 F and torque values in the order of 10-11 N m have been calculated in agreement with previous measurements and simulations from this type of motor. A dynamic model has been developed for the motor by calculating the inertia coefficient and estimating the friction-coefficient-based values calculated previously for other similar devices. Starting voltage results obtained from experimental measurement are in good agreement with our proposed simulation model. Simulation results of starting voltage values, step response, switching response and continuous operation of the micromotor, based on the dynamic model of the torque, are also presented. Four VHDL-AMS blocks were created, validated and simulated for power supply, excitation control, micromotor torque creation and micromotor dynamics. These blocks can be considered as the initial phase towards the creation of intellectual property (IP) blocks for microsystems in general and electrostatic micromotors in particular.

Discovery and Biochemical Characterization of PlyP56, PlyN74, and PlyTB40—Bacillus Specific Endolysins

PubMed Central

Etobayeva, Irina; Linden, Sara B.; Alem, Farhang; Rizkalla, Lucas; Temple, Louise; Hakami, Ramin M.

2018-01-01

Three Bacillus bacteriophage-derived endolysins, designated PlyP56, PlyN74, and PlyTB40, were identified, cloned, purified, and characterized for their antimicrobial properties. Sequence alignment reveals these endolysins have an N-terminal enzymatically active domain (EAD) linked to a C-terminal cell wall binding domain (CBD). PlyP56 has a Peptidase_M15_4/VanY superfamily EAD with a conserved metal binding motif and displays biological dependence on divalent ions for activity. In contrast, PlyN74 and PlyTB40 have T7 lysozyme-type Amidase_2 and carboxypeptidase T-type Amidase_3 EADs, respectively, which are members of the MurNAc-LAA superfamily, but are not homologs and thus do not have a shared protein fold. All three endolysins contain similar SH3-family CBDs. Although minor host range differences were noted, all three endolysins show relatively broad antimicrobial activity against members of the Bacillus cereus sensu lato group with the highest lytic activity against B. cereus ATCC 4342. Characterization studies determined the optimal lytic activity for these enzymes was at physiological pH (pH 7.0–8.0), over a broad temperature range (4–55 °C), and at low concentrations of NaCl (<50 mM). Direct comparison of lytic activity shows the PlyP56 enzyme to be twice as effective at lysing the cell wall peptidoglycan as PlyN74 or PlyTB40, suggesting PlyP56 is a good candidate for further antimicrobial development as well as bioengineering studies. PMID:29883383

Impact of emphysema and airway wall thickness on quality of life in smoking-related COPD.

PubMed

Gietema, Hester A; Edwards, Lisa D; Coxson, Harvey O; Bakke, Per S

2013-08-01

Limited data are available as to the relationship between computed tomography (CT) derived data on emphysema and airway wall thickness, and quality of life in subjects with chronic obstructive pulmonary disease (COPD). Such data may work to clarify the clinical correlate of the CT findings. We included 1778 COPD subjects aged 40-75 years with a smoking history of at least 10 pack-years. They were examined with St George's Respiratory Questionnaire (SGRQ-C) and high-resolution chest CT. Level of emphysema was assessed as percent low-attenuation areas less than -950 Hounsfield units (%LAA). Airway wall thickness was estimated by calculating the square root of wall area of an imaginary airway with an internal perimeter of 10 mm (Pi10). In both men and women, the mean total score and most of the subscores of SGRQ-C increased with increasing level of emphysema and increasing level of airway wall thickness, after adjusting for age, smoking status, pack years, body mass index and FEV1. The highest gradient was seen in the relationship between the activity score and the emphysema level. The activity score increased by 35% from the lowest to the highest emphysema tertile. The relationship between level of emphysema and the total SGRQ-C score became weaker with increasing GOLD (Global initiative for Chronic Obstructive Lung Disease) stages (p < 0.001), while the impact of gender was limited. In subjects with COPD, increasing levels of emphysema and airway wall thickness are independently related to impaired quality of life. Copyright © 2013 Elsevier Ltd. All rights reserved.

High Resolution Rotational Spectroscopy of Hcssh: a CS_{2} Proxy in the ISM

NASA Astrophysics Data System (ADS)

Prudenzano, Domenico; Laas, Jacob; Palumbo, Maria Elisabetta; Caselli, Paola

2017-06-01

In the last few decades sulfur bearing molecules have become a relevant topic in astrochemistry. The observed overall abundances of these compounds in the dense gas and around young stellar objects is indeed not in agreement with the estimated cosmic abundance of sulfur (Tieftrunk et al. 1994; Palumbo et al. 1997). Many studies point to polysulphanes and sulphur polymers, mainly S_{8}, as possible sulfur reservoirs, which from solid phase might be released into gas phase as simpler sulfur compounds, e.g. in shocked or hot environments (Wakelam et al. 2004; Laas, in prep.). Laboratory studies on dust and ice analogues indicate CS_{2} as a potential decomposition product of the sulfur residue (Jiménez-Escobar et al. 2014 and references therein). Nevertheless, this species is not detectable by radio-telescopes due to lack of permanent dipole moment. Dithioformic acid (HCSSH), a possible byproduct of interstellar CS_{2}, may thus serve as a proxy for this non-polar S-bearing molecule. Millimeter and sub-millimeter spectra have been recorded and analyzed for the trans and cis conformers of HCSSH, up to 478 GHz. We employed the frequency modulation sub-millimeter absorption spectrometer recently developed at the Center for Astrochemical Studies (CAS) in Garching. HCSSH was produced by a glow discharge mixture of CS_{2} and H_{2} diluted in Ar. Accurate rest frequencies, which might serve as guidance for astronomical searches have been obtained thanks to our recent experiment. In particular trans-HCSSH, the lowest-energy conformer, is the best candidate for a potential detection.

Characteristics of Left Atrial Deformation Parameters and Their Prognostic Impact in Patients with Pathological Left Ventricular Hypertrophy: Analysis by Speckle Tracking Echocardiography.

PubMed

Iio, Chiharuko; Inoue, Katsuji; Nishimura, Kazuhisa; Fujii, Akira; Nagai, Takayuki; Suzuki, Jun; Okura, Takafumi; Higaki, Jitsuo; Ogimoto, Akiyoshi

2015-12-01

The pathological process of left ventricular (LV) hypertrophy is associated with left atrial (LA) remodeling. This study was aimed to evaluate the prognostic value of LA strain parameters in patients with pathological LV hypertrophy. This study included 95 patients with hypertensive heart disease (HHD: n = 24), hypertrophic cardiomyopathy (HCM: n = 56), cardiac amyloidosis (CA: n = 15), and control subjects (n = 20). We used two-dimensional speckle tracking echocardiography (STE) to analyze LA global strain. LA electromechanical conduction time (EMT) at the septal (EMT-septal) and lateral wall (EMT-lateral), and their time difference (EMT-diff) were calculated. The incidence of cardiac death and heart failure hospitalization was defined as major cardiac events and that of atrial fibrillation as secondary outcome. Left atrial volume index was increased and LA booster strain was decreased in the HCM and CA groups compared with the HHD group. EMT-lateral was increased in the diseased groups compared with the control. EMT-diff was prolonged in the CA group compared with the HCM group. During the follow-up period (mean 3.4 years), major cardiac events and atrial fibrillation occurred in 17 and 13 patients, respectively. The occurrence of atrial fibrillation was associated with CA etiology, E/e', LA volume index, LAa, and EMT-lateral. The incidence of major cardiac events was independently correlated with LA volume index and EMT-diff in multivariate analysis. This study suggested that the EMT-diff could discriminate patients with a high risk of cardiac events among patients with pathological LV hypertrophy. © 2015, Wiley Periodicals, Inc.

Short communication: milk protein genetic variation and casein haplotype structure in the Original Pinzgauer cattle.

PubMed

Caroli, A; Rizzi, R; Lühken, G; Erhardt, G

2010-03-01

Milk protein genetic polymorphisms are often used for characterizing domesticated mammalian species and breeds, and for studying associations with economic traits. The aim of this work was to analyze milk protein genetic variation in the Original Pinzgauer, a dual-purpose (dairy and beef) cattle breed of European origin that was influenced in the past by human movements from different regions as well as by crossbreeding with Red Holstein. A total of 485 milk samples from Original Pinzgauer from Austria (n=275) and Germany (n=210) were typed at milk proteins alpha(S1)-casein, beta-casein, kappa-casein, alpha-lactalbumin, and beta-lactoglobulin by isoelectrofocusing to analyze the genetic variation affecting the protein amino acid charge. The Original Pinzgauer breed is characterized by a rather high genetic variation affecting the amino acid charge of milk proteins, with a total of 15 alleles, 12 of which were found at a frequency >0.05. The most polymorphic protein was beta-casein with 4 alleles detected. The prevalent alleles were CSN1S1*B, CSN2*A(2), CSN1S2*A, CSN3*A, LGB*A, and LAA*B. A relatively high frequency of CSN1S2*B (0.202 in the whole data set) was found, mainly occurring within the C-A(2)-B-A haplotype (in the order CSN1S1-CSN2-CSN1S2-CSN3), which seems to be peculiar to the Original Pinzgauer, possibly because the survival of an ancestral haplotype or the introgression of Bos indicus.

Incidence of seizures following initial ischemic stroke in a community-based cohort: The Framingham Heart Study.

PubMed

Stefanidou, Maria; Das, Rohit R; Beiser, Alexa S; Sundar, Banu; Kelly-Hayes, Margaret; Kase, Carlos S; Devinsky, Orrin; Seshadri, Sudha; Friedman, Daniel

2017-04-01

We examined the incidence of seizures following ischemic stroke in a community-based sample. All subjects with incident ischemic strokes in the Framingham Original and Offspring cohorts between 1982 and 2003 were identified and followed for up to 20 years to determine incidence of seizures. Seizure-type was based on the 2010 International League Against Epilepsy (ILAE) classification. Disability was stratified into mild/none, moderate and severe, based on post-stroke neurological deficit documentation according to the Framingham Heart Study (FHS) protocol and functional status was determined using the Barthel Index. An initial ischemic stroke occurred in 469 subjects in the cohort and seizures occurred in 25 (5.3%) of these subjects. Seizure incidence was similar in both large artery atherosclerosis (LAA) (6.8%) and cardio-embolic (CE) (6.2%) strokes. No seizures occurred following lacunar strokes. The predominant seizure type was focal seizure with or without evolution to bilateral convulsive seizure. One third of participants had seizures within the first 24h from stroke onset and half of all seizures occurred within the first 30days. On multivariate analysis, moderate and severe disability following stroke was associated with increased risk of incident seizure. Seizures occurred in approximately 5% of subjects after an ischemic stroke. One third of these seizures occurred in the first 24h after stroke and none followed lacunar strokes. Focal seizures with or without evolution in bilateral convulsive seizures were the most common seizure type. Moderate and severe disability was predictive of incident seizures. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

A composite material based on nanoparticles of yttrium (III) oxide for the selective and sensitive electrochemical determination of acetaminophen.

PubMed

Baytak, Aysegul Kutluay; Teker, Tugce; Duzmen, Sehriban; Aslanoglu, Mehmet

2016-09-01

An electrochemical sensor was prepared by modifying a glassy carbon electrode (GCE) with a composite of yttrium (III) oxide nanoparticles (Y2O3NPs) and carbon nanotubes (CNTs) for the determination of acetaminophen (ACT). Compared with a bare GCE and CNTs/GCE, the Y2O3NPs/CNTs/GCE exhibited a well-defined redox couple for ACT and highly enhanced the current response. The separations in the anodic and cathodic peak potentials (ΔEp) for ACT were 552mV, 24mV and 10mV at ba4re GCE, CNTs/GCE and Y2O3NPs/CNTs/GCE, respectively. The observation of only 10mV of ΔEp for ACT at Y2O3NPs/CNTs/GCE was a clear indication of a great acceleration of the electrode process compared to bare GCE and GCE modified with CNTs. Also, l-ascorbic acid (l-AA) and l-tyrosine (l-TRY) did not interfere with the selective determination of ACT. Square wave voltammetry (SWV) was performed for the quantification of ACT. A linear plot was obtained for current responses versus the concentrations of ACT over the range from 1.0×10(-10) to 1.8×10(-8)M with a detection limit of 3.0×10(-11)M (based on 3Sb/m). The proposed composite material provided high electrocatalytic activity, improved voltammetric behavior, good selectivity and good reproducibility. The accurate quantification of ACT makes the proposed electrode of great interest for the public health. Copyright © 2016 Elsevier B.V. All rights reserved.

Production of volatiles in fresh-cut apple: effect of applying alginate coatings containing linoleic acid or isoleucine.

PubMed

Maya-Meraz, Irma O; Espino-Díaz, Miguel; Molina-Corral, Francisco J; González-Aguilar, Gustavo A; Jacobo-Cuellar, Juan L; Sepulveda, David R; Olivas, Guadalupe I

2014-11-01

One of the main quality parameters in apples is aroma, its main precursors are fatty acids (FA) and amino acids (AA). In this study, alginate edible coatings were used as carriers of linoleic acid or isoleucine to serve as precursors for the production of aroma in cut apples. Apple wedges were immersed in a CaCl2 solution and coated with one of the following formulations: alginate solution (Alg-Ca), Alg-Ca-low-level linoleic acid (0.61 g/Lt), (LFA), Alg-Ca-high-level linoleic acid (2.44 g/L; HFA), Alg-Ca-low-level isoleucine (0.61 g/L; LAA), and Alg-Ca-high-level isoleucine (2.44 g/L; HAA). Apple wedges were stored at 3 °C and 85% relative humidity for 21 d and key volatiles were studied during storage. Addition of precursors, mainly isoleucine, showed to increase the production of some key volatiles on coated fresh-cut apples during storage. The concentration of 2-methyl-1-butanol was 4 times higher from day 12 to day 21 in HAA, while 2-methyl butyl acetate increased from day 12 to day 21 in HAA. After 21 d, HAA-apples presented a 40-fold value of 2-methyl-butyl acetate, compared to Alg-Ca cut apples. Values of hexanal increased during cut apple storage when the coating carried linoleic acid, mainly on HFA, from 3 to 12 d. The ability of apples to metabolize AA and FA depends on the concentration of precursors, but also depends on key enzymes, previous apple storage, among others. Further studies should be done to better clarify the behavior of fresh-cut apples as living tissue to metabolize precursors contained in edible coatings for the production of volatiles. © 2014 Institute of Food Technologists®

Stereoconversion of amino acids and peptides in uryl-pendant binol schiff bases.

PubMed

Park, Hyunjung; Nandhakumar, Raju; Hong, Jooyeon; Ham, Sihyun; Chin, Jik; Kim, Kwan Mook

2008-01-01

(S)-2-Hydroxy-2'-(3-phenyluryl-benzyl)-1,1'-binaphthyl-3-carboxaldehyde (1) forms Schiff bases with a wide range of nonderivatized amino acids, including unnatural ones. Multiple hydrogen bonds, including resonance-assisted ones, fix the whole orientation of the imine and provoke structural rigidity around the imine C==N bond. Due to the structural difference and the increase in acidity of the alpha proton of the amino acid, the imine formed with an L-amino acid (1-l-aa) is converted into the imine of the D-amino acid (1-D-aa), with a D/L ratio of more than 10 for most amino acids at equilibrium. N-terminal amino acids in dipeptides are also predominantly epimerized to the D form upon imine formation with 1. Density functional theory calculations show that 1-D-Ala is more stable than 1-L-Ala by 1.64 kcal mol(-1), a value that is in qualitative agreement with the experimental result. Deuterium exchange of the alpha proton of alanine in the imine form was studied by (1)H NMR spectroscopy and the results support a stepwise mechanism in the L-into-D conversion rather than a concerted one; that is, deprotonation and protonation take place in a sequential manner. The deprotonation rate of L-Ala is approximately 16 times faster than that of D-Ala. The protonation step, however, appears to favor L-amino acid production, which prevents a much higher predominance of the D form in the imine. Receptor 1 and the predominantly D-form amino acid can be recovered from the imine by simple extraction under acidic conditions. Hence, 1 is a useful auxiliary to produce D-amino acids of industrial interest by the conversion of naturally occurring L-amino acids or relatively easily obtainable racemic amino acids.

Enhanced perfusion defect clarity and inhomogeneity in smokers' lungs with deep-inspiratory breath-hold perfusion SPECT images.

PubMed

Suga, Kazuyoshi; Yasuhiko, Kawakami; Iwanaga, Hideyuki; Hayashi, Norio; Yamashita, Tomio; Matsunaga, Naofumi

2005-09-01

Deep-inspiratory breath-hold (DIBrH) Tc-99m-macroaggregated albumin (MAA) SPECT images were developed to accurately evaluate perfusion impairment in smokers' lungs. DIBrH SPECT was performed in 28 smokers with or without low attenuation areas (LAA) on CT images, using a triple-headed SPECT system and a laser light respiratory tracking device. DIBrH SPECT images were reconstructed from every 4 degrees projection of five adequate 360 degrees projection data sets with almost the same respiratory dimension at 20 sec DIBrH. Perfusion defect clarity was assessed by the lesion (defect)-to-contralateral normal lung count ratios (L/N ratios). Perfusion inhomogeneity was assessed by the coefficient of variation (CV) values of pixel counts and correlated with the diffusing capacity of the lungs for carbon monoxide/alveolar volume (DLCO/VA) ratios. The results were compared with those on conventional images. Five DIBrH projection data sets with minimal dimension differences of 2.9+/-0.6 mm were obtained in all subjects. DIBrH images enhanced perfusion defects compared with conventional images, with significantly higher L/N ratios (P<0.0001), and detected a total of 109 (26.9%) additional detects (513 vs. 404), with excellent inter-observer agreement (kappa value of 0.816). CV values in the smokers' lungs on DIBrH images were also significantly higher compared with those on conventional images (0.31+/-0.10 vs. 0.19+/-0.06, P<0.0001). CV values in smokers on DIBrH images showed a significantly closer correlation with DLCO/VA ratios compared with conventional images (R = 0.872, P<0.0001 vs. R=0.499, P<0.01). By reducing adverse effect of respiratory motion, DIBrH SPECT images enhance perfusion defect clarity and inhomogeneity, and provide more accurate assessment of impaired perfusion in smokers' lungs compared with conventional images.

Early High-dosage Atorvastatin Treatment Improved Serum Immune-inflammatory Markers and Functional Outcome in Acute Ischemic Strokes Classified as Large Artery Atherosclerotic Stroke

PubMed Central

Tuttolomondo, Antonino; Di Raimondo, Domenico; Pecoraro, Rosaria; Maida, Carlo; Arnao, Valentina; Corte, Vittoriano Della; Simonetta, Irene; Corpora, Francesca; Di Bona, Danilo; Maugeri, Rosario; Iacopino, Domenico Gerardo; Pinto, Antonio

2016-01-01

Abstract Statins have beneficial effects on cerebral circulation and brain parenchyma during ischemic stroke and reperfusion. The primary hypothesis of this randomized parallel trial was that treatment with 80 mg/day of atorvastatin administered early at admission after acute atherosclerotic ischemic stroke could reduce serum levels of markers of immune-inflammatory activation of the acute phase and that this immune-inflammatory modulation could have a possible effect on prognosis of ischemic stroke evaluated by some outcome indicators. We enrolled 42 patients with acute ischemic stroke classified as large arteries atherosclerosis stroke (LAAS) randomly assigned in a randomized parallel trial to the following groups: Group A, 22 patients treated with atorvastatin 80 mg (once-daily) from admission day until discharge; Group B, 20 patients not treated with atorvastatin 80 mg until discharge, and after discharge, treatment with atorvastatin has been started. At 72 hours and at 7 days after acute ischemic stroke, subjects of group A showed significantly lower plasma levels of tumor necrosis factor-α, interleukin (IL)-6, vascular cell adhesion molecule-1, whereas no significant difference with regard to plasma levels of IL-10, E-Selectin, and P-Selectin was observed between the 2 groups. At 72 hours and 7 days after admission, stroke patients treated with atorvastatin 80 mg in comparison with stroke subjects not treated with atorvastatin showed a significantly lower mean National Institutes of Health Stroke Scale and modified Rankin scores. Our findings provide the first evidence that atorvastatin acutely administered immediately after an atherosclerotic ischemic stroke exerts a lowering effect on immune-inflammatory activation of the acute phase of stroke and that its early use is associated to a better functional and prognostic profile. PMID:27043681

Characterization of Na+ and Ca2+ Channels in Zebrafish Dorsal Root Ganglion Neurons

PubMed Central

Won, Yu-Jin; Ono, Fumihito; Ikeda, Stephen R.

2012-01-01

Background Dorsal root ganglia (DRG) somata from rodents have provided an excellent model system to study ion channel properties and modulation using electrophysiological investigation. As in other vertebrates, zebrafish (Danio rerio) DRG are organized segmentally and possess peripheral axons that bifurcate into each body segment. However, the electrical properties of zebrafish DRG sensory neurons, as compared with their mammalian counterparts, are relatively unexplored because a preparation suitable for electrophysiological studies has not been available. Methodology/Principal Findings We show enzymatically dissociated DRG neurons from juvenile zebrafish expressing Isl2b-promoter driven EGFP were easily identified with fluorescence microscopy and amenable to conventional whole-cell patch-clamp studies. Two kinetically distinct TTX-sensitive Na+ currents (rapidly- and slowly-inactivating) were discovered. Rapidly-inactivating INa were preferentially expressed in relatively large neurons, while slowly-inactivating INa was more prevalent in smaller DRG neurons. RT-PCR analysis suggests zscn1aa/ab, zscn8aa/ab, zscn4ab and zscn5Laa are possible candidates for these INa components. Voltage-gated Ca2+ currents (ICa) were primarily (87%) comprised of a high-voltage activated component arising from ω-conotoxin GVIA-sensitive CaV2.2 (N-type) Ca2+ channels. A few DRG neurons (8%) displayed a miniscule low-voltage-activated component. ICa in zebrafish DRG neurons were modulated by neurotransmitters via either voltage-dependent or -independent G-protein signaling pathway with large cell-to-cell response variability. Conclusions/Significance Our present results indicate that, as in higher vertebrates, zebrafish DRG neurons are heterogeneous being composed of functionally distinct subpopulations that may correlate with different sensory modalities. These findings provide the first comparison of zebrafish and rodent DRG neuron electrical properties and thus provide a basis for

Incidence of pericardial effusion after left atrial appendage closure: The impact of underlying heart rhythm. data from the EWOLUTION study.

PubMed

Schmidt, Boris; Betts, Timothy R; Sievert, Horst; Bergmann, Martin W; Kische, Stephan; Pokushalov, Evgeny; Schmitz, Thomas; Meincke, Felix; Mazzone, Patrizio; Stein, Kenneth M; Ince, Hüseyin; Boersma, Lucas V A

2018-05-03

Pericardial effusion/tamponade (PE/PT) is a rare but serious complication following left atrial appendage closure (LAAC). It may be speculated that LAA contraction during sinus rhythm (SR) exerts mechanical force on the device that eventually leads to PE. We sought to determine the incidence and predictors of PE following LAAC using Watchman with special emphasis on the underlying heart rhythm during implant. From 47 centers in 13 European countries 1020 patients underwent LAAC and data on baseline rhythm were available from 1010 patients (mean age 73 ± 9 years, 60% male, median CHA2DS2-VASc = 4). Data were collected via electronic case report forms. A Cox-proportional hazard model was calculated adjusting for multiple variables: age, gender, number of recaptures and device oversizing. During implant, 41% and 59% of patients were in SR and atrial fibrillation (AF), respectively. PE/PT rate was significantly lower in patients implanted during AF at day 30 post implant (n = 1; 0.2% versus n = 6; 1.5%; p = 0.02). No PE requiring intervention occurred in the AF group compared to 5 events (1.2%) in the SR group (p = 0.01). While univariate analysis identified SR and gender as predictors for PE/tamponade, multivariate analysis only showed a statistical trend for both variables. The overall incidence of PE/PT was very low after LAAC using Watchman. Although SR was not identified as an independent predictor of PE/PT, all events requiring intervention occurred in patients with SR. It may be advisable to perform an extended echocardiographic follow-up in that patient population. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Early High-dosage Atorvastatin Treatment Improved Serum Immune-inflammatory Markers and Functional Outcome in Acute Ischemic Strokes Classified as Large Artery Atherosclerotic Stroke: A Randomized Trial.

PubMed

Tuttolomondo, Antonino; Di Raimondo, Domenico; Pecoraro, Rosaria; Maida, Carlo; Arnao, Valentina; Della Corte, Vittoriano; Simonetta, Irene; Corpora, Francesca; Di Bona, Danilo; Maugeri, Rosario; Iacopino, Domenico Gerardo; Pinto, Antonio

2016-03-01

Statins have beneficial effects on cerebral circulation and brain parenchyma during ischemic stroke and reperfusion. The primary hypothesis of this randomized parallel trial was that treatment with 80 mg/day of atorvastatin administered early at admission after acute atherosclerotic ischemic stroke could reduce serum levels of markers of immune-inflammatory activation of the acute phase and that this immune-inflammatory modulation could have a possible effect on prognosis of ischemic stroke evaluated by some outcome indicators. We enrolled 42 patients with acute ischemic stroke classified as large arteries atherosclerosis stroke (LAAS) randomly assigned in a randomized parallel trial to the following groups: Group A, 22 patients treated with atorvastatin 80 mg (once-daily) from admission day until discharge; Group B, 20 patients not treated with atorvastatin 80 mg until discharge, and after discharge, treatment with atorvastatin has been started. At 72 hours and at 7 days after acute ischemic stroke, subjects of group A showed significantly lower plasma levels of tumor necrosis factor-α, interleukin (IL)-6, vascular cell adhesion molecule-1, whereas no significant difference with regard to plasma levels of IL-10, E-Selectin, and P-Selectin was observed between the 2 groups. At 72 hours and 7 days after admission, stroke patients treated with atorvastatin 80 mg in comparison with stroke subjects not treated with atorvastatin showed a significantly lower mean National Institutes of Health Stroke Scale and modified Rankin scores. Our findings provide the first evidence that atorvastatin acutely administered immediately after an atherosclerotic ischemic stroke exerts a lowering effect on immune-inflammatory activation of the acute phase of stroke and that its early use is associated to a better functional and prognostic profile.

Morphological control of La0.7Sr0.3Co0.2Fe0.8O3-δ and La0.7Sr0.3MnO3-δ catalytic membrane using PEG-H2O additive

NASA Astrophysics Data System (ADS)

Iqbal, R. M.; Nurherdiana, S. D.; Hartanto, D.; Othman, M. H. D.; Fansuri, H.

2018-04-01

Methane is the primary combustible component in non condensable part of natural gas. It is a promising source for syngas (CO and H2) production by partial oxidation method. The conversion of methane to syngas by partial oxidation method needs a controlled amount of oxygen. Membrane which has asymmetric structure and selectively permeates oxygen can be used to supply just enough oxygen to the reaction. One pathway to the fabricate asymmetric membrane is phase inversion method with an addition of PEG to increase pore size. La0.7Sr0.3Co0.2Fe0.8O3-δ (LSCF 7328) and Laa0.7Sr0.3MnO3-δ (LSM 73) powder were synthesized by solid-state method and they were characterized by XRD. The green membrane was prepared by phase inversion method. A dope solution was made by mixing LSCF 7328 or LSM 73 powder with PEG and stirred them in NMP for 24 h. PESf was then added into the dope solution and the stirring was continued to another 24 h. The resulted dope solution was degassed by immersing the solution inside and conical flask in an ultrasonic bath to remove air bubbles. The degassed mixture was then casted by spreading it on a glass surface (with a thickness of 2 mm) followed by immersion in a water bath for 24 h to coagulate the degassed mixture. Membrane morphology was characterized by Scanning Electron Microscopy (SEM) while the decomposition temperature of the polymer binder was analyzed by Thermogravimetric Analyzer (TGA). The XRD results show that phase of LSCF 7328 and LSM 73 are similar to LaCoO3 and LaMnO3, respectively. It indicated that the perovskite synthesis was successful. SEM micrograph of membrane cross sections show that the green membrane have finger like pores and a dense layer. Pores also appear on top and bottom surface of the membrane. Based on TGA results, the highest weight lost of green membrane at 550-600°C which represents the decomposition of PESf binder.

Usefulness of the desaturation–distance ratio from the six-minute walk test for patients with COPD

PubMed Central

Fujimoto, Yukari; Oki, Yutaro; Kaneko, Masahiro; Sakai, Hideki; Misu, Shogo; Yamaguchi, Takumi; Mitani, Yuji; Yasuda, Hisafumi; Ishikawa, Akira

2017-01-01

Purpose A straightforward, noninvasive method is needed to assess emphysema and pulmonary hypertension (PH) in COPD patients. The desaturation–distance ratio (DDR) is an index derived from the distance traveled and level of desaturation during a six-minute walk test (6MWT); it has previously been shown to be associated with percentage of forced expiratory volume in the first second of expiration (%FEV1.0) and percentage of diffusion capacity of the lung for carbon monoxide (%DLCO). The aim of this study was to examine the associations between DDR and emphysema and PH. Patients and methods We collected the following data for 74 stable COPD outpatients: lung function tests (%FEV1.0 and %DLCO), 6MWT distance and desaturation, and area of emphysema on computed tomography (percentage of low attenuation area). Enlargement of the pulmonary artery (PA) was assessed by the ratio of the diameter of the PA to that of the aorta (PA:A ratio) as an index of PH. DDR was calculated by the distance traveled and the degree of desaturation reached during a 6MWT. The relationships between study outcomes were assessed with Spearman’s rank-correlation analysis. Receiver operating characteristic (ROC) curves were used to determine the threshold values with the optimum cutoff points for predicting severe or very severe airway obstruction, pulmonary diffusing capacity disorder, moderate or severe emphysema, and enlargement of the PA. Results DDR correlated significantly with %FEV1.0, %DLCO, %LAA, and PA:A ratio. DDR showed high accuracy (area under the ROC curve >0.7) for predicting severe or very severe airway obstruction, pulmonary diffusing capacity disorder, moderate or severe emphysema, and enlargement of the PA. Conclusion The results suggest that DDR is a good index of emphysema and PH in COPD patients. The 6MWT is widely used to assess COPD, and DDR could help with the early diagnosis of COPD. PMID:28919734

Comparative effects of amlodipine and benazepril on left atrial pressure in dogs with experimentally-induced mitral valve regurgitation.

PubMed

Suzuki, Shuji; Fukushima, Ryuji; Ishikawa, Taisuke; Yamamoto, Yuta; Hamabe, Lina; Kim, Soomin; Yoshiyuki, Rieko; Machida, Noboru; Tanaka, Ryou

2012-09-18

One of the purposes of treatment for dogs with mitral regurgitation (MR) is lowering left atrial pressure (LAP). There has been few study of the amlodipine in dogs with MR and amlodipine's effect on LAP has not been fully evaluated in a quantitative manner because of difficulties in directly measuring LAP. The objective of our study was to compare the short-term effects of amlodipine (0.2 mg/kg PO q12h) vs benazepril (0.5 mg/kg PO q12h), on LAP and echocardiographic parameters in five beagle dogs with experimentally-induced MR. LAP of eight dogs that has own control were measured using radiotelemetry system at baseline and again on days 1, 2, 3, 4, 5, 6, 7 of the drug administration. Mean LAP decreased significantly after amlodipine (11.20 ± 4.19 mmHg vs 14.61 ± 3.81 mmHg at baseline, p < .01) but not after benazepril treatment (13.19 ± 3.47 mmHg, p > .05). LAP was lower after 7 days of amlodipine treatment than after 7 days of benazepril treatment. Significant reduction was seen for the first time 4 days after the administration amlodipine. The rate of the maximal area of the regurgitant jet signals to the left atrium area (ARJ/LAA) of the amlodipine treatment was significantly lower (p < .05) after 7 days compared to baseline. Other echocardiographic parameters did not change significantly. LAP was significantly decreased after amlodipine treatment in dogs with surgically-induced MR but not after benazepril treatment. Although this study did not focus on adverse effects, amlodipine may be an effective drug for helping the patients with acute onset of severe MR, such as rupture of chordae tendinae or end stage patients were the LAP is likely to be elevated. Additional studies in clinical patients with degenerative mitral valve disease and acute chordal rupture are warranted because the blood-pressure lowering effects of amlodipine can decrease renal perfusion and this can further activate the RAAS.

Midplane Ices in the Embedded Phase

NASA Astrophysics Data System (ADS)

Drozdovskaya, Maria; Walsh, Catherine; van Dishoeck, Ewine

2015-08-01

Icy grains in the midplanes of the youngest protoplanetary disks are the building blocks of protoplanets and protocometary bodies. Our Solar System shows significant chemical diversity. The chemical content is thought to be either inherited from the initial prestellar cloud, out of which our Solar System formed, or formed in-situ during the subsequent evolution of the protoplanetary disk. In this poster, the chemical analysis of midplanes in the context of globally evolving and collapsing star-forming systems will be presented. Previous studies compared various solid species relative to water ice in comets and towards young protostars [e.g., 1, 2, 3]. It remains unclear whether the overlap in abundances is just a coincidence or whether the origins of cometary ices are that of a prestellar cloud. For this work, an axisymmentric 2D semi-analytic collapse model [4], wavelength-dependent radiative transfer calculations with RADMC3D [5] and a comprehensive gas-grain chemical network [6] are used to pin down ice abundances in a midplane. The methanol content of protoplanetary disks will be presented [7], but also that of other main ice components, such as water, carbon monoxide and carbon dioxide [8]. Our models can be used to probe the validity of theories on the origin of chemical complexity and also to access the degree of processing upon inheritance into the forming disk.[1] Öberg K. I., Boogert A. C. A., Pontoppidan K. M., van den Broek S., van Dishoeck E. F., Bottinelli S., Blake G. A., Evans, II N. J., 2011, ApJ, 740, 109[2] Mumma M. J., Charnley S. B., 2011, ARA&A, 49, 471[3] Bockelée-Morvan D. et al., 2000, A&A, 353, 1101[4] Visser R., van Dishoeck E. F., Doty S. D., Dullemond C. P., 2009, A&A, 495, 881[5] Dullemond C. P., Dominik C., 2004, A&A, 417, 159[6] Walsh C., Millar T. J., Nomura H., Herbst E., Widicus Weaver S., Aikawa Y., Laas J. C., Vasyunin A. I., 2014, A&A, 563, A33[7] Drozdovskaya M. N., Walsh C., Visser R., Harsono D., van Dishoeck E. F., 2014

A Complex Organic Slushy Bathing Low-Mass Protostars

NASA Astrophysics Data System (ADS)

Drozdovskaya, Maria; Walsh, Catherine; Visser, Ruud; Harsono, Daniel; van Dishoeck, Ewine

2015-08-01

Complex organic molecules are ubiquitous companions of young forming stars. They were first observed in hot cores surrounding high-mass protostars [e.g., 1], but have since also been detected in the environs of several low-mass counterparts [e.g., 2]. Recent studies have shown that colder envelopes and positions with impinging outflows may also glow with emission from complex organic species [e.g., 3, 4]. For this meeting, I would like to present physicochemical modeling results on the synthesis of complex organics in an envelope-cavity system that is subject to non-thermal processing. This includes wavelength-dependent radiative transfer calculations with RADMC [5] and a comprehensive gas-grain chemical network [6]. The results show that the morphology of such a system delineates three distinct regions: the cavity wall layer with time-dependent and species-variant enhancements; a torus rich in complex organic ices, but not reflected in gas-phase abundances; and the remaining outer envelope abundant in simpler solid and gaseous molecules. Within the adopted paradigm, complex organic molecules are demonstrated to have unique lifetimes and be grouped into early and late species [7]. Key chemical processes for forming and destroying complex organic molecules will be discussed. In addition, the results of adding newly experimentally verified routes [8] into the existing chemical networks will be shown.[1] Blake G. A., Sutton E. C., Masson C. R., Phillips T. G., 1987, ApJ, 315, 621[2] Jørgensen J. K., Favre C., Bisschop S. E., Bourke T. L., van Dishoeck E. F., Schmalzl M., 2012, ApJ, 757, L4[3] Arce H. G., Santiago-García J., Jørgensen J. K., Tafalla M., Bachiller R., 2008, ApJ, 681, L21[4] Öberg K. I., Bottinelli S., Jørgensen J. K., van Dishoeck E. F., 2010, ApJ, 716, 825[5] Dullemond C. P., Dominik C., 2004, A&A, 417, 159[6] Walsh C., Millar T. J., Nomura H., Herbst E., Widicus Weaver S., Aikawa Y., Laas J. C., Vasyunin A. I., 2014, A&A, 563, A33[7] Drozdovskaya

Comparative effects of amlodipine and benazepril on Left Atrial Pressure in Dogs with experimentally-induced Mitral Valve Regurgitation

PubMed Central

2012-01-01

Background One of the purposes of treatment for dogs with mitral regurgitation (MR) is lowering left atrial pressure (LAP). There has been few study of the amlodipine in dogs with MR and amlodipine’s effect on LAP has not been fully evaluated in a quantitative manner because of difficulties in directly measuring LAP. The objective of our study was to compare the short-term effects of amlodipine (0.2 mg/kg PO q12h) vs benazepril (0.5 mg/kg PO q12h), on LAP and echocardiographic parameters in five beagle dogs with experimentally-induced MR. LAP of eight dogs that has own control were measured using radiotelemetry system at baseline and again on days 1, 2, 3, 4, 5, 6, 7 of the drug administration. Results Mean LAP decreased significantly after amlodipine (11.20 ± 4.19 mmHg vs 14.61 ± 3.81 mmHg at baseline, p < .01) but not after benazepril treatment (13.19 ± 3.47 mmHg, p > .05). LAP was lower after 7 days of amlodipine treatment than after 7 days of benazepril treatment. Significant reduction was seen for the first time 4 days after the administration amlodipine. The rate of the maximal area of the regurgitant jet signals to the left atrium area (ARJ/LAA) of the amlodipine treatment was significantly lower (p < .05) after 7 days compared to baseline. Other echocardiographic parameters did not change significantly. Conclusions LAP was significantly decreased after amlodipine treatment in dogs with surgically-induced MR but not after benazepril treatment. Although this study did not focus on adverse effects, amlodipine may be an effective drug for helping the patients with acute onset of severe MR, such as rupture of chordae tendinae or end stage patients were the LAP is likely to be elevated. Additional studies in clinical patients with degenerative mitral valve disease and acute chordal rupture are warranted because the blood-pressure lowering effects of amlodipine can decrease renal perfusion and this can further

Relative receiver autonomous integrity monitoring for future GNSS-based aircraft navigation

NASA Astrophysics Data System (ADS)

Gratton, Livio Rafael

The Global Positioning System (GPS) has enabled reliable, safe, and practical aircraft positioning for en-route and non-precision phases of flight for more than a decade. Intense research is currently devoted to extending the use of Global Navigation Satellite Systems (GNSS), including GPS, to precision approach and landing operations. In this context, this work is focused on the development, analysis, and verification of the concept of Relative Receiver Autonomous Integrity Monitoring (RRAIM) and its potential applications to precision approach navigation. RRAIM fault detection algorithms are developed, and associated mathematical bounds on position error are derived. These are investigated as possible solutions to some current key challenges in precision approach navigation, discussed below. Augmentation systems serving continent-size areas (like the Wide Area Augmentation System or WAAS) allow certain precision approach operations within the covered region. More and better satellites, with dual frequency capabilities, are expected to be in orbit in the mid-term future, which will potentially allow WAAS-like capabilities worldwide with a sparse ground station network. Two main challenges in achieving this goal are (1) ensuring that navigation fault detection functions are fast enough to alert worldwide users of hazardously misleading information, and (2) minimizing situations in which navigation is unavailable because the user's local satellite geometry is insufficient for safe position estimation. Local augmentation systems (implemented at individual airports, like the Local Area Augmentation System or LAAS) have the potential to allow precision approach and landing operations by providing precise corrections to user-satellite range measurements. An exception to these capabilities arises during ionospheric storms (caused by solar activity), when hazardous situations can exist with residual range errors several orders of magnitudes higher than nominal. Until dual

Directional charge transfer mediated by mid-gap states: A transient absorption spectroscopy study of CdSe quantum dot/β-Pb 0.33V 2O 5 heterostructures

DOE PAGES

Milleville, Christopher C.; Pelcher, Kate E.; Sfeir, Matthew Y.; ...

2016-02-15

For solar energy conversion, not only must a semiconductor absorb incident solar radiation efficiently but also its photoexcited electron—hole pairs must further be separated and transported across interfaces. Charge transfer across interfaces requires consideration of both thermodynamic driving forces as well as the competing kinetics of multiple possible transfer, cooling, and recombination pathways. In this work, we demonstrate a novel strategy for extracting holes from photoexcited CdSe quantum dots (QDs) based on interfacing with β-Pb 0.33V 2O 5 nanowires that have strategically positioned midgap states derived from the intercalating Pb 2+ ions. Unlike midgap states derived from defects or dopants,more » the states utilized here are derived from the intrinsic crystal structure and are thus homogeneously distributed across the material. CdSe/β-Pb 0.33V 2O 5 heterostructures were assembled using two distinct methods: successive ionic layer adsorption and reaction (SILAR) and linker-assisted assembly (LAA). Transient absorption spectroscopy measurements indicate that, for both types of heterostructures, photoexcitation of CdSe QDs was followed by the transfer of electrons to the conduction band of β-Pb 0.33V 2O 5 nanowires and holes to the midgap states of β-Pb 0.33V 2O 5 nanowires. Holes were transferred on time scales less than 1 ps, whereas electrons were transferred more slowly on time scales of ~2 ps. In contrast, for analogous heterostructures consisting of CdSe QDs interfaced with V 2O 5 nanowires (wherein midgap states are absent), only electron transfer was observed. Interestingly, electron transfer was readily achieved for CdSe QDs interfaced with V 2O 5 nanowires by the SILAR method; however, for interfaces incorporating molecular linkers, electron transfer was observed only upon excitation at energies substantially greater than the bandgap absorption threshold of CdSe. Furthermore, transient absorbance decay traces reveal longer excited

Interstellar Methanol from the Lab to Protoplanetary Disks

NASA Astrophysics Data System (ADS)

Drozdovskaya, Maria; Walsh, Catherine; Visser, Ruud; Harsono, Daniel; van Dishoeck, Ewine

2015-08-01

., Nomura H., Herbst E., Widicus Weaver S., Aikawa Y., Laas J. C., Vasyunin A. I., 2014, A&A, 563, A33[7] Drozdovskaya M. N., Walsh C., Visser R., Harsono D., van Dishoeck E. F., 2014, MNRAS, 445, 91

Neisseria gonorrhoeae and extended-spectrum cephalosporins in California: surveillance and molecular detection of mosaic penA.

PubMed

Gose, Severin; Nguyen, Duylinh; Lowenberg, Daniella; Samuel, Michael; Bauer, Heidi; Pandori, Mark

2013-12-04

The spread of Neisseria gonorrhoeae strains with mosaic penA alleles and reduced susceptibility to extended-spectrum cephalosporins is a major public health problem. While much work has been performed internationally, little is known about the genetics or molecular epidemiology of N. gonorrhoeae isolates with reduced susceptibility to extended-spectrum cephalosporins in the United States. The majority of N. gonorrhoeae infections are diagnosed without a live culture. Molecular tools capable of detecting markers of extended-spectrum cephalosporin resistance are needed. Urethral N. gonorrhoeae isolates were collected from 684 men at public health clinics in California in 2011. Minimum inhibitory concentrations (MICs) to ceftriaxone, cefixime, cefpodoxime and azithromycin were determined by Etest and categorized according to the U.S. Centers for Disease Control 2010 alert value breakpoints. 684 isolates were screened for mosaic penA alleles using real-time PCR (RTPCR) and 59 reactive isolates were subjected to DNA sequencing of their penA alleles and Neisseria gonorrhoeae multi-antigen sequence typing (NG-MAST). To increase the specificity of the screening RTPCR in detecting isolates with alert value extended-spectrum cephalosporin MICs, the primers were modified to selectively amplify the mosaic XXXIV penA allele. Three mosaic penA alleles were detected including two previously described alleles (XXXIV, XXXVIII) and one novel allele (LA-A). Of the 29 isolates with an alert value extended-spectrum cephalosporin MIC, all possessed the mosaic XXXIV penA allele and 18 were sequence type 1407, an internationally successful strain associated with multi-drug resistance. The modified RTPCR detected the mosaic XXXIV penA allele in urethral isolates and urine specimens and displayed no amplification of the other penA alleles detected in this study. N. gonorrhoeae isolates with mosaic penA alleles and reduced susceptibility to extended-spectrum cephalosporins are currently

Neisseria gonorrhoeae and extended-spectrum cephalosporins in California: surveillance and molecular detection of mosaic penA

PubMed Central

2013-01-01

Background The spread of Neisseria gonorrhoeae strains with mosaic penA alleles and reduced susceptibility to extended-spectrum cephalosporins is a major public health problem. While much work has been performed internationally, little is known about the genetics or molecular epidemiology of N. gonorrhoeae isolates with reduced susceptibility to extended-spectrum cephalosporins in the United States. The majority of N. gonorrhoeae infections are diagnosed without a live culture. Molecular tools capable of detecting markers of extended-spectrum cephalosporin resistance are needed. Methods Urethral N. gonorrhoeae isolates were collected from 684 men at public health clinics in California in 2011. Minimum inhibitory concentrations (MICs) to ceftriaxone, cefixime, cefpodoxime and azithromycin were determined by Etest and categorized according to the U.S. Centers for Disease Control 2010 alert value breakpoints. 684 isolates were screened for mosaic penA alleles using real-time PCR (RTPCR) and 59 reactive isolates were subjected to DNA sequencing of their penA alleles and Neisseria gonorrhoeae multi-antigen sequence typing (NG-MAST). To increase the specificity of the screening RTPCR in detecting isolates with alert value extended-spectrum cephalosporin MICs, the primers were modified to selectively amplify the mosaic XXXIV penA allele. Results Three mosaic penA alleles were detected including two previously described alleles (XXXIV, XXXVIII) and one novel allele (LA-A). Of the 29 isolates with an alert value extended-spectrum cephalosporin MIC, all possessed the mosaic XXXIV penA allele and 18 were sequence type 1407, an internationally successful strain associated with multi-drug resistance. The modified RTPCR detected the mosaic XXXIV penA allele in urethral isolates and urine specimens and displayed no amplification of the other penA alleles detected in this study. Conclusion N. gonorrhoeae isolates with mosaic penA alleles and reduced susceptibility to extended

CdSe/beta-Pb0.33V2O5 heterostructures: Nanoscale semiconductor interfaces with tunable energetic configurations for solar energy conversion and storage

NASA Astrophysics Data System (ADS)

Milleville, Christopher C.

This dissertation focuses on the formation and characterization of semiconductor heterostructures, consisting of light-harvesting cadmium selenide quantum dots (CdSe QDs) and single crystalline lead vanadium oxide nanowires (β-Pb0.33V2O5 NWs), for the purpose of excited-state charge transfer and photocatalytic production of solar fuels. We reported two distinct routes for assembling CdSe/β-Pb0.33V2O5 heterostructures: linker-assisted assembly (LAA) mediated by a bifunctional ligand and successive ionic layer adsorption and reaction (SILAR). In the former case, the thiol end of a molecular linker, cysteine (Cys) is found to bind to the QD surface, whereas a protonated amine moiety interacts electrostatically with the negatively charged NW surface. In the alternative SILAR route, the surface coverage of CdSe on the β-Pb0.33V2O5 NWs is tuned by varying the number of successive precipitation cycles. Hard X-ray photoelectron spectroscopy (HAXPES) measurements revealed that the mid-gap states of β-Pb0.33V2O5 NWs are closely overlapped in energy with the valence band edges of CdSe QDs, suggesting that hole transfer from the valence band of CdSe into the mid-gap states is possible. Preliminary evidence of hole transfer was obtained through photoluminescence quenching experiments. Steady-state and time-resolved photoluminescence measurements on Cys-CdSe dispersions, mixed dispersions of Cys-CdSe QDs and β-Pb0.33V¬2O5 NWs, and mixed dispersions of Cys-CdS QDs and V2O5 revealed a greater extent of quenching of the emission of Cys-CdSe QDs by β Pb0.33V¬2O5 relative to V2O5. V2O5, devoid of mid-gap states, is unable to accept holes from CdSe and therefore should not quench emission to the same extent as β-Pb0.33V¬2O5. The additional quenching was dynamic, consistent with a mechanism involving the transfer of photogenerated holes from CdSe QDs to the mid-gap states of β Pb0.33V2O5. Transient absorption spectroscopy (TA) was used to probe the dynamics of interfacial

Evaluation of errors in quantitative determination of asbestos in rock

NASA Astrophysics Data System (ADS)

Baietto, Oliviero; Marini, Paola; Vitaliti, Martina

2016-04-01

The quantitative determination of the content of asbestos in rock matrices is a complex operation which is susceptible to important errors. The principal methodologies for the analysis are Scanning Electron Microscopy (SEM) and Phase Contrast Optical Microscopy (PCOM). Despite the PCOM resolution is inferior to that of SEM, PCOM analysis has several advantages, including more representativity of the analyzed sample, more effective recognition of chrysotile and a lower cost. The DIATI LAA internal methodology for the analysis in PCOM is based on a mild grinding of a rock sample, its subdivision in 5-6 grain size classes smaller than 2 mm and a subsequent microscopic analysis of a portion of each class. The PCOM is based on the optical properties of asbestos and of the liquids with note refractive index in which the particles in analysis are immersed. The error evaluation in the analysis of rock samples, contrary to the analysis of airborne filters, cannot be based on a statistical distribution. In fact for airborne filters a binomial distribution (Poisson), which theoretically defines the variation in the count of fibers resulting from the observation of analysis fields, chosen randomly on the filter, can be applied. The analysis in rock matrices instead cannot lean on any statistical distribution because the most important object of the analysis is the size of the of asbestiform fibers and bundles of fibers observed and the resulting relationship between the weights of the fibrous component compared to the one granular. The error evaluation generally provided by public and private institutions varies between 50 and 150 percent, but there are not, however, specific studies that discuss the origin of the error or that link it to the asbestos content. Our work aims to provide a reliable estimation of the error in relation to the applied methodologies and to the total content of asbestos, especially for the values close to the legal limits. The error assessments must

Evolution of the eastern Austrian Molasse Basin: The Lower Miocene (Burdigalian) as a key to the understanding of the Eastern Alps - Molasse Basin system

NASA Astrophysics Data System (ADS)

Palzer, Markus; Knierzinger, Wolfgang; Wagreich, Michael; Meszar, Maria E.; Gier, Susanne; Soliman, Ali; -Elena Kallanxhi, Mǎdǎlina

2016-04-01

The eastern Austrian Molasse Basin is situated between the Bohemian Massif, the Waschberg-Zone and the Alps. There, sands of the Lower Miocene (Upper Ottnangian) Traisen Formation represent a clastic interval at the top of pelitic Schlier successions, which is correlated with the global sea level drop Bur3 (Burdigalian). North of the Danube River, the continuation of the Traisen-Formation is overlain by the Karpatian Laa-Formation. Drill cores from OMV-wells predominantly from the continuation of the Traisen Formation in deep parts in the NE of the basin show hundreds of meters of pelites with intersections of sands. Contrary to the exposed, mainly brackish TF, a turbiditic and predominantly fully marine deep-water environment is inferred from the cores. Profiles of carbonate content, XRD, XRF, whole rock chemistry, clay minerals, calcareous nannoplankton and dinoflagellate cysts of 7 wells were investigated representing a NE-SW transect through the LAMB. Based on these data, a new stratigraphy for the Burdigalian distal parts of the LAMB can be defined and correlated with the proximal units. The Traisen Formation and its equivalents are characterized at their base by an increased clastic input in the south and by increasing mica content in the northern parts. The complete interval is characterized by the decreased carbonate content. The XRD data show strongly reduced calcite contents which goe hand in hand with the absence of nannoplankton. Whether the signal is related to a crisis in primary production or to carbonate dissolution remains unclear. The absence of dinoflagellate cysts and the chemical data (reduced B/Al* ratios indicate reduced salinity) are considered as an argument for an environmental crisis. However, the absence of resedimented Cretaceous to Paleocene nannofossils, which usually occur together with the autochthonous NN4-nannofossils, indicates carbonate dissolution. These results enable us to define a basinal interval as equivalent to the

Wireless and chip-less passive radiation sensors for high dose monitoring

DOE Office of Scientific and Technical Information (OSTI.GOV)

Debourg, E.; Aubert, H.; Pons, P.

The safety of nuclear infrastructures may involve the monitoring of many parameters in harsh environments (high radiation level, high temperature, high pressure,..). If technological solutions exist for transducers part in such environments, the electronic part used in reader is not appropriate and still a challenging task. Well-known solutions to remove the electronic part from the harsh environment consist of connecting the transducer and the reader by long electrical wires or performing ex situ remote sensing. However wires may practically be difficult to implement while ex situ measurements are not compatible with on line monitoring. Wireless and passive sensors working inmore » harsh environments could be an appropriate solution for the remote sensing of critical parameters. Passive sensors without electronics in the sensing unit are available (e.g., SAW sensors) but they suffer from short reading range (typically lower than 10 meters). In order to overcome this range limitation a new class of electromagnetic transducers was developed in the mid-2000's. The operating principle is based on the modification of the properties of high-frequency (>> 1 GHz) passive electromagnetic devices by the quantity to be measured. Based on this principle a wide range of sensing properties can be addressed and a large number of materials can be chosen. Moreover the use of high frequency allows reducing the size of the sensor elements (antenna, transducer) and enhancing the immunity to multi-path. Several principles of RF transducers have been already validated by LAAS-CNRS (e;g; pressure, temperature, stress) as well as radar-based solution for the wireless long-range sensors interrogation. The sensor dosimeter exploit here the known property of Hydrogen-Pressure Dosimeters (HPD) for which the polymer material dehydrogenates under nuclear irradiation. The transducer principle is described. The irradiation will generate the out-gazing (hydrogen) of the polymer inside a micro

Préface

NASA Astrophysics Data System (ADS)

Aspect, Alain

2004-11-01

ouverture sur les recherches de base d'aujourd'hui qui seront peut-être les outils quotidiens de l'optique de demain. Quant aux 169 communications par affiches elles ont, suivant la règle, couvert sans restriction tous les sujets de l'optique actuelle. Ce volume spécial du Journal de Physique IV regroupe la majorité des conférences invitées et des communications par affiches. Profitant de la participation des mondes académique et industriel, un forum sur “innovation et nouveaux débouchés pour l'optique” a permis de dégager des raisons d'espoir pour l'emploi des chercheurs en optique. Enfin, renouvelant l'expérience d'éditions précédentes, la dernière demi journée a été consacrée à deux conférences qui étaient ouvertes à un public élargi, notamment les étudiants de l'université et des classes préparatoires ainsi que leurs enseignants. Si Antoine Labeyrie nous a laissés sans voix avec ses projets “hyperfuturistes” d'hypertélescopes à l'échelle du million de kilomètres, Pierre Lena nous a donné un moment de vrai bonheur en célébrant le mariage sans cesse renouvelé du toujours jeune couple que sont l'optique et l'astronomie : qu'il soit remercié aussi pour le magnifique teste publié dans ce volume. COLOQ se devait d'honorer la mémoire de deux personnalités hors du commun de l'optique, Jean Brossel et Gilbert Grynberg. Tous ceux qui avaient connu l'un ou l'autre ont pu apprécier la justesse des évocations, par d'anciens collaborateurs, de l'oeuvre scientifique mais aussi des personnalités de ces deux grands physiciens. On trouvera les textes de ces interventions émouvantes dans ce recueil. La réussite de COLOQ 8 est évidemment due; avant tout, à la qualité scientifique des présentations, mais elle repose aussi sur l'action conjuguée des comités d'organisation national et local. Au niveau local, Françoise Lozes et Jacques Vigué ont mobilisé les membres du LCAR-IRSAMC et du LAAS pour l'organisation conjointe - particuli