Aortic baroreflex control of heart rate after 15 days of simulated microgravity exposure

NASA Technical Reports Server (NTRS)

Crandall, Craig G.; Engelke, Keith A.; Convertino, Victor A.; Raven, Peter B.

1994-01-01

To determine the effects of simulated microgravity on aortic baroreflex control of heart rate, we exposed seven male subjects to 15 days of bed rest in the 6 deg head-down position. The sensitivity of the aortic-cardiac baroreflex was determined during a steady-state phenylephrine-induced increase in mean arterial pressure combined with lower body negative pressure to counteract central venous pressure increases and neck pressure to offset the increased carotid sinus transmural pressure. The aortic-cardiac baroreflex gain was assessed by determining the ratio of the change in heart rate to the change in mean arterial pressure between baseline conditions and aortic baroreceptor-isolated conditions (i.e., phenylephrine + lower body negative pressure + neck pressure stage). Fifteen days of head-down tilt increased the gain of the aortic-cardiac baroreflex. Reductions in blood volume and/or maximal aerobic capacity may represent the underlying mechanism(s) responsible for increased aortic baroreflex responsiveness after exposure to a ground-based analogue of microgravity.

CERN@school: bringing CERN into the classroom

NASA Astrophysics Data System (ADS)

Whyntie, T.; Cook, J.; Coupe, A.; Fickling, R. L.; Parker, B.; Shearer, N.

2016-04-01

CERN@school brings technology from CERN into the classroom to aid with the teaching of particle physics. It also aims to inspire the next generation of physicists and engineers by giving participants the opportunity to be part of a national collaboration of students, teachers and academics, analysing data obtained from detectors based on the ground and in space to make new, curiosity-driven discoveries at school. CERN@school is based around the Timepix hybrid silicon pixel detector developed by the Medipix 2 Collaboration, which features a 300 μm thick silicon sensor bump-bonded to a Timepix readout ASIC. This defines a 256-by-256 grid of pixels with a pitch of 55 μm, the data from which can be used to visualise ionising radiation in a very accessible way. Broadly speaking, CERN@school consists of a web portal that allows access to data collected by the Langton Ultimate Cosmic ray Intensity Detector (LUCID) experiment in space and the student-operated Timepix detectors on the ground; a number of Timepix detector kits for ground-based experiments, to be made available to schools for both teaching and research purposes; and educational resources for teachers to use with LUCID data and detector kits in the classroom. By providing access to cutting-edge research equipment, raw data from ground and space-based experiments, CERN@school hopes to provide the foundation for a programme that meets the many of the aims and objectives of CERN and the project's supporting academic and industrial partners. The work presented here provides an update on the status of the programme as supported by the UK Science and Technology Facilities Council (STFC) and the Royal Commission for the Exhibition of 1851. This includes recent results from work with the GridPP Collaboration on using grid resources with schools to run GEANT4 simulations of CERN@school experiments.

Maintenance steroid use at 30 days post-transplant and outcomes of pediatric heart transplantation: A propensity matched analysis of the Pediatric Heart Transplant Study database.

PubMed

Auerbach, Scott R; Kukreja, Manisha; Gilbert, Deborah; Bastardi, Heather; Feingold, Brian; Knecht, Kenneth; Kaufman, Beth D; Brown, Robert N; Miyamoto, Shelley D

2015-08-01

Maintenance steroid (MS) use in pediatric heart transplantation is variable. The purpose of this study was to evaluate the impact of MS use on graft outcomes. All patients <18 years old in the Pediatric Heart Transplant Study database at the time of first heart transplant between 1993 and 2011 who survived ≥30 days post-transplant and were from centers with a protocolized approach to MS use were included (N = 2,178). Patients were grouped by MS use at 30 days post-transplant as MS+ or MS- (no MS use). Propensity score analysis was used to generate matched groups of MS+ and MS- patients based on pre-transplant and peri-transplant factors. Kaplan-Meier survival analysis was used to compare freedom from graft loss, graft loss secondary to rejection, rejection, rejection with severe hemodynamic compromise (RSHC), malignancy, and infection between groups. Of patients, 1,393 (64%) were MS+ and 785 (36%) were MS-. There were 315 MS- patients who had propensity matched MS+ controls. Kaplan-Meier estimates showed no difference in graft loss (p = 0.9) or graft loss secondary to rejection (p = 0.09). At 1 year post-transplant, there was no difference in freedom from rejection (p = 0.15) or malignancy (p = 0.07), but there was lower freedom from RSHC and infection in the MS- group (p = 0.05 and p = 0.02, respectively). MS use at 30 days post-transplant was not associated with enhanced graft survival after pediatric heart transplant. MS- patients had a higher incidence of RSHC and infection. These risks should be taken into consideration when determining MS use for pediatric recipients of heart transplants. Copyright © 2015 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Prolonged Elevated Heart Rate and 90-Day Survival in Acutely Ill Patients: Data From the MIMIC-III Database.

PubMed

Sandfort, Veit; Johnson, Alistair E W; Kunz, Lauren M; Vargas, Jose D; Rosing, Douglas R

2018-01-01

We sought to evaluate the association of prolonged elevated heart rate (peHR) with survival in acutely ill patients. We used a large observational intensive care unit (ICU) database (Multiparameter Intelligent Monitoring in Intensive Care III [MIMIC-III]), where frequent heart rate measurements were available. The peHR was defined as a heart rate >100 beats/min in 11 of 12 consecutive hours. The outcome was survival status at 90 days. We collected heart rates, disease severity (simplified acute physiology scores [SAPS II]), comorbidities (Charlson scores), and International Classification of Diseases (ICD) diagnosis information in 31 513 patients from the MIMIC-III ICU database. Propensity score (PS) methods followed by inverse probability weighting based on the PS was used to balance the 2 groups (the presence/absence of peHR). Multivariable weighted logistic regression was used to assess for association of peHR with the outcome survival at 90 days adjusting for additional covariates. The mean age was 64 years, and the most frequent main disease category was circulatory disease (41%). The mean SAPS II score was 35, and the mean Charlson comorbidity score was 2.3. Overall survival of the cohort at 90 days was 82%. Adjusted logistic regression showed a significantly increased risk of death within 90 days in patients with an episode of peHR ( P < .001; odds ratio for death 1.79; confidence interval, 1.69-1.88). This finding was independent of median heart rate. We found a significant association of peHR with decreased survival in a large and heterogenous cohort of ICU patients.

Early Ambulation Among Hospitalized Heart Failure Patients Is Associated With Reduced Length of Stay and 30-Day Readmissions.

PubMed

Fleming, Lisa M; Zhao, Xin; DeVore, Adam D; Heidenreich, Paul A; Yancy, Clyde W; Fonarow, Gregg C; Hernandez, Adrian F; Kociol, Robb D

2018-04-01

Early ambulation (EA) is associated with improved outcomes for mechanically ventilated and stroke patients. Whether the same association exists for patients hospitalized with acute heart failure is unknown. We sought to determine whether EA among patients hospitalized with heart failure is associated with length of stay, discharge disposition, 30-day post discharge readmissions, and mortality. The study population included 369 hospitals and 285 653 patients with heart failure enrolled in the Get With The Guidelines-Heart Failure registry. We used multivariate logistic regression with generalized estimating equations at the hospital level to identify predictors of EA and determine the association between EA and outcomes. Sixty-five percent of patients ambulated by day 2 of the hospital admission. Patient-level predictors of EA included younger age, male sex, and hospitalization outside of the Northeast ( P <0.01 for all). Hospital size and academic status were not predictive. Hospital-level analysis revealed that those hospitals with EA rates in the top 25% were less likely to have a long length of stay (defined as >4 days) compared with those in the bottom 25% (odds ratio, 0.83; confidence interval, 0.73-0.94; P =0.004). Among a subgroup of fee-for-service Medicare beneficiaries, we found that hospitals in the highest quartile of rates of EA demonstrated a statistically significant 24% lower 30-day readmission rates ( P <0.0001). Both end points demonstrated a dose-response association and statistically significant P for trend test. Multivariable-adjusted hospital-level analysis suggests an association between EA and both shorter length of stay and lower 30-day readmissions. Further prospective studies are needed to validate these findings. © 2018 American Heart Association, Inc.

EMG and Heart Rate Responses Decline within 5 Days of Daily Whole-Body Vibration Training with Squatting

PubMed Central

Rosenberger, André; Liphardt, Anna-Maria; Bargmann, Arne; Müller, Klaus; Beck, Luis; Mester, Joachim; Zange, Jochen

2014-01-01

In this study, we examined the acute effects of a 5-day daily whole-body vibration (WBV) training on electromyography (EMG) responses of the m. rectus femoris and m. gastrocnemius lateralis, heart rate (HR, continuously recorded), and blood lactate levels. The purpose of the study was to investigate the adaptation of muscle activity, heart rate and blood lactate levels during 5 days of daily training. Two groups of healthy male subjects performed either squat exercises with vibration at 20 Hz on a side alternating platform (SE+V, n = 20, age  = 31.9±7.5 yrs., height  = 178.8±6.2 cm, body mass  = 79.2±11.4 kg) or squat exercises alone (SE, n = 21, age  = 28.4±7.3 years, height  = 178.9±7.4 cm, body mass  = 77.2±9.7 kg). On training day 1, EMG amplitudes of the m. rectus femoris were significantly higher (P<0.05) during SE+V than during SE. However, this difference was no longer statistically significant on training days 3 and 5. The heart rate (HR) response was significantly higher (P<0.05) during SE+V than during SE on all training days, but showed a constant decline throughout the training days. On training day 1, blood lactate increased significantly more after SE+V than after SE (P<0.05). On the following training days, this difference became much smaller but remained significantly different. The specific physiological responses to WBV were largest on the initial training day and most of them declined during subsequent training days, showing a rapid neuromuscular and cardiovascular adaptation to the vibration stimulus. PMID:24905721

Determinants of ischemic heart disease in Seventh-day Adventists: a review.

PubMed

Fraser, G E

1988-09-01

Most data from several countries shows Seventh-day Adventist men to have lower rates of ischemic heart disease (IHD) mortality. Similar data for women are somewhat conflicting. There is clear evidence that Adventists have lower serum total cholesterol and lower serum HDL cholesterol with the ratio of total cholesterol to HDL cholesterol being similar to that of non-Adventists. The risk relationships of this ratio may differ in different populations. There is a certain amount of evidence that vegetarians may have lower blood pressures but this is not clearly supported by data from Seventh-day Adventists. The lower risk for IHD in Adventist men, at least, is probably related to their dietary habits, nonsmoking status, possibly their better exercise habits, and greater social support.

Association between health literacy and 30-day healthcare use after hospital discharge in the heart failure population.

PubMed

Cox, Sarah R; Liebl, Michael G; McComb, Meghan N; Chau, Jason Q; Wilson, Allison A; Achi, May; Garey, Kevin W; Wallace, David

Low health literacy increases the risk for hospital readmissions. Despite this, the measurement and use of health literacy to guide discharge counseling and planning in heart failure patients is not commonly performed. A short 3-Question Brief Health Literacy Screen (BHLS) is available and takes less than three minutes to complete, but has never been evaluated to help determine whether health literacy affects healthcare use after discharge in patients with heart failure. The purpose of this study was to assess 30-day readmissions and emergency department visits based on health literacy evaluated by the BHLS in an acute care heart failure population. This was a prospective observational cohort study conducted at a large quaternary health system. Hospitalized patients with a diagnosis of heart failure were assessed for health literacy using the BHLS. Unplanned healthcare use after discharge including 30-day, all-cause ED visits and hospital readmissions was assessed using univariate and logistic regression models. Two hundred and sixty four patients aged 66.6 ± 14.3 (mean ± SD) years met inclusion/exclusion criteria of whom 175 (66.3%) had a BHLS score >9 (adequate health literacy) and 89 (33.7%) had a BHLS score ≤9 (low health literacy). Predictors of low health literacy included older age (p = 0.019), lower education level (p < 0.001) and unemployed (p = 0.048). After controlling for potential confounders, low health literacy was independently associated with 30-day healthcare use after hospital discharge (OR:1.80; 95% CI: 1.04-3.11; p = 0.035). Using a short, 3-question validated survey instrument, it was demonstrated that low health literacy was associated with increased 30-day unplanned healthcare use after discharge in this heart failure population. These results provide a clinically useful, easily incorporated tool that could identify high-risk patients at need for clinical interventions. Copyright © 2016 Elsevier Inc. All rights reserved.

Hangout with CERN: a direct conversation with the public

NASA Astrophysics Data System (ADS)

Rao, Achintya; Goldfarb, Steven; Kahle, Kate

2016-04-01

Hangout with CERN refers to a weekly, half-hour-long, topical webcast hosted at CERN. The aim of the programme is threefold: (i) to provide a virtual tour of various locations and facilities at CERN, (ii) to discuss the latest scientific results from the laboratory, and, most importantly, (iii) to engage in conversation with the public and answer their questions. For each ;episode;, scientists gather around webcam-enabled computers at CERN and partner institutes/universities, connecting to one another using the Google+ social network's ;Hangouts; tool. The show is structured as a conversation mediated by a host, usually a scientist, and viewers can ask questions to the experts in real time through a Twitter hashtag or YouTube comments. The history of Hangout with CERN can be traced back to ICHEP 2012, where several physicists crowded in front of a laptop connected to Google+, using a ;Hangout On Air; webcast to explain to the world the importance of the discovery of the Higgs-like boson, announced just two days before at the same conference. Hangout with CERN has also drawn inspiration from two existing outreach endeavours: (i) ATLAS Virtual Visits, which connected remote visitors with scientists in the ATLAS Control Room via video conference, and (ii) the Large Hangout Collider, in which CMS scientists gave underground tours via Hangouts to groups of schools and members of the public around the world. In this paper, we discuss the role of Hangout with CERN as a bi-directional outreach medium and an opportunity to train scientists in effective communication.

Effect of spironolactone on 30-day death and heart failure rehospitalization (from the COACH Study).

PubMed

Maisel, Alan; Xue, Yang; van Veldhuisen, Dirk J; Voors, Adriaan A; Jaarsma, Tiny; Pang, Peter S; Butler, Javed; Pitt, Bertram; Clopton, Paul; de Boer, Rudolf A

2014-09-01

The aim of our study is to investigate the effect of spironolactone on 30-day outcomes in patients with acute heart failure (AHF) and the association between treatment and outcomes stratified by biomarkers. We conducted a secondary analysis of the biomarker substudy of the multicenter COACH (Co-ordinating Study Evaluating Outcomes of Advising and Counseling in Heart Failure) trial involving 534 AHF patients for 30-day mortality and HF rehospitalizations. Spironolactone therapy was initiated and terminated at the discretion of the treating physician; 30-day outcomes were compared between patients who were treated with spironolactone and those who were not. Outcomes with spironolactone therapy were explored based on N-terminal pro-B-type natriuretic peptide, ST2, galectin-3, and creatinine levels. Spironolactone was prescribed to 297 (55.6%) patients at discharge (158 new and 139 continued). There were 19 deaths and 30 HF rehospitalizations among 46 patients by 30 days. Patients discharged on spironolactone had significantly less 30-day event (hazard ratio 0.538, p = 0.039) after adjustment for multiple risk factors. Initiation of spironolactone in patients who were not on spironolactone before admission was associated with a significant reduction in event rate (hazard ratio 0.362, p = 0.027). The survival benefit of spironolactone was more prominent in patient groups with elevations of creatinine, N-terminal pro-B-type natriuretic peptide, ST2, or galectin-3. In conclusion, AHF patients who received spironolactone during hospitalization had significantly fewer 30-day mortality and HF rehospitalizations, especially in high-risk patients. Copyright © 2014 Elsevier Inc. All rights reserved.

Determining 30-day readmission risk for heart failure patients: the Readmission After Heart Failure scale

PubMed Central

Chamberlain, Ronald S; Sond, Jaswinder; Mahendraraj, Krishnaraj; Lau, Christine SM; Siracuse, Brianna L

2018-01-01

Background Chronic heart failure (CHF), which affects >5 million Americans, accounts for >1 million hospitalizations annually. As a part of the Hospital Readmission Reduction Program, the Affordable Care Act requires that the Centers for Medicare and Medicaid Services reduce payments to hospitals with excess readmissions. This study sought to develop a scale that reliably predicts readmission rates among patients with CHF. Methods The State Inpatient Database (2006–2011) was utilized, and discharge data including demographic and clinical characteristics on 642,448 patients with CHF from California and New York (derivation cohort) and 365,359 patients with CHF from Florida and Washington (validation cohort) were extracted. The Readmission After Heart Failure (RAHF) scale was developed to predict readmission risk. Results The 30-day readmission rates were 9.42 and 9.17% (derivation and validation cohorts, respectively). Age <65 years, male gender, first income quartile, African American race, race other than African American or Caucasian, Medicare, Medicaid, self-pay/no insurance, drug abuse, renal failure, chronic pulmonary disorder, diabetes, depression, and fluid and electrolyte disorder were associated with higher readmission risk after hospitalization for CHF. The RAHF scale was created and explained the 95% of readmission variability within the validation cohort. The RAHF scale was then used to define the following three levels of risk for readmission: low (RAHF score <12; 7.58% readmission rate), moderate (RAHF score 12–15; 9.78% readmission rate), and high (RAHF score >15; 12.04% readmission rate). The relative risk of readmission was 1.67 for the high-risk group compared with the low-risk group. Conclusion The RAHF scale reliably predicts a patient’s 30-day CHF readmission risk based on demographic and clinical factors present upon initial admission. By risk-stratifying patients, using models such as the RAHF scale, strategies tailored to each patient

Income inequality and 30 day outcomes after acute myocardial infarction, heart failure, and pneumonia: retrospective cohort study.

PubMed

Lindenauer, Peter K; Lagu, Tara; Rothberg, Michael B; Avrunin, Jill; Pekow, Penelope S; Wang, Yongfei; Krumholz, Harlan M

2013-02-14

To examine the association between income inequality and the risk of mortality and readmission within 30 days of hospitalization. Retrospective cohort study of Medicare beneficiaries in the United States. Hierarchical, logistic regression models were developed to estimate the association between income inequality (measured at the US state level) and a patient's risk of mortality and readmission, while sequentially controlling for patient, hospital, other state, and patient socioeconomic characteristics. We considered a 0.05 unit increase in the Gini coefficient as a measure of income inequality. US acute care hospitals. Patients aged 65 years and older, and hospitalized in 2006-08 with a principal diagnosis of acute myocardial infarction, heart failure, or pneumonia. Risk of death within 30 days of admission or rehospitalization for any cause within 30 days of discharge. The potential number of excess deaths and readmissions associated with higher levels of inequality in US states in the three highest quarters of income inequality were compared with corresponding data in US states in the lowest quarter. Mortality analyses included 555,962 admissions (4348 hospitals) for acute myocardial infarction, 1,092,285 (4484) for heart failure, and 1,146,414 (4520); readmission analyses included 553,037 (4262), 1,345,909 (4494), and 1,345,909 (4524) admissions, respectively. In 2006-08, income inequality in US states (as measured by the average Gini coefficient over three years) varied from 0.41 in Utah to 0.50 in New York. Multilevel models showed no significant association between income inequality and mortality within 30 days of admission for patients with acute myocardial infarction, heart failure, or pneumonia. By contrast, income inequality was associated with rehospitalization (acute myocardial infarction, risk ratio 1.09 (95% confidence interval 1.03 to 1.15), heart failure 1.07 (1.01 to 1.12), pneumonia 1.09 (1.03 to 1.15)). Further adjustment for individual income

Hospital Nursing and 30-Day Readmissions among Medicare Patients with Heart Failure, Acute Myocardial Infarction, and Pneumonia

PubMed Central

McHugh, Matthew D.; Ma, Chenjuan

2013-01-01

Background Provisions of the Affordable Care Act that increase hospitals’ financial accountability for preventable readmissions have heightened interest in identifying system-level interventions to reduce readmissions. Objectives To determine the relationship between hospital nursing; i.e. nurse work environment, nurse staffing levels, and nurse education, and 30-day readmissions among Medicare patients with heart failure, acute myocardial infarction, and pneumonia. Method and Design Analysis of linked data from California, New Jersey, and Pennsylvania that included information on the organization of hospital nursing (i.e., work environment, patient-to-nurse ratios, and proportion of nurses holding a BSN degree) from a survey of nurses, as well as patient discharge data, and American Hospital Association Annual Survey data. Robust logistic regression was used to estimate the relationship between nursing factors and 30-day readmission. Results Nearly one-quarter of heart failure index admissions (23.3% [n=39,954]); 19.1% (n=12,131) of myocardial infarction admissions; and 17.8% (n=25,169) of pneumonia admissions were readmitted within 30-days. Each additional patient per nurse in the average nurse’s workload was associated with a 7% higher odds of readmission for heart failure (OR=1.07, [1.05–1.09]), 6% for pneumonia patients (OR=1.06, [1.03–1.09]), and 9% for myocardial infarction patients (OR=1.09, [1.05–1.13]). Care in a hospital with a good versus poor work environment was associated with odds of readmission that were 7% lower for heart failure (OR = 0.93, [0.89–0.97]); 6% lower for myocardial infarction (OR = 0.94, [0.88–0.98]); and 10% lower for pneumonia (OR = 0.90, [0.85–0.96]) patients. Conclusions Improving nurses’ work environments and staffing may be effective interventions for preventing readmissions. PMID:23151591

Signature CERN-URSS

ScienceCinema

None

2017-12-09

Le DG W.Jentschke souhaite la bienvenue à l'assemblée et aux invités pour la signature du protocole entre le Cern et l'URSS qui est un événement important. C'est en 1955 que 55 visiteurs soviétiques ont visité le Cern pour la première fois. Le premier DG au Cern, F.Bloch, et Mons.Amaldi sont aussi présents. Tandis que le discours anglais de W.Jentschke est traduit en russe, le discours russe de Mons.Morozov est traduit en anglais.

Association between N-terminal pro B-type natriuretic peptide and day-to-day blood pressure and heart rate variability in a general population: the Ohasama study.

PubMed

Satoh, Michihiro; Hosaka, Miki; Asayama, Kei; Kikuya, Masahiro; Inoue, Ryusuke; Metoki, Hirohito; Tsubota-Utsugi, Megumi; Hara, Azusa; Hirose, Takuo; Obara, Taku; Totsune, Kazuhito; Hoshi, Haruhisa; Mano, Nariyasu; Node, Koichi; Imai, Yutaka; Ohkubo, Takayoshi

2015-08-01

In addition to day-to-day variability in blood pressure (BP) or heart rate (HR), N-terminal pro B-type natriuretic peptide (NT-proBNP) has been reported to be a predictor of cardiovascular disease. Here, we tested the hypothesis that day-to-day BP or HR variability calculated as the intraindividual standard deviation (SD) of home BP or HR is associated with elevated NT-proBNP in a cross-sectional study. Among 664 participants (mean age, 61.9 years; female, 70.5%) from a general Japanese population without a history of heart disease, 86 (13.0%) had NT-proBNP at least 125 pg/ml. Each 1 SD increase in the SD of home systolic BP (SBP) [odds ratio (OR), 1.82; P < .0001) and in the SD of home HR (OR, 1.44; P = 0.008) were significantly associated with the prevalence of NT-proBNP at least 125 pg/ml after adjustment for possible confounding factors including home SBP and HR. Among the four groups defined by the median SD of home SBP and of home HR, the group with higher SDs in home SBP (≥8.0 mmHg) and HR (≥5.0 bpm) had the greatest OR for the prevalence of NT-proBNP at least 125 pg/ml (OR, 4.80; P = 0007 vs. a reference group with lower SDs of home SBP and HR). These results suggest that day-to-day variability in BP and HR may be associated with target-organ damage or complications, which can lead to an elevated NT-proBNP level. An elevated NT-proBNP level may be involved in the prognostic significance of day-to-day variability in BP or HR.

Comprehensive electronic medical record implementation levels not associated with 30-day all-cause readmissions within Medicare beneficiaries with heart failure.

PubMed

Patterson, M E; Marken, P; Zhong, Y; Simon, S D; Ketcherside, W

2014-01-01

Regulatory standards for 30-day readmissions incentivize hospitals to improve quality of care. Implementing comprehensive electronic health record systems potentially decreases readmission rates by improving medication reconciliation at discharge, demonstrating the additional benefits of inpatient EHRs beyond improved safety and decreased errors. To compare 30-day all-cause readmission incidence rates within Medicare fee-for-service with heart failure discharged from hospitals with full implementation levels of comprehensive EHR systems versus those without. This retrospective cohort study uses data from the American Hospital Association Health IT survey and Medicare Part A claims to measure associations between hospital EHR implementation levels and beneficiary readmissions. Multivariable Cox regressions estimate the hazard ratio of 30-day all-cause readmissions within beneficiaries discharged from hospitals implementing comprehensive EHRs versus those without, controlling for beneficiary health status and hospital organizational factors. Propensity scores are used to account for selection bias. The proportion of heart failure patients with 30-day all-cause readmissions was 30%, 29%, and 32% for those discharged from hospitals with full, some, and no comprehensive EHR systems. Heart failure patients discharged from hospitals with fully implemented comprehensive EHRs compared to those with no comprehensive EHR systems had equivalent 30-day readmission incidence rates (HR = 0.97, 95% CI 0.73 - 1.3). Implementation of comprehensive electronic health record systems does not necessarily improve a hospital's ability to decrease 30-day readmission rates. Improving the efficiency of post-acute care will require more coordination of information systems between inpatient and ambulatory providers.

Big Bang Day : Physics Rocks

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

None

2009-10-07

Is particle physics the new rock 'n' roll? The fundamental questions about the nature of the universe that particle physics hopes to answer have attracted the attention of some very high profile and unusual fans. Alan Alda, Ben Miller, Eddie Izzard, Dara O'Briain and John Barrowman all have interests in this branch of physics. Brian Cox - CERN physicist, and former member of 90's band D:Ream, tracks down some very well known celebrity enthusiasts and takes a light-hearted look at why this subject can appeal to all of us.

Big Bang Day : Physics Rocks

ScienceCinema

None

2017-12-09

Is particle physics the new rock 'n' roll? The fundamental questions about the nature of the universe that particle physics hopes to answer have attracted the attention of some very high profile and unusual fans. Alan Alda, Ben Miller, Eddie Izzard, Dara O'Briain and John Barrowman all have interests in this branch of physics. Brian Cox - CERN physicist, and former member of 90's band D:Ream, tracks down some very well known celebrity enthusiasts and takes a light-hearted look at why this subject can appeal to all of us.

Healthy Body, Happy Heart: Improve Your Heart Health

MedlinePlus

... November 2017 Print this issue Healthy Body, Happy Heart Improve Your Heart Health En español Send us your comments Every moment of the day, your heart is pumping blood throughout your body. In silent ...

Integrating Containers in the CERN Private Cloud

NASA Astrophysics Data System (ADS)

Noel, Bertrand; Michelino, Davide; Velten, Mathieu; Rocha, Ricardo; Trigazis, Spyridon

2017-10-01

Containers remain a hot topic in computing, with new use cases and tools appearing every day. Basic functionality such as spawning containers seems to have settled, but topics like volume support or networking are still evolving. Solutions like Docker Swarm, Kubernetes or Mesos provide similar functionality but target different use cases, exposing distinct interfaces and APIs. The CERN private cloud is made of thousands of nodes and users, with many different use cases. A single solution for container deployment would not cover every one of them, and supporting multiple solutions involves repeating the same process multiple times for integration with authentication services, storage services or networking. In this paper we describe OpenStack Magnum as the solution to offer container management in the CERN cloud. We will cover its main functionality and some advanced use cases using Docker Swarm and Kubernetes, highlighting some relevant differences between the two. We will describe the most common use cases in HEP and how we integrated popular services like CVMFS or AFS in the most transparent way possible, along with some limitations found. Finally we will look into ongoing work on advanced scheduling for both Swarm and Kubernetes, support for running batch like workloads and integration of container networking technologies with the CERN infrastructure.

NEWS: A trip to CERN

NASA Astrophysics Data System (ADS)

Ellison, A. D.

2000-07-01

Two years ago John Kinchin and myself were lucky enough to attend the Goldsmith's particle physics course. As well as many interesting lectures and activities, this course included a visit to CERN. To most physics teachers CERN is Mecca, a hallowed place where gods manipulate and manufacture matter. The experience of being there was even better. Alison Wright was an enthusiastic and very knowledgeable host who ensured the visit went smoothly and we all learned a lot. While we were there, John and I discussed the possibility of bringing a party of A-level students to see real physics in action. In February of this year we managed it. 33 students from two schools, Boston Grammar School and Northampton School for Boys, and four staff left England and caught the 2 am ferry to France. Many hours and a few `short cuts' later we arrived at our hotel in St Genis, not far from CERN. The first day was spent sight-seeing in Lausanne and Geneva. The Olympic museum in Lausanne is well worth a visit. Unfortunately, the famous fountain in Geneva was turned off, but then you can't have everything. The following morning we turned up at CERN late due to the coach's brakes being iced up! We were met once again by Alison Wright who forgave us and introduced the visit by giving an excellent talk on CERN, its background and its reason for existing. At this point we met another member of our Goldsmith's course and his students so we joined forces once again. We then piled back into the coach to re-cross the border and visit ALEPH. ALEPH is a monster of a detector 150 m below ground. We divided into four groups, each with a very able and knowledgeable guide, and toured the site. The size and scale of the detector are awesome and the students were suitably impressed. We repeated the speed of sound experiment of two years ago at the bottom of a 150 m concrete shaft (320 m s-1), posed for a group photo in front of the detector (figure 1) and returned to the main site for lunch in

Morning surge of ventricular arrhythmias in a new arrhythmogenic canine model of chronic heart failure is associated with attenuation of time-of-day dependence of heart rate and autonomic adaptation, and reduced cardiac chaos.

PubMed

Zhu, Yujie; Hanafy, Mohamed A; Killingsworth, Cheryl R; Walcott, Gregory P; Young, Martin E; Pogwizd, Steven M

2014-01-01

Patients with chronic heart failure (CHF) exhibit a morning surge in ventricular arrhythmias, but the underlying cause remains unknown. The aim of this study was to determine if heart rate dynamics, autonomic input (assessed by heart rate variability (HRV)) and nonlinear dynamics as well as their abnormal time-of-day-dependent oscillations in a newly developed arrhythmogenic canine heart failure model are associated with a morning surge in ventricular arrhythmias. CHF was induced in dogs by aortic insufficiency & aortic constriction, and assessed by echocardiography. Holter monitoring was performed to study time-of-day-dependent variation in ventricular arrhythmias (PVCs, VT), traditional HRV measures, and nonlinear dynamics (including detrended fluctuations analysis α1 and α2 (DFAα1 & DFAα2), correlation dimension (CD), and Shannon entropy (SE)) at baseline, as well as 240 days (240 d) and 720 days (720 d) following CHF induction. LV fractional shortening was decreased at both 240 d and 720 d. Both PVCs and VT increased with CHF duration and showed a morning rise (2.5-fold & 1.8-fold increase at 6 AM-noon vs midnight-6 AM) during CHF. The morning rise in HR at baseline was significantly attenuated by 52% with development of CHF (at both 240 d & 720 d). Morning rise in the ratio of low frequency to high frequency (LF/HF) HRV at baseline was markedly attenuated with CHF. DFAα1, DFAα2, CD and SE all decreased with CHF by 31, 17, 34 and 7%, respectively. Time-of-day-dependent variations in LF/HF, CD, DFA α1 and SE, observed at baseline, were lost during CHF. Thus in this new arrhythmogenic canine CHF model, attenuated morning HR rise, blunted autonomic oscillation, decreased cardiac chaos and complexity of heart rate, as well as aberrant time-of-day-dependent variations in many of these parameters were associated with a morning surge of ventricular arrhythmias.

Morning Surge of Ventricular Arrhythmias in a New Arrhythmogenic Canine Model of Chronic Heart Failure Is Associated with Attenuation of Time-Of-Day Dependence of Heart Rate and Autonomic Adaptation, and Reduced Cardiac Chaos

PubMed Central

Zhu, Yujie; Hanafy, Mohamed A.; Killingsworth, Cheryl R.; Walcott, Gregory P.; Young, Martin E.; Pogwizd, Steven M.

2014-01-01

Patients with chronic heart failure (CHF) exhibit a morning surge in ventricular arrhythmias, but the underlying cause remains unknown. The aim of this study was to determine if heart rate dynamics, autonomic input (assessed by heart rate variability (HRV)) and nonlinear dynamics as well as their abnormal time-of-day-dependent oscillations in a newly developed arrhythmogenic canine heart failure model are associated with a morning surge in ventricular arrhythmias. CHF was induced in dogs by aortic insufficiency & aortic constriction, and assessed by echocardiography. Holter monitoring was performed to study time-of-day-dependent variation in ventricular arrhythmias (PVCs, VT), traditional HRV measures, and nonlinear dynamics (including detrended fluctuations analysis α1 and α2 (DFAα1 & DFAα2), correlation dimension (CD), and Shannon entropy (SE)) at baseline, as well as 240 days (240d) and 720 days (720d) following CHF induction. LV fractional shortening was decreased at both 240d and 720d. Both PVCs and VT increased with CHF duration and showed a morning rise (2.5-fold & 1.8-fold increase at 6 AM-noon vs midnight-6 AM) during CHF. The morning rise in HR at baseline was significantly attenuated by 52% with development of CHF (at both 240d & 720d). Morning rise in the ratio of low frequency to high frequency (LF/HF) HRV at baseline was markedly attenuated with CHF. DFAα1, DFAα2, CD and SE all decreased with CHF by 31, 17, 34 and 7%, respectively. Time-of-day-dependent variations in LF/HF, CD, DFA α1 and SE, observed at baseline, were lost during CHF. Thus in this new arrhythmogenic canine CHF model, attenuated morning HR rise, blunted autonomic oscillation, decreased cardiac chaos and complexity of heart rate, as well as aberrant time-of-day-dependent variations in many of these parameters were associated with a morning surge of ventricular arrhythmias. PMID:25140699

Trapezius Muscle Load, Heart Rate and Time Pressure during Day and Night Shift in Swiss and Japanese Nurses

PubMed Central

NICOLETTI, Corinne; MÜLLER, Christian; TOBITA, Itoko; NAKASEKO, Masaru; LÄUBLI, Thomas

2014-01-01

The aim of the present study was to analyze the activity of the trapezius muscle, the heart rate and the time pressure of Swiss and Japanese nurses during day and night shifts. The parameters were measured during a day and a night shift of 17 Swiss and 22 Japanese nurses. The observed rest time of the trapezius muscle was longer for Swiss than for Japanese nurses during both shifts. The 10th and the 50th percentile of the trapezius muscle activity showed a different effect for Swiss than for Japanese nurses. It was higher during the day shift of Swiss nurses and higher during the night shift of Japanese nurses. Heart rate was higher for both Swiss and Japanese nurses during the day. The time pressure was significantly higher for Japanese than for Swiss nurses. Over the duration of the shifts, time pressure increased for Japanese nurses and slightly decreased for those from Switzerland. Considering trapezius muscle activity and time pressure, the nursing profession was more burdening for the examined Japanese nurses than for Swiss nurses. In particular, the night shift for Japanese nurses was characterized by a high trapezius muscle activity and only few rest times for the trapezius muscle. PMID:24633074

Trapezius muscle load, heart rate and time pressure during day and night shift in Swiss and Japanese nurses.

PubMed

Nicoletti, Corinne; Müller, Christian; Tobita, Itoko; Nakaseko, Masaru; Läubli, Thomas

2014-01-01

The aim of the present study was to analyze the activity of the trapezius muscle, the heart rate and the time pressure of Swiss and Japanese nurses during day and night shifts. The parameters were measured during a day and a night shift of 17 Swiss and 22 Japanese nurses. The observed rest time of the trapezius muscle was longer for Swiss than for Japanese nurses during both shifts. The 10th and the 50th percentile of the trapezius muscle activity showed a different effect for Swiss than for Japanese nurses. It was higher during the day shift of Swiss nurses and higher during the night shift of Japanese nurses. Heart rate was higher for both Swiss and Japanese nurses during the day. The time pressure was significantly higher for Japanese than for Swiss nurses. Over the duration of the shifts, time pressure increased for Japanese nurses and slightly decreased for those from Switzerland. Considering trapezius muscle activity and time pressure, the nursing profession was more burdening for the examined Japanese nurses than for Swiss nurses. In particular, the night shift for Japanese nurses was characterized by a high trapezius muscle activity and only few rest times for the trapezius muscle.

Dietary sodium restriction below 2 gram per day predicted shorter event-free survival in patients with mild heart failure

PubMed Central

Song, Eun Kyeung; Moser, Debra K.; Dunbar, Sandra B.; Pressler, Susan J.; Lennie, Terry A.

2015-01-01

Background Despite a growing recognition that a strict low sodium diet may not be warranted in compensated heart failure (HF) patients, the link between sodium restriction below 2g/day and health outcomes is unknown in patients at different levels of HF severity. Purpose To compare differences in event-free survival among patients with < 2g/day, 2–3g/day, or > 3g/day sodium intake stratified by New York Heart Association (NYHA) class. Method A total of 244 patients with HF completed a four-day food diary to measure daily sodium intake. All-cause hospitalization or death for a median of 365follow-up days and covariates on age, gender, etiology, body mass index, NYHA class, ejection fraction, total comorbidity score, the presence of ankle edema, and prescribed medications were determined by patient interview and medical record review. Hierarchical Cox hazard regression was used to address the purpose. Results In NYHA class I/II (n=134), patients with < 2g/day sodium intake had a 3.7-times higher risk (p = .025), while patients with > 3g/day sodium intake had a 0.4-times lower risk (p = .047) for hospitalization or death than those with 2–3g/day sodium intake after controlling for covariates. In NYHA class III/IV (n=110), > 3g/day sodium intake predicted shorter event-free survival (p = .044), whereas there was no difference in survival curves between patients with < 2g/day and those with 2–3g/day sodium intake. Conclusion Sodium restriction below 2g/day is not warranted in mild HF patients, whereas excessive sodium intake above 3g/day may be harmful in moderate to severe HF patients. PMID:24366983

Illness Representations, Treatment Beliefs, Medication Adherence, and 30-Day Hospital Readmission in Adults With Chronic Heart Failure: A Prospective Correlational Study.

PubMed

Turrise, Stephanie

2016-01-01

An estimated 5.1 million Americans have chronic heart failure, yet despite advances in its treatment, there has been no improvement in hospital readmissions among aging adult patients with chronic heart failure. The purpose of this study is to investigate the relationships among illness representations, treatment beliefs, medication adherence, and 30-day hospital readmission for heart failure exacerbation in aging adults with chronic heart failure. Using a prospective, correlational design, 96 older adults with a primary or secondary diagnosis of heart failure discharged to home from a hospital in the Southeastern United States participated in telephone surveys and follow-up telephone calls. Data analysis included correlation and logistic regression analyses. Participants were highly adherent to their medications. Individuals who did not believe their treatment was effective in controlling their HF were readmitted within 30 days of hospital discharge for HF exacerbation; that is, treatment control was inversely related to 30-day hospital readmission. In post hoc analyses, personal control was inversely related to dichotomized medication adherence and necessity-concern differential was directly related to dichotomized medication adherence. The necessity-concern differential, or the belief that medication necessity outweighed the concerns they had about their medicines, was a significant predictor of medication adherence. Nurses can use these study findings to help identify individuals who may be at risk of being nonadherent to their medications and hospital readmission. Recommendations for future research include replication with multiple sites, the addition of objective measures of medication adherence, investigation of both the cognitive and emotional pathways, and qualitative exploration of personal control in the context of medication adherence in HF.

A randomized comparison of 5 versus 12 hours per day of cardiac contractility modulation treatment for heart failure patients: A preliminary report.

PubMed

Kloppe, Axel; Mijic, Dejan; Schiedat, Fabian; Bogossian, Harilaos; Mügge, Andreas; Rousso, Benny; Lemke, Bernd

2016-01-01

Cardiac contractility modulation (CCM) signals are non-excitatory electrical signals delivered during the absolute refractory period intended to improve contraction and cardiac function. Clinical trials have shown that CCM treatment significantly improves exercise tolerance and quality of life in symptomatic heart failure patients. Studies with CCM therapy typically include CCM delivery for 3, 5 or 7 h per day, although other configurations are also commonly used. Each has been associated with improved outcomes in heart failure, but it is not clear whether different application durations are associated with the various degrees of benefit. The purpose of the current pilot evaluation study was to evaluate the quality of life, exercise tolerance, and cardiac function, over a 6-month period when CCM was delivered for 5 h/day vs. 12 h/day. Increasing the daily CCM therapy duration is safe and as good as the standard CCM periods of application per day. This single center pilot evaluation study involved 19 medically refractory symptomatic patients with heart failure and reduced left ventricular function who underwent implantation of an Optimizer™ system (Impulse Dynamics, Orangeburg, NY, USA). Patients were randomized into one of two treatment groups; 5 h/day CCM treatment or 12 h/day CCM treatment. Subjects and evaluating physicians were blinded to the study group. Subjects returned to the hospital after 12 and 24 weeks. Efficacy evaluations included changes from baseline to 24 weeks in Minnesota Living With Heart Failure Questionnaire score (MLWHFQ), maximal oxygen consumption in the cardio-pulmonary stress test (peak VO2), New York Heart Association classification (NYHA), 6-min walk distance (6MWD), and ejection fraction (EF). At the end of 24 weeks, clinical improvement was observed in the entire cohort in all efficacy measures (mean change from baseline of -17.1 in MLWHFQ, -0.86 in NYHA, and improvement trend of 1.48 mL O2/kg/min in peak VO2, 31.3 m in 6MWD, and 2

Influence of gestational age and time of day in baseline and heart rate variation of fetuses.

PubMed

Li, Guangfei; Zhang, Song; Yang, Lin; Li, Shufang; Wang, Yan; Hao, Dongmei; Yang, Yimin; Li, Xuwen; Zhang, Lei; Xu, Mingzhou

2016-04-29

Fetal electrocardiography (FECG) places electrodes on the maternal abdomen to convert the fetal electrocardiosignals into fetal heart rate (FHR), improving the accuracy and comfort of pregnant woman. At the same time, FECG simplifies the procedure of long term monitoring in the perinatal period. Investigating the influence of gestational age and time of day on FHR features to distinguish between non-stress test (NST) normal fetuses and NST suspicious fetuses. A novel method of FHR baseline estimation was presented; then baseline value and fetal heart rate variation (FHRV) were analyzed in the time domain using FHR signals recorded from 52 fetuses. Baseline values in 1:00, 2:00, 4:00, 5:00 and heart rate variation (HRV) distribution showed a significant difference (p< 0.05) between NST normal fetuses and NST suspicious fetuses. The results suggest that NST normal and suspicious fetuses had same outcome and different FHR features. Accurately distinguishing normal fetuses and suspicious fetuses is important for lowering the false positive rate and reducing unnecessary clinical intervention.

CERN welcomes new members

NASA Astrophysics Data System (ADS)

2017-08-01

Lithuania is on course to become an associate member of CERN, pending final approval by the Lithuanian parliament. Associate membership will allow representatives of the Baltic nation to take part in meetings of the CERN Council, which oversees the Geneva-based physics lab.

Heart failure and the holidays.

PubMed

Shah, Mahek; Bhalla, Vikas; Patnaik, Soumya; Maludum, Obiora; Lu, Marvin; Figueredo, Vincent M

2016-10-01

Studies suggest increased cardiac morbidity and heart failure exacerbations during winter months with a peak around the holiday season. Major sporting events and intense encounters in sports have been shown to affect cardiovascular outcomes amongst its fans. All patients admitted to Einstein Medical Center between January 1, 2003 and December 31, 2013 with a diagnosis of congestive heart failure were included in the study. They were included on the basis of the presence of an ICD-9CM code representing congestive heart failure as the primary diagnosis. Comparisons were made between the rates of heart failure admissions on the holiday, 4 days following the holiday and the rest of the month for 5 specific days: Christmas day, New Year's day, Independence day, Thanksgiving day and Super Bowl Sunday. Our study included 22,727 heart failure admissions at an average of 5.65 admissions per day. The mean patient age was 68 ± 15 years. There was a significant increase in daily heart failure admissions following Independence day (5.65 vs. 5; p = 0.027) and Christmas day (6.5 vs. 5.5; p = 0.046) when compared to the rest of the month. A history of alcohol abuse or dependence did not correlate with the reported+ rise in heart failure admissions immediately following the holidays. The mean number of daily admissions on the holidays were significantly lower for all holidays compared to the following 4 days. All holidays apart from Super Bowl Sunday demonstrated lower admission rates on the holiday compared to the rest of the month. Christmas and Independence day were associated with increased heart failure admissions immediately following the holidays. The holidays themselves saw lower admission rates. Overeating on holidays, associated emotional stressors, lesser exercise and postponing medical around holidays may be among the factors responsible for the findings.

Lack of Evidence for Racial Disparity in 30-Day All-Cause Readmission Rate for Older US Veterans Hospitalized with Heart Failure.

PubMed

Kheirbek, Raya Elfadel; Wojtusiak, Janusz; Vlaicu, Sorina O; Alemi, Farrokh

Heart failure is the leading cause for 30-day all-cause readmission. Although racial disparities in health care are well documented, their impact on 30-day all-cause readmission rate is inconclusive. We examined the impact of racial disparity on 30-day readmission for hospitalized patients with heart failure. This is a retrospective secondary data analysis for a large veteran cohort in 130 Veterans Affairs Medical Centers. Propensity scores were used to reduce differences in age, gender, survival days, and comorbidities in index hospitalization among 46 524 whites and 14 124 African Americans (AA). At index hospitalization, AA patients were younger (73.04 vs 67.10 years, t = -54.58, P < .000) and less likely to have myocardial infarcts (8.02% vs 9.80%, t = -6.36, P = .000), peripheral vascular disease (15.25% vs 22.51%, t = -18.68, P = .000), chronic obstructive pulmonary disease (39.59% vs 50.05%, t = -21.89, P < .000), and complicated diabetes (23.42% vs 26.24%, t = -6.73, P = .000). AA patients had lower mortality 30 days post-index hospitalization (3.51% vs 5.69%, t = -10.23, P = .000). In contrast, AA patients were more likely to have renal disease (44.03% vs 38.71%, t = 11.32, P < .000) and HIV/AIDS (1.56% vs 0.20%, t = 19.71, P < .000). The 30-day all-cause readmission rate before adjustments was 17.82% for AA patients versus 18.72% for white patients. There was no difference in the 2 rates after adjustments (18% vs 18%; odds of readmission = 1.002, z = 0.08, P = .937). In a large Department of Veterans Affairs (VA) cohort, white and AA veterans hospitalized for heart failure had similar 30-day all-cause readmission rates after adjustments were made for age, gender, survival days, and comorbidities. However, the 30-day all-cause mortality rate was higher for white patients than for AA patients. Future prospective studies are needed to validate results and test generalizability outside the VA system of care.

Impact of geriatric assessment variables on 30-day mortality among older patients with acute heart failure.

PubMed

Martín-Sánchez, Francisco Javier; Rodríguez-Adrada, Esther; Vidán, María Teresa; Díez Villanueva, Pablo; Llopis García, Guillermo; González Del Castillo, Juan; Alberto Rizzi, Miguel; Alquézar, Aitor; Herrera Mateo, Sergio; Piñera, Pascual; Sánchez Nicolás, José Andrés; Lázaro Aragues, Paula; Llorens, Pere; Herrero, Pablo; Jacob, Javier; Gil, Víctor; Fernández, Cristina; Bueno, Héctor; Miró, Òscar

2018-06-01

To study the impact of geriatric assessment variables on 30-day mortality among older patients with acute heart failure (AHF). Retrospective analysis of cases in the OAK Registry (Older Acute Heart Failure Key Data), a prospectively compiled database of consecutive patients aged 65 years or older treated for AHF in 3 Spanish emergency departments over a 4-month period (November-December 2011 and January-February 2014). The patients underwent a geriatric assessment adapted for emergency department use on weekdays between 8 AM and 10 PM. Demographic, clinical, laboratory, and geriatric assessment variables were recorded. The geriatric variables were concurrent diseases; polypharmacy; frailty; functional, social, and cognitive status at baseline; results of screening for confusional state, cognitive impairment, and depression; and nutritional status. The primary outcome was all-cause mortality at 30 days. We included 565 patients with a mean (SD) age of 83 (7.1) years; 346 (61.6%) were women. Sixty-five (11.5%) died within 30 days. Independent factors associated with 30-day mortality were acute confusional state (adjusted odds ratio [aOR], 2.2; 95% CI, 1.0–4.8; P=.04), acute illness (aOR, 1.8; 95% CI, 0.9–3.4; P=.05), loss of appetite in the past 3 months (aOR, 1.8; 95% CI, 1.0–3.4; P=.04), frailty (aOR, 2.0, 95% CI, 1.0–4.1; P=.05), and severe disability (aOR, 4.4; 95% CI, 1.9–11.4; P=.01). Certain geriatric variables should be considered when assessing short-term risk in older patients with AHF.

Introduction to CERN

ScienceCinema

Heuer, R.-D.

2018-02-19

Summer Student Lecture Programme Introduction. The mission of CERN; push back the frontiers of knowledge, e.g. the secrets of the Big Bang...what was the matter like within the first moments of the Universe's existence? You have to develop new technologies for accelerators and detectors (also information technology--the Web and the GRID and medicine--diagnosis and therapy). There are three key technology areas at CERN; accelerating, particle detection, large-scale computing.

Prognostic Value of Urinary Neutrophil Gelatinase-Associated Lipocalin on the First Day of Admission for Adverse Events in Patients With Acute Decompensated Heart Failure.

PubMed

Nakada, Yasuki; Kawakami, Rika; Matsui, Masaru; Ueda, Tomoya; Nakano, Tomoya; Takitsume, Akihiro; Nakagawa, Hitoshi; Nishida, Taku; Onoue, Kenji; Soeda, Tsunenari; Okayama, Satoshi; Watanabe, Makoto; Kawata, Hiroyuki; Okura, Hiroyuki; Saito, Yoshihiko

2017-05-18

Urinary neutrophil gelatinase-associated lipocalin (U-NGAL) is an early predictor of acute kidney injury and adverse events in various diseases; however, in acute decompensated heart failure patients, its significance remains poorly understood. This study aimed to investigate the prognostic value of U-NGAL on the first day of admission for the occurrence of acute kidney injury and long-term outcomes in acute decompensated heart failure patients. We studied 260 acute decompensated heart failure patients admitted to our department between 2011 and 2014 by measuring U-NGAL in 24-hour urine samples collected on the first day of admission. Primary end points were all-cause death, cardiovascular death, and heart failure admission. Patients were divided into 2 groups according to their median U-NGAL levels (32.5 μg/gCr). The high-U-NGAL group had a significantly higher occurrence of acute kidney injury during hospitalization than the low-U-NGAL group ( P =0.0012). Kaplan-Meier analysis revealed that the high-U-NGAL group exhibited a worse prognosis than the low-U-NGAL group in all-cause death (hazard ratio 2.07; 95%CI 1.38-3.12, P =0.0004), cardiovascular death (hazard ratio 2.29; 95%CI 1.28-4.24, P =0.0052), and heart failure admission (hazard ratio 1.77; 95%CI 1.13-2.77, P =0.0119). The addition of U-NGAL to the estimated glomerular filtration rate significantly improved the predictive accuracy of all-cause mortality ( P =0.0083). In acute decompensated heart failure patients, an elevated U-NGAL level on the first day of admission was related to the development of clinical acute kidney injury and independently associated with poor prognosis. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Scaling the CERN OpenStack cloud

NASA Astrophysics Data System (ADS)

Bell, T.; Bompastor, B.; Bukowiec, S.; Castro Leon, J.; Denis, M. K.; van Eldik, J.; Fermin Lobo, M.; Fernandez Alvarez, L.; Fernandez Rodriguez, D.; Marino, A.; Moreira, B.; Noel, B.; Oulevey, T.; Takase, W.; Wiebalck, A.; Zilli, S.

2015-12-01

CERN has been running a production OpenStack cloud since July 2013 to support physics computing and infrastructure services for the site. In the past year, CERN Cloud Infrastructure has seen a constant increase in nodes, virtual machines, users and projects. This paper will present what has been done in order to make the CERN cloud infrastructure scale out.

Emergency Heart Failure Mortality Risk Grade score performance for 7-day mortality prediction in patients with heart failure attended at the emergency department: validation in a Spanish cohort.

PubMed

Gil, Víctor; Miró, Òscar; Schull, Michael J; Llorens, Pere; Herrero-Puente, Pablo; Jacob, Javier; Ríos, José; Lee, Douglas S; Martín-Sánchez, Francisco J

2018-06-01

The Emergency Heart Failure Mortality Risk Grade (EHMRG) scale, derived in 86 Canadian emergency departments (EDs), stratifies patients with acute-decompensated heart failure (ADHF) according to their 7-day mortality risk. We evaluated its external validity in a Spanish cohort. We applied the EHMRG scale to ADHF patients consecutively included in the Epidemiology of Acute Heart Failure in Emergency departments (EAHFE) registry (29 Spanish EDs) and measured its performance. Patients were distributed into quintiles according to the original and their self-defined score cutoffs. The 7-day mortality rates were compared internally among different categories and with categories of Canadian cohorts. The EAHFE group [n: 1553 patients; 80 (10) years; 55.6% women] had a 5.5% 7-day mortality rate and the EHMRG scale c-statistic was 0.741 (95% confidence interval: 0.688-0.793) compared with 0.807 (0.761-0.842) and 0.804 (0.763-0.840) obtained in the Canadian derivation and validation cohorts. The mortality rate of the EAHFE group mortality increased progressively as the quintile categories increased using intervals defined by either the Canadian or the Spanish EHMRG score cutoffs, although with more regular increments with the EAHFE-defined intervals; using the latter, patients at quintiles 2, 3, 4, 5a and 5b had (compared with quintile 1) odds ratios of 1.77, 3.36, 4.44, 9.39 and 16.19, respectively. The EHMRG scale stratified risk in an ADHF cohort that included both palliative and nonpalliative patients in Spanish EDs, showing an extrapolation to a higher mortality risk cohort than the original derivation sample. Stratification improved when the score was recalibrated in the Spanish cohort.

Helix Nebula and CERN: A Symbiotic approach to exploiting commercial clouds

NASA Astrophysics Data System (ADS)

Barreiro Megino, Fernando H.; Jones, Robert; Kucharczyk, Katarzyna; Medrano Llamas, Ramón; van der Ster, Daniel

2014-06-01

The recent paradigm shift toward cloud computing in IT, and general interest in "Big Data" in particular, have demonstrated that the computing requirements of HEP are no longer globally unique. Indeed, the CERN IT department and LHC experiments have already made significant R&D investments in delivering and exploiting cloud computing resources. While a number of technical evaluations of interesting commercial offerings from global IT enterprises have been performed by various physics labs, further technical, security, sociological, and legal issues need to be address before their large-scale adoption by the research community can be envisaged. Helix Nebula - the Science Cloud is an initiative that explores these questions by joining the forces of three European research institutes (CERN, ESA and EMBL) with leading European commercial IT enterprises. The goals of Helix Nebula are to establish a cloud platform federating multiple commercial cloud providers, along with new business models, which can sustain the cloud marketplace for years to come. This contribution will summarize the participation of CERN in Helix Nebula. We will explain CERN's flagship use-case and the model used to integrate several cloud providers with an LHC experiment's workload management system. During the first proof of concept, this project contributed over 40.000 CPU-days of Monte Carlo production throughput to the ATLAS experiment with marginal manpower required. CERN's experience, together with that of ESA and EMBL, is providing a great insight into the cloud computing industry and highlighted several challenges that are being tackled in order to ease the export of the scientific workloads to the cloud environments.

New directions in the CernVM file system

NASA Astrophysics Data System (ADS)

Blomer, Jakob; Buncic, Predrag; Ganis, Gerardo; Hardi, Nikola; Meusel, Rene; Popescu, Radu

2017-10-01

The CernVM File System today is commonly used to host and distribute application software stacks. In addition to this core task, recent developments expand the scope of the file system into two new areas. Firstly, CernVM-FS emerges as a good match for container engines to distribute the container image contents. Compared to native container image distribution (e.g. through the “Docker registry”), CernVM-FS massively reduces the network traffic for image distribution. This has been shown, for instance, by a prototype integration of CernVM-FS into Mesos developed by Mesosphere, Inc. We present a path for a smooth integration of CernVM-FS and Docker. Secondly, CernVM-FS recently raised new interest as an option for the distribution of experiment conditions data. Here, the focus is on improved versioning capabilities of CernVM-FS that allows to link the conditions data of a run period to the state of a CernVM-FS repository. Lastly, CernVM-FS has been extended to provide a name space for physics data for the LIGO and CMS collaborations. Searching through a data namespace is often done by a central, experiment specific database service. A name space on CernVM-FS can particularly benefit from an existing, scalable infrastructure and from the POSIX file system interface.

EFQPSK Versus CERN: A Comparative Study

NASA Technical Reports Server (NTRS)

Borah, Deva K.; Horan, Stephen

2001-01-01

This report presents a comparative study on Enhanced Feher's Quadrature Phase Shift Keying (EFQPSK) and Constrained Envelope Root Nyquist (CERN) techniques. These two techniques have been developed in recent times to provide high spectral and power efficiencies under nonlinear amplifier environment. The purpose of this study is to gain insights into these techniques and to help system planners and designers with an appropriate set of guidelines for using these techniques. The comparative study presented in this report relies on effective simulation models and procedures. Therefore, a significant part of this report is devoted to understanding the mathematical and simulation models of the techniques and their set-up procedures. In particular, mathematical models of EFQPSK and CERN, effects of the sampling rate in discrete time signal representation, and modeling of nonlinear amplifiers and predistorters have been considered in detail. The results of this study show that both EFQPSK and CERN signals provide spectrally efficient communications compared to filtered conventional linear modulation techniques when a nonlinear power amplifier is used. However, there are important differences. The spectral efficiency of CERN signals, with a small amount of input backoff, is significantly better than that of EFQPSK signals if the nonlinear amplifier is an ideal clipper. However, to achieve such spectral efficiencies with a practical nonlinear amplifier, CERN processing requires a predistorter which effectively translates the amplifier's characteristics close to those of an ideal clipper. Thus, the spectral performance of CERN signals strongly depends on the predistorter. EFQPSK signals, on the other hand, do not need such predistorters since their spectra are almost unaffected by the nonlinear amplifier, Ibis report discusses several receiver structures for EFQPSK signals. It is observed that optimal receiver structures can be realized for both coded and uncoded EFQPSK

Vidyo@CERN: A Service Update

NASA Astrophysics Data System (ADS)

Fernandes, J.; Baron, T.

2015-12-01

We will present an overview of the current real-time video service offering for the LHC, in particular the operation of the CERN Vidyo service will be described in terms of consolidated performance and scale: The service is an increasingly critical part of the daily activity of the LHC collaborations, topping recently more than 50 million minutes of communication in one year, with peaks of up to 852 simultaneous connections. We will elaborate on the improvement of some front-end key features such as the integration with CERN Indico, or the enhancements of the Unified Client and also on new ones, released or in the pipeline, such as a new WebRTC client and CERN SSO/Federated SSO integration. An overview of future infrastructure improvements, such as virtualization techniques of Vidyo routers and geo-location mechanisms for load-balancing and optimum user distribution across the service infrastructure will also be discussed. The work done by CERN to improve the monitoring of its Vidyo network will also be presented and demoed. As a last point, we will touch the roadmap and strategy established by CERN and Vidyo with a clear objective of optimizing the service both on the end client and backend infrastructure to make it truly universal, to serve Global Science. To achieve those actions, the introduction of the multitenant concept to serve different communities is needed. This is one of the consequences of CERN's decision to offer the Vidyo service currently operated for the LHC, to other Sciences, Institutions and Virtual Organizations beyond HEP that might express interest for it.

Heart failure - medicines

MedlinePlus

CHF - medicines; Congestive heart failure - medicines; Cardiomyopathy - medicines; HF - medicines ... You will need to take most of your heart failure medicines every day. Some medicines are taken ...

Heart Rate at Hospital Discharge in Patients With Heart Failure Is Associated With Mortality and Rehospitalization

PubMed Central

Laskey, Warren K.; Alomari, Ihab; Cox, Margueritte; Schulte, Phillip J.; Zhao, Xin; Hernandez, Adrian F.; Heidenreich, Paul A.; Eapen, Zubin J.; Yancy, Clyde; Bhatt, Deepak L.; Fonarow, Gregg C.

2015-01-01

Background Whether heart rate upon discharge following hospitalization for heart failure is associated with long‐term adverse outcomes and whether this association differs between patients with sinus rhythm (SR) and atrial fibrillation (AF) have not been well studied. Methods and Results We conducted a retrospective cohort study from clinical registry data linked to Medicare claims for 46 217 patients participating in Get With The Guidelines®–Heart Failure. Cox proportional‐hazards models were used to estimate the association between discharge heart rate and all‐cause mortality, all‐cause readmission, and the composite outcome of mortality/readmission through 1 year. For SR and AF patients with heart rate ≥75, the association between heart rate and mortality (expressed as hazard ratio [HR] per 10 beats‐per‐minute increment) was significant at 0 to 30 days (SR: HR 1.30, 95% CI 1.22 to 1.39; AF: HR 1.23, 95% CI 1.16 to 1.29) and 31 to 365 days (SR: HR 1.15, 95% CI 1.12 to 1.20; AF: HR 1.05, 95% CI 1.01 to 1.08). Similar associations between heart rate and all‐cause readmission and the composite outcome were obtained for SR and AF patients from 0 to 30 days but only in the composite outcome for SR patients over the longer term. The HR from 0 to 30 days exceeded that from 31 to 365 days for both SR and AF patients. At heart rates <75, an association was significant for mortality only for both SR and AF patients. Conclusions Among older patients hospitalized with heart failure, higher discharge heart rate was associated with increased risks of death and rehospitalization, with higher risk in the first 30 days and for SR compared with AF. PMID:25904590

30-Day Episode Payments and Heart Failure Outcomes Among Medicare Beneficiaries.

PubMed

Wadhera, Rishi K; Joynt Maddox, Karen E; Wang, Yun; Shen, Changyu; Yeh, Robert W

2018-05-01

The purpose of this study was to examine the association of 30-day payments for an episode of heart failure (HF) care at the hospital level with patient outcomes. There is increased focus among policymakers on improving value for HF care, given its rising prevalence and associated financial burden in the United States; however, little is known about the relationship between payments and mortality for a 30-day episode of HF care. Using Medicare claims data for all fee-for-service beneficiaries hospitalized for HF between July 1, 2011, and June 30, 2014, we examined the association between 30-day Medicare payments at the hospital level (beginning with a hospital admission for HF and across multiple settings following discharge) and patient 30-day mortality using mixed-effect logistic regression models. We included 1,343,792 patients hospitalized for HF across 2,948 hospitals. Mean hospital-level 30-day Medicare payments per beneficiary were $15,423 ± $1,523. Overall observed mortality in the cohort was 11.3%. Higher hospital-level 30-day payments were associated with lower patient mortality after adjustment for patient characteristics (odds ratio per $1,000 increase in payments: 0.961; 95% confidence interval [CI]: 0.954 to 0.967). This relationship was slightly attenuated after accounting for hospital characteristics and HF volume, but remained significant (odds ratio per $1,000 increase: 0.968; 95% CI: 0.962 to 0.975). Additional adjustment for potential mediating factors, including cardiac service capability and post-acute service use, did not significantly affect the relationship. Higher hospital-level 30-day episode payments were associated with lower patient mortality following a hospitalization for HF. This has implications for policies that incentivize reduction in payments without considering value. Further investigation is needed to understand the mechanisms that underlie this relationship. Copyright © 2018 American College of Cardiology

Predictors of 30-day mortality in patients admitted to ED for acute heart failure.

PubMed

Marchetti, Matthieu; Benedetti, Antoine; Mimoz, Olivier; Lardeur, Jean-Yves; Guenezan, Jérémy; Marjanovic, Nicolas

2017-03-01

Acute heart failure (AHF) is a leading cause of admission in emergency departments (ED). It is associated with significant in-hospital mortality, suggesting that there is room for improvement of care. Our aims were to investigate clinical patterns, biological characteristics and determinants of 30-day mortality. We conducted a single site, retrospective review of adult patients (≥18years) admitted to ED for AHF over a 12-month period. Data collected included demographics, clinical, biological and outcomes data. Epidemiologic data were collected at baseline, and patients were followed up during a 30-day period. There were a total of 322 patients. Mean age was 83.9±9.1years, and 47% of the patients were men. Among them, 59 patients (18.3%) died within 30days of admission to the ED. The following three characteristics were associated with increased mortality: age>85years (OR=1.5[95%CI:0.8-2.7], p=0.01), creatinine clearance <30mL/min (OR=2.6[95%CI:1.4-5], p<0.001) and Nt-proBNP >5000pg/mL (OR=2.2[95%CI:1.2-4], p<0.001). The best Nt-proBNP cut-off value to predict first-day mortality was 9000pg/mL (area under the curve (AUC) [95%CI] of 0.790 [0.634-0.935], p<0.001). For 7-day mortality, it was 7900pg/mL (0.698 [0.578-0.819], p<0.001) and for 30-day mortality, 5000pg/mL (0.667 [0.576-0.758], p<0.001). Nt-proBNP level on admission, age and creatinine clearance, are predictive of 30-day mortality in adult patients admitted to ED for AHF. Copyright © 2016 Elsevier Inc. All rights reserved.

CERN alerter—RSS based system for information broadcast to all CERN offices

NASA Astrophysics Data System (ADS)

Otto, R.

2008-07-01

Nearly every large organization uses a tool to broadcast messages and information across the internal campus (messages like alerts announcing interruption in services or just information about upcoming events). These tools typically allow administrators (operators) to send 'targeted' messages which are sent only to specific groups of users or computers, e/g only those located in a specified building or connected to a particular computing service. CERN has a long history of such tools: CERNVMS's SPM_quotMESSAGE command, Zephyr [2] and the most recent the NICE Alerter based on the NNTP protocol. The NICE Alerter used on all Windows-based computers had to be phased out as a consequence of phasing out NNTP at CERN. The new solution to broadcast information messages on the CERN campus continues to provide the service based on cross-platform technologies, hence minimizing custom developments and relying on commercial software as much as possible. The new system, called CERN Alerter, is based on RSS (Really Simple Syndication) [9] for the transport protocol and uses Microsoft SharePoint as the backend for database and posting interface. The windows-based client relies on Internet Explorer 7.0 with custom code to trigger the window pop-ups and the notifications for new events. Linux and Mac OS X clients could also rely on any RSS readers to subscribe to targeted notifications. The paper covers the architecture and implementation aspects of the new system.

Association of heart rate at hospital discharge with mortality and hospitalizations in patients with heart failure.

PubMed

Habal, Marlena V; Liu, Peter P; Austin, Peter C; Ross, Heather J; Newton, Gary E; Wang, Xuesong; Tu, Jack V; Lee, Douglas S

2014-01-01

Heart failure (HF) is associated with a high burden of morbidity and mortality. Hospital discharge is an opportunity for identification of modifiable prognostic factors in the transition to chronic HF. We examined the association of discharge heart rate with 30-day and 1-year mortality and hospitalization outcomes in a cohort of 9097 patients with HF discharged from hospital. Discharge heart rate was categorized into predefined groups: 40 to 60 (n=1333), 61 to 70 (n=2170), 71 to 80 (n=2631), 81 to 90 (n=1700), and >90 bpm (n=1263). There was a significant increase in all-cause 30-day mortality with adjusted odds ratios of 1.59 (95% confidence interval [CI], 1.18-2.14; P=0.003) for discharge heart rates 81 to 90 bpm and 1.56 (95% CI, 1.13-2.16; P=0.007) for heart rates>90 bpm when compared with the reference group (heart rates, 61-70 bpm). Cardiovascular death risk at 30 days was also higher with adjusted odds ratio 1.59 (discharge heart rates, 81-90 bpm; 95% CI, 1.09-2.33; P=0.017) and 1.65 (discharge heart rates, >90 bpm; 95% CI, 1.09-2.48; P=0.017). One-year all-cause mortality (adjusted odds ratio, 1.41; 95% CI, 1.16-1.72; P<0.001) and cardiovascular death (adjusted odds ratio, 1.47; 95% CI, 1.12-1.92; P=0.005) were higher with discharge heart rates>90 bpm when compared with the reference group (heart rates, 40-60 bpm). Readmissions for HF (adjusted hazard ratio, 1.26; 95% CI, 1.04-1.54; P=0.021) and cardiovascular disease (adjusted hazard ratio, 1.29; 95% CI, 1.08-1.54; P=0.004) within 30 days were also higher with discharge heart rates>90 bpm. Higher discharge heart rates were associated with greater risk of all-cause and cardiovascular mortality≤1-year follow-up and an elevated risk of 30-day readmission for HF and cardiovascular disease.

Factors Associated With Adherence to 14-Day Office Appointments After Heart Failure Discharge.

PubMed

Distelhorst, Karen; Claussen, Renee; Dion, Kelly; Bena, James F; Morrison, Shannon L; Walker, Donna; Tai, Hua-Li; Albert, Nancy M

2018-06-01

Follow-up within 14 days after hospital discharge for heart failure (HF) may prevent 30-day hospital readmission, but adherence varies. The purpose of this study was to determine predictors of nonadherence to scheduled appointments. A medical record review included patients hospitalized for decompensated HF at 3 health system hospitals who had a scheduled 14-day office appointment. Patient demographics, and social, HF, and hospital factors were studied for association with appointment adherence. Multivariable modeling was used to determine the odds of missing scheduled appointments. Of 701 cases, mean (standard deviation) age was 73.5 (13.8) years, 46.4% were female and 38.9% were nonwhite. Appointment nonadherence was 16.2%. In multivariate analyses, 4 factors predicted missed appointments: drug use history (odds ratio [OR], 3.95; 95% confidence interval [CI], 1.70-9.20; P < .001), nonwhite race (OR, 1.85; 95% CI, 1.08-3.16; P = .024), pulmonary disease (OR, 1.80; 95% CI, 1.12-2.87; P = .014), and anemia (OR, 1.58; 95% CI, 1.01-2.46; P = .044). Scheduling appointments postdischarge vs predischarge was not associated with missed appointments (OR, 0.72; 95% CI, 0.45-1.15; P = .17). Findings may help practitioners identify patients who are likely to miss a follow-up visit; all 4 predictors were easily retrievable from medical records during hospitalization. Copyright © 2018 Elsevier Inc. All rights reserved.

CERN and high energy physics, the grand picture

ScienceCinema

Heuer, Rolf-Dieter

2018-05-24

The lecture will touch on several topics, to illustrate the role of CERN in the present and future of high-energy physics: how does CERN work? What is the role of the scientific community, of bodies like Council and SPC, and of international cooperation, in the definition of CERN's scientific programme? What are the plans for the future of the LHC and of the non-LHC physics programme? What is the role of R&D; and technology transfer at CERN?

Novel apparatus and methods for performing remotely controlled particle-solid interaction experiments at CERN

NASA Astrophysics Data System (ADS)

Krause, H. F.; Deveney, E. F.; Jones, N. L.; Vane, C. R.; Datz, S.; Knudsen, H.; Grafström, P.; Schuch, R.

1997-04-01

Recent atomic physics studies involving ultrarelativistic Pb ions required solid target positioners, scintillators, and a sophisticated data acquisition and control system placed in a remote location at the CERN Super Proton Synchrotron near Geneva, Switzerland. The apparatus, installed in a high-radiation zone underground, had to (i) function for months, (ii) automatically respond to failures such as power outages and particle-induced computer upsets, and (iii) communicate with the outside world via a telephone line. The heart of the apparatus developed was an Apple Macintosh-based CAMAC system that answered the telephone and interpreted and executed remote control commands that (i) sensed and set targets, (ii) controlled voltages and discriminator levels for scintillators, (iii) modified data acquisition hardware logic, (iv) reported control information, and (v) automatically synchronized data acquisition to the CERN spill cycle via a modem signal and transmitted experimental data to a remote computer. No problems were experienced using intercontinental telephone connections at 1200 baud. Our successful "virtual laboratory" approach that uses off-the-shelf electronics is generally adaptable to more conventional bench-type experiments.

25th Birthday Cern- Amphi

ScienceCinema

None

2017-12-09

Cérémonie du 25ème anniversaire du Cern avec 2 orateurs: le Prof.Weisskopf parle de la signification et le rôle du Cern et le Prof.Casimir(?) fait un exposé sur les rélations entre la science pure et la science appliquée et la "big science" (science légère)

Causes and Temporal Patterns of 30-Day Readmission Among Older Adults Hospitalized With Heart Failure With Preserved or Reduced Ejection Fraction.

PubMed

Goyal, Parag; Loop, Matthew; Chen, Ligong; Brown, Todd M; Durant, Raegan W; Safford, Monika M; Levitan, Emily B

2018-04-23

It is unknown whether causes and temporal patterns of 30-day readmission vary between heart failure (HF) with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF). We sought to address this question by examining a 5% national sample of Medicare beneficiaries. We included individuals who experienced a hospitalization for HFpEF or HFrEF between 2007 and 2013. We identified causes of 30-day readmission based on primary discharge diagnosis and further classified causes of readmission as HF-related, non-HF cardiovascular-related, and non-cardiovascular-related. We calculated the cumulative incidence of these classifications for HFpEF and HFrEF in a competing risks model and calculated subdistribution hazard ratios of these classifications by comparing those with HFpEF and those with HFrEF. Among 60 640 Medicare beneficiaries, we identified 13 785 unique older adults hospitalized with HFpEF and 15 205 who were hospitalized with HFrEF. Noncardiovascular diagnoses represented the most common causes of 30-day readmission (HFpEF: 59%; HFrEF: 47%), a pattern that was observed for each week of the 30-day study period for both HFpEF and HFrEF participants. In comparing readmission diagnoses in an adjusted model, non-cardiovascular-related diagnoses were more common and HF-related diagnoses were less common in HFpEF participants. Non-cardiovascular-related diagnoses represented the most common causes of 30-day readmission following HF hospitalization for each week of the 30-day postdischarge period. HF diagnoses were less common among those with HFpEF compared with HFrEF. Future interventions aimed at reducing 30-day readmissions following an HF hospitalization would benefit from an increased focus on noncardiovascular comorbidity and interventions that target HFpEF and HFrEF separately. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

CERN automatic audio-conference service

NASA Astrophysics Data System (ADS)

Sierra Moral, Rodrigo

2010-04-01

Scientists from all over the world need to collaborate with CERN on a daily basis. They must be able to communicate effectively on their joint projects at any time; as a result telephone conferences have become indispensable and widely used. Managed by 6 operators, CERN already has more than 20000 hours and 5700 audio-conferences per year. However, the traditional telephone based audio-conference system needed to be modernized in three ways. Firstly, to provide the participants with more autonomy in the organization of their conferences; secondly, to eliminate the constraints of manual intervention by operators; and thirdly, to integrate the audio-conferences into a collaborative working framework. The large number, and hence cost, of the conferences prohibited externalization and so the CERN telecommunications team drew up a specification to implement a new system. It was decided to use a new commercial collaborative audio-conference solution based on the SIP protocol. The system was tested as the first European pilot and several improvements (such as billing, security, redundancy...) were implemented based on CERN's recommendations. The new automatic conference system has been operational since the second half of 2006. It is very popular for the users and has doubled the number of conferences in the past two years.

INTEGRATED OPERATIONAL DOSIMETRY SYSTEM AT CERN.

PubMed

Dumont, Gérald; Pedrosa, Fernando Baltasar Dos Santos; Carbonez, Pierre; Forkel-Wirth, Doris; Ninin, Pierre; Fuentes, Eloy Reguero; Roesler, Stefan; Vollaire, Joachim

2017-04-01

CERN, the European Organization for Nuclear Research, upgraded its operational dosimetry system in March 2013 to be prepared for the first Long Shutdown of CERN's facilities. The new system allows the immediate and automatic checking and recording of the dosimetry data before and after interventions in radiation areas. To facilitate the analysis of the data in context of CERN's approach to As Low As Reasonably Achievable (ALARA), this new system is interfaced to the Intervention Management Planning and Coordination Tool (IMPACT). IMPACT is a web-based application widely used in all CERN's accelerators and their associated technical infrastructures for the planning, the coordination and the approval of interventions (work permit principle). The coupling of the operational dosimetry database with the IMPACT repository allows a direct and almost immediate comparison of the actual dose with the estimations, in addition to enabling the configuration of alarm levels in the dosemeter in function of the intervention to be performed. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

[Early implementation of home care and 30 day readmissions in >65 years Veneto region patients discharged for heart failure and with disability].

PubMed

Gennaro, Nicola; Maggi, Stefania; Pellizzari, Michele; Carlucci, Francesco; Pilotto, Alberto; Saugo, Mario

2014-01-01

Early implementation of home care and 30 day readmissions in >65 years Veneto region patients discharged for heart failure and with disability. The effectiveness of Home care (HC) on preventing rehospitalizations in patients discharged for heart failure (HF) are uncertain. The aim of the study was to measure the impact of HC on early rehospitalizations of patients discharged for HF and with disabilities. Cohort retrospective study on >65 years patients, discharged at home and with a Barthel index <50. Variables considered were: previous hospitalizations for ischaemic cardiopathy ad/or chronic obstructive pulmonary disease, number of hospital admissions in the previous year, length of index hospitalization; outcomes considered were: hospital readmissions and days of hospitalizations 30 days from hospital discharge in patients with or without a home care visit within two days from hospital discharge. Of the 5.094 patients (60%>85 years), 14.8% received a HC visit within 2 days from discharge (43.7% from a nurse); 18.3% of patients (933) were readmitted within one month. In multivariate analyses an HC access within 2 days did not reduce the risk for readmission (although with better results in younger males but not in older women). An early HC visit reduced the days of hospital stay in males of all ages (65-74 years IRR 0.53 CI 95% 0.37-0.75; 75-84 years IRR 0.71 CI95% 0.60-0.83; 85+ years IRR 0.79 CI 95% 0.67-0.93) while in >75 years females there was a significant increase. An early HC visit (within two days from discharge) may have positive effects on males, but not in older women, possibly for the coexistence of socio-economic factors.

Influence of Sacubitril/Valsartan (LCZ696) on 30-Day Readmission After Heart Failure Hospitalization.

PubMed

Desai, Akshay S; Claggett, Brian L; Packer, Milton; Zile, Michael R; Rouleau, Jean L; Swedberg, Karl; Shi, Victor; Lefkowitz, Martin; Starling, Randall; Teerlink, John; McMurray, John J V; Solomon, Scott D

2016-07-19

Patients with heart failure (HF) are at high risk for hospital readmission in the first 30 days following HF hospitalization. This study sought to determine if treatment with sacubitril/valsartan (LCZ696) reduces rates of hospital readmission at 30-days following HF hospitalization compared with enalapril. We assessed the risk of 30-day readmission for any cause following investigator-reported hospitalizations for HF in the PARADIGM-HF trial, which randomized 8,399 participants with HF and reduced ejection fraction to treatment with LCZ696 or enalapril. Accounting for multiple hospitalizations per patient, there were 2,383 investigator-reported HF hospitalizations, of which 1,076 (45.2%) occurred in subjects assigned to LCZ696 and 1,307 (54.8%) occurred in subjects assigned to enalapril. Rates of readmission for any cause at 30 days were 17.8% in LCZ696-assigned subjects and 21.0% in enalapril-assigned subjects (odds ratio: 0.74; 95% confidence interval: 0.56 to 0.97; p = 0.031). Rates of readmission for HF at 30-days were also lower in subjects assigned to LCZ696 (9.7% vs. 13.4%; odds ratio: 0.62; 95% confidence interval: 0.45 to 0.87; p = 0.006). The reduction in both all-cause and HF readmissions with LCZ696 was maintained when the time window from discharge was extended to 60 days and in sensitivity analyses restricted to adjudicated HF hospitalizations. Compared with enalapril, treatment with LCZ696 reduces 30-day readmissions for any cause following discharge from HF hospitalization. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Pericarditis - after heart attack

MedlinePlus

... medlineplus.gov/ency/article/000166.htm Pericarditis - after heart attack To use the sharing features on this page, ... occur in the days or weeks following a heart attack . Causes Two types of pericarditis can occur after ...

[Heart rate and energy expenditure during extravehicular activity in different time of day].

PubMed

Stepanova, S I; Katuntsev, V P; Osipov, Iu Iu; Galichiĭ, V A

2013-01-01

The article discusses the comparative heart rate (HR) characteristics associated with day and night extravehicular activities (EVA). HR was commonly higher in the night but not in the daytime. Presumably, the reason is psychological and physiological challenges of the night work on the background of natural performance decrement. These circumstances could lead to elevation of psychic tension and, consequently, increase of heartbeats to a greater extent as compared with daytime EVA. According to the correlation analysis data, the pattern of HR relation to physical loads evaluated by energy expenditure in the daytime was other than at night, i.e. it was positive unlike the nighttime correlation. We cannot exclude it that in the daytime increase in cardiac output (CO) in response to physical work was largely due to increase in HR, whereas it was stroke volume that dominated during night work; at least, it could support CO fully in the periods of low loading.

The significance of Cern

ScienceCinema

None

2017-12-09

Le Prof. V.Weisskopf, DG du Cern de 1961 à 1965, est né à Vienne, a fait ses études à Göttingen et a une carrière académique particulièrement riche. Il a travaillé à Berlin, Copenhague et Berlin et est parti aux Etats Unis pour participer au projet Manhattan et était Prof. au MTT jusqu'à 1960. Revenu en Europe, il a été DG du Cern et lui a donné l'impulsion que l'on sait.

Heart rate monitoring mobile applications

PubMed Central

2016-01-01

Total number of times a heart beats in a minute is known as the heart rate. Traditionally, heart rate was measured using clunky gadgets but these days it can be measured with a smartphone’s camera. This can help you measure your heart rate anywhere and at anytime, especially during workouts so you can adjust your workout intensity to achieve maximum health benefits. With simple and easy to use mobile app, ‘Unique Heart Rate Monitor’, you can also maintain your heart rate history for personal reflection and sharing with a provider. PMID:28293594

Heart rate monitoring mobile applications.

PubMed

Chaudhry, Beenish M

2016-01-01

Total number of times a heart beats in a minute is known as the heart rate. Traditionally, heart rate was measured using clunky gadgets but these days it can be measured with a smartphone's camera. This can help you measure your heart rate anywhere and at anytime, especially during workouts so you can adjust your workout intensity to achieve maximum health benefits. With simple and easy to use mobile app, 'Unique Heart Rate Monitor', you can also maintain your heart rate history for personal reflection and sharing with a provider.

Service management at CERN with Service-Now

NASA Astrophysics Data System (ADS)

Toteva, Z.; Alvarez Alonso, R.; Alvarez Granda, E.; Cheimariou, M.-E.; Fedorko, I.; Hefferman, J.; Lemaitre, S.; Clavo, D. Martin; Martinez Pedreira, P.; Pera Mira, O.

2012-12-01

The Information Technology (IT) and the General Services (GS) departments at CERN have decided to combine their extensive experience in support for IT and non-IT services towards a common goal - to bring the services closer to the end user based on Information Technology Infrastructure Library (ITIL) best practice. The collaborative efforts have so far produced definitions for the incident and the request fulfilment processes which are based on a unique two-dimensional service catalogue that combines both the user and the support team views of all services. After an extensive evaluation of the available industrial solutions, Service-now was selected as the tool to implement the CERN Service-Management processes. The initial release of the tool provided an attractive web portal for the users and successfully implemented two basic ITIL processes; the incident management and the request fulfilment processes. It also integrated with the CERN personnel databases and the LHC GRID ticketing system. Subsequent releases continued to integrate with other third-party tools like the facility management systems of CERN as well as to implement new processes such as change management. Independently from those new development activities it was decided to simplify the request fulfilment process in order to achieve easier acceptance by the CERN user community. We believe that due to the high modularity of the Service-now tool, the parallel design of ITIL processes e.g., event management and non-ITIL processes, e.g., computer centre hardware management, will be easily achieved. This presentation will describe the experience that we have acquired and the techniques that were followed to achieve the CERN customization of the Service-Now tool.

Global atmospheric particle formation from CERN CLOUD measurements.

PubMed

Dunne, Eimear M; Gordon, Hamish; Kürten, Andreas; Almeida, João; Duplissy, Jonathan; Williamson, Christina; Ortega, Ismael K; Pringle, Kirsty J; Adamov, Alexey; Baltensperger, Urs; Barmet, Peter; Benduhn, Francois; Bianchi, Federico; Breitenlechner, Martin; Clarke, Antony; Curtius, Joachim; Dommen, Josef; Donahue, Neil M; Ehrhart, Sebastian; Flagan, Richard C; Franchin, Alessandro; Guida, Roberto; Hakala, Jani; Hansel, Armin; Heinritzi, Martin; Jokinen, Tuija; Kangasluoma, Juha; Kirkby, Jasper; Kulmala, Markku; Kupc, Agnieszka; Lawler, Michael J; Lehtipalo, Katrianne; Makhmutov, Vladimir; Mann, Graham; Mathot, Serge; Merikanto, Joonas; Miettinen, Pasi; Nenes, Athanasios; Onnela, Antti; Rap, Alexandru; Reddington, Carly L S; Riccobono, Francesco; Richards, Nigel A D; Rissanen, Matti P; Rondo, Linda; Sarnela, Nina; Schobesberger, Siegfried; Sengupta, Kamalika; Simon, Mario; Sipilä, Mikko; Smith, James N; Stozkhov, Yuri; Tomé, Antonio; Tröstl, Jasmin; Wagner, Paul E; Wimmer, Daniela; Winkler, Paul M; Worsnop, Douglas R; Carslaw, Kenneth S

2016-12-02

Fundamental questions remain about the origin of newly formed atmospheric aerosol particles because data from laboratory measurements have been insufficient to build global models. In contrast, gas-phase chemistry models have been based on laboratory kinetics measurements for decades. We built a global model of aerosol formation by using extensive laboratory measurements of rates of nucleation involving sulfuric acid, ammonia, ions, and organic compounds conducted in the CERN CLOUD (Cosmics Leaving Outdoor Droplets) chamber. The simulations and a comparison with atmospheric observations show that nearly all nucleation throughout the present-day atmosphere involves ammonia or biogenic organic compounds, in addition to sulfuric acid. A considerable fraction of nucleation involves ions, but the relatively weak dependence on ion concentrations indicates that for the processes studied, variations in cosmic ray intensity do not appreciably affect climate through nucleation in the present-day atmosphere. Copyright © 2016, American Association for the Advancement of Science.

Learning with the ATLAS Experiment at CERN

ERIC Educational Resources Information Center

Barnett, R. M.; Johansson, K. E.; Kourkoumelis, C.; Long, L.; Pequenao, J.; Reimers, C.; Watkins, P.

2012-01-01

With the start of the LHC, the new particle collider at CERN, the ATLAS experiment is also providing high-energy particle collisions for educational purposes. Several education projects--education scenarios--have been developed and tested on students and teachers in several European countries within the Learning with ATLAS@CERN project. These…

Association of Hospital Performance Based on 30-Day Risk-Standardized Mortality Rate With Long-term Survival After Heart Failure Hospitalization: An Analysis of the Get With The Guidelines-Heart Failure Registry.

PubMed

Pandey, Ambarish; Patel, Kershaw V; Liang, Li; DeVore, Adam D; Matsouaka, Roland; Bhatt, Deepak L; Yancy, Clyde W; Hernandez, Adrian F; Heidenreich, Paul A; de Lemos, James A; Fonarow, Gregg C

2018-06-01

Among patients hospitalized with heart failure (HF), the long-term clinical implications of hospitalization at hospitals based on 30-day risk-standardized mortality rates (RSMRs) is not known. To evaluate the association of hospital-specific 30-day RSMR with long-term survival among patients hospitalized with HF in the American Heart Association Get With The Guidelines-HF registry. The longitudinal observational study included 106 304 patients with HF who were admitted to 317 centers participating in the Get With The Guidelines-HF registry from January 1, 2005, to December 31, 2013, and had Medicare-linked follow-up data. Hospital-specific 30-day RSMR was calculated using a hierarchical logistic regression model. In the model, 30-day mortality rate was a binary outcome, patient baseline characteristics were included as covariates, and the hospitals were treated as random effects. The association of 30-day RSMR-based hospital groups (low to high 30-day RSMR: quartile 1 [Q1] to Q4) with long-term (1-year, 3-year, and 5-year) mortality was assessed using adjusted Cox models. Data analysis took place from June 29, 2017, to February 19, 2018. Thirty-day RSMR for participating hospitals. One-year, 3-year, and 5-year mortality rates. Of the 106 304 patients included in the analysis, 57 552 (54.1%) were women and 84 595 (79.6%) were white, and the median (interquartile range) age was 81 (74-87) years. The 30-day RSMR ranged from 8.6% (Q1) to 10.7% (Q4). Hospitals in the low 30-day RSMR group had greater availability of advanced HF therapies, cardiac surgery, and percutaneous coronary interventions. In the primary landmarked analyses among 30-day survivors, there was a graded inverse association between 30-day RSMR and long-term mortality (Q1 vs Q4: 5-year mortality, 73.7% vs 76.8%). In adjusted analysis, patients admitted to hospitals in the high 30-day RSMR group had 14% (95% CI, 10-18) higher relative hazards of 5-year mortality compared with those admitted to

Update on CERN Search based on SharePoint 2013

NASA Astrophysics Data System (ADS)

Alvarez, E.; Fernandez, S.; Lossent, A.; Posada, I.; Silva, B.; Wagner, A.

2017-10-01

CERN’s enterprise Search solution “CERN Search” provides a central search solution for users and CERN service providers. A total of about 20 million public and protected documents from a wide range of document collections is indexed, including Indico, TWiki, Drupal, SharePoint, JACOW, E-group archives, EDMS, and CERN Web pages. In spring 2015, CERN Search was migrated to a new infrastructure based on SharePoint 2013. In the context of this upgrade, the document pre-processing and indexing process was redesigned and generalised. The new data feeding framework allows to profit from new functionality and it facilitates the long term maintenance of the system.

A Hospital Level Analysis of 30-Day Readmission Performance for Heart Failure Patients and Long-Term Survival: Findings from Get With The Guidelines-Heart Failure.

PubMed

Jalnapurkar, Sawan; Zhao, Xin; Heidenreich, Paul A; Bhatt, Deepak L; Smith, Eric E; DeVore, Adam D; Hernandez, Adrian F; Matsouaka, Roland; Yancy, Clyde W; Fonarow, Gregg C

2018-06-01

Medicare utilizes 30-day risk-standardized readmission rates (RSRR) as a measure of hospital quality and applies penalties based on this measure. The objective of this study was to identify the relationship between hospital performance on 30-day RSRR in heart failure (HF) patients and long-term patient survival. Data were collected from Get With The Guidelines (GWTG)-HF and linked with Medicare data. Based on hospital performance for 30-day RSRR, hospitals were grouped into performance quartiles: top 25% (N=11,181), 25-50% (N=10,367), 50-75% (N=8729), and bottom 25% (N=7180). The primary outcome was mortality at 3 years applying Cox proportional hazards regression adjusted for patient and hospital characteristics. The overall 30-day readmission rate was 19.8% and the 3-year mortality rates were 61.8%, 61.0%, 62.6%, and 59.9% for top 25%, 25-50%, 50-75%, and bottom 25% hospitals for 30-day RSRR performance, respectively. Compared to bottom 25% performing hospitals, adjusted hazard ratios (HR) for 3-year mortality were HR 0.96 (95% confidence interval [CI] 0.90-1.01), HR 0.89 (95% CI 0.84-0.94), HR 1.01 (95% CI 0.95-1.06) for the top 25%, 25-50% and 50-75% hospitals respectively. Median survival time was highest for the bottom 25% hospitals on the 30-day RSRR metric. Hospital performance on 30-day readmissions in HF has no or little association with risk adjusted 3-year mortality or median survival. There is a compelling need to utilize more meaningful and patient-centered outcome measures for reporting and incentivizing quality care for HF. Copyright © 2018 Elsevier Inc. All rights reserved.

News UK public libraries offer walk-in access to research Atoms for Peace? The Atomic Weapons Establishment and UK universities Students present their research to academics: CERN@school Science in a suitcase: Marvin and Milo visit Ethiopia Inspiring telescopes A day for everyone teaching physics 2014 Forthcoming Events

NASA Astrophysics Data System (ADS)

2014-05-01

UK public libraries offer walk-in access to research Atoms for Peace? The Atomic Weapons Establishment and UK universities Students present their research to academics: CERN@school Science in a suitcase: Marvin and Milo visit Ethiopia Inspiring telescopes A day for everyone teaching physics 2014 Forthcoming Events

The effect of the sequential therapy in end-stage heart failure (ESHF)--from ECMO, through the use of implantable pump for a pneumatic heart assist system, Religa Heart EXT, as a bridge for orthotopic heart transplant (OHT). Case study.

PubMed

Religa, Grzegorz; Jasińska, Małgorzata; Czyżewski, Łukasz; Torba, Krzysztof; Różański, Jacek

2014-10-21

Modern Polish medicine offers patients various treatments for end-stage treatment-resistant heart failure. Methods applied at the right time before the occurrence of irreversible changes in organs give a chance for survival and prolong life. Here, we report on the safety and efficacy of the sequential use of the above treatments in a 58-year old patient with heart failure in dilatative cardiomyopathy (DCM). A 7-day mechanical blood circulatory support and extracorporeal membrane oxygenation of blood (ECMO), followed by a 13-day implantation of a left ventricular assist device, Religa Heart EXT, was used as a bridge to a successful orthotopic heart transplant (OHT). On Day 40 after OHT, the patient was discharged home with stable function of the circulatory system. We describe our experiences with the qualification, preparation, and procedure of sequential ECMO, Religa Heart EXT, and OHT. Application of short-term ECMO as a bridge-to-bridge helped save the patient from severe cardiogenic shock caused by increased left ventricular afterload. The experimental implantation of an innovative Religa Heart EXT prosthesis was a safe and efficacious bridge to transplantation. Too short time of Religa Heart EXT implantation in the discussed patient prevented the possibility to evaluate the occurrence of thromboembolic complications and infections compared to the documented complications of POLVAD implanted until now. OHT is a safe and efficacious method of treatment of patients previously supported by ECMO and Religa Heart EXT.

Mapping the Heart

ERIC Educational Resources Information Center

Hulse, Grace

2012-01-01

In this article, the author describes how her fourth graders made ceramic heart maps. The impetus for this project came from reading "My Map Book" by Sara Fanelli. This book is a collection of quirky, hand-drawn and collaged maps that diagram a child's world. There are maps of her stomach, her day, her family, and her heart, among others. The…

CERN IRRADIATION FACILITIES.

PubMed

Pozzi, Fabio; Garcia Alia, Ruben; Brugger, Markus; Carbonez, Pierre; Danzeca, Salvatore; Gkotse, Blerina; Richard Jaekel, Martin; Ravotti, Federico; Silari, Marco; Tali, Maris

2017-09-28

CERN provides unique irradiation facilities for applications in dosimetry, metrology, intercomparison of radiation protection devices, benchmark of Monte Carlo codes and radiation damage studies to electronics. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

CERN Collider, France-Switzerland

NASA Image and Video Library

2013-08-23

This image, acquired by NASA Terra spacecraft, is of the CERN Large Hadron Collider, the world largest and highest-energy particle accelerator laying beneath the French-Swiss border northwest of Geneva yellow circle.

Heart rate and physical activity patterns in persons with profound intellectual and multiple disabilities.

PubMed

Waninge, Aly; van der Putten, Annette A J; Stewart, Roy E; Steenbergen, Bert; van Wijck, Ruud; van der Schans, Cees P

2013-11-01

Because physical fitness and health are related to physical activity, it is important to gain an insight into the physical activity levels of persons with profound intellectual and multiple disabilities (PIMD). The purpose of this study was to examine heart rate patterns to measure the activity levels of persons with PIMD and to analyze these heart rate patterns according to participant characteristics, observed level of activity, days, and time of day. The heart rate patterns of 24 participants with PIMD were measured continuously using a heart rate monitor for 8 h · d for a period of 6 days. Physical activity levels were measured with questionnaires. Data were analyzed using multilevel analysis. The results indicate that the participants use only 32% of their heart rate reserve over 6 days. The intensity of heart rate reserve ranged from 1 to 62%. On a given day, wide ranges in heart rates between participants and within persons were observed. Between days, only small ranges in the heart rate were found. The participants could be grouped into 4 classes according to their heart rate. In addition, factors such as time of day, physical activity, and age are significantly related to heart rate patterns. In conclusion, this study is an important first step in exploring activity patterns based on heart rate patterns in persons with PIMD. The participants used relatively small fractions of their heart rate reserves. Time of day and age appear to have a considerable influence on heart rate patterns. The observed classes in heart rate patterns suggest that other probably more personal and psychosocial factors have significant influences on heart rate patterns, as well.

CERN goes iconic

NASA Astrophysics Data System (ADS)

2017-06-01

There are more than 1800 emoji that can be sent and received in text messages and e-mails. Now, the CERN particle-physics lab near Geneva has got in on the act and released its own collection of 35 images that can be used by anyone with an Apple device.

Wi-Fi Service enhancement at CERN

NASA Astrophysics Data System (ADS)

Ducret, V.; Sosnowski, A.; Gonzalez Caballero, B.; Barrand, Q.

2017-10-01

Since the early 2000’s, the number of mobile devices connected to CERN’s internal network has increased from just a handful to well over 10,000. Wireless access is no longer simply “nice to have” or just for conference and meeting rooms; support for mobility is expected by most, if not all, of the CERN community. In this context, a full renewal of the CERN Wi-Fi network has been launched to deliver a state-of-the-art campus-wide Wi-Fi Infrastructure. We aim to deliver, in more than 200 office buildings with a surface area of over 400,000m2 and including many high-priority and high-occupation zones, an end-user experience comparable, for most applications, to a wired connection and with seamless mobility support. We describe here the studies and tests performed at CERN to ensure the solution we are deploying can meet these goals as well as delivering a single, simple, flexible and open management platform.

Review of CERN Data Centre Infrastructure

NASA Astrophysics Data System (ADS)

Andrade, P.; Bell, T.; van Eldik, J.; McCance, G.; Panzer-Steindel, B.; Coelho dos Santos, M.; Traylen and, S.; Schwickerath, U.

2012-12-01

The CERN Data Centre is reviewing strategies for optimizing the use of the existing infrastructure and expanding to a new data centre by studying how other large sites are being operated. Over the past six months, CERN has been investigating modern and widely-used tools and procedures used for virtualisation, clouds and fabric management in order to reduce operational effort, increase agility and support unattended remote data centres. This paper gives the details on the project's motivations, current status and areas for future investigation.

Animal product consumption and mortality because of all causes combined, coronary heart disease, stroke, diabetes, and cancer in Seventh-day Adventists.

PubMed

Snowdon, D A

1988-09-01

This report reviews, contrasts, and illustrates previously published findings from a cohort of 27,529 California Seventh-day Adventist adults who completed questionnaires in 1960 and were followed for mortality between 1960 and 1980. Within this population, meat consumption was positively associated with mortality because of all causes of death combined (in males), coronary heart disease (in males and females), and diabetes (in males). Egg consumption was positively associated with mortality because of all causes combined (in females), coronary heart disease (in females), and cancers of the colon (in males and females combined) and ovary. Milk consumption was positively associated with only prostate cancer mortality, and cheese consumption did not have a clear relationship with any cause of death. The consumption of meat, eggs, milk, and cheese did not have negative associations with any of the causes of death investigated.

Status and Roadmap of CernVM

NASA Astrophysics Data System (ADS)

Berzano, D.; Blomer, J.; Buncic, P.; Charalampidis, I.; Ganis, G.; Meusel, R.

2015-12-01

Cloud resources nowadays contribute an essential share of resources for computing in high-energy physics. Such resources can be either provided by private or public IaaS clouds (e.g. OpenStack, Amazon EC2, Google Compute Engine) or by volunteers computers (e.g. LHC@Home 2.0). In any case, experiments need to prepare a virtual machine image that provides the execution environment for the physics application at hand. The CernVM virtual machine since version 3 is a minimal and versatile virtual machine image capable of booting different operating systems. The virtual machine image is less than 20 megabyte in size. The actual operating system is delivered on demand by the CernVM File System. CernVM 3 has matured from a prototype to a production environment. It is used, for instance, to run LHC applications in the cloud, to tune event generators using a network of volunteer computers, and as a container for the historic Scientific Linux 5 and Scientific Linux 4 based software environments in the course of long-term data preservation efforts of the ALICE, CMS, and ALEPH experiments. We present experience and lessons learned from the use of CernVM at scale. We also provide an outlook on the upcoming developments. These developments include adding support for Scientific Linux 7, the use of container virtualization, such as provided by Docker, and the streamlining of virtual machine contextualization towards the cloud-init industry standard.

Isovolumic loading of the failing heart by intraventricular placement of a spring expander attenuates cardiac atrophy after heterotopic heart transplantation.

PubMed

Pokorný, Martin; Mrázová, Iveta; Šochman, Jan; Melenovský, Vojtěch; Malý, Jiří; Pirk, Jan; Červenková, Lenka; Sadowski, Janusz; Čermák, Zdeněk; Volenec, Karel; Vacková, Šárka; Maxová, Hana; Červenka, Luděk; Netuka, Ivan

2018-05-09

Cardiac atrophy is the most common complication of prolonged application of the left ventricle assist device in patients with advanced heart failure. Our aim was to evaluate the course of unloading-induced cardiac atrophy in rats with failing hearts, and to examine if increased isovolumic loading obtained by intraventricular implantation of an especially designed spring expander would attenuate this process. Heterotopic abdominal heart transplantation (HT x ) was used as a rat model of heart unloading. Heart failure (HF) was induced by volume overload achieved by creation of the aorto-caval fistula. The degree of cardiac atrophy was assessed as the weight ratio of the heterotopically transplanted heart (HW) to the control heart. Isovolumic loading was increased by intraventricular implantation of a stainless steel three-branch spring expander. The course of cardiac atrophy was evaluated on days 7, 14, 21 and 28 after HT x Seven-days unloading by HT x in failing hearts sufficed to substantially decrease HW (-59 ± 3%), the decrease progressed when measured on days 14, 21 and 28 after HT x Implantation of the spring expander significantly reduced the decreases in whole HW at all the time-points (-39 ± 3 vs. -59 ± 3, -52 ± 2 vs. -69 ± 3, -51 ± 2 vs. - 71 ± 2 and -44 ± 2 vs. -71 ± 3%, respectively; p<0.05 in each case). We conclude that the enhanced isovolumic heart loading obtained by implantation of the spring expander attenuates the development of unloading-induced cardiac atrophy in the failing rat heart. ©2018 The Author(s).

Wolfgang Kummer at CERN

NASA Astrophysics Data System (ADS)

Schopper, Herwig

Wolfgang Kummer was not only a great theorist but also a man with a noble spirit and extensive education, based on a fascinating long-term Austrian cultural tradition. As an experimentalist I am not sufficiently knowledgeable to evaluate his contributions to theoretical physics - this will certainly be done by more competent scientists. Nevertheless I admired him for not only being attached to fundamental and abstract problems like quantum field theory, quantum gravity or black holes, but for his interest in down to earth questions like electron-proton scattering or the toponium mass. I got to know Wolfgang Kummer very well and appreciate his human qualities during his long attachment to CERN, in particular when he served as president of the CERN Council, the highest decision taking authority of this international research centre, from 1985 to 1987 falling into my term as Director-General…

Face Validity of the Single Work Ability Item: Comparison with Objectively Measured Heart Rate Reserve over Several Days

PubMed Central

Gupta, Nidhi; Jensen, Bjørn Søvsø; Søgaard, Karen; Carneiro, Isabella Gomes; Christiansen, Caroline Stordal; Hanisch, Christiana; Holtermann, Andreas

2014-01-01

Purpose: The purpose of this study was to investigate the face validity of the self-reported single item work ability with objectively measured heart rate reserve (%HRR) among blue-collar workers. Methods: We utilized data from 127 blue-collar workers (Female = 53; Male = 74) aged 18–65 years from the cross-sectional “New method for Objective Measurements of physical Activity in Daily living (NOMAD)” study. The workers reported their single item work ability and completed an aerobic capacity cycling test and objective measurements of heart rate reserve monitored with Actiheart for 3–4 days with a total of 5,810 h, including 2,640 working hours. Results: A significant moderate correlation between work ability and %HRR was observed among males (R = −0.33, P = 0.005), but not among females (R = 0.11, P = 0.431). In a gender-stratified multi-adjusted logistic regression analysis, males with high %HRR were more likely to report a reduced work ability compared to males with low %HRR [OR = 4.75, 95% confidence interval (95% CI) = 1.31 to 17.25]. However, this association was not found among females (OR = 0.26, 95% CI 0.03 to 2.16), and a significant interaction between work ability, %HRR and gender was observed (P = 0.03). Conclusions: The observed association between work ability and objectively measured %HRR over several days among male blue-collar workers supports the face validity of the single work ability item. It is a useful and valid measure of the relation between physical work demands and resources among male blue-collar workers. The contrasting association among females needs to be further investigated. PMID:24840350

First experience with the new .cern Top Level Domain

NASA Astrophysics Data System (ADS)

Alvarez, E.; Malo de Molina, M.; Salwerowicz, M.; Silva De Sousa, B.; Smith, T.; Wagner, A.

2017-10-01

In October 2015, CERN’s core website has been moved to a new address, http://home.cern, marking the launch of the brand new top-level domain .cern. In combination with a formal governance and registration policy, the IT infrastructure needed to be extended to accommodate the hosting of Web sites in this new top level domain. We will present the technical implementation in the framework of the CERN Web Services that allows to provide virtual hosting, a reverse proxy solution and that also includes the provisioning of SSL server certificates for secure communications.

Dissemination of CERN's Technology Transfer: Added Value from Regional Transfer Agents

ERIC Educational Resources Information Center

Hofer, Franz

2005-01-01

Technologies developed at CERN, the European Organization for Nuclear Research, are disseminated via a network of external technology transfer officers. Each of CERN's 20 member states has appointed at least one technology transfer officer to help establish links with CERN. This network has been in place since 2001 and early experiences indicate…

Offering Global Collaboration Services beyond CERN and HEP

NASA Astrophysics Data System (ADS)

Fernandes, J.; Ferreira, P.; Baron, T.

2015-12-01

The CERN IT department has built over the years a performant and integrated ecosystem of collaboration tools, from videoconference and webcast services to event management software. These services have been designed and evolved in very close collaboration with the various communities surrounding the laboratory and have been massively adopted by CERN users. To cope with this very heavy usage, global infrastructures have been deployed which take full advantage of CERN's international and global nature. If these services and tools are instrumental in enabling the worldwide collaboration which generates major HEP breakthroughs, they would certainly also benefit other sectors of science in which globalization has already taken place. Some of these services are driven by commercial software (Vidyo or Wowza for example), some others have been developed internally and have already been made available to the world as Open Source Software in line with CERN's spirit and mission. Indico for example is now installed in 100+ institutes worldwide. But providing the software is often not enough and institutes, collaborations and project teams do not always possess the expertise, or human or material resources that are needed to set up and maintain such services. Regional and national institutions have to answer needs, which are growingly global and often contradict their operational capabilities or organizational mandate and so are looking at existing worldwide service offers such as CERN's. We believe that the accumulated experience obtained through the operation of a large scale worldwide collaboration service combined with CERN's global network and its recently- deployed Agile Infrastructure would allow the Organization to set up and operate collaborative services, such as Indico and Vidyo, at a much larger scale and on behalf of worldwide research and education institutions and thus answer these pressing demands while optimizing resources at a global level. Such services would

Sharing scientific discovery globally: toward a CERN virtual visit service

NASA Astrophysics Data System (ADS)

Goldfarb, S.; Hatzifotiadou, D.; Lapka, M.; Papanestis, A.

2017-10-01

The installation of virtual visit services by the LHC collaborations began shortly after the first high-energy collisions were provided by the CERN accelerator in 2010. The experiments: ATLAS [1], CMS [2], LHCb [3], and ALICE [4] have all joined in this popular and effective method to bring the excitement of scientific exploration and discovery into classrooms and other public venues around the world. Their programmes, which use a combination of video conference, webcast, and video recording to communicate with remote audiences have already reached tens of thousands of viewers, and the demand only continues to grow. Other venues, such as the CERN Control Centre, are also considering similar permanent installations. We present a summary of the development of the various systems in use around CERN today, including the technology deployed and a variety of use cases. We then lay down the arguments for the creation of a CERN-wide service that would support these programmes in a more coherent and effective manner. Potential services include a central booking system and operational management similar to what is currently provided for the common CERN video conference facilities. Certain choices in technology could be made to support programmes based on popular tools including (but not limited to) Skype™ [5], Google Hangouts [6], Facebook Live [7], and Periscope [8]. Successful implementation of the project, which relies on close partnership between the experiments, CERN IT CDA [9], and CERN IR ECO [10], has the potential to reach an even larger, global audience, more effectively than ever before.

PREFACE: Lectures from the CERN Winter School on Strings, Supergravity and Gauge Theories, CERN, 9-13 February 2009 Lectures from the CERN Winter School on Strings, Supergravity and Gauge Theories, CERN, 9-13 February 2009

NASA Astrophysics Data System (ADS)

Uranga, A. M.

2009-11-01

This special section is devoted to the proceedings of the conference `Winter School on Strings, Supergravity and Gauge Theories', which took place at CERN, the European Centre for Nuclear Research, in Geneva, Switzerland 9-13 February 2009. This event is part of a yearly series of scientific schools, which represents a well established tradition. Previous events have been held at SISSA, in Trieste, Italy, in February 2005 and at CERN in January 2006, January 2007 and January 2008, and were funded by the European Mobility Research and Training Network `Constituents, Fundamental Forces and Symmetries of the Universe'. The next event will take place again at CERN, in January 2010. The school was primarily meant for young doctoral students and postdoctoral researchers working in the area of string theory. It consisted of several general lectures of four hours each, whose notes are published in this special section, and six working group discussion sessions, focused on specific topics of the network research program. It was well attended by over 200 participants. The topics of the lectures were chosen to provide an introduction to some of the areas of recent progress, and to the open problems, in string theory. One of the most active areas in string theory in recent years has been the AdS/CFT or gauge/gravity correspondence, which proposes the complete equivalence of string theory on (asymptotically) anti de Sitter spacetimes with certain quantum (gauge) field theories. The duality has recently been applied to understanding the hydrodynamical properties of a hot plasma in gauge theories (like the quark-gluon plasma created in heavy ion collisions at the RHIC experiment at Brookhaven, and soon at the LHC at CERN) in terms of a dual gravitational AdS theory in the presence of a black hole. These developments were reviewed in the lecture notes by M Rangamani. In addition, the AdS/CFT duality has been proposed as a tool to study interesting physical properties in other

A machine learning model to predict the risk of 30-day readmissions in patients with heart failure: a retrospective analysis of electronic medical records data.

PubMed

Golas, Sara Bersche; Shibahara, Takuma; Agboola, Stephen; Otaki, Hiroko; Sato, Jumpei; Nakae, Tatsuya; Hisamitsu, Toru; Kojima, Go; Felsted, Jennifer; Kakarmath, Sujay; Kvedar, Joseph; Jethwani, Kamal

2018-06-22

Heart failure is one of the leading causes of hospitalization in the United States. Advances in big data solutions allow for storage, management, and mining of large volumes of structured and semi-structured data, such as complex healthcare data. Applying these advances to complex healthcare data has led to the development of risk prediction models to help identify patients who would benefit most from disease management programs in an effort to reduce readmissions and healthcare cost, but the results of these efforts have been varied. The primary aim of this study was to develop a 30-day readmission risk prediction model for heart failure patients discharged from a hospital admission. We used longitudinal electronic medical record data of heart failure patients admitted within a large healthcare system. Feature vectors included structured demographic, utilization, and clinical data, as well as selected extracts of un-structured data from clinician-authored notes. The risk prediction model was developed using deep unified networks (DUNs), a new mesh-like network structure of deep learning designed to avoid over-fitting. The model was validated with 10-fold cross-validation and results compared to models based on logistic regression, gradient boosting, and maxout networks. Overall model performance was assessed using concordance statistic. We also selected a discrimination threshold based on maximum projected cost saving to the Partners Healthcare system. Data from 11,510 patients with 27,334 admissions and 6369 30-day readmissions were used to train the model. After data processing, the final model included 3512 variables. The DUNs model had the best performance after 10-fold cross-validation. AUCs for prediction models were 0.664 ± 0.015, 0.650 ± 0.011, 0.695 ± 0.016 and 0.705 ± 0.015 for logistic regression, gradient boosting, maxout networks, and DUNs respectively. The DUNs model had an accuracy of 76.4% at the classification threshold that

Evolution of a 90-day model of care for bundled episodic payments for congestive heart failure in home care.

PubMed

Feld, April; Madden-Baer, Rose; McCorkle, Ruth

2016-01-01

The Centers for Medicare and Medicaid Services Innovation Center's Episode-Based Payment initiatives propose a large opportunity to reduce cost from waste and variation and stand to align hospitals, physicians, and postacute providers in the redesign of care that achieves savings and improve quality. Community-based organizations are at the forefront of this care redesign through innovative models of care aimed at bridging gaps in care coordination and reducing hospital readmissions. This article describes a community-based provider's approach to participation under the Bundled Payments for Care Improvement initiative and a 90-day model of care for congestive heart failure in home care.

First day of life pulse oximetry screening to detect congenital heart defects.

PubMed

Meberg, Alf; Brügmann-Pieper, Sabine; Due, Reidar; Eskedal, Leif; Fagerli, Ingebjørg; Farstad, Teresa; Frøisland, Dag Helge; Sannes, Catharina Hovland; Johansen, Ole Jakob; Keljalic, Jasmina; Markestad, Trond; Nygaard, Egil Andre; Røsvik, Alet; Silberg, Inger Elisabeth

2008-06-01

To evaluate the efficacy of first day of life pulse oximetry screening to detect congenital heart defects (CHDs). We performed a population-based prospective multicenter study of postductal (foot) arterial oxygen saturation (SpO(2)) in apparently healthy newborns after transfer from the delivery suite to the nursery. SpO(2) < 95% led to further diagnostic evaluations. Of 57,959 live births, 50,008 (86%) were screened. In the screened population, 35 CHDs were [corrected] classified as critical (ductus dependent, cyanotic). CHDs were prospectively registered and diagnosed in 658/57,959 (1.1%) [corrected] Of the infants screened, 324 (0.6%) failed the test. Of these, 43 (13%) had CHDs (27 critical), and 134 (41%) had pulmonary diseases or other disorders. The remaining 147 infants (45%) were healthy with transitional circulation. The median age for babies with CHDs at failing the test was 6 hours (range, 1-21 hours). For identifying critical CHDs, the pulse oximetry screening had a sensitivity rate of 77.1% (95% CI, 59.4-89.0), specificity rate of 99.4% (95% CI, 99.3-99.5), and a false-positive rate of 0.6% (95% CI, 0.5-0.7). Early pulse oximetry screening promotes early detection of critical CHDs and other potentially severe diseases. The sensitivity rate for detecting critical CHDs is high, and the false-positive rate is low.

History of Cern

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

None

2007-12-20

Cérémonie à l'occasion de l'apparition du premier volume du livre sur l'histoire du Cern, avec plusieurs personnes présentes qui jouaient un rôle important dans cette organisation européenne couronnée de succès grâce à l'esprit des membres fondateurs qui est et restera essentiel

Taking Aspirin to Protect Your Heart

MedlinePlus

Toolkit No. 23 Taking Aspirin to Protect Your Heart What can taking aspirin do for me? If you are at high risk for or if you have heart disease, taking a low dose aspirin every day may help. Aspirin can also help ...

CERN Winter School on Supergravity, Strings, and Gauge Theory 2010

ScienceCinema

None

2018-05-15

The CERN Winter School on Supergravity, Strings, and Gauge Theory is the analytic continuation of the yearly training school of the former EC-RTN string network Constituents, Fundamental Forces and Symmetries of the Universe. The 2010 edition of the school is supported and organized by the CERN Theory Divison, and will take place from Monday January 25 to Friday January 29, at CERN. As its predecessors, this school is meant primarily for training of doctoral students and young postdoctoral researchers in recent developments in theoretical high-energy physics and string theory. The programme of the school will consist of five series of pedagogical lectures, complemented by tutorial discussion sessions in the afternoons. Previous schools in this series were organized in 2005 at SISSA in Trieste, and in 2006, 2007, 2008, and 2009 at CERN, Geneva.

Peptidomics Analysis of Transient Regeneration in the Neonatal Mouse Heart.

PubMed

Fan, Yi; Zhang, Qijun; Li, Hua; Cheng, Zijie; Li, Xing; Chen, Yumei; Shen, Yahui; Wang, Liansheng; Song, Guixian; Qian, Lingmei

2017-09-01

Neonatal mouse hearts have completely regenerative capability after birth, but the ability to regenerate rapidly lost after 7 days, the mechanism has not been clarified. Previous studies have shown that mRNA profile of adult mouse changed greatly compared to neonatal mouse. So far, there is no research of peptidomics related to heart regeneration. In order to explore the changes of proteins, enzymes, and peptides related to the transient regeneration, we used comparative petidomics technique to compare the endogenous peptides in the mouse heart of postnatal 1 and 7 days. In final, we identified 236 differentially expressed peptides, 169 of which were upregulated and 67 were downregulated in the postnatal 1 day heart, and also predicted 36 functional peptides associated with transient regeneration. The predicted 36 candidate peptides are located in the important domains of precursor proteins and/or contain the post-transcriptional modification (PTM) sites, which are involved in the biological processes of cardiac development, cardiac muscle disease, cell proliferation, necrosis, and apoptosis. In conclusion, for the first time, we compared the peptidomics profiles of neonatal heart between postnatal 1 day and postnatal 7 day. This study provides a new direction and an important basis for the mechanism research of transient regeneration in neonatal heart. J. Cell. Biochem. 118: 2828-2840, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Changing the diagnostic criteria for myocardial infarction in patients with a suspected heart attack affects the measurement of 30 day mortality but not long term survival

PubMed Central

Packham, C; Gray, D; Weston, C; Large, A; Silcocks, P; Hampton, J

2002-01-01

Objectives: To explore the effects of alternative methods of defining myocardial infarction on the numbers and survival patterns of patients identified as having sustained a confirmed myocardial infarct. Design: An inclusive historical cohort of patients admitted with a suspected heart attack. Patients were recoded from raw clinical data (collected at the index admission) to the epidemiological definitions of myocardial infarction used by the Nottingham heart attack register (NHAR), the World Health Organization (MONICA), and the UK heart attack study. Setting: Single health district. Patients: The NHAR identified all patients admitted in 1992 with suspected myocardial infarction. Outcome measures: Survival at 30 days and four year postdischarge. Results: 2739 patients were identified, of whom 90% survived to discharge. Recoding increased the numbers of patients defined as having confirmed myocardial infarction from 26% under the original NHAR classification to 69%, depending on the classification system used. In confirmed myocardial infarction, subsequent 30 day survival from admission varied from 77–86% depending on the classification system; four year survival after discharge was not affected. The distribution of important prognostic variables differed significantly between groups of patients with confirmed myocardial infarction defined by different systems. Patients with suspected but unconfirmed myocardial infarction under all classification systems had a worse postdischarge mortality. Conclusions: The classification system used had a substantial effect on the numbers of patients identified as having had a myocardial infarct, and on the 30 day survival. There were significant numbers of patients with more atypical presentations, not labelled as myocardial infarction, who did badly following discharge. More research is needed on these patients. PMID:12231586

Worsening heart failure in the setting of dronedarone initiation.

PubMed

Coons, James C; Plauger, Kara M; Seybert, Amy L; Sokos, George G

2010-09-01

To describe a challenging patient case in which dronedarone was selected for a patient with atrial fibrillation and heart failure; the drug may have been associated with worsening heart failure, leading to acute renal and hepatic failure. A 47-year-old male with a history of heart failure with New York Heart Association class III-IV symptoms presented to our institution with ventricular fibrillation and ventricular tachycardia storm. Torsade de pointes secondary to a combination of dofetilide and hypokalemia was determined to be the etiology. Upon stabilization, the patient was initiated on dronedarone 400 mg orally twice daily by the electrophysiology service for atrial fibrillation. The patient had a questionable history of amiodarone intolerance. By hospital day 9 (day 4 of dronedarone therapy), the patient demonstrated a clinical picture consistent with acute renal and hepatic failure possibly due to worsening heart failure. Dronedarone was discontinued on hospital day 10. He was subsequently transferred to an outside hospital where he required milrinone therapy for cardiogenic shock. Laboratory markers of renal and hepatic function improved over the remainder of his hospitalization and he was discharged on hospital day 20. Dronedarone is a newly approved antiarrhythmic agent with multichannel blocking properties similar to amiodarone. Use of the Naranjo probability scale determined that this patient's worsening heart failure leading to acute renal and hepatic failure was possibly caused by dronedarone. The implication from the ANDROMEDA trial as well as our experience in this case is that dronedarone should be used cautiously in patients with heart failure and avoided in patients specifically outlined in the product labeling. This case report, to our knowledge, represents the first published postmarketing report of worsening heart failure complicated by multiorgan dysfunction in the setting of dronedarone initiation. Dronedarone use must be approached with

Chronomics of pressure overload-induced cardiac hypertrophy in mice reveals altered day/night gene expression and biomarkers of heart disease.

PubMed

Tsimakouridze, Elena V; Straume, Marty; Podobed, Peter S; Chin, Heather; LaMarre, Jonathan; Johnson, Ron; Antenos, Monica; Kirby, Gordon M; Mackay, Allison; Huether, Patsy; Simpson, Jeremy A; Sole, Michael; Gadal, Gerard; Martino, Tami A

2012-08-01

There is critical demand in contemporary medicine for gene expression markers in all areas of human disease, for early detection of disease, classification, prognosis, and response to therapy. The integrity of circadian gene expression underlies cardiovascular health and disease; however time-of-day profiling in heart disease has never been examined. We hypothesized that a time-of-day chronomic approach using samples collected across 24-h cycles and analyzed by microarrays and bioinformatics advances contemporary approaches, because it includes sleep-time and/or wake-time molecular responses. As proof of concept, we demonstrate the value of this approach in cardiovascular disease using a murine Transverse Aortic Constriction (TAC) model of pressure overload-induced cardiac hypertrophy in mice. First, microarrays and a novel algorithm termed DeltaGene were used to identify time-of-day differences in gene expression in cardiac hypertrophy 8 wks post-TAC. The top 300 candidates were further analyzed using knowledge-based platforms, paring the list to 20 candidates, which were then validated by real-time polymerase chain reaction (RTPCR). Next, we tested whether the time-of-day gene expression profiles could be indicative of disease progression by comparing the 1- vs. 8-wk TAC. Lastly, since protein expression is functionally relevant, we monitored time-of-day cycling for the analogous cardiac proteins. This approach is generally applicable and can lead to new understanding of disease.

HIGH ENERGY PHYSICS: Bulgarians Sue CERN for Leniency.

PubMed

Koenig, R

2000-10-13

In cash-strapped Bulgaria, scientists are wondering whether a ticket for a front-row seat in high-energy physics is worth the price: Membership dues in CERN, the European particle physics lab, nearly equal the country's entire budget for competitive research grants. Faced with that grim statistic and a plea for leniency from Bulgaria's government, CERN's governing council is considering slashing the country's membership dues for the next 2 years.

Clinical course of infants with congenital heart disease who developed thyroid dysfunction within 100 days

PubMed Central

Lee, Hye Jin; Yu, Hyeoh Won; Kim, Gi Beom; Shin, Choong Ho; Yang, Sei Won

2017-01-01

Purpose We investigated the clinical course of infants with congenital heart disease (CHD) who experienced thyroid dysfunction within 100 days of birth. Methods We performed retrospective medical reviews of 54 CHD patients (24 male patients) who underwent a thyroid function test (TFT) between January 2007 and July 2016. Data were collected on birth history, diagnosis of CHD, underlying chromosomal or genetic abnormalities, medication history, surgery, ventilator care, and exposure to iodine contrast media (ICM). Results of neonatal screening tests (NSTs) and TFTs were reviewed. Results A total of 36 patients (29 transient, 7 permanent) showed thyroid dysfunction. Among the seven patients with permanent hypothyroidism, three had an underlying syndrome, three showed abnormal NST results, and one was admitted to the intensive care unit for macroglossia and feeding cyanosis. We found that infants with transient thyroid dysfunction had a lower birth weight and were more commonly exposed to thyroid disrupting medication and/or ICM. However, these risk factors were not significant. A total of 8 patients with a history of ICM exposure showed thyroid dysfunction. Excluding 3 patients with elevated thyroid stimulating hormone before ICM exposure, 5 patients recovered from transient thyroid dysfunction. Conclusions We observed thyroid dysfunction in two-thirds of CHD infants (53.7% transient, 13.0% permanent) who had risk factors and received TFT screening within 100 days, despite normal NSTs. Further studies with larger sample sizes are required to revise the criteria for TFT screening in CHD infants. PMID:29301186

Hands on CERN: A Well-Used Physics Education Project

ERIC Educational Resources Information Center

Johansson, K. E.

2006-01-01

The "Hands on CERN" education project makes it possible for students and teachers to get close to the forefront of scientific research. The project confronts the students with contemporary physics at its most fundamental level with the help of particle collisions from the DELPHI particle physics experiment at CERN. It now exists in 14 languages…

History of Cern

ScienceCinema

None

2017-12-09

Cérémonie à l'occasion de l'apparition du premier volume du livre sur l'histoire du Cern, avec plusieurs personnes présentes qui jouaient un rôle important dans cette organisation européenne couronnée de succès grâce à l'esprit des membres fondateurs qui est et restera essentiel

Prospects for observation at CERN in NA62

NASA Astrophysics Data System (ADS)

Hahn, F.; NA62 Collaboration; Aglieri Rinella, G.; Aliberti, R.; Ambrosino, F.; Angelucci, B.; Antonelli, A.; Anzivino, G.; Arcidiacono, R.; Azhinenko, I.; Balev, S.; Bendotti, J.; Biagioni, A.; Biino, C.; Bizzeti, A.; Blazek, T.; Blik, A.; Bloch-Devaux, B.; Bolotov, V.; Bonaiuto, V.; Bragadireanu, M.; Britton, D.; Britvich, G.; Brook, N.; Bucci, F.; Butin, F.; Capitolo, E.; Capoccia, C.; Capussela, T.; Carassiti, V.; Cartiglia, N.; Cassese, A.; Catinaccio, A.; Cecchetti, A.; Ceccucci, A.; Cenci, P.; Cerny, V.; Cerri, C.; Chikilev, O.; Ciaranfi, R.; Collazuol, G.; Cooke, P.; Cooper, P.; Corradi, G.; Cortina Gil, E.; Costantini, F.; Cotta Ramusino, A.; Coward, D.; D'Agostini, G.; Dainton, J.; Dalpiaz, P.; Danielsson, H.; Degrange, J.; De Simone, N.; Di Filippo, D.; Di Lella, L.; Dixon, N.; Doble, N.; Duk, V.; Elsha, V.; Engelfried, J.; Enik, T.; Falaleev, V.; Fantechi, R.; Federici, L.; Fiorini, M.; Fry, J.; Fucci, A.; Fulton, L.; Gallorini, S.; Gatignon, L.; Gianoli, A.; Giudici, S.; Glonti, L.; Goncalves Martins, A.; Gonnella, F.; Goudzovski, E.; Guida, R.; Gushchin, E.; Hahn, F.; Hallgren, B.; Heath, H.; Herman, F.; Hutchcroft, D.; Iacopini, E.; Jamet, O.; Jarron, P.; Kampf, K.; Kaplon, J.; Karjavin, V.; Kekelidze, V.; Kholodenko, S.; Khoriauli, G.; Khudyakov, A.; Kiryushin, Yu; Kleinknecht, K.; Kluge, A.; Koval, M.; Kozhuharov, V.; Krivda, M.; Kudenko, Y.; Kunze, J.; Lamanna, G.; Lazzeroni, C.; Leitner, R.; Lenci, R.; Lenti, M.; Leonardi, E.; Lichard, P.; Lietava, R.; Litov, L.; Lomidze, D.; Lonardo, A.; Lurkin, N.; Madigozhin, D.; Maire, G.; Makarov, A.; Mannelli, I.; Mannocchi, G.; Mapelli, A.; Marchetto, F.; Massarotti, P.; Massri, K.; Matak, P.; Mazza, G.; Menichetti, E.; Mirra, M.; Misheva, M.; Molokanova, N.; Morant, J.; Morel, M.; Moulson, M.; Movchan, S.; Munday, D.; Napolitano, M.; Newson, F.; Norton, A.; Noy, M.; Nuessle, G.; Obraztsov, V.; Padolski, S.; Page, R.; Palladino, V.; Pardons, A.; Pedreschi, E.; Pepe, M.; Perez Gomez, F.; Perrin-Terrin, M.; Petrov, P.; Petrucci, F.; Piandani, R.; Piccini, M.; Pietreanu, D.; Pinzino, J.; Pivanti, M.; Polenkevich, I.; Popov, I.; Potrebenikov, Yu; Protopopescu, D.; Raffaelli, F.; Raggi, M.; Riedler, P.; Romano, A.; Rubin, P.; Ruggiero, G.; Russo, V.; Ryjov, V.; Salamon, A.; Salina, G.; Samsonov, V.; Santovetti, E.; Saracino, G.; Sargeni, F.; Schifano, S.; Semenov, V.; Sergi, A.; Serra, M.; Shkarovskiy, S.; Sotnikov, A.; Sougonyaev, V.; Sozzi, M.; Spadaro, T.; Spinella, F.; Staley, R.; Statera, M.; Sutcliffe, P.; Szilasi, N.; Tagnani, D.; Valdata-Nappi, M.; Valente, P.; Vasile, M.; Vassilieva, V.; Velghe, B.; Veltri, M.; Venditti, S.; Vormstein, M.; Wahl, H.; Wanke, R.; Wertelaers, P.; Winhart, A.; Winston, R.; Wrona, B.; Yushchenko, O.; Zamkovsky, M.; Zinchenko, A.

2015-07-01

The rare decays are excellent processes to probe the Standard Model and indirectly search for new physics complementary to the direct LHC searches. The NA62 experiment at CERN SPS aims to collect and analyse O(1013) kaon decays before the CERN long-shutdown 2 (in 2018). This will allow to measure the branching ratio to a level of 10% accuracy. The experimental apparatus has been commissioned during a first run in autumn 2014.

Heart failure overview

MedlinePlus

... bicycle. Your provider can provide a safe and effective exercise plan for you. DO NOT exercise on days ... changing your lifestyle . Get enough rest, including after exercise, ... as your health care team directed. These medicines: Help the heart ...

First Report of 90-Day Support of Two Calves with a Continuous-Flow Total Artificial Heart

PubMed Central

Karimov, Jamshid H.; Moazami, Nader; Kobayashi, Mariko; Sale, Shiva; Such, Kimberly; Byram, Nicole; Sunagawa, Gengo; Horvath, David; Gao, Shengqiang; Kuban, Barry; Golding, Leonard A.; Fukamachi, Kiyotaka

2015-01-01

Objective The Cleveland Clinic continuous-flow total artificial heart (CFTAH) is a compact, single-piece, valveless, pulsatile pump providing self-regulated hemodynamic output to left/right circulation. We evaluated chronic in vivo pump performance, physiologic and hemodynamic parameters, and biocompatibility of the CFTAH in a well-established calf model. Methods CFTAH pumps have been implanted in 17 calves total. Hemodynamics, pump performance, and device-related adverse events were evaluated during studies and at necropsy. Results In vivo experiments demonstrated good hemodynamic performance (pump flow, 7.3 ± 0.7 L/min; left atrial pressure [LAP], 16 ± 3 mm Hg; right atrial pressure [RAP], 17 ± 3 mm Hg; RAP-LAP difference, 1 ± 2 mm Hg; mean arterial pressure, 103 ± 7 mm Hg; arterial pulse pressure, 30 ± 11 mm Hg; pulmonary arterial pressure, 34 ± 5 mm Hg). The CFTAH has operated within design specifications and never failed. With ever-improving pump design, the implants have shown no chronic hemolysis. Three recent animals with the CFTAH recovered well, with no postoperative anticoagulation, during planned in vivo durations of 30, 90, and 90 days (last two were intended to be 90-day studies). All these longest-surviving cases showed good biocompatibility, with no thromboembolism in organs. Conclusions The current CFTAH has demonstrated reliable self-regulation of hemodynamic output and acceptable biocompatibility without anticoagulation throughout 90 days of chronic implantation in calves. Meeting these milestones is in accord with our strategy to achieve transfer of this unique technology to surgical practice, thus filling the urgent need for cardiac replacement devices as destination therapy. PMID:26173607

Disk storage at CERN

NASA Astrophysics Data System (ADS)

Mascetti, L.; Cano, E.; Chan, B.; Espinal, X.; Fiorot, A.; González Labrador, H.; Iven, J.; Lamanna, M.; Lo Presti, G.; Mościcki, JT; Peters, AJ; Ponce, S.; Rousseau, H.; van der Ster, D.

2015-12-01

CERN IT DSS operates the main storage resources for data taking and physics analysis mainly via three system: AFS, CASTOR and EOS. The total usable space available on disk for users is about 100 PB (with relative ratios 1:20:120). EOS actively uses the two CERN Tier0 centres (Meyrin and Wigner) with 50:50 ratio. IT DSS also provide sizeable on-demand resources for IT services most notably OpenStack and NFS-based clients: this is provided by a Ceph infrastructure (3 PB) and few proprietary servers (NetApp). We will describe our operational experience and recent changes to these systems with special emphasis to the present usages for LHC data taking, the convergence to commodity hardware (nodes with 200-TB each with optional SSD) shared across all services. We also describe our experience in coupling commodity and home-grown solution (e.g. CERNBox integration in EOS, Ceph disk pools for AFS, CASTOR and NFS) and finally the future evolution of these systems for WLCG and beyond.

Single-Cell Resolution of Temporal Gene Expression during Heart Development.

PubMed

DeLaughter, Daniel M; Bick, Alexander G; Wakimoto, Hiroko; McKean, David; Gorham, Joshua M; Kathiriya, Irfan S; Hinson, John T; Homsy, Jason; Gray, Jesse; Pu, William; Bruneau, Benoit G; Seidman, J G; Seidman, Christine E

2016-11-21

Activation of complex molecular programs in specific cell lineages governs mammalian heart development, from a primordial linear tube to a four-chamber organ. To characterize lineage-specific, spatiotemporal developmental programs, we performed single-cell RNA sequencing of >1,200 murine cells isolated at seven time points spanning embryonic day 9.5 (primordial heart tube) to postnatal day 21 (mature heart). Using unbiased transcriptional data, we classified cardiomyocytes, endothelial cells, and fibroblast-enriched cells, thus identifying markers for temporal and chamber-specific developmental programs. By harnessing these datasets, we defined developmental ages of human and mouse pluripotent stem-cell-derived cardiomyocytes and characterized lineage-specific maturation defects in hearts of mice with heterozygous mutations in Nkx2.5 that cause human heart malformations. This spatiotemporal transcriptome analysis of heart development reveals lineage-specific gene programs underlying normal cardiac development and congenital heart disease. Copyright © 2016 Elsevier Inc. All rights reserved.

Intravenous Milrinone in Treatment of Advanced Congestive Heart Failure

PubMed Central

Zewail, Aly M.; Nawar, Mohammad; Vrtovec, Bojan; Eastwood, Cathy; Kar, Biswajit; Delgado, Reynolds M.

2003-01-01

Phosphodiesterase inhibitors such as milrinone can relieve symptoms and improve hemodynamics in patients with advanced congestive heart failure. We retrospectively evaluated the hemodynamic and clinical outcomes of long-term combination therapy with intravenous milrinone and oral β-blockers in 65 patients with severe congestive heart failure (New York Heart Association class IV function and ejection fraction <25%) refractory to oral medical therapy. Fifty-one patients successfully began β-blocker therapy while on intravenous milrinone. Oral medical therapy was maximized when possible. The mean duration of milrinone treatment in this combination-treatment group was 269 days (range, 14–1,026 days). Functional class improved from IV to II–III with milrinone therapy. Twenty-four such patients tolerated β-blocker up-titration and were successfully weaned from milrinone. Sixteen patients (31%) died while receiving combination therapy; one died of sudden cardiac death (on treatment day 116); the other 15 died of progressive heart failure or other complications. Hospital admissions during the previous 6 months and admissions within 6 months after milrinone initiation stayed the same. Meanwhile, the total number of hospital days decreased from 450 to 380 (a 15.6% reduction), and the mean length of stay decreased by 1.4 days (a 14.7% reduction). We conclude that 1) milrinone plus β-blocker combination therapy is an effective treatment for heart failure even with β-blocker up-titration, 2) weaning from milrinone may be possible once medications are maximized, 3) patients' functional status improves on the combination regimen, and 4) treatment-related sudden death is relatively infrequent during the combination regimen. (Tex Heart Inst J 2003;30:109–13) PMID:12809251

CERN and 60 years of science for peace

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

Heuer, Rolf-Dieter, E-mail: Rolf.Heuer@cern.ch

2015-02-24

This paper presents CERN as it celebrates its 60{sup th} Anniversary since its founding. The presentation first discusses the mission of CERN and its role as an inter-governmental Organization. The paper also reviews aspects of the particle physics research programme, looking at both current and future accelerator-based facilities at the high-energy and intensity frontiers. Finally, the paper considers issues beyond fundamental research, such as capacity-building and the interface between Art and Science.

Plans for an ERL Test Facility at CERN

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

Jensen, Erik; Bruning, O S; Calaga, Buchi Rama Rao

2014-12-01

The baseline electron accelerator for LHeC and one option for FCC-he is an Energy Recovery Linac. To prepare and study the necessary key technologies, CERNhas started – in collaboration with JLAB and Mainz University – the conceptual design of an ERL Test Facility (ERL-TF). Staged construction will allow the study under different conditions with up to 3 passes, beam energies of up to about 1 GeV and currents of up to 50 mA. The design and development of superconducting cavity modules, including coupler and HOM damper designs, are also of central importance for other existing and future accelerators and theirmore » tests are at the heart of the current ERL-TF goals. However, the ERL-TF could also provide a unique infrastructure for several applications that go beyond developing and testing the ERL technology at CERN. In addition to experimental studies of beam dynamics, operational and reliability issues in an ERL, it could equally serve for quench tests of superconducting magnets, as physics experimental facility on its own right or as test stand for detector developments. This contribution will describe the goals and the concept of the facility and the status of the R&D.« less

Discharge Processes and 30-Day Readmission Rates of Patients Hospitalized for Heart Failure on General Medicine and Cardiology Services.

PubMed

Salata, Brian M; Sterling, Madeline R; Beecy, Ashley N; Ullal, Ajayram V; Jones, Erica C; Horn, Evelyn M; Goyal, Parag

2018-05-01

Given high rates of heart failure (HF) hospitalizations and widespread adoption of the hospitalist model, patients with HF are often cared for on General Medicine (GM) services. Differences in discharge processes and 30-day readmission rates between patients on GM and those on Cardiology during the contemporary hospitalist era are unknown. The present study compared discharge processes and 30-day readmission rates of patients with HF admitted on GM services and those on Cardiology services. We retrospectively studied 926 patients discharged home after HF hospitalization. The primary outcome was 30-day all-cause readmission after discharge from index hospitalization. Although 60% of patients with HF were admitted to Cardiology services, 40% were admitted to GM services. Prevalence of cardiovascular and noncardiovascular co-morbidities were similar between patients admitted to GM services and Cardiology services. Discharge summaries for patients on GM services were less likely to have reassessments of ejection fraction, new study results, weights, discharge vital signs, discharge physical examinations, and scheduled follow-up cardiologist appointments. In a multivariable regression analysis, patients on GM services were more likely to experience 30-day readmissions compared with those on Cardiology services (odds ratio 1.43 95% confidence interval [1.05 to 1.96], p = 0.02). In conclusion, outcomes are better among those admitted to Cardiology services, signaling the need for studies and interventions focusing on noncardiology hospital providers that care for patients with HF. Copyright © 2018 Elsevier Inc. All rights reserved.

A phenomenological study of day-to-day experiences of living with heart failure: do cultural differences matter?

PubMed

Chiaranai, Chantira

2014-07-01

Although there is a significant body of literature addressing heart failure (HF) epidemiology, physiology, and treatment, little is known about the experiences of Thai patients living with this chronic condition. The primary goal of this study was to gain a better understanding of how Thai patients with HF live with chronic and debilitating illness. A phenomenological approach was chosen to investigate the experience of living with HF. Fifteen Thai men and women with HF in New York Heart Association classes I to III, aged between 47 and 75 years, were interviewed with open-ended questions. Data were analyzed using qualitative inductive content analysis. Three themes emerged from the data analysis: identifying losses or changes in their lives, accepting the losses, and regaining some control. Unlike their western counterparts, the Thai patients with HF incorporated their karma, a Buddhist belief system, as a tool to rationalize the occurrence of their HF experience. The participants of this study used kreng jai as a cultural desire not to disrupt the happiness of others, even at the expense of efficiency, or to burden others, which might affect their own quality of life. The Thai patients with HF faced many limitations. The Thai patients with HF use religion and traditional culture to overcome their life situations. To support Thai patients with HF, healthcare providers must have an understanding of cultural differences.

CERN's approach to public outreach

NASA Astrophysics Data System (ADS)

Landua, Rolf

2016-03-01

CERN's communication goes beyond publishing scientific results. Education and outreach are equally important ways of communicating with the general public, and in particular with the young generation. Over the last decade, CERN has significantly increased its efforts to accommodate the very large interest of the general public (about 300,000 visit requests per year), by ramping up its capacity for guided tours from 25,000 to more than 100,000 visitors per year, by creating six new of state-of-the-art exhibitions on-site, by building and operating a modern physics laboratory for school teachers and students, and by showing several traveling exhibitions in about 10 countries per year. The offer for school teachers has also been expanded, to 35-40 weeks of teacher courses with more than 1000 participants from more than 50 countries per year. The talk will give an overview about these and related activities.

CERN: A European laboratory for a global project

NASA Astrophysics Data System (ADS)

Voss, Rüdiger

2015-06-01

In the most important shift of paradigm of its membership rules in 60 years, CERN in 2010 introduced a policy of “Geographical Enlargement” which for the first time opened the door for membership of non-European States in the Organization. This short article reviews briefly the history of CERN's membership rules, discusses the rationale behind the new policy, its relationship with the emerging global roadmap of particle physics, and gives a short overview of the status of the enlargement process.

Artificial heart for humanoid robot

NASA Astrophysics Data System (ADS)

Potnuru, Akshay; Wu, Lianjun; Tadesse, Yonas

2014-03-01

A soft robotic device inspired by the pumping action of a biological heart is presented in this study. Developing artificial heart to a humanoid robot enables us to make a better biomedical device for ultimate use in humans. As technology continues to become more advanced, the methods in which we implement high performance and biomimetic artificial organs is getting nearer each day. In this paper, we present the design and development of a soft artificial heart that can be used in a humanoid robot and simulate the functions of a human heart using shape memory alloy technology. The robotic heart is designed to pump a blood-like fluid to parts of the robot such as the face to simulate someone blushing or when someone is angry by the use of elastomeric substrates and certain features for the transport of fluids.

Effects of head-down bed rest on complex heart rate variability: Response to LBNP testing

NASA Technical Reports Server (NTRS)

Goldberger, Ary L.; Mietus, Joseph E.; Rigney, David R.; Wood, Margie L.; Fortney, Suzanne M.

1994-01-01

Head-down bed rest is used to model physiological changes during spaceflight. We postulated that bed rest would decrease the degree of complex physiological heart rate variability. We analyzed continuous heart rate data from digitized Holter recordings in eight healthy female volunteers (age 28-34 yr) who underwent a 13-day 6 deg head-down bed rest study with serial lower body negative pressure (LBNP) trials. Heart rate variability was measured on a 4-min data sets using conventional time and frequency domain measures as well as with a new measure of signal 'complexity' (approximate entropy). Data were obtained pre-bed rest (control), during bed rest (day 4 and day 9 or 11), and 2 days post-bed rest (recovery). Tolerance to LBNP was significantly reduced on both bed rest days vs. pre-bed rest. Heart rate variability was assessed at peak LBNP. Heart rate approximate entropy was significantly decreased at day 4 and day 9 or 11, returning toward normal during recovery. Heart rate standard deviation and the ratio of high- to low-power frequency did not change significantly. We conclude that short-term bed rest is associated with a decrease in the complex variability of heart rate during LBNP testing in healthy young adult women. Measurement of heart rate complexity, using a method derived from nonlinear dynamics ('chaos theory'), may provide a sensitive marker of this loss of physiological variability, complementing conventional time and frequency domain statistical measures.

CERN Winter School on Supergravity, Strings, and Gauge Theory 2010

ScienceCinema

McAllister, Liam

2018-05-14

The CERN Winter School on Supergravity, Strings, and Gauge Theory is the analytic continuation of the yearly training school of the former EC-RTN string network "Constituents, Fundamental Forces and Symmetries of the Universe". The 2010 edition of the school is supported and organized by the CERN Theory Divison, and will take place from Monday January 25 to Friday January 29, at CERN. As its predecessors, this school is meant primarily for training of doctoral students and young postdoctoral researchers in recent developments in theoretical high-energy physics and string theory. The programme of the school will consist of five series of pedagogical lectures, complemented by tutorial discussion sessions in the afternoons. Previous schools in this series were organized in 2005 at SISSA in Trieste, and in 2006, 2007, 2008, and 2009 at CERN, Geneva. Other similar schools have been organized in the past by the former related RTN network "The Quantum Structure of Spacetime and the Geometric Nature of Fundamental Interactions". This edition of the school is not funded by the European Union. The school is funded by the CERN Theory Division, and the Arnold Sommerfeld Center at Ludwig-Maximilians University of Munich. Scientific committee: M. Gaberdiel, D. Luest, A. Sevrin, J. Simon, K. Stelle, S. Theisen, A. Uranga, A. Van Proeyen, E. Verlinde Local organizers: A. Uranga, J. Walcher

CERN Winter School on Supergravity, Strings, and Gauge Theory 2010

ScienceCinema

None

2018-05-22

The CERN Winter School on Supergravity, Strings, and Gauge Theory is the analytic continuation of the yearly training school of the former EC-RTN string network "Constituents, Fundamental Forces and Symmetries of the Universe". The 2010 edition of the school is supported and organized by the CERN Theory Divison, and will take place from Monday January 25 to Friday January 29, at CERN. As its predecessors, this school is meant primarily for training of doctoral students and young postdoctoral researchers in recent developments in theoretical high-energy physics and string theory. The programme of the school will consist of five series of pedagogical lectures, complemented by tutorial discussion sessions in the afternoons.Previous schools in this series were organized in 2005 at SISSA in Trieste, and in 2006, 2007, 2008, and 2009 at CERN, Geneva. Other similar schools have been organized in the past by the former related RTN network "The Quantum Structure of Spacetime and the Geometric Nature of Fundamental Interactions". This edition of the school is not funded by the European Union. The school is funded by the CERN Theory Division, and the Arnold Sommerfeld Center at Ludwig-Maximilians University of Munich. Scientific committee: M. Gaberdiel, D. Luest, A. Sevrin, J. Simon, K. Stelle, S. Theisen, A. Uranga, A. Van Proeyen, E. Verlinde Local organizers: A. Uranga, J. Walcher

CERN Winter School on Supergravity, Strings, and Gauge Theory 2010

ScienceCinema

Sen, Ashoke

2017-12-18

Part 7.The CERN Winter School on Supergravity, Strings, and Gauge Theory is the analytic continuation of the yearly training school of the former EC-RTN string network "Constituents, Fundamental Forces and Symmetries of the Universe". The 2010 edition of the school is supported and organized by the CERN Theory Divison, and will take place from Monday January 25 to Friday January 29, at CERN. As its predecessors, this school is meant primarily for training of doctoral students and young postdoctoral researchers in recent developments in theoretical high-energy physics and string theory. The programme of the school will consist of five series of pedagogical lectures, complemented by tutorial discussion sessions in the afternoons. Previous schools in this series were organized in 2005 at SISSA in Trieste, and in 2006, 2007, 2008, and 2009 at CERN, Geneva. Other similar schools have been organized in the past by the former related RTN network "The Quantum Structure of Spacetime and the Geometric Nature of Fundamental Interactions". This edition of the school is not funded by the European Union. The school is funded by the CERN Theory Division, and the Arnold Sommerfeld Center at Ludwig-Maximilians University of Munich. Scientific committee: M. Gaberdiel, D. Luest, A. Sevrin, J. Simon, K. Stelle, S. Theisen, A. Uranga, A. Van Proeyen, E. Verlinde Local organizers: A. Uranga, J. Walcher

CERN Winter School on Supergravity, Strings, and Gauge Theory 2010

ScienceCinema

None

2018-06-28

The CERN Winter School on Supergravity, Strings, and Gauge Theory is the analytic continuation of the yearly training school of the former EC-RTN string network "Constituents, Fundamental Forces and Symmetries of the Universe". The 2010 edition of the school is supported and organized by the CERN Theory Divison, and will take place from Monday January 25 to Friday January 29, at CERN. As its predecessors, this school is meant primarily for training of doctoral students and young postdoctoral researchers in recent developments in theoretical high-energy physics and string theory. The programme of the school will consist of five series of pedagogical lectures, complemented by tutorial discussion sessions in the afternoons. Previous schools in this series were organized in 2005 at SISSA in Trieste, and in 2006, 2007, 2008, and 2009 at CERN, Geneva. Other similar schools have been organized in the past by the former related RTN network "The Quantum Structure of Spacetime and the Geometric Nature of Fundamental Interactions". This edition of the school is not funded by the European Union. The school is funded by the CERN Theory Division, and the Arnold Sommerfeld Center at Ludwig-Maximilians University of Munich. Scientific committee: M. Gaberdiel, D. Luest, A. Sevrin, J. Simon, K. Stelle, S. Theisen, A. Uranga, A. Van Proeyen, E. Verlinde Local organizers: A. Uranga, J. Walcher

CERN Winter School on Supergravity, Strings, and Gauge Theory 2010

ScienceCinema

None

2018-05-23

The CERN Winter School on Supergravity, Strings, and Gauge Theory is the analytic continuation of the yearly training school of the former EC-RTN string network "Constituents, Fundamental Forces and Symmetries of the Universe". The 2010 edition of the school is supported and organized by the CERN Theory Divison, and will take place from Monday January 25 to Friday January 29, at CERN. As its predecessors, this school is meant primarily for training of doctoral students and young postdoctoral researchers in recent developments in theoretical high-energy physics and string theory. The programme of the school will consist of five series of pedagogical lectures, complemented by tutorial discussion sessions in the afternoons. Previous schools in this series were organized in 2005 at SISSA in Trieste, and in 2006, 2007, 2008, and 2009 at CERN, Geneva. Other similar schools have been organized in the past by the former related RTN network "The Quantum Structure of Spacetime and the Geometric Nature of Fundamental Interactions". This edition of the school is not funded by the European Union. The school is funded by the CERN Theory Division, and the Arnold Sommerfeld Center at Ludwig-Maximilians University of Munich. Scientific committee: M. Gaberdiel, D. Luest, A. Sevrin, J. Simon, K. Stelle, S. Theisen, A. Uranga, A. Van Proeyen, E. Verlinde Local organizers: A. Uranga, J. Walcher

CERN Winter School on Supergravity, Strings, and Gauge Theory 2010

ScienceCinema

None

2017-12-09

The CERN Winter School on Supergravity, Strings, and Gauge Theory is the analytic continuation of the yearly training school of the former EC-RTN string network "Constituents, Fundamental Forces and Symmetries of the Universe". The 2010 edition of the school is supported and organized by the CERN Theory Divison, and will take place from Monday January 25 to Friday January 29, at CERN. As its predecessors, this school is meant primarily for training of doctoral students and young postdoctoral researchers in recent developments in theoretical high-energy physics and string theory. The programme of the school will consist of five series of pedagogical lectures, complemented by tutorial discussion sessions in the afternoons. Previous schools in this series were organized in 2005 at SISSA in Trieste, and in 2006, 2007, 2008, and 2009 at CERN, Geneva. Other similar schools have been organized in the past by the former related RTN network "The Quantum Structure of Spacetime and the Geometric Nature of Fundamental Interactions". This edition of the school is not funded by the European Union. The school is funded by the CERN Theory Division, and the Arnold Sommerfeld Center at Ludwig-Maximilians University of Munich. Scientific committee: M. Gaberdiel, D. Luest, A. Sevrin, J. Simon, K. Stelle, S. Theisen, A. Uranga, A. Van Proeyen, E. Verlinde Local organizers: A. Uranga, J. Walcher

CERN Winter School on Supergravity, Strings, and Gauge Theory 2010

ScienceCinema

None

2018-02-09

The CERN Winter School on Supergravity, Strings, and Gauge Theory is the analytic continuation of the yearly training school of the former EC-RTN string network "Constituents, Fundamental Forces and Symmetries of the Universe". The 2010 edition of the school is supported and organized by the CERN Theory Divison, and will take place from Monday January 25 to Friday January 29, at CERN. As its predecessors, this school is meant primarily for training of doctoral students and young postdoctoral researchers in recent developments in theoretical high-energy physics and string theory. The programme of the school will consist of five series of pedagogical lectures, complemented by tutorial discussion sessions in the afternoons. Previous schools in this series were organized in 2005 at SISSA in Trieste, and in 2006, 2007, 2008, and 2009 at CERN, Geneva. Other similar schools have been organized in the past by the former related RTN network "The Quantum Structure of Spacetime and the Geometric Nature of Fundamental InteractionS". This edition of the school is not funded by the European Union. The school is funded by the CERN Theory Division, and the Arnold Sommerfeld Center at Ludwig-Maximilians University of Munich. Scientific committee: M. Gaberdiel, D. Luest, A. Sevrin, J. Simon, K. Stelle, S. Theisen, A. Uranga, A. Van Proeyen, E. Verlinde Local organizers: A. Uranga, J. Walcher

CERN Winter School on Supergravity, Strings, and Gauge Theory 2010

ScienceCinema

McAllister, Liam

2018-05-24

The CERN Winter School on Supergravity, Strings, and Gauge Theory is the analytic continuation of the yearly training school of the former EC-RTN string network "Constituents, Fundamental Forces and Symmetries of the Universe";. The 2010 edition of the school is supported and organized by the CERN Theory Divison, and will take place from Monday January 25 to Friday January 29, at CERN. As its predecessors, this school is meant primarily for training of doctoral students and young postdoctoral researchers in recent developments in theoretical high-energy physics and string theory. The programme of the school will consist of five series of pedagogical lectures, complemented by tutorial discussion sessions in the afternoons. Previous schools in this series were organized in 2005 at SISSA in Trieste, and in 2006, 2007, 2008, and 2009 at CERN, Geneva. Other similar schools have been organized in the past by the former related RTN network "The Quantum Structure of Spacetime and the Geometric Nature of Fundamental Interactions".This edition of the school is not funded by the European Union. The school is funded by the CERN Theory Division, and the Arnold Sommerfeld Center at Ludwig-Maximilians University of Munich. Scientific committee: M. Gaberdiel, D. Luest, A. Sevrin, J. Simon, K. Stelle, S. Theisen, A. Uranga, A. Van Proeyen, E. Verlinde. Local organizers: A. Uranga, J. Walcher

CERN Winter School on Supergravity, Strings, and Gauge Theory 2010

ScienceCinema

Sen, Ashoke

2018-04-27

The CERN Winter School on Supergravity, Strings, and Gauge Theory is the analytic continuation of the yearly training school of the former EC-RTN string network "Constituents, Fundamental Forces and Symmetries of the Universe". The 2010 edition of the school is supported and organized by the CERN Theory Divison, and will take place from Monday January 25 to Friday January 29, at CERN. As its predecessors, this school is meant primarily for training of doctoral students and young postdoctoral researchers in recent developments in theoretical high-energy physics and string theory. The programme of the school will consist of five series of pedagogical lectures, complemented by tutorial discussion sessions in the afternoons. Previous schools in this series were organized in 2005 at SISSA in Trieste, and in 2006, 2007, 2008, and 2009 at CERN, Geneva. Other similar schools have been organized in the past by the former related RTN network". The Quantum Structure of Spacetime and the Geometric Nature of Fundamental Interactions". This edition of the school is not funded by the European Union. The school is funded by the CERN Theory Division, and the Arnold Sommerfeld Center at Ludwig-Maximilians University of Munich. Scientific committee: M. Gaberdiel, D. Luest, A. Sevrin, J. Simon, K. Stelle, S. Theisen, A. Uranga, A. Van Proeyen, E. Verlinde Local organizers: A. Uranga, J. Walcher.

CERN Winter School on Supergravity, Strings, and Gauge Theory 2010

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

None

2010-01-22

The CERN Winter School on Supergravity, Strings, and Gauge Theory is the analytic continuation of the yearly training school of the former EC-RTN string network "Constituents, Fundamental Forces and Symmetries of the Universe". The 2010 edition of the school is supported and organized by the CERN Theory Divison, and will take place from Monday January 25 to Friday January 29, at CERN. As its predecessors, this school is meant primarily for training of doctoral students and young postdoctoral researchers in recent developments in theoretical high-energy physics and string theory. The programme of the school will consist of five series ofmore » pedagogical lectures, complemented by tutorial discussion sessions in the afternoons. Previous schools in this series were organized in 2005 at SISSA in Trieste, and in 2006, 2007, 2008, and 2009 at CERN, Geneva. Other similar schools have been organized in the past by the former related RTN network "The Quantum Structure of Spacetime and the Geometric Nature of Fundamental Interactions". This edition of the school is not funded by the European Union. The school is funded by the CERN Theory Division, and the Arnold Sommerfeld Center at Ludwig-Maximilians University of Munich. Scientific committee: M. Gaberdiel, D. Luest, A. Sevrin, J. Simon, K. Stelle, S. Theisen, A. Uranga, A. Van Proeyen, E. Verlinde Local organizers: A. Uranga, J. Walcher« less

CERN Winter School on Supergravity, Strings, and Gauge Theory 2010

ScienceCinema

None

2018-05-23

The CERN Winter School on Supergravity, Strings, and Gauge Theory is the analytic continuation of the yearly training school of the former EC-RTN string network "Constituents, Fundamental Forces and Symmetries of the Universe";. The 2010 edition of the school is supported and organized by the CERN Theory Divison, and will take place from Monday January 25 to Friday January 29, at CERN. As its predecessors, this school is meant primarily for training of doctoral students and young postdoctoral researchers in recent developments in theoretical high-energy physics and string theory. The programme of the school will consist of five series of pedagogical lectures, complemented by tutorial discussion sessions in the afternoons. Previous schools in this series were organized in 2005 at SISSA in Trieste, and in 2006, 2007, 2008, and 2009 at CERN, Geneva. Other similar schools have been organized in the past by the former related RTN network "The Quantum Structure of Spacetime and the Geometric Nature of Fundamental Interactions". This edition of the school is not funded by the European Union. The school is funded by the CERN Theory Division, and the Arnold Sommerfeld Center at Ludwig-Maximilians University of Munich. Scientific committee: M. Gaberdiel, D. Luest, A. Sevrin, J. Simon, K. Stelle, S. Theisen, A. Uranga, A. Van Proeyen, E. Verlinde Local organizers: A. Uranga, J. Walcher

First report of 90-day support of 2 calves with a continuous-flow total artificial heart.

PubMed

Karimov, Jamshid H; Moazami, Nader; Kobayashi, Mariko; Sale, Shiva; Such, Kimberly; Byram, Nicole; Sunagawa, Gengo; Horvath, David; Gao, Shengqiang; Kuban, Barry; Golding, Leonard A R; Fukamachi, Kiyotaka

2015-09-01

The Cleveland Clinic continuous-flow total artificial heart (CFTAH) is a compact, single-piece, valveless, pulsatile pump providing self-regulated hemodynamic output to left/right circulation. We evaluated chronic in vivo pump performance, physiologic and hemodynamic parameters, and biocompatibility of the CFTAH in a well-established calf model. CFTAH pumps have been implanted in 17 calves total. Hemodynamic parameters, pump performance, and device-related adverse events were evaluated during studies and at necropsy. In vivo experiments demonstrated good hemodynamic performance (pump flow, 7.3 ± 0.7 L/min; left atrial pressure, 16 ± 3 mm Hg; right atrial pressure, 17 ± 3 mm Hg; right atrial pressure-left atrial pressure difference, 1 ± 2 mm Hg; mean arterial pressure, 103 ± 7 mm Hg; arterial pulse pressure, 30 ± 11 mm Hg; and pulmonary arterial pressure, 34 ± 5 mm Hg). The CFTAH has operated within design specifications and never failed. With ever-improving pump design, the implants have shown no chronic hemolysis. Three animals with recent CFTAH implantation recovered well, with no postoperative anticoagulation, during planned in vivo durations of 30, 90, and 90 days (last 2 were intended to be 90-day studies). All these longest-surviving cases showed good biocompatibility, with no thromboembolism in organs. The current CFTAH has demonstrated reliable self-regulation of hemodynamic output and acceptable biocompatibility without anticoagulation throughout 90 days of chronic implantation in calves. Meeting these milestones is in accord with our strategy to achieve transfer of this unique technology to human surgical practice, thus filling the urgent need for cardiac replacement devices as destination therapy. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Galectin 3 complements BNP in risk stratification in acute heart failure.

PubMed

Fermann, Gregory J; Lindsell, Christopher J; Storrow, Alan B; Hart, Kimberly; Sperling, Matthew; Roll, Susan; Weintraub, Neal L; Miller, Karen F; Maron, David J; Naftilan, Allen J; McPherson, John A; Sawyer, Douglas B; Christenson, Robert; Collins, Sean P

2012-12-01

Galectin 3 (G3) is a mediator of fibrosis and remodeling in heart failure. Patients diagnosed with and treated for Acute Heart Failure Syndromes were prospectively enrolled in the Decision Making in Acute Decompensated Heart Failure multicenter trial. Patients with a higher G3 had a history of renal disease, a lower heart rate and acute kidney injury. They also tended to have a history of HF and 30-day adverse events compared with B-type natriuretic peptide. In Acute Heart Failure Syndromes, G3 levels do not provide prognostic value, but when used complementary to B-type natriuretic peptide, G3 is associated with renal dysfunction and may predict 30-day events.

Galectin 3 complements BNP in risk stratification in acute heart failure

PubMed Central

Fermann, Gregory J.; Lindsell, Christopher J.; Storrow, Alan B.; Hart, Kimberly; Sperling, Matthew; Roll, Susan; Weintraub, Neal L.; Miller, Karen F.; Maron, David J.; Naftilan, Allen J.; Mcpherson, John A.; Sawyer, Douglas B.; Christenson, Robert; Collins, Sean P.

2013-01-01

Background Galectin 3 (G3) is a mediator of fibrosis and remodeling in heart failure. Methods Patients diagnosed with and treated for Acute Heart Failure Syndromes were prospectively enrolled in the Decision Making in Acute Decompensated Heart Failure multicenter trial. Results Patients with a higher G3 had a history of renal disease, a lower heart rate and acute kidney injury. They also tended to have a history of HF and 30-day adverse events compared with B-type natriuretic peptide. Conclusion In Acute Heart Failure Syndromes, G3 levels do not provide prognostic value, but when used complementary to B-type natriuretic peptide, G3 is associated with renal dysfunction and may predict 30-day events. PMID:22998064

CERN data services for LHC computing

NASA Astrophysics Data System (ADS)

Espinal, X.; Bocchi, E.; Chan, B.; Fiorot, A.; Iven, J.; Lo Presti, G.; Lopez, J.; Gonzalez, H.; Lamanna, M.; Mascetti, L.; Moscicki, J.; Pace, A.; Peters, A.; Ponce, S.; Rousseau, H.; van der Ster, D.

2017-10-01

Dependability, resilience, adaptability and efficiency. Growing requirements require tailoring storage services and novel solutions. Unprecedented volumes of data coming from the broad number of experiments at CERN need to be quickly available in a highly scalable way for large-scale processing and data distribution while in parallel they are routed to tape for long-term archival. These activities are critical for the success of HEP experiments. Nowadays we operate at high incoming throughput (14GB/s during 2015 LHC Pb-Pb run and 11PB in July 2016) and with concurrent complex production work-loads. In parallel our systems provide the platform for the continuous user and experiment driven work-loads for large-scale data analysis, including end-user access and sharing. The storage services at CERN cover the needs of our community: EOS and CASTOR as a large-scale storage; CERNBox for end-user access and sharing; Ceph as data back-end for the CERN OpenStack infrastructure, NFS services and S3 functionality; AFS for legacy distributed-file-system services. In this paper we will summarise the experience in supporting LHC experiments and the transition of our infrastructure from static monolithic systems to flexible components providing a more coherent environment with pluggable protocols, tuneable QoS, sharing capabilities and fine grained ACLs management while continuing to guarantee dependable and robust services.

Neutrino Factory Plans at CERN

NASA Astrophysics Data System (ADS)

Riche, J. A.

2002-10-01

The considerable interest raised by the discovery of neutrino oscillations and recent progress in studies of muon colliders has triggered interest in considering a neutrino factory at CERN. This paper explains the reference scenario, indicates the other possible choices and mentions the R&D that are foreseen.

Cortisol and progestin release, heart rate and heart rate variability in the pregnant and postpartum mare, fetus and newborn foal.

PubMed

Nagel, C; Erber, R; Bergmaier, C; Wulf, M; Aurich, J; Möstl, E; Aurich, C

2012-09-01

The mechanisms leading to parturition in the horse in many aspects differ from those in other species. Pregnancy is maintained not by progesterone but by 5α-pregnanes and the progestin precursor pregnenolone originates from the fetus. As parturition approaches, the fetal adrenal switches from pregnenolone to cortisol synthesis but it is not known whether cortisol crosses the placenta. We hypothesized that in parallel to fetal cortisol release, cortisol in the maternal circulation increases before foaling and this increase can be determined in both saliva and plasma. In addition, maternal, fetal and neonatal heart rate and heart rate variability were measured. In 25 pregnant mares, saliva for cortisol analysis was collected 4 times daily from 15 days before to 5 days after foaling. In 13 mares, in addition, fetomaternal electrocardiogram (ECG) recordings were made and blood samples for progestin and cortisol analysis were collected once daily. Heart rate (HR) was recorded until 5 days after foaling. The heart rate variability (HRV) variables standard deviation of the beat-to-beat (RR) interval (SDRR) and root mean square of successive RR differences (RMSSD) were calculated. From Days 15 to 4 before parturition, progestin concentration increased (peak 267 ± 42 ng/mL) and decreased thereafter (P < 0.05, day of foaling 113 ± 18 ng/mL). A prepartum increase in maternal cortisol concentrations was evident in blood (P < 0.05) and saliva (P < 0.05) and paralleled the decrease in progestin concentrations. In mares, HR remained constant during the last days of pregnancy but decreased within one day after parturition (P < 0.05) while maternal HRV did not change. In the fetus and neonate, HR increased from before to after birth (P < 0.05) indicating increasing demands on the cardiovascular system with adaptation to extrauterine life. Copyright © 2012 Elsevier Inc. All rights reserved.

The predictive value of resting heart rate following osmotherapy in brain injury: back to basics.

PubMed

Hasanpour Mir, Mahsa; Yousefshahi, Fardin; Abdollahi, Mohammad; Ahmadi, Arezoo; Nadjafi, Atabak; Mojtahedzadeh, Mojtaba

2012-12-30

The importance of resting heart rate as a prognostic factor was described in several studies. An elevated heart rate is an independent risk factor for adverse cardiovascular events and total mortality in patients with coronary artery disease, chronic heart failure, and the general population. Also heart rate is elevated in the Multi Organ Dysfunction Syndrome (MODS) and the mortality due to MODS is highly correlated with inadequate sinus tachycardia.To evaluate the value of resting heart rate in predicting mortality in patients with traumatic brain injury along scoring systems like Acute Physiology and Chronic Health Evaluation(APACHE II), Sequential Organ Failure Assessment (SOFA) and Glasgow Coma Score (GCS). By analyzing data which was collected from an open labeled randomized clinical trial that compared the different means of osmotherapy (mannitol vs bolus or infusion hypertonic saline), heart rate, GCS, APACHE II and SOFA score were measured at baseline and daily for 7 days up to 60 days and the relationship between elevated heart rate and mortality during the first 7 days and 60th day were assessed. After adjustments for confounding factors, although there was no difference in mean heart rate between either groups of alive and expired patients, however, we have found a relative correlation between 60th day mortality rate and resting heart rate (P=0.07). Heart rate can be a prognostic factor for estimating mortality rate in brain injury patients along with APACHE II and SOFA scores in patients with brain injury.

CERN launches high-school internship programme

NASA Astrophysics Data System (ADS)

Johnston, Hamish

2017-07-01

The CERN particle-physics lab has hosted 22 high-school students from Hungary in a pilot programme designed to show teenagers how science, technology, engineering and mathematics is used at the particle-physics lab.

Heart rate as an independent risk factor in patients with multiple organ dysfunction: a prospective, observational study.

PubMed

Hoke, Robert S; Müller-Werdan, Ursula; Lautenschläger, Christine; Werdan, Karl; Ebelt, Henning

2012-02-01

To study the association between baseline heart rate and outcome in patients with multiple organ dysfunction (MODS) as well as the course of heart rate over the first 4 days during MODS. Prospective observational study in 89 patients with MODS, defined as an APACHE-II score ≥20. Baseline heart rate (HR(0)) was determined over a 60-minute period at the time of MODS diagnosis. 28-day all-cause mortality was the primary endpoint of the study, a fall of the APACHE-II score by 4 points or more from day 0 to day 4 constituted the secondary endpoint. Hazard ratios for heart rate of 90 beats per minute (bpm) or greater relative to less than 90 bpm were calculated using Cox proportional hazards model and adjusted for confounding variables. Median baseline heart rate was 83 bpm in survivors and 92 bpm in non-survivors (p = 0.048). 28-day mortality was 32 and 61% in patients with HR(0) < 90 bpm and HR(0) ≥ 90 bpm, respectively. The adjusted hazard ratio for 28-day mortality was 2.30 (95% confidence interval 1.21-4.36, p = 0.001) for HR(0) ≥ 90 bpm relative to HR(0) < 90 bpm. No correlation was found between baseline heart rate and the secondary endpoint. From day 0 to day 4, heart rate remained elevated in all patients, as well as in survivors and non-survivors. A heart rate ≥90 bpm at the time of MODS diagnosis is an independent risk factor for increased 28-day mortality. As in patients with cardiovascular conditions such as coronary heart disease or chronic heart failure, heart rate might constitute a target for heart rate-lowering therapy in the narrow initial treatment window of MODS.

Monitoring Evolution at CERN

NASA Astrophysics Data System (ADS)

Andrade, P.; Fiorini, B.; Murphy, S.; Pigueiras, L.; Santos, M.

2015-12-01

Over the past two years, the operation of the CERN Data Centres went through significant changes with the introduction of new mechanisms for hardware procurement, new services for cloud provisioning and configuration management, among other improvements. These changes resulted in an increase of resources being operated in a more dynamic environment. Today, the CERN Data Centres provide over 11000 multi-core processor servers, 130 PB disk servers, 100 PB tape robots, and 150 high performance tape drives. To cope with these developments, an evolution of the data centre monitoring tools was also required. This modernisation was based on a number of guiding rules: sustain the increase of resources, adapt to the new dynamic nature of the data centres, make monitoring data easier to share, give more flexibility to Service Managers on how they publish and consume monitoring metrics and logs, establish a common repository of monitoring data, optimise the handling of monitoring notifications, and replace the previous toolset by new open source technologies with large adoption and community support. This contribution describes how these improvements were delivered, present the architecture and technologies of the new monitoring tools, and review the experience of its production deployment.

Heart Rate Variability During Early Adaptation to Space

NASA Technical Reports Server (NTRS)

Toscano, W. B.; Cowings, P. S.

1994-01-01

A recent report hypothesized that episodes of space motion sickness (SMS) were reliably associated with low frequency oscillations (less than 0.03 to less than 0.01 Hz) in heart rate variability. This paper archives a large data set for review of investigators in this field which may facilitate the evaluation of this hypothesis. Continuous recording of Electro-cardiography (ECG) and other measures were made for 6 to 12 hours per day (waking hours) of six Shuttle crewmembers for the first 3 mission days of two separate Shuttle flights. Spectral analyses of heart rate variability during approximately 200 hours of inflight is presented. In addition, nearly 200 hours of data collected on these same individuals during ground tests prior to the mission are presented. The Purpose of this Publication is to document the incidence of low frequency oscillations of heart rate in 4 people exposed to microgravity over a period of five days. In addition, this report contains spectral analyses of heart rate data collected on these same individuals during ground-based mission simulations. By archiving these data in this manner, it is our intention to make this information available to other investigators interested in studying this phenomena.

CERN, ESA and ESO Launch "Physics On Stage"

NASA Astrophysics Data System (ADS)

2000-03-01

countries of at least one of the participating organisations or the European Union: Austria, Belgium, Bulgaria, the Czech Republic, Denmark, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Luxembourg, the Netherlands, Norway, Poland, Portugal, the Slovak Republic, Spain, Sweden, Switzerland, United Kingdom. Statements by the Directors General of CERN, ESA and ESO Luciano Maiani (CERN) : "Science is a critical resource for mankind and, among natural sciences, physics will continue to play a crucial role, well into the next century. The young people of Europe deserve the best possible physics teaching. An enormous resource of first class teachers, teaching materials and innovative thinking exists in our countries. The "Physics on Stage" project will bring these together to generate a new interest in physics education which will be to the long term benefit of children all over Europe. CERN is delighted to take part in this collaboration between the European Community and the continent's three leading physics research organizations." Antonio Rodotà (ESA) : "Space has become an integral part of every day life. The immense technological development that has led to this achievement has taken place and might be taken for granted. But now is the time to follow up and form the future on this basis, a future that has to made by the youth and has to give its benefits to the youth. The European Space Agency is dedicated to support the youth in its development to become a space generation. Many activities have been done and are taking place, and many more are planned for the future. Teachers and educational institutions and organisations form a key role in this development. ESA is enthusiastic about co-operating with ESO and CERN to create an opportunity to receiving ideas from the educational society and will perform a dedicated effort in finding ways to support the realisation of those ideas." Catherine Cesarsky (ESO) : "Astronomy and Astrophysics are at the very heart of

Perfusion-decellularized matrix: using nature's platform to engineer a bioartificial heart.

PubMed

Ott, Harald C; Matthiesen, Thomas S; Goh, Saik-Kia; Black, Lauren D; Kren, Stefan M; Netoff, Theoden I; Taylor, Doris A

2008-02-01

About 3,000 individuals in the United States are awaiting a donor heart; worldwide, 22 million individuals are living with heart failure. A bioartificial heart is a theoretical alternative to transplantation or mechanical left ventricular support. Generating a bioartificial heart requires engineering of cardiac architecture, appropriate cellular constituents and pump function. We decellularized hearts by coronary perfusion with detergents, preserved the underlying extracellular matrix, and produced an acellular, perfusable vascular architecture, competent acellular valves and intact chamber geometry. To mimic cardiac cell composition, we reseeded these constructs with cardiac or endothelial cells. To establish function, we maintained eight constructs for up to 28 d by coronary perfusion in a bioreactor that simulated cardiac physiology. By day 4, we observed macroscopic contractions. By day 8, under physiological load and electrical stimulation, constructs could generate pump function (equivalent to about 2% of adult or 25% of 16-week fetal heart function) in a modified working heart preparation.

The predictive value of resting heart rate following osmotherapy in brain injury: back to basics

PubMed Central

2012-01-01

Background The importance of resting heart rate as a prognostic factor was described in several studies. An elevated heart rate is an independent risk factor for adverse cardiovascular events and total mortality in patients with coronary artery disease, chronic heart failure, and the general population. Also heart rate is elevated in the Multi Organ Dysfunction Syndrome (MODS) and the mortality due to MODS is highly correlated with inadequate sinus tachycardia. To evaluate the value of resting heart rate in predicting mortality in patients with traumatic brain injury along scoring systems like Acute Physiology and Chronic Health Evaluation(APACHE II), Sequential Organ Failure Assessment (SOFA) and Glasgow Coma Score (GCS). Method By analyzing data which was collected from an open labeled randomized clinical trial that compared the different means of osmotherapy (mannitol vs bolus or infusion hypertonic saline), heart rate, GCS, APACHE II and SOFA score were measured at baseline and daily for 7 days up to 60 days and the relationship between elevated heart rate and mortality during the first 7 days and 60th day were assessed. Results After adjustments for confounding factors, although there was no difference in mean heart rate between either groups of alive and expired patients, however, we have found a relative correlation between 60th day mortality rate and resting heart rate (P=0.07). Conclusion Heart rate can be a prognostic factor for estimating mortality rate in brain injury patients along with APACHE II and SOFA scores in patients with brain injury. PMID:23351393

Incidence and predictors of 6 months mortality after an acute heart failure event in rural Uganda: The Mbarara Heart Failure Registry (MAHFER).

PubMed

Abeya, Fardous Charles; Lumori, Boniface Amanee Elias; Akello, Suzan Joan; Annex, Brian H; Buda, Andrew J; Okello, Samson

2018-03-29

We sought to estimate the incidence and predictors of all-cause mortality 6 months after heart failure hospitalization in Uganda. Mbarara Heart Failure Registry is a cohort of patients hospitalized with a clinical diagnosis of heart failure at Mbarara Regional Referral Hospital, Uganda. We measured serum electrolytes, cardiac markers, and echocardiograms. All participants were followed until death or end of 6 months. We used Fine and Gray models to estimate the incidence and predictors all-cause mortality. A total of 215 participants were enrolled, 141 (66%) were women, and mean age 53 (standard deviation 22) years. Nineteen (9%) had diabetes, 40 (19%) had HIV, and 119 (55%) had hypertension. The overall incidence of all-cause mortality was 3.58 (95% CI 2.92, 4.38) per 1000 person-days. Men had higher incidence of death compared to women (4.02 vs 3.37 per 1000 person-days). The incidence of all-cause mortality during hospitalization was almost twice that of in the community (27.5 vs 14.77 per 1000 person-days). In adjusted analysis, increasing age, NYHA class IV, decreasing renal function, smoking, each unit increase in serum levels of Potassium, BNP, and Creatine kinase-MB predicted increased incidence of 6 months all-cause death whereas taking beta-blockers and having an index admission on a weekend compared to a week day predicted survival. There is a high incidence of all-cause mortality occurring in-hospital among patients hospitalized with heart failure in rural Uganda. Heart failure directed therapies should be instituted to curb heart failure-related mortality. Copyright © 2017 Elsevier B.V. All rights reserved.

Heart Rate During Sleep: Implications for Monitoring Training Status

PubMed Central

Waldeck, Miriam R.; Lambert, Michael I.

2003-01-01

Resting heart rate has sometimes been used as a marker of training status. It is reasonable to assume that the relationship between heart rate and training status should be more evident during sleep when extraneous factors that may influence heart rate are reduced. Therefore the aim of the study was to assess the repeatability of monitoring heart rate during sleep when training status remained unchanged, to determine if this measurement had sufficient precision to be used as a marker of training status. The heart rate of ten female subjects was monitored for 24 hours on three occasions over three weeks whilst training status remained unchanged. Average, minimum and maximum heart rate during sleep was calculated. The average heart rate of the group during sleep was similar on each of the three tests (65 ± 9, 63 ± 6 and 67 ± 7 beats·min-1 respectively). The range in minimum heart rate variation during sleep for all subjects over the three testing sessions was from 0 to 10 beats·min-1 (mean = 5 ± 3 beats·min-1) and for maximum heart rate variation was 2 to 31 beats·min-1 (mean = 13 ± 9 beats·min-1). In summary it was found that on an individual basis the minimum heart rate during sleep varied by about 8 beats·min-1. This amount of intrinsic day-to-day variation needs to be considered when changes in heart rate that may occur with changes in training status are interpreted. PMID:24688273

Fetal heart rate and fetal heart rate variability in Lipizzaner broodmares.

PubMed

Baska-Vincze, Boglárka; Baska, Ferenc; Szenci, Ottó

2015-03-01

Monitoring fetal heart rate (FHR) and fetal heart rate variability (FHRV) helps to understand and evaluate normal and pathological conditions in the foal. The aim of this study was to establish normal heart rate reference values for the ongoing equine pregnancy and to perform a heart rate variability (HRV) time-domain analysis in Lipizzaner mares. Seventeen middle- and late-term (days 121-333) pregnant Lipizzaner mares were examined using fetomaternal electrocardiography (ECG). The mean FHR (P = 0.004) and the standard deviation of FHR (P = 0.012) significantly decreased during the pregnancy. FHR ± SD values decreased from 115 ± 35 to 79 ± 9 bpm between months 5 and 11. Our data showed that HRV in the foal decreased as the pregnancy progressed, which is in contrast with the findings of earlier equine studies. The standard deviation of normal-normal intervals (SDNN) was higher (70 ± 25 to 166 ± 108 msec) than described previously. The root mean square of successive differences (RMSSD) decreased from 105 ± 69 to 77 ± 37 msec between the 5th and 11th month of gestation. Using telemetric ECG equipment, we could detect equine fetal heartbeat on day 121 for the first time. In addition, the large differences observed in the HR values of four mare-fetus pairs in four consecutive months support the assumption that there might be 'high-HR' and 'low-HR' fetuses in horses. It can be concluded that the analysis of FHR and FHRV is a promising tool for the assessment of fetal well-being but the applicability of these parameters in the clinical setting and in studs requires further investigation.

The Evolution of CERN EDMS

NASA Astrophysics Data System (ADS)

Wardzinska, Aleksandra; Petit, Stephan; Bray, Rachel; Delamare, Christophe; Garcia Arza, Griselda; Krastev, Tsvetelin; Pater, Krzysztof; Suwalska, Anna; Widegren, David

2015-12-01

Large-scale long-term projects such as the LHC require the ability to store, manage, organize and distribute large amounts of engineering information, covering a wide spectrum of fields. This information is a living material, evolving in time, following specific lifecycles. It has to reach the next generations of engineers so they understand how their predecessors designed, crafted, operated and maintained the most complex machines ever built. This is the role of CERN EDMS. The Engineering and Equipment Data Management Service has served the High Energy Physics Community for over 15 years. It is CERN's official PLM (Product Lifecycle Management), supporting engineering communities in their collaborations inside and outside the laboratory. EDMS is integrated with the CAD (Computer-aided Design) and CMMS (Computerized Maintenance Management) systems used at CERN providing tools for engineers who work in different domains and who are not PLM specialists. Over the years, human collaborations and machines grew in size and complexity. So did EDMS: it is currently home to more than 2 million files and documents, and has over 6 thousand active users. In April 2014 we released a new major version of EDMS, featuring a complete makeover of the web interface, improved responsiveness and enhanced functionality. Following the results of user surveys and building upon feedback received from key users group, we brought what we think is a system that is more attractive and makes it easy to perform complex tasks. In this paper we will describe the main functions and the architecture of EDMS. We will discuss the available integration options, which enable further evolution and automation of engineering data management. We will also present our plans for the future development of EDMS.

Comparison of 2 heterotopic heart transplant techniques in rats: cervical and abdominal heart.

PubMed

Ma, Yi; Wang, Guodong

2011-04-01

Heterotopic heart transplant in rats has been accepted as the most commonly used animal model to investigate the mechanisms of transplant immunology. Many ingenious approaches to this model have been reported. We sought to improve this model and compare survival rates and histologic features of acute rejection in cervical and abdominal heart transplants. Rats were divided into cervical and abdominal groups. Microsurgical techniques were introduced for vascular anastomoses. In the abdominal heart transplant group, the donor's thoracic aorta was anastomosed end-to-side to the recipient's infrarenal abdominal aorta, and the donor's pulmonary artery was anastomosed to the recipient's inferior vena cava. In the cervical heart transplant group, the donor's thoracic aorta was anastomosed to the recipient's common carotid artery, and the donor's pulmonary artery was anastomosed to the recipient's external jugular vein. Survival time of the 2 models was followed and pathology was examined. Histologic features of allogeneic rejection also were compared in the cervical and abdominal heart transplant groups. The mean time to recover the donor's hearts was 7.4 ± 2.2 minutes in the cervical group and 7.2 ± 1.8 minutes in the abdominal group. In the cervical and abdominal heart transplant models, the mean recipient's operative time was 23.2 ± 2.6 minutes and 21.6 ± 2.8 minutes. Graft survival was 98% and 100% in the cervical and abdominal heart transplant groups. There was no significant difference in graft survival between the 2 methods. Heart allografts rejected at 5.7 and 6.2 days in the cervical and abdominal transplant groups. There was no difference in the histologic features of acute allogenic rejection in cervical and abdominal heart transplant. Both cervical and abdominal heart transplants can achieve a high rate of success. The histologic features of acute allogeneic rejection in the models are comparable.

Total Artificial Heart as Rescue Therapy for Primary Graft Failure in an Infant.

PubMed

Ziegler, Luke A; Sainathan, Sandeep; Morell, Victor O; Sharma, Mahesh S

2018-04-01

An infant unable to be weaned from cardiopulmonary bypass after orthotopic heart transplantation was cannulated for extracorporeal membrane oxygenation. During the next 3 days, allograft failure and intracardiac thrombosis necessitated cardiectomy. To provide acute mechanical circulatory support, artificial atrial chambers were constructed with Gore-Tex conduits and PediMag centrifugal pumps were connected to each by Berlin Heart EXCOR cannulae. The PediMag pumps were subsequently exchanged for 10-mL Berlin Heart EXCOR pumps. After 60 days of support by total artificial heart, the patient was bridged successfully to a second heart transplant. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Resonance of about-weekly human heart rate rhythm with solar activity change.

PubMed

Cornelissen, G; Halberg, F; Wendt, H W; Bingham, C; Sothern, R B; Haus, E; Kleitman, E; Kleitman, N; Revilla, M A; Revilla, M; Breus, T K; Pimenov, K; Grigoriev, A E; Mitish, M D; Yatsyk, G V; Syutkina, E V

1996-12-01

In several human adults, certain solar activity rhythms may influence an about 7-day rhythm in heart rate. When no about-weekly feature was found in the rate of change in sunspot area, a measure of solar activity, the double amplitude of a circadian heart rate rhythm, approximated by the fit of a 7-day cosine curve, was lower, as was heart rate corresponds to about-weekly features in solar activity and/or relates to a sunspot cycle.

A bioprosthetic total artificial heart for end-stage heart failure: Results from a pilot study.

PubMed

Latrémouille, Christian; Carpentier, Alain; Leprince, Pascal; Roussel, Jean-Christian; Cholley, Bernard; Boissier, Elodie; Epailly, Eric; Capel, Antoine; Jansen, Piet; Smadja, David M

2018-01-01

The electro-hydraulically actuated Carmat total artificial heart (C-TAH) is designed to replace the heart in patients with end-stage heart failure, either as bridge to transplant or destination therapy. It provides pulsatile flow and contains bio-prosthetic blood contacting materials. A clinical feasibility study was conducted to evaluate the C-TAH safety and performance. Hospitalized patients, at imminent risk of death from irreversible biventricular failure despite optimal medical management, and not eligible for transplant or eligible but on extracorporeal life support, were enrolled. The primary endpoint was 30-days survival. Four patients were implanted with the C-TAH, three as destination therapy (ages 76, 68, 74) and one as bridge to transplant (age 58). They had implant times of 74, 270, 254 and 20 days respectively. All patients were free from hemolysis, clinical neurologic events, clinical evidence of thrombus and device-related infections. Hemodynamic and physical recovery allowed two patients to be discharged home for a cumulative duration of 7 months. The anticoagulation management strategy comprised initial unfractionated heparin, from postoperative day 2, followed by low molecular weight heparin and aspirin. An increased D-dimer level was observed in all patients during months 1 to 4. Temporary suspension of heparin anticoagulation resulted in thrombocytopenia and increased fibrin monomer, reversed by resuming anticoagulation with heparin. Causes of death were device-related (2 cases), respiratory failure and multi-organ failure. Preliminary clinical results with the C-TAH demonstrated good safety and performance profiles in patients suffering from biventricular failure, which need to be confirmed in a pivotal study. Copyright © 2018 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Music close to one's heart: heart rate variability with music, diagnostic with e-bra and smartphone

NASA Astrophysics Data System (ADS)

Hegde, Shantala; Kumar, Prashanth S.; Rai, Pratyush; Mathur, Gyanesh N.; Varadan, Vijay K.

2012-04-01

Music is a powerful elicitor of emotions. Emotions evoked by music, through autonomic correlates have been shown to cause significant modulation of parameters like heart rate and blood pressure. Consequently, Heart Rate Variability (HRV) analysis can be a powerful tool to explore evidence based therapeutic functions of music and conduct empirical studies on effect of musical emotion on heart function. However, there are limitations with current studies. HRV analysis has produced variable results to different emotions evoked via music, owing to variability in the methodology and the nature of music chosen. Therefore, a pragmatic understanding of HRV correlates of musical emotion in individuals listening to specifically chosen music whilst carrying out day to day routine activities is needed. In the present study, we aim to study HRV as a single case study, using an e-bra with nano-sensors to record heart rate in real time. The e-bra developed previously, has several salient features that make it conducive for this study- fully integrated garment, dry electrodes for easy use and unrestricted mobility. The study considers two experimental conditions:- First, HRV will be recorded when there is no music in the background and second, when music chosen by the researcher and by the subject is playing in the background.

Effects of gonadectomy and hormonal replacement on rat hearts.

PubMed

Scheuer, J; Malhotra, A; Schaible, T F; Capasso, J

1987-07-01

To evaluate the effects of sex hormones on heart function and biochemistry, gonadectomy (GX) was performed in postpubertal male (M) and female (F) rats and compared with sham-operated controls (SH). The groups were MSH; MGX; MGX replaced with testosterone 3 mg/day s.c. (MGX + T), FSH, and FGX replaced with estrogen 2 mg/day (FGX + E), progesterone 0.4 mg/day (FGX + P), estrogen and progesterone (FGX + EP), or testosterone 2 mg/day (FGX + T). Body weight was decreased in MGX and was decreased further in MGX + T. Heart weight was decreased in both MGX and MGX + T. Body weights were increased in FGX and FTX + P and were increased further in FGX + T but were normal in FGX + E and FGX + EP. Heart weights were unchanged in F groups except in FGX + T, where it was increased. Cardiac performance in perfused hearts, as measured by stroke work, ejection fraction, fractional shortening and mean velocity of circumferential fiber shortening, was decreased in MGX but was slightly increased in MGX + T. Papillary muscle studies showed increases in time to peak tension and one-half relaxation in MGX, but these were decreased in MGX + T. Isotonic shortening studies showed decreased velocity of shortening in MGX and increased velocity in MGX + T. Heart function was significantly decreased in FGX and FGX + P compared with FSH but was similar to FSH in FGX + E and FGX + EP. FGX + T had greater stroke work and ejection fraction than FSH and FGX.(ABSTRACT TRUNCATED AT 250 WORDS)

Altering hemodynamics leads to congenital heart defects (Conference Presentation)

NASA Astrophysics Data System (ADS)

Ford, Stephanie M.; McPheeters, Matthew T.; Wang, Yves T.; Gu, Shi; Doughman, Yong Qiu; Strainic, James P.; Rollins, Andrew M.; Watanabe, Michiko; Jenkins, Michael W.

2016-03-01

The role of hemodynamics in early heart development is poorly understood. In order to successfully assess the impact of hemodynamics on development, we need to monitor and perturb blood flow, and quantify the resultant effects on morphology. Here, we have utilized cardiac optical pacing to create regurgitant flow in embryonic hearts and OCT to quantify regurgitation percentage and resultant morphology. Embryonic quail in a shell-less culture were optically paced at 3 Hz (well above the intrinsic rate or 1.33-1.67 Hz) on day 2 of development (3-4 weeks human) for 5 minutes. The pacing fatigued the heart and led to a prolonged period (> 1 hour) of increased regurgitant flow. Embryos were kept alive until day 3 (cardiac looping - 4-5 weeks human) or day 8 (4 chambered heart - 8 weeks human) to quantify resultant morphologic changes with OCT. All paced embryos imaged at day 3 displayed cardiac defects. The extent of regurgitant flow immediately after pacing was correlated with cardiac cushion size 24-hours post pacing (p-value < 0.01) with higher regurgitation leading to smaller cushions. Almost all embryos (16/18) surviving to day 8 exhibited congenital heart defects (CHDs) including 11/18 with valve defects, 5/18 with ventricular septal defects and 5/18 with hypoplastic right ventricles. Our data suggests that regurgitant flow leads to smaller cushions, which develop into abnormal valves and septa. Our model produces similar phenotypes as found in our fetal alcohol syndrome and velo-cardio-facial/DiGeorge syndrome models suggesting that hemodynamics plays a role in these syndromes as well. Utilizing OCT and optical pacing to understand hemodynamics in development is an important step towards determining CHD mechanisms and ultimately developing earlier treatments.

Immunostaining of dissected zebrafish embryonic heart.

PubMed

Yang, Jingchun; Xu, Xiaolei

2012-01-10

Zebrafish embryo becomes a popular in vivo vertebrate model for studying cardiac development and human heart diseases due to its advantageous embryology and genetics. About 100-200 embryos are readily available every week from a single pair of adult fish. The transparent embryos that develop ex utero make them ideal for assessing cardiac defects. The expression of any gene can be manipulated via morpholino technology or RNA injection. Moreover, forward genetic screens have already generated a list of mutants that affect different perspectives of cardiogenesis. Whole mount immunostaining is an important technique in this animal model to reveal the expression pattern of the targeted protein to a particular tissue. However, high resolution images that can reveal cellular or subcellular structures have been difficult, mainly due to the physical location of the heart and the poor penetration of the antibodies. Here, we present a method to address these bottlenecks by dissecting heart first and then conducting the staining process on the surface of a microscope slide. To prevent the loss of small heart samples and to facilitate solution handling, we restricted the heart samples within a circle on the surface of the microscope slides drawn by an immEdge pen. After the staining, the fluorescence signals can be directly observed by a compound microscope. Our new method significantly improves the penetration for antibodies, since a heart from an embryonic fish only consists of few cell layers. High quality images from intact hearts can be obtained within a much reduced procession time for zebrafish embryos aged from day 2 to day 6. Our method can be potentially extended to stain other organs dissected from either zebrafish or other small animals. Copyright © 2012 Journal of Visualized Experiments

[Iron Deficiency in Chronic Heart Failure: Diagnostic Algorithm and Present-Day Therapeutic Options].

PubMed

Doehner, Wolfram; Blankenberg, Stefan; Erdmann, Erland; Ertl, Georg; Hasenfuß, Gerd; Landmesser, Ulf; Pieske, Burkert; Schieffer, Bernhard; Schunkert, Heribert; von Haehling, Stephan; Zeiher, Andreas; Anker, Stefan D

2017-05-01

Iron deficiency (ID) occurs in up to 50% of patients with heart failure (HF). Even without presence of anaemia ID contributes to more severe symptoms, increased hospitalization and mortality. A number of randomized controlled trials demonstrated the clinical benefit of replenishment of iron stores with improvement of symptoms and fewer hospitalizations. Assessment of iron status should therefore become routine assessment in newly diagnosed and in symptomatic patients with HF. ID can be identified with simple and straightforward diagnostic steps. Assessment of Ferritin (indicating iron stores) and transferrin saturation (TSAT, indication capability to mobilise internal iron stores) are sufficient to detect ID. In this review a plain diagnostic algorithm for ID is suggested. Confounding factors for diagnosis and adequate treatment of ID in HF are discussed. A regular workup for iron deficiency parameters may benefit patients with heart failure by providing symptomatic improvements and fewer hospitalizations. © Georg Thieme Verlag KG Stuttgart · New York.

Effect of a telemonitoring-facilitated collaboration between general practitioner and heart failure clinic on mortality and rehospitalization rates in severe heart failure: the TEMA-HF 1 (TElemonitoring in the MAnagement of Heart Failure) study.

PubMed

Dendale, Paul; De Keulenaer, Gilles; Troisfontaines, Pierre; Weytjens, Caroline; Mullens, Wilfried; Elegeert, Ivan; Ector, Bavo; Houbrechts, Marita; Willekens, Koen; Hansen, Dominique

2012-03-01

Chronic heart failure (CHF) patients are frequently rehospitalized within 6 months after an episode of fluid retention. Rehospitalizations are preventable, but this requires an extensive organization of the healthcare system. In this study, we tested whether intensive follow-up of patients through a telemonitoring-facilitated collaboration between general practitioners (GPs) and a heart failure clinic could reduce mortality and rehospitalization rate. One hunderd and sixty CHF patients [mean age 76 ± 10 years, 104 males, mean left ventricular ejection fraction (LVEF) 35 ± 15%] were block randomized by sealed envelopes and assigned to 6 months of intense follow-up facilitated by telemonitoring (TM) or usual care (UC). The TM group measured body weight, blood pressure, and heart rate on a daily basis with electronic devices that transferred the data automatically to an online database. Email alerts were sent to the GP and heart failure clinic to intervene when pre-defined limits were exceeded. All-cause mortality was significantly lower in the TM group as compared with the UC group (5% vs. 17.5%, P = 0.01). The total number of follow-up days lost to hospitalization, dialysis, or death was significantly lower in the TM group as compared with the UC group (13 vs. 30 days, P = 0.02). The number of hospitalizations for heart failure per patient showed a trend (0.24 vs. 0.42 hospitalizations/patient, P = 0.06) in favour of TM. Telemonitoring-facilitated collaboration between GPs and a heart failure clinic reduces mortality and number of days lost to hospitalization, death, or dialysis in CHF patients. These findings need confirmation in a large trial.

Predictors of early dyspnoea relief in acute heart failure and the association with 30-day outcomes: findings from ASCEND-HF

PubMed Central

Mentz, Robert J.; Hernandez, Adrian F.; Stebbins, Amanda; Ezekowitz, Justin A.; Felker, G. Michael; Heizer, Gretchen M.; Atar, Dan; Teerlink, John R.; Califf, Robert M.; Massie, Barry M.; Hasselblad, Vic; Starling, Randall C.; O'Connor, Christopher M.; Ponikowski, Piotr

2013-01-01

Aims To examine the characteristics associated with early dyspnoea relief during acute heart failure (HF) hospitalization, and its association with 30-day outcomes. Methods and results ASCEND-HF was a randomized trial of nesiritide vs. placebo in 7141 patients hospitalized with acute HF in which dyspnoea relief at 6 h was measured on a 7-point Likert scale. Patients were classified as having early dyspnoea relief if they experienced moderate or marked dyspnoea improvement at 6 h. We analysed the clinical characteristics, geographical variation, and outcomes (mortality, mortality/HF hospitalization, and mortality/hospitalization at 30 days) associated with early dyspnoea relief. Early dyspnoea relief occurred in 2984 patients (43%). In multivariable analyses, predictors of dyspnoea relief included older age and oedema on chest radiograph; higher systolic blood pressure, respiratory rate, and natriuretic peptide level; and lower serum blood urea nitrogen (BUN), sodium, and haemoglobin (model mean C index = 0.590). Dyspnoea relief varied markedly across countries, with patients enrolled from Central Europe having the lowest risk-adjusted likelihood of improvement. Early dyspnoea relief was associated with lower risk-adjusted 30-day mortality/HF hospitalization [hazard ratio (HR) 0.81; 95% confidence interval (CI) 0.68–0.96] and mortality/hospitalization (HR 0.85; 95% CI 0.74–0.99), but similar mortality. Conclusion Clinical characteristics such as respiratory rate, pulmonary oedema, renal function, and natriuretic peptide levels are associated with early dyspnoea relief, and moderate or marked improvement in dyspnoea was associated with a lower risk for 30-day outcomes. PMID:23159547

Building an organic block storage service at CERN with Ceph

NASA Astrophysics Data System (ADS)

van der Ster, Daniel; Wiebalck, Arne

2014-06-01

Emerging storage requirements, such as the need for block storage for both OpenStack VMs and file services like AFS and NFS, have motivated the development of a generic backend storage service for CERN IT. The goals for such a service include (a) vendor neutrality, (b) horizontal scalability with commodity hardware, (c) fault tolerance at the disk, host, and network levels, and (d) support for geo-replication. Ceph is an attractive option due to its native block device layer RBD which is built upon its scalable, reliable, and performant object storage system, RADOS. It can be considered an "organic" storage solution because of its ability to balance and heal itself while living on an ever-changing set of heterogeneous disk servers. This work will present the outcome of a petabyte-scale test deployment of Ceph by CERN IT. We will first present the architecture and configuration of our cluster, including a summary of best practices learned from the community and discovered internally. Next the results of various functionality and performance tests will be shown: the cluster has been used as a backend block storage system for AFS and NFS servers as well as a large OpenStack cluster at CERN. Finally, we will discuss the next steps and future possibilities for Ceph at CERN.

Medical Applications at CERN and the ENLIGHT Network

PubMed Central

Dosanjh, Manjit; Cirilli, Manuela; Myers, Steve; Navin, Sparsh

2016-01-01

State-of-the-art techniques derived from particle accelerators, detectors, and physics computing are routinely used in clinical practice and medical research centers: from imaging technologies to dedicated accelerators for cancer therapy and nuclear medicine, simulations, and data analytics. Principles of particle physics themselves are the foundation of a cutting edge radiotherapy technique for cancer treatment: hadron therapy. This article is an overview of the involvement of CERN, the European Organization for Nuclear Research, in medical applications, with specific focus on hadron therapy. It also presents the history, achievements, and future scientific goals of the European Network for Light Ion Hadron Therapy, whose co-ordination office is at CERN. PMID:26835422

Medical Applications at CERN and the ENLIGHT Network.

PubMed

Dosanjh, Manjit; Cirilli, Manuela; Myers, Steve; Navin, Sparsh

2016-01-01

State-of-the-art techniques derived from particle accelerators, detectors, and physics computing are routinely used in clinical practice and medical research centers: from imaging technologies to dedicated accelerators for cancer therapy and nuclear medicine, simulations, and data analytics. Principles of particle physics themselves are the foundation of a cutting edge radiotherapy technique for cancer treatment: hadron therapy. This article is an overview of the involvement of CERN, the European Organization for Nuclear Research, in medical applications, with specific focus on hadron therapy. It also presents the history, achievements, and future scientific goals of the European Network for Light Ion Hadron Therapy, whose co-ordination office is at CERN.

Commissioning the CERN IT Agile Infrastructure with experiment workloads

NASA Astrophysics Data System (ADS)

Medrano Llamas, Ramón; Harald Barreiro Megino, Fernando; Kucharczyk, Katarzyna; Kamil Denis, Marek; Cinquilli, Mattia

2014-06-01

In order to ease the management of their infrastructure, most of the WLCG sites are adopting cloud based strategies. In the case of CERN, the Tier 0 of the WLCG, is completely restructuring the resource and configuration management of their computing center under the codename Agile Infrastructure. Its goal is to manage 15,000 Virtual Machines by means of an OpenStack middleware in order to unify all the resources in CERN's two datacenters: the one placed in Meyrin and the new on in Wigner, Hungary. During the commissioning of this infrastructure, CERN IT is offering an attractive amount of computing resources to the experiments (800 cores for ATLAS and CMS) through a private cloud interface. ATLAS and CMS have joined forces to exploit them by running stress tests and simulation workloads since November 2012. This work will describe the experience of the first deployments of the current experiment workloads on the CERN private cloud testbed. The paper is organized as follows: the first section will explain the integration of the experiment workload management systems (WMS) with the cloud resources. The second section will revisit the performance and stress testing performed with HammerCloud in order to evaluate and compare the suitability for the experiment workloads. The third section will go deeper into the dynamic provisioning techniques, such as the use of the cloud APIs directly by the WMS. The paper finishes with a review of the conclusions and the challenges ahead.

Coronary heart disease mortality among Seventh-Day Adventists with differing dietary habits: a preliminary report.

PubMed

Phillips, R L; Lemon, F R; Beeson, W L; Kuzma, J W

1978-10-01

Seventh-Day Adventists (SDAs) are a conservative religious denomination who abstain from tobacco and alcohol; approximately one-half follow a lacto-ovo-vegetarian diet. In this 6-year prospective study of 24,044 California SDAs age 35 and over, coronary heart disease (CHD) mortality rates for ages 35 to 64 and 65+ are 28% and 50% respectively, of the rates for the same age groups of the total California population. This reduced risk of CHD mortality among SDAs is partially due to abstinence from smoking; however, at least half the low risk among SDAs is likely attributable to other characteristics of the SDA lifestyle. The risk of fatal CHD among nonvegetarian SDA males, ages 35 to 64, is three times greater than vegetarian SDA males of comparable age (P less than 0.01), suggesting that the SDA diet may account for a large share of their low risk. This differential was much smaller for older SDA males and SDA females. Although the differential in risk of fatal CHD for male nonvegetarians versus vegetarians may be partially accounted for by other CHD risk factors, which are more frequent among nonvegetarians, a significant differential persists after adjustment for each of six other CHD risk factors.

Association of operative time of day with outcomes after thoracic organ transplant.

PubMed

George, Timothy J; Arnaoutakis, George J; Merlo, Christian A; Kemp, Clinton D; Baumgartner, William A; Conte, John V; Shah, Ashish S

2011-06-01

Recent emphasis on systems-based approaches to patient safety has led to several studies demonstrating worse outcomes associated with surgery at night. To evaluate whether operative time of day was associated with thoracic organ transplant outcomes, hypothesizing that it would not be associated with increased morbidity or mortality. We conducted a retrospective cohort study of adult heart and lung transplant recipients in the United Network for Organ Sharing database from January 2000 through June 2010. Primary stratification was by operative time of day (night, 7 PM-7 AM; day, 7 AM-7 PM). Primary end points were short-term survival, assessed by the Kaplan-Meier method at 30, 90, and 365 days. Secondary end points encompassed common postoperative complications. Risk-adjusted multivariable Cox proportional hazards regression examined mortality. A total of 27,118 patients were included in the study population. Of the 16,573 who underwent a heart transplant, 8346 (50.36%) did so during the day and 8227 (49.64%) during the night. Of the 10,545 who underwent a lung transplant, 5179 (49.11%) did so during the day and 5366 (50.89%) during the night. During a median follow-up of 32.2 months (interquartile range, 11.2-61.1 months), 8061 patients (28.99%) died. Survival was similar for organ transplants performed during the day and night. Survival rates at 30 days for heart transplants during the day were 95.0% vs 95.2% during the night (hazard ratio [HR], 1.05; 95% confidence interval, 0.83-1.32; P = .67) and for lung transplants during the day were 96.0% vs 95.5% during the night (HR, 1.22; 95% CI, 0.97-1.55; P = .09). At 90 days, survival rates for heart transplants were 92.6% during the day vs 92.7% during the night (HR, 1.05; 95% CI, 0.88-1.26; P = .59) and for lung transplants during the day were 92.7% vs 91.7% during the night (HR, 1.23; 95% CI, 1.04-1.47; P = .02). At 1 year, survival rates for heart transplants during the day were 88.0% vs 87.7% during the night (HR

Venoarterial Extracorporeal Membrane Oxygenation Support as a Bridge to Heart Transplant: Report of 3 Cases.

PubMed

Gedik, Ender; Ulaş, Aydın; Ersoy, Özgür; Atar, Funda; Camkıran Fırat, Aynur; Pirat, Arash

2016-11-01

Heart transplant is the only definitive treatment of end-stage heart failure. Venoarterial extracorporeal membrane oxygenation may be used as a bridge to heart transplant. Among 31 patients who underwent heart transplant between January 2014 and June 2016, we present our experiences with 3 patients who received venoarterial extracorporeal support as a bridge to heart transplant. The first patient was a 51-year-old male with ischemic dilated cardiomyopathy. Transplant was performed after 6 days of extracorporeal support, and the patient was discharged and alive at follow-up. Patient 2 was a 12-yearold girl with dilated cardiomyopathy who presented with cardiac arrest. Extracorporeal support was initiated during cardiopulmonary resuscitation. She had full neurologic recovery and remained on the wait list. She received a transplant 22 days after resuscitation. She survived and was alive at day 220 posttransplant. The third patient was a 50-year-old male with ischemic dilated cardiomyopathy requiring venoarterial extracorporeal support. Percutaneous balloon atrial septostomy was performed for left ventricle venting. He underwent transplant on day 28 after intensive care unit admission. He died 29 days after release from the hospital. Regarding patients on heart transplant wait lists who are worsening despite optimal medical therapy, venoarterial extracorporeal membrane oxygenation support is a safe and viable last resort.

The influence of cardiac rhythm type and frequency on the prognosis of severe heart failure patients initially qualified for heart transplantation.

PubMed

Sobieszczańska-Małek, Małgorzata; Zieliński, Tomasz; Rywik, Tomasz; Piotrowska, Małgorzata; Religa, Grzegorz; Przybyłowski, Piotr; Rózański, Jacek; Korewicki, Jerzy

2010-01-01

Atrial fibrillation (AF) is the most common arrhythmia among patients (pts) with heart failure and has significant influence on survival. to assess prognosis of pts with refractory heart failure (HF) qualified for heart transplantation (HTX). 872 pts (107 W and 765 M) were qualified for HTX between Dec 2003 and Oct 2007. Patient's death or super urgent heart transplantation were considered the end point in Kaplan-Meier survival curves. 680 pts were on sinus rhythm (SR) and 192(22.0%) had atrial fibrillation (AF). During follow-up (1-1464 days, mean 550 days) 155 pts (17.7%) died, 17.65% with SR and 18.23% with AF (ns). EF - mean 21,6 (SR) and 21,8 (FA), NYHA 3,1 (SR), NTproBNP- mean 3635, 4 (SR) and 4349,4 (FA), Arronson - mean 7,8 (SR) and 7,7 (FA). There were no significant differences between groups. We analyzed influence of heart rate (Kaplan-Maier method) on survival. The pts were divided according to HR: gr.I <70/min, gr II 71-89/min, gr III >90/min. The shortest survival rate was noticed in group III. There was no difference in survival between group I and II. The prognosis for patients qualified for heart transplant does not depend on the type of the dominant cardiac rhythm (atrial fibrillation or sinus rhythm). The prognosis is significantly better for those patients whose basic, resting heart rate does not exceed 90 bpm regardless of the rhythm type.

Ceremony 25th birthday Cern

ScienceCinema

None

2018-05-18

Celebration of CERN's 25th birthday with a speech by L. Van Hove and J.B. Adams, musical interludes by Ms. Mey and her colleagues (starting with Beethoven). The general managers then proceed with the presentation of souvenirs to members of the personnel who have 25 years of service in the organization. A gesture of recognition is also given to Zwerner.

Optical fibres in the radiation environment of CERN

NASA Astrophysics Data System (ADS)

Guillermain, E.

2017-11-01

CERN, the European Organization for Nuclear Research (in Geneva, Switzerland), is home to a complex scientific instrument: the 27-kilometre Large Hadron Collider (LHC) collides beams of high-energy particles at close to the speed of light. Optical fibres are widely used at CERN, both in surface areas (e.g. for inter-building IT networks) and in the accelerator complex underground (e.g. for cryogenics, vacuum, safety systems). Optical fibres in the accelerator are exposed to mixed radiation fields (mainly composed of protons, pions, neutrons and other hadrons, gamma rays and electrons), with dose rates depending on the particular installation zone, and with radiation levels often significantly higher than those encountered in space. In the LHC and its injector chain radiation levels range from relatively low annual doses of a few Gy up to hundreds of kGy. Optical fibres suffer from Radiation Induced Attenuation (RIA, expressed in dB per unit length) that affect light transmission and which depends on the irradiation conditions (e.g. dose rate, total dose, temperature). In the CERN accelerator complex, the failure of an optical link can affect the proper functionality of control or monitoring systems and induce the interruption of the accelerator operation. The qualification of optical fibres for installation in critical radiation areas is therefore crucial. Thus, all optical fibre types installed in radiation areas at CERN are subject to laboratory irradiation tests, in order to evaluate their RIA at different total dose and dose rates. This allows the selection of the appropriate optical fibre type (conventional or radiation resistant) compliant with the requirements of each installation. Irradiation tests are performed in collaboration with Fraunhofer INT (irradiation facilities and expert team in Euskirchen, Germany). Conventional off-the-shelf optical fibres can be installed for optical links exposed to low radiation levels (i.e. annual dose typically below few

Heart failure: a weak link in CHA2 DS2 -VASc.

PubMed

Friberg, Leif; Lund, Lars H

2018-06-01

In atrial fibrillation, stroke risk is assessed by the CHA 2 DS 2 -VASc score. Heart failure is included in CHA 2 DS 2 -VASc, but the rationale is uncertain. Our objective was to test if heart failure is a risk factor for stroke, independent of other risk factors in CHA 2 DS 2 -VASc. We studied 300 839 patients with atrial fibrillation in the Swedish Patient Register 2005-11. Three definitions of heart failure were used in order to assess the robustness of the results. In the main analysis, heart failure was defined by a hospital discharge diagnosis of heart failure as first or second diagnosis and a filled prescription of a diuretic within 3 months before index + 30 days. The second definition counted first or second discharge diagnoses <1 year before index + 30 days and the third definition any heart failure diagnosis in open or hospital care before index + 30 days. Associations with outcomes were assessed with multivariable Cox analyses. Patients with heart failure were older (80.5 vs. 74.0 years, P < 0.001) and had higher CHA 2 DS 2 -VASc score (4.4 vs. 2.7, P < 0.001). The 1 year incidence of ischaemic stroke without warfarin was 4.4% with heart failure and 3.1% without. Adjustment for the cofactors in CHA 2 DS 2 -VASc eradicated the difference in stroke risk between patients with and without heart failure (hazard ratio 1.01 with 95% confidence interval 0.96-1.05). The area under the receiver operating characteristic curve for CHA 2 DS 2 -VASc was not improved by points for heart failure. A clinical diagnosis of heart failure was not an independent risk factor for stroke in patients with atrial fibrillation, which may have implications for anticoagulation management. © 2018 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

Effect of suprachiasmatic lesions on diurnal heart rate rhythm in the rat

NASA Technical Reports Server (NTRS)

Saleh, M. A.; Winget, C. M.

1977-01-01

Heart rate and locomotor activity of rats kept under 12L/12D illumination regimen were recorded every six minutes for ten days using implantable radio transmitters. Some of the rats then received bilateral RF lesions into the suprachiasmatic nucleus (SCN). Control sham operations were performed on the rest of the animals. After recovery from surgery, recording of heart rate and locomotor activity was continued for ten days. SCN-lesioned rats showed no significant diurnal fluctuation in heart rate, while normal and sham-operated rats showed the normal diurnal rhythm in that function. The arrhythmic diurnal heart-rate pattern of SCN rats appeared to be correlated with their sporadic activity pattern. The integrity of the suprachiasmatic nucleus is therefore necessary for the generation and/or expression of diurnal rhythmicity in heart rate in the rat.

Effects of insulin treatment on heart rhythm, body temperature and physical activity in streptozotocin-induced diabetic rat.

PubMed

Howarth, F C; Jacobson, M; Shafiullah, M; Adeghate, E

2006-04-01

1. Streptozotocin (STZ)-induced diabetic cardiomyopathy is frequently associated with depressed diastolic/systolic function and altered heart rhythm. 2. The effects of insulin treatment on heart rhythm, body temperature and physical activity in STZ-induced diabetic rats were investigated using biotelemetry techniques. 3. Transmitter devices were surgically implanted in the peritoneal cavity of young adult male Wistar rats. Electrodes from the transmitter were arranged in Einthoven bipolar - Lead II configuration. Electrocardiogram, physical activity and body temperature data were recorded with a telemetry system for 10 days before STZ treatment, for 20 days following administration of STZ (60 mg/kg) and thereafter, for 30 days while rats received daily insulin. 4. Heart rate, physical activity and body temperature declined rapidly 3-5 days after administration of STZ. Pre-STZ heart rate was 362 +/- 7 b.p.m., falling to 266 +/- 12 b.p.m. 5-15 days after STZ with significant recovery to 303 +/- 14 b.p.m. 10-20 days after commencement of insulin. Pre-STZ body temperature was 37.5 +/- 0.1C, falling to 37.2 +/- 0.2C 5-15 days after STZ with significant recovery to 37.5 +/- 0.1C 10-20 days after commencement of insulin. Physical activity and heart rate variability were also reduced after STZ but there was no significant recovery during insulin replacement. 5. Defective autonomic regulation and/or mechanisms of control that are intrinsic to the heart may underlie disturbances in heart rhythm in the STZ-induced diabetic rat.

The Penn State Heart Assistant: A pilot study of a web-based intervention to improve self-care of heart failure patients.

PubMed

Lloyd, Tom; Buck, Harleah; Foy, Andrew; Black, Sara; Pinter, Antony; Pogash, Rosanne; Eismann, Bobby; Balaban, Eric; Chan, John; Kunselman, Allen; Smyth, Joshua; Boehmer, John

2017-05-01

The Penn State Heart Assistant, a web-based, tablet computer-accessed, secure application was developed to conduct a proof of concept test, targeting patient self-care activities of heart failure patients including daily medication adherence, weight monitoring, and aerobic activity. Patients (n = 12) used the tablet computer-accessed program for 30 days-recording their information and viewing a short educational video. Linear random coefficient models assessed the relationship between weight and time and exercise and time. Good medication adherence (66% reporting taking 75% of prescribed medications) was reported. Group compliance over 30 days for weight and exercise was 84 percent. No persistent weight gain over 30 days, and some indication of weight loss (slope of weight vs time was negative (-0.17; p value = 0.002)), as well as increased exercise (slope of exercise vs time was positive (0.08; p value = 0.04)) was observed. This study suggests that mobile technology is feasible, acceptable, and has potential for cost-effective opportunities to manage heart failure patients safely at home.

High-Resolution Tissue Doppler Imaging of the Zebrafish Heart During Its Regeneration

PubMed Central

Su, Ta-Han; Shih, Cho-Chiang

2015-01-01

Abstract The human heart cannot regenerate after injury, whereas the adult zebrafish can fully regenerate its heart even after 20% of the ventricle is amputated. Many studies have begun to reveal the cellular and molecular mechanisms underlying this regenerative process, which have exciting implications for human cardiac diseases. However, the dynamic functions of the zebrafish heart during regeneration are not yet understood. This study established a high-resolution echocardiography for tissue Doppler imaging (TDI) of the zebrafish heart to explore the cardiac functions during different regeneration phases. Experiments were performed on AB-line adult zebrafish (n=40) in which 15% of the ventricle was surgically removed. An 80-MHz ultrasound TDI based on color M-mode imaging technology was employed. The cardiac flow velocities and patterns from both the ventricular chamber and myocardium were measured at different regeneration phases relative to the day of amputation. The peak velocities of early diastolic inflow, early diastolic myocardial motion, late diastolic myocardial motion, early diastolic deceleration slope, and heart rate were increased at 3 days after the myocardium amputation, but these parameters gradually returned to close to their baseline values for the normal heart at 7 days after amputation. The peak velocities of late diastolic inflow, ventricular systolic outflow, and systolic myocardial motion did not significantly differ during the heart regeneration. PMID:25517185

The HEART Pathway randomized trial: identifying emergency department patients with acute chest pain for early discharge.

PubMed

Mahler, Simon A; Riley, Robert F; Hiestand, Brian C; Russell, Gregory B; Hoekstra, James W; Lefebvre, Cedric W; Nicks, Bret A; Cline, David M; Askew, Kim L; Elliott, Stephanie B; Herrington, David M; Burke, Gregory L; Miller, Chadwick D

2015-03-01

The HEART Pathway is a decision aid designed to identify emergency department patients with acute chest pain for early discharge. No randomized trials have compared the HEART Pathway with usual care. Adult emergency department patients with symptoms related to acute coronary syndrome without ST-elevation on ECG (n=282) were randomized to the HEART Pathway or usual care. In the HEART Pathway arm, emergency department providers used the HEART score, a validated decision aid, and troponin measures at 0 and 3 hours to identify patients for early discharge. Usual care was based on American College of Cardiology/American Heart Association guidelines. The primary outcome, objective cardiac testing (stress testing or angiography), and secondary outcomes, index length of stay, early discharge, and major adverse cardiac events (death, myocardial infarction, or coronary revascularization), were assessed at 30 days by phone interview and record review. Participants had a mean age of 53 years, 16% had previous myocardial infarction, and 6% (95% confidence interval, 3.6%-9.5%) had major adverse cardiac events within 30 days of randomization. Compared with usual care, use of the HEART Pathway decreased objective cardiac testing at 30 days by 12.1% (68.8% versus 56.7%; P=0.048) and length of stay by 12 hours (9.9 versus 21.9 hours; P=0.013) and increased early discharges by 21.3% (39.7% versus 18.4%; P<0.001). No patients identified for early discharge had major adverse cardiac events within 30 days. The HEART Pathway reduces objective cardiac testing during 30 days, shortens length of stay, and increases early discharges. These important efficiency gains occurred without any patients identified for early discharge suffering MACE at 30 days. URL: http://www.clinicaltrials.gov. Unique Identifier: NCT01665521. © 2015 American Heart Association, Inc.

The Tromsø Heart Study: coronary risk factors in Seventh-Day Adventists.

PubMed

Fønnebø, V

1985-11-01

Seventh-Day Adventists in Tromsø showed a coronary risk factor pattern similar to Seventh-Day Adventists in other parts of the world. Compared with non-Seventh-Day Adventists, serum cholesterol was 1.35 mmol/liter (1974) and 0.83 mmol/liter (1979-1980) lower in males and 0.64 mmol/liter (1979-1980) lower in females. Blood pressure was lower in Seventh-Day Adventist women. The religiously inactive Seventh-Day Adventists had risk factor patterns more similar to non-Seventh-Day Adventists.

Novel Method of Infection Prophylaxis in Heart Transplantation by Retrosternal Gentamycin Sponge Application.

PubMed

Urbanowicz, T; Straburzyńska-Migaj, E; Buczkowski, P; Grajek, S; Jemielity, M

2015-01-01

Surgical wound infections are more frequent in patients undergoing heart transplantation than in other heart surgery patients. There is a wide spread of sternal wound infection incidence in transplant patients ranging from 4% to 40%. It is first study describing local gentamicin sponge application during heart transplantation procedure. We enrolled 75 patients in a retrospective, single-center study, including 25 patients who underwent orthotopic heart transplantation (heart transplant group) and 50 in the cardiac surgery group. They were in mean age of 49 ± 12 years and 51 ± 13 years in heart transplantation and cardiac surgery group, respectively. A gentamicin sponge was inserted intraoperatively between sternal borders before chest closure in all heart transplantation patients. There was 1 early death (4%) on postoperative day 7 owing to Clostridium difficile infection in the heart transplant group. There was 1 death (2%) in the cardiac surgery group owing to multiorgan failure secondary to perioperative heart ischemia. There was neither bacterial sternal wound infection nor sternal instability in the heart transplant group. None of the patients who had gentamicin sponge applied had wound healing problems. Two patients (4%) had a deep sternal wound infection in the cardiac surgery group, who had no sponge application; 1 (2%) was treated by surgical debridement and active drainage and 1 (2%) by vacuum therapy. There were 11 patients (44%) discharged on insulin therapy in the heart transplant group and 21 (21%) in the cardiac surgery group. Mean overall postoperative hospital stay was 35 ± 19 days in the heart transplant group and 10 ± 4 days in the cardiac surgery group. Gentamicin sponge is an effective local infection prophylaxis in heart transplant patients. Copyright © 2015 Elsevier Inc. All rights reserved.

Sleep-wake differences in heart rate variability during a 105-day simulated mission to Mars.

PubMed

Vigo, Daniel E; Ogrinz, Barbara; Wan, Li; Bersenev, Evgeny; Tuerlinckx, Francis; Van Den Bergh, Omer; Aubert, André E

2012-02-01

In prolonged spaceflights the effect of long-term confinement on the autonomic regulation of the heart is difficult to separate from the effect of prolonged exposure to microgravity or other space-related stressors. Our objective was to investigate whether the sleep-wake variations in the autonomic control of the heart are specifically altered by long-term confinement during the 105-d pilot study of the Earth-based Mars500 project. Before (pre), during (T1: 30, T2: 70, andT3: 100 d), and after (post) confinement, 24-h EKG records were obtained from the six crewmembers that participated in the mission. Sleep and wake periods were determined by fitting a square wave to the data. Autonomic activity was evaluated through time and frequency domain indexes of heart rate variability (HRV) analysis during wake and sleep periods. During confinement, wake HRV showed decreased mean heart rate and increased amplitude at all frequency levels, particularly in the very low (pre: 13.3 +/- 0.2; T1: 13.9 +/- 0.3; T2: 13.9 +/- 0.2; T3: 13.9 +/- 0.2; post: 13.2 +/- 0.2) and high (pre: 7.6 +/- 0.4; T1: 8.3 +/- 0.5; T2: 8.2 +/- 0.4; T3: 8.1 +/- 0.4; post: 7.6 +/- 0.3) frequency components (values expressed as mean +/- SE of wavelet power coefficients). Sleep HRV remained constant, while sleep-wake high frequency HRV differences diminished. The observed autonomic changes during confinement reflect an increase in parasympathetic activity during wake periods. Several factors could account for this observation, including reduced daylight exposure related to the confinement situation.

CERN: A global project

NASA Astrophysics Data System (ADS)

Voss, Rüdiger

2017-07-01

In the most important shift of paradigm of its membership rules in 60 years, CERN in 2010 introduced a policy of “Geographical Enlargement” which for the first time opened the door for membership of non-European States in the Organization. This short article reviews briefly the history of CERN’s membership rules, discusses the rationale behind the new policy, its relationship with the emerging global roadmap of particle physics, and gives a short overview of the status of the enlargement process.

Functional and structural regeneration in the axolotl heart (Ambystoma mexicanum) after partial ventricular amputation.

PubMed

Cano-Martínez, Agustina; Vargas-González, Alvaro; Guarner-Lans, Verónica; Prado-Zayago, Esteban; León-Oleda, Martha; Nieto-Lima, Betzabé

2010-01-01

"In the present study we evaluated the effect of partial ventricular amputation (PVA) in the heart of the adult urodele amphibian (Ambystoma mexicanum) in vivo on spontaneous heart contractile activity recorded in vitro in association to the structural recovery at one, five, 30 and 90 days after injury. One day after PVA, ventricular-tension (VT) (16 ± 3%), atrium-tension (AT) (46 ± 4%) and heart rate (HR) (58+10%) resulted lower in comparison to control hearts. On days five, 30 and 90 after damage, values achieved a 61 ± 5, 93 ± 3, and 98 ± 5% (VT), 60 ± 4, 96 ± 3 and 99 ± 5% (AT) and 74 ± 5, 84 ± 10 and 95 ± 10% (HR) of the control values, respectively. Associated to contractile activity recovery we corroborated a gradual tissue restoration by cardiomyocyte proliferation. Our results represent the first quantitative evidence about the recovery of heart of A. mexicanum restores its functional capacity concomitantly to the structural recovery of the myocardium by proliferation of cardiomyocytes after PVA. These properties make the heart of A. mexicanum a potential model to study the mechanisms underlying heart regeneration in adult vertebrates in vivo.

TOWARDS A NOVEL MODULAR ARCHITECTURE FOR CERN RADIATION MONITORING.

PubMed

Boukabache, Hamza; Pangallo, Michel; Ducos, Gael; Cardines, Nicola; Bellotta, Antonio; Toner, Ciarán; Perrin, Daniel; Forkel-Wirth, Doris

2017-04-01

The European Organization for Nuclear Research (CERN) has the legal obligation to protect the public and the people working on its premises from any unjustified exposure to ionising radiation. In this context, radiation monitoring is one of the main concerns of the Radiation Protection Group. After 30 y of reliable service, the ARea CONtroller (ARCON) system is approaching the end of its lifecycle, which raises the need for new, more efficient radiation monitors with a high level of modularity to ensure better maintainability. Based on these two main principles, new detectors are currently being developed that will be capable of measuring very low dose rates down to 50 nSv h-1, whilst being able to measure radiation over an extensive range of 8 decades without any auto scaling. To reach these performances, CERN Radiation MOnitoring Electronics (CROME), the new generation of CERN radiation monitors, is based on the versatile architecture that includes new read-out electronics developed by the Instrumentation and Logistics section of the CERN Radiation Protection Group as well as a reconfigurable system on chip capable of performing complex processing calculations. Beside the capabilities of CROME to continuously measure the ambient dose rate, the system generates radiation alarms, provides interlock signals, drives alarm display units through a fieldbus and provides long-term, permanent and reliable data logging. The measurement tests performed during the first phase of the development show very promising results that pave the way to the second phase: the certification. © The Author 2016. Published by Oxford University Press.

TOWARDS A NOVEL MODULAR ARCHITECTURE FOR CERN RADIATION MONITORING

PubMed Central

Boukabache, Hamza; Pangallo, Michel; Ducos, Gael; Cardines, Nicola; Bellotta, Antonio; Toner, Ciarán; Perrin, Daniel; Forkel-Wirth, Doris

2017-01-01

Abstract The European Organization for Nuclear Research (CERN) has the legal obligation to protect the public and the people working on its premises from any unjustified exposure to ionising radiation. In this context, radiation monitoring is one of the main concerns of the Radiation Protection Group. After 30 y of reliable service, the ARea CONtroller (ARCON) system is approaching the end of its lifecycle, which raises the need for new, more efficient radiation monitors with a high level of modularity to ensure better maintainability. Based on these two main principles, new detectors are currently being developed that will be capable of measuring very low dose rates down to 50 nSv h−1, whilst being able to measure radiation over an extensive range of 8 decades without any auto scaling. To reach these performances, CERN Radiation MOnitoring Electronics (CROME), the new generation of CERN radiation monitors, is based on the versatile architecture that includes new read-out electronics developed by the Instrumentation and Logistics section of the CERN Radiation Protection Group as well as a reconfigurable system on chip capable of performing complex processing calculations. Beside the capabilities of CROME to continuously measure the ambient dose rate, the system generates radiation alarms, provides interlock signals, drives alarm display units through a fieldbus and provides long-term, permanent and reliable data logging. The measurement tests performed during the first phase of the development show very promising results that pave the way to the second phase: the certification. PMID:27909154

Microwave effects on isolated chick embryo hearts

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

Caddemi, A.; Tamburello, C.C.; Zanforlin, L.

1986-01-01

This study was designed to examine the effects of microwaves on the electric activity of hearts as a means of elucidating interactive mechanisms of nonionizing radiation with cardiac tissue. Experiments were performed on isolated hearts of 9-12-day-old chick embryos placed in small petri dishes. Oxygenated isotonic Ringer's solution at 37 degrees C permitted heart survival. Samples were irradiated at 2.45 GHz with a power density of 3 mW/cm2. The heart signal was detected with a glass micropipet inserted into the sinoatrial node and examined by means of a Berg-Fourier analyzer. Pulsed microwaves caused the locking of the heartbeat to themore » modulation frequency, whereas continuous wave irradiation might have induced slight bradycardia. Pulsed fields induced stimulation or regularization of the heartbeat in arrhythmia, fibrillation, or arrest of the heart.« less

Randomised controlled trial of specialist nurse intervention in heart failure

PubMed Central

Blue, Lynda; Lang, Elanor; McMurray, John J V; Davie, Andrew P; McDonagh, Theresa A; Murdoch, David R; Petrie, Mark C; Connolly, Eugene; Norrie, John; Round, Caroline E; Ford, Ian; Morrison, Caroline E

2001-01-01

Objectives To determine whether specialist nurse intervention improves outcome in patients with chronic heart failure. Design Randomised controlled trial. Setting Acute medical admissions unit in a teaching hospital. Participants 165 patients admitted with heart failure due to left ventricular systolic dysfunction. The intervention started before discharge and continued thereafter with home visits for up to 1 year. Main outcome measures Time to first event analysis of death from all causes or readmission to hospital with worsening heart failure. Results 31 patients (37%) in the intervention group died or were readmitted with heart failure compared with 45 (53%) in the usual care group (hazard ratio=0.61, 95% confidence interval 0.33 to 0.96).Compared with usual care, patients in the intervention group had fewer readmissions for any reason (86 v 114, P=0.018), fewer admissions for heart failure (19 v 45, P<0.001) and spent fewer days in hospital for heart failure (mean 3.43 v 7.46 days, P=0.0051). Conclusions Specially trained nurses can improve the outcome of patients admitted to hospital with heart failure. What is already known on this topicStudies have suggested that nurse intervention may reduce readmission in patients with heart failureWhat this study addsHome based intervention from nurses reduces readmissions for worsening heart failureRegular contact to review treatment and patient education are likely to contribute to this effect PMID:11576977

Assessment of post-laparotomy pain in laboratory mice by telemetric recording of heart rate and heart rate variability

PubMed Central

Arras, Margarete; Rettich, Andreas; Cinelli, Paolo; Kasermann, Hans P; Burki, Kurt

2007-01-01

Background Pain of mild to moderate grade is difficult to detect in laboratory mice because mice are prey animals that attempt to elude predators or man by hiding signs of weakness, injury or pain. In this study, we investigated the use of telemetry to identify indicators of mild-to-moderate post-laparotomy pain. Results Adult mice were subjected to laparotomy, either combined with pain treatment (carprofen or flunixin, 5 mg/kg s/c bid, for 1 day) or without pain relief. Controls received anesthesia and analgesics or vehicle only. Telemetrically measured locomotor activity was undisturbed in all animals, thus confirming that any pain experienced was of the intended mild level. No symptoms of pain were registered in any of the groups by scoring the animals' outer appearance or spontaneous and provoked behavior. In contrast, the group receiving no analgesic treatment after laparotomy demonstrated significant changes in telemetry electrocardiogram recordings: increased heart rate and decreased heart rate variability parameters pointed to sympathetic activation and pain lasting for 24 hours. In addition, core body temperature was elevated. Body weight and food intake were reduced for 3 and 2 days, respectively. Moreover, unstructured cage territory and destroyed nests appeared for 1–2 days in an increased number of animals in this group only. In controls these parameters were not affected. Conclusion In conclusion, real-time telemetric recordings of heart rate and heart rate variability were indicative of mild-to-moderate post-laparotomy pain and could define its duration in our mouse model. This level of pain cannot easily be detected by direct observation. PMID:17683523

Heart Rate Dynamics During A Treadmill Cardiopulmonary Exercise Test in Optimized Beta-Blocked Heart Failure Patients

PubMed Central

Carvalho, Vitor Oliveira; Guimarães, Guilherme Veiga; Ciolac, Emmanuel Gomes; Bocchi, Edimar Alcides

2008-01-01

BACKGROUND Calculating the maximum heart rate for age is one method to characterize the maximum effort of an individual. Although this method is commonly used, little is known about heart rate dynamics in optimized beta-blocked heart failure patients. AIM The aim of this study was to evaluate heart rate dynamics (basal, peak and % heart rate increase) in optimized beta-blocked heart failure patients compared to sedentary, normal individuals (controls) during a treadmill cardiopulmonary exercise test. METHODS Twenty-five heart failure patients (49±11 years, 76% male), with an average LVEF of 30±7%, and fourteen controls were included in the study. Patients with atrial fibrillation, a pacemaker or noncardiovascular functional limitations or whose drug therapy was not optimized were excluded. Optimization was considered to be 50 mg/day or more of carvedilol, with a basal heart rate between 50 to 60 bpm that was maintained for 3 months. RESULTS Basal heart rate was lower in heart failure patients (57±3 bpm) compared to controls (89±14 bpm; p<0.0001). Similarly, the peak heart rate (% maximum predicted for age) was lower in HF patients (65.4±11.1%) compared to controls (98.6±2.2; p<0.0001). Maximum respiratory exchange ratio did not differ between the groups (1.2±0.5 for controls and 1.15±1 for heart failure patients; p=0.42). All controls reached the maximum heart rate for their age, while no patients in the heart failure group reached the maximum. Moreover, the % increase of heart rate from rest to peak exercise between heart failure (48±9%) and control (53±8%) was not different (p=0.157). CONCLUSION No patient in the heart failure group reached the maximum heart rate for their age during a treadmill cardiopulmonary exercise test, despite the fact that the percentage increase of heart rate was similar to sedentary normal subjects. A heart rate increase in optimized beta-blocked heart failure patients during cardiopulmonary exercise test over 65% of the

WorldWide Web: Hypertext from CERN.

ERIC Educational Resources Information Center

Nickerson, Gord

1992-01-01

Discussion of software tools for accessing information on the Internet focuses on the WorldWideWeb (WWW) system, which was developed at the European Particle Physics Laboratory (CERN) in Switzerland to build a worldwide network of hypertext links using available networking technology. Its potential for use with multimedia documents is also…

What Are Congenital Heart Defects?

MedlinePlus

... surgery to close an atrial septal defect? This study tests a tool that allows surgeons to tell the difference between various types of heart tissue and avoid injury. To participate in this study, your child must be between 30 days and ...

Towards a 21st century telephone exchange at CERN

NASA Astrophysics Data System (ADS)

Valentín, F.; Hesnaux, A.; Sierra, R.; Chapron, F.

2015-12-01

The advent of mobile telephony and Voice over IP (VoIP) has significantly impacted the traditional telephone exchange industry—to such an extent that private branch exchanges are likely to disappear completely in the near future. For large organisations, such as CERN, it is important to be able to smooth this transition by implementing new multimedia platforms that can protect past investments and the flexibility needed to securely interconnect emerging VoIP solutions and forthcoming developments such as Voice over LTE (VoLTE). We present the results of ongoing studies and tests at CERN of the latest technologies in this area.

Pacing-induced congenital heart defects assessed by OCT (Conference Presentation)

NASA Astrophysics Data System (ADS)

Ford, Stephanie M.; McPheeters, Matt T.; Wang, Yves T.; Gu, Shi; Doughman, Yong Qiu; Strainic, James P.; Rollins, Andrew M.; Watanabe, Michiko; Jenkins, Michael W.

2016-03-01

The role of hemodynamics in early heart development is poorly understood. In order to successfully assess the impact of hemodynamics on development, we need to monitor and perturb blood flow, and quantify the resultant effects on morphology. Here, we have utilized cardiac optical pacing to create regurgitant flow in embryonic hearts and OCT to quantify regurgitation percentage and resultant morphology. Embryonic quail in a shell-less culture were optically paced at 3 Hz (well above the intrinsic rate or 1.33-1.67 Hz) on day 2 of development (3-4 weeks human) for 5 minutes. The pacing fatigued the heart and led to a prolonged period (> 1 hour) of increased regurgitant flow. Embryos were kept alive until day 3 (cardiac looping - 4-5 weeks human) or day 8 (4 chambered heart - 8 weeks human) to quantify resultant morphologic changes with OCT. All paced embryos imaged at day 3 displayed cardiac defects. The extent of regurgitant flow immediately after pacing was correlated with cardiac cushion size 24-hours post pacing (p-value < 0.01) with higher regurgitation leading to smaller cushions. Almost all embryos (16/18) surviving to day 8 exhibited congenital heart defects (CHDs) including 11/18 with valve defects, 5/18 with ventricular septal defects and 5/18 with hypoplastic right ventricles. Our data suggests that regurgitant flow leads to smaller cushions, which develop into abnormal valves and septa. Our model produces similar phenotypes as found in our fetal alcohol syndrome and velo-cardio-facial/DiGeorge syndrome models suggesting that hemodynamics plays a role in these syndromes as well. Utilizing OCT and optical pacing to understand hemodynamics in development is an important step towards determining CHD mechanisms and ultimately developing earlier treatments.

Analysis of Machine Learning Techniques for Heart Failure Readmissions.

PubMed

Mortazavi, Bobak J; Downing, Nicholas S; Bucholz, Emily M; Dharmarajan, Kumar; Manhapra, Ajay; Li, Shu-Xia; Negahban, Sahand N; Krumholz, Harlan M

2016-11-01

The current ability to predict readmissions in patients with heart failure is modest at best. It is unclear whether machine learning techniques that address higher dimensional, nonlinear relationships among variables would enhance prediction. We sought to compare the effectiveness of several machine learning algorithms for predicting readmissions. Using data from the Telemonitoring to Improve Heart Failure Outcomes trial, we compared the effectiveness of random forests, boosting, random forests combined hierarchically with support vector machines or logistic regression (LR), and Poisson regression against traditional LR to predict 30- and 180-day all-cause readmissions and readmissions because of heart failure. We randomly selected 50% of patients for a derivation set, and a validation set comprised the remaining patients, validated using 100 bootstrapped iterations. We compared C statistics for discrimination and distributions of observed outcomes in risk deciles for predictive range. In 30-day all-cause readmission prediction, the best performing machine learning model, random forests, provided a 17.8% improvement over LR (mean C statistics, 0.628 and 0.533, respectively). For readmissions because of heart failure, boosting improved the C statistic by 24.9% over LR (mean C statistic 0.678 and 0.543, respectively). For 30-day all-cause readmission, the observed readmission rates in the lowest and highest deciles of predicted risk with random forests (7.8% and 26.2%, respectively) showed a much wider separation than LR (14.2% and 16.4%, respectively). Machine learning methods improved the prediction of readmission after hospitalization for heart failure compared with LR and provided the greatest predictive range in observed readmission rates. © 2016 American Heart Association, Inc.

NA61/SHINE facility at the CERN SPS: beams and detector system

NASA Astrophysics Data System (ADS)

Abgrall, N.; Andreeva, O.; Aduszkiewicz, A.; Ali, Y.; Anticic, T.; Antoniou, N.; Baatar, B.; Bay, F.; Blondel, A.; Blumer, J.; Bogomilov, M.; Bogusz, M.; Bravar, A.; Brzychczyk, J.; Bunyatov, S. A.; Christakoglou, P.; Cirkovic, M.; Czopowicz, T.; Davis, N.; Debieux, S.; Dembinski, H.; Diakonos, F.; Di Luise, S.; Dominik, W.; Drozhzhova, T.; Dumarchez, J.; Dynowski, K.; Engel, R.; Efthymiopoulos, I.; Ereditato, A.; Fabich, A.; Feofilov, G. A.; Fodor, Z.; Fulop, A.; Gaździcki, M.; Golubeva, M.; Grebieszkow, K.; Grzeszczuk, A.; Guber, F.; Haesler, A.; Hasegawa, T.; Hierholzer, M.; Idczak, R.; Igolkin, S.; Ivashkin, A.; Jokovic, D.; Kadija, K.; Kapoyannis, A.; Kaptur, E.; Kielczewska, D.; Kirejczyk, M.; Kisiel, J.; Kiss, T.; Kleinfelder, S.; Kobayashi, T.; Kolesnikov, V. I.; Kolev, D.; Kondratiev, V. P.; Korzenev, A.; Koversarski, P.; Kowalski, S.; Krasnoperov, A.; Kurepin, A.; Larsen, D.; Laszlo, A.; Lyubushkin, V. V.; Maćkowiak-Pawłowska, M.; Majka, Z.; Maksiak, B.; Malakhov, A. I.; Maletic, D.; Manglunki, D.; Manic, D.; Marchionni, A.; Marcinek, A.; Marin, V.; Marton, K.; Mathes, H.-J.; Matulewicz, T.; Matveev, V.; Melkumov, G. L.; Messina, M.; Mrówczyński, St.; Murphy, S.; Nakadaira, T.; Nirkko, M.; Nishikawa, K.; Palczewski, T.; Palla, G.; Panagiotou, A. D.; Paul, T.; Peryt, W.; Petukhov, O.; Pistillo, C.; Płaneta, R.; Pluta, J.; Popov, B. A.; Posiadala, M.; Puławski, S.; Puzovic, J.; Rauch, W.; Ravonel, M.; Redij, A.; Renfordt, R.; Richter-Was, E.; Robert, A.; Röhrich, D.; Rondio, E.; Rossi, B.; Roth, M.; Rubbia, A.; Rustamov, A.; Rybczyński, M.; Sadovsky, A.; Sakashita, K.; Savic, M.; Schmidt, K.; Sekiguchi, T.; Seyboth, P.; Sgalaberna, D.; Shibata, M.; Sipos, R.; Skrzypczak, E.; Słodkowski, M.; Sosin, Z.; Staszel, P.; Stefanek, G.; Stepaniak, J.; Stroebele, H.; Susa, T.; Szuba, M.; Tada, M.; Tereshchenko, V.; Tolyhi, T.; Tsenov, R.; Turko, L.; Ulrich, R.; Unger, M.; Vassiliou, M.; Veberic, D.; Vechernin, V. V.; Vesztergombi, G.; Vinogradov, L.; Wilczek, A.; Włodarczyk, Z.; Wojtaszek-Szwarz, A.; Wyszyński, O.; Zambelli, L.; Zipper, W.

2014-06-01

NA61/SHINE (SPS Heavy Ion and Neutrino Experiment) is a multi-purpose experimental facility to study hadron production in hadron-proton, hadron-nucleus and nucleus-nucleus collisions at the CERN Super Proton Synchrotron. It recorded the first physics data with hadron beams in 2009 and with ion beams (secondary 7Be beams) in 2011. NA61/SHINE has greatly profited from the long development of the CERN proton and ion sources and the accelerator chain as well as the H2 beamline of the CERN North Area. The latter has recently been modified to also serve as a fragment separator as needed to produce the Be beams for NA61/SHINE. Numerous components of the NA61/SHINE set-up were inherited from its predecessors, in particular, the last one, the NA49 experiment. Important new detectors and upgrades of the legacy equipment were introduced by the NA61/SHINE Collaboration. This paper describes the state of the NA61/SHINE facility — the beams and the detector system — before the CERN Long Shutdown I, which started in March 2013.

Chronobiology of death in heart failure.

PubMed

Ribas, Nuria; Domingo, Maite; Gastelurrutia, Paloma; Ferrero-Gregori, Andreu; Rull, Pilar; Noguero, Mariana; Garcia, Carmen; Puig, Teresa; Cinca, Juan; Bayes-Genis, Antoni

2014-05-01

In the general population, heart events occur more often during early morning, on Mondays, and during winter. However, the chronobiology of death in heart failure has not been analyzed. The aim of this study was to determine the circadian, day of the week, and seasonal variability of all-cause mortality in chronic heart failure. This was an analysis of all consecutive heart failure patients followed in a heart failure unit from January 2003 to December 2008. The circadian moment of death was analyzed at 6-h intervals and was determined by reviewing medical records and by information provided by the relatives. Of 1196 patients (mean [standard deviation] age, 69 [13] years; 62% male), 418 (34.9%) died during a mean (standard deviation) follow-up of 29 (21) months. Survivors were younger, had higher body mass index, left ventricular ejection fraction, glomerular filtration rate, hemoglobin and sodium levels, and lower Framingham risk scores, amino-terminal pro-B type natriuretic peptide, troponin T, and urate values. They were more frequently treated with angiotensin receptor blockers, beta-blockers, mineralocorticoids receptor antagonists, digoxin, nitrates, hydralazine, statins, loop diuretics, and thiazides. The analysis of the circadian and weekly variability did not reveal significant differences between the four 6-h intervals or the days of the week. Mortality occurred more frequently during the winter (30.6%) compared with the other seasons (P = .024). All cause mortality does not follow a circadian pattern, but a seasonal rhythm in patients with heart failure. This finding is in contrast to the circadian rhythmicity of cardiovascular events reported in the general population. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

Security in the CernVM File System and the Frontier Distributed Database Caching System

NASA Astrophysics Data System (ADS)

Dykstra, D.; Blomer, J.

2014-06-01

Both the CernVM File System (CVMFS) and the Frontier Distributed Database Caching System (Frontier) distribute centrally updated data worldwide for LHC experiments using http proxy caches. Neither system provides privacy or access control on reading the data, but both control access to updates of the data and can guarantee the authenticity and integrity of the data transferred to clients over the internet. CVMFS has since its early days required digital signatures and secure hashes on all distributed data, and recently Frontier has added X.509-based authenticity and integrity checking. In this paper we detail and compare the security models of CVMFS and Frontier.

Heart rate reduction and longevity in mice.

PubMed

Gent, Sabine; Kleinbongard, Petra; Dammann, Philip; Neuhäuser, Markus; Heusch, Gerd

2015-03-01

Heart rate correlates inversely with life span across all species, including humans. In patients with cardiovascular disease, higher heart rate is associated with increased mortality, and such patients benefit from pharmacological heart rate reduction. However, cause-and-effect relationships between heart rate and longevity, notably in healthy individuals, are not established. We therefore prospectively studied the effects of a life-long pharmacological heart rate reduction on longevity in mice. We hypothesized, that the total number of cardiac cycles is constant, and that a 15% heart rate reduction might translate into a 15% increase in life span. C57BL6/J mice received either placebo or ivabradine at a dose of 50 mg/kg/day in drinking water from 12 weeks to death. Heart rate and body weight were monitored. Autopsy was performed on all non-autolytic cadavers, and parenchymal organs were evaluated macroscopically. Ivabradine reduced heart rate by 14% (median, interquartile range 12-15%) throughout life, and median life span was increased by 6.2% (p = 0.01). Body weight and macroscopic findings were not different between placebo and ivabradine. Life span was not increased to the same extent as heart rate was reduced, but nevertheless significantly prolonged by 6.2%.

N° 15-2000: ESA, CERN and ESO launch "Physics on Stage"

NASA Astrophysics Data System (ADS)

2000-03-01

European public. Why ESA, CERN, and ESO? As Europe's principal organisations in physics research (particle physics, space and astronomy), the three recognised their mutual responsibility to address the issue with the launch of a new initiative and the creative use of their own research to attract the attention of the general public and teachers alike. About the "European Science and Technology Week" The objective of the "European Science and Technology Week" is to improve the public's knowledge and understanding of science and technology - including the associated benefits for society as a whole. The week focuses on the European dimension of research, such as pan-European scientific and technological co-operation. The rationale for holding the Week has its roots in the importance of the role of science and technology in modern societies and the need therefore, to ensure that the public recognises its significance in our lives. The Week is a framework for special TV programmes, exhibitions, contests, conferences, electronic networking, and other science related activities to promote the public understanding of science and technology. The Week was launched in 1993, on the initiative of the European Commission. Raising public awareness of science and technology is now the subject of a clearly defined action within the Human Potential Programme of the Fifth Framework Programme. Notes [1] The same press release is published also by CERN and ESO. [2] The 22 countries are the member countries of at least one of the participating organisations or the European Union: Austria, Belgium, Bulgaria, the Czech Republic, Denmark, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Luxembourg, the Netherlands, Norway, Poland, Portugal, the Slovak Republic, Spain, Sweden, Switzerland, United Kingdom. Statements by the Directors General of ESA, CERN, and ESO Antonio Rodotà (ESA): "Space has become an integral part of every day life. The immense technological development that has led

Risk of Congenital Heart Defects after Ambient Heat Exposure Early in Pregnancy.

PubMed

Auger, Nathalie; Fraser, William D; Sauve, Reg; Bilodeau-Bertrand, Marianne; Kosatsky, Tom

2017-01-01

Congenital heart defects may be environmentally related, but the association with elevated ambient temperature has received little attention. We studied the relationship between outdoor heat during the first trimester of pregnancy and risk of congenital heart defects. We carried out a retrospective cohort study of 704,209 fetuses between 2 and 8 weeks postconception from April to September in Quebec, Canada, 1988-2012. We calculated the prevalence of congenital heart defects at birth according to the number of days women were exposed to maximum temperature ≥ 30°C. In log-binomial regression models, we estimated prevalence ratios (PR) and 95% confidence intervals (CI) for the relationship of temperature with seven critical and eight noncritical heart defects, adjusted for pregnancy characteristics. Prevalence of congenital heart defects was 979.5 per 100,000 for 10 days or more of temperature ≥ 30°C compared with 878.9 per 100,000 for 0 days of exposure. Temperature was more precisely associated with noncritical than critical defects, which had lower prevalence. Fetuses exposed to 15 days of temperature ≥ 30°C between 2 and 8 weeks postconception had 1.06 times the risk of critical defects (95% CI: 0.67, 1.67) and 1.12 times the risk of noncritical defects (95% CI: 0.98, 1.29) relative to 0 days. Associations were higher for atrial septal defects (PR 1.37, 95% CI: 1.10, 1.70) than for other noncritical defects. For atrial septal defects, associations with elevated temperatures began the 3rd week postconception. Extreme heat exposure during the first trimester may be associated with noncritical heart defects, especially of the atrial septum. Citation: Auger N, Fraser WD, Sauve R, Bilodeau-Bertrand M, Kosatsky T. 2017. Risk of congenital heart defects after ambient heat exposure early in pregnancy. Environ Health Perspect 125:8-14; http://dx.doi.org/10.1289/EHP171.

Commissioning of a CERN Production and Analysis Facility Based on xrootd

NASA Astrophysics Data System (ADS)

Campana, Simone; van der Ster, Daniel C.; Di Girolamo, Alessandro; Peters, Andreas J.; Duellmann, Dirk; Coelho Dos Santos, Miguel; Iven, Jan; Bell, Tim

2011-12-01

The CERN facility hosts the Tier-0 of the four LHC experiments, but as part of WLCG it also offers a platform for production activities and user analysis. The CERN CASTOR storage technology has been extensively tested and utilized for LHC data recording and exporting to external sites according to experiments computing model. On the other hand, to accommodate Grid data processing activities and, more importantly, chaotic user analysis, it was realized that additional functionality was needed including a different throttling mechanism for file access. This paper will describe the xroot-based CERN production and analysis facility for the ATLAS experiment and in particular the experiment use case and data access scenario, the xrootd redirector setup on top of the CASTOR storage system, the commissioning of the system and real life experience for data processing and data analysis.

Relief and Recurrence of Congestion During and After Hospitalization for Acute Heart Failure: Insights From Diuretic Optimization Strategy Evaluation in Acute Decompensated Heart Failure (DOSE-AHF) and Cardiorenal Rescue Study in Acute Decompensated Heart Failure (CARESS-HF).

PubMed

Lala, Anuradha; McNulty, Steven E; Mentz, Robert J; Dunlay, Shannon M; Vader, Justin M; AbouEzzeddine, Omar F; DeVore, Adam D; Khazanie, Prateeti; Redfield, Margaret M; Goldsmith, Steven R; Bart, Bradley A; Anstrom, Kevin J; Felker, G Michael; Hernandez, Adrian F; Stevenson, Lynne W

2015-07-01

Congestion is the most frequent cause for hospitalization in acute decompensated heart failure. Although decongestion is a major goal of acute therapy, it is unclear how the clinical components of congestion (eg, peripheral edema, orthopnea) contribute to outcomes after discharge or how well decongestion is maintained. A post hoc analysis was performed of 496 patients enrolled in the Diuretic Optimization Strategy Evaluation in Acute Decompensated Heart Failure (DOSE-AHF) and Cardiorenal Rescue Study in Acute Decompensated Heart Failure (CARRESS-HF) trials during hospitalization with acute decompensated heart failure and clinical congestion. A simple orthodema congestion score was generated based on symptoms of orthopnea (≥2 pillows=2 points, <2 pillows=0 points) and peripheral edema (trace=0 points, moderate=1 point, severe=2 points) at baseline, discharge, and 60-day follow-up. Orthodema scores were classified as absent (score of 0), low-grade (score of 1-2), and high-grade (score of 3-4), and the association with death, rehospitalization, or unscheduled medical visits through 60 days was assessed. At baseline, 65% of patients had high-grade orthodema and 35% had low-grade orthodema. At discharge, 52% patients were free from orthodema at discharge (score=0) and these patients had lower 60-day rates of death, rehospitalization, or unscheduled visits (50%) compared with those with low-grade or high-grade orthodema (52% and 68%, respectively; P=0.038). Of the patients without orthodema at discharge, 27% relapsed to low-grade orthodema and 38% to high-grade orthodema at 60-day follow-up. Increased severity of congestion by a simple orthodema assessment is associated with increased morbidity and mortality. Despite intent to relieve congestion, current therapy often fails to relieve orthodema during hospitalization or to prevent recurrence after discharge. URL: http://www.clinicaltrials.gov. Unique identifiers: NCT00608491, NCT00577135. © 2015 American Heart

Predicting short-term mortality in advanced decompensated heart failure - role of the updated acute decompensated heart failure/N-terminal pro-B-type natriuretic Peptide risk score.

PubMed

Scrutinio, Domenico; Ammirati, Enrico; Passantino, Andrea; Guida, Pietro; D'Angelo, Luciana; Oliva, Fabrizio; Ciccone, Marco Matteo; Iacoviello, Massimo; Dentamaro, Ilaria; Santoro, Daniela; Lagioia, Rocco; Sarzi Braga, Simona; Guzzetti, Daniela; Frigerio, Maria

2015-01-01

The first few months after admission are the most vulnerable period in patients with acute decompensated heart failure (ADHF). We assessed the association of the updated ADHF/N-terminal pro-B-type natriuretic peptide (NT-proBNP) risk score with 90-day and in-hospital mortality in 701 patients admitted with advanced ADHF, defined as severe symptoms of worsening HF, severely depressed left ventricular ejection fraction, and the need for i.v. diuretic and/or inotropic drugs. A total of 15.7% of the patients died within 90 days of admission and 5.2% underwent ventricular assist device (VAD) implantation or urgent heart transplantation (UHT). The C-statistic of the ADHF/NT-proBNP risk score for 90-day mortality was 0.810 (95% CI: 0.769-0.852). Predicted and observed mortality rates were in close agreement. When the composite outcome of death/VAD/UHT at 90 days was considered, the C-statistic decreased to 0.741. During hospitalization, 7.6% of the patients died. The C-statistic for in-hospital mortality was 0.815 (95% CI: 0.761-0.868) and Hosmer-Lemeshow χ(2)=3.71 (P=0.716). The updated ADHF/NT-proBNP risk score outperformed the Acute Decompensated Heart Failure National Registry, the Organized Program to Initiate Lifesaving Treatment in Patients Hospitalized for Heart Failure, and the American Heart Association Get with the Guidelines Program predictive models. Updated ADHF/NT-proBNP risk score is a valuable tool for predicting short-term mortality in severe ADHF, outperforming existing inpatient predictive models.

Clinical Correlates and Prognostic Value of Proenkephalin in Acute and Chronic Heart Failure.

PubMed

Matsue, Yuya; Ter Maaten, Jozine M; Struck, Joachim; Metra, Marco; O'Connor, Christopher M; Ponikowski, Piotr; Teerlink, John R; Cotter, Gad; Davison, Beth; Cleland, John G; Givertz, Michael M; Bloomfield, Daniel M; Dittrich, Howard C; van Veldhuisen, Dirk J; van der Meer, Peter; Damman, Kevin; Voors, Adriaan A

2017-03-01

Proenkephalin (pro-ENK) has emerged as a novel biomarker associated with both renal function and cardiac function. However, its clinical and prognostic value have not been well evaluated in symptomatic patients with heart failure. The association between pro-ENK and markers of renal function was evaluated in 95 patients with chronic heart failure who underwent renal hemodynamic measurements, including renal blood flow (RBF) and glomerular filtration rate (GFR) with the use of 131 I-Hippuran and 125 I-iothalamate clearances, respectively. The association between pro-ENK and clinical outcome in acute heart failure was assessed in another 1589 patients. Pro-ENK was strongly correlated with both RBF (P < .001) and GFR (P < .001), but not with renal tubular markers. In the acute heart failure cohort, pro-ENK was a predictor of death through 180 days, heart failure rehospitalization through 60 days, and death or cardiovascular or renal rehospitalization through day 60 in univariable analyses, but its predictive value was lost in a multivariable model when other renal markers were entered in the model. In patients with chronic and acute heart failure, pro-ENK is strongly associated with glomerular function, but not with tubular damage. Pro-ENK provides limited prognostic information in patients with acute heart failure on top of established renal markers. Copyright © 2016 Elsevier Inc. All rights reserved.

[Routine hormonal therapy in the heart transplant donor].

PubMed

Zetina-Tun, Hugo; Lezama-Urtecho, Carlos; Careaga-Reyna, Guillermo

2016-01-01

Successful heart transplantation depends largely on donor heart function. During brain death many hormonal changes occur. These events lead to the deterioration of the donor hearts. The 2002 Crystal Consensus advises the use of a triple hormonal scheme to rescue marginal cardiac organs. A prospective, longitudinal study was conducted on potential donor hearts during the period 1 July 2011 to 31 May 2013. All donor hearts received a dual hormonal rescue scheme, with methylprednisolone 15mg/kg IV and 200mcg levothyroxine by the enteral route. There was at least a 4 hour wait prior to the harvesting. The preload and afterload was optimised. The variables measured were: left ventricular ejection fraction cardiac graft recipient; immediate and delayed mortality. A total of 30 orthotopic heart transplants were performed, 11 female and 19 male patients, with age range between 19 and 63 years-old (Mean: 44.3, SD 12.92 years). The donor hearts were 7 female and 23 male, with age range between 15 and 45 years-old (mean 22.5, SD 7.3 years). Immediate mortality was 3.3%, 3.3% intermediate, and delayed 3.3%, with total 30 day-mortality of 10%. Month survival was 90%. The immediate graft left ventricular ejection fraction was 45%, 60% intermediate, and 68% delayed. The causes of death were: 1 primary graft dysfunction, one massive pulmonary embolism, and one due to nosocomial pneumonia. It was concluded that the use of double rescue scheme hormonal therapy is useful for the recovery and preservation of the donor hearts. This scheme improves survival within the first 30 days after transplantation. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

Time-dependent expression of ICAM-1 & VCAM-1 on coronaries of the heterotopically transplanted mouse heart.

PubMed Central

Lee, J. R.; Huh, J. H.; Seo, J. W.; Suk, C. J.; Jeong, H. M.; Kim, E. K.

1999-01-01

To investigate the pathogenesis of accelerated graft atherosclerosis after cardiac transplantation, a genetically well-defined and reproducible animal model is required. We performed heterotopic intraabdominal heart transplantation between the two inbred strains of mice. Forty hearts from B10.A mice were transplanted into B10.BR mice. Recipients were sacrificed at 1, 3, 5, 7, 14, 28, and 42 days after implantation. The specimens from both donor and recipient were examined with fluorescent immunohistochemistry and the serial histopathologic changes were evaluated. In the donor hearts, ICAM-1 and VCAM-1 expressions were minimal at day 1 and they gradually increased, reaching their peaks on day 5 or 7 and remained unchanged by day 42. However, there were very little expressions in the recipients' hearts. Mean percent areas of intima in the donor coronaries revealed progressive increase by day 42. However, those in the recipients occupied consistently less than 5% of the lumen. In conclusion, we demonstrated that a heterotopic murine heart transplantation model was a useful tool to produce transplantation coronary artery disease and that adhesion molecules on the cardiac allografts were activated very early and remained elevated at all time-points, nonetheless the arterial lesion was detected after day 28 and its progression was accelerated thereafter. PMID:10402165

System overview of the fully implantable destination therapy--ReinHeart-total artificial heart.

PubMed

Pelletier, Benedikt; Spiliopoulos, Sotirios; Finocchiaro, Thomas; Graef, Felix; Kuipers, Kristin; Laumen, Marco; Guersoy, Dilek; Steinseifer, Ulrich; Koerfer, Reiner; Tenderich, Gero

2015-01-01

Owing to the lack of suitable allografts, the demand for long-term mechanical circulatory support in patients with biventricular end-stage heart failure is rising. Currently available Total Artificial Heart (TAH) systems consist of pump units with only limited durability, percutaneous tubes and bulky external equipment that limit the quality of life. Therefore we are focusing on the development of a fully implantable, highly durable destination therapy total artificial heart. The ReinHeart-TAH system consists of a passively filling pump unit driven by a low-wear linear drive between two artificial ventricles, an implantable control unit and a compliance chamber. The TAH is powered by a transcutaneous energy transmission system. The flow distribution inside the ventricles was analysed by fluid structure interaction simulation and particle image velocimetry measurements. Along with durability tests, the hydrodynamic performance and flow balance capability were evaluated in a mock circulation loop. Animal trials are ongoing. Based on fluid structure interaction simulation and particle image velocimetry, blood stagnation areas have been significantly reduced. In the mock circulation loop the ReinHeart-TAH generated a cardiac output of 5 l/min at an operating frequency of 120 bpm and an aortic pressure of 120/80 mmHg. The highly effective preload sensitivity of the passively filling ventricles allowed the sensorless integration of the Frank Starling mechanism. The ReinHeart-TAH effectively replaced the native heart's function in animals for up to 2 days. In vitro and in vivo testing showed a safe and effective function of the ReinHeart-TAH system. This has the potential to become an alternative to transplantation. However, before a first-in-man implant, chronic animal trials still have to be completed. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Ex-vivo perfusion of donor hearts for human heart transplantation (PROCEED II): a prospective, open-label, multicentre, randomised non-inferiority trial.

PubMed

Ardehali, Abbas; Esmailian, Fardad; Deng, Mario; Soltesz, Edward; Hsich, Eileen; Naka, Yoshifumi; Mancini, Donna; Camacho, Margarita; Zucker, Mark; Leprince, Pascal; Padera, Robert; Kobashigawa, Jon

2015-06-27

The Organ Care System is the only clinical platform for ex-vivo perfusion of human donor hearts. The system preserves the donor heart in a warm beating state during transport from the donor hospital to the recipient hospital. We aimed to assess the clinical outcomes of the Organ Care System compared with standard cold storage of human donor hearts for transplantation. We did this prospective, open-label, multicentre, randomised non-inferiority trial at ten heart-transplant centres in the USA and Europe. Eligible heart-transplant candidates (aged >18 years) were randomly assigned (1:1) to receive donor hearts preserved with either the Organ Care System or standard cold storage. Participants, investigators, and medical staff were not masked to group assignment. The primary endpoint was 30 day patient and graft survival, with a 10% non-inferiority margin. We did analyses in the intention-to-treat, as-treated, and per-protocol populations. This trial is registered with ClinicalTrials.gov, number NCT00855712. Between June 29, 2010, and Sept 16, 2013, we randomly assigned 130 patients to the Organ Care System group (n=67) or the standard cold storage group (n=63). 30 day patient and graft survival rates were 94% (n=63) in the Organ Care System group and 97% (n=61) in the standard cold storage group (difference 2·8%, one-sided 95% upper confidence bound 8·8; p=0·45). Eight (13%) patients in the Organ Care System group and nine (14%) patients in the standard cold storage group had cardiac-related serious adverse events. Heart transplantation using donor hearts adequately preserved with the Organ Care System or with standard cold storage yield similar short-term clinical outcomes. The metabolic assessment capability of the Organ Care System needs further study. TransMedics. Copyright © 2015 Elsevier Ltd. All rights reserved.

75 FR 74605 - Thanksgiving Day, 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-01

... our normal pursuits on this day and join in a spirit of fellowship and gratitude for the year's... the promise of the next, we lift up our hearts in gratitude to God for our many blessings, for one... willing to lay down their lives in our defense, and they and their families deserve our profound gratitude...

Hippo signaling impedes adult heart regeneration

PubMed Central

Heallen, Todd; Morikawa, Yuka; Leach, John; Tao, Ge; Willerson, James T.; Johnson, Randy L.; Martin, James F.

2013-01-01

Heart failure due to cardiomyocyte loss after ischemic heart disease is the leading cause of death in the United States in large part because heart muscle regenerates poorly. The endogenous mechanisms preventing mammalian cardiomyocyte regeneration are poorly understood. Hippo signaling, an ancient organ size control pathway, is a kinase cascade that inhibits developing cardiomyocyte proliferation but it has not been studied postnatally or in fully mature adult cardiomyocytes. Here, we investigated Hippo signaling in adult cardiomyocyte renewal and regeneration. We found that unstressed Hippo-deficient adult mouse cardiomyocytes re-enter the cell cycle and undergo cytokinesis. Moreover, Hippo deficiency enhances cardiomyocyte regeneration with functional recovery after adult myocardial infarction as well as after postnatal day eight (P8) cardiac apex resection and P8 myocardial infarction. In damaged hearts, Hippo mutant cardiomyocytes also have elevated proliferation. Our findings reveal that Hippo signaling is an endogenous repressor of adult cardiomyocyte renewal and regeneration. Targeting the Hippo pathway in human disease might be beneficial for the treatment of heart disease. PMID:24255096

Associations between diet and cancer, ischemic heart disease, and all-cause mortality in non-Hispanic white California Seventh-day Adventists.

PubMed

Fraser, G E

1999-09-01

Results associating diet with chronic disease in a cohort of 34192 California Seventh-day Adventists are summarized. Most Seventh-day Adventists do not smoke cigarettes or drink alcohol, and there is a wide range of dietary exposures within the population. About 50% of those studied ate meat products <1 time/wk or not at all, and vegetarians consumed more tomatoes, legumes, nuts, and fruit, but less coffee, doughnuts, and eggs than did nonvegetarians. Multivariate analyses showed significant associations between beef consumption and fatal ischemic heart disease (IHD) in men [relative risk (RR) = 2.31 for subjects who ate beef > or =3 times/wk compared with vegetarians], significant protective associations between nut consumption and fatal and nonfatal IHD in both sexes (RR approximately 0.5 for subjects who ate nuts > or =5 times/wk compared with those who ate nuts <1 time/wk), and reduced risk of IHD in subjects preferring whole-grain to white bread. The lifetime risk of IHD was reduced by approximately 31% in those who consumed nuts frequently and by 37% in male vegetarians compared with nonvegetarians. Cancers of the colon and prostate were significantly more likely in nonvegetarians (RR of 1.88 and 1.54, respectively), and frequent beef consumers also had higher risk of bladder cancer. Intake of legumes was negatively associated with risk of colon cancer in nonvegetarians and risk of pancreatic cancer. Higher consumption of all fruit or dried fruit was associated with lower risks of lung, prostate, and pancreatic cancers. Cross-sectional data suggest vegetarian Seventh-day Adventists have lower risks of diabetes mellitus, hypertension, and arthritis than nonvegetarians. Thus, among Seventh-day Adventists, vegetarians are healthier than nonvegetarians but this cannot be ascribed only to the absence of meat.

Stress, social support and cardiovascular activity over the working day.

PubMed

Steptoe, A

2000-09-01

The influence of stress on ambulatory blood pressure monitored over the working day, and the potential buffering effect of social support, was assessed in 104 school teachers (37 men and 67 women). Blood pressure and heart rate were measured every 20 min and energy expenditure was assessed using accelerometers. Participants rated the degree of stress they were experiencing at the time of each measurement on a seven-point scale. Episodes of both high and low stress during the working day were reported by 62 participants. They were divided by median split into high and low social support groups on the Interpersonal Support Evaluation List. After controlling for body mass and concomitant energy expenditure, high stress was associated with increased systolic blood pressure, diastolic blood pressure and heart rate. However, the impact of stress was buffered by social support, with no significant increase in blood pressure or heart rate with stress in the high support group. The accelerometers were also shown effectively to discriminate between blood pressure readings taken in the seated and standing positions in terms of energy expenditure. The results corroborate laboratory studies, in showing that social support buffers the impact of episodic stress on cardiovascular activity under naturalistic conditions during the working day.

Chronodiagnostic acquisition of recovery speed of heart rate under bathing stress.

PubMed

Ishijima, M; Togawa, T

1999-11-01

Cycling on an ergometer is one effective means of measuring cardiovascular function while applying stress on the heart. Bathing in a hot water bath applies a low stress to the heart. The electrocardiograms of a healthy adult male (aged 35 at the start of study) were recorded while taking a hot water bath with no electrode attached to the body over a period of 2 years (376 days over a 762 day period). The recovery speed following the initial overshoot of the heart rate (HR) was observed. The bathtub was designed for the automatic acquisition of ECG data. Immediately after immersion in the tub, the HR reached a peak within 20 s and then exponentially decreased toward the lowest rate in the 120 s of bathing. The initial recovery speed of the HR from the stress of bathing had a specific rhythm in the subject. Spectrum analysis of the speed series indicated that slow recovery speed appeared in cyclic periods of approximately 1 year, 42 days and 17 days. The methodology may provide a chronodiagnostic index of an exercise test for cardiovascular function.

Open heart surgery after renal transplantation.

PubMed

Yamamura, Mitsuhiro; Miyamoto, Yuji; Mitsuno, Masataka; Tanaka, Hiroe; Ryomoto, Masaaki; Fukui, Shinya; Tsujiya, Noriko; Kajiyama, Tetsuya; Nojima, Michio

2014-09-01

to evaluate the strategy for open heart surgery after renal transplantation performed in a single institution in Japan. we reviewed 6 open heart surgeries after renal transplantation in 5 patients, performed between January 1992 and December 2012. The patients were 3 men and 2 women with a mean age of 60 ± 11 years (range 46-68 years). They had old myocardial infarction and unstable angina, aortic and mitral stenosis, left arterial myxoma, aortic stenosis, and native valve endocarditis followed by prosthetic valve endocarditis. Operative procedures included coronary artery bypass grafting, double-valve replacement, resection of left arterial myxoma, 2 aortic valve replacements, and a double-valve replacement. Renal protection consisted of steroid cover (hydrocortisone 100-500 mg or methylprednisolone 1000 mg) and intravenous immunosuppressant infusion (cyclosporine 30-40 mg day(-1) or tacrolimus 1.0 mg day(-1)). 5 cases were uneventful and good renal graft function was maintained at discharge (serum creatinine 2.1 ± 0.5 mg dL(-1)). There was one operative death after emergency double-valve replacement for methicillin-resistant Staphylococcus aureus-associated prosthetic valve endocarditis. Although the endocarditis improved after valve replacement, the patient died of postoperative pneumonia on postoperative day 45. careful perioperative management can allow successful open heart surgery after renal transplantation. However, severe complications, especially methicillin-resistant Staphylococcus aureus infection, may cause renal graft loss. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Cardiac acute care nurse practitioner and 30-day readmission.

PubMed

David, Daniel; Britting, Lorraine; Dalton, Joanne

2015-01-01

The utilization outcomes of nurse practitioners (NPs) in the acute care setting have not been widely studied. The purpose of this study was to determine the impact on utilization outcomes of NPs on medical teams who take care of patients admitted to a cardiovascular intensive care unit. A retrospective 2-group comparative design was used to evaluate the outcomes of 185 patients with ST- or non ST-segment elevation myocardial infarction or heart failure who were admitted to a cardiovascular intensive care unit in an urban medical center. Patients received care from a medical team that included a cardiac acute care NP (n = 109) or medical team alone (n = 76). Patient history, cardiac assessment, medical interventions, discharge disposition, discharge time, and 3 utilization outcomes (ie, length of stay, 30-day readmission, and time of discharge) were compared between the 2 treatment groups. Logistic regression was used to identify predictors of 30-day readmission. Patients receiving care from a medical team that included an NP were rehospitalized approximately 50% less often compared with those receiving care from a medical team without an NP. Thirty-day hospital readmission (P = .011) and 30-day return rates to the emergency department (P = .021) were significantly lower in the intervention group. Significant predictors for rehospitalization included diagnosis of heart failure versus myocardial infarction (odds ratio [OR], 3.153, P = 0.005), treatment by a medical team without NP involvement (OR, 2.905, P = 0.008), and history of diabetes (OR, 2.310, P = 0.032). The addition of a cardiac acute care NP to medical teams caring for myocardial infarction and heart failure patients had a positive impact on 30-day emergency department return and hospital readmission rates.

Medical costs in patients with heart failure after acute heart failure events: one-year follow-up study.

PubMed

Kim, Eugene; Kwon, Hye-Young; Baek, Sang Hong; Lee, Haeyoung; Yoo, Byung-Su; Kang, Seok-Min; Ahn, Youngkeun; Yang, Bong-Min

2018-03-01

This study investigated annual medical costs using real-world data focusing on acute heart failure. The data were retrospectively collected from six tertiary hospitals in South Korea. Overall, 330 patients who were hospitalized for acute heart failure between January 2011 and July 2012 were selected. Data were collected on their follow-up medical visits for 1 year, including medical costs incurred toward treatment. Those who died within the observational period or who had no records of follow-up visits were excluded. Annual per patient medical costs were estimated according to the type of medical services, and factors contributing to the costs using Gamma Generalized Linear Models (GLM) with log link were analyzed. On average, total annual medical costs for each patient were USD 6,199 (±9,675), with hospitalization accounting for 95% of the total expenses. Hospitalization cost USD 5,904 (±9,666) per patient. Those who are re-admitted have 88.5% higher medical expenditure than those who have not been re-admitted in 1 year, and patients using intensive care units have 19.6% higher expenditure than those who do not. When the number of hospital days increased by 1 day, medical expenses increased by 6.7%. Outpatient drug costs were not included. There is a possibility that medical expenses for AHF may have been under-estimated. It was found that hospitalization resulted in substantial costs for treatment of heart failure in South Korea, especially in patients with an acute heart failure event. Prevention strategies and appropriate management programs that would reduce both frequency of hospitalization and length of stay for patients with the underlying risk of heart failure are needed.

CERN - Six Decades of Science, Innovation, Cooperation, and Inspiration

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

Quigg, Chris

The European Laboratory for Particle Physics, which straddles the Swiss-French border northwest of Geneva, celebrates its sixtieth birthday in 2014 CERN is the preeminent particle-physics institution in the world, currently emphasizing the study of collisions of protons and heavy nuclei at very high energies and the exploration of physics on the electroweak scale (energies where electromagnetism and the weak nuclear force merge). With brilliant accomplishments in research, innovation, and education, and a sustained history of cooperation among people from different countries and cultures, CERN ranks as one of the signal achievements of the postwar European Project. For physicists the worldmore » over, the laboratory is a source of pride and inspiration.« less

3 CFR 8860 - Proclamation 8860 of September 10, 2012. Patriot Day and National Day of Service and Remembrance...

Code of Federal Regulations, 2013 CFR

2013-01-01

... bright autumn day was darkened by the worst attack on the American people in our history. Thousands of innocent men, women, and children perished when mighty towers collapsed in the heart of New York City and... victims who perished as a result of the terrorist attacks of September 11, 2001. IN WITNESS WHEREOF, I...

Dorothy Day: A Love of Fiction and Her Love of the Poor

ERIC Educational Resources Information Center

Brady, Judith Ann

2010-01-01

Dorothy Day's love of the poor originated from reading novels that portrayed the poor as persons worthy of respect. This article explores how Day's reading novels opened her mind and heart to the realities of poverty. The methodology is literature-based. Dorothy Day's autobiography reveals the novelists who captivated her mind and cultivated a…

ChIP-seq Identification of Weakly Conserved Heart Enhancers

PubMed Central

Blow, Matthew J.; McCulley, David J.; Li, Zirong; Zhang, Tao; Akiyama, Jennifer A.; Holt, Amy; Plajzer-Frick, Ingrid; Shoukry, Malak; Wright, Crystal; Chen, Feng; Afzal, Veena; Bristow, James; Ren, Bing; Black, Brian L.; Rubin, Edward M.; Visel, Axel; Pennacchio, Len A.

2011-01-01

Accurate control of tissue-specific gene expression plays a pivotal role in heart development, but few cardiac transcriptional enhancers have thus far been identified. Extreme non-coding sequence conservation successfully predicts enhancers active in many tissues, but fails to identify substantial numbers of heart enhancers. Here we used ChIP-seq with the enhancer-associated protein p300 from mouse embryonic day 11.5 heart tissue to identify over three thousand candidate heart enhancers genome-wide. Compared to other tissues studied at this time-point, most candidate heart enhancers are less deeply conserved in vertebrate evolution. Nevertheless, the testing of 130 candidate regions in a transgenic mouse assay revealed that most of them reproducibly function as enhancers active in the heart, irrespective of their degree of evolutionary constraint. These results provide evidence for a large population of poorly conserved heart enhancers and suggest that the evolutionary constraint of embryonic enhancers can vary depending on tissue type. PMID:20729851

Pulsatile mechanical cardiac assistance in pediatric patients with the Berlin heart ventricular assist device.

PubMed

Merkle, Frank; Boettcher, Wolfgang; Stiller, Brigitte; Hetzer, Roland

2003-06-01

Mechanical cardiac assistance for neonates, infants, children and adolescents may be accomplished with pulsatile ventricular assist devices (VAD) instead of extracorporeal membrane oxygenation or centrifugal pumps. The Berlin Heart VAD consists of extracorporeal, pneumatically driven blood pumps for pulsatile univentricular or biventricular assistance for patients of all age groups. The blood pumps are heparin-coated. The stationary driving unit (IKUS) has the required enhanced compressor performance for pediatric pump sizes. The Berlin Heart VAD was used in a total number of 424 patients from 1987 to November 2001 at our institution. In 45 pediatric patients aged 2 days-17 years the Berlin Heart VAD was applied for long-term support (1-111 days, mean 20 days). There were three patient groups: Group I: "Bridge to transplantation" with various forms of cardiomyopathy (N = 21) or chronic stages of congenital heart disease (N = 9); Group II: "Rescue" in intractable heart failure after corrective surgery for congenital disease (N = 7) or in early graft failure after heart transplantation (N = 1); and Group III: "Acute myocarditis" (N = 7) as either bridge to transplantation or bridge to recovery. Seventeen patients were transplanted after support periods of between 4 and 111 days with 12 long-term survivors, having now survived for up to 10 years. Five patients (Groups I and III) were weaned from the system with four long-term survivors. In Group II only one patient survived after successful transplantation. Prolonged circulatory support with the Berlin Heart VAD is an effective method for bridging until cardiac recovery or transplantation in the pediatric age group. Extubation, mobilization, and enteral nutrition are possible. For long-term use, the Berlin Heart VAD offers advantages over centrifugal pumps and ECMO in respect to patient mobility and safety.

Day to day variability in fat oxidation and the effect after only 1 day of change in diet composition.

PubMed

Støa, Eva Maria; Nyhus, Lill-Katrin; Børresen, Sandra Claveau; Nygaard, Caroline; Hovet, Åse Marie; Bratland-Sanda, Solfrid; Helgerud, Jan; Støren, Øyvind

2016-04-01

Indirect calorimetry is a common and noninvasive method to estimate rate of fat oxidation (FatOx) during exercise, and test-retest reliability should be considered when interpreting results. Diet also has an impact on FatOx. The aim of the present study was to investigate day to day variations in FatOx during moderate exercise given the same diet and 2 different isoenergetic diets. Nine healthy, moderately-trained females participated in the study. They performed 1 maximal oxygen uptake test and 4 FatOx tests. Habitual diets were recorded and repeated to assess day to day variability in FatOx. FatOx was also measured after 1 day of fat-rich (26.8% carbohydrates (CHO), 23.2% protein, 47.1% fat) and 1 day of CHO-rich diet (62.6% CHO, 20.1% protein, 12.4% fat). The reliability test revealed no differences in FatOx, respiratory exchange ratio (RER), oxygen uptake, carbon dioxide production, heart rate, blood lactate concentration, or blood glucose between the 2 habitual diet days. FatOx decreased after the CHO-rich diet compared with the habitual day 2 (from 0.42 ± 0.15 to 0.29 ± 0.13 g·min(-1), p < 0.05). No difference was found in FatOx between fat-rich diet and the 2 habitual diet days. FatOx was 31% lower (from 0.42 ± 0.14 to 0.29 ± 0.13 g·min(-1), p < 0.01) after the CHO-rich diet compared with the fat-rich diet. Using RER data to measure FatOx is a reliable method as long as the diet is strictly controlled. However, even a 1-day change in macronutrient composition will likely affect the FatOx results.

Drp1-Dependent Mitochondrial Autophagy Plays a Protective Role Against Pressure Overload-Induced Mitochondrial Dysfunction and Heart Failure.

PubMed

Shirakabe, Akihiro; Zhai, Peiyong; Ikeda, Yoshiyuki; Saito, Toshiro; Maejima, Yasuhiro; Hsu, Chiao-Po; Nomura, Masatoshi; Egashira, Kensuke; Levine, Beth; Sadoshima, Junichi

2016-03-29

Mitochondrial autophagy is an important mediator of mitochondrial quality control in cardiomyocytes. The occurrence of mitochondrial autophagy and its significance during cardiac hypertrophy are not well understood. Mice were subjected to transverse aortic constriction (TAC) and observed at multiple time points up to 30 days. Cardiac hypertrophy developed after 5 days, the ejection fraction was reduced after 14 days, and heart failure was observed 30 days after TAC. General autophagy was upregulated between 1 and 12 hours after TAC but was downregulated below physiological levels 5 days after TAC. Mitochondrial autophagy, evaluated by electron microscopy, mitochondrial content, and Keima with mitochondrial localization signal, was transiently activated at ≈3 to 7 days post-TAC, coinciding with mitochondrial translocation of Drp1. However, it was downregulated thereafter, followed by mitochondrial dysfunction. Haploinsufficiency of Drp1 abolished mitochondrial autophagy and exacerbated the development of both mitochondrial dysfunction and heart failure after TAC. Injection of Tat-Beclin 1, a potent inducer of autophagy, but not control peptide, on day 7 after TAC, partially rescued mitochondrial autophagy and attenuated mitochondrial dysfunction and heart failure induced by overload. Haploinsufficiency of either drp1 or beclin 1 prevented the rescue by Tat-Beclin 1, suggesting that its effect is mediated in part through autophagy, including mitochondrial autophagy. Mitochondrial autophagy is transiently activated and then downregulated in the mouse heart in response to pressure overload. Downregulation of mitochondrial autophagy plays an important role in mediating the development of mitochondrial dysfunction and heart failure, whereas restoration of mitochondrial autophagy attenuates dysfunction in the heart during pressure overload. © 2016 American Heart Association, Inc.

Clinical Decision Support to Efficiently Identify Patients Eligible for Advanced Heart Failure Therapies.

PubMed

Evans, R Scott; Kfoury, Abdallah G; Horne, Benjamin D; Lloyd, James F; Benuzillo, Jose; Rasmusson, Kismet D; Roberts, Colleen; Lappé, Donald L

2017-10-01

Patients who need and receive timely advanced heart failure (HF) therapies have better long-term survival. However, many of these patients are not identified and referred as soon as they should be. A clinical decision support (CDS) application sent secure email notifications to HF patients' providers when they transitioned to advanced disease. Patients identified with CDS in 2015 were compared with control patients from 2013 to 2014. Kaplan-Meier methods and Cox regression were used in this intention-to-treat analysis to compare differences between visits to specialized and survival. Intervention patients were referred to specialized heart facilities significantly more often within 30 days (57% vs 34%; P < .001), 60 days (69% vs 44%; P < .0001), 90 days (73% vs 49%; P < .0001), and 180 days (79% vs 58%; P < .0001). Age and sex did not predict heart facility visits, but renal disease did and patients of nonwhite race were less likely to visit specialized heart facilities. Significantly more intervention patients were found to be alive at 30 (95% vs 92%; P = .036), 60 (95% vs 90%; P = .0013), 90 (94% vs 87%; P = .0002), and 180 days (92% vs 84%; P = .0001). Age, sex, and some comorbid diseases were also predictors of mortality, but race was not. We found that CDS can facilitate the early identification of patients needing advanced HF therapy and that its use was associated with significantly more patients visiting specialized heart facilities and longer survival. Copyright © 2017 Elsevier Inc. All rights reserved.

Dissemination of data measured at the CERN n_TOF facility

NASA Astrophysics Data System (ADS)

Dupont, E.; Otuka, N.; Cabellos, O.; Aberle, O.; Aerts, G.; Altstadt, S.; Alvarez, H.; Alvarez-Velarde, F.; Andriamonje, S.; Andrzejewski, J.; Audouin, L.; Bacak, M.; Badurek, G.; Balibrea, J.; Barbagallo, M.; Barros, S.; Baumann, P.; Bécares, V.; Bečvář, F.; Beinrucker, C.; Belloni, F.; Berthier, B.; Berthoumieux, E.; Billowes, J.; Boccone, V.; Bosnar, D.; Brown, A.; Brugger, M.; Caamaño, M.; Calviani, M.; Calviño, F.; Cano-Ott, D.; Capote, R.; Cardella, R.; Carrapiço, C.; Casanovas, A.; Castelluccio, D. M.; Cennini, P.; Cerutti, F.; Chen, Y. H.; Chiaveri, E.; Chin, M.; Colonna, N.; Cortés, G.; Cortés-Giraldo, M. A.; Cosentino, L.; Couture, A.; Cox, J.; Damone, L. A.; David, S.; Deo, K.; Diakaki, M.; Dillmann, I.; Domingo-Pardo, C.; Dressler, R.; Dridi, W.; Duran, I.; Eleftheriadis, C.; Embid-Segura, M.; Fernández-Domínguez, B.; Ferrant, L.; Ferrari, A.; Ferreira, P.; Finocchiaro, P.; Fraval, K.; Frost, R. J. W.; Fujii, K.; Furman, W.; Ganesan, S.; Garcia, A. R.; Gawlik, A.; Gheorghe, I.; Gilardoni, S.; Giubrone, G.; Glodariu, T.; Göbel, K.; Gomez-Hornillos, M. B.; Goncalves, I. F.; Gonzalez-Romero, E.; Goverdovski, A.; Gramegna, F.; Griesmayer, E.; Guerrero, C.; Gunsing, F.; Gurusamy, P.; Haight, R.; Harada, H.; Heftrich, T.; Heil, M.; Heinitz, S.; Hernández-Prieto, A.; Heyse, J.; Igashira, M.; Isaev, S.; Jenkins, D. G.; Jericha, E.; Kadi, Y.; Kaeppeler, F.; Kalamara, A.; Karadimos, D.; Karamanis, D.; Katabuchi, T.; Kavrigin, P.; Kerveno, M.; Ketlerov, V.; Khryachkov, V.; Kimura, A.; Kivel, N.; Kokkoris, M.; Konovalov, V.; Krtička, M.; Kroll, J.; Kurtulgil, D.; Lampoudis, C.; Langer, C.; Leal-Cidoncha, E.; Lederer, C.; Leeb, H.; Naour, C. Le; Lerendegui-Marco, J.; Leong, L. S.; Licata, M.; Meo, S. Lo; Lonsdale, S. J.; Losito, R.; Lozano, M.; Macina, D.; Manousos, A.; Marganiec, J.; Martinez, T.; Marrone, S.; Masi, A.; Massimi, C.; Mastinu, P.; Mastromarco, M.; Matteucci, F.; Maugeri, E. A.; Mazzone, A.; Mendoza, E.; Mengoni, A.; Milazzo, P. M.; Mingrone, F.; Mirea, M.; Mondelaers, W.; Montesano, S.; Moreau, C.; Mosconi, M.; Musumarra, A.; Negret, A.; Nolte, R.; O'Brien, S.; Oprea, A.; Palomo-Pinto, F. R.; Pancin, J.; Paradela, C.; Patronis, N.; Pavlik, A.; Pavlopoulos, P.; Perkowski, J.; Perrot, L.; Pigni, M. T.; Plag, R.; Plompen, A.; Plukis, L.; Poch, A.; Porras, I.; Praena, J.; Pretel, C.; Quesada, J. M.; Radeck, D.; Rajeev, K.; Rauscher, T.; Reifarth, R.; Riego, A.; Robles, M.; Roman, F.; Rout, P. C.; Rudolf, G.; Rubbia, C.; Rullhusen, P.; Ryan, J. A.; Sabaté-Gilarte, M.; Salgado, J.; Santos, C.; Sarchiapone, L.; Sarmento, R.; Saxena, A.; Schillebeeckx, P.; Schmidt, S.; Schumann, D.; Sedyshev, P.; Smith, A. G.; Sosnin, N. V.; Stamatopoulos, A.; Stephan, C.; Suryanarayana, S. V.; Tagliente, G.; Tain, J. L.; Tarifeño-Saldivia, A.; Tarrío, D.; Tassan-Got, L.; Tavora, L.; Terlizzi, R.; Tsinganis, A.; Valenta, S.; Vannini, G.; Variale, V.; Vaz, P.; Ventura, A.; Versaci, R.; Vermeulen, M. J.; Villamarin, D.; Vicente, M. C.; Vlachoudis, V.; Vlastou, R.; Voss, F.; Wallner, A.; Walter, S.; Ware, T.; Warren, S.; Weigand, M.; Weiß, C.; Wolf, C.; Wiesher, M.; Wisshak, K.; Woods, P. J.; Wright, T.; Žugec, P.

2017-09-01

The n_TOF neutron time-of-flight facility at CERN is used for high quality nuclear data measurements from thermal energy up to hundreds of MeV. In line with the CERN open data policy, the n_TOF Collaboration takes actions to preserve its unique data, facilitate access to them in standardised format, and allow their re-use by a wide community in the fields of nuclear physics, nuclear astrophysics and various nuclear technologies. The present contribution briefly describes the n_TOF outcomes, as well as the status of dissemination and preservation of n_TOF final data in the international EXFOR library.

HIGH ENERGY PHYSICS: CERN Link Breathes Life Into Russian Physics.

PubMed

Stone, R

2000-10-13

Without fanfare, 600 Russian scientists here at CERN, the European particle physics laboratory, are playing key roles in building the Large Hadron Collider (LHC), a machine that will explore fundamental questions such as why particles have mass, as well as search for exotic new particles whose existence would confirm supersymmetry, a popular theory that aims to unify the four forces of nature. In fact, even though Russia is not one of CERN's 20 member states, most top high-energy physicists in Russia are working on the LHC. Some say their work could prove the salvation of high-energy physics back home.

Outcomes of Early Adolescent Donor Hearts in Adult Transplant Recipients.

PubMed

Madan, Shivank; Patel, Snehal R; Vlismas, Peter; Saeed, Omar; Murthy, Sandhya; Forest, Stephen; Jakobleff, William; Sims, Daniel; Lamour, Jacqueline M; Hsu, Daphne T; Shin, Julia; Goldstein, Daniel; Jorde, Ulrich P

2017-12-01

This study sought to determine outcomes of adult recipients of early adolescent (EA) (10 to 14 years) donor hearts. Despite a shortage of donor organs, EA donor hearts (not used for pediatric patients) are seldom used for adults because of theoretical concerns for lack of hormonal activation and changes in left ventricular mass. Nonetheless, the outcomes of adult transplantation using EA donor hearts are not clearly established. All adult (≥18 years of age) heart transplant recipients in the United Network for Organ Sharing database between April 1994 and September 2015 were eligible for this analysis. Recipients of EA donor hearts were compared with recipients of donor hearts from the usual adult age group (ages 18 to 55 years). Main outcomes were all-cause mortality and cardiac allograft vasculopathy up to 5 years, and primary graft failure up to 90 days post-transplant. Propensity score analysis was used to identify a cohort of recipients with similar baseline characteristics. Of the 35,054 eligible adult recipients, 1,123 received hearts from EA donors and 33,931 from usual-age adult donors. With the use of propensity score matching, 944 recipients of EA donor hearts were matched to 944 recipients of usual-age adult donor hearts. There was no difference in 30-day, 1-year, 3-year, and 5-year recipient survival or primary graft failure rates in the 2 groups using both Cox hazards ratio and Kaplan-Meier analysis. Of note, adult patients who received EA donor hearts had a trend toward less cardiac allograft vasculopathy (Cox hazard ratio, 0.80; 95% confidence interval: 0.62 to 1.01; p = 0.07). In this largest analysis to date, we found strong evidence that EA donor hearts, not used for pediatric patients, can be safely transplanted in appropriate adult patients and have good outcomes. This finding should help increase the use of EA donor hearts. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Cost analysis of the History, ECG, Age, Risk factors, and initial Troponin (HEART) Pathway randomized control trial.

PubMed

Riley, Robert F; Miller, Chadwick D; Russell, Gregory B; Harper, Erin N; Hiestand, Brian C; Hoekstra, James W; Lefebvre, Cedric W; Nicks, Bret A; Cline, David M; Askew, Kim L; Mahler, Simon A

2017-01-01

The HEART Pathway is a diagnostic protocol designed to identify low-risk patients presenting to the emergency department with chest pain that are safe for early discharge. This protocol has been shown to significantly decrease health care resource utilization compared with usual care. However, the impact of the HEART Pathway on the cost of care has yet to be reported. We performed a cost analysis of patients enrolled in the HEART Pathway trial, which randomized participants to either usual care or the HEART Pathway protocol. For low-risk patients, the HEART Pathway recommended early discharge from the emergency department without further testing. We compared index visit cost, cost at 30 days, and cardiac-related health care cost at 30 days between the 2 treatment arms. Costs for each patient included facility and professional costs. Cost at 30 days included total inpatient and outpatient costs, including the index encounter, regardless of etiology. Cardiac-related health care cost at 30 days included the index encounter and costs adjudicated to be cardiac-related within that period. Two hundred seventy of the 282 patients enrolled in the trial had cost data available for analysis. There was a significant reduction in cost for the HEART Pathway group at 30 days (median cost savings of $216 per individual), which was most evident in low-risk (Thrombolysis In Myocardial Infarction score of 0-1) patients (median savings of $253 per patient) and driven primarily by lower cardiac diagnostic costs in the HEART Pathway group. Using the HEART Pathway as a decision aid for patients with undifferentiated chest pain resulted in significant cost savings. Copyright © 2016 Elsevier Inc. All rights reserved.

Entropy information of heart rate variability and its power spectrum during day and night

NASA Astrophysics Data System (ADS)

Jin, Li; Jun, Wang

2013-07-01

Physiologic systems generate complex fluctuations in their output signals that reflect the underlying dynamics. We employed the base-scale entropy method and the power spectral analysis to study the 24 hours heart rate variability (HRV) signals. The results show that such profound circadian-, age- and pathologic-dependent changes are accompanied by changes in base-scale entropy and power spectral distribution. Moreover, the base-scale entropy changes reflect the corresponding changes in the autonomic nerve outflow. With the suppression of the vagal tone and dominance of the sympathetic tone in congestive heart failure (CHF) subjects, there is more variability in the date fluctuation mode. So the higher base-scale entropy belongs to CHF subjects. With the decrease of the sympathetic tone and the respiratory frequency (RSA) becoming more pronounced with slower breathing during sleeping, the base-scale entropy drops in CHF subjects. The HRV series of the two healthy groups have the same diurnal/nocturnal trend as the CHF series. The fluctuation dynamics trend of data in the three groups can be described as “HF effect”.

Upgrade of the cryogenic CERN RF test facility

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

Pirotte, O.; Benda, V.; Brunner, O.

2014-01-29

With the large number of superconducting radiofrequency (RF) cryomodules to be tested for the former LEP and the present LHC accelerator a RF test facility was erected early in the 1990’s in the largest cryogenic test facility at CERN located at Point 18. This facility consisted of four vertical test stands for single cavities and originally one and then two horizontal test benches for RF cryomodules operating at 4.5 K in saturated helium. CERN is presently working on the upgrade of its accelerator infrastructure, which requires new superconducting cavities operating below 2 K in saturated superfluid helium. Consequently, the RFmore » test facility has been renewed in order to allow efficient cavity and cryomodule tests in superfluid helium and to improve its thermal performances. The new RF test facility is described and its performances are presented.« less

Heart Health - Brave Heart

MedlinePlus

... Bar Home Current Issue Past Issues Cover Story Heart Health Brave Heart Past Issues / Winter 2009 Table of Contents For ... you can have a good life after a heart attack." Lifestyle Changes Surviving—and thriving—after such ...

PARTICLE PHYSICS: CERN Gives Higgs Hunters Extra Month to Collect Data.

PubMed

Morton, O

2000-09-22

After 11 years of banging electrons and positrons together at higher energies than any other machine in the world, CERN, the European laboratory for particle physics, had decided to shut down the Large Electron-Positron collider (LEP) and install a new machine, the Large Hadron Collider (LHC), in its 27-kilometer tunnel. In 2005, the LHC will start bashing protons together at even higher energies. But tantalizing hints of a long-sought fundamental particle have forced CERN managers to grant LEP a month's reprieve.

Hangout with CERN: Reaching the Public with the Collaborative Tools of Social Media

NASA Astrophysics Data System (ADS)

Goldfarb, S.; Kahle, K. L. M.; Rao, A.

2014-06-01

On 4 July 2012, particle physics became a celebrity. Around 1,000,000,000 people (yes, 1 billion) [1] saw rebroadcasts of two technical presentations announcing the discovery of a new boson. The occasion was a joint seminar of the CMS [2] and ATLAS [3] collaborations, and the target audience were particle physicists. Yet the world ate it up like a sporting event. Roughly two days later, in a parallel session of ICHEP in Melbourne, Australia [4], a group of physicists decided to explain the significance of this discovery to the public. They used a tool called "Hangout", part of the relatively new Google+ social media platform [5], to converse directly with the public via a webcast videoconference. The demand to join this Hangout [6] overloaded the server several times. In the end, a compromise involving Q&A via comments was set up, and the conversation was underway. We present a new project born shortly after this experience called Hangout with CERN [7], and discuss its success in creating an effective conversational channel between the public and particle physicists. We review earlier efforts by both CMS and ATLAS contributing to this development, and then describe the current programme, involving nearly all aspects of CERN, and some topics that go well beyond that. We conclude by discussing the potential of the programme both to improve our accountability to the public and to train our community for public communication.

Comparison of the effect of pindolol and propranolol on heart rate after acute and chronic administration.

PubMed Central

Finch, M B; O'Connor, P C; Harron, D W; Shanks, R G

1983-01-01

1 The present study compared the effects in healthy volunteers of the acute and chronic administration of placebo, pindolol and propranolol to see if the partial agonist activity of pindolol was reduced by the beta-adrenoceptor blocking activity of pindolol on chronic administration. 2 Five subjects received in random order for 8 days placebo, propranolol 160 mg and pindolol 10 mg; on days 1 and 8 treatments were given twice at 0 and 2 h. Heart rate in supine position and at end of exercise was recorded before dosing and at 2 and 4 h post-dosing on days 1 and 8. 3 Propranolol and pindolol reduced exercise heart rate to the same extent on days 1 and 8. 4 Propranolol reduced supine heart rate more than pindolol on days 1 and 8 but the difference was only significant on day 8. PMID:6849778

Mitochondria selective S-nitrosation by mitochondria-targeted S-nitrosothiol protects against post-infarct heart failure in mouse hearts.

PubMed

Methner, Carmen; Chouchani, Edward T; Buonincontri, Guido; Pell, Victoria R; Sawiak, Stephen J; Murphy, Michael P; Krieg, Thomas

2014-07-01

Recently it has been shown that the mitochondria-targeted S-nitrosothiol MitoSNO protects against acute ischaemia/reperfusion (IR) injury by inhibiting the reactivation of mitochondrial complex I in the first minutes of reperfusion of ischaemic tissue, thereby preventing free radical formation that underlies IR injury. However, it remains unclear how this transient inhibition of mitochondrial complex I-mediated free radicals at reperfusion affects the long-term recovery of the heart following IR injury. Here we determined whether the acute protection by MitoSNO at reperfusion prevented the subsequent development of post-myocardial infarction heart failure. Mice were subjected to 30 min left coronary artery occlusion followed by reperfusion and recovery over 28 days. MitoSNO (100 ng/kg) was applied 5 min before the onset of reperfusion followed by 20 min infusion (1 ng/kg/min). Infarct size and cardiac function were measured by magnetic resonance imaging (MRI) 24 h after infarction. MitoSNO-treated mice exhibited reduced infarct size and preserved function. In addition, MitoSNO at reperfusion improved outcome measures 28 days post-IR, including preserved systolic function (63.7 ±1.8% LVEF vs. 53.7 ± 2.1% in controls, P = 0.01) and tissue fibrosis. MitoSNO action acutely at reperfusion reduces infarct size and protects from post-myocardial infarction heart failure. Therefore, targeted inhibition of mitochondrial complex I in the first minutes of reperfusion by MitoSNO is a rational therapeutic strategy for preventing subsequent heart failure in patients undergoing IR injury. © 2014 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.

Vagal Nerve Stimulation Evoked Heart Rate Changes and Protection from Cardiac Remodeling.

PubMed

Agarwal, Rahul; Mokelke, Eric; Ruble, Stephen B; Stolen, Craig M

2016-02-01

This study investigated whether vagal nerve stimulation (VNS) leads to improvements in ischemic heart failure via heart rate modulation. At 7 ± 1 days post left anterior descending artery (LAD) ligation, 63 rats with myocardial infarctions (MI) were implanted with ECG transmitters and VNS devices (MI + VNS, N = 44) or just ECG transmitters (MI, N = 17). VNS stimulation was active from 14 ± 1 days to 8 ± 1 weeks post MI. The average left ventricular (LV) end diastolic volumes at 8 ± 1 weeks were MI = 672.40 μl and MI + VNS = 519.35 μl, p = 0.03. The average heart weights, normalized to body weight (± std) at 14 ± 1 weeks were MI = 3.2 ± 0.6 g*kg(-1) and MI + VNS = 2.9 ± 0.3 g*kg(-1), p = 0.03. The degree of cardiac remodeling was correlated with the magnitude of acute VNS-evoked heart rate (HR) changes. Further research is required to determine if the acute heart rate response to VNS activation is useful as a heart failure biomarker or as a tool for VNS therapy characterization.

Associations between nursing home performance and hospital 30-day readmissions for acute myocardial infarction, heart failure and pneumonia at the healthcare community level in the United States.

PubMed

Pandolfi, Michelle M; Wang, Yun; Spenard, Ann; Johnson, Florence; Bonner, Alice; Ho, Shih-Yieh; Elwell, Timothy; Bakullari, Anila; Galusha, Deron; Leifheit-Limson, Erica; Lichtman, Judith H; Krumholz, Harlan M

2017-12-01

To evaluate community-specific nursing home performance with community-specific hospital 30-day readmissions for Medicare patients discharged with acute myocardial infarction, heart failure or pneumonia. Cross-sectional study using 2009-2012 hospital risk-standardised 30-day readmission data for Medicare fee-for-service patients hospitalised for all three conditions and nursing home performance data from the Centers for Medicare & Medicaid Services Five-Star Quality Rating System. Medicare-certified nursing homes and acute care hospitals. 12,542 nursing homes and 3,039 hospitals treating 30 or more Medicare fee-for-service patients for all three conditions across 2,032 hospital service areas in the United States. Community-specific hospital 30-day risk-standardised readmission rates. Community-specific nursing home performance measures: health inspection, staffing, Registered Nurses and quality performance; and an aggregated performance score. Mixed-effects models evaluated associations between nursing home performance and hospital 30-day risk-standardised readmission rates for all three conditions. The relationship between community-specific hospital risk-standardised readmission rates and community-specific overall nursing home performance was statistically significant for all three conditions. Increasing nursing home performance by one star resulted in decreases of 0.29% point (95% CI: 0.12-0.47), 0.78% point (95% CI: 0.60-0.95) and 0.46% point (95% CI: 0.33-0.59) of risk-standardised readmission rates for AMI, HF and pneumonia, respectively. Among the specific measures, higher performance in nursing home overall staffing and Registered Nurse staffing measures was statistically significantly associated with lower hospital readmission rates for all three conditions. Notable geographic variation in the community-specific nursing home performance was observed. Community-specific nursing home performance is associated with community-specific hospital 30-day

Postoperative infections after major heart surgery and prevention of ventilator-associated pneumonia: a one-day European prevalence study (ESGNI-008).

PubMed

Bouza, E; Hortal, J; Muñoz, P; Pascau, J; Pérez, M J; Hiesmayr, M

2006-11-01

Few data have been published on the prevalence of postoperative infection in patients undergoing major heart surgery (MHS). The degree of compliance with standard measures used to prevent them is unknown. This study assessed the prevalence of infections, particularly ventilator-associated pneumonia (VAP), in patients undergoing MHS in 42 institutions from 13 European countries. On the study day, there were 321 postoperative MHS patients, of whom 164 (51%) were mechanically ventilated. The overall prevalence of infection was 26.8%. Lower respiratory tract infections represented 57% of all the infections present on the study day. Other infections included intravenous-catheter-related bloodstream infections (2.8%), surgical site infections (2.2%), urinary tract infections (0.9%) and postoperative mediastinitis (0.9%). Of the mechanically ventilated patients, 55 (33.5%) were not being nursed in a semi-recumbent position, 36 (22%) had heat-moisture exchangers with no antibacterial filters, and intracuff pressure was not monitored in 78 patients (47.6%). Only 13 patients (8%) were given continuous subglottic suctioning, 64 patients (39%) did not receive postural oscillation, and gastric overdistension was not actively prevented in 23 patients (14%). In conclusion, these data from intensive care units across Europe provide information on postoperative infections in an important subset of the patient population, and stress the need for active interventions to prevent VAP in patients undergoing MHS.

In vivo wall shear measurements within the developing zebrafish heart.

PubMed

Jamison, R Aidan; Samarage, Chaminda R; Bryson-Richardson, Robert J; Fouras, Andreas

2013-01-01

Physical forces can influence the embryonic development of many tissues. Within the cardiovascular system shear forces resulting from blood flow are known to be one of the regulatory signals that shape the developing heart. A key challenge in investigating the role of shear forces in cardiac development is the ability to obtain shear force measurements in vivo. Utilising the zebrafish model system we have developed a methodology that allows the shear force within the developing embryonic heart to be determined. Accurate wall shear measurement requires two essential pieces of information; high-resolution velocity measurements near the heart wall and the location and orientation of the heart wall itself. We have applied high-speed brightfield imaging to capture time-lapse series of blood flow within the beating heart between 3 and 6 days post-fertilization. Cardiac-phase filtering is applied to these time-lapse images to remove the heart wall and other slow moving structures leaving only the red blood cell movement. Using particle image velocimetry to calculate the velocity of red blood cells in different regions within the heart, and using the signal-to-noise ratio of the cardiac-phase filtered images to determine the boundary of blood flow, and therefore the position of the heart wall, we have been able to generate the necessary information to measure wall shear in vivo. We describe the methodology required to measure shear in vivo and the application of this technique to the developing zebrafish heart. We identify a reduction in shear at the ventricular-bulbar valve between 3 and 6 days post-fertilization and demonstrate that the shear environment of the ventricle during systole is constantly developing towards a more uniform level.

Interactive effects of temperature and hypoxia on heart rate and oxygen consumption of the 3-day old chicken embryo.

PubMed

Mortola, Jacopo P; Wills, Kathryn; Trippenbach, Teresa; Al Awam, Khalid

2010-03-01

In the chick embryo at day 3, gas exchange occurs by diffusion and oxygen consumption (V(O(2))) does not depend on the cardiovascular convection of O(2). Whether or not this is the case in hypoxia is not known and represents the aim of the study. The heart of chicken embryos at 72 h (stage HH18) was filmed through a window of the eggshell by a camera attached to a microscope. Stroke volume was estimated from the changes in heart silhouette between systole and diastole. V(O(2))was measured by a closed system methodology. In normoxia, a decrease in temperature (T) from 39 to 31 degrees C had parallel depressant effects on V(O(2))and HR. At 39 degrees C, a progressive decrease in O(2) lowered V(O(2)); HR was maintained until the O(2) threshold of approximately 15%. In severe hypoxia (4% O(2)) V(O(2))and HR were, respectively, approximately 12% and approximately 62% of normoxia. At 32 degrees C the hypoxic threshold for HR was significantly lower. During constant hypoxia (7% O(2)) V(O(2))did not respond to T, while the HR response was preserved. Stroke volume changed little with changes in T or O(2), except at 6 and 4% O(2), when it decreased by approximately 20 and 30%. In embryos growth-retarded because of incubation in chronic hypoxia, V(O(2))and HR responses to T and hypoxia were similar to those of normal embryos. We conclude that in the early embryo during hypoxia cardiovascular O(2) convection is not responsible for the drop in V(O(2)). The generalised hypometabolic response, in combination with the extremely small cardiac V(O(2)), probably explains the minor effects of hypoxia on cardiac activity. Copyright 2009 Elsevier Inc. All rights reserved.

Ambient temperature and biomarkers of heart failure: a repeated measures analysis.

PubMed

Wilker, Elissa H; Yeh, Gloria; Wellenius, Gregory A; Davis, Roger B; Phillips, Russell S; Mittleman, Murray A

2012-08-01

Extreme temperatures have been associated with hospitalization and death among individuals with heart failure, but few studies have explored the underlying mechanisms. We hypothesized that outdoor temperature in the Boston, Massachusetts, area (1- to 4-day moving averages) would be associated with higher levels of biomarkers of inflammation and myocyte injury in a repeated-measures study of individuals with stable heart failure. We analyzed data from a completed clinical trial that randomized 100 patients to 12 weeks of tai chi classes or to time-matched education control. B-type natriuretic peptide (BNP), C-reactive protein (CRP), and tumor necrosis factor (TNF) were measured at baseline, 6 weeks, and 12 weeks. Endothelin-1 was measured at baseline and 12 weeks. We used fixed effects models to evaluate associations with measures of temperature that were adjusted for time-varying covariates. Higher apparent temperature was associated with higher levels of BNP beginning with 2-day moving averages and reached statistical significance for 3- and 4-day moving averages. CRP results followed a similar pattern but were delayed by 1 day. A 5°C change in 3- and 4-day moving averages of apparent temperature was associated with 11.3% [95% confidence interval (CI): 1.1, 22.5; p = 0.03) and 11.4% (95% CI: 1.2, 22.5; p = 0.03) higher BNP. A 5°C change in the 4-day moving average of apparent temperature was associated with 21.6% (95% CI: 2.5, 44.2; p = 0.03) higher CRP. No clear associations with TNF or endothelin-1 were observed. Among patients undergoing treatment for heart failure, we observed positive associations between temperature and both BNP and CRP-predictors of heart failure prognosis and severity.

Fitness characteristics of competitors in a six day sailboard marathon.

PubMed

McLean, B; Chad, K E

1992-09-01

The purpose of this study was to profile the fitness characteristics of competitors in a 6 day sailboard marathon and assess the aerobic demands encountered. Twenty one male sailboarders were assessed for body composition, horizontal shoulder adduction and abduction strength as well as grip strength. Body composition was assessed by skinfold measurement and strength measured by dynamometer. A subgroup of 5 subjects were assessed for VO2 max by indirect calorimetry using a treadmill protocol. Functional capacity was determined as the quotient of VO2 max and the VO2 at rest and the aerobic conditioning threshold estimated. The corresponding threshold heart rate was determined. During each days racing, heart rate was continuously monitored from 2 different members of the subgroup. In the total group body fat was 19.1 +/- 5.1%, grip strength was 502.3 +/- 61.8 N and horizontal shoulder adduction and abduction strength was 449.3 +/- 121.6 N and 437 +/- 94.2 N respectively. In the subgroup, VO2 max was 49.6 +/- 3.7 ml/kg/min, functional capacity was 8.8 +/- 0.9 METS and threshold heart rate occurred between 155 +/- 5.2 and 161 +/- 4.6 beats/min. Heart rate response during sailing was typically in the 120-150 beats/min range. The results indicated that sailboarding does not promote high levels of aerobic fitness.

Systolic time interval v heart rate regression equations using atropine: reproducibility studies.

PubMed Central

Kelman, A W; Sumner, D J; Whiting, B

1981-01-01

1. Systolic time intervals (STI) were recorded in six normal male subjects over a period of 3 weeks. On one day per week, each subject received incremental doses of atropine intravenously to increase heart rate, allowing the determination of individual STI v HR regression equations. On the other days STI were recorded with the subjects resting, in the supine position. 2. There were highly significant regression relationships between heart rate and both LVET and QS2, but not between heart rate and PEP. 3. The regression relationships showed little intra-subject variability, but a large degree of inter-subject variability: they proved adequate to correct the STI for the daily fluctuations in heart rate. 4. Administration of small doses of atropine intravenously provides a satisfactory and convenient method of deriving individual STI v HR regression equations which can be applied over a period of weeks. PMID:7248136

Systolic time interval v heart rate regression equations using atropine: reproducibility studies.

PubMed

Kelman, A W; Sumner, D J; Whiting, B

1981-07-01

1. Systolic time intervals (STI) were recorded in six normal male subjects over a period of 3 weeks. On one day per week, each subject received incremental doses of atropine intravenously to increase heart rate, allowing the determination of individual STI v HR regression equations. On the other days STI were recorded with the subjects resting, in the supine position. 2. There were highly significant regression relationships between heart rate and both LVET and QS2, but not between heart rate and PEP. 3. The regression relationships showed little intra-subject variability, but a large degree of inter-subject variability: they proved adequate to correct the STI for the daily fluctuations in heart rate. 4. Administration of small doses of atropine intravenously provides a satisfactory and convenient method of deriving individual STI v HR regression equations which can be applied over a period of weeks.

CERN@school: demonstrating physics with the Timepix detector

NASA Astrophysics Data System (ADS)

Whyntie, T.; Bithray, H.; Cook, J.; Coupe, A.; Eddy, D.; Fickling, R. L.; McKenna, J.; Parker, B.; Paul, A.; Shearer, N.

2015-10-01

This article shows how the Timepix hybrid silicon pixel detector, developed by the Medipix2 Collaboration, can be used by students and teachers alike to demonstrate some key aspects of any well-rounded physics curriculum with CERN@school. After an overview of the programme, the detector's capabilities for measuring and visualising ionising radiation are examined. The classification of clusters - groups of adjacent pixels - is discussed with respect to identifying the different types of particles. Three demonstration experiments - background radiation measurements, radiation profiles and the attenuation of radiation - are described; these can used as part of lessons or as inspiration for independent research projects. Results for exemplar data-sets are presented for reference, as well as details of ongoing research projects inspired by these experiments. Interested readers are encouraged to join the CERN@school Collaboration and so contribute to achieving the programme's aim of inspiring the next generation of scientists and engineers.

Improving Patient Outcomes With Oral Heart Failure Medications.

PubMed

Sherrod, Melissa M; Cheek, Dennis J; Seale, Ashlie

2016-05-01

Hospitals are under immense pressure to reduce heart failure readmissions that occur within 30 days of discharge, and to improve the quality of care for these patients. Penalties mandated by the Affordable Care Act decrease hospital reimbursement and ultimately the overall cost of caring for these patients increases if they are not well managed. Approximately 25% of patients hospitalized for heart failure are at high risk for readmission and these rates have not changed over the past decade. As a result of an aging population, the incidence of heart failure is expected to increase to one in five Americans over the age of 65. Pharmacologic management can reduce the risk of death and help prevent unnecessary hospitalizations. Healthcare providers who have knowledge of heart failure medications and drug interactions and share this information with their patients contribute to improved long-term survival and physical functioning as well as fewer hospitalizations and a delay of progressive worsening of heart failure.

Transient and persistent worsening renal function during hospitalization for acute heart failure.

PubMed

Krishnamoorthy, Arun; Greiner, Melissa A; Sharma, Puza P; DeVore, Adam D; Johnson, Katherine Waltman; Fonarow, Gregg C; Curtis, Lesley H; Hernandez, Adrian F

2014-12-01

Transient and persistent worsening renal function (WRF) may be associated with different risks during hospitalization for acute heart failure. We compared outcomes of patients hospitalized for acute heart failure with transient, persistent, or no WRF. We identified patients 65 years or older hospitalized with acute heart failure from a clinical registry linked to Medicare claims data. We defined WRF as an increase in serum creatinine of ≥ 0.3 mg/dL after admission. We further classified patients with WRF by the difference between admission and last recorded serum creatinine levels into transient WRF (< 0.3 mg/dL) or persistent WRF (≥ 0.3 mg/dL). We examined unadjusted rates and adjusted associations between 90-day outcomes and WRF status. Among 27,309 patients, 18,568 (68.0%) had no WRF, 3,205 (11.7%) had transient WRF, and 5,536 (20.3%) had persistent WRF. Patients with WRF had higher observed rates of 90-day postdischarge all-cause readmission and 90-day postadmission mortality (P < .001). After multivariable adjustment, transient WRF (hazard ratio [HR] 1.19, 99% CI 1.05-1.35) and persistent WRF (HR 1.73, 99% CI 1.57-1.91) were associated with higher risks of 90-day postadmission mortality (P < .001 for both). Compared with transient WRF, persistent WRF was associated with a higher risk of 90-day postadmission mortality (HR 1.46, 99% CI 1.28-1.66, P < .001). Transient and persistent WRF during hospitalization for acute heart failure were associated with higher adjusted risks for 90-day all-cause postadmission mortality. Patients with persistent WRF had worse outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

Brain-heart connection and the risk of heart attack.

PubMed

Singh, R B; Kartik, C; Otsuka, K; Pella, D; Pella, J

2002-01-01

Autonomic functions, such as increased sympathetic and parasympathetic activity and the brain's suprachiasmatic nucleus, higher nervous centres, depression, hostility and aggression appear to be important determinants of heart rate variability (HRV), which is, itself, an important risk factor of myocardial infarction, arrhythmias, sudden death, heart failure and atherosclerosis. The circadian rhythm of these complications with an increased occurrence in the second quarter of the day may be due to autonomic dysfunction as well as to the presence of excitatory brain and heart tissues. While increased sympathetic activity is associated with increased levels of cortisol, catecholamines, serotonin, renin, aldosterone, angiotensin and free radicals; increased parasympathetic activity may be associated with greater levels of acetylecholine, dopamine, nitric oxide, endorphins, coenzyme Q10, antioxidants and other protective factors. Recent studies indicate that hyperglycemia, diabetes, hyperlipidemia, ambient pollution, insulin resistance and mental stress can increase the risk of low HRV. These risk factors, which are known to favour cardiovascular disease, seem to act by decreasing HRV. There is evidence that regular fasting may modulate HRV and other risk factors of heart attack. While exercise is known to decrease HRV, exercise training may not have any adverse effect on HRV. In a recent study among 202 patients with acute myocardial infarction (AMI), the incidence of onset of chest pain was highest in the second quarter of the day (41.0%), mainly between 4.0-8.0 AM, followed by the fourth quarter, usually after large meals (28.2%). Emotion was the second most common trigger (43.5%). Cold weather was a predisposing factor in 29.2% and hot temperature (> 40 degrees celsius) was common in 24.7% of the patients. Dietary n-3 fatty acids and coenzyme Q10 have been found to prevent the increased circadian occurrence of cardiac events in our randomized controlled trials

Usefulness of combining admission brain natriuretic peptide (BNP) plus hospital discharge bioelectrical impedance vector analysis (BIVA) in predicting 90 days cardiovascular mortality in patients with acute heart failure.

PubMed

Santarelli, Simona; Russo, Veronica; Lalle, Irene; De Berardinis, Benedetta; Navarin, Silvia; Magrini, Laura; Piccoli, Antonio; Codognotto, Marta; Castello, Luigi Maria; Avanzi, Gian Carlo; Villacorta, Humberto; Precht, Bernardo Luiz Campanário; de Araújo Porto, Pilar Barreto; Villacorta, Aline Sterque; Di Somma, Salvatore

2017-06-01

Heart failure is a disease characterized by high prevalence and mortality, and frequent rehospitalizations. The aim of this study is to investigate the prognostic power of combining brain natriuretic peptide (BNP) and congestion status detected by bioelectrical impedance vector analysis (BIVA) in acute heart failure patients. This is an observational, prospective, and a multicentre study. BNP assessment was measured upon hospital arrival, while BIVA analysis was obtained at the time of discharge. Cardiovascular deaths were evaluated at 90 days by a follow up phone call. 292 patients were enrolled. Compared to survivors, BNP was higher in the non-survivors group (mean value 838 vs 515 pg/ml, p < 0.001). At discharge, BIVA shows a statistically significant difference in hydration status between survivors and non-survivors [respectively, hydration index (HI) 85 vs 74, p < 0.001; reactance (Xc) 26.7 vs 37, p < 0.001; resistance (R) 445 vs 503, p < 0.01)]. Discharge BIVA shows a prognostic value in predicting cardiovascular death [HI: area under the curve (AUC) 0.715, 95% confidence interval (95% CI) 0.65-0.76; p < 0.004; Xc: AUC 0.712, 95% CI 0.655-0.76, p < 0.007; R: AUC 0.65, 95% CI 0.29-0.706, p < 0.0247]. The combination of BIVA with BNP gives a greater prognostic power for cardiovascular mortality [combined receiving operating characteristic (ROC): AUC 0.74; 95% CI 0.68-0.79; p < 0.001]. In acute heart failure patients, higher BNP levels upon hospital admission, and congestion detected by BIVA at discharge have a significant predictive value for 90 days cardiovascular mortality. The combined use of admission BNP and BIVA discharge seems to be a useful tool for increasing prognostic power in these patients.

Perinatal sulfur dioxide exposure alters brainstem parasympathetic control of heart rate.

PubMed

Woerman, Amanda L; Mendelowitz, David

2013-07-01

Sulfur dioxide (SO₂) is an air pollutant that impedes neonatal development and induces adverse cardiorespiratory health effects, including tachycardia. Here, an animal model was developed that enabled characterization of (i) in vivo alterations in heart rate and (ii) altered activity in brainstem neurons that control heart rate after perinatal SO₂ exposure. Pregnant Sprague-Dawley dams and their pups were exposed to 5 parts per million SO₂ for 1 h daily throughout gestation and 6 days postnatal. Electrocardiograms were recorded from pups at 5 days postnatal to examine changes in basal and diving reflex-evoked changes in heart rate following perinatal SO₂ exposure. In vitro studies employed whole-cell patch-clamp electrophysiology to examine changes in neurotransmission to cardiac vagal neurons within the nucleus ambiguus upon SO₂ exposure using a preparation that maintains fictive inspiratory activity recorded from the hypoglossal rootlet. Perinatal SO₂ exposure increased heart rate and blunted the parasympathetic-mediated diving reflex-evoked changes in heart rate. Neither spontaneous nor inspiratory-related inhibitory GABAergic or glycinergic neurotransmission to cardiac vagal neurons was altered by SO₂ exposure. However, excitatory glutamatergic neurotransmission was decreased by 51.2% upon SO₂ exposure. This diminished excitatory neurotransmission was tetrodotoxin-sensitive, indicating SO₂ exposure impaired the activity of preceding glutamatergic neurons that synapse upon cardiac vagal neurons. Diminished glutamatergic, but unaltered inhibitory neurotransmission to cardiac vagal neurons provides a mechanism for the observed SO₂-induced elevated heart rate via an impairment of brainstem cardioinhibitory parasympathetic activity to the heart.

Heart rate, body temperature and physical activity are variously affected during insulin treatment in alloxan-induced type 1 diabetic rat.

PubMed

Howarth, F C; Jacobson, M; Shafiullah, M; Ljubisavljevic, M; Adeghate, E

2011-01-01

Diabetes mellitus is associated with a variety of cardiovascular complications including impaired cardiac muscle function. The effects of insulin treatment on heart rate, body temperature and physical activity in the alloxan (ALX)-induced diabetic rat were investigated using in vivo biotelemetry techniques. The electrocardiogram, physical activity and body temperature were recorded in vivo with a biotelemetry system for 10 days before ALX treatment, for 20 days following administration of ALX (120 mg/kg) and thereafter, for 15 days whilst rats received daily insulin. Heart rate declined rapidly after administration of ALX. Pre-ALX heart rate was 321+/-9 beats per minute, falling to 285+/-12 beats per minute 15-20 days after ALX and recovering to 331+/-10 beats per minute 5-10 days after commencement of insulin. Heart rate variability declined and PQ, QRS and QT intervals were prolonged after administration of ALX. Physical activity and body temperature declined after administration of ALX. Pre-ALX body temperature was 37.6+/-0.1 °C, falling to 37.3+/-0.1 °C 15-20 days after ALX and recovering to 37.8+/-0.1 °C 5-10 days after commencement insulin. ALX-induced diabetes is associated with disturbances in heart rhythm, physical activity and body temperature that are variously affected during insulin treatment.

Validation of Donor-Specific Tolerance of Intestinal Transplant by a Secondary Heart Transplantation Model.

PubMed

Pengcheng, Wang; Xiaosong, Li; Xiaofeng, Li; Zhongzhi, Li

2017-02-01

It is well accepted that survival after a second organ transplant without immunosuppressive agents indicates tolerance for the first transplant. To validate donor-specific tolerance, we established a rat model with a secondary heart transplant after intestinal transplant, which has so far not been described in the literature. We transplanted intestine from Fischer F344 rats to Lewis rats orthotopically. Lewis rats received tacrolimus pretreatment before transplant and a 14-day course of rapamycin 1 month after transplant. At 120 days after primary intestinal transplant, hearts from 6 F344 rats (group A) or 6 Brown Norway rats (group B) were transplanted to Lewis rats that had survived intestinal transplant and without additional immunosuppressive agents. We analyzed survival data, histologic changes, cells positive for the ED1 macrophage marker in transplanted hearts, and 3 lymphocyte levels in both groups. Thirty days after secondary heart transplant, group A hearts were continuously beating; however, group B hearts stopped beating at around 10 days after transplant (8.5 ± 1.5 d; P < .05). Our histologic study showed that both groups had muscle damage and cellular infiltration in hearts that were distinctly different from normal hearts, with ED1-positive cells counted in both groups (85 ± 16 in group A, 116 ± 28 in group B; P > .05). Fluorescence-activated cell sorting showed that CD4/CD25-positive regulatory T cell, CTLA4/CD4/CD25-positive regulatory T cell, and Natural killer T-cell levels were significantly higher level in group A versus B (P < .05). The donor-specific tolerance that we observed was possibly a state of "clinical tolerance" rather than "immunologic tolerance." Our rat model is a feasible and reliable model to study donor-specific tolerance. The higher levels of lymphocytic T cells shown in intestinal transplant recipients were associated with longer allograft survival, possibly contributing to donor-specific tolerance.

A holistic approach to managing a patient with heart failure.

PubMed

Duncan, Alison; Cunnington, Colin

2013-03-01

Despite varied and complex therapeutic strategies for managing patients with heart failure, the prognosis may remain poor in certain groups. Recognition that patients with heart failure frequently require input from many care groups formed the basis of The British Society of Heart Failure Annual Autumn Meeting in London (UK), in November 2012, entitled: 'Heart failure: a multidisciplinary approach'. Experts in cardiology, cardiac surgery, general practice, care of the elderly, palliative care and cardiac imaging shared their knowledge and expertise. The 2-day symposium was attended by over 500 participants from the UK, Europe and North America, and hosted physicians, nurses, scientists, trainees and representatives from the industry, as well as patient and community groups. The symposium, accredited by the Royal College of Physicians and the Royal College of Nursing, focused on the multidisciplinary approach to heart failure, in particular, current therapeutic advances, cardiac remodeling, palliative care, atrial fibrillation, heart rate-lowering therapies, management of acute heart failure and the management of patients with mitral regurgitation and heart failure.

Changes in heart rate variability during the induction and decay of heat acclimation.

PubMed

Flouris, Andreas D; Poirier, Martin P; Bravi, Andrea; Wright-Beatty, Heather E; Herry, Christophe; Seely, Andrew J; Kenny, Glen P

2014-10-01

We evaluated the changes in core temperature, heart rate, and heart rate variability (HRV) during the induction and decay of heat acclimation. Ten males (23 ± 3 years; 79.5 ± 3.5 kg; 15.2 ± 4.5 percent body fat; 51.13 ± 4.61 mLO(2)∙kg(-1)∙min(-1) peak oxygen uptake) underwent a 14-day heat acclimation protocol comprising of 90-min cycling at ~50 % peak oxygen uptake at 40 °C and ~20 % relative humidity. Core temperature, heart rate, and 102 HRV measures were recorded during a heat tolerance test conducted at baseline (day 0) and at the end of the induction (day 14) and decay (day 28) phases. Heat acclimation resulted in significantly reduced core temperature [rectal (χ (2) = 1298.14, p < 0.001); esophageal (χ (2) = 1069.88, p < 0.001)] and heart rate (χ (2) = 1230.17, p < 0.001). Following the decay phase, 26, 40, and 60 % of the heat acclimation-induced reductions in rectal temperature, esophageal temperature, and heart rate, respectively, were lost. Heat acclimation was accompanied by profound and broad changes in HRV: at the end of the induction phase, 75 of the 102 variability measures computed were significantly different (p < 0.001), compared to only 47 of the 102 at the end of the decay phase. Heat acclimation is accompanied by reduced core temperature, significant bradycardia, and marked alterations in HRV, which we interpret as being related to vagal dominance. The observed changes in core temperature persist for at least 2 weeks of non-exposure to heat, while the changes in heart rate and HRV decay faster and are only partly evident after 2 weeks of non-exposure to heat.

The influence of betamethasone on fetal heart rate variability, obtained by non-invasive fetal electrocardiogram recordings.

PubMed

Verdurmen, Kim M J; Warmerdam, Guy J J; Lempersz, Carlijn; Hulsenboom, Alexandra D J; Renckens, Joris; Dieleman, Jeanne P; Vullings, Rik; van Laar, Judith O E H; Oei, S Guid

2018-04-01

Betamethasone is widely used to enhance fetal lung maturation in case of threatened preterm labour. Fetal heart rate variability is one of the most important parameters to assess in fetal monitoring, since it is a reliable indicator for fetal distress. To describe the effect of betamethasone on fetal heart rate variability, by applying spectral analysis on non-invasive fetal electrocardiogram recordings. Prospective cohort study. Patients that require betamethasone, with a gestational age from 24 weeks onwards. Fetal heart rate variability parameters on day 1, 2, and 3 after betamethasone administration are compared to a reference measurement. Following 68 inclusions, 12 patients remained with complete series of measurements and sufficient data quality. During day 1, an increase in absolute fetal heart rate variability values was seen. During day 2, a decrease in these values was seen. All trends indicate to return to pre-medication values on day 3. Normalised high- and low-frequency power show little changes during the study period. The changes in fetal heart rate variability following betamethasone administration show the same pattern when calculated by spectral analysis of the fetal electrocardiogram, as when calculated by cardiotocography. Since normalised spectral values show little changes, the influence of autonomic modulation seems minor. Copyright © 2018 Elsevier B.V. All rights reserved.

Ceremony 25th birthday Cern

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

None

2006-05-08

Célébration du 25ème anniversaire du Cern (jour par jour) avec discours de L.Van Hove et J.B.Adams, des interludes musicals offerts par Mme Mey et ses collègues (au debut 1.mouvement du quatuor avec piano no 3 de L.van Beethoven) Les directeurs généraux procéderont à la remise du souvenir aux membres de personnel ayant 25 années de service dans l'organisation. Un témoignage de reconnaissance est auss fait à l'interprète Mme Zwerner

Development and Validation of an Agency for Healthcare Research and Quality Indicator for Mortality After Congenital Heart Surgery Harmonized With Risk Adjustment for Congenital Heart Surgery (RACHS-1) Methodology.

PubMed

Jenkins, Kathy J; Koch Kupiec, Jennifer; Owens, Pamela L; Romano, Patrick S; Geppert, Jeffrey J; Gauvreau, Kimberlee

2016-05-20

The National Quality Forum previously approved a quality indicator for mortality after congenital heart surgery developed by the Agency for Healthcare Research and Quality (AHRQ). Several parameters of the validated Risk Adjustment for Congenital Heart Surgery (RACHS-1) method were included, but others differed. As part of the National Quality Forum endorsement maintenance process, developers were asked to harmonize the 2 methodologies. Parameters that were identical between the 2 methods were retained. AHRQ's Healthcare Cost and Utilization Project State Inpatient Databases (SID) 2008 were used to select optimal parameters where differences existed, with a goal to maximize model performance and face validity. Inclusion criteria were not changed and included all discharges for patients <18 years with International Classification of Diseases, Ninth Revision, Clinical Modification procedure codes for congenital heart surgery or nonspecific heart surgery combined with congenital heart disease diagnosis codes. The final model includes procedure risk group, age (0-28 days, 29-90 days, 91-364 days, 1-17 years), low birth weight (500-2499 g), other congenital anomalies (Clinical Classifications Software 217, except for 758.xx), multiple procedures, and transfer-in status. Among 17 945 eligible cases in the SID 2008, the c statistic for model performance was 0.82. In the SID 2013 validation data set, the c statistic was 0.82. Risk-adjusted mortality rates by center ranged from 0.9% to 4.1% (5th-95th percentile). Congenital heart surgery programs can now obtain national benchmarking reports by applying AHRQ Quality Indicator software to hospital administrative data, based on the harmonized RACHS-1 method, with high discrimination and face validity. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

[Heart functions in monkeys during a 2-week antiorthostatic hypokinesia

NASA Technical Reports Server (NTRS)

Krotov, V. P.; Convertino, V.; Korol'kov, V. I.; Latham, R.; Trambovetskii, E. V.; Fanton, J.; Crisman, R.; Truzhennikov, A. N.; Evert, D.; Nosovskii, A. M.;

Health status of Seventh-Day Adventists.

PubMed

Webster, I W; Rawson, G K

1979-05-19

A comparison of health status between 779 Seventh-day Adventists, who have a strong commitment to heal-related life styles, and two other groups of people--8363 persons referred by general practitioners and 9825 volunteers--was made. The Seventh-day Adventists showed less impairment of systolic and diastolic blood pressures, of plasma cholesterol and plasma urate concentrations, and of lung ventilatory capacity; and less obesity at most specific ages. With increasing age, the level of breathlessness, reported heart disease, hypertension, and hypertensive and diuretic therapy in this sample approached that of the comparative groups, possibly because of natural attrition of high-risk persons in the latter. Depression, sleeplessness, use of sedatives and tranquillizers were lower in the Seventh-day Adventists; although, once again, a drawing together of the three groups in older age categories was evident. It is concluded that the life style of Seventh-day Adventists is conducive to lessened morbidity, delayed mortality, and decreased call on health services in comparison with the general population.

Effectiveness of Remote Patient Monitoring After Discharge of Hospitalized Patients With Heart Failure: The Better Effectiveness After Transition -- Heart Failure (BEAT-HF) Randomized Clinical Trial.

PubMed

Ong, Michael K; Romano, Patrick S; Edgington, Sarah; Aronow, Harriet U; Auerbach, Andrew D; Black, Jeanne T; De Marco, Teresa; Escarce, Jose J; Evangelista, Lorraine S; Hanna, Barbara; Ganiats, Theodore G; Greenberg, Barry H; Greenfield, Sheldon; Kaplan, Sherrie H; Kimchi, Asher; Liu, Honghu; Lombardo, Dawn; Mangione, Carol M; Sadeghi, Bahman; Sadeghi, Banafsheh; Sarrafzadeh, Majid; Tong, Kathleen; Fonarow, Gregg C

2016-03-01

It remains unclear whether telemonitoring approaches provide benefits for patients with heart failure (HF) after hospitalization. To evaluate the effectiveness of a care transition intervention using remote patient monitoring in reducing 180-day all-cause readmissions among a broad population of older adults hospitalized with HF. We randomized 1437 patients hospitalized for HF between October 12, 2011, and September 30, 2013, to the intervention arm (715 patients) or to the usual care arm (722 patients) of the Better Effectiveness After Transition-Heart Failure (BEAT-HF) study and observed them for 180 days. The dates of our study analysis were March 30, 2014, to October 1, 2015. The setting was 6 academic medical centers in California. Participants were hospitalized individuals 50 years or older who received active treatment for decompensated HF. The intervention combined health coaching telephone calls and telemonitoring. Telemonitoring used electronic equipment that collected daily information about blood pressure, heart rate, symptoms, and weight. Centralized registered nurses conducted telemonitoring reviews, protocolized actions, and telephone calls. The primary outcome was readmission for any cause within 180 days after discharge. Secondary outcomes were all-cause readmission within 30 days, all-cause mortality at 30 and 180 days, and quality of life at 30 and 180 days. Among 1437 participants, the median age was 73 years. Overall, 46.2% (664 of 1437) were female, and 22.0% (316 of 1437) were African American. The intervention and usual care groups did not differ significantly in readmissions for any cause 180 days after discharge, which occurred in 50.8% (363 of 715) and 49.2% (355 of 722) of patients, respectively (adjusted hazard ratio, 1.03; 95% CI, 0.88-1.20; P = .74). In secondary analyses, there were no significant differences in 30-day readmission or 180-day mortality, but there was a significant difference in 180-day quality of life between the

Heart transplantation in the setting of complex congenital heart disease and physiologic single lung.

PubMed

Zuckerman, Warren A; Richmond, Marc E; Lee, Teresa M; Bacha, Emile A; Chai, Paul J; Chen, Jonathan M; Addonizio, Linda J

2015-12-01

To highlight the success of heart transplantation in patients with complex congenital heart disease and physiologic single lung by providing an update on the world's largest reported cohort. Demographic, perioperative, postoperative, and outcomes data were collected retrospectively on all patients undergoing heart transplant to single lung at Columbia University Medical Center since 1992, and compared with all other patients undergoing transplants performed for single ventricle or tetralogy of Fallot during that time. Twenty-two patients (mean age, 20.6 years; range, 5 months-47 years) underwent heart transplant to single lung. Compared with controls (n = 67), the single lung group had more male patients and a greater proportion of tetralogy compared with single ventricle patients, although the single lung group had fewer post-Fontan patients. Age, weight, and body surface area were similar between the groups as were use of mechanical circulatory support and mechanical ventilation before transplant. Median time to extubation, time on inotropes, and length of stay were similar. There were 3 perioperative deaths, including a patient who died during postoperative day 1 from primary graft failure, likely related to a combination of elevated pulmonary vascular resistance and volume load. There were 5 additional mortalities during intermediate- and long-term follow-up, none of which were related to single-lung physiology. There was no significant survival difference between the groups. In patients with complex congenital heart disease and single lung physiology, heart transplant alone remains an excellent option, with comparable outcomes to patients undergoing transplant with similar cardiac anatomy and dual lung physiology. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Keeping a Beat on the Heart

NASA Technical Reports Server (NTRS)

Liszka, Kathy J.; Mackin, Michael A.; Liehter, Michael J.; York, David W.; Pillai, Dilip; Rosenbaum, David S.

2005-01-01

Feel the relief of a patient suffering from heart arrhythmia, who is able to return home while having her heart monitored by health professionals 24 hours a day, without the fear that she will miss an important indicator and suffer a fatal heart attack - using technology originally developed to conduct experiments on the Space Shuttle. Approximately 400,000 Americans die every year from sudden heart attacks . Medical research revealed that patterns of electrical activity in the heart can act as predictors of these lethal cardiac events known as arrhythmias. Fortunately, certain arrhythmias such as ventricular fibrillation (loss of regular heartbeat and subsequent loss of function) and ventricular tachycardia (rapid heartbeats), can be detected and appropriately treated. Today, patients at moderate risk of arrhythmias can benefit from technology that would permit long- term continuous monitoring of electrical cardiac rhythms outside the hospital environment in the comfort of their own homes. Medical telemetry systems, also known as telemedicine, are evolving rapidly as wireless communication technology advances, evidenced by the commercial products and research prototypes for remote health monitoring that have appeared in recent years. Wireless systems allow patients to move freely in their home and work environment while being monitored remotely by health care professionals.

Effects of changes in vertical occlusal dimension on heart rate fluctuations in guinea pigs.

PubMed

Taga, Hitoshi; Azuma, Yukio; Maehara, Kiyoshi; Nomura, Shuichi

2012-01-01

We have previously reported that the decrease of the vertical occlusal dimension (VOD) led to heart failure and abnormalities in creatine phosphokinase (CPK) in guinea pigs. In the present study, we investigated the autonomic activity and the origin of the abnormality in CPK under different occlusal conditions. Guinea pigs were separated into the following five groups: untreated control, reduced VOD, slit, restored VOD and increased VOD groups and compared for their electrocardiogram and heart rate fluctuations for two weeks using Fluclet, computer software. The control group revealed no changes in heart rate fluctuations or posture. The reduced VOD group exhibited a two-phase wave of heart rate fluctuations, with the first peak 0-2 days after teeth grinding, and the second peak starting from 4 days after teeth grinding until sudden death (usually 12th day), accompanied by head drop. The slit and the restored VOD groups exhibited only the first peak. The increased VOD group, with approximately 3 mm-thick acrylic pellets bonded to the posterior teeth, showed no heart rate fluctuations. Body weight loss was most prominent in the reduced VOD group, and became much milder in the order of increased VOD, restored and slit groups. The reduced VOD group exhibited transient elevation of skeletal muscle type of CPK isozyme activity within two days after treatment. The present study suggests that the first peak of heart rate fluctuations is caused by pulpal stimulation, and the second peak by excessive contraction (excessive excitation of the motor output system and the autonomic nervous system) of the masticatory muscles. On the other hand, increased VOD did not influence either the motor or the autonomic nervous system.

A remote monitoring and telephone nurse coaching intervention to reduce readmissions among patients with heart failure: study protocol for the Better Effectiveness After Transition - Heart Failure (BEAT-HF) randomized controlled trial.

PubMed

Black, Jeanne T; Romano, Patrick S; Sadeghi, Banafsheh; Auerbach, Andrew D; Ganiats, Theodore G; Greenfield, Sheldon; Kaplan, Sherrie H; Ong, Michael K

2014-04-13

Heart failure is a prevalent health problem associated with costly hospital readmissions. Transitional care programs have been shown to reduce readmissions but are costly to implement. Evidence regarding the effectiveness of telemonitoring in managing the care of this chronic condition is mixed. The objective of this randomized controlled comparative effectiveness study is to evaluate the effectiveness of a care transition intervention that includes pre-discharge education about heart failure and post-discharge telephone nurse coaching combined with home telemonitoring of weight, blood pressure, heart rate, and symptoms in reducing all-cause 180-day hospital readmissions for older adults hospitalized with heart failure. A multi-center, randomized controlled trial is being conducted at six academic health systems in California. A total of 1,500 patients aged 50 years and older will be enrolled during a hospitalization for treatment of heart failure. Patients in the intervention group will receive intensive patient education using the 'teach-back' method and receive instruction in using the telemonitoring equipment. Following hospital discharge, they will receive a series of nine scheduled health coaching telephone calls over 6 months from nurses located in a centralized call center. The nurses also will call patients and patients' physicians in response to alerts generated by the telemonitoring system, based on predetermined parameters. The primary outcome is readmission for any cause within 180 days. Secondary outcomes include 30-day readmission, mortality, hospital days, emergency department (ED) visits, hospital cost, and health-related quality of life. BEAT-HF is one of the largest randomized controlled trials of telemonitoring in patients with heart failure, and the first explicitly to adapt the care transition approach and combine it with remote telemonitoring. The study population also includes patients with a wide range of demographic and socioeconomic

A possible biomedical facility at the European Organization for Nuclear Research (CERN).

PubMed

Dosanjh, M; Jones, B; Myers, S

2013-05-01

A well-attended meeting, called "Brainstorming discussion for a possible biomedical facility at CERN", was held by the European Organization for Nuclear Research (CERN) at the European Laboratory for Particle Physics on 25 June 2012. This was concerned with adapting an existing, but little used, 78-m circumference CERN synchrotron to deliver a wide range of ion species, preferably from protons to at least neon ions, with beam specifications that match existing clinical facilities. The potential extensive research portfolio discussed included beam ballistics in humanoid phantoms, advanced dosimetry, remote imaging techniques and technical developments in beam delivery, including gantry design. In addition, a modern laboratory for biomedical characterisation of these beams would allow important radiobiological studies, such as relative biological effectiveness, in a dedicated facility with standardisation of experimental conditions and biological end points. A control photon and electron beam would be required nearby for relative biological effectiveness comparisons. Research beam time availability would far exceed that at other facilities throughout the world. This would allow more rapid progress in several biomedical areas, such as in charged hadron therapy of cancer, radioisotope production and radioprotection. The ethos of CERN, in terms of open access, peer-reviewed projects and governance has been so successful for High Energy Physics that application of the same to biomedicine would attract high-quality research, with possible contributions from Europe and beyond, along with potential new funding streams.

Subacute pyridostigmine exposure increases heart rate recovery and cardiac parasympathetic tone in rats.

PubMed

Bharadwaj, Manushree; Pope, Carey; Davis, Michael; Katz, Stuart; Cook, Christian; Maxwell, Lara

2017-08-01

Heart rate recovery (HRR) describes the rapid deceleration of heart rate after strenuous exercise and is an indicator of parasympathetic tone. A reduction in parasympathetic tone occurs in patients with congestive heart failure, resulting in prolonged HRR. Acetylcholinesterase inhibitors, such as pyridostigmine, can enhance parasympathetic tone by increasing cholinergic input to the heart. The objective of this study was to develop a rodent model of HRR to test the hypothesis that subacute pyridostigmine administration decreases cholinesterase activity and accelerates HRR in rats. Ten days after implantation of radiotelemetry transmitters, male Sprague Dawley rats were randomized to control (CTL) or treated (PYR; 0.14 mg/mL pyridostigmine in the drinking water, 29 days) groups. Rats were exercised on a treadmill to record HRR, and blood samples were collected on days 0, 7, 14, and 28 of pyridostigmine administration. Total cholinesterase and acetylcholinesterase (AChE) activity in plasma was decreased by 32%-43% and 57%-80%, respectively, in PYR rats on days 7-28, while plasma butyrylcholinesterase activity did not significantly change. AChE activity in red blood cells was markedly reduced by 64%-66%. HRR recorded 1 minute after exercise was higher in the PYR group on days 7, 14 and 28, and on day 7 when HRR was estimated at 3 and 5 minutes. Autonomic tone was evaluated pharmacologically using sequential administration of muscarinic (atropine) and adrenergic (propranolol) blockers. Parasympathetic tone was increased in PYR rats as compared with the CTL group. These data support the study hypothesis that subacute pyridostigmine administration enhances HRR by increasing cardiac parasympathetic tone. © 2017 John Wiley & Sons Australia, Ltd.

Combining training in knowledge translation with quality improvement reduced 30-day heart failure readmissions in a community hospital: a case study.

PubMed

Wyer, Peter; Stojanovic, Zorica; Shaffer, Jonathan A; Placencia, Mitzy; Klink, Kathleen; Fosina, Michael J; Lin, Susan X; Barron, Beth; Graham, Ian D

2016-04-01

Training programmes in evidence-based practice (EBP) frequently fail to translate their content into practice change and care improvement. We linked multidisciplinary training in EBP to an initiative to decrease 30-day readmissions among patients admitted to a community teaching hospital for heart failure (HF). Hospital staff reflecting all services and disciplines relevant to care of patients with HF attended a 3-day innovative capacity building conference in evidence-based health care over a 3-year period beginning in 2009. The team, facilitated by a conference faculty member, applied a knowledge-to-action model taught at the conference. We reviewed published research, profiled our population and practice experience, developed a three-phase protocol and implemented it in late 2010. We tracked readmission rates, adverse clinical outcomes and programme cost. The protocol emphasized patient education, medication reconciliation and transition to community-based care. Senior administration approved a full-time nurse HF coordinator. Thirty-day HF readmissions decreased from 23.1% to 16.4% (adjusted OR = 0.64, 95% CI = 0.42-0.97) during the year following implementation. Corresponding rates in another hospital serving the same population but not part of the programme were 22.3% and 20.2% (adjusted OR = 0.87, 95% CI = 0.71-1.08). Adherence to mandated HF quality measures improved. Following a start-up cost of $15 000 US, programme expenses balanced potential savings from decreased HF readmissions. Training of a multidisciplinary hospital team in use of a knowledge translation model, combined with ongoing facilitation, led to implementation of a budget neutral programme that decreased HF readmissions. © 2015 John Wiley & Sons, Ltd.

Development of the cryogenic system of AEgIS at CERN

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

Derking, J. H.; Bremer, J.; Burghart, G.

2014-01-29

The AEgIS (Antimatter Experiment: Gravity, Interferometry, Spectroscopy) experiment is located at the antiproton decelerator complex of CERN. The main goal of the experiment is to perform the first direct measurement of the Earth’s gravitational acceleration on antihydrogen atoms within 1% precision. The antihydrogen is produced in a cylindrical Penning trap by combining antiprotons with positrons. To reach the precision of 1%, the antihydrogen has to be cooled to 100 mK to reduce its random velocity. A dilution refrigerator is selected to deliver the necessary cooling capacity of 100 μW at 50 mK. The AEgIS cryogenic system basically consists of cryostatsmore » for a 1-T and for a 5-T superconducting magnet, a central region cryostat, a dilution refrigerator cryostat and a measurement cryostat with a Moiré deflectometer to measure the gravitational acceleration. In autumn 2012, the 1-T cryostat, 5-T cryostat and central region cryostat were assembled and commissioned. The apparatus is cooled down in eight days using 2500 L of liquid helium and liquid nitrogen. During operation, the average consumption of liquid helium is 150 L⋅day{sup −1} and of liquid nitrogen 5 L⋅day{sup −1}. The temperature sensors at the Penning traps measured 12 K to 18 K, which is higher than expected. Simulations show that this is caused by a bad thermalization of the trap wiring. The implementation of the sub-kelvin region is foreseen for mid-2015. The antihydrogen will be cooled down to 100 mK in an ultra-cold trap consisting of multiple high-voltage electrodes made of sapphire with gold plated electrode sectors.« less

Development of the cryogenic system of AEgIS at CERN

NASA Astrophysics Data System (ADS)

Derking, J. H.; Bremer, J.; Burghart, G.; Doser, M.; Dudarev, A.; Haider, S.

2014-01-01

The AEgIS (Antimatter Experiment: Gravity, Interferometry, Spectroscopy) experiment is located at the antiproton decelerator complex of CERN. The main goal of the experiment is to perform the first direct measurement of the Earth's gravitational acceleration on antihydrogen atoms within 1% precision. The antihydrogen is produced in a cylindrical Penning trap by combining antiprotons with positrons. To reach the precision of 1%, the antihydrogen has to be cooled to 100 mK to reduce its random velocity. A dilution refrigerator is selected to deliver the necessary cooling capacity of 100 μW at 50 mK. The AEgIS cryogenic system basically consists of cryostats for a 1-T and for a 5-T superconducting magnet, a central region cryostat, a dilution refrigerator cryostat and a measurement cryostat with a Moiré deflectometer to measure the gravitational acceleration. In autumn 2012, the 1-T cryostat, 5-T cryostat and central region cryostat were assembled and commissioned. The apparatus is cooled down in eight days using 2500 L of liquid helium and liquid nitrogen. During operation, the average consumption of liquid helium is 150 Lṡday-1 and of liquid nitrogen 5 Lṡday-1. The temperature sensors at the Penning traps measured 12 K to 18 K, which is higher than expected. Simulations show that this is caused by a bad thermalization of the trap wiring. The implementation of the sub-kelvin region is foreseen for mid-2015. The antihydrogen will be cooled down to 100 mK in an ultra-cold trap consisting of multiple high-voltage electrodes made of sapphire with gold plated electrode sectors.

Perinatal sulfur dioxide exposure alters brainstem parasympathetic control of heart rate

PubMed Central

Woerman, Amanda L.; Mendelowitz, David

2013-01-01

Aims Sulfur dioxide (SO2) is an air pollutant that impedes neonatal development and induces adverse cardiorespiratory health effects, including tachycardia. Here, an animal model was developed that enabled characterization of (i) in vivo alterations in heart rate and (ii) altered activity in brainstem neurons that control heart rate after perinatal SO2 exposure. Methods and results Pregnant Sprague–Dawley dams and their pups were exposed to 5 parts per million SO2 for 1 h daily throughout gestation and 6 days postnatal. Electrocardiograms were recorded from pups at 5 days postnatal to examine changes in basal and diving reflex-evoked changes in heart rate following perinatal SO2 exposure. In vitro studies employed whole-cell patch-clamp electrophysiology to examine changes in neurotransmission to cardiac vagal neurons within the nucleus ambiguus upon SO2 exposure using a preparation that maintains fictive inspiratory activity recorded from the hypoglossal rootlet. Perinatal SO2 exposure increased heart rate and blunted the parasympathetic-mediated diving reflex-evoked changes in heart rate. Neither spontaneous nor inspiratory-related inhibitory GABAergic or glycinergic neurotransmission to cardiac vagal neurons was altered by SO2 exposure. However, excitatory glutamatergic neurotransmission was decreased by 51.2% upon SO2 exposure. This diminished excitatory neurotransmission was tetrodotoxin-sensitive, indicating SO2 exposure impaired the activity of preceding glutamatergic neurons that synapse upon cardiac vagal neurons. Conclusions Diminished glutamatergic, but unaltered inhibitory neurotransmission to cardiac vagal neurons provides a mechanism for the observed SO2-induced elevated heart rate via an impairment of brainstem cardioinhibitory parasympathetic activity to the heart. PMID:23504550

The ATLAS Experiment at the CERN Large Hadron Collider

NASA Astrophysics Data System (ADS)

ATLAS Collaboration; Aad, G.; Abat, E.; Abdallah, J.; Abdelalim, A. A.; Abdesselam, A.; Abdinov, O.; Abi, B. A.; Abolins, M.; Abramowicz, H.; Acerbi, E.; Acharya, B. S.; Achenbach, R.; Ackers, M.; Adams, D. L.; Adamyan, F.; Addy, T. N.; Aderholz, M.; Adorisio, C.; Adragna, P.; Aharrouche, M.; Ahlen, S. P.; Ahles, F.; Ahmad, A.; Ahmed, H.; Aielli, G.; Åkesson, P. F.; Åkesson, T. P. A.; Akimov, A. V.; Alam, S. M.; Albert, J.; Albrand, S.; Aleksa, M.; Aleksandrov, I. N.; Aleppo, M.; Alessandria, F.; Alexa, C.; Alexander, G.; Alexopoulos, T.; Alimonti, G.; Aliyev, M.; Allport, P. P.; Allwood-Spiers, S. E.; Aloisio, A.; Alonso, J.; Alves, R.; Alviggi, M. G.; Amako, K.; Amaral, P.; Amaral, S. P.; Ambrosini, G.; Ambrosio, G.; Amelung, C.; Ammosov, V. V.; Amorim, A.; Amram, N.; Anastopoulos, C.; Anderson, B.; Anderson, K. J.; Anderssen, E. C.; Andreazza, A.; Andrei, V.; Andricek, L.; Andrieux, M.-L.; Anduaga, X. S.; Anghinolfi, F.; Antonaki, A.; Antonelli, M.; Antonelli, S.; Apsimon, R.; Arabidze, G.; Aracena, I.; Arai, Y.; Arce, A. T. H.; Archambault, J. P.; Arguin, J.-F.; Arik, E.; Arik, M.; Arms, K. E.; Armstrong, S. R.; Arnaud, M.; Arnault, C.; Artamonov, A.; Asai, S.; Ask, S.; Åsman, B.; Asner, D.; Asquith, L.; Assamagan, K.; Astbury, A.; Athar, B.; Atkinson, T.; Aubert, B.; Auerbach, B.; Auge, E.; Augsten, K.; Aulchenko, V. M.; Austin, N.; Avolio, G.; Avramidou, R.; Axen, A.; Ay, C.; Azuelos, G.; Baccaglioni, G.; Bacci, C.; Bachacou, H.; Bachas, K.; Bachy, G.; Badescu, E.; Bagnaia, P.; Bailey, D. C.; Baines, J. T.; Baker, O. K.; Ballester, F.; Baltasar Dos Santos Pedrosa, F.; Banas, E.; Banfi, D.; Bangert, A.; Bansal, V.; Baranov, S. P.; Baranov, S.; Barashkou, A.; Barberio, E. L.; Barberis, D.; Barbier, G.; Barclay, P.; Bardin, D. Y.; Bargassa, P.; Barillari, T.; Barisonzi, M.; Barnett, B. M.; Barnett, R. M.; Baron, S.; Baroncelli, A.; Barone, M.; Barr, A. J.; Barreiro, F.; Barreiro Guimarães da Costa, J.; Barrillon, P.; Barriuso Poy, A.; Barros, N.; Bartheld, V.; Bartko, H.; Bartoldus, R.; Basiladze, S.; Bastos, J.; Batchelor, L. E.; Bates, R. L.; Batley, J. R.; Batraneanu, S.; Battistin, M.; Battistoni, G.; Batusov, V.; Bauer, F.; Bauss, B.; Baynham, D. E.; Bazalova, M.; Bazan, A.; Beauchemin, P. H.; Beaugiraud, B.; Beccherle, R. B.; Beck, G. A.; Beck, H. P.; Becks, K. H.; Bedajanek, I.; Beddall, A. J.; Beddall, A.; Bednár, P.; Bednyakov, V. A.; Bee, C.; Behar Harpaz, S.; Belanger, G. A. N.; Belanger-Champagne, C.; Belhorma, B.; Bell, P. J.; Bell, W. H.; Bella, G.; Bellachia, F.; Bellagamba, L.; Bellina, F.; Bellomo, G.; Bellomo, M.; Beltramello, O.; Belymam, A.; Ben Ami, S.; Ben Moshe, M.; Benary, O.; Benchekroun, D.; Benchouk, C.; Bendel, M.; Benedict, B. H.; Benekos, N.; Benes, J.; Benhammou, Y.; Benincasa, G. P.; Benjamin, D. P.; Bensinger, J. R.; Benslama, K.; Bentvelsen, S.; Beretta, M.; Berge, D.; Bergeaas, E.; Berger, N.; Berghaus, F.; Berglund, S.; Bergsma, F.; Beringer, J.; Bernabéu, J.; Bernardet, K.; Berriaud, C.; Berry, T.; Bertelsen, H.; Bertin, A.; Bertinelli, F.; Bertolucci, S.; Besson, N.; Beteille, A.; Bethke, S.; Bialas, W.; Bianchi, R. M.; Bianco, M.; Biebel, O.; Bieri, M.; Biglietti, M.; Bilokon, H.; Binder, M.; Binet, S.; Bingefors, N.; Bingul, A.; Bini, C.; Biscarat, C.; Bischof, R.; Bischofberger, M.; Bitadze, A.; Bizzell, J. P.; Black, K. M.; Blair, R. E.; Blaising, J. J.; Blanch, O.; Blanchot, G.; Blocker, C.; Blocki, J.; Blondel, A.; Blum, W.; Blumenschein, U.; Boaretto, C.; Bobbink, G. J.; Bocci, A.; Bocian, D.; Bock, R.; Boehm, M.; Boek, J.; Bogaerts, J. A.; Bogouch, A.; Bohm, C.; Bohm, J.; Boisvert, V.; Bold, T.; Boldea, V.; Bondarenko, V. G.; Bonino, R.; Bonis, J.; Bonivento, W.; Bonneau, P.; Boonekamp, M.; Boorman, G.; Boosten, M.; Booth, C. N.; Booth, P. S. L.; Booth, P.; Booth, J. R. A.; Borer, K.; Borisov, A.; Borjanovic, I.; Bos, K.; Boscherini, D.; Bosi, F.; Bosman, M.; Bosteels, M.; Botchev, B.; Boterenbrood, H.; Botterill, D.; Boudreau, J.; Bouhova-Thacker, E. V.; Boulahouache, C.; Bourdarios, C.; Boutemeur, M.; Bouzakis, K.; Boyd, G. R.; Boyd, J.; Boyer, B. H.; Boyko, I. R.; Bozhko, N. I.; Braccini, S.; Braem, A.; Branchini, P.; Brandenburg, G. W.; Brandt, A.; Brandt, O.; Bratzler, U.; Braun, H. M.; Bravo, S.; Brawn, I. P.; Brelier, B.; Bremer, J.; Brenner, R.; Bressler, S.; Breton, D.; Brett, N. D.; Breugnon, P.; Bright-Thomas, P. G.; Brochu, F. M.; Brock, I.; Brock, R.; Brodbeck, T. J.; Brodet, E.; Broggi, F.; Broklova, Z.; Bromberg, C.; Brooijmans, G.; Brouwer, G.; Broz, J.; Brubaker, E.; Bruckman de Renstrom, P. A.; Bruncko, D.; Bruni, A.; Bruni, G.; Bruschi, M.; Buanes, T.; Buchanan, N. J.; Buchholz, P.; Budagov, I. A.; Büscher, V.; Bugge, L.; Buira-Clark, D.; Buis, E. J.; Bujor, F.; Buran, T.; Burckhart, H.; Burckhart-Chromek, D.; Burdin, S.; Burns, R.; Busato, E.; Buskop, J. J. F.; Buszello, K. P.; Butin, F.; Butler, J. M.; Buttar, C. M.; Butterworth, J.; Butterworth, J. M.; Byatt, T.; Cabrera Urbán, S.; Cabruja Casas, E.; Caccia, M.; Caforio, D.; Cakir, O.; Calafiura, P.; Calderini, G.; Calderón Terol, D.; Callahan, J.; Caloba, L. P.; Caloi, R.; Calvet, D.; Camard, A.; Camarena, F.; Camarri, P.; Cambiaghi, M.; Cameron, D.; Cammin, J.; Campabadal Segura, F.; Campana, S.; Canale, V.; Cantero, J.; Capeans Garrido, M. D. M.; Caprini, I.; Caprini, M.; Caprio, M.; Caracinha, D.; Caramarcu, C.; Carcagno, Y.; Cardarelli, R.; Cardeira, C.; Cardiel Sas, L.; Cardini, A.; Carli, T.; Carlino, G.; Carminati, L.; Caron, B.; Caron, S.; Carpentieri, C.; Carr, F. S.; Carter, A. A.; Carter, J. R.; Carvalho, J.; Casadei, D.; Casado, M. 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G.; Toth, J.; Touchard, F.; Tovey, D. R.; Tovey, S. N.; Towndrow, E. F.; Trefzger, T.; Treichel, M.; Treis, J.; Tremblet, L.; Tribanek, W.; Tricoli, A.; Trigger, I. M.; Trilling, G.; Trincaz-Duvoid, S.; Tripiana, M. F.; Trischuk, W.; Trka, Z.; Trocmé, B.; Troncon, C.; C-L Tseng, J.; Tsiafis, I.; Tsiareshka, P. V.; Tsipolitis, G.; Tskhadadze, E. G.; Tsukerman, I. I.; Tsulaia, V.; Tsuno, S.; Turala, M.; Turk Cakir, I.; Turlay, E.; Tuts, P. M.; Twomey, M. S.; Tyndel, M.; Typaldos, D.; Tyrvainen, H.; Tzamarioudaki, E.; Tzanakos, G.; Ueda, I.; Uhrmacher, M.; Ukegawa, F.; Ullán Comes, M.; Unal, G.; Underwood, D. G.; Undrus, A.; Unel, G.; Unno, Y.; Urkovsky, E.; Usai, G.; Usov, Y.; Vacavant, L.; Vacek, V.; Vachon, B.; Vahsen, S.; Valderanis, C.; Valenta, J.; Valente, P.; Valero, A.; Valkar, S.; Valls Ferrer, J. A.; Van der Bij, H.; van der Graaf, H.; van der Kraaij, E.; Van Eijk, B.; van Eldik, N.; van Gemmeren, P.; van Kesteren, Z.; van Vulpen, I.; Van Berg, R.; Vandelli, W.; Vandoni, G.; Vaniachine, A.; Vannucci, F.; Varanda, M.; Varela Rodriguez, F.; Vari, R.; Varnes, E. W.; Varouchas, D.; Vartapetian, A.; Varvell, K. E.; Vassilakopoulos, V. I.; Vassilieva, L.; Vataga, E.; Vaz, L.; Vazeille, F.; Vedrine, P.; Vegni, G.; Veillet, J. J.; Vellidis, C.; Veloso, F.; Veness, R.; Veneziano, S.; Ventura, A.; Ventura, S.; Vercesi, V.; Verducci, M.; Verkerke, W.; Vermeulen, J. C.; Vertogardov, L.; Vetterli, M. C.; Vichou, I.; Vickey, T.; Viehhauser, G. H. A.; Vigeolas, E.; Villa, M.; Villani, E. G.; Villate, J.; Villella, I.; Vilucchi, E.; Vincent, P.; Vincke, H.; Vincter, M. G.; Vinogradov, V. B.; Virchaux, M.; Viret, S.; Virzi, J.; Vitale, A.; Vivarelli, I.; Vives, R.; Vives Vaques, F.; Vlachos, S.; Vogt, H.; Vokac, P.; Vollmer, C. F.; Volpi, M.; Volpini, G.; von Boehn-Buchholz, R.; von der Schmitt, H.; von Toerne, E.; Vorobel, V.; Vorobiev, A. P.; Vorozhtsov, A. S.; Vorozhtsov, S. B.; Vos, M.; Voss, K. C.; Voss, R.; Vossebeld, J. H.; Vovenko, A. S.; Vranjes, N.; Vrba, V.; Vreeswijk, M.; Anh, T. Vu; Vuaridel, B.; Vudragovic, M.; Vuillemin, V.; Vuillermet, R.; Wänanen, A.; Wahlen, H.; Walbersloh, J.; Walker, R.; Walkowiak, W.; Wall, R.; Wallny, R. S.; Walsh, S.; Wang, C.; Wang, J. C.; Wappler, F.; Warburton, A.; Ward, C. P.; Warner, G. P.; Warren, M.; Warsinsky, M.; Wastie, R.; Watkins, P. M.; Watson, A. T.; Watts, G.; Waugh, A. T.; Waugh, B. M.; Weaverdyck, C.; Webel, M.; Weber, G.; Weber, J.; Weber, M.; Weber, P.; Weidberg, A. R.; Weilhammer, P. M.; Weingarten, J.; Weiser, C.; Wellenstein, H.; Wellisch, H. P.; Wells, P. S.; Wemans, A.; Wen, M.; Wenaus, T.; Wendler, S.; Wengler, T.; Wenig, S.; Wermes, N.; Werneke, P.; Werner, P.; Werthenbach, U.; Wheeler-Ellis, S. J.; Whitaker, S. P.; White, A.; White, M. J.; White, S.; Whittington, D.; Wicek, F.; Wicke, D.; Wickens, F. J.; Wiedenmann, W.; Wielers, M.; Wienemann, P.; Wiesmann, M.; Wiesmann, M.; Wijnen, T.; Wildauer, A.; Wilhelm, I.; Wilkens, H. G.; Williams, H. H.; Willis, W.; Willocq, S.; Wilmut, I.; Wilson, J. A.; Wilson, A.; Wingerter-Seez, I.; Winton, L.; Witzeling, W.; Wlodek, T.; Woehrling, E.; Wolter, M. W.; Wolters, H.; Wosiek, B.; Wotschack, J.; Woudstra, M. J.; Wright, C.; Wu, S. L.; Wu, X.; Wuestenfeld, J.; Wunstorf, R.; Xella-Hansen, S.; Xiang, A.; Xie, S.; Xie, Y.; Xu, G.; Xu, N.; Yamamoto, A.; Yamamoto, S.; Yamaoka, H.; Yamazaki, Y.; Yan, Z.; Yang, H.; Yang, J. C.; Yang, S.; Yang, U. K.; Yang, Y.; Yang, Z.; Yao, W.-M.; Yao, Y.; Yarradoddi, K.; Yasu, Y.; Ye, J.; Yilmaz, M.; Yoosoofmiya, R.; Yorita, K.; Yoshida, H.; Yoshida, R.; Young, C.; Youssef, S. P.; Yu, D.; Yu, J.; Yu, M.; Yu, X.; Yuan, J.; Yurkewicz, A.; Zaets, V. G.; Zaidan, R.; Zaitsev, A. M.; Zajac, J.; Zajacova, Z.; Zalite, A. Yu; Zalite, Yo K.; Zanello, L.; Zarzhitsky, P.; Zaytsev, A.; Zdrazil, M.; Zeitnitz, C.; Zeller, M.; Zema, P. F.; Zendler, C.; Zenin, A. V.; Zenis, T.; Zenonos, Z.; Zenz, S.; Zerwas, D.; Zhang, H.; Zhang, J.; Zheng, W.; Zhang, X.; Zhao, L.; Zhao, T.; Zhao, X.; Zhao, Z.; Zhelezko, A.; Zhemchugov, A.; Zheng, S.; Zhichao, L.; Zhou, B.; Zhou, N.; Zhou, S.; Zhou, Y.; Zhu, C. G.; Zhu, H. Z.; Zhuang, X. A.; Zhuravlov, V.; Zilka, B.; Zimin, N. I.; Zimmermann, S.; Ziolkowski, M.; Zitoun, R.; Zivkovic, L.; Zmouchko, V. V.; Zobernig, G.; Zoccoli, A.; Zoeller, M. M.; Zolnierowski, Y.; Zsenei, A.; zur Nedden, M.; Zychacek, V.

2008-08-01

The ATLAS detector as installed in its experimental cavern at point 1 at CERN is described in this paper. A brief overview of the expected performance of the detector when the Large Hadron Collider begins operation is also presented.

The effect of relaxing massage on heart rate and heart rate variability in purebred Arabian racehorses.

PubMed

Kowalik, Sylwester; Janczarek, Iwona; Kędzierski, Witold; Stachurska, Anna; Wilk, Izabela

2017-04-01

The objective of this study was to assess the effect of relaxing massage on the heart rate (HR) and heart rate variability (HRV) in young racehorses during their first racing season. In the study, 72 Purebred Arabian racehorses were included. The study was implemented during the full race season. The horses from control and experimental groups were included in regular race training 6 days a week. The horses from the experimental group were additionally subject to the relaxing massage 3 days a week during the whole study. HR and HRV were assumed as indicators of the emotional state of the horses. The measurements were taken six times, every 4-5 weeks. The HRV parameters were measured at rest, during grooming and saddling the horse and during warm-up walking under a rider. The changes of the parameters throughout the season suggest that the relaxing massage may be effectively used to make the racehorses more relaxed and calm. Moreover, the horses from the experimental group had better race performance records. © 2016 Japanese Society of Animal Science.

The kaon identification system in the NA62 experiment at CERN

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

Romano, A.

2015-07-01

The main goal of the NA62 experiment at CERN is to measure the branching ratio of the ultra-rare K{sup +} → π{sup +} ν ν-bar decay with 10% accuracy. NA62 will use a 750 MHz high-energy un-separated charged hadron beam, with kaons corresponding to ∼6% of the beam, and a kaon decay-in-flight technique. The positive identification of kaons is performed with a differential Cherenkov detector (CEDAR), filled with Nitrogen gas and placed in the incoming beam. To stand the kaon rate (45 MHz average) and meet the performances required in NA62, the Cherenkov detector has been upgraded (KTAG) with newmore » photon detectors, readout, mechanics and cooling systems. The KTAG provides a fast identification of kaons with an efficiency of at least 95% and precise time information with a resolution below 100 ps. A half-equipped KTAG detector has been commissioned during a technical run at CERN in 2012, while the fully equipped detector, its readout and front-end have been commissioned during a pilot run at CERN in October 2014. The measured time resolution and efficiency are within the required performances. (authors)« less

[CERN-MEDICIS (Medical Isotopes Collected from ISOLDE): a new facility].

PubMed

Viertl, David; Buchegger, Franz; Prior, John O; Forni, Michel; Morel, Philippe; Ratib, Osman; Bühler Léo H; Stora, Thierry

2015-06-17

CERN-MEDICIS is a facility dedicated to research and development in life science and medical applications. The research platform was inaugurated in October 2014 and will produce an increasing range of innovative isotopes using the proton beam of ISOLDE for fundamental studies in cancer research, for new imaging and therapy protocols in cell and animal models and for preclinical trials, possibly extended to specific early phase clinical studies (phase 0) up to phase I trials. CERN, the University Hospital of Geneva (HUG), the University Hospital of Lausanne (CHUV), the Swiss Institute for Experimental Cancer (ISREC) at Swiss Federal Institutes of Technology (EPFL) that currently support the project will benefit of the initial production that will then be extended to other centers.

Hypothyroidism and oxidative stress: differential effect on the heart of virgin and pregnant rats.

PubMed

Carmona, Y V; Coria, M J; Oliveros, L B; Gimenez, M S

2014-01-01

The present study investigates the effects of hypothyroidism on both the redox state and the thyroid hormone receptors expression in the heart ventricle of virgin and pregnant rats.Hypothyroid state was induced by 6-n-propyl-2-thiouracil in drinking water given to Wistar rats starting 8 days before mating until day 21 of pregnancy or for 30 days in virgin rats. Serum paraoxonase-1 (PON-1) activity, serum and heart nitrites, and thiobarbituric acid-reactive substances (TBARS) were analyzed. Heart protein oxidation, as carbonyls, and copper-zinc superoxide dismutase (CuZnSOD), glutathione peroxidase (GPx), and catalase (CAT) activities, were determined. In addition, heart expressions of NADPH oxidase (NOX-2), CAT, SOD, GPx, and thyroid receptors (TRα and TRβ) mRNA were assessed by RT-PCR. Inducible and endothelial Nitric Oxide Synthase (iNOS and eNOS) were determined by Western blot. Hypothyroidism in the heart of virgin rats decreased TRα and TRβ expressions, and induced oxidative stress, leading to a decrease of nitrites and an increase of carbonyls, NOX-2 mRNA, and GPx activity. A decreased PON-1 activity suggested low protection against oxidative stress in blood circulation. Pregnancy reduced TRα and TRβ mRNA expressions and induced oxidative stress by increasing nitrite and TBARS levels, SOD and CAT activities and NOX-2, eNOS and iNOS expressions, while hypothyroidism, emphasized the decreases of TRα mRNA levels and did not alter the redox state in the heart. TR expressions and redox balance of rat hearts depend on the physiological state. Pregnancy per se seems to protect the heart against oxidative stress induced by hypothyroidism. Supporting Information for this article is available online at http://www.thieme-connect.de/ejournals/toc/hmr. © Georg Thieme Verlag KG Stuttgart · New York.

LHC@Home: a BOINC-based volunteer computing infrastructure for physics studies at CERN

NASA Astrophysics Data System (ADS)

Barranco, Javier; Cai, Yunhai; Cameron, David; Crouch, Matthew; Maria, Riccardo De; Field, Laurence; Giovannozzi, Massimo; Hermes, Pascal; Høimyr, Nils; Kaltchev, Dobrin; Karastathis, Nikos; Luzzi, Cinzia; Maclean, Ewen; McIntosh, Eric; Mereghetti, Alessio; Molson, James; Nosochkov, Yuri; Pieloni, Tatiana; Reid, Ivan D.; Rivkin, Lenny; Segal, Ben; Sjobak, Kyrre; Skands, Peter; Tambasco, Claudia; Veken, Frederik Van der; Zacharov, Igor

2017-12-01

The LHC@Home BOINC project has provided computing capacity for numerical simulations to researchers at CERN since 2004, and has since 2011 been expanded with a wider range of applications. The traditional CERN accelerator physics simulation code SixTrack enjoys continuing volunteers support, and thanks to virtualisation a number of applications from the LHC experiment collaborations and particle theory groups have joined the consolidated LHC@Home BOINC project. This paper addresses the challenges related to traditional and virtualized applications in the BOINC environment, and how volunteer computing has been integrated into the overall computing strategy of the laboratory through the consolidated LHC@Home service. Thanks to the computing power provided by volunteers joining LHC@Home, numerous accelerator beam physics studies have been carried out, yielding an improved understanding of charged particle dynamics in the CERN Large Hadron Collider (LHC) and its future upgrades. The main results are highlighted in this paper.

Novel biomarkers in acute heart failure: MR-pro-adrenomedullin.

PubMed

Peacock, W Frank

2014-10-01

First isolated from human pheochromocytoma cells, adrenomedullin (ADM) is a peptide hormone with natriuretic, vasodilatory, and hypotensive effects mediated by cyclic adenosine monophosphate (cAMP), nitric oxide, and renal prostaglandin systems. ADM expression occurs in many tissues and organ systems, including cardiovascular, renal, pulmonary, cerebrovascular, gastrointestinal, and endocrine tissues where it acts as a circulating hormone and a local autocrine and paracrine hormone. ADM plasma concentrations are increased in hypertension, chronic renal disease, and heart failure. As ADM is unstable in vitro, it is necessary to measure its mid-regional pro-hormone fragment, the levels of which correspond to ADM concentration (MR-proADM). The prognostic potential of MR-proADM was recently demonstrated in the Biomarkers in Acute Heart Failure (BACH) trial. In this trial of 568 acute heart failure patients, MR-proADM was superior to both brain natriuretic peptide (BNP) and NT-proBNP in predicting mortality within 14 days. MR-proADM also provided significant additive incremental predictive value for 90-day mortality when added to BNP and NT-proBNP.

An Educational Intervention to Evaluate Nurses' Knowledge of Heart Failure.

PubMed

Sundel, Siobhan; Ea, Emerson E

2018-07-01

Nurses are the main providers of patient education in inpatient and outpatient settings. Unfortunately, nurses may lack knowledge of chronic medical conditions, such as heart failure. The purpose of this one-group pretest-posttest intervention was to determine the effectiveness of teaching intervention on nurses' knowledge of heart failure self-care principles in an ambulatory care setting. The sample consisted of 40 staff nurses in ambulatory care. Nurse participants received a focused education intervention based on knowledge deficits revealed in the pretest and were then resurveyed within 30 days. Nurses were evaluated using the valid and reliable 20-item Nurses Knowledge of Heart Failure Education Principles Survey tool. The results of this project demonstrated that an education intervention on heart failure self-care principles improved nurses' knowledge of heart failure in an ambulatory care setting, which was statistically significant (p < .05). Results suggest that a teaching intervention could improve knowledge of heart failure, which could lead to better patient education and could reduce patient readmission for heart failure. J Contin Educ Nurs. 2018;49(7):315-321. Copyright 2018, SLACK Incorporated.

Preattentive processing of heart cues and the perception of heart symptoms in congenital heart disease.

PubMed

Karsdorp, Petra A; Kindt, Merel; Everaerd, Walter; Mulder, Barbara J M

2007-08-01

The present study was aimed at clarifying whether preattentive processing of heart cues results in biased perception of heart sensations in patients with congenital heart disease (ConHD) who are also highly trait anxious. Twenty-six patients with ConHD and 22 healthy participants categorized heart-related (heart rate) or neutral sensations (constant vibration) as either heart or neutral. Both sensations were evoked using a bass speaker that was attached on the chest of the participant. Before each physical sensation, a subliminal heart-related or neutral prime was presented. Biased perception of heart-sensations would become evident by a delayed categorization of the heart-related sensations. In line with the prediction, a combination of high trait anxiety and ConHD resulted in slower responses after a heart-related sensation that was preceded by a subliminal heart cue. Preattentive processing of harmless heart cues may easily elicit overperception of heart symptoms in highly trait anxious patients with ConHD.

Simvastatin after orthotopic heart transplantation. Costs and consequences.

PubMed

Krobot, K J; Wenke, K; Reichart, B

1999-03-01

Recent data indicate that the combination of a low cholesterol diet and simvastatin following heart transplantation is associated with significant reduction of serum cholesterol levels, lower incidence of graft vessel disease (GVD) and significantly superior 4-year survival rates than dietary treatment alone. On the basis of this first randomised long term study evaluating survival as the clinical end-point, we investigated the cost effectiveness of the above regimens as well as the long term consequences for the patient and for heart transplantation as a high-tech procedure. The perspective of the economic analysis was that of the German health insurance fund. Life-years gained were calculated on the basis of the Kaplan-Meier survival curves from the 4-year clinical trial and from the International Society for Heart and Lung Transplantation (ISHLT) overall survival statistics. Incremental costs and incremental cost-effectiveness ratios were determined using various sources of data, and both costs and consequences were discounted by 3% per year. Sensitivity analyses using alternative assumptions were conducted in addition to the base-case analysis. As in the original clinical trial, the target population of the economic evaluation comprised all heart transplant recipients on standard triple immunosuppression consisting of cyclosporin, azathioprine and prednisolone, regardless of the postoperative serum lipid profile. The therapeutic regimens investigated in the analysis were the American Heart Association (AHA) step II diet plus simvastatin (titrated to a maximum dosage of 20 mg/day) and AHA step II diet alone. Four years of treatment with simvastatin (mean dosage 8.11 mg/day) translated into an undiscounted survival benefit per patient of 2.27 life-years; 0.64 life-years within the trial period and 1.63 life-years thereafter. Discounted costs per year of life gained were $US1050 (sensitivity analyses $US800 to $US15,400) for simvastatin plus diet versus diet alone

A Zebrafish Heart Failure Model for Assessing Therapeutic Agents.

PubMed

Zhu, Xiao-Yu; Wu, Si-Qi; Guo, Sheng-Ya; Yang, Hua; Xia, Bo; Li, Ping; Li, Chun-Qi

2018-03-20

Heart failure is a leading cause of death and the development of effective and safe therapeutic agents for heart failure has been proven challenging. In this study, taking advantage of larval zebrafish, we developed a zebrafish heart failure model for drug screening and efficacy assessment. Zebrafish at 2 dpf (days postfertilization) were treated with verapamil at a concentration of 200 μM for 30 min, which were determined as optimum conditions for model development. Tested drugs were administered into zebrafish either by direct soaking or circulation microinjection. After treatment, zebrafish were randomly selected and subjected to either visual observation and image acquisition or record videos under a Zebralab Blood Flow System. The therapeutic effects of drugs on zebrafish heart failure were quantified by calculating the efficiency of heart dilatation, venous congestion, cardiac output, and blood flow dynamics. All 8 human heart failure therapeutic drugs (LCZ696, digoxin, irbesartan, metoprolol, qiliqiangxin capsule, enalapril, shenmai injection, and hydrochlorothiazide) showed significant preventive and therapeutic effects on zebrafish heart failure (p < 0.05, p < 0.01, and p < 0.001) in the zebrafish model. The larval zebrafish heart failure model developed and validated in this study could be used for in vivo heart failure studies and for rapid screening and efficacy assessment of preventive and therapeutic drugs.

Health literacy and mortality: a cohort study of patients hospitalized for acute heart failure.

PubMed

McNaughton, Candace D; Cawthon, Courtney; Kripalani, Sunil; Liu, Dandan; Storrow, Alan B; Roumie, Christianne L

2015-04-29

More than 30% of patients hospitalized for heart failure are rehospitalized or die within 90 days of discharge. Lower health literacy is associated with mortality among outpatients with chronic heart failure; little is known about this relationship after hospitalization for acute heart failure. Patients hospitalized for acute heart failure and discharged home between November 2010 and June 2013 were followed through December 31, 2013. Nurses administered the Brief Health Literacy Screen at admission; low health literacy was defined as Brief Health Literacy Screen ≤9. The primary outcome was all-cause mortality. Secondary outcomes were time to first rehospitalization and, separately, time to first emergency department visit within 90 days of discharge. Cox proportional hazards models determined their relationships with health literacy, adjusting for age, gender, race, insurance, education, comorbidity, and hospital length of stay. For the 1379 patients, average age was 63.1 years, 566 (41.0%) were female, and 324 (23.5%) had low health literacy. Median follow-up was 20.7 months (interquartile range 12.8 to 29.6 months), and 403 (29.2%) patients died. Adjusted hazard ratio [aHR] for death among patients with LHL was 1.32 (95%confidence interval [CI] 1.05, 1.66, P=0.02) compared to BHLS>9 [corrected].Within 90 days of discharge, there were 415 (30.1%) rehospitalizations and 201 (14.6%) emergency department visits, with no evident association with health literacy. Lower health literacy was associated with increased risk of death after hospitalization for acute heart failure. There was no evident relationship between health literacy and 90-day rehospitalization or emergency department visits. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Post-exercise heart rate recovery independently predicts mortality risk in patients with chronic heart failure.

PubMed

Tang, Yi-Da; Dewland, Thomas A; Wencker, Detlef; Katz, Stuart D

2009-12-01

Post-exercise heart rate recovery (HRR) is an index of parasympathetic function associated with clinical outcomes in populations with and without documented coronary heart disease. Decreased parasympathetic activity is thought to be associated with disease progression in chronic heart failure (HF), but an independent association between post-exercise HRR and clinical outcomes among such patients has not been established. We measured HRR (calculated as the difference between heart rate at peak exercise and after 1 minute of recovery) in 202 HF subjects and recorded 17 mortality and 15 urgent transplantation outcome events over 624 days of follow-up. Reduced post-exercise HRR was independently associated with increased event risk after adjusting for other exercise-derived variables (peak oxygen uptake and change in minute ventilation per change in carbon dioxide production slope), for the Heart Failure Survival Score (adjusted HR 1.09 for 1 beat/min reduction, 95% CI 1.05-1.13, P < .0001), and the Seattle Heart Failure Model score (adjusted HR 1.08 for one beat/min reduction, 95% CI 1.05-1.12, P < .0001). Subjects in the lowest risk tertile based on post-exercise HRR (>or=30 beats/min) had low risk of events irrespective of the risk predicted by the survival scores. In a subgroup of 15 subjects, reduced post-exercise HRR was associated with increased serum markers of inflammation (interleukin-6, r = 0.58, P = .024; high-sensitivity C-reactive protein, r = 0.66, P = .007). Post-exercise HRR predicts mortality risk in patients with HF and provides prognostic information independent of previously described survival models. Pathophysiologic links between autonomic function and inflammation may be mediators of this association.

CERN Computing in Commercial Clouds

NASA Astrophysics Data System (ADS)

Cordeiro, C.; Field, L.; Garrido Bear, B.; Giordano, D.; Jones, B.; Keeble, O.; Manzi, A.; Martelli, E.; McCance, G.; Moreno-García, D.; Traylen, S.

2017-10-01

By the end of 2016 more than 10 Million core-hours of computing resources have been delivered by several commercial cloud providers to the four LHC experiments to run their production workloads, from simulation to full chain processing. In this paper we describe the experience gained at CERN in procuring and exploiting commercial cloud resources for the computing needs of the LHC experiments. The mechanisms used for provisioning, monitoring, accounting, alarming and benchmarking will be discussed, as well as the involvement of the LHC collaborations in terms of managing the workflows of the experiments within a multicloud environment.

The keys to CERN conference rooms - Managing local collaboration facilities in large organisations

NASA Astrophysics Data System (ADS)

Baron, T.; Domaracky, M.; Duran, G.; Fernandes, J.; Ferreira, P.; Gonzalez Lopez, J. B.; Jouberjean, F.; Lavrut, L.; Tarocco, N.

2014-06-01

For a long time HEP has been ahead of the curve in its usage of remote collaboration tools, like videoconference and webcast, while the local CERN collaboration facilities were somewhat behind the expected quality standards for various reasons. This time is now over with the creation by the CERN IT department in 2012 of an integrated conference room service which provides guidance and installation services for new rooms (either equipped for videoconference or not), as well as maintenance and local support. Managing now nearly half of the 246 meeting rooms available on the CERN sites, this service has been built to cope with the management of all CERN rooms with limited human resources. This has been made possible by the intensive use of professional software to manage and monitor all the room equipment, maintenance and activity. This paper focuses on presenting these packages, either off-the-shelf commercial products (asset and maintenance management tool, remote audio-visual equipment monitoring systems, local automation devices, new generation touch screen interfaces for interacting with the room) when available or locally developed integration and operational layers (generic audio-visual control and monitoring framework) and how they help overcoming the challenges presented by such a service. The aim is to minimise local human interventions while preserving the highest service quality and placing the end user back in the centre of this collaboration platform.

The use of heart rate turbulence and heart rate variability in the assessment of autonomic regulation and circadian rhythm in patients with systemic lupus erythematosus without apparent heart disease.

PubMed

Poliwczak, A R; Waszczykowska, E; Dziankowska-Bartkowiak, B; Koziróg, M; Dworniak, K

2018-03-01

Background Systemic lupus erythematosus is a progressive autoimmune disease. There are reports suggesting that patients even without overt signs of cardiovascular complications have impaired autonomic function. The aim of this study was to assess autonomic function using heart rate turbulence and heart rate variability parameters indicated in 24-hour ECG Holter monitoring. Methods Twenty-six women with systemic lupus erythematosus and 30 healthy women were included. Twenty-four hour ambulatory ECG-Holter was performed in home conditions. The basic parameters of heart rate turbulence and heart rate variability were calculated. The analyses were performed for the entire day and separately for daytime activity and night time rest. Results There were no statistically significant differences in the basic anthropometric parameters. The mean duration of disease was 11.52 ± 7.42. There was a statistically significant higher turbulence onset (To) value in patients with systemic lupus erythematosus, median To = -0.17% (minimum -1.47, maximum 3.0) versus To = -1.36% (minimum -4.53, maximum -0.41), P < 0.001. There were no such differences for turbulence slope (Ts). In the 24-hour analysis almost all heart rate variability parameters were significantly lower in the systemic lupus erythematosus group than in the healthy controls, including SDANN and r-MSSD and p50NN. Concerning the morning activity and night resting periods, the results were similar as for the whole day. In the control group, higher values in morning activity were noted for parameters that characterise sympathetic activity, especially SDANN, and were significantly lower for parasympathetic parameters, including r-MSSD and p50NN, which prevailed at night. There were no statistically significant changes for systemic lupus erythematosus patients for p50NN and low and very low frequency. There was a positive correlation between disease duration and SDNN, R = 0.417; P < 0.05 and SDANN, R�

FA composition of heart and skeletal muscle during embryonic development of the king penguin.

PubMed

Decrock, Frederic; Groscolas, Rene; Speake, Brian K

2002-04-01

Since the yolk lipids of the king penguin (Aptenodytes patagonicus) naturally contain the highest concentrations of DHA and EPA yet reported for the eggs of any avian species, the effects of this (n-3)-rich yolk on the FA profiles of the embryonic heart and skeletal muscle were investigated. The concentrations (mg/g wet tissue) of phospholipid (PL) in the developing heart and leg muscle of the penguin doubled between days 27 and 55 from the beginning of egg incubation (i.e., from the halfway stage of embryonic development to 2 d posthatch), whereas no net increase occurred in pectoral muscle. During this period, the concentration of TAG in heart decreased by half but increased two- and sixfold in leg and pectoral muscle, respectively. The most notable change in cholesteryl ester concentration occurred in pectoral muscle, increasing ninefold between days 27 and 55. Arachidonic acid (ARA) was the major polyunsaturate in PL of the penguin's heart, where it formed about 20% (w/w) of FA at day 55. At the equivalent developmental stage, the heart PL of the chicken contained a 1.3-fold greater proportion of ARA, contained a fifth less DHA, and was almost devoid of EPA, whereas the latter FA was a significant component (7% of FA) of penguin heart PL. Similarly, in PL of leg and pectoral muscle, the chicken displayed about 1.4-fold more ARA, up to 50% less DHA, and far less EPA in comparison with the penguin. Thus, although ARA-rich PL profiles are achieved in the heart and muscle of the penguin embryo, these profiles are significantly affected by the high n-3 content of the yolk.

Heart Disease

MedlinePlus

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Heart rate at baseline influences the effect of ivabradine on cardiovascular outcomes in chronic heart failure: analysis from the SHIFT study.

PubMed

Böhm, Michael; Borer, Jeffrey; Ford, Ian; Gonzalez-Juanatey, Jose R; Komajda, Michel; Lopez-Sendon, Jose; Reil, Jan-Christian; Swedberg, Karl; Tavazzi, Luigi

2013-01-01

We analysed the effect of ivabradine on outcomes in heart failure (HF) patients on recommended background therapies with heart rates ≥75 bpm and <75 bpm in the SHIFT trial. A cut-off value of ≥75 bpm was chosen by the EMEA for approval for the use of ivabradine in chronic heart failure. The SHIFT population was divided by baseline heart rate ≥75 or <75 bpm. The effect of ivabradine was analysed for primary composite endpoint (cardiovascular death or HF hospitalization) and other endpoints. In the ≥75 bpm group, ivabradine reduced primary endpoint (HR 0.76, 95 % CI 0.68-0.85, P < 0.0001), all-cause mortality (HR 0.83, 95 % CI, 0.72-0.96, P = 0.0109), cardiovascular mortality (HR 0.83, 95 % CI, (0.71-0.97, P = 0.0166), HF death (HR 0.61, 95 % CI, 0.46-0.81, P < 0.0006), and HF hospitalization (HR 0.70, 95 % CI, 0.61-0.80, P < 0.0001). Risk reduction depended on heart rate after 28 days, with the best protection for heart rates <60 bpm or reductions >10 bpm. None of the endpoints was significantly reduced in the <75 bpm group, though there were trends for risk reductions in HF death and hospitalization for heart rate <60 bpm and reductions >10 bpm. Ivabradine was tolerated similarly in both groups. The effect of ivabradine on outcomes is greater in patients with heart rate ≥75 bpm with heart rates achieved <60 bpm or heart rate reductions >10 bpm predicting best risk reduction. Our findings emphasize the importance of identification of high-risk HF patients by high heart rates and their treatment with heart rate-lowering drugs such as ivabradine.

HeartWare HVAD for Biventricular Support in Children and Adolescents: The Stanford Experience.

PubMed

Stein, Mary Lyn; Yeh, Justin; Reinhartz, Olaf; Rosenthal, David N; Kaufman, Beth D; Almond, Chris S; Hollander, Seth A; Maeda, Katsuhide

2016-01-01

Despite increasing use of mechanical circulatory support in children, experience with biventricular device implantation remains limited. We describe our experience using the HeartWare HVAD to provide biventricular support to three patients and compare these patients with five patients supported with HeartWare left ventricular assist device (LVAD). At the end of the study period, all three biventricular assist device (BiVAD) patients had been transplanted and were alive. LVAD patients were out of bed and ambulating a median of 10.5 days postimplantation. The BiVAD patients were out of bed a median of 31 days postimplantation. Pediatric patients with both left ventricular and biventricular heart failure can be successfully bridged to transplantation with the HeartWare HVAD. Rapid improvement in functional status following HVAD implantation for isolated left ventricular support is seen. Patients supported with BiVAD also demonstrate functional recovery, albeit more modestly. In the absence of infection, systemic inflammatory response raises concern for inadequate support.

Prenatal Nicotine Increases Matrix Metalloproteinase 2 (MMP-2) Expression in Fetal Guinea Pig Hearts

PubMed Central

Thompson, Loren P.; Liu, Hongshan; Evans, LaShauna; Mong, Jessica A.

2011-01-01

This study tested the hypothesis that maternal nicotine ingestion increases matrix metalloproteinase (MMP) expression in fetal hearts, which is mediated by the generation of reactive oxygen species. Timed pregnant guinea pigs were administered either water alone, nicotine (200 μg/mL), N-acetylcysteine (NAC), or nicotine plus NAC in their drinking water for 10 days at 52-day gestation (term = 65 days). Near-term (62 days), anesthetized fetuses were extracted, hearts were excised, and left cardiac ventricles snap frozen for analysis of MMP-2/-9/-13 protein and activity levels. Interstitial collagens were identified by Picrosirius red stain to assess changes in the extracellular matrix. Prenatal nicotine increased active MMP-2 forms and interstitial collagen but had no effect on either pro- or active MMP-9 or MMP-13 forms. In the presence of nicotine, NAC decreased active MMP-2 protein levels and reversed the nicotine-induced increase in collagen staining. We conclude that prenatal nicotine alters MMP-2 expression in fetal hearts that may be mediated by reactive oxygen species generation. PMID:21775771

Heart transplantation in adults with congenital heart disease.

PubMed

Houyel, Lucile; To-Dumortier, Ngoc-Tram; Lepers, Yannick; Petit, Jérôme; Roussin, Régine; Ly, Mohamed; Lebret, Emmanuel; Fadel, Elie; Hörer, Jürgen; Hascoët, Sébastien

2017-05-01

With the advances in congenital cardiac surgery and postoperative care, an increasing number of children with complex congenital heart disease now reach adulthood. There are already more adults than children living with a congenital heart defect, including patients with complex congenital heart defects. Among these adults with congenital heart disease, a significant number will develop ventricular dysfunction over time. Heart failure accounts for 26-42% of deaths in adults with congenital heart defects. Heart transplantation, or heart-lung transplantation in Eisenmenger syndrome, then becomes the ultimate therapeutic possibility for these patients. This population is deemed to be at high risk of mortality after heart transplantation, although their long-term survival is similar to that of patients transplanted for other reasons. Indeed, heart transplantation in adults with congenital heart disease is often challenging, because of several potential problems: complex cardiac and vascular anatomy, multiple previous palliative and corrective surgeries, and effects on other organs (kidney, liver, lungs) of long-standing cardiac dysfunction or cyanosis, with frequent elevation of pulmonary vascular resistance. In this review, we focus on the specific problems relating to heart and heart-lung transplantation in this population, revisit the indications/contraindications, and update the long-term outcomes. Copyright © 2017. Published by Elsevier Masson SAS.

Eotaxin/CCL11 expression by infiltrating macrophages in rat heart transplants during ongoing acute rejection.

PubMed

Zweifel, Martin; Mueller, Christoph; Schaffner, Thomas; Dahinden, Clemens; Matozan, Katja; Driscoll, Robert; Mohacsi, Paul

2009-10-01

Eotaxin/CCL11 chemokine is expressed in different organs, including the heart, but its precise cellular origin in the heart is unknown. Eotaxin is associated with Th2-like responses and exerts its chemotactic effect through the chemokine receptor-3 (CCR3), which is also expressed on mast cells (MC). The aim of our study was to find the cellular origin of eotaxin in the heart, and to assess whether expression is changing during ongoing acute heart transplant rejection, indicating a correlation with mast cell infiltration which we observed in a previous study. In a model of ongoing acute heart transplant rejection in the rat, we found eotaxin mRNA expression within infiltrating macrophages, but not in mast cells, by in situ-hybridization. A five-fold increase in eotaxin protein in rat heart transplants during ongoing acute rejection was measured on day 28 after transplantation, compared to native and isogeneic control hearts. Eotaxin concentrations in donor hearts on day 28 after transplantation were significantly higher compared to recipient hearts, corroborating an origin of eotaxin from cells within the heart, and not from the blood. The quantitative comparison of eotaxin mRNA expression between native hearts, isografts, and allografts, respectively, revealed no statistically significant difference after transplantation, probably due to an overall increase in the housekeeping gene's 18S rRNA during rejection. Quantitative RT-PCR showed an increase in mRNA expression of CCR3, the receptor for eotaxin, during ongoing acute rejection of rat heart allografts. Although a correlation between increasing eotaxin expression by macrophages and mast cell infiltration is suggestive, functional studies will elucidate the role of eotaxin in the process of ongoing acute heart transplant rejection.

Comparing Usual Care With a Warfarin Initiation Protocol After Mechanical Heart Valve Replacement.

PubMed

Roberts, Gregory; Razooqi, Rasha; Quinn, Stephen

2017-03-01

The immediate postoperative warfarin sensitivity for patients receiving heart valve prostheses is increased. Established warfarin initiation protocols may lack clinical applicability, resulting in dosing based on clinical judgment. To compare current practice for warfarin initiation with a known warfarin initiation protocol, with doses proportionally reduced to account for the increased postoperative sensitivity. We compared the Mechanical Heart Valve Warfarin Initiation Protocol (Protocol group) with current practice (clinical judgment-Empirical group) for patients receiving mechanical heart valves in an observational before-and-after format. End points were the time to achieve a stable therapeutic international normalized ratio (INR), doses held in the first 6 days, and overanticoagulation in the first 6 days. The Protocol group (n = 37) achieved a stable INR more rapidly than the Empirical group (n = 77; median times 5.1 and 8.7 days, respectively; P = 0.002). Multivariable analysis indicated that the Protocol group (hazard ratio [HR] = 2.22; P = 0.005) and men (HR = 1.76; P = 0.043) more rapidly achieved a stable therapeutic INR. Age, serum albumin, amiodarone, presence of severe heart failure, and surgery type had no impact. Protocol patients had fewer doses held (1.1% vs 10.1%, P < 0.001) and no difference in overanticoagulation (2.7% vs 9.1%, P = 0.27). The Mechanical Heart Valve Warfarin Initiation Protocol provided a reliable approach to initiating warfarin in patients receiving mechanical aortic or mitral valves.

Day-to-Day Heart-Rate Variability Recordings in World-Champion Rowers: Appreciating Unique Athlete Characteristics.

PubMed

Plews, Daniel J; Laursen, Paul B; Buchheit, Martin

2017-05-01

Heart-rate variability (HRV) is a popular tool for monitoring autonomic nervous system status and training adaptation in athletes. It is believed that increases in HRV indicate effective training adaptation, but these are not always apparent in elite athletes. Resting HRV was recorded in 4 elite rowers (rowers A, B, C, and D) over the 7-wk period before their success at the 2015 World Rowing Championships. The natural logarithm of the square root of the mean sum of the squared differences (Ln rMSSD) between R-R intervals, Ln rMSSD:R-R ratio trends, and the Ln-rMSSD-to-R-R-interval relationship were assessed for each championship-winning rower. The time course of change in Ln rMSSD was athlete-dependent, with stagnation and decreases apparent. However, there were consistent substantial reductions in the Ln rMSSD:R-R ratio: rower A, baseline toward wk 5 (-2.35 ± 1.94); rower B, baseline to wk 4 and 5 (-0.41 ± 0.48 and -0.64 ± 0.65, respectively); rower C, baseline to wk 4 (-0.58 ± 0.66); and rower D, baseline to wk 4, 5, and 6 (-1.15 ± 0.91, -0.81 ± 0.74, and -1.43 ± 0.69, respectively). Reductions in Ln rMSSD concurrent with reductions in the Ln rMSSD:R-R ratio are indicative of parasympathetic saturation. Consequently, 3 of 4 rowers displayed substantial increases in parasympathetic activity despite having decreases in Ln rMSSD. These results confirm that a combination of indices should be used to monitor cardiac autonomic activity.

[Effect of hyperglycaemia on fetal heart in pregnant rats].

PubMed

Zou, Yan; Ding, Yiling

2009-02-01

To investigate the effect of hyperglycaemia on the cardiomyodial change of rat fetus. Thirty clean SD pregnant rats were randomly dividing into group A, B and C, 10 in each group. Group A were injected intraperitoneally 50 mg/kg streptozotocin on the 6th day of pregnancy, Group B were injected the same dose on the 13th day of pregnancy, while Group C were injected intraperitoneally 0.1 mmol/L citrate buffer solution on the 6th day of pregnancy. All rats were killed on the 21st day of pregnancy, the total fetus, live fetus, weight, and length of fetus were recorded. The blood glucose in the fetal rats was measured, and the fetal hearts were collected. The fetal hearts were pathologically examined under light microscope and electron microscope. Immunohistochemical staining was applied to determine Caspase-3 in the heart of fetus. (1) The blood glucose of pregnant rats in the 3 groups showed no difference before intervening (P>0.05). There was significant difference between Group A and C, Group B and C after intervening (P<0.01), but no significant difference between Group A and B was found (P>0.05). (2 )The fetus in Group A and B was heavier and longer than in Group C, with significant difference (P<0.01), but not between Group A and B (P>0.05). The blood glucose of fetus in Group A and B was lower than that in Group C, with significant difference (P<0.01), but not between Group A and B (P>0.05). The rate of fetal death in Group A, B, and C were 31.96%,12.84%, and 3.88%, respectively. Significant deviation existed in the 3 groups (P<0.01). (3) Under light microscope, fetal hearts in Group A and B showed disorder, cardiac muscle cells swelled. There were vacuoles in cytolymph and necrosis in the myocardial tissue. Significant deviation in the integral of fetal necrosis existed in the 3 groups (P<0.01). (4) Caspase-3 was detected in the fetal hearts, the positive area ratio and mean OD value had significant deviation in the 3 groups (P<0.01).(5) Under the electron

Cryogenic Control System Migration and Developments towards the UNICOS CERN Standard at INFN

NASA Astrophysics Data System (ADS)

Modanese, Paolo; Calore, Andrea; Contran, Tiziano; Friso, Alessandro; Pengo, Marco; Canella, Stefania; Burioli, Sergio; Gallese, Benedetto; Inglese, Vitaliano; Pezzetti, Marco; Pengo, Ruggero

The cryogenic control systems at Laboratori Nazionali di Legnaro (LNL) are undergoing an important and radical modernization, allowing all the plants controls and supervision systems to be renewed in a homogeneous way towards the CERN-UNICOS standard. Before the UNICOS migration project started there were as many as 7 different types of PLC and 7 different types of SCADA, each one requiring its own particular programming language. In these conditions, even a simple modification and/or integration on the program or on the supervision, required the intervention of a system integrator company, specialized in its specific control system. Furthermore it implied that the operators have to be trained to learn the different types of control systems. The CERN-UNICOS invented for LHC [1] has been chosen due to its reliability and planned to run and be maintained for decades on. The complete migration is part of an agreement between CERN and INFN.

The influence of low-frequency magnetic field on plasma antioxidant capacity and heart rate.

PubMed

Ciejka, Elzbieta B; Goraca, Anna

2009-01-01

Low-frequency magnetic field is widely applied as magnetotherapy in physiotherapeutic treatment. Recognition of positive and negative effects of the magnetic field has been the subject of numerous studies. Experimental studies concern, among others, the effect of this field on the heart rate and plasma antioxidant capacity. The aim of the study was to check whether a time-variable magnetic field of constant frequency and induction affects the heart rate and plasma antioxidant capacity. The tests were performed on Spraque-Dawley rats exposed to the magnetic field of the following parameters: frequency - 40 Hz, induction - 7 mT, time of exposure - 30 and 60 minutes. The measurements of ECG and plasma antioxidant capacity expressed in the number of reduced iron ions were performed on experimental animals: before, after a single exposure and after 14 days of exposure. A significant decrease of the heart rate was observed after 14 days of exposure. A variable magnetic field of the parameters: frequency - 40 Hz, induction - 7 mT and exposure time of 14 days caused an increase of the organism antioxidant defence, whereas a variable magnetic field of the frequency of 40 Hz, induction - 7 mT and exposure time 60 minutes for 14 days caused a significant decrease of the organism antioxidant defence. The exposure time affects heart rate, plasma antioxidant capacity and the organism defense ability against free radicals.

Women's Heart Disease: Heart Attack Symptoms

MedlinePlus

... this page please turn JavaScript on. Feature: Women's Heart Disease Heart Attack Symptoms Past Issues / Winter 2014 Table ... NHLBI has uncovered some of the causes of heart diseases and conditions, as well as ways to prevent ...

Physician-directed heart failure transitional care program: a retrospective case review.

PubMed

Ota, Ken S; Beutler, David S; Gerkin, Richard D; Weiss, Jessica L; Loli, Akil I

2013-10-01

Despite a variety of national efforts to improve transitions of care for patients at risk for rehospitalization, 30-day rehospitalization rates for patients with heart failure have remained largely unchanged. This is a retrospective review of 73 patients enrolled in our hospital-based, physican-directed Heart Failure Transitional Care Program (HFTCP). This study evaluated the 30- and 90- day readmission rates before and after enrollment in the program. The Transitionalist's services focused on bedside consultation prior to hospital discharge, follow-up home visits within 72 hours of discharge, frequent follow-up phone calls, disease-specific education, outpatient intravenous diuretic therapy, and around-the-clock telephone access to the Transitionalist. The pre-enrollment 30-day readmission rates for acute decompensated heart failure (ADHF) and all-cause readmission was 26.0% and 28.8%, respectively, while the post-enrollment rates for ADHF and all-cause readmission were 4.1% (P < 0.001) and 8.2% (P = 0.002), respectively. The pre-enrollment 90-day all-cause and ADHF readmission rates were 69.8%, and 58.9% respectively, while the post-enrollment rates for all-cause and ADHF were 27.3% (P < 0.001) and 16.4% (P < 0.001) respectively. Our physician-implemented HFTCP reduced rehospitalization risk for patients enrolled in the program. This program may serve as a model to assist other hospital systems to reduce readmission rates of patients with HF.

Chronobiological considerations for exercise and heart disease.

PubMed

Atkinson, Greg; Drust, Barry; George, Keith; Reilly, Thomas; Waterhouse, Jim

2006-01-01

Although regular physical activity is beneficial for many clinical conditions, an acute bout of exercise might increase the risk of an adverse clinical event, such as sudden cardiac death or myocardial infarction, particularly in vulnerable individuals. Since it is also known that the incidence of these events peaks in the morning and that some cardiac patients prefer to schedule leisure-time physical activity before lunch, the question arises as to whether morning exercise is 'inherently' more risky than physical activity performed at other times of day. We attempt to answer this question by reviewing the relevant epidemiological data as well as the results of chronobiological and exercise-related studies that have concentrated on the pathophysiological mechanisms for sudden cardiac events. We also consider generally how chronobiology might impact on exercise prescription in heart disease. We performed a structured literature search in the PubMed and WEBofSCIENCE databases for relevant studies published between 1981 and 2004. The limited amount of published epidemiological data did not allow us to conclude that a bout of vigorous exercise in the morning increases the relative risk of either primary cardiac events in apparently healthy individuals, or secondary events in cardiac patients enrolled in supervised exercise programmes. Nevertheless, these data are not directly relevant to individuals who have a history of heart disease and perform uncontrolled habitual activities. It appears as though the influence of time of day on the cardiovascular safety of this type of exercise has not been examined in this population. There is evidence that several pathophysiological variables (e.g. blood pressure, endothelial function, fibrinolysis) vary in parallel with typical diurnal changes in freely chosen activity. Nevertheless, few studies have been designed to examine specifically whether such variables respond differently to a 'set' level of exercise in the morning

Effectiveness of massage therapy on the mood of patients after open-heart surgery.

PubMed

Babaee, Sima; Shafiei, Zahra; Sadeghi, Mohsen Mir Mohammad; Nik, Ahmadreza Yazdan; Valiani, Mahboobeh

2012-02-01

Cardiovascular diseases have the highest death rates in human society. Coronary artery disease is among the most important of these diseases. No treatment of cardiovascular disease has as much impact on the quality of life of the patients as the heart surgery. The recovery from heart surgery is associated with symptoms of pain and psychological distress. In the early recovery period, the patients will face moderate symptoms of anxiety and depression. In this regard, various measures of nursing, as complementary therapy practices have been performed to help the patients for overcoming the physical and psychological needs. One of these methods, in recent years has been the use of complementary and alternative therapies, particularly massage therapy, after heart surgery. Thus, the aim of this study was to determine the effectiveness of massage therapy on the mood of patients after open-heart surgery in Isfahan Chamran Hospital during 2010-11. In this study 72 patients, who underwent coronary artery bypass surgery, were selected. They were randomly assigned to the two case and control groups. The patients of the case group (n = 36) received Swedish massage for 20 minutes in 4 sessions in 4 consecutive days, 3 to 6 days after the open-heart surgery. The patients in the control group received only the routine care. The mood questionnaire (POMS) which was used in this study has been completed the day before the start of the study and intervention and again after the last day of the intervention. SPSS software version 12 and descriptive and inferential statistical methods were used for data analysis. The comparison of study results showed that massage decreased the overall rating of the patients' mood after the surgery. The use of massage therapy as an effective nursing intervention can improve the patients' mood after open-heart surgery. Due to the low cost and simplicity of this method, it can perhaps be used as a complement to drug therapy and postoperative

Variations in vital signs in the last days of life in patients with advanced cancer.

PubMed

Bruera, Sebastian; Chisholm, Gary; Dos Santos, Renata; Crovador, Camila; Bruera, Eduardo; Hui, David

2014-10-01

Few studies have examined variation in vital signs in the last days of life. We determined the variation of vital signs in the final two weeks of life in patients with advanced cancer and examined their association with impending death in three days. In this prospective, longitudinal, observational study, we enrolled consecutive patients admitted to two acute palliative care units and documented their vital signs (heart rate, blood pressure, respiratory rate, oxygen saturation, and temperature) twice a day serially from admission to death or discharge. Of 357 patients, 203 (57%) died in hospital. Systolic blood pressure (P < 0.001), diastolic blood pressure (P < 0.001), and oxygen saturation (P < 0.001) decreased significantly in the final three days of life, and temperature increased slightly (P < 0.04). Heart rate (P = 0.22) and respiratory rate (P = 0.24) remained similar in the last three days. Impending death in three days was significantly associated with increased heart rate (odds ratio [OR] = 2; P = 0.01), decreased systolic blood pressure (OR = 2.5; P = 0.004), decreased diastolic blood pressure (OR = 2.3; P = 0.002), and decreased oxygen saturation (OR = 3.7; P = 0.003) from baseline readings on admission. These changes had high specificity (≥ 80%), low sensitivity (≤ 35%), and modest positive likelihood ratios (≤ 5) for impending death within three days. A large proportion of patients had normal vital signs in the last days of life. Blood pressure and oxygen saturation decreased in the last days of life. Clinicians and families cannot rely on vital sign changes alone to rule in or rule out impending death. Our findings do not support routine vital signs monitoring of patients who are imminently dying. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Variations in Vital Signs in the Last Days of Life in Patients With Advanced Cancer

PubMed Central

Bruera, Sebastian; Chisholm, Gary; Dos Santos, Renata; Crovador, Camila; Bruera, Eduardo; Hui, David

2014-01-01

Context Few studies have examined variation in vital signs in the last days of life. Objectives We determined the variation of vital signs in the final two weeks of life in patients with advanced cancer and examined their association with impending death in three days. Methods In this prospective, longitudinal, observational study, we enrolled consecutive patients admitted to two acute palliative care units and documented their vital signs (heart rate, blood pressure, respiratory rate, oxygen saturation, and temperature) twice a day serially from admission to death or discharge. Results Of 357 patients, 203 (55%) died in hospital. Systolic blood pressure (P < 0.001), diastolic blood pressure (P < 0.001), and oxygen saturation (P < 0.001) decreased significantly in the final three days of life, and temperature increased slightly (P < 0.04). Heart rate (P = 0.22) and respiratory rate (P = 0.24) remained similar in the last three days. Impending death in three days was significantly associated with increased heart rate (odds ratio [OR] = 2; P = 0.01), decreased systolic blood pressure (OR = 2.5; P = 0.004), decreased diastolic blood pressure (OR = 2.3; P = 0.002), and decreased oxygen saturation (OR = 3.7; P = 0.003) from baseline readings on admission. These changes had high specificity (≥80%), low sensitivity (≤35%), and modest positive likelihood ratios (≤5) for impending death within three days. A large proportion of patients had normal vital signs in the last days of life. Conclusion Blood pressure and oxygen saturation decreased in the last days of life. Clinicians and families cannot rely on vital sign changes alone to rule in or rule out impending death. Our findings do not support routine vital signs monitoring of patients who are imminently dying. PMID:24731412

Identifying predictors of hospital readmission following congenital heart surgery through analysis of a multiinstitutional administrative Database.

PubMed

Smith, Andrew H; Doyle, Thomas P; Mettler, Bret A; Bichell, David P; Gay, James C

2015-01-01

Despite resource burdens associated with hospital readmission, there remains little multiinstitutional data available to identify children at risk for readmission following congenital heart surgery. Children undergoing congenital heart surgery and discharged home between January of 2011 and December 2012 were identified within the Pediatric Health Information System database, a multiinstitutional collection of clinical and administrative data. Patient discharges were assigned to derivation and validation cohorts for the purposes of predictive model design, with 17 871 discharges meeting inclusion criteria. Readmission within 30 days was noted following 956 (11%) of discharges within the derivation cohort (n = 9104), with a median time to readmission of 9 days (interquartile range [IQR] 5-18 days). Readmissions resulted in a rehospitalization length of stay of 4 days (IQR 2-8 days) and were associated with an intensive care unit (ICU) admission in 36% of cases. Independent perioperative predictors of readmission included Risk Adjustment in Congenital Heart Surgery score of 6 (odds ratio [OR] 2.6, 95% confidence interval [CI] 1.8-3.7, P < .001) and ICU length of stay of at least 7 days (OR 1.9 95% CI 1.6-2.2, P < .001). Demographic predictors included Hispanic ethnicity (OR 1.2, 95% CI 1.1-1.4, P = .014) and government payor status (OR 1.2, 95% CI 1.1-1.4, P = .007). Predictive model performance was modest among validation cohort (c statistic 0.68, 95% CI 0.66-0.69, P < .001). Readmissions following congenital heart surgery are common and associated with significant resource consumption. While we describe independent predictors that may identify patients at risk for readmission prior to hospital discharge, there likely remains other unreported factors that may contribute to readmission following congenital heart surgery. © 2014 Wiley Periodicals, Inc.

Increase in hospital admission rates for heart failure in The Netherlands, 1980-1993.

PubMed Central

Reitsma, J. B.; Mosterd, A.; de Craen, A. J.; Koster, R. W.; van Capelle, F. J.; Grobbee, D. E.; Tijssen, J. G.

1996-01-01

OBJECTIVE: To study the trend in hospital admission rates for heart failure in the Netherlands from 1980 to 1993. DESIGN: All hospital admissions in the Netherlands with a principal discharge diagnosis of heart failure were analysed. In addition, individual records of heart failure patients from a subset of 7 hospitals were analysed to estimate the frequency and timing of readmissions. RESULTS: The total number of discharges for men increased from 7377 in 1980 to 13 022 in 1993, and for women from 7064 to 12 944. From 1980 through 1993 age adjusted discharge rates rose 48% for men and 40% for women. Age adjusted in-hospital mortality for heart failure decreased from 19% in 1980 to 15% in 1993. For all age groups in-hospital mortality for men was higher than for women. The mean length of hospital admissions in 1993 was 14.0 days for men and 16.4 days for women. A review of individual patient records from a 6.3% sample of all hospital admissions in the Netherlands indicated that within a 2 year period 18% of the heart failure patients were admitted more than once and 5% more than twice. CONCLUSIONS: For both men and women a pronounced increase in age adjusted discharge rates for heart failure was observed in the Netherlands from 1980 to 1993. Readmissions were a prominent feature among heart failure patients. Higher survival rates after acute myocardial infarction and the longer survival of patients with heart disease, including heart failure may have contributed to the observed increase. The importance of advances in diagnostic tools and of possible changes in admission policy remain uncertain. PMID:8944582

Effects of Physician Volume on Readmission and Mortality in Elderly Patients with Heart Failure: Nationwide Cohort Study.

PubMed

Lee, Joo Eun; Park, Eun Cheol; Jang, Suk Yong; Lee, Sang Ah; Choy, Yoon Soo; Kim, Tae Hyun

2018-03-01

Readmission and mortality rates of patients with heart failure are good indicators of care quality. To determine whether hospital resources are associated with care quality for cardiac patients, we analyzed the effect of number of physicians and the combined effects of number of physicians and beds on 30-day readmission and 1-year mortality. We used national cohort sample data of the National Health Insurance Service (NHIS) claims in 2002-2013. Subjects comprised 2345 inpatients (age: >65 years) admitted to acute-care hospitals for heart failure. A multivariate Cox regression was used. Of the 2345 patients hospitalized with heart failure, 812 inpatients (34.6%) were readmitted within 30 days and 190 (8.1%) had died within a year. Heart-failure patients treated at hospitals with low physician volumes had higher readmission and mortality rates than high physician volumes [30-day readmission: hazard ratio (HR)=1.291, 95% confidence interval (CI)=1.020-1.633; 1-year mortality: HR=2.168, 95% CI=1.415-3.321]. Patients admitted to hospitals with low or middle bed and physician volume had higher 30-day readmission and 1-year mortality rates than those admitted to hospitals with high volume (30-day readmission: HR=2.812, 95% CI=1.561-5.066 for middle-volume beds & low-volume physicians, 1-year mortality: HR=8.638, 95% CI=2.072-36.02 for middle-volume beds & low-volume physicians). Physician volume is related to lower readmission and mortality for heart failure. Of interest, 30-day readmission and 1-year mortality were significantly associated with the combined effects of physician and institution bed volume. © Copyright: Yonsei University College of Medicine 2018

CERN openlab: Engaging industry for innovation in the LHC Run 3-4 R&D programme

NASA Astrophysics Data System (ADS)

Girone, M.; Purcell, A.; Di Meglio, A.; Rademakers, F.; Gunne, K.; Pachou, M.; Pavlou, S.

2017-10-01

LHC Run3 and Run4 represent an unprecedented challenge for HEP computing in terms of both data volume and complexity. New approaches are needed for how data is collected and filtered, processed, moved, stored and analysed if these challenges are to be met with a realistic budget. To develop innovative techniques we are fostering relationships with industry leaders. CERN openlab is a unique resource for public-private partnership between CERN and leading Information Communication and Technology (ICT) companies. Its mission is to accelerate the development of cutting-edge solutions to be used by the worldwide HEP community. In 2015, CERN openlab started its phase V with a strong focus on tackling the upcoming LHC challenges. Several R&D programs are ongoing in the areas of data acquisition, networks and connectivity, data storage architectures, computing provisioning, computing platforms and code optimisation and data analytics. This paper gives an overview of the various innovative technologies that are currently being explored by CERN openlab V and discusses the long-term strategies that are pursued by the LHC communities with the help of industry in closing the technological gap in processing and storage needs expected in Run3 and Run4.

Heart murmurs

MedlinePlus

Chest sounds - murmurs; Heart sounds - abnormal; Murmur - innocent; Innocent murmur; Systolic heart murmur; Diastolic heart murmur ... The heart has 4 chambers: Two upper chambers (atria) Two lower chambers (ventricles) The heart has valves that close ...

[Immunological status of the pediatric patient who has undergone heart surgery].

PubMed

Valenzuela Flores, A; Wakida, G; Limón Rojas, A; Obregón, C; Orihuela, O; Romero, C

1995-01-01

Communication of results a study the effect of open and closed-heart surgery in the immune system of infants and children. Data collected 24 hrs before anesthesia and surgery and five days after surgery. Operating room and pediatric intensive care of Hospital Central de Petróleos Mexicanos (PEMEX) in the South, Mexico City. Children undergoing surgery for correction of congenital heart disease (age 16 months to 14 years). A total of 16 patients. increased neutrophil counts with luymphopenia in both groups (p < 0.05), serum levels of the complement components C3 and C4 were higher after surgery, serum immunoglobulin IgG, IgA and IgM were higher after surgery, serum immunoglobulin IgG, IgA and IgM were decreased form preoperative levels (p < 0.01). Two patients had infection in the surgical wound. The effect of open and closed-heart surgery produced transitory immunodeficiency with recuperation of his immune systems and 5th day after surgery.

Daily physical activity in stable heart failure patients.

PubMed

Dontje, Manon L; van der Wal, Martje H L; Stolk, Ronald P; Brügemann, Johan; Jaarsma, Tiny; Wijtvliet, Petra E P J; van der Schans, Cees P; de Greef, Mathieu H G

2014-01-01

Physical activity is the only nonpharmacological therapy that is proven to be effective in heart failure (HF) patients in reducing morbidity. To date, little is known about the levels of daily physical activity in HF patients and about related factors. The objectives of this study were to (a) describe performance-based daily physical activity in HF patients, (b) compare it with physical activity guidelines, and (c) identify related factors of daily physical activity. The daily physical activity of 68 HF patients was measured using an accelerometer (SenseWear) for 48 hours. Psychological characteristics (self-efficacy, motivation, and depression) were measured using questionnaires. To have an indication how to interpret daily physical activity levels of the study sample, time spent on moderate- to vigorous-intensity physical activities was compared with the 30-minute activity guideline. Steps per day was compared with the criteria for healthy adults, in the absence of HF-specific criteria. Linear regression analyses were used to identify related factors of daily physical activity. Forty-four percent were active for less than 30 min/d, whereas 56% were active for more than 30 min/d. Fifty percent took fewer than 5000 steps per day, 35% took 5000 to 10 000 steps per day, and 15% took more than 10 000 steps per day. Linear regression models showed that New York Heart Association classification and self-efficacy were the most important factors explaining variance in daily physical activity. The variance in daily physical activity in HF patients is considerable. Approximately half of the patients had a sedentary lifestyle. Higher New York Heart Association classification and lower self-efficacy are associated with less daily physical activity. These findings contribute to the understanding of daily physical activity behavior of HF patients and can help healthcare providers to promote daily physical activity in sedentary HF patients.

Health Literacy and Mortality: A Cohort Study of Patients Hospitalized for Acute Heart Failure

PubMed Central

McNaughton, Candace D; Cawthon, Courtney; Kripalani, Sunil; Liu, Dandan; Storrow, Alan B; Roumie, Christianne L

2015-01-01

Background More than 30% of patients hospitalized for heart failure are rehospitalized or die within 90 days of discharge. Lower health literacy is associated with mortality among outpatients with chronic heart failure; little is known about this relationship after hospitalization for acute heart failure. Methods and Results Patients hospitalized for acute heart failure and discharged home between November 2010 and June 2013 were followed through December 31, 2013. Nurses administered the Brief Health Literacy Screen at admission; low health literacy was defined as Brief Health Literacy Screen ≤9. The primary outcome was all-cause mortality. Secondary outcomes were time to first rehospitalization and, separately, time to first emergency department visit within 90 days of discharge. Cox proportional hazards models determined their relationships with health literacy, adjusting for age, gender, race, insurance, education, comorbidity, and hospital length of stay. For the 1379 patients, average age was 63.1 years, 566 (41.0%) were female, and 324 (23.5%) had low health literacy. Median follow-up was 20.7 months (interquartile range 12.8 to 29.6 months), and 403 (29.2%) patients died. Adjusted hazard ratio for death among patients with low health literacy was 1.34 (95% CI 1.04, 1.73, P=0.02) compared to Brief Health Literacy Screen >9. Within 90 days of discharge, there were 415 (30.1%) rehospitalizations and 201 (14.6%) emergency department visits, with no evident association with health literacy. Conclusions Lower health literacy was associated with increased risk of death after hospitalization for acute heart failure. There was no evident relationship between health literacy and 90-day rehospitalization or emergency department visits. PMID:25926328

Changes in Heart Rate and Autonomic Nervous Activity after Orthopedic Surgery in Elderly Japanese Patients

PubMed Central

TAN, CHIEKO; SAITO, NAO; MIYAWAKI, IKUKO

2016-01-01

Evidence regarding nursing support for delirium prevention is currently insufficient. An evaluation of changes in autonomic nervous activity over time after surgery would elucidate the features of autonomic nervous activity in patients with delirium. These results could provide a basis for effective nursing intervention and timing for preventing the onset of delirium. Here, we aimed to obtain basic data on effective nursing interventions for preventing the onset of postoperative delirium. Heart rate variability was recorded during the morning and nighttime on the day before surgery until 3 days postoperatively in elderly patients who underwent orthopedic surgery to investigate the manner in which heart rate and autonomic nervous activity changed over time. Data were collected over 11 months from July 2013 to November 2014. Surgical stress led to the maintenance of heart rate at a significantly higher value from the day of the surgery until postoperative day 3 compared to that before surgery. Moreover, the autonomic nervous activity remained unchanged during the morning, and it was significantly lower during the night from postoperative day 1 until postoperative day 3 than before the surgery. These results suggest that there is a decrease in parasympathetic nervous activity during the nighttime postoperatively. PMID:28289270

Prospective Heart Tracking for Whole-heart Magnetic Resonance Angiography

PubMed Central

Moghari, Mehdi H.; Geva, Tal; Powell, Andrew J.

2015-01-01

Purpose To develop a prospective respiratory-gating technique (Heart-NAV) for use with contrast-enhanced 3D inversion recovery (IR) whole-heart magnetic resonance angiography (MRA) acquisitions that directly tracks heart motion without creating image inflow artifact. Methods With Heart-NAV, 1 of the startup pulses for the whole-heart steady-state free precession MRA sequence is used to collect the centerline of k-space, and its 1-dimensional reconstruction is fed into the standard diaphragm-navigator (NAV) signal analysis process to prospectively gate and track respiratory-induced heart displacement. Ten healthy volunteers underwent non-contrast whole-heart MRA acquisitions using the conventional diaphragm-NAV and Heart-NAV with 5 and 10 mm acceptance windows in a 1.5T scanner. Five patients underwent contrast-enhanced IR whole-heart MRA using a diaphragm-NAV and Heart-NAV with a 5 mm acceptance window. Results For non-contrast whole-heart MRA with both the 5 and 10 mm acceptance windows, Heart-NAV yielded coronary artery vessel sharpness and subjective visual scores that were not significantly different than those using a conventional diaphragm-NAV. Scan time for Heart-NAV was 10% shorter (p<0.05). In patients undergoing contrast-enhanced IR whole-heart MRA, inflow artifact was seen with the diaphragm-NAV but not with Heart-NAV. Conclusion Compared to a conventional diaphragm-NAV, Heart-NAV achieves similar image quality in a slightly shorter scan time and eliminates inflow artifact. PMID:26843458

Work environment of Danish shift and day workers.

PubMed

Bøggild, H; Burr, H; Tüchsen, F; Jeppesen, H J

2001-04-01

Both shift work and other work environment factors have been shown to be related to heart disease. This study examined whether shift work is associated with other work environment factors related to heart disease in a random sample of the population. If so, shift work could be acting as a proxy for work environment differences. Data on 5940 employees in the Danish Work Environment Cohort Study from 1990 were reanalyzed. The information included work schedules [permanent day work, irregular workhours (including morning work), 2-shift or fixed evening and 3-shift or fixed night], length of workweek, physical factors (noise, heat, dust, passive smoking, walking, standing and monotonous repetitive tasks), and psychosocial factors (including demands and control dimensions, social support, conflicts and job insecurity). At least 1 group of shift workers had a higher prevalence of nearly every unfavorable work environment factor investigated. Exceptions were dust exposure and quantitative demands. Especially conflicts at work and low decision latitude were higher among all the groups of shift workers, and all-day walking or standing work and part-time jobs were more often found among female shift workers. The 3 different shiftwork groups were exposed to different parts of the work environment, and also men and women in shift work differed in relation to the work environment. Age and social class influenced the relationship, but not in any particular pattern. In a heterogenous population shift work was found to be associated with other work environment factors suspected to cause heart disease.

Post-Exercise Heart Rate Recovery Independently Predicts Clinical Outcome in Patients with Acute Decompensated Heart Failure.

PubMed

Youn, Jong-Chan; Lee, Hye Sun; Choi, Suk-Won; Han, Seong-Woo; Ryu, Kyu-Hyung; Shin, Eui-Cheol; Kang, Seok-Min

2016-01-01

Post-exercise heart rate recovery (HRR) is an index of parasympathetic function associated with clinical outcome in patients with chronic heart failure. However, its relationship with the pro-inflammatory response and prognostic value in consecutive patients with acute decompensated heart failure (ADHF) has not been investigated. We measured HRR and pro-inflammatory markers in 107 prospectively and consecutively enrolled, recovered ADHF patients (71 male, 59 ± 15 years, mean ejection fraction 28.9 ± 14.2%) during the pre-discharge period. The primary endpoint included cardiovascular (CV) events defined as CV mortality, cardiac transplantation, or rehospitalization due to HF aggravation. The CV events occurred in 30 (28.0%) patients (5 cardiovascular deaths and 7 cardiac transplantations) during the follow-up period (median 214 days, 11-812 days). When the patients with ADHF were grouped by HRR according to the Contal and O'Quigley's method, low HRR was shown to be associated with significantly higher levels of serum monokine-induced by gamma interferon (MIG) and poor clinical outcome. Multivariate Cox regression analysis revealed that low HRR was an independent predictor of CV events in both enter method and stepwise method. The addition of HRR to a model significantly increased predictability for CV events across the entire follow-up period. Impaired post-exercise HRR is associated with a pro-inflammatory response and independently predicts clinical outcome in patients with ADHF. These findings may explain the relationship between autonomic dysfunction and clinical outcome in terms of the inflammatory response in these patients.

The acute physiological stress response to an emergency alarm and mobilization during the day and at night.

PubMed

Hall, Sarah J; Aisbett, Brad; Tait, Jamie L; Turner, Anne I; Ferguson, Sally A; Main, Luana C

2016-01-01

The purpose of this study was to investigate the acute physiological stress response to an emergency alarm and mobilization during the day and at night. Sixteen healthy males aged 25 ± 4 years (mean ± SD) spent four consecutive days and nights in a sleep laboratory. This research used a within-participants design with repeated measures for time, alarm condition (alarm or control), and trial (day or night). When an alarm sounded, participants were required to mobilize immediately. Saliva samples for cortisol analysis were collected 0 min, 15 min, 30 min, 45 min, 60 min, 90 min, and 120 min after mobilization, and at corresponding times in control conditions. Heart rate was measured continuously throughout the study. Heart rate was higher in the day (F(20,442) = 9.140, P < 0.001) and night (F(23,459) = 8.356, P < 0.001) alarm conditions compared to the respective control conditions. There was no difference in saliva cortisol between day alarm and day control conditions. Cortisol was higher (F(6,183) = 2.450, P < 0.001) following the night alarm and mobilization compared to the night control condition. The magnitude of difference in cortisol between night control and night alarm conditions was greater (F(6,174) = 4.071, P < 0.001) than the magnitude of difference between the day control and day alarm conditions. The augmented heart rate response to the day and night alarms supports previous observations in field settings. Variations in the cortisol responses between conditions across the day and night may relate to differences in participants' ability to interpret the alarm when sleeping versus when awake.

The acute physiological stress response to an emergency alarm and mobilization during the day and at night

PubMed Central

Hall, Sarah J; Aisbett, Brad; Tait, Jamie L; Turner, Anne I; Ferguson, Sally A; Main, Luana C

2016-01-01

The purpose of this study was to investigate the acute physiological stress response to an emergency alarm and mobilization during the day and at night. Sixteen healthy males aged 25 ± 4 years (mean ± SD) spent four consecutive days and nights in a sleep laboratory. This research used a within-participants design with repeated measures for time, alarm condition (alarm or control), and trial (day or night). When an alarm sounded, participants were required to mobilize immediately. Saliva samples for cortisol analysis were collected 0 min, 15 min, 30 min, 45 min, 60 min, 90 min, and 120 min after mobilization, and at corresponding times in control conditions. Heart rate was measured continuously throughout the study. Heart rate was higher in the day (F20,442 = 9.140, P < 0.001) and night (F23,459 = 8.356, P < 0.001) alarm conditions compared to the respective control conditions. There was no difference in saliva cortisol between day alarm and day control conditions. Cortisol was higher (F6,183 = 2.450, P < 0.001) following the night alarm and mobilization compared to the night control condition. The magnitude of difference in cortisol between night control and night alarm conditions was greater (F6,174 = 4.071, P < 0.001) than the magnitude of difference between the day control and day alarm conditions. The augmented heart rate response to the day and night alarms supports previous observations in field settings. Variations in the cortisol responses between conditions across the day and night may relate to differences in participants’ ability to interpret the alarm when sleeping versus when awake. PMID:27157688

Prospective heart tracking for whole-heart magnetic resonance angiography.

PubMed

Moghari, Mehdi H; Geva, Tal; Powell, Andrew J

2017-02-01

To develop a prospective respiratory-gating technique (Heart-NAV) for use with contrast-enhanced three-dimensional (3D) inversion recovery (IR) whole-heart magnetic resonance angiography (MRA) acquisitions that directly tracks heart motion without creating image inflow artifact. With Heart-NAV, one of the startup pulses for the whole-heart steady-state free precession MRA sequence is used to collect the centerline of k-space, and its one-dimensional reconstruction is fed into the standard diaphragm-navigator (NAV) signal analysis process to prospectively gate and track respiratory-induced heart displacement. Ten healthy volunteers underwent non-contrast whole-heart MRA acquisitions using the conventional diaphragm-NAV and Heart-NAV with 5 and 10-mm acceptance windows in a 1.5T scanner. Five patients underwent contrast-enhanced IR whole-heart MRA using a diaphragm-NAV and Heart-NAV with a 5-mm acceptance window. For non-contrast whole-heart MRA with both the 5 and 10-mm acceptance windows, Heart-NAV yielded coronary artery vessel sharpness and subjective visual scores that were not significantly different than those using a conventional diaphragm-NAV. Scan time for Heart-NAV was 10% shorter (p < 0.05). In patients undergoing contrast-enhanced IR whole-heart MRA, inflow artifact was seen with the diaphragm-NAV but not with Heart-NAV. Compared with a conventional diaphragm-NAV, Heart-NAV achieves similar image quality in a slightly shorter scan time and eliminates inflow artifact. Magn Reson Med 77:759-765, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

Preparation of a primary argon beam for the CERN fixed target physics.

PubMed

Küchler, D; O'Neil, M; Scrivens, R; Thomae, R

2014-02-01

The fixed target experiment NA61 in the North Area of the Super Proton Synchrotron is studying phase transitions in strongly interacting matter. Up to now they used the primary beams available from the CERN accelerator complex (protons and lead ions) or fragmented beams created from the primary lead ion beam. To explore a wider range of energies and densities a request was made to provide primary argon and xenon beams. This paper describes the results of the setting up and 10 week test run of the Ar(11+) beam from the 14.5 GHz ECR ion source and the linear accelerator (Linac3) at CERN.

76 FR 76601 - International Day of Persons With Disabilities, 2011

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-08

... securing fundamental human rights for all persons with disabilities around the world. On International Day... make at home and abroad, and we remember that disability rights are universal rights to be recognized... around the world, my Administration is putting disability rights at the heart of our Nation's foreign...

Heart Failure

MedlinePlus

Heart failure is a condition in which the heart can't pump enough blood to meet the body's needs. Heart failure does not mean that your heart has stopped ... and shortness of breath Common causes of heart failure are coronary artery disease, high blood pressure and ...

User and group storage management the CMS CERN T2 centre

NASA Astrophysics Data System (ADS)

Cerminara, G.; Franzoni, G.; Pfeiffer, A.

2015-12-01

A wide range of detector commissioning, calibration and data analysis tasks is carried out by CMS using dedicated storage resources available at the CMS CERN Tier-2 centre. Relying on the functionalities of the EOS disk-only storage technology, the optimal exploitation of the CMS user/group resources has required the introduction of policies for data access management, data protection, cleanup campaigns based on access pattern, and long term tape archival. The resource management has been organised around the definition of working groups and the delegation to an identified responsible of each group composition. In this paper we illustrate the user/group storage management, and the development and operational experience at the CMS CERN Tier-2 centre in the 2012-2015 period.

Across Europe to CERN: Taking students on the ultimate physics experience

NASA Astrophysics Data System (ADS)

Wheeler, Sam

2018-05-01

In 2013, I was an Einstein Fellow with the U.S. Department of Energy and I was asked by a colleague, working in a senator's office, if I would join him in a meeting with a physicist to "translate" the science into something more understandable. That meeting turned out to be a wonderful opportunity I would never have otherwise had. During the meeting I met Michael Tuts, a physicist who was working on project ATLAS at CERN. Afterwards, I walked with him out of the Senate office building to Union Station and, in parting, he gave me his card and told me that if I were in Geneva that he could help me get a tour of CERN and the LHC.

Heart MRI

MedlinePlus

Magnetic resonance imaging - cardiac; Magnetic resonance imaging - heart; Nuclear magnetic resonance - cardiac; NMR - cardiac; MRI of the heart; Cardiomyopathy - MRI; Heart failure - MRI; Congenital heart disease - MRI

Dynamic changes in scope for heart rate and cardiac autonomic control during warm acclimation in rainbow trout.

PubMed

Ekström, Andreas; Hellgren, Kim; Gräns, Albin; Pichaud, Nicolas; Sandblom, Erik

2016-04-15

Time course studies are critical for understanding regulatory mechanisms and temporal constraints in ectothermic animals acclimating to warmer temperatures. Therefore, we investigated the dynamics of heart rate and its neuro-humoral control in rainbow trout ( ITALIC! Onchorhynchus mykissL.) acclimating to 16°C for 39 days after being acutely warmed from 9°C. Resting heart rate was 39 beats min(-1)at 9°C, and increased significantly when fish were acutely warmed to 16°C ( ITALIC! Q10=1.9), but then declined during acclimation ( ITALIC! Q10=1.2 at day 39), mainly due to increased cholinergic inhibition while the intrinsic heart rate and adrenergic tone were little affected. Maximum heart rate also increased with warming, although a partial modest decrease occurred during the acclimation period. Consequently, heart rate scope exhibited a complex pattern with an initial increase with acute warming, followed by a steep decline and then a subsequent increase, which was primarily explained by cholinergic inhibition of resting heart rate. © 2016. Published by The Company of Biologists Ltd.

Physician-Directed Heart Failure Transitional Care Program: A Retrospective Case Review

PubMed Central

Ota, Ken S.; Beutler, David S.; Gerkin, Richard D.; Weiss, Jessica L.; Loli, Akil I.

2013-01-01

Background Despite a variety of national efforts to improve transitions of care for patients at risk for rehospitalization, 30-day rehospitalization rates for patients with heart failure have remained largely unchanged. Methods This is a retrospective review of 73 patients enrolled in our hospital-based, physican-directed Heart Failure Transitional Care Program (HFTCP). This study evaluated the 30- and 90- day readmission rates before and after enrollment in the program. The Transitionalist’s services focused on bedside consultation prior to hospital discharge, follow-up home visits within 72 hours of discharge, frequent follow-up phone calls, disease-specific education, outpatient intravenous diuretic therapy, and around-the-clock telephone access to the Transitionalist. Results The pre-enrollment 30-day readmission rates for acute decompensated heart failure (ADHF) and all-cause readmission was 26.0% and 28.8%, respectively, while the post-enrollment rates for ADHF and all-cause readmission were 4.1% (P < 0.001) and 8.2% (P = 0.002), respectively. The pre-enrollment 90-day all-cause and ADHF readmission rates were 69.8%, and 58.9% respectively, while the post-enrollment rates for all-cause and ADHF were 27.3% (P < 0.001) and 16.4% (P < 0.001) respectively. Conclusions Our physician-implemented HFTCP reduced rehospitalization risk for patients enrolled in the program. This program may serve as a model to assist other hospital systems to reduce readmission rates of patients with HF. PMID:23976905

Heart Health - Heart Disease: Symptoms, Diagnosis, Treatment

MedlinePlus

... Bar Home Current Issue Past Issues Cover Story Heart Health Heart Disease: Symptoms, Diagnosis, Treatment Past Issues / Winter 2009 ... of this page please turn Javascript on. Most heart attacks happen when a clot in the coronary ...

Deregulated Cardiac Specific MicroRNAs in Postnatal Heart Growth.

PubMed

Yu, Pujiao; Wang, Hongbao; Xie, Yuan; Zhou, Jinzhe; Yao, Jianhua; Che, Lin

2016-01-01

The heart is recognized as an organ that is terminally differentiated by adulthood. However, during the process of human development, the heart is the first organ with function in the embryo and grows rapidly during the postnatal period. MicroRNAs (miRNAs, miRs), as regulators of gene expression, play important roles during the development of multiple systems. However, the role of miRNAs in postnatal heart growth is still unclear. In this study, by using qRT-PCR, we compared the expression of seven cardiac- or muscle-specific miRNAs that may be related to heart development in heart tissue from mice at postnatal days 0, 3, 8, and 14. Four miRNAs-miR-1a-3p, miR-133b-3p, miR-208b-3p, and miR-206-3p-were significantly decreased while miR-208a-3p was upregulated during the postnatal heart growth period. Based on these results, GeneSpring GX was used to predict potential downstream targets by performing a 3-way comparison of predictions from the miRWalk, PITA, and microRNAorg databases. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis were used to identify potential functional annotations and signaling pathways related to postnatal heart growth. This study describes expression changes of cardiac- and muscle-specific miRNAs during postnatal heart growth and may provide new therapeutic targets for cardiovascular diseases.

77 FR 35807 - Flag Day and National Flag Week, 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-15

.... Generations of service members have raised our country's colors over military bases and at sea, and... Day and National Flag Week, 2012 By the President of the United States of America A Proclamation... Woodrow Wilson asked us to ``stand with united hearts for an America which no man can corrupt, no...

Heart Health: The Heart Truth Campaign 2009

MedlinePlus

... Bar Home Current Issue Past Issues Cover Story Heart Health The Heart Truth Campaign 2009 Past Issues / Winter 2009 Table ... one of the celebrities supporting this year's The Heart Truth campaign. Both R&B singer Ashanti (center) ...

Women's Heart Disease: Heart Disease Risk Factors

MedlinePlus

... this page please turn JavaScript on. Feature: Women's Heart Disease Heart Disease Risk Factors Past Issues / Winter 2014 Table ... or habits may raise your risk for coronary heart disease (CHD). These conditions are known as risk ...

Fluid intake, hydration, work physiology of wildfire fighters working in the heat over consecutive days.

PubMed

Raines, Jenni; Snow, Rodney; Nichols, David; Aisbett, Brad

2015-06-01

(i) To evaluate firefighters' pre- and post-shift hydration status across two shifts of wildfire suppression work in hot weather conditions. (ii) To document firefighters' fluid intake during and between two shifts of wildfire suppression work. (iii) To compare firefighters' heart rate, activity, rating of perceived exertion (RPE), and core temperature across the two consecutive shifts of wildfire suppression work. Across two consecutive days, 12 salaried firefighters' hydration status was measured immediately pre- and post-shift. Hydration status was also measured 2h post-shift. RPE was also measured immediately post-shift on each day. Work activity, heart rate, and core temperature were logged continuously during each shift. Ten firefighters also manually recorded their food and fluid intake before, during, and after both fireground shifts. Firefighters were not euhydrated at all measurement points on Day one (292±1 mOsm l(-1)) and euhydrated across these same time points on Day two (289±0.5 mOsm l(-1)). Fluid consumption following firefighters' shift on Day one (1792±1134ml) trended (P = 0.08) higher than Day two (1108±1142ml). Daily total fluid intake was not different (P = 0.27), averaging 6443±1941ml across both days. Core temperature and the time spent ≥ 70%HRmax were both elevated on Day one (when firefighters were not euhydrated). Firefighters' work activity profile was not different between both days of work. There was no difference in firefighters' pre- to post-shift hydration within each shift, suggesting ad libitum drinking was at least sufficient to maintain pre-shift hydration status, even in hot conditions. Firefighters' relative hypohydration on Day one (despite a slightly lower ambient temperature) may have been associated with elevations in core temperature, more time in the higher heart rate zones, and 'post-shift' RPE. © The Author 2015. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

PARTICLE PHYSICS: CERN Collider Glimpses Supersymmetry--Maybe.

PubMed

Seife, C

2000-07-14

Last week, particle physicists at the CERN laboratory in Switzerland announced that by smashing together matter and antimatter in four experiments, they detected an unexpected effect in the sprays of particles that ensued. The anomaly is subtle, and physicists caution that it might still be a statistical fluke. If confirmed, however, it could mark the long-sought discovery of a whole zoo of new particles--and the end of a long-standing model of particle physics.

"Young at heart": Regenerative potential linked to immature cardiac phenotypes.

PubMed

Gomes, Renata S M; Skroblin, Philipp; Munster, Alex B; Tomlins, Hannah; Langley, Sarah R; Zampetaki, Anna; Yin, Xiaoke; Wardle, Fiona C; Mayr, Manuel

2016-03-01

The adult human myocardium is incapable of regeneration; yet, the zebrafish (Danio rerio) can regenerate damaged myocardium. Similar to the zebrafish heart, hearts of neonatal, but not adult mice are capable of myocardial regeneration. We performed a proteomics analysis of adult zebrafish hearts and compared their protein expression profile to hearts from neonatal and adult mice. Using difference in-gel electrophoresis (DIGE), there was little overlap between the proteome from adult mouse (>8weeks old) and adult zebrafish (18months old) hearts. Similarly, there was a significant degree of mismatch between the protein expression in neonatal and adult mouse hearts. Enrichment analysis of the selected proteins revealed over-expression of DNA synthesis-related proteins in the cardiac proteome of the adult zebrafish heart similar to neonatal and 4days old mice, whereas in hearts of adult mice there was a mitochondria-related predominance in protein expression. Importantly, we noted pronounced differences in the myofilament composition: the adult zebrafish heart lacks many of the myofilament proteins of differentiated adult cardiomyocytes such as the ventricular isoforms of myosin light chains and nebulette. Instead, troponin I and myozenin 1 were expressed as skeletal isoforms rather than cardiac isoforms. The relative immaturity of the adult zebrafish heart was further supported by cardiac microRNA data. Our assessment of zebrafish and mammalian hearts challenges the assertions on the translational potential of cardiac regeneration in the zebrafish model. The immature myofilament composition of the fish heart may explain why adult mouse and human cardiomyocytes lack this endogenous repair mechanism. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Disease management: remote monitoring in heart failure patients with implantable defibrillators, resynchronization devices, and haemodynamic monitors.

PubMed

Abraham, William T

2013-06-01

Heart failure represents a major public health concern, associated with high rates of morbidity and mortality. A particular focus of contemporary heart failure management is reduction of hospital admission and readmission rates. While optimal medical therapy favourably impacts the natural history of the disease, devices such as cardiac resynchronization therapy devices and implantable cardioverter defibrillators have added incremental value in improving heart failure outcomes. These devices also enable remote patient monitoring via device-based diagnostics. Device-based measurement of physiological parameters, such as intrathoracic impedance and heart rate variability, provide a means to assess risk of worsening heart failure and the possibility of future hospitalization. Beyond this capability, implantable haemodynamic monitors have the potential to direct day-to-day management of heart failure patients to significantly reduce hospitalization rates. The use of a pulmonary artery pressure measurement system has been shown to significantly reduce the risk of heart failure hospitalization in a large randomized controlled study, the CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in NYHA Class III Heart Failure Patients (CHAMPION) trial. Observations from a pilot study also support the potential use of a left atrial pressure monitoring system and physician-directed patient self-management paradigm; these observations are under further investigation in the ongoing LAPTOP-HF trial. All these devices depend upon high-intensity remote monitoring for successful detection of parameter deviations and for directing and following therapy.

[Clinical experience with 53 consecutive heart transplants].

PubMed

Villavicencio, Mauricio; Rossel, Víctor; Larrea, Ricardo; Peralta, Juan Pablo; Larraín, Ernesto; Sung Lim, Jong; Rojo, Pamela; Gajardo, Francesca; Donoso, Erika; Hurtado, Margarita

2013-12-01

Heart transplantation is the therapy of choice for advance heart failure. Our group developed two transplant programs at Instituto Nacional del Tórax and Clínica Dávila. We report our clinical experience based on distinctive clinical policies. Fifty-three consecutive patients were transplanted between November 2008 and April 2013, representing 51% of all Chilean cases. Distinctive clinical policies include intensive donor management, generic immunosuppression and VAD (ventricular assist devices) insertion. Ischemic or dilated cardiomyopathy were the main indications (23 (43%) each), age 48 ± 13 years and 48 (91%) were male. Transplant listing Status: IA 14 (26%) (VAD or 2 inotropes), IB 14 (26%) (1 inotrope) and II25 (47%) (no inotrope). Mean waiting time 70 ± 83 days. Twelve (24%) were transplanted during VAD support (median support: 36 days). orthotopic bicaval transplant with ischemia time: 175 ± 54 min. Operative mortality: 3 (6%), all due to right ventricular failure. Re-exploration for bleeding 2 (4%), stroke 3 (6%), mediastinitis 0 (0%), pneumonia 4 (8%), and transient dialysis 6 (11%). Mean follow-up was 21 ± 14 months. Three-year survival was 86 ± 6%. One patient died of Pneumocystis jirovecii pneumonia and the other died suddenly (non-compliance). Freedom from rejection requiring specific therapy was 80 ± 7% at 3 years of follow-up. Four hundred eighty four endomyocardial biopsies were done: 11 (2.3%) had 2R rejection. All survivors are in NYHA (New York Heart Association) functional class I and all but one have normal biventricular function. Mid-term results are similar to those reported by the registry of the International Society for Heart and Lung Transplantation. This experience has a higher proportion of VAD support than previous national series. Rejection rates are low in spite of generic immunosuppression.

Stroke and Intracranial Hemorrhage in HeartMate II and HeartWare Left Ventricular Assist Devices: A Systematic Review.

PubMed

Cho, Sung M; Moazami, Nader; Frontera, Jennifer A

2017-08-01

Ischemic stroke and intracranial hemorrhage (ICH) following left ventricular assist device (LVAD) placement are major causes of morbidity. The incidence and mortality associated with these events stratified by device type have not been systematically explored. A systematic review of PubMed was conducted from January 2007 through June 2016 for all English-language articles involving HeartMate II (HMII) and HeartWare LVAD patients. Ischemic stroke and/or ICH incidence (events per patient-year) and associated mortality rates were abstracted for each device type. Of 735 articles reviewed, 48 (11,310 patients) met inclusion criteria (33 HMII, six HeartWare, eight both devices, and one unspecified). The median duration of device support was 112 days (total 13,723 patient-years). Overall, ischemic stroke or ICH occurred in 9.8% (1110 persons and 0.08 events per patient year [EPPY]). Ischemic stroke occurred in a median of 6.0% or 0.06 EPPY (range 0-16% or 0-0.21 EPPY) of HMII patients versus 7.5% or 0.09 EPPY (range 4-17.1% or 0.01-0.94 EPPY) of HeartWare patients. ICH occurred in a median of 3.0% or 0.04 EPPY (range 0-13.5% or 0-0.13 EPPY) of HMII and 8.0% or 0.08 EPPY (range 3-23% or 0.01-0.56 EPPY) of HeartWare patients. The median mortality rate for LVAD-associated ischemic stroke was 31% (HMII: 33%, [range 2.4-75%] and HeartWare: 11.5% [range 3.9-40%]), and the median mortality rate following ICH was 71% (HMII: 75%, [range 3.9-100%] and HeartWare: 44%, [range 3.1-88%]). Ischemic stroke and ICH are common after LVAD placement, but heterogeneous event rates are reported in the literature. Given the high associated mortality, further prospective study is warranted.

Measurements and FLUKA simulations of bismuth and aluminium activation at the CERN Shielding Benchmark Facility (CSBF)

NASA Astrophysics Data System (ADS)

Iliopoulou, E.; Bamidis, P.; Brugger, M.; Froeschl, R.; Infantino, A.; Kajimoto, T.; Nakao, N.; Roesler, S.; Sanami, T.; Siountas, A.

2018-03-01

The CERN High Energy AcceleRator Mixed field facility (CHARM) is located in the CERN Proton Synchrotron (PS) East Experimental Area. The facility receives a pulsed proton beam from the CERN PS with a beam momentum of 24 GeV/c with 5 ṡ1011 protons per pulse with a pulse length of 350 ms and with a maximum average beam intensity of 6.7 ṡ1010 p/s that then impacts on the CHARM target. The shielding of the CHARM facility also includes the CERN Shielding Benchmark Facility (CSBF) situated laterally above the target. This facility consists of 80 cm of cast iron and 360 cm of concrete with barite concrete in some places. Activation samples of bismuth and aluminium were placed in the CSBF and in the CHARM access corridor in July 2015. Monte Carlo simulations with the FLUKA code have been performed to estimate the specific production yields for these samples. The results estimated by FLUKA Monte Carlo simulations are compared to activation measurements of these samples. The comparison between FLUKA simulations and the measured values from γ-spectrometry gives an agreement better than a factor of 2.

Extended duration orbiter medical project variability of blood pressure and heart rate (STS-50/USML-1)

NASA Technical Reports Server (NTRS)

Fritsch-Yelle, Janice M.; Charles, John B.; Boettcher, Sheila W.

1994-01-01

Decreases in arterial baroreflex function after space flight may be related to changes in blood pressure and heart rate patterns during flight. Ambulatory blood pressure and heart rate were measured for 24 hours, in fourteen astronauts on two occasions before flight, two to three occasions in flight, and 2 days after landing on Shuttle missions lasting 4 to 14 days. Blood pressure and heart rate were recorded every 20minutes during awake periods and every 30 minutes during sleep. In pre- and postflight studies, the 24-hour ambulatory measurements were followed by studies of carotid baroreceptor-cardiac reflex responses. Carotid baroreceptors were stimulated using a sequence of neck pressure and suction from +40 to -65 mmHg.

Masking of the circadian rhythms of heart rate and core temperature by the rest-activity cycle in man

NASA Technical Reports Server (NTRS)

Gander, Philippa H.; Connell, Linda J.; Graeber, R. Curtis

1986-01-01

Experiments were conducted to estimate the magnitude of the masking effect produced in humans by alternate periods of physical activity and rest or sleep on the circadian rhythms of heart rate and core temperature. The heart rate, rectal temperature, and nondominant wrist activity were monitored in 12 male subjects during 6 days of normal routine at home and during 6 days of controlled bed-rest regimen. The comparisons of averaged waveforms for the activity, heart rate, and temperature indicated that about 45 percent of the range of the circadian heart rate rhythm during normal routine and about 14 percent of the range of the circadian temperature rhythm were attributable to the effects of activity. The smaller effect of activity on the temperature rhythm may be partially attributable to the fact that core temperature is being more rigorously conserved than heart rate, at least during moderate exercise.

Get With The Guidelines program participation, process of care, and outcome for Medicare patients hospitalized with heart failure.

PubMed

Heidenreich, Paul A; Hernandez, Adrian F; Yancy, Clyde W; Liang, Li; Peterson, Eric D; Fonarow, Gregg C

2012-01-01

Hospitals enrolled in the American Heart Association's Get With The Guidelines Program for heart failure (GWTG-HF) have improved their process of care. However, it is unclear if process of care and outcomes are better in the GWTG-HF hospitals compared with hospitals not enrolled. We compared hospitals enrolled in GWTG-HF from 2006 to 2007 with other hospitals using data on 4 process of heart failure care measures, 5 noncardiac process measures, risk-adjusted 30-day mortality, and 30-day all-cause readmission after a heart failure hospitalization, as reported by the Center for Medicare and Medicaid Services (CMS). Among the 4460 hospitals reporting data to CMS, 215 (5%) were enrolled in GWTG-HF. Of the 4 CMS heart failure performance measures, GWTG-HF hospitals had significantly higher documentation of the left ventricular ejection fraction (93.4% versus 88.8%), use of angiotensin-converting enzyme inhibitor or angiotensin receptor antagonist (88.3% versus 86.6%), and discharge instructions (74.9% versus 70.5%) (P<0.005 for all). Smoking cessation counseling rates were similar (94.1% versus 94.0%; P=0.51). There was no significant difference in compliance with noncardiac process of care. After heart failure discharge, all-cause readmission at 30 days was 24.5% and mortality at 30 days after admission was 11.1%. After adjustment for hospital characteristics, 30-day mortality rates were no different (P=0.45). However, 30-day readmission was lower for GWTG hospitals (-0.33%; 95% CI, -0.53% to -0.12%; P=0.002). Although there was evidence that hospitals enrolled in the GTWG-HF program demonstrated better processes of care than other hospitals, there were few clinically important differences in outcomes. Further identification of opportunities to improve outcomes, and inclusion of these metrics in GTWG-HF, may further support the value of GTWG-HF in improving care for patients with HF.

DNS load balancing in the CERN cloud

NASA Astrophysics Data System (ADS)

Reguero Naredo, Ignacio; Lobato Pardavila, Lorena

2017-10-01

Load Balancing is one of the technologies enabling deployment of large-scale applications on cloud resources. A DNS Load Balancer Daemon (LBD) has been developed at CERN as a cost-effective way to balance applications accepting DNS timing dynamics and not requiring persistence. It currently serves over 450 load-balanced aliases with two small VMs acting as master and slave. The aliases are mapped to DNS subdomains. These subdomains are managed with DDNS according to a load metric, which is collected from the alias member nodes with SNMP. During the last years, several improvements were brought to the software, for instance: support for IPv6, parallelization of the status requests, implementing the client in Python to allow for multiple aliases with differentiated states on the same machine or support for application state. The configuration of the Load Balancer is currently managed by a Puppet type. It discovers the alias member nodes and gets the alias definitions from the Ermis REST service. The Aiermis self-service GUI for the management of the LB aliases has been produced and is based on the Ermis service above that implements a form of Load Balancing as a Service (LBaaS). The Ermis REST API has authorisation based in Foreman hostgroups. The CERN DNS LBD is Open Software with Apache 2 license.

Preparation of a primary argon beam for the CERN fixed target physics

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

Küchler, D., E-mail: detlef.kuchler@cern.ch; O’Neil, M.; Scrivens, R.

2014-02-15

The fixed target experiment NA61 in the North Area of the Super Proton Synchrotron is studying phase transitions in strongly interacting matter. Up to now they used the primary beams available from the CERN accelerator complex (protons and lead ions) or fragmented beams created from the primary lead ion beam. To explore a wider range of energies and densities a request was made to provide primary argon and xenon beams. This paper describes the results of the setting up and 10 week test run of the Ar{sup 11+} beam from the 14.5 GHz ECR ion source and the linear acceleratormore » (Linac3) at CERN.« less

Air liquide 1.8 K refrigeration units for CERN LHC project

NASA Astrophysics Data System (ADS)

Hilbert, Benoît; Gistau-Baguer, Guy M.; Caillaud, Aurélie

2002-05-01

The Large Hadron Collider (LHC) will be CERN's next research instrument for high energy physics. This 27 km long circular accelerator will make intensive use of superconducting magnets, operated below 2.0 K. It will thus require high capacity refrigeration below 2.0 K [1, 2]. Coupled to a refrigerator providing 18 kW equivalent at 4.5 K [3], these systems will be able to absorb a cryogenic power of 2.4 kW at 1.8 K in nominal conditions. Air Liquide has designed one Cold Compressor System (CCS) pre-series for CERN-preceding 3 more of them (among 8 in total located around the machine). These systems, making use of cryogenic centrifugal compressors in a series arrangement coupled to room temperature screw compressors, are presented. Key components characteristics will be given.

Heart Attack

MedlinePlus

Each year almost 800,000 Americans have a heart attack. A heart attack happens when blood flow to the heart suddenly ... it's important to know the symptoms of a heart attack and call 9-1-1 if you or ...

[Reduction of rehospitalisation on elderly heart failure patients: A retrospective cohort VISage network].

PubMed

Labranche, D; Mestre-Fernandes, C; Delahaye, F; Sanchez, S

2016-11-01

Heart failure was a public health problem for one million of French patients. Patients are particularly concerned in rehospitalisation for this chronic pathology. A specific healthcare network was created to take care of patients with heart failure directly at home. This healthcare network (named VISage) brings a specific and adapted monitoring in heart failure. The main of this study was to evaluate the impact of healthcare network in rehospitalisation rate for heart failure of patients. We conducted a retrospective cohort study with patients' hospital files of the CH Vienne. Patients who were included in our healthcare network (VISage) were screened. Primary endpoint was 30days, 6 months, and 1year rehospitalisation rate for heart failure before and after using healthcare network. One hundred and four patients with comorbidities were included between February 2009 and November 2015. A significant reduction of rehospitalisation rate for heart failure was observed before and after network: 0.65 (±0.52) vs. 0.17 (±0.43) 30days, 1.17 (±0.74) vs. 0.42 (±0.71) at 6 months and 1.35 (±0.95) vs. 0.47 (±0.74) at 1 year (P<0.0001). Results were significant for global rehospitalisation rate too. No significant differences were shown on hospital length of stay. Coordinated healthcare by a specific network at home for elderly is benefic for the rehospitalisation rate. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Motivational Interviewing Tailored Interventions for Heart Failure (MITI-HF): study design and methods.

PubMed

Masterson Creber, Ruth; Patey, Megan; Dickson, Victoria Vaughan; DeCesaris, Marissa; Riegel, Barbara

2015-03-01

Lack of engagement in self-care is common among patients needing to follow a complex treatment regimen, especially patients with heart failure who are affected by comorbidity, disability and side effects of poly-pharmacy. The purpose of Motivational Interviewing Tailored Interventions for Heart Failure (MITI-HF) is to test the feasibility and comparative efficacy of an MI intervention on self-care, acute heart failure physical symptoms and quality of life. We are conducting a brief, nurse-led motivational interviewing randomized controlled trial to address behavioral and motivational issues related to heart failure self-care. Participants in the intervention group receive home and phone-based motivational interviewing sessions over 90-days and those in the control group receive care as usual. Participants in both groups receive patient education materials. The primary study outcome is change in self-care maintenance from baseline to 90-days. This article presents the study design, methods, plans for statistical analysis and descriptive characteristics of the study sample for MITI-HF. Study findings will contribute to the literature on the efficacy of motivational interviewing to promote heart failure self-care. We anticipate that using an MI approach can help patients with heart failure focus on their internal motivation to change in a non-confrontational, patient-centered and collaborative way. It also affirms their ability to practice competent self-care relevant to their personal health goals. Copyright © 2015 Elsevier Inc. All rights reserved.

Commissioning results of CERN HIE-ISOLDE and INFN ALPI cryogenic control systems

NASA Astrophysics Data System (ADS)

Inglese, V.; Pezzetti, M.; Calore, A.; Modanese, P.; Pengo, R.

2017-02-01

The cryogenic systems of both accelerators, namely HIE ISOLDE (High Intensity and Energy Isotope Separator On Line DEvice) at CERN and ALPI (Acceleratore Lineare Per Ioni) at LNL, have been refurbished. HIE ISOLDE is a major upgrade of the existing ISOLDE facilities, which required the construction of a superconducting linear accelerator consisting of six cryomodules, each containing five superconductive RF cavities and superconducting solenoids. The ALPI linear accelerator, similar to HIE ISOLDE, is located at Legnaro National Laboratories (LNL) and became operational in the early 90’s. It is composed of 74 superconducting RF cavities, assembled inside 22 cryostats. The new control systems are equipped with PLC, developed on the CERN UNICOS framework, which include Schneider and Siemens PLCs and various fieldbuses (Profibus DP and PA, WorldFIP). The control systems were developed in synergy between CERN and LNL in order to build, effectively and with an optimized use of resources, control systems allowing to enhance ease of operation, maintainability, and long-term availability. This paper describes (i) the cryogenic systems, with special focus on the design of the control systems hardware and software, (ii) the strategy adopted in order to achieve a synergic approach, and (iii) the commissioning results after the cool-down to 4.5 K of the cryomodules.

Changes in histopathology and tumor necrosis factor-α levels in the hearts of rats following asphyxial cardiac arrest.

PubMed

Lee, Jung Hoon; Lee, Tae-Kyeong; Kim, In Hye; Lee, Jae Chul; Won, Moo-Ho; Park, Joon Ha; Ahn, Ji Hyeon; Shin, Myoung Chul; Ohk, Taek Geun; Moon, Joong Bum; Cho, Jun Hwi; Park, Chan Woo; Tae, Hyun-Jin

2017-09-01

Post cardiac arrest (CA) syndrome is associated with a low survival rate in patients who initially have return of spontaneous circulation (ROSC) after CA. The aim of this study was to examine the histopathology and inflammatory response in the heart during the post CA syndrome. We induced asphyxial CA in male Sprague-Dawley rats and determined the survival rate of these rats during the post resuscitation phase. Survival of the rats decreased after CA: 66.7% at 6 hours, 36.7% at 1 day, and 6.7% at 2 days after ROSC following CA. The rats were sacrificed at 6 hours, 12 hours, 1 day, and 2 days after ROSC, and their heart tissues were examined. Histopathological scores increased at 12 hours post CA and afterwards, histopathological changes were not significant. In addition, levels of tumor necrosis factor-α immunoreactivity gradually increased after CA. The survival rate of rats 2 days post CA was very low, even though histopathological and inflammatory changes in the heart were not pronounced in the early stage following CA.

Big Bang Day: Engineering Solutions

ScienceCinema

None

2017-12-09

CERN's Large Hadron Collider is the most complicated scientific apparatus ever built. Many of the technologies it uses hadn't even been invented when scientists started building it. Adam Hart-Davis discovers what it takes to build the world's most intricate discovery machine.

Heart Transplantation

MedlinePlus

A heart transplant removes a damaged or diseased heart and replaces it with a healthy one. The healthy heart comes from a donor who has died. It is the last resort for people with heart failure when all other treatments have failed. The ...

Heart Diseases

MedlinePlus

... you're like most people, you think that heart disease is a problem for others. But heart disease is the number one killer in the ... of disability. There are many different forms of heart disease. The most common cause of heart disease ...

Transplantation of "high-risk" donor hearts: Implications for infection.

PubMed

Gaffey, Ann C; Doll, Stacey L; Thomasson, Arwin M; Venkataraman, Chantel; Chen, Carol W; Goldberg, Lee R; Blumberg, Emily A; Acker, Michael A; Stone, Francis; Atluri, Pavan

2016-07-01

Heart transplantation is the gold-standard treatment for end-stage heart failure. Short- and long-term outcomes have been excellent, but the shortage of organs persists. The number of potential recipients who die while awaiting orthotopic heart transplantation increases yearly. In 2004, the label "high-risk donor" (HRD) was applied, by the United Network for Organ Sharing (UNOS), to any organ donor who met the Centers for Disease Control (CDC) criteria for behavior that put them at high risk of infection. Despite organ shortages, grafts from HRD CDCs are often declined, because of concerns regarding infection. We undertook this study to analyze our extensive experience with orthotopic heart transplantation of grafts from HRD CDCs, and to determine the short- and long-term outcomes associated with recipients of hearts from HRD CDCs, particularly transmission of infection. We performed 367 heart transplantations at our center from September 2008 to September 2014, a timeframe during which the HRD CDC labeling had been implemented. Of the total number of orthotopic heart transplantations performed, 55 patients (15%) received organs from HRD CDCs that had known negative serology for human immunodeficiency virus (HIV), hepatitis B, and hepatitis C. We reviewed demographic, perioperative, and short- and long-term outcomes. The recipients of grafts from HRD CDCs were followed closely, with 3- and 12-month surveillance laboratory testing of viral load for HIV, for hepatitis B, and for hepatitis C core- and surface-antigen serology. All 55 patients (72.7% were men) underwent a successful transplantation procedure. One patient was excluded from follow-up analysis because he was re-transplanted within 4 days owing to the posttransplant finding of metastatic lung adenocarcinoma within the donor. Primary etiology of heart failure was ischemic in 18 of the patients. The most common blood type was O positive, in 20 patients (37.1%), followed by A positive, in 19 patients (35

2013 update on congenital heart disease, clinical cardiology, heart failure, and heart transplant.

PubMed

Subirana, M Teresa; Barón-Esquivias, Gonzalo; Manito, Nicolás; Oliver, José M; Ripoll, Tomás; Lambert, Jose Luis; Zunzunegui, José L; Bover, Ramon; García-Pinilla, José Manuel

2014-03-01

This article presents the most relevant developments in 2013 in 3 key areas of cardiology: congenital heart disease, clinical cardiology, and heart failure and transplant. Within the area of congenital heart disease, we reviewed contributions related to sudden death in adult congenital heart disease, the importance of specific echocardiographic parameters in assessing the systemic right ventricle, problems in patients with repaired tetralogy of Fallot and indication for pulmonary valve replacement, and confirmation of the role of specific factors in the selection of candidates for Fontan surgery. The most recent publications in clinical cardiology include a study by a European working group on correct diagnostic work-up in cardiomyopathies, studies on the cost-effectiveness of percutaneous aortic valve implantation, a consensus document on the management of type B aortic dissection, and guidelines on aortic valve and ascending aortic disease. The most noteworthy developments in heart failure and transplantation include new American guidelines on heart failure, therapeutic advances in acute heart failure (serelaxin), the management of comorbidities such as iron deficiency, risk assessment using new biomarkers, and advances in ventricular assist devices. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

Renal Function Recovery with Total Artificial Heart Support.

PubMed

Quader, Mohammed A; Goodreau, Adam M; Shah, Keyur B; Katlaps, Gundars; Cooke, Richard; Smallfield, Melissa C; Tchoukina, Inna F; Wolfe, Luke G; Kasirajan, Vigneshwar

2016-01-01

Heart failure patients requiring total artificial heart (TAH) support often have concomitant renal insufficiency (RI). We sought to quantify renal function recovery in patients supported with TAH at our institution. Renal function data at 30, 90, and 180 days after TAH implantation were analyzed for patients with RI, defined as hemodialysis supported or an estimated glomerular filtration rate (eGFR) less than 60 ml/min/1.73 m. Between January 2008 and December 2013, 20 of the 46 (43.5%) TAH recipients (age 51 ± 9 years, 85% men) had RI, mean preoperative eGFR of 48 ± 7 ml/min/1.73 m. Renal function recovery was noted at each follow-up interval: increment in eGFR (ml/min/1.73 m) at 30, 90, and 180 days was 21 ± 35 (p = 0.1), 16.5 ± 18 (p = 0.05), and 10 ± 9 (p = 0.1), respectively. Six patients (30%) required preoperative dialysis. Of these, four recovered renal function, one remained on dialysis, and one died. Six patients (30%) required new-onset dialysis. Of these, three recovered renal function and three died. Overall, 75% (15 of 20) of patients' renal function improved with TAH support. Total artificial heart support improved renal function in 75% of patients with pre-existing significant RI, including those who required preoperative dialysis.

Win some, lose some: parental hypertension and heart rate change in an incentive versus response cost paradigm.

PubMed

Hastrup, J L; Johnson, C A; Hotchkiss, A P; Kraemer, D L

1986-11-01

Fowles (1983), citing evidence from separate studies, suggests that both incentive and response cost paradigms increase heart rate and should be subsumed under Gray's (1975) 'appetitive motivational system'. Shock avoidance and loss of reward (response cost) contingencies, while aversive, appear to evoke this motivational system; consequently both should elicit heart rate increases independent of anxiety. The present investigation compared magnitude of heart rate changes observed under conditions of winning and losing money. Results showed: no differences between incentive and response cost conditions; no effect of state anxiety on heart rate in these conditions, despite an elevation of state anxiety on the task day relative to a subsequent relaxation day assessment; and some evidence for the presence under both such appetitive conditions of cardiovascular hyperresponsivity among offspring of hypertensive parents. The results suggest a need for systematic parametric studies of experimental conditions.

Pediatric heart surgery

MedlinePlus

Heart surgery - pediatric; Heart surgery for children; Acquired heart disease; Heart valve surgery - children ... There are many kinds of heart defects. Some are minor, and others are more serious. Defects can occur inside the heart or in the large blood vessels ...

Decreased baseline variability on fetal heart rate pattern in a fetus with heterotaxy syndrome.

PubMed

Yamada, Ryutaro; Takei, Kohta; Kaneshi, Yosuke; Morikawa, Mamoru; Cho, Kazutoshi; Minakami, Hisanori

2015-12-01

In a fetus with suspected heterotaxy syndrome, a decreased/absent baseline variability of fetal heart rate pattern developed at gestational week 36(+5) and continued for 5 days until birth at gestational week 37(+2), while repeat biophysical profile scorings with ultrasound were consistently unremarkable. This neonate weighing 2404 g with Apgar scores of 7 (1-min) and 8 (5-min) and umbilical arterial cord blood pH of 7.28 with base deficit of 3.9 mmol/L, showed a heart rate of 120 b.p.m. for 3 h after birth, but subsequently developed sinus bradycardia (84 b.p.m.) unresponsive to crying. Isoproterenol initiated 9 h after birth was effective in the increase of heart rate to 120 b.p.m. in this neonate. Brain magnetic resonance imaging at 16 days of age was unremarkable. The decreased/absent baseline variability of fetal heart rate pattern was speculated to have been caused by sinus node dysfunction, and not by reduced fetal oxygenation in this case. © 2015 Japan Society of Obstetrics and Gynecology.

Stem cell homing and angiomyogenesis in transplanted hearts are enhanced by combined intramyocardial SDF-1α delivery and endogenous cytokine signaling

PubMed Central

Zhao, Tiemin; Zhang, Dongsheng; Millard, Ronald W.; Ashraf, Muhammad; Wang, Yigang

2009-01-01

We used a heterotopic transplanted working heart model to probe the collaborative role of bone marrow-derived progenitor cells (BPCs) and stromal cell-derived factor (SDF)-1α in attenuating tissue remodeling in recipient and transplanted hearts. BPCs from male transgenic rats expressing green fluorescent protein (GFP+ BPCs, 2 × 106 cells) were injected intravenously into myeloablated female rats. One month later, heterotopic heart transplantation was performed. The left anterior descending coronary artery (LAD) of the recipient heart was occluded permanently. Mesenchymal stem cells (MSCs; 2 × 106 cells) with a null gene (null group) or overexpressing SDF-1α (SDF-1α group) were injected intramyocardially in the LAD perfusion region of both recipient and transplanted hearts. Recipient and transplanted hearts (n = 10 hearts/group) were harvested 21 days later for analysis. The survival of transplanted hearts was assessed daily by palpation in additional animals (n = 7). Five days after LAD occlusion, subpopulations of GFP+ BPCs in the circulation were significantly higher in the SDF-1α group. Y chromosome, 5-bromo-2′-deoxyuridine, Ki67-positive nuclei, newly formed vessels, and GFP+ cells significantly increased in transplanted hearts of the SDF-1α group at 21 days after the injection of MSCs overexpressing SDF-1α, whereas fewer TUNEL-positive nuclei were found. The survival of transplanted hearts was also markedly increased in the SDF-1α group (P < 0.05). Supplementation of endogenous cytokines released from the ischemic myocardium with exogenous MSCs overexpressing SDF-1α significantly increased BPC homing to acutely ischemic recipient and progressively ischemic transplanted hearts. BPC recruitment resulted in the regeneration of new cardiomyocytes and blood vessels and extended survival of the transplanted hearts. PMID:19181961

Customizing national models for a medical center's population to rapidly identify patients at high risk of 30-day all-cause hospital readmission following a heart failure hospitalization.

PubMed

Cox, Zachary L; Lai, Pikki; Lewis, Connie M; Lindenfeld, JoAnn; Collins, Sean P; Lenihan, Daniel J

2018-05-28

Nationally-derived models predicting 30-day readmissions following heart failure (HF) hospitalizations yield insufficient discrimination for institutional use. Develop a customized readmission risk model from Medicare-employed and institutionally-customized risk factors and compare the performance against national models in a medical center. Medicare patients age ≥ 65 years hospitalized for HF (n = 1,454) were studied in a derivation cohort and in a separate validation cohort (n = 243). All 30-day hospital readmissions were documented. The primary outcome was risk discrimination (c-statistic) compared to national models. A customized model demonstrated improved discrimination (c-statistic 0.72; 95% CI 0.69 - 0.74) compared to national models (c-statistics of 0.60 and 0.61) with a c-statistic of 0.63 in the validation cohort. Compared to national models, a customized model demonstrated superior readmission risk profiling by distinguishing a high-risk (38.3%) from a low-risk (9.4%) quartile. A customized model improved readmission risk discrimination from HF hospitalizations compared to national models. Copyright © 2018 Elsevier Inc. All rights reserved.

Contextualized Magnetism in Secondary School: Learning from the LHC (CERN)

ERIC Educational Resources Information Center

Cid, Ramon

2005-01-01

Physics teachers in secondary schools usually mention the world's largest particle physics laboratory--CERN (European Organization for Nuclear Research)--only because of the enormous size of the accelerators and detectors used there, the number of scientists involved in their activities and also the necessary international scientific…

Follow-Up After Cardiac Surgery Should be Extended to at Least 120 Days When Benchmarking Cardiac Surgery Centers.

PubMed

Hansen, Laura S; Sloth, Erik; Hjortdal, Vibeke E; Jakobsen, Carl-Johan

2015-08-01

Short-term (30 days) mortality frequently is used as an outcome measure after cardiac surgery, although it has been proposed that the follow-up period should be extended to 120 days to allow for more accurate benchmarking. The authors aimed to evaluate whether mortality rates 120 days after surgery were comparable to general mortality and to compare causes of death between the cohort and the general population. A multicenter descriptive cohort study using prospectively entered registry data. University hospital. The cohort was obtained from the Western Denmark Heart Registry and matched to the Danish National Hospital Register as well as the Danish Register of Causes of Death. A weighted, age-matched general population consisting of all Danish patients who died within the study period was identified through the central authority on Danish statistics. A total of 11,988 patients (>15 years) who underwent cardiac-surgery at Aarhus, Aalborg and Odense University Hospitals from April 1, 2006 to December 31, 2012 were included. Coronary artery bypass grafting, valve surgery and combinations. Mortality after cardiac surgery matches with mortality in the general population after 140 days. Mortality curves run almost parallel from this point onwards, regardless of The European system for cardiac operative risk evaluation (EuroSCORE) and intervention. The causes of death in the cohort differed statistically significantly from the background population (p<0.0001; one-sample t-test) throughout the first postoperative year. The leading cause of death in the cohort was cardiac (38%); 53% of which was categorized as heart failure. A total of 54% of these patients were assessed preoperatively as having normal or mildly impaired heart function (EuroSCORE). This study supported an extended follow-up period after cardiac surgery when benchmarking cardiac surgery centers. Regardless of preoperative heart function, heart failure was the consistent leading cause of death. Copyright �

Chronic mercury exposure impairs the sympathovagal control of the rat heart.

PubMed

Simões, M R; Azevedo, B F; Fiorim, J; Jr Freire, D D; Covre, E P; Vassallo, D V; Dos Santos, L

2016-11-01

Mercury is known to cause harmful neural effects affecting the cardiovascular system. Here, we evaluated the chronic effects of low-dose mercury exposure on the autonomic control of the cardiovascular system. Wistar rats were treated for 30 days with HgCl 2 (1st dose 4.6 μg/kg followed by 0.07 μg/kg per day, intramuscular) or saline. The femoral artery and vein were then cannulated for evaluation of autonomic control of the hemodynamic function, which was evaluated in awake rats. The following tests were performed: baroreflex sensitivity, Von Bezold-Jarisch reflex, heart rate variability (HRV) and pharmacological blockade with methylatropine and atenolol to test the autonomic tone of the heart. Exposure to HgCl 2 for 30 days slightly increased the mean arterial pressure and heart rate (HR). There was a significant reduction in the baroreflex gain of animals exposed to HgCl 2 . Moreover, haemodynamic responses to the activation of the Von Bezold-Jarisch reflex were also reduced. The changes in the spectral analysis of HRV suggested a shift in the sympathovagal balance toward a sympathetic predominance after mercury exposure, which was confirmed by autonomic pharmacological blockade in the HgCl 2 group. This group also exhibited reduced intrinsic HR after the double block suggesting that the pacemaker activity of the sinus node was also affected. These findings suggested that the autonomic modulation of the heart was significantly altered by chronic mercury exposure, thus reinforcing that even at low concentrations such exposure might be associated with increased cardiovascular risk. © 2016 John Wiley & Sons Australia, Ltd.

Lecture archiving on a larger scale at the University of Michigan and CERN

NASA Astrophysics Data System (ADS)

Herr, Jeremy; Lougheed, Robert; Neal, Homer A.

2010-04-01

The ATLAS Collaboratory Project at the University of Michigan has been a leader in the area of collaborative tools since 1999. Its activities include the development of standards, software and hardware tools for lecture archiving, and making recommendations for videoconferencing and remote teaching facilities. Starting in 2006 our group became involved in classroom recordings, and in early 2008 we spawned CARMA, a University-wide recording service. This service uses a new portable recording system that we developed. Capture, archiving and dissemination of rich multimedia content from lectures, tutorials and classes are increasingly widespread activities among universities and research institutes. A growing array of related commercial and open source technologies is becoming available, with several new products introduced in the last couple years. As the result of a new close partnership between U-M and CERN IT, a market survey of these products was conducted and a summary of the results are presented here. It is informing an ambitious effort in 2009 to equip many CERN rooms with automated lecture archiving systems, on a much larger scale than before. This new technology is being integrated with CERN's existing webcast, CDS, and Indico applications.

Combined heart-kidney transplantation after total artificial heart insertion.

PubMed

Ruzza, A; Czer, L S C; Ihnken, K A; Sasevich, M; Trento, A; Ramzy, D; Esmailian, F; Moriguchi, J; Kobashigawa, J; Arabia, F

2015-01-01

We present the first single-center report of 2 consecutive cases of combined heart and kidney transplantation after insertion of a total artificial heart (TAH). Both patients had advanced heart failure and developed dialysis-dependent renal failure after implantation of the TAH. The 2 patients underwent successful heart and kidney transplantation, with restoration of normal heart and kidney function. On the basis of this limited experience, we consider TAH a safe and feasible option for bridging carefully selected patients with heart and kidney failure to combined heart and kidney transplantation. Recent FDA approval of the Freedom driver may allow outpatient management at substantial cost savings. The TAH, by virtue of its capability of providing pulsatile flow at 6 to 10 L/min, may be the mechanical circulatory support device most likely to recover patients with marginal renal function and advanced heart failure. Copyright © 2015 Elsevier Inc. All rights reserved.

Heart rate variabilty changes during first week of acclimatization to 3500 m altitude in Indian military personnel.

PubMed

Bhaumik, G; Dass, D; Bhattacharyya, D; Sharma, Y K; Singh, S B

2013-01-01

Acute exposure to hypobaric hypoxia induces the changes in autonomic control of heart rate. Due to emergencies or war like conditions, rapid deployment of Indian military personnel into high altitude frequently occurs. Rapid deployment to high altitude soldiers are at risk of developing high altitude sickness. The present study was conducted to evaluate the acute exposure to high altitude hypobaric hypoxia (3500 m altitude) on the autonomic nervous control of heart rate in Indian military personnel during first week of acclimatization Indices of heart rate variability (viz; R-R interval, total power, low frequency, high frequency, ratio of low to high frequency) and pulse arterial oxygen saturation were measured at sea level and 3500m altitude. Power spectrum of heart rate variability was quantified by low frequency (LF: 0.04-0.15 Hz) and high frequency (HF: 0.15-0.5 Hz) widths. The ratio of LF to HF was also assessed as an index of the sympathovagal balance. Mean R-R interval decreased significantly on day 2 on induction to altitude which tended to increase on day 5. Total power (TP) decreased high altitude and tended to recover within a week. Both HF and LF power showed decrement at 3500m in comparison to sea level. The ratio of LF to HF (LF/HF) at 3500m was significantly higher at 3500m. SpO2 values decreased significantly (P < 0.05) at high altitude on day-2 which increased on day-5. We conclude that autonomic control of the heart rate measured by heart rate variability was altered on acute induction to 3500m which showed a significant decrease in parasympathetic tone and increase in sympathetic tone, then acclimatization seems to be characterized by progressive shift toward a higher parasympathetic tone.

Dexamethasone Treatment of Newborn Rats Decreases Cardiomyocyte Endowment in the Developing Heart through Epigenetic Modifications

PubMed Central

Gay, Maresha S.; Li, Yong; Xiong, Fuxia; Lin, Thant; Zhang, Lubo

2015-01-01

The potential adverse effect of synthetic glucocorticoid, dexamethasone therapy on the developing heart remains unknown. The present study investigated the effects of dexamethasone on cardiomyocyte proliferation and binucleation in the developing heart of newborn rats and evaluated DNA methylation as a potential mechanism. Dexamethasone was administered intraperitoneally in a three day tapered dose on postnatal day 1 (P1), 2 and 3 to rat pups in the absence or presence of a glucocorticoid receptor antagonist Ru486, given 30 minutes prior to dexamethasone. Cardiomyocytes from P4, P7 or P14 animals were analyzed for proliferation, binucleation and cell number. Dexamethasone treatment significantly increased the percentage of binucleated cardiomyocytes in the hearts of P4 pups, decreased myocyte proliferation in P4 and P7 pups, reduced cardiomyocyte number and increased the heart to body weight ratio in P14 pups. Ru486 abrogated the effects of dexamethasone. In addition, 5-aza-2'-deoxycytidine (5-AZA) blocked the effects of dexamethasone on binucleation in P4 animals and proliferation at P7, leading to recovered cardiomyocyte number in P14 hearts. 5-AZA alone promoted cardiomyocyte proliferation at P7 and resulted in a higher number of cardiomyocytes in P14 hearts. Dexamethasone significantly decreased cyclin D2, but not p27 expression in P4 hearts. 5-AZA inhibited global DNA methylation and blocked dexamethasone-mediated down-regulation of cyclin D2 in the heart of P4 pups. The findings suggest that dexamethasone acting on glucocorticoid receptors inhibits proliferation and stimulates premature terminal differentiation of cardiomyocytes in the developing heart via increased DNA methylation in a gene specific manner. PMID:25923220

Repeated exposure to methamphetamine induces sex-dependent hypersensitivity to ischemic injury in the adult rat heart

PubMed Central

Seeley, Sarah L.; Stoops, Thorne S.; D’Souza, Manoranjan S.

2017-01-01

Background We previously reported that adult female, but not male rats that were prenatally exposed to methamphetamine exhibit myocardial hypersensitivity to ischemic injury. However, it is unknown whether hypersensitivity to ischemic injury develops when rats are exposed to methamphetamine during adulthood. The goal of this study was to determine whether methamphetamine exposure during adulthood sensitizes the heart to ischemic injury. Methods Adult male and female rats received daily injections of methamphetamine (5 mg/kg) or saline for 10 days. Their hearts were isolated on day 11 and subjected to a 20 min ischemic insult on a Langendorff isolated heart apparatus. Cardiac contractile function was measured by an intraventricular balloon, and infarct size was measured by triphenyltetrazolium chloride staining. Results Hearts from methamphetamine-treated females exhibited significantly larger infarcts and suppressed postischemic recovery of contractile function compared to hearts from saline-treated females. In contrast, methamphetamine had no effect on infarct size or contractile recovery in male hearts. Subsequent experiments demonstrated that hypersensitivity to ischemic injury persisted in female hearts following a 1 month period of abstinence from methamphetamine. Myocardial protein kinase C-ε expression, Akt phosphorylation, and ERK phosphorylation were unaffected by adult exposure to methamphetamine. Conclusions Exposure of adult rats to methamphetamine sex-dependently increases the extent of myocardial injury following an ischemic insult. These data suggest that women who have a heart attack might be at risk of more extensive myocardial injury if they have a recent history of methamphetamine abuse. PMID:28575091

Repeated exposure to methamphetamine induces sex-dependent hypersensitivity to ischemic injury in the adult rat heart.

PubMed

Rorabaugh, Boyd R; Seeley, Sarah L; Stoops, Thorne S; D'Souza, Manoranjan S

2017-01-01

We previously reported that adult female, but not male rats that were prenatally exposed to methamphetamine exhibit myocardial hypersensitivity to ischemic injury. However, it is unknown whether hypersensitivity to ischemic injury develops when rats are exposed to methamphetamine during adulthood. The goal of this study was to determine whether methamphetamine exposure during adulthood sensitizes the heart to ischemic injury. Adult male and female rats received daily injections of methamphetamine (5 mg/kg) or saline for 10 days. Their hearts were isolated on day 11 and subjected to a 20 min ischemic insult on a Langendorff isolated heart apparatus. Cardiac contractile function was measured by an intraventricular balloon, and infarct size was measured by triphenyltetrazolium chloride staining. Hearts from methamphetamine-treated females exhibited significantly larger infarcts and suppressed postischemic recovery of contractile function compared to hearts from saline-treated females. In contrast, methamphetamine had no effect on infarct size or contractile recovery in male hearts. Subsequent experiments demonstrated that hypersensitivity to ischemic injury persisted in female hearts following a 1 month period of abstinence from methamphetamine. Myocardial protein kinase C-ε expression, Akt phosphorylation, and ERK phosphorylation were unaffected by adult exposure to methamphetamine. Exposure of adult rats to methamphetamine sex-dependently increases the extent of myocardial injury following an ischemic insult. These data suggest that women who have a heart attack might be at risk of more extensive myocardial injury if they have a recent history of methamphetamine abuse.

CERN's Common Unix and X Terminal Environment

NASA Astrophysics Data System (ADS)

Cass, Tony

The Desktop Infrastructure Group of CERN's Computing and Networks Division has developed a Common Unix and X Terminal Environment to ease the migration to Unix based Interactive Computing. The CUTE architecture relies on a distributed filesystem—currently Trans arc's AFS—to enable essentially interchangeable client work-stations to access both "home directory" and program files transparently. Additionally, we provide a suite of programs to configure workstations for CUTE and to ensure continued compatibility. This paper describes the different components and the development of the CUTE architecture.

Tissue engineering of heart valves: in vitro experiences.

PubMed

Sodian, R; Hoerstrup, S P; Sperling, J S; Daebritz, S H; Martin, D P; Schoen, F J; Vacanti, J P; Mayer, J E

2000-07-01

Tissue engineering is a new approach, whereby techniques are being developed to transplant autologous cells onto biodegradable scaffolds to ultimately form new functional tissue in vitro and in vivo. Our laboratory has focused on the tissue engineering of heart valves, and we have fabricated a trileaflet heart valve scaffold from a biodegradable polymer, a polyhydroxyalkanoate. In this experiment we evaluated the suitability of this scaffold material as well as in vitro conditioning to create viable tissue for tissue engineering of a trileaflet heart valve. We constructed a biodegradable and biocompatible trileaflet heart valve scaffold from a porous polyhydroxyalkanoate (Meatabolix Inc, Cambridge, MA). The scaffold consisted of a cylindrical stent (1 x 15 x 20 mm inner diameter) and leaflets (0.3 mm thick), which were attached to the stent by thermal processing techniques. The porous heart valve scaffold (pore size 100 to 240 microm) was seeded with vascular cells grown and expanded from an ovine carotid artery and placed into a pulsatile flow bioreactor for 1, 4, and 8 days. Analysis of the engineered tissue included biochemical examination, enviromental scanning electron microscopy, and histology. It was possible to create a trileaflet heart valve scaffold from polyhydroxyalkanoate, which opened and closed synchronously in a pulsatile flow bioreactor. The cells grew into the pores and formed a confluent layer after incubation and pulsatile flow exposure. The cells were mostly viable and formed connective tissue between the inside and the outside of the porous heart valve scaffold. Additionally, we demonstrated cell proliferation (DNA assay) and the capacity to generate collagen as measured by hydroxyproline assay and movat-stained glycosaminoglycans under in vitro pulsatile flow conditions. Polyhydroxyalkanoates can be used to fabricate a porous, biodegradable heart valve scaffold. The cells appear to be viable and extracellular matrix formation was induced

Outcomes after ABO-incompatible heart transplantation in adults: A registry study.

PubMed

Bergenfeldt, Henrik; Andersson, Bodil; Bućin, Dragan; Stehlik, Josef; Edwards, Leah; Rådegran, Göran; Nilsson, Johan

2015-07-01

In the past, ABO incompatibility was considered an absolute contraindication to heart transplantation (HT) in adults. Advances in ABO-incompatible HT in pediatric patients and ABO-incompatible abdominal transplantation in adult patients have led to clinical exploration of intentional ABO-incompatible HT in adults. However, it is not well known how outcomes in ABO-incompatible adult heart transplant recipients compare with outcomes in ABO-compatible recipients. We analyzed International Society for Heart and Lung Transplantation transplant registry data from heart donors and recipients ≥18 years old at the time of transplant for HT performed between 1988 and 2011. We compared baseline characteristics and post-transplant outcomes in ABO-incompatible and ABO-compatible HT. Death or retransplantation was the composite primary end-point. Among 76,663 adult patients undergoing HT between 1988 and June 30, 2011, 94 ABO-incompatible heart transplants were performed. The incidence of death or retransplantation in the ABO-incompatible group was higher than in the ABO-compatible group: 21% vs 9% at 30 days (hazard ratio = 2.38, p < 0.001) and 36% vs 19% at 1 year after transplant. However, ABO-incompatible grafts surviving past the first year after transplant had a similar incidence of failure compared with the ABO-compatible group. After 2005, the rate ABO-incompatible HT in adults increased, likely as a result of planned, intentional (rather than accidental) ABO-incompatible HT. In this group of patients, short-term and long-term incidence of death or retransplantation was similar to ABO-compatible recipients (p = 0.822): 7% at 30 days and 19% at 1 year after transplantation. We found no difference in incidence of death or retransplantation between ABO-compatible and ABO-incompatible HT in patients who underwent transplantation after 2005. Copyright © 2015 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Short- and Long-Term Prognostic Utility of the HEART Score in Patients Evaluated in the Emergency Department for Possible Acute Coronary Syndrome.

PubMed

Jain, Tarun; Nowak, Richard; Hudson, Michael; Frisoli, Tiberio; Jacobsen, Gordon; McCord, James

2016-06-01

The HEART score is a risk-stratification tool that was developed and validated for patients evaluated for possible acute coronary syndrome (ACS) in the emergency department (ED). We sought to determine the short-term and long-term prognostic utility of the HEART score. A retrospective single-center analysis of 947 patients evaluated for possible ACS in the ED in 1999 was conducted. Patients were followed for major adverse cardiac events (MACEs) at 30 days: death, acute myocardial infarction, or revascularization procedure. All-cause mortality was assessed at 5 years. The HEART score was compared with the Thrombolysis in Myocardial Infarction (TIMI) score. At 30 days, 14% (135/947) of patients had an MACE: 48 deaths (5%), 84 acute myocardial infarctions (9%), and 48 (5%) revascularization procedures. The MACE rate in patients with HEART score ≤3 was 0.6% (1/175) involving a revascularization procedure, 9.5% (53/557) in patients with HEART score between 4 and 6, and 38% (81/215) with HEART score ≥7. The C-statistic for the HEART score was 0.82 and 0.68 for the TIMI score for predicting 30-day MACE (P < 0.05). Patients with HEART score ≤3 had lower 5-year mortality rate compared with those with TIMI score of 0 (10.6% vs. 20.5%, P = 0.02). The HEART score is a valuable risk-stratification tool in predicting not only short-term MACE but also long-term mortality in patients evaluated for possible ACS in the ED. The HEART score had a superior prognostic value compared with the TIMI score.

Cardioprotective properties of citicoline against hyperthyroidism-induced reperfusion damage in rat hearts.

PubMed

Hernández-Esquivel, Luz; Pavón, Natalia; Buelna-Chontal, Mabel; González-Pacheco, Héctor; Belmont, Javier; Chávez, Edmundo

2015-06-01

Hyperthyroidism represents an increased risk factor for cardiovascular morbidity, especially when the heart is subjected to an ischemia/reperfusion process. The aim of this study was to explore the possible protective effect of the nucleotide citicoline on the susceptibility of hyperthyroid rat hearts to undergo reperfusion-induced damage, which is associated with mitochondrial dysfunction. Hence, we analyzed the protective effect of citicoline on the electrical behavior and on the mitochondrial function in rat hearts. Hyperthyroidism was established after a daily i.p. injection of triiodothyronine (at 2 mg/kg of body weight) during 5 days. Thereafter, citicoline was administered i.p. (at 125 mg/kg of body weight) for 5 days. In hyperthyroid rat hearts, citicoline protected against reperfusion-induced ventricular arrhythmias. Moreover, citicoline maintained the accumulation of mitochondrial Ca(2+), allowing mitochondria to reach a high transmembrane electric gradient that protected against the release of cytochrome c. It also preserved the activity of the enzyme aconitase that inhibited the release of cytokines. The protection also included the inhibition of oxidative stress-induced mDNA disruption. We conclude that citicoline protects against the reperfusion damage that is found in the hyperthyroid myocardium. This effect might be due to its inhibitory action on the permeability transition in mitochondria.

Successful heart transplantation in patients with total artificial heart infections.

PubMed

Taimur, Sarah; Sullivan, Timothy; Rana, Mennakshi; Patel, Gopi; Roldan, Julie; Ashley, Kimberly; Pinney, Sean; Anyanwu, Anelechi; Huprikar, Shirish

2018-02-01

Data are limited on clinical outcomes in patients awaiting heart transplant (HT) with total artificial heart (TAH) infections. We retrospectively reviewed all TAH recipients at our center. TAH infection was classified as definite if a microorganism was isolated in cultures from the exit site or deep tissues around the TAH; as probable in patients without surgical or microbiologic evidence of infection but no other explanation for persistent or recurrent bloodstream infection (BSI); or possible in patients with clinical suspicion and radiographic findings suggestive of TAH infection, but without surgical intervention or microbiologic evidence. From 2012 to 2015, a total of 13 patients received a TAH, with a median age at implantation of 52 years (range: 28-60). TAH infection occurred in nine patients (seven definite, one probable, one possible) a median of 41 days after implant (range: 17-475). The majority of TAH infections were caused by Staphylococcus species. Seven of nine patients underwent HT (four had pre-HT mediastinal washout, and five had positive HT operative cultures). Three patients had an active BSI caused by the same pathogen causing TAH infection at the time of HT, with one developing a post-HT BSI with the same bacteria. No patient developed post-HT surgical site infection caused by the TAH infection pathogen. No deaths among HT recipients were attributed to infection. TAH infection is frequently associated with BSI and mediastinitis and Staphylococcus was the most common pathogen. A multimodal approach of appropriate pre- and post-HT antimicrobial therapy, surgical drainage, and heart transplantation with radical mediastinal debridement was successful in curing infection. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Participation in Heart-Healthy Behaviors: A Secondary Analysis of the American Heart Association Go Red Heart Match Data.

PubMed

Arslanian-Engoren, Cynthia; Eastwood, Jo-Ann; De Jong, Marla J; Berra, Kathy

2015-01-01

The American Heart Association created Go Red Heart Match, a free and secure online program that enables women to connect with each other to fight heart disease either personally or as a caregiver for someone with heart disease. Through these connections, participants have an opportunity to develop a personal, private, and supportive relationship with other women; share common experiences; and motivate and encourage each other to follow a heart-healthy lifestyle. The aims of this study were to describe the demographic characteristics of the Go Red Heart Match responders and to determine whether participation in the program prompted participants to engage in heart-healthy behaviors. A secondary analysis of data collected as part of a needs assessment survey from the American Heart Association Go Red Heart Match was conducted. A total of 117 (35%) of the 334 invited women completed the survey. Most responders were female, married, and college educated. A total of 105 (90%) responders were diagnosed with a type of heart disease or stroke and 77 (73%) responders had undergone treatment. As a result of participating in the program, 75% of the responders reported the following improvements in heart-healthy behaviors: eating a more heart-healthy diet (54%), exercising more frequently (53%), losing weight (47%), and quitting smoking (10%). Responders who had a diagnosis of heart attack (n = 48) were more likely (P = .003) to quit smoking than were those with other diagnoses (n = 69). Notably, 48% of responders reported encouraging someone else in their life to speak to their doctor about their risk for heart disease. Most women who participated in Heart Match reported engaging in new heart-healthy behaviors. The findings support expanding the existing program in a more diverse population as a potentially important way to reach women and encourage cardiovascular disease risk reduction for those with heart disease and stroke.

Long-term beta-adrenergic stimulation leads to downregulation of protein phosphatase inhibitor-1 in the heart.

PubMed

El-Armouche, Ali; Gocht, Fabian; Jaeckel, Elmar; Wittköpper, Katrin; Peeck, Micha; Eschenhagen, Thomas

2007-11-01

Desensitization of the beta-adrenoceptor/cAMP/PKA pathway is a hallmark of heart failure. Inhibitor-1 (I-1) acts as a conditional amplifier of beta-adrenergic signalling downstream of PKA by inhibiting type-1 phosphatases in the PKA-phosphorylated form. I-1 is downregulated in failing hearts and thus presumably contributes to beta-adrenergic desensitization. To test whether I-1 downregulation is a consequence of excessive adrenergic drive in heart failure, rats were treated via minipumps with isoprenaline 2.4 mg/kg/day (ISO) or 0.9% NaCl for 4 days. As expected, chronic ISO increased heart-to-body weight ratio by approximately 40% and abolished the inotropic response to acute ISO in papillary muscles by approximately 50%. In the ISO-treated hearts I-1 mRNA and protein levels were decreased by 30% and 54%, respectively. This was accompanied by decreased phospholamban phosphorylation (-40%), a downstream target of I-1, and a reduction in 45Ca2+ uptake (-54%) in membrane vesicles. Notably, phospholamban phosphorylation correlated significantly with I-1 protein levels indicating a causal relationship. We conclude that I-1 downregulation in heart failure is likely a consequence of the increased sympathetic adrenergic drive and participates in desensitization of the beta-adrenergic signalling cascade.

Enlarged Heart

MedlinePlus

... rheumatic fever, a heart defect, infections (infectious endocarditis), connective tissue disorders, certain medications or radiation treatments for cancer, your heart may enlarge. Disease of the heart ...

Nursing diagnoses in children with congenital heart disease: a survival analysis.

PubMed

Martins da Silva, Viviane; Lopes, Marcos Venícios de Oliveira; Leite de Araujo, Thelma

2007-01-01

To analyze the relationship between nursing diagnoses and survival rates in children with congenital heart disease. A total of 270 observations were carried out in 45 children with congenital heart disease who were followed for 15 days. Differences in mean survival times were identified in children not more than 4 months of age with respect to the following diagnoses: impaired gas exchange, ineffective breathing pattern, activity intolerance, delayed growth and development, and decreased cardiac output. The main diagnoses are identified early in the hospitalization period and are conditions resulting from hemodynamic alterations and prescribed medical treatment. Congenital heart disease provokes serious hemodynamic alterations that generate human responses, which should be treated proactively.

About Heart Attacks

MedlinePlus

... Artery Disease Venous Thromboembolism Aortic Aneurysm More About Heart Attacks Updated:Jan 11,2018 A heart attack is ... coronary artery damage leads to a heart attack . Heart Attack Questions and Answers What is a heart attack? ...

Highlights from High Energy Neutrino Experiments at CERN

NASA Astrophysics Data System (ADS)

Schlatter, W.-D.

2015-07-01

Experiments with high energy neutrino beams at CERN provided early quantitative tests of the Standard Model. This article describes results from studies of the nucleon quark structure and of the weak current, together with the precise measurement of the weak mixing angle. These results have established a new quality for tests of the electroweak model. In addition, the measurements of the nucleon structure functions in deep inelastic neutrino scattering allowed first quantitative tests of QCD.

Resting Heart Rate Variability Among Professional Baseball Starting Pitchers.

PubMed

Cornell, David J; Paxson, Jeffrey L; Caplinger, Roger A; Seligman, Joshua R; Davis, Nicholas A; Ebersole, Kyle T

2017-03-01

Cornell, DJ, Paxson, JL, Caplinger, RA, Seligman, JR, Davis, NA, and Ebersole, KT. Resting heart rate variability among professional baseball starting pitchers. J Strength Cond Res 31(3): 575-581, 2017-The purpose of this study was to examine the changes in resting heart rate variability (HRV) across a 5-day pitching rotation schedule among professional baseball starting pitchers. The HRV data were collected daily among 8 Single-A level professional baseball starting pitchers (mean ± SD, age = 21.9 ± 1.3 years; height = 185.4 ± 3.6 cm; weight = 85.2 ± 7.5 kg) throughout the entire baseball season with the participant quietly lying supine for 10 minutes. The HRV was quantified by calculating the natural log of the square root of the mean sum of the squared differences (lnRMSSD) during the middle 5 minutes of each R-R series data file. A split-plot repeated-measures analysis of variance was used to examine the influence of pitching rotation day on resting lnRMSSD. A statistically significant main effect of rotation day was identified (F4,706 = 3.139, p = 0.029). Follow-up pairwise analyses indicated that resting lnRMSSD on day 2 was significantly (p ≤ 0.05) lower than all other rotation days. In addition, a statistically significant main effect of pitcher was also identified (F7,706 = 83.388, p < 0.001). These results suggest that professional baseball starting pitchers display altered autonomic nervous system function 1 day after completing a normally scheduled start, as day 2 resting HRV was significantly lower than all other rotation days. In addition, the season average resting lnRMSSD varied among participants, implying that single-subject analysis of resting measures of HRV may be more appropriate when monitoring cumulative workload among this cohort population of athletes.

Women's Heart Disease: Join the Heart Truth Community

MedlinePlus

... this page please turn JavaScript on. Feature: Women's Heart Disease Join The Heart Truth Community Past Issues / Winter 2014 Table of Contents National Symbol The centerpiece of The Heart Truth ® is The Red Dress ® which was introduced ...

Heart to Heart Art: Empowering Homeless Children and Youth

ERIC Educational Resources Information Center

Shepard, Jerri; Booth, Deborah

2009-01-01

This article describes Heart to Heart Art, an after-school program developed for homeless children and youth at the YWCA in Spokane, Washington. Pre-service teacher candidates from a local university create meaningful activities that engage homeless students in visual art, music, drama, cooking, and community service. Heart to Heart Art was…

Impact of Nurse-Led, Multidisciplinary Home-Based Intervention on Event-Free Survival Across the Spectrum of Chronic Heart Disease

PubMed Central

Wiley, Joshua F.; Ball, Jocasta; Chan, Yih-Kai; Ahamed, Yasmin; Thompson, David R.; Carrington, Melinda J.

2016-01-01

Background— We sought to determine the overall impact of a nurse-led, multidisciplinary home-based intervention (HBI) adapted to hospitalized patients with chronic forms of heart disease of varying types. Methods and Results— Prospectively planned, combined, secondary analysis of 3 randomized trials (1226 patients) of HBI were compared with standard management. Hospitalized patients presenting with heart disease but not heart failure, atrial fibrillation but not heart failure, and heart failure, as well, were recruited. Overall, 612 and 614 patients, respectively, were allocated to a home visit 7 to 14 days postdischarge by a cardiac nurse with follow-up and multidisciplinary support according to clinical need or standard management. The primary outcome of days-alive and out-of-hospital was examined on an intention-to-treat basis. During 1371 days (interquartile range, 1112–1605) of follow-up, 218 patients died and 17 917 days of hospital stay were recorded. In comparison with standard management, HBI patients achieved significantly prolonged event-free survival (90.1% [95% confidence interval, 88.2–92.0] versus 87.2% [95% confidence interval, 85.1–89.3] days-alive and out-of-hospital; P=0.020). This reflected less all-cause mortality (adjusted hazard ratio, 0.67; 95% confidence interval, 0.50–0.88; P=0.005) and unplanned hospital stay (median, 0.22 [interquartile range, 0–1.3] versus 0.36 [0–2.1] days/100 days follow-up; P=0.011). Analyses of the differential impact of HBI on all-cause mortality showed significant interactions (characterized by U-shaped relationships) with age (P=0.005) and comorbidity (P=0.041); HBI was most effective for those aged 60 to 82 years (59%–65% of individual trial cohorts) and with a Charlson Comorbidity Index Score of 5 to 8 (36%–61%). Conclusions— These data provide further support for the application of postdischarge HBI across the full spectrum of patients being hospitalized for chronic forms of heart

Hospital Volume and 30-Day Mortality for Three Common Medical Conditions

PubMed Central

Ross, Joseph S.; Normand, Sharon-Lise T.; Wang, Yun; Ko, Dennis T.; Chen, Jersey; Drye, Elizabeth E.; Keenan, Patricia S.; Lichtman, Judith H.; Bueno, Héctor; Schreiner, Geoffrey C.; Krumholz, Harlan M.

2010-01-01

Background The association between hospital volume and the death rate for patients who are hospitalized for acute myocardial infarction, heart failure, or pneumonia remains unclear. It is also not known whether a volume threshold for such an association exists. Methods We conducted cross-sectional analyses of data from Medicare administrative claims for all fee-for-service beneficiaries who were hospitalized between 2004 and 2006 in acute care hospitals in the United States for acute myocardial infarction, heart failure, or pneumonia. Using hierarchical logistic-regression models for each condition, we estimated the change in the odds of death within 30 days associated with an increase of 100 patients in the annual hospital volume. Analyses were adjusted for patients’ risk factors and hospital characteristics. Bootstrapping procedures were used to estimate 95% confidence intervals to identify the condition-specific volume thresholds above which an increased volume was not associated with reduced mortality. Results There were 734,972 hospitalizations for acute myocardial infarction in 4128 hospitals, 1,324,287 for heart failure in 4679 hospitals, and 1,418,252 for pneumonia in 4673 hospitals. An increased hospital volume was associated with reduced 30-day mortality for all conditions (P<0.001 for all comparisons). For each condition, the association between volume and outcome was attenuated as the hospital's volume increased. For acute myocardial infarction, once the annual volume reached 610 patients (95% confidence interval [CI], 539 to 679), an increase in the hospital volume by 100 patients was no longer significantly associated with reduced odds of death. The volume threshold was 500 patients (95% CI, 433 to 566) for heart failure and 210 patients (95% CI, 142 to 284) for pneumonia. Conclusions Admission to higher-volume hospitals was associated with a reduction in mortality for acute myocardial infarction, heart failure, and pneumonia, although there was a

NASA's Functional Task Test: High Intensity Exercise Improves the Heart Rate Response to a Stand Test Following 70 Days of Bedrest

NASA Technical Reports Server (NTRS)

Laurie, Steven S.; Lee, Stuart M. C.; Phillips, Tiffany R.; Dillon, E. Lichar; Sheffield-Moore, Melinda; Urban, Randall J.; Ploutz-Snyder, Lori; Stenger, Michael B.; Bloomberg, Jacob J.

2015-01-01

Cardiovascular adaptations due to spaceflight are modeled with 6deg head-down tilt bed rest (BR) and result in decreased orthostatic tolerance. We investigated if high-intensity resistive and aerobic exercise with and without testosterone supplementation would improve the heart rate (HR) response to a 3.5-min stand test and how quickly these changes recovered following BR. During 70 days of BR male subjects performed no exercise (Control, n=10), high intensity supine resistive and aerobic exercise (Exercise, n=9), or supine exercise plus supplemental testosterone (Exercise+T, n=8; 100 mg i.m., weekly in 2-week on/off cycles). We measured HR for 2 min while subjects were prone and for 3 min after standing twice before and 0, 1, 6, and 11 days after BR. Mixed-effects linear regression models were used to evaluate group, time, and interaction effects. Compared to pre-bed rest, prone HR was elevated on BR+0 and BR+1 in Control, but not Exercise or Exercise+T groups, and standing HR was greater in all 3 groups. The increase in prone and standing HR in Control subjects was greater than either Exercise or Exercise+T groups and all groups recovered by BR+6. The change in HR from prone to standing more than doubled on BR+0 in all groups, but was significantly less in the Exericse+T group compared to the Control, but not Exercise group. Exercise reduces, but does not prevent the increase in HR observed in response to standing. The significantly lower HR response in the Exercise+T group requires further investigation to determine physiologic significance.

Heart rate and treatment effect in children with disruptive behavior disorders.

PubMed

Stadler, Christina; Grasmann, Dörte; Fegert, Jörg M; Holtmann, Martin; Poustka, Fritz; Schmeck, Klaus

2008-09-01

To examine whether children with disruptive behavior disorders (DBDs; hyperkinetic conduct disorder, conduct disorder, hyperkinetic disorder) characterized by low heart rate profit less from an intensive cognitive behavioral intervention aimed at reducing impulsive, oppositional and aggressive behavior problems. Basal heart rate was studied in twenty-three children (aged 7-12 years) with DBD at the beginning of intervention comprising an intensive day-care treatment and parent training. The disruptive behavior of the child was assessed before treatment and after termination (12 weeks later). Therapy responders and non-responders were compared in regard to heart rate and other risk factors (cognitive functioning and socio-economic status). Statistical analyses yielded evidence for a significant reduction of disruptive problem behaviors (aggression, delinquency) that is more prominent in DBD children with high heart rate scores compared to patients with low heart rate scores. Heart rate was significantly lower in children who did not profit from therapy. A logistic regression analysis revealed that heart rate is a significant predictor for therapy success whereas other risk factors had no impact on therapy success. Further studies investigating biological and psychosocial predictors of treatment effectiveness are necessary. In addition, it might be helpful to consider different subtypes of aggressive behavior for selecting the best possible treatment options.

Home telemonitoring in heart failure patients: the HHH study (Home or Hospital in Heart Failure)

PubMed Central

Mortara, Andrea; Pinna, Gian Domenico; Johnson, Paul; Maestri, Roberto; Capomolla, Soccorso; La Rovere, Maria Teresa; Ponikowski, Piotr; Tavazzi, Luigi; Sleight, Peter

2009-01-01

Aims The Home or Hospital in Heart failure (HHH) study was a European Community-funded, multinational, randomized controlled clinical trial, conducted in the UK, Poland, and Italy, to assess the feasibility of a new system of home telemonitoring (HT). The HT system was used to monitor clinical and physiological parameters, and its effectiveness (compared with usual care) in reducing cardiac events in heart failure (HF) patients was evaluated. Measurements were patient-managed. Methods and results From 2002 to 2004, 461 HF patients (age 60 ± 11 years, New York Heart Association class 2.4 ± 0.6, left ventricular ejection fraction 29 ± 7%) were enrolled at 11 centres and randomized (1:2) to either usual outpatient care or HT administered as three randomized strategies: (i) monthly telephone contact; (ii) strategy 1 plus weekly transmission of vital signs; and (iii) strategy 2 plus monthly 24 h recording of cardiorespiratory activity. Patients completed 81% of vital signs transmissions, as well as 92% of cardiorespiratory recordings. Over a 12-month follow-up, there was no significant effect of HT in reducing bed-days occupancy for HF or cardiac death plus HF hospitalization. Post hoc analysis revealed a heterogeneous effect of HT in the three countries with a trend towards a reduction of events in Italy. Conclusion Home or Hospital in Heart failure indicates that self-managed HT of clinical and physiological parameters is feasible in HF patients, with surprisingly high compliance. Whether HT contributes to a reduction of cardiac events requires further investigation. PMID:19228800

The trigger system for K0→2 π0 decays of the NA48 experiment at CERN

NASA Astrophysics Data System (ADS)

Mikulec, I.

1998-02-01

A fully pipelined 40 MHz "dead-time-free" trigger system for neutral K0 decays for the NA48 experiment at CERN is described. The NA48 experiment studies CP-violation using the high intensity beam of the CERN SPS accelerator. The trigger system sums, digitises, filters and processes signals from 13 340 channels of the liquid krypton electro-magnetic calorimeter. In 1996 the calorimeter and part of the trigger electronics were installed and tested. In 1997 the system was completed and prepared to be used in the first NA48 physics data taking period. Cagliari, Cambridge, CERN, Dubna, Edinburgh, Ferrara, Firenze, Mainz, Orsay, Perugia, Pisa, Saclay, Siegen, Torino, Warszawa, Wien Collaboration.

Heart Health: Learn the Truth About Your Heart

MedlinePlus

... Bar Home Current Issue Past Issues Cover Story Heart Health Learn the Truth About Your Heart Past Issues / Winter 2009 Table of Contents For ... turn Javascript on. Photo: iStock February is American Heart Month. Now is the time to make sure ...

Eotaxin/CCL11 levels correlate with myocardial fibrosis and mast cell density in native and transplanted rat hearts.

PubMed

Zweifel, M; Matozan, K; Dahinden, C; Schaffner, T; Mohacsi, P

2010-09-01

Myocardial fibrosis contributes to hemodynamic and cardiac functional alterations commonly observed posttransplantation. Cardiac mast cells (MC) have been linked to fibrosis in posttransplantation hearts. Eotaxin, which has been shown to be involved in fibrogenesis, has been demonstrated to be increased in production in cardiac macrophages. The aim of our study was to correlate myocardial fibrosis during heart transplant rejection in the rat with eotaxin/chemokine [c-c motif] ligand 11 (CCL11) expression, and with various subtypes of infiltrating cardiac MC, namely connective-type MC (CTMC) and mucosa-type MC (MMC). We used tissues from 2 previous studies of ongoing acute rejection in allogeneic Brown-Norway to Lewis rat and an isogeneic Brown-Norway to Brown-Norway heterotopic heart transplantation models under cyclosporin/prednisolone immunosuppression. Collagen fibrils were stained with Masson's trichrome with myocardial fibrosis expressed as percent fibrotic area per total section area. Eotaxin/CCL11 previously measured in heart tissue using enzyme-linked immunosorbent assay (ELISA) was correlated with the extent of myocardial fibrosis. We compared values from native hearts (n = 4) as well as transplants on days 5, 16, and 28 (n = 4 in each group). The area of myocardial fibrosis was significantly increased in the allogeneic compared with the isogeneic group at day 16 (38% vs 21%) and at day 28 (49% vs 22%) after transplantation. Myocardial fibrosis correlated significantly with eotaxin/CCL11 concentrations and the density of MMC, but not with CTMC in heart tissue. Eotaxin-triggered MC infiltration of the heart may contribute to myocardial fibrosis after transplantation. Targeting eotaxin/CCL11 with monoclonal antibodies, such as bertilimumab, could reduce MC infiltration, possibly resulting in decreased myocardial fibrosis and improved contractile function after heart transplantation. 2010 Elsevier Inc. All rights reserved.

Effects of thalidomide treatment in heart failure patients.

PubMed

Orea-Tejeda, Arturo; Arrieta-Rodríguez, Oscar; Castillo-Martínez, Lilia; Rodríguez-Reyna, Tatiana; Asensio-Lafuente, Enrique; Granados-Arriola, Julio; Dorantes-García, Joel

2007-01-01

Several studies have reported a direct association between elevated plasma levels of inflammatory cytokines and worse functional class (New York Heart Association [NYHA]) and cardiac function, measured as left ventricular ejection fraction (LVEF). Thalidomide has recently shown to improve LVEF in chronic heart failure patients, accompanied by a marked decrease in plasma levels of tumor necrosis factor alpha (TNF-alpha). In a randomized prospective open label study of men and women with heart failure (HF) due to ischemic and non-ischemic cardiomyopathy who had systolic dysfunction (LVEF <40%) and NHYA classification, functional classes II and III were assigned to control (without thalidomide, 60 patients) or thalidomide group (20 patients). The initial dose of thalidomide was 100 mg once a day, and it was increased to 100 mg twice a day after a period of 10 days, if the prior dosage was well-tolerated. Demographic characteristics, etiology of HF, prior myocardial infarction, co-morbidities associated were registered and laboratory routine test, TNF-alpha serum levels, and echocardiogram were obtained at the beginning and after 6 months of follow-up. Clinical status (NYHA) at the end of the follow-up period, improved moderately in both groups. TNF-alpha levels were initially of 5.88 +/- 0.9 and 6.49 +/- 1.82 vs. 6.32 +/- 1.6 and 7.94 +/- 3.8 pg/ml during follow-up, for thalidomide and control groups, respectively. There were non-significant differences in echocardiography variables. In conclusion, although there is a large amount of information supporting a direct relationship between TNF-alpha and worsening of symptoms and prognosis in patients with HF and recently, the beneficial effect on thalidomide treatment has been suggested, these preliminary observations should be confirmed in a larger prospective study, specially trying to clarify the action mechanisms. (c) 2007 S. Karger AG, Basel.

Total artificial heart in the pediatric patient with biventricular heart failure.

PubMed

Park, S S; Sanders, D B; Smith, B P; Ryan, J; Plasencia, J; Osborn, M B; Wellnitz, C M; Southard, R N; Pierce, C N; Arabia, F A; Lane, J; Frakes, D; Velez, D A; Pophal, S G; Nigro, J J

2014-01-01

Mechanical circulatory support emerged for the pediatric population in the late 1980s as a bridge to cardiac transplantation. The Total Artificial Heart (TAH-t) (SynCardia Systems Inc., Tuscon, AZ) has been approved for compassionate use by the Food and Drug Administration for patients with end-stage biventricular heart failure as a bridge to heart transplantation since 1985 and has had FDA approval since 2004. However, of the 1,061 patients placed on the TAH-t, only 21 (2%) were under the age 18. SynCardia Systems, Inc. recommends a minimum patient body surface area (BSA) of 1.7 m(2), thus, limiting pediatric application of this device. This unique case report shares this pediatric institution's first experience with the TAH-t. A 14-year-old male was admitted with dilated cardiomyopathy and severe biventricular heart failure. The patient rapidly decompensated, requiring extracorporeal life support. An echocardiogram revealed severe biventricular dysfunction and diffuse clot formation in the left ventricle and outflow tract. The decision was made to transition to biventricular assist device. The biventricular failure and clot formation helped guide the team to the TAH-t, in spite of a BSA (1.5 m(2)) below the recommendation of 1.7 m(2). A computed tomography (CT) scan of the thorax, in conjunction with a novel three-dimensional (3D) modeling system and team, assisted in determining appropriate fit. Chest CT and 3D modeling following implantation were utilized to determine all major vascular structures were unobstructed and the bronchi were open. The virtual 3D model confirmed appropriate device fit with no evidence of compression to the left pulmonary veins. The postoperative course was complicated by a left lung opacification. The left lung anomalies proved to be atelectasis and improved with aggressive recruitment maneuvers. The patient was supported for 11 days prior to transplantation. Chest CT and 3D modeling were crucial in assessing whether the device would

Early administration of tolvaptan preserves renal function in elderly patients with acute decompensated heart failure.

PubMed

Kimura, Kazuhiro; Momose, Tomoyasu; Hasegawa, Tomoya; Morita, Takehiro; Misawa, Takuo; Motoki, Hirohiko; Izawa, Atsushi; Ikeda, Uichi

2016-05-01

Loop diuretics used in the treatment of heart failure often induce renal impairment. This study was conducted in order to evaluate the renal protective effect of adding tolvaptan (TLV), compared to increasing the furosemide (FRM) dose, for the treatment of acute decompensated heart failure (ADHF) in a real-world elderly patient population. This randomized controlled trial enrolled 52 consecutive hospitalized patients (age 83.4±9.6 years) with ADHF. The patients were assigned alternately to either the TLV group (TLV plus conventional treatment, n=26) or the FRM group (increasing the dose of FRM, n=26). TLV was administered within 24h from admission. The incidence of worsening renal function (WRF) within 7 days from admission was significantly lower in the TLV group (26.9% vs. 57.7%, p=0.025). Furthermore, the rates of occurrence of persistent and late-onset (≥5 days from admission) WRF were significantly lower in the TLV group. Persistent and late-onset WRF were significantly associated with a higher incidence of cardiac death or readmission for worsening heart failure in the 90 days following discharge, compared to transient and early-onset WRF, respectively. Early administration of TLV, compared to increased FRM dosage, reduces the incidence of WRF in real-world elderly ADHF patients. In addition, it reduces the occurrence of 'worse' WRF-persistent and late-onset WRF-which are associated with increased rates of cardiac death or readmission for worsening heart failure in the 90 days after discharge. Copyright © 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

Adrenal hormones interact with sympathetic innervation to modulate growth of embryonic heart in oculo.

PubMed

Tucker, D C; Torres, A

1992-02-01

To allow experimental manipulation of adrenal hormone and autonomic influences on developing myocardium without alteration of hemodynamic load, embryonic rat heart was cultured in the anterior eye chamber of an adult rat. Sympathetic innervation of embryonic day 12 heart grafts was manipulated by surgical sympathectomy of one eye chamber in each host rat. Adrenal hormone exposure was manipulated by host adrenal medullectomy (MEDX) in experiment 1 and by host adrenalectomy (ADX) in experiment 2. In experiment 1, whole heart grafts were larger in MEDX than in sham-operated hosts by 8 wk in oculo (6.14 +/- 0.71 vs. 5.09 +/- 0.69 mm2 with innervation intact and 7.97 +/- 2.07 vs. 3.09 +/- 0.63 mm2 with sympathetic innervation prevented). In experiment 2, host ADX increased growth of embryonic day 12 ventricles grafted into sympathectomized eye chambers (0.69 +/- 0.10 vs. 0.44 +/- 0.04 mm2) but did not affect growth of grafts in intact eye chambers (0.85 +/- 0.09 vs. 1.05 +/- 0.15 mm2). Corticosterone replacement (4 mg/day) entirely reversed the effect of host ADX on graft growth (superior cervical ganglionectomy, 0.47 +/- 0.03 mm2; intact eye chambers, 0.90 +/- 0.91 mm2). Beating rate of grafts was not affected by adrenal hormone manipulations. These experiments indicate that the compromised growth of embryonic heart grafts placed in sympathectomized eye chambers requires exposure to adult levels of glucocorticoids during the early days after grafting. These results suggest that interactions between neural and hormonal stimulation influence cardiac growth in the in oculo culture system and during normal development.

76 FR 21999 - Education and Sharing Day, U.S.A., 2011

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-20

... remains a beacon of hope for many across the globe because of our open hearts during times of... dedicated his life to improving education and fostering goodwill for all people. His legacy continues to... Sharing Day, U.S.A., reminds us of our obligation to create opportunities for a better tomorrow--life...

Heart transplantation in adult congenital heart disease.

PubMed

Burchill, Luke J

2016-12-01

Heart failure (HF) in adult congenital heart disease (ACHD) is vastly different to that observed in acquired heart disease. Unlike acquired HF in which pharmacological strategies are the cornerstone for protecting and improving ventricular function, ACHD-related HF relies heavily upon structural and other interventions to achieve these aims. patients with ACHD constitute a small percentage of the total adult heart transplant population (∼3%), although the number of ACHD heart transplant recipients is growing rapidly with a 40% increase over the last two decades. The worldwide experience to date has confirmed heart transplantation as an effective life-extending treatment option in carefully selected patients with ACHD with end-stage cardiac disease. Opportunities for improving outcomes in patients with ACHD-related HF include (i) earlier recognition and referral to centres with combined expertise in ACHD and HF, (ii) increased awareness of arrhythmia and sudden cardiac death risk in this population, (iii) greater collaboration between HF and ACHD specialists at the time of heart transplant assessment, (iv) expert surgical planning to reduce ischaemic time and bleeding risk at the time of transplant, (v) tailored immunosuppression in the post-transplant period and (vi) development and validation of ACHD-specific risk scores to predict mortality and guide patient selection. The purpose of this article is to review current approaches to diagnosing and treating advanced HF in patients with ACHD including indications, contraindications and clinical outcomes after heart transplantation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Heart attack

MedlinePlus

... infarction; Non-ST - elevation myocardial infarction; NSTEMI; CAD - heart attack; Coronary artery disease - heart attack ... made up of cholesterol and other cells. A heart attack may occur when: A tear in the ...

Change of Exhaled Acetone Concentration in a Diabetic Patient with Acute Decompensated Heart Failure.

PubMed

Yokokawa, Tetsuro; Ichijo, Yasuhiro; Houtsuki, Yu; Matsumoto, Yoshiyuki; Oikawa, Masayoshi; Yoshihisa, Akiomi; Sugimoto, Koichi; Nakazato, Kazuhiko; Suzuki, Hitoshi; Saitoh, Shu-Ichi; Shimouchi, Akito; Takeishi, Yasuchika

2017-10-21

In heart failure patients, exhaled acetone concentration, a noninvasive biomarker, is increased according to heart failure severity. Moreover, exhaled acetone concentration is also known to be affected by diabetes mellitus. However, there have been no reports on exhaled acetone concentration in heart failure patients with diabetes mellitus. A 77-year old man was admitted to our hospital with acute decompensated heart failure and atrioventricular block. He had controlled diabetes mellitus under insulin treatment with hemoglobin A1c of 6.5%. He underwent treatment of diuretics and permanent pacemaker implantation. His condition improved and he was discharged at Day 12. Due to the heart failure improvement, his levels of exhaled acetone concentration decreased from 1.623 ppm at admission to 0.664 ppm at discharge. This is the first report to reveal a change of exhaled acetone concentration in a diabetic patient with acute decompensated heart failure.

Techniques for hazard analysis and their use at CERN.

PubMed

Nuttall, C; Schönbacher, H

2001-01-01

CERN, The European Organisation for Nuclear Research is situated near Geneva and has its accelerators and experimental facilities astride the Swiss and French frontiers attracting physicists from all over the world to this unique laboratory. The main accelerator is situated in a 27 km underground ring and the experiments take place in huge underground caverns in order to detect the fragments resulting from the collision of subatomic particles at speeds approaching that of light. These detectors contain many hundreds of tons of flammable materials, mainly plastics in cables and structural components, flammable gases in the detectors themselves, and cryogenic fluids such as helium and argon. The experiments consume high amounts of electrical power, thus the dangers involved have necessitated the use of analytical techniques to identify the hazards and quantify the risks to personnel and the infrastructure. The techniques described in the paper have been developed in the process industries where they have been to be of great value. They have been successfully applied to CERN industrial and experimental installations and, in some cases, have been instrumental in changing the philosophy of the experimentalists and their detectors.

Interrelationship between 3,5,3′-triiodothyronine and the circadian clock in the rodent heart

PubMed Central

Peliciari-Garcia, Rodrigo Antonio; Prévide, Rafael Maso; Nunes, Maria Tereza; Young, Martin Elliot

2017-01-01

Triiodothyronine (T3) is an important modulator of cardiac metabolism and function, often through modulation of gene expression. The cardiomyocyte circadian clock is a transcriptionally-based molecular mechanism capable of regulating cardiac processes, in part by modulating responsiveness of the heart to extra-cardiac stimuli/stresses in a time-of-day- (TOD) dependent manner. Although TOD-dependent oscillations in circulating levels of T3 (and its intermediates) have been established, whether oscillations in T3 sensitivity in the heart occur is unknown. To investigate the latter possibility, euthyroid male Wistar rats were treated with vehicle or T3 at distinct times of the day, after which induction of known T3 target genes were assessed in the heart (4-h later). The expression of mRNA was assessed by Real-Time qPCR. Here, we report greater T3 induction of transcript levels at the end of the dark phase. Surprisingly, use of cardiomyocyte-specific clock mutant (CCM) mice revealed that TOD-dependent oscillations in T3 sensitivity were independent of this cell autonomous mechanism. Investigation of genes encoding for proteins that affect T3 sensitivity revealed that Dio1, Dio2, and Thrb1 exhibited TOD-dependent variations in the heart, while Thra1 and Thra2 did not. Of these, Dio1 and Thrb1 were increased in the heart at the end of the dark phase. Interestingly, we observed that T3 acutely altered the expression of core clock components (e.g., Bmal1) in the rat heart. To investigate this further, rats were injected with a single dose of T3, after which expression of clock genes were interrogated at 3-h intervals over the subsequent 24h-period. These studies revealed robust effects of T3 on oscillations of both core clock components and clock-controlled genes. In summary, the current study exposed time-of-day-dependent rhythms in cardiac T3 sensitivity, and that T3 alters the circadian clock in the heart. PMID:27661292

Metabolic support for the heart: complementary therapy for heart failure?

PubMed

Heggermont, Ward A; Papageorgiou, Anna-Pia; Heymans, Stephane; van Bilsen, Marc

2016-12-01

The failing heart has an increased metabolic demand and at the same time suffers from impaired energy efficiency, which is a detrimental combination. Therefore, therapies targeting the energy-deprived failing heart and rewiring cardiac metabolism are of great potential, but are lacking in daily clinical practice. Metabolic impairment in heart failure patients has been well characterized for patients with reduced ejection fraction, and is coming of age in patients with 'preserved' ejection fraction. Targeting cardiomyocyte metabolism in heart failure could complement current heart failure treatments that do improve cardiovascular haemodynamics, but not the energetic status of the heart. In this review, we discuss the hallmarks of normal cardiac metabolism, typical metabolic disturbances in heart failure, and past and present therapeutic targets that impact on cardiac metabolism. © 2016 The Authors. European Journal of Heart Failure © 2016 European Society of Cardiology.

Heart rate turbulence in healthy dogs and dogs with dilated cardiomyopathy.

PubMed

Noszczyk-Nowak, A

2012-01-01

Heart rate turbulence (HRT) is modulated by the baroreceptor reflex and it was suggested that it could be used as a measure of autonomic dysfunction. Impaired HRT is of a significant prognostic value in humans after myocardial infarction, suffering from dilated cardiomyopathy and patients with heart failure. So far no studies were performed assessing the importance of HRT in dogs. The aim of this study was to prospectively evaluate the HRT turbulence onset (TO) and the turbulence slope (TS) in healthy dogs and in dogs with DCM and to compare the HRT in dogs with DCM that died during the first 30 days of observation and dogs with DCM that survived the first 30 days after the HRT analysis. The current study was aimed at determining reference value of the TO and TS of HRT in healthy dogs (control group) and dogs with dilated cardiomyopathy (DCM group). The tests were carried out on 30 healthy dogs and 30 dogs with DCM composed of Boxers, Doberman pinschers and Great Danes, of different sexes and body weights from 22 to 72 kg, aged between 1.5 and 11.5 years, submitted to the 24-hour Holter monitoring. HRT parameters were calculated using an HolCard software algorithm. TO is a percentage difference between the heart rate immediately following ventricular premature complex (VPC) and the heart rate immediately preceding VPC. TS corresponds to the steepest slope of the linear regression line for each sequence of five consecutive normal intervals in the local tachogram. The average TO in healthy dogs was determined as -13.55 +/- 11.12%, TS was 21.33 +/- 9.66 ms/RR. TO in dogs with DCM was determined as - 2.61 +/- 2.1% and TS was 6.15 +/- 3.86 ms/RR. Parameters of HRT were statistically significantly decreased (p < 0.01) in dogs with DCM. HRT TO and TS were statistically significantly decreased in dogs with DCM. Dogs with DCM that survived more than 30 days of observation had HRT statistically significantly decreased in comparison to dogs with DCM that died after the 30'th

[Length of stay in patients admitted for acute heart failure].

PubMed

Martín-Sánchez, Francisco Javier; Carbajosa, Virginia; Llorens, Pere; Herrero, Pablo; Jacob, Javier; Miró, Òscar; Fernández, Cristina; Bueno, Héctor; Calvo, Elpidio; Ribera Casado, José Manuel

2016-01-01

To identify the factors associated with prolonged length of hospital stay in patients admitted for acute heart failure. Multipurpose observational cohort study including patients from the EAHFE registry admitted for acute heart failure in 25 Spanish hospitals. Data were collected on demographic and clinical variables and on the day and place of admission. The primary outcome was length of hospital stay longer than the median. We included 2,400 patients with a mean age of 79.5 (9.9) years; of these, 1,334 (55.6%) were women. Five hundred and ninety (24.6%) were admitted to the short stay unit (SSU), 606 (25.2%) to cardiology, and 1,204 (50.2%) to internal medicine or gerontology. The mean length of hospital stay was 7.0 (RIC 4-11) days. Fifty-eight (2.4%) patients died and 562 (23.9%) were readmitted within 30 days after discharge. The factors associated with prolonged length of hospital stay were chronic pulmonary disease; being a device carrier; having an unknown or uncommon triggering factor; the presence of renal insufficiency, hyponatremia and anaemia in the emergency department; not being admitted to an SSU or the lack of this facility in the hospital; and being admitted on Monday, Tuesday or Wednesday. The factors associated with length of hospital stay≤7days were hypertension, having a hypertensive episode, or a lack of treatment adherence. The area under the curve of the mixed model adjusted to the center was 0.78 (95% CI: 0.76-0.80; p<0.001). A series of factors is associated with prolonged length of hospital stay and should be taken into account in the management of acute heart failure. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

More "Hands-On" Particle Physics: Learning with ATLAS at CERN

ERIC Educational Resources Information Center

Long, Lynne

2011-01-01

This article introduces teachers and students to a new portal of resources called Learning with ATLAS at CERN (http://learningwithatlas-portal.eu/), which has been developed by a European consortium of academic researchers and schools' liaison and outreach providers from countries across Europe. It includes the use of some of the mind-boggling…

Changes in force and calcium sensitivity in the developing avian heart.

PubMed

Godt, R E; Fogaça, R T; Nosek, T M

1991-11-01

The aim of this study was to characterize the development of the contractile properties of intact and chemically skinned muscle from chicken heart and to compare these characteristics with those of developing mammalian heart reported by others. Small trabeculae were dissected from left ventricles of Arbor Acre chickens between embryonic day 7 and young adulthood (7 weeks post-hatching). At all ages, increasing extracellular calcium (0.45-3.6 mM) progressively increased twitch force of electrically stimulated trabeculae. Twitch force at 1.8 mM extracellular calcium, normalized to cross-sectional area, increased to a maximum at 1 day post-hatching, remained constant through 3 weeks post-hatching, but then decreased at 7 weeks post-hatching. The maximal calcium-activated force of trabeculae chemically skinned with Triton X-100 detergent increased to a maximum 2 days before the time of hatching and was not significantly changed up to 7 weeks post-hatching. Over the ages studied, average twitch force in 1.8 mM calcium was between 26 and 66% of maximal calcium-activated force after skinning, suggesting that the contractile apparatus is not fully activated during the twitch in normal Ringer. In skinned trabeculae, the calcium sensitivity of the contractile apparatus was higher in the embryo than in the young adult. These age-dependent changes in calcium sensitivity are correlated with isoform switching in troponin T. A decrease in pH from 7.0 to 6.5 decreased the calcium sensitivity of the contractile apparatus to a greater degree in skinned trabeculae from young adult hearts than in those from embryonic hearts. This change in susceptibility to acidosis is temporally associated with isoform switching in troponin I.(ABSTRACT TRUNCATED AT 250 WORDS)