Exploring links between greenspace and sudden unexpected death: a spatial analysis
Greenspace has been increasingly recognized as having numerous health benefits. However, its effects are unknown concerning sudden unexpected death (SUD), commonly referred to as sudden cardiac death, which constitutes a large proportion of mortality in the United States. Because...
NASA Astrophysics Data System (ADS)
Plavcová, Eva; Kyselý, Jan
2010-09-01
The study examines the relationship between sudden changes in weather conditions in summer, represented by (1) sudden air temperature changes, (2) sudden atmospheric pressure changes, and (3) passages of strong atmospheric fronts; and variations in daily mortality in the population of the Czech Republic. The events are selected from data covering 1986-2005 and compared with the database of daily excess all-cause mortality for the whole population and persons aged 70 years and above. Relative deviations of mortality, i.e., ratios of the excess mortality to the expected number of deaths, were averaged over the selected events for days D-2 (2 days before a change) up to D+7 (7 days after), and their statistical significance was tested by means of the Monte Carlo method. We find that the periods around weather changes are associated with pronounced patterns in mortality: a significant increase in mortality is found after large temperature increases and on days of large pressure drops; a decrease in mortality (partly due to a harvesting effect) occurs after large temperature drops, pressure increases, and passages of strong cold fronts. The relationship to variations in excess mortality is better expressed for sudden air temperature/pressure changes than for passages of atmospheric fronts. The mortality effects are usually more pronounced in the age group 70 years and above. The impacts associated with large negative changes of pressure are statistically independent of the effects of temperature; the corresponding dummy variable is found to be a significant predictor in the ARIMA model for relative deviations of mortality. This suggests that sudden weather changes should be tested also in time series models for predicting excess mortality as they may enhance their performance.
Sawers, Andrew; Hahn, Michael E
2013-08-01
Motor learning strategies that increase practice difficulty and the size of movement errors are thought to facilitate motor learning. In contrast to this, gradual training minimizes movement errors and reduces practice difficulty by incrementally introducing task requirements, yet remains as effective as sudden training and its large movement errors for learning novel reaching tasks. While attractive as a locomotor rehabilitation strategy, it remains unknown whether the efficacy of gradual training extends to learning locomotor tasks and their unique requirements. The influence of gradual vs. sudden training on learning a locomotor task, asymmetric split belt treadmill walking, was examined by assessing whole body sagittal plane kinematics during 24 hour retention and transfer performance following either gradual or sudden training. Despite less difficult and less specific practice for the gradual cohort on day 1, gradual training resulted in equivalent motor learning of the novel locomotor task as sudden training when assessed by retention and transfer a day later. This suggests that large movement errors and increased practice difficulty may not be necessary for learning novel locomotor tasks. Further, gradual training may present a viable locomotor rehabilitation strategy avoiding large movement errors that could limit or impair improvements in locomotor performance. Copyright © 2013 Elsevier B.V. All rights reserved.
NASA Astrophysics Data System (ADS)
Plavcová, Eva; Kyselý, Jan
2014-08-01
Sudden weather changes have long been thought to be associated with negative impacts on human health, but relatively few studies have attempted to quantify these relationships. We use large 6-h changes in atmospheric pressure as a proxy for sudden weather changes and evaluate their association with hospital admissions for cardiovascular diseases (CVD). Winter and summer seasons and positive and negative pressure changes are analysed separately, using data for the city of Prague (population 1.2 million) over a 16-year period (1994-2009). We found that sudden pressure drops in winter are associated with significant rise in hospital admissions. Increased CVD morbidity was observed neither for pressure drops in summer nor pressure increases in any season. Analysis of synoptic weather maps shows that large pressure drops in winter are associated with strong zonal flow and rapidly moving low-pressure systems with centres over northern Europe and atmospheric fronts affecting western and central Europe. Analysis of links between passages of strong atmospheric fronts and hospital admissions, however, shows that the links disappear if weather changes are characterised by frontal passages. Sudden pressure drops in winter are associated also with significant excess CVD mortality. As climate models project strengthening of zonal circulation in winter and increased frequency of windstorms, the negative effects of such weather phenomena and their possible changes in a warmer climate of the twenty-first century need to be better understood, particularly as their importance in inducing excess morbidity and mortality in winter may increase compared to cold spells.
Krous, Henry F; Haas, Elisabeth A; Manning, Julie M; Deeds, Anita; Silva, Patricia D; Chadwick, Amy E; Stanley, Christina
2006-08-01
The potential diagnostic significance of prior family referral to Child Protective Services (CPS) in cases of sudden infant death is unknown. Therefore, the authors retrospectively searched for CPS data for the 5-year referral history on all 533 families whose infants died suddenly from Sudden Infant Death Syndrome (SIDS), other natural diseases, accidents, or inflicted injuries and underwent postmortem examination by the medical examiner during a 10-year period. No family had more than one infant death. At least 27% of the families in each group had at least one CPS referral. The data suggest that a family's referral to CPS prior to their sudden death of their infant does not increase the likelihood that it was caused by inflicted injuries, and prior referral should not preclude a diagnosis of SIDS. The authors recommend future prospective studies that include refined exposure histories and that are large enough to have sufficient statistical power to compare family CPS referrals and outcomes in groups of infants who died suddenly with a matched group of living infants.
Effects of sudden air pressure changes on hospital admissions for cardiovascular diseases in Prague
NASA Astrophysics Data System (ADS)
Kysely, Jan; Plavcova, Eva
2013-04-01
Sudden weather changes have long been supposed to be associated with negative impacts on human health. However, relatively few studies attempted to quantify these relationships. In this study, we use large 6-hour changes of atmospheric sea level pressure as proxy for sudden weather changes, and evaluate their association with hospital admissions for cardiovascular diseases. Winter and summer seasons and positive and negative pressure changes are analyzed separately, using data for the city of Prague (population of 1.2 million) over 16-year period (1994-2009). We find that sudden pressure drops in winter are associated with significant increases in the number of hospital admissions. Increases in morbidity are not observed for pressure drops in summer, nor pressure increases in any season. Analysis of synoptic weather maps shows that the large pressure drops in winter are associated with strong zonal (westerly) flow and rapidly moving low pressure systems with centres over Northern Europe and atmospheric fronts affecting the area of Western and Central Europe. Several of the largest pressure decreases were associated with infamous winter storms (such as Lothar on December 25, 1999 and Kyrill on January 18, 2007). Analysis of links between passages of strong atmospheric fronts and hospital admissions shows that the links are much weaker if weather changes are characterized by frontal passages. Since climate models project strengthening of the zonal circulation in winter and increased frequency of winter storms, the negative effects of such weather phenomena and their possible changes in a warmer climate of the 21st century need to be better understood, particularly as their importance in inducing excess morbidity and mortality in winter may increase compared to cold spells.
Parametric Study on Responses of a Self-Anchored Suspension Bridge to Sudden Breakage of a Hanger
Jiang, Meng; Huang, Cailiang
2014-01-01
The girder of self-anchored suspension bridge is subjected to large compression force applied by main cables. So, serious damage of the girder due to breakage of hangers may cause the collapse of the whole bridge. With the time increasing, the hangers may break suddenly for their resistance capacities decrease due to corrosion. Using nonlinear static and dynamic analysis methods and adopting 3D finite element model, the responses of an actual self-anchored suspension bridge to sudden breakage of hangers are studied in this paper. The results show that the sudden breakage of a hanger causes violent vibration and large changes in internal forces of the bridge. In the process of the vibration, the maximum tension of hanger produced by breakage of a hanger exceeds 2.22 times its initial value, and the reaction forces of the bearings increase by more than 1.86 times the tension of the broken hanger. Based on the actual bridge, the influences of some factors including flexural stiffness of girder, torsion stiffness of girder, flexural stiffness of main cable, weight of girder, weight of main cable, span to sag ratio of main cable, distance of hangers, span length, and breakage time of hanger on the dynamic responses are studied in detail, and the influencing extent of the factors is presented. PMID:25045734
Parametric study on responses of a self-anchored suspension bridge to sudden breakage of a hanger.
Qiu, Wenliang; Jiang, Meng; Huang, Cailiang
2014-01-01
The girder of self-anchored suspension bridge is subjected to large compression force applied by main cables. So, serious damage of the girder due to breakage of hangers may cause the collapse of the whole bridge. With the time increasing, the hangers may break suddenly for their resistance capacities decrease due to corrosion. Using nonlinear static and dynamic analysis methods and adopting 3D finite element model, the responses of an actual self-anchored suspension bridge to sudden breakage of hangers are studied in this paper. The results show that the sudden breakage of a hanger causes violent vibration and large changes in internal forces of the bridge. In the process of the vibration, the maximum tension of hanger produced by breakage of a hanger exceeds 2.22 times its initial value, and the reaction forces of the bearings increase by more than 1.86 times the tension of the broken hanger. Based on the actual bridge, the influences of some factors including flexural stiffness of girder, torsion stiffness of girder, flexural stiffness of main cable, weight of girder, weight of main cable, span to sag ratio of main cable, distance of hangers, span length, and breakage time of hanger on the dynamic responses are studied in detail, and the influencing extent of the factors is presented.
Genetic and forensic implications in epilepsy and cardiac arrhythmias: a case series.
Partemi, Sara; Vidal, Monica Coll; Striano, Pasquale; Campuzano, Oscar; Allegue, Catarina; Pezzella, Marianna; Elia, Maurizio; Parisi, Pasquale; Belcastro, Vincenzo; Casellato, Susanna; Giordano, Lucio; Mastrangelo, Massimo; Pietrafusa, Nicola; Striano, Salvatore; Zara, Federico; Bianchi, Amedeo; Buti, Daniela; La Neve, Angela; Tassinari, Carlo Alberto; Oliva, Antonio; Brugada, Ramon
2015-05-01
Epilepsy affects approximately 3% of the world's population, and sudden death is a significant cause of death in this population. Sudden unexpected death in epilepsy (SUDEP) accounts for up to 17% of all these cases, which increases the rate of sudden death by 24-fold as compared to the general population. The underlying mechanisms are still not elucidated, but recent studies suggest the possibility that a common genetic channelopathy might contribute to both epilepsy and cardiac disease to increase the incidence of death via a lethal cardiac arrhythmia. We performed genetic testing in a large cohort of individuals with epilepsy and cardiac conduction disorders in order to identify genetic mutations that could play a role in the mechanism of sudden death. Putative pathogenic disease-causing mutations in genes encoding cardiac ion channel were detected in 24% of unrelated individuals with epilepsy. Segregation analysis through genetic screening of the available family members and functional studies are crucial tasks to understand and to prove the possible pathogenicity of the variant, but in our cohort, only two families were available. Despite further research should be performed to clarify the mechanism of coexistence of both clinical conditions, genetic analysis, applied also in post-mortem setting, could be very useful to identify genetic factors that predispose epileptic patients to sudden death, helping to prevent sudden death in patients with epilepsy.
Sudden cardiac death secondary to antidepressant and antipsychotic drugs
Sicouri, Serge; Antzelevitch, Charles
2008-01-01
A number of antipsychotic and antidepressant drugs are known to increase the risk of ventricular arrhythmias and sudden cardiac death. Based largely on a concern over QT prolongation and the development of life-threatening arrhythmias, a number of antipsychotic drugs have been temporarily or permanently withdrawn from the market or their use restricted. Some antidepressants and antipsychotics have been linked to QT prolongation and the development of Torsade de pointes arrhythmias, whereas others have been associated with a Brugada syndrome phenotype and the development of polymorphic ventricular arrhythmias. This review examines the mechanisms and predisposing factors underlying the development of cardiac arrhythmias, and sudden cardiac death, associated with antidepressant and antipsychotic drugs in clinical use. PMID:18324881
NASA Astrophysics Data System (ADS)
Liu, Donghui; Yong, Huadong; Zhou, Youhe
2017-11-01
No-insulation (NI) high-temperature superconducting (HTS) REBCO coil has been a promising candidate for manufacturing high-field superconducting magnets with high thermal stability and self-protecting features. When NI coil is operated at the external field, it is necessary to analyze charging and sudden-discharging characteristics of NI coil by considering the effect of magnetic field. In addition, the self-field effect has an obvious influence on the critical current for large-scale coil. Thus, an electromagnetic coupling model in which an equivalent circuit axisymmetric model considers the effect of magnetic field is proposed. The results show that when the radial current exists, the coil voltage and central field will tend to be stable faster. In a high field, the decrease of the critical current leads to the increase of radial current and this effect is more obvious for a larger field. And the charging time with the increase of the external field reduces significantly, while the sudden-discharging time is almost unchanged. For NI coils composed of many double-pancake coils, the charging time and sudden-discharging time proportionally increase with the increase of the number of double-pancake coil and turn number of single-pancake coil.
Recession Depression: Mental Health Effects of the 2008 Stock Market Crash*
McInerney, Melissa; Mellor, Jennifer M.; Nicholas, Lauren Hersch
2013-01-01
Do sudden, large wealth losses affect mental health? We use exogenous variation in the interview dates of the 2008 Health and Retirement Study to assess the impact of large wealth losses on mental health among older U.S. adults. We compare cross-wave changes in wealth and mental health for respondents interviewed before and after the October 2008 stock market crash. We find that the crash reduced wealth and increased feelings of depression and use of antidepressant drugs, and that these effects were largest among respondents with high levels of stock holdings prior to the crash. These results suggest that sudden wealth losses cause immediate declines in subjective measures of mental health. However, we find no evidence that wealth losses lead to increases in clinically-validated measures of depressive symptoms or indicators of depression. PMID:24113241
Atypical Antipsychotic Drugs and the Risk of Sudden Cardiac Death
Ray, Wayne A.; Chung, Cecilia P.; Murray, Katherine T.; Hall, Kathi; Stein, C. Michael
2009-01-01
Background Users of typical antipsychotics have increased risk of serious ventricular arrhythmias and sudden cardiac death. However, less is known regarding the cardiac safety of the atypical antipsychotic drugs, which have largely replaced the older agents in clinical practice. Methods We calculated the adjusted incidence of sudden cardiac death among current users of antipsychotics in a retrospective cohort of Tennessee Medicaid enrollees. The primary analysis included 44,218 and 46,089 baseline users of single typical and atypical drugs, respectively, and 186,600 matched nonuser controls. To assess residual confounding related to antipsychotic indication, we performed a secondary analysis of antipsychotic users with no baseline diagnosis of schizophrenia or related psychoses, propensity-score matched with nonusers. Results Current users of both typical and atypical antipsychotics had greater rates of sudden cardiac death than did nonusers of any antipsychotic, with adjusted incidence-rate ratios (IRRs) of 2.00 (95% CI, 1.69–2.35) and 2.27 (1.89–2.73), respectively. Former antipsychotic users had no significantly increased risk (IRR = 1.13 [0.98–1.30]). For both classes of drugs, the risk for current users increased significantly with dose. For typical antipsychotics the IRRs increased from 1.31 (0.97–1.77) for low doses to 2.42 (1.91–3.06) for high doses (p<.001). For atypical agents the IRRs increased from 1.59 (1.03–2.46) for low doses to 2.86 (2.25–3.65) for high doses (p=.015). The IRR for atypical vs typical antipsychotics was 1.14 (.93–1.39). Similar findings were present in the propensity-score matched cohort. Conclusion Current users of both typical and atypical antipsychotics had a similar, dose-related increased risk of sudden cardiac death. PMID:19144938
Sudden Gains in Cognitive Therapy of Depression and Depression Relapse/Recurrence
ERIC Educational Resources Information Center
Tang, Tony Z.; DeRubeis, Robert J.; Hollon, Steven D.; Amsterdam, Jay; Shelton, Richard
2007-01-01
Cognitive therapy (CT) may have significant advantages over antidepressants in preventing depression relapses. Many CT patients experience sudden gains: large symptom improvement in 1 between-session interval. Past studies have associated CT sudden gains with in-session cognitive changes but not with life events. This study examined sudden gains…
Sudden Relaminarization and Lifetimes in Forced Isotropic Turbulence.
Linkmann, Moritz F; Morozov, Alexander
2015-09-25
We demonstrate an unexpected connection between isotropic turbulence and wall-bounded shear flows. We perform direct numerical simulations of isotropic turbulence forced at large scales at moderate Reynolds numbers and observe sudden transitions from a chaotic dynamics to a spatially simple flow, analogous to the laminar state in wall bounded shear flows. We find that the survival probabilities of turbulence are exponential and the typical lifetimes increase superexponentially with the Reynolds number. Our results suggest that both isotropic turbulence and wall-bounded shear flows qualitatively share the same phase-space dynamics.
Sudden gains in exposure-focused cognitive-behavioral group therapy for panic disorder.
Nogueira-Arjona, Raquel; Santacana, Martí; Montoro, María; Rosado, Silvia; Guillamat, Roser; Vallès, Vicenç; Fullana, Miquel A
2017-11-01
In the context of psychological treatment, a sudden gain is a large and enduring improvement in symptom severity that occurs between two single therapy sessions. The influence of sudden gains on long-term outcomes and functional impairment in anxiety disorders is not well understood, and little is known with regard to panic disorder in particular. In addition, previous research on patients with anxiety disorders has produced inconsistent results regarding the relationship between sudden gains and cognitive change. We examined the incidence of sudden gains in a large sample (n = 116) of panic disorder patients undergoing exposure-focused cognitive-behavioral group therapy, and compared panic severity, functional impairment, and cognitive change in patients with and without sudden gains at posttreatment and 6-month follow-up. Participants who experienced sudden gains displayed lower levels of panic severity and functional impairment at posttreatment and 6-month follow-up than those who did not experience sudden gains. However, we observed no difference in cognitive changes between groups, either at posttreatment or at follow-up. Our results demonstrate that the beneficial effects of sudden gains on therapeutic outcomes not only extend to long-term and functional outcome measures but are also evident in less cognitive (i.e., exposure-focused) forms of psychological treatment. Sudden gains are common in panic disorder patients undergoing exposure-based cognitive-behavioral group therapy. Sudden gains during exposure-focused therapy are linked to greater improvement in panic disorder severity and functional impairment. The positive impact of sudden gains on panic disorder severity and functional impairment is maintained in the long term. Copyright © 2017 John Wiley & Sons, Ltd.
Bika Lele, E C; Pepouomi, M N; Temfemo, A; Mekoulou, J; Assomo Ndemba, P; Mandengue, S H
2018-02-01
Several cases of sudden deaths are observed among students practicing sport and physical activity (SPA). Just few studies have been carried out on the variation of the QT (interval) and risk of sudden death during sporting exercises. To determine the effect of variable intermittent stress intensity on the variation of QT and the risk of sudden cardiac death. Form 4, lower sixth and upper sixth students were recruited from a high school in Douala (Cameroon). Each subject was tested; starting with a 2-km walk followed by a sprint race or an endurance race, protocol I (P1) or the reverse; protocol II (P2). Two electrocardiograms were recorded; prior to the beginning of the SPA and 5minutes after the last race. QT was corrected using four formulas. Forty-one subjects (21 women and 20 men), mean age 18±2 years were recruited. At the end of the exercise, corrected QT increased with Bazzet's formula and decreased with Frahmingam's formula. The difference was not significant with Fridericia and Hodges formulas. The frequency of long QT was higher at the end of the exercise with Bazzet's formula (12.2% vs. 24.4%, P=0.009) while the difference was not significant for the other formulas. The risk of sudden cardiac death increases significantly after SPA. More studies on large samples are needed. Copyright © 2017. Published by Elsevier SAS.
Defibrillation at a football stadium: an experiment with Brighton and Hove Albion.
Jaggarao, N S; Sless, H; Grainger, R; Vincent, R; Chamberlain, D A
1982-05-15
Over a five-year period arrangements have been made to increase the prospects of resuscitation for victims of sudden death at a large football stadium. Seven cases of ventricular fibrillation occurred. Four were resuscitated successfully and were subsequently discharged from hospital.
Non-locality Sudden Death in Tripartite Systems
NASA Astrophysics Data System (ADS)
Jaeger, Gregg; Ann, Kevin
2009-03-01
Bell non-locality sudden death is the disappearance of non-local properties in finite times under local phase noise, which decoheres states only in the infinite-time limit. We consider the relationship between decoherence, disentanglement, and Bell non-locality sudden death in bipartite and tripartite systems in specific large classes of state preparation.
Gadelha, Ary; Zugman, André; Calzavara, Mariana Bendlin; de Mendonça Furtado, Remo Holanda; Scorza, Fulvio Alexandre; Bressan, Rodrigo Afonsecca
2018-01-01
Schizophrenia is associated with an increased mortality from cardiovascular disease. Relatively few studies have assessed the putative association of schizophrenia pathophysiology with sudden death. Low adenosine levels have been associated with schizophrenia. In cardiology, increased mortality among patients with congestive heart failure has been associated with genetic polymorphisms that potentially lead to lower adenosine levels. Thus, we hypothesize that adenosine could link schizophrenia and cardiovascular mortality, with decreased adenosine levels leading to increased vulnerability to hyperexcitability following hypoxic insults, increasing the odds of fatal arrhythmias. Low adenosine levels might also lead to a small increase in overall mortality rates and a major increase in the sudden death rate. This hypothesis paves the way for further investigation of the increased cardiac mortality associated with schizophrenia. Potentially, a better characterization of adenosine-related mechanisms of sudden death in schizophrenia could lead to new evidence of factors leading to sudden death in the general population. Copyright © 2017. Published by Elsevier Ltd.
Cedars, Ari M.
2015-01-01
Transposition of the great arteries encompasses a set of structural congenital cardiac lesions that has in common ventriculoarterial discordance. Primarily because of advances in medical and surgical care, an increasing number of children born with this anomaly are surviving into adulthood. Depending upon the subtype of lesion or the particular corrective surgery that the patient might have undergone, this group of adult congenital heart disease patients constitutes a relatively new population with unique medical sequelae. Among the more common and difficult to manage are cardiac arrhythmias and other sequelae that can lead to sudden cardiac death. To date, the question of whether implantable cardioverter-defibrillators should be placed in this cohort as a preventive measure to abort sudden death has largely gone unanswered. Therefore, we review the available literature surrounding this issue. PMID:26413012
ERIC Educational Resources Information Center
Tang, Tony Z.; DeRubeis, Robert J.; Beberman, Rachel; Pham, Thu
2005-01-01
Using an independent cognitive-behavioral therapy (CBT) data set, the authors replicated T. Z. Tang and R. J. DeRubeis' (1999) discovery of sudden gains--sudden and large decreases in depression severity in a single between-session interval. By incorporating therapy session transcripts, the authors of this study improved the reliability of the…
Major transitions in information technology
Valverde, Sergi
2016-01-01
When looking at the history of technology, we can see that all inventions are not of equal importance. Only a few technologies have the potential to start a new branching series (specifically, by increasing diversity), have a lasting impact in human life and ultimately became turning points. Technological transitions correspond to times and places in the past when a large number of novel artefact forms or behaviours appeared together or in rapid succession. Why does that happen? Is technological change continuous and gradual or does it occur in sudden leaps and bounds? The evolution of information technology (IT) allows for a quantitative and theoretical approach to technological transitions. The value of information systems experiences sudden changes (i) when we learn how to use this technology, (ii) when we accumulate a large amount of information, and (iii) when communities of practice create and exchange free information. The coexistence between gradual improvements and discontinuous technological change is a consequence of the asymmetric relationship between complexity and hardware and software. Using a cultural evolution approach, we suggest that sudden changes in the organization of ITs depend on the high costs of maintaining and transmitting reliable information. This article is part of the themed issue ‘The major synthetic evolutionary transitions’. PMID:27431527
Chang, Tae Ik; Nam, Joo Young; Shin, Sug Kyun; Kang, Ea Wha
2015-06-05
A direct association between low triiodothyronine (T3) syndrome and cardiovascular (CV) mortality has been reported in hemodialysis patients. However, the implications of this syndrome in peritoneal dialysis (PD) patients have not been properly investigated. This study examined the association between low T3 syndrome and CV mortality including sudden death in a large cohort of incident PD patients. This prospective observational study included 447 euthyroid patients who started PD between January 2000 and December 2009. Measurement of thyroid hormones was performed at baseline. All-cause and cause-specific deaths were registered during the median 46 months of follow-up. The survival rate was compared among three groups based on tertile of T3 levels. In Kaplan-Meyer analysis, patients with the lowest tertile were significantly associated with higher risk of all-cause and CV mortality including sudden death (P<0.001 for trend). In Cox analyses, T3 level was a significant predictor of all-cause mortality (per 10-unit increase, adjusted hazard ratio [HR], 0.86; 95% confidence interval [95% CI], 0.78 to 0.94; P=0.002), CV death (per 10-unit increase, adjusted HR, 0.84; 95% CI, 0.75 to 0.98; P=0.01), and sudden death (per 10-unit increase, adjusted HR, 0.69; 95% CI, 0.56 to 0.86; P=0.001) after adjusting for well known risk factors including inflammation and malnutrition. The higher T3 level was also independently associated with lower risk for sudden death (per 10-unit increase, adjusted HR, 0.71; 95% CI, 0.56 to 0.90; P=0.01) even when accounting for competing risks of death from other causes. T3 level at the initiation of PD was a strong independent predictor of long-term CV mortality, particularly sudden death, even after adjusting well known risk factors. Low T3 syndrome might represent a factor directly implicated in cardiac complications in PD patients. Copyright © 2015 by the American Society of Nephrology.
Federal Register 2010, 2011, 2012, 2013, 2014
2013-04-12
... prices of a large number of individual securities suddenly declining by significant amounts in a very short time period before suddenly reversing to prices consistent with their pre-decline levels.\\8\\ This severe price volatility led to a large number of trades being executed at temporarily depressed prices...
The Educational Effects of Rapid Rural Population Growth.
ERIC Educational Resources Information Center
Ross, Peggy J.; Green, Bernal L.
Rapid population growth in rural areas has confronted rural communities and particularly rural educational systems with a number of problems. Sudden, large increases in students crowd school facilities and strain budgets. The different values, attitudes, and orientations toward education of the newcomers act as a catalyst for changes and can cause…
NASA Technical Reports Server (NTRS)
Webber, W. R.; Mcdonald, F. B.; Cummings, A. C.; Stone, E. C.; Heikkila, B.; Lal, N.
2012-01-01
Voyager 1 has entered regions of different propagation conditions for energetic cosmic rays in the outer heliosheathat a distance of about 111 AU from the Sun. The low energy 614 MeV galactic electron intensity increased by 20over a time period 10 days and the electron radial intensity gradient abruptly decreased from 19AU to 8AU at2009.7 at a radial distance of 111.2 AU. At about 2011.2 at a distance of 116.6 AU a second abrupt intensity increase of25 was observed for electrons. After the second sudden electron increase the radial intensity gradient increased to18AU. This large positive gradient and the 13 day periodic variations of 200 MeV particles observed near theend of 2011 indicate that V1 is still within the overall heliospheric modulating region. The implications of these resultsregarding the proximity of the heliopause are discussed.
[Genetics of sudden unexplained death].
Campuzano, Oscar; Allegue, Catarina; Brugada, Ramon
2014-03-20
Sudden unexplained death is defined by death without a conclusive diagnosis after autopsy and it is responsible for a large percentage of sudden deaths. The progressive interaction between genetics and forensics in post-mortem studies has identified inheritable alterations responsible for pathologies associated with arrhythmic sudden death. The genetic diagnosis of the deceased enables the undertaking of preventive measures in family members, many of them asymptomatic but at risk. The implications of this multidisciplinary translational medical approach are complex, requiring the dedication of a specialized team. Copyright © 2013 Elsevier España, S.L. All rights reserved.
Understanding the long-term fire risks in forests affected by sudden oak death
Yana Valachovic; Chris Lee; Radoslaw Glebocki; Hugh Scanlon; J. Morgan Varner; David Rizzo
2010-01-01
It is assumed that large numbers of dead and down tanoak in forests infested by Phytophthora ramorum contribute to increased fire hazard risk and fuel loading. We studied the impact of P. ramorum infestation on surface fuel loading, potential fire hazard, and potential fire behavior in Douglas-fir- (Pseudotsuga...
Max A. Moritz; Dennis C. Odion
2006-01-01
Fire is often integral to forest ecology and can affect forest disease dynamics. Sudden oak death has spread across a large, fire-prone portion of California, killing large numbers of oaks and tanoaks and infecting most associated woody plants. Building on our earlier study of fire-disease dynamics, we examined spatial patterns of confirmed infections in relation to...
Relationship between emotional stress and cardiovascular events.
Senan, Mahavir; Petrosyan, A
2014-01-01
During last years the relationship has been found in between sudden cardiac death and autonomic disbalance of nervous system, which effect on baroreflector regulation of heart rhythm. The importance of heart rate in cardiovascular prognosis can be explained by its relationship with major pathophysiological determinants. We considered this fact as an actual problem and we performed our own study among 346 native Indians (260 males and 86 females), aged 41-54 years and employed by the Civil Service. They were consecutively examined between 1997 and 2004. Our large and long prospective study has disclosed a higher risk for sudden death for those apparently healthy individuals whose heart rate responses are exaggerated under mild emotional stress and below normal during peak exercise. This implies novel and simple ways for the early identification of subjects at increased future risk for sudden cardiac death. As well as we find out that autonomic disbalance is related with high risk of development of arrhythmias which is possible to find out exercise stress test. Individuals showing a high heart rate increase with mild emotional stress must be considered for additional investigations and for tailored preventive strategies aimed in first place to reduce the probability of ischemic heart disease.
Major transitions in information technology.
Valverde, Sergi
2016-08-19
When looking at the history of technology, we can see that all inventions are not of equal importance. Only a few technologies have the potential to start a new branching series (specifically, by increasing diversity), have a lasting impact in human life and ultimately became turning points. Technological transitions correspond to times and places in the past when a large number of novel artefact forms or behaviours appeared together or in rapid succession. Why does that happen? Is technological change continuous and gradual or does it occur in sudden leaps and bounds? The evolution of information technology (IT) allows for a quantitative and theoretical approach to technological transitions. The value of information systems experiences sudden changes (i) when we learn how to use this technology, (ii) when we accumulate a large amount of information, and (iii) when communities of practice create and exchange free information. The coexistence between gradual improvements and discontinuous technological change is a consequence of the asymmetric relationship between complexity and hardware and software. Using a cultural evolution approach, we suggest that sudden changes in the organization of ITs depend on the high costs of maintaining and transmitting reliable information.This article is part of the themed issue 'The major synthetic evolutionary transitions'. © 2016 The Author(s).
Geomagnetically Induced Currents Around the World During the 17 March 2015 Storm
NASA Technical Reports Server (NTRS)
Carter, B. A.; Yizengaw, E.; Pradipta, R.; Weygand, J. M.; Piersanti, M.; Pulkkinen, Antti Aleksi; Moldwin, M. B.; Norman, R.; Zhang, K.
2016-01-01
Geomagnetically induced currents (GICs) represent a significant space weather issue for power grid and pipeline infrastructure, particularly during severe geomagnetic storms. In this study, magnetometer data collected from around the world are analyzed to investigate the GICs caused by the 2015 St. Patricks Day storm. While significant GIC activity in the high-latitude regions due to storm time substorm activity is shown for this event, enhanced GIC activity was also measured at two equatorial stations in the American and Southeast Asian sectors. This equatorial GIC activity is closely examined, and it is shown that it is present both during the arrival of the interplanetary shock at the storm sudden commencement (SSC) in Southeast Asia and during the main phase of the storm approximately 10 h later in South America. The SSC caused magnetic field variations at the equator in Southeast Asia that were twice the magnitude of those observed only a few degrees to the north, strongly indicating that the equatorial electrojet (EEJ) played a significant role. The large equatorial magnetic field variations measured in South America are also examined, and the coincident solar wind data are used to investigate the causes of the sudden changes in the EEJ approximately 10 h into the storm. From this analysis it is concluded that sudden magnetopause current increases due to increases in the solarwind dynamic pressure, and the sudden changes in the resultant magnetospheric and ionospheric current systems, are the primary drivers of equatorial GICs.
Chang, Tae Ik; Nam, Joo Young; Shin, Sug Kyun
2015-01-01
Background and objectives A direct association between low triiodothyronine (T3) syndrome and cardiovascular (CV) mortality has been reported in hemodialysis patients. However, the implications of this syndrome in peritoneal dialysis (PD) patients have not been properly investigated. This study examined the association between low T3 syndrome and CV mortality including sudden death in a large cohort of incident PD patients. Design, setting, participants, & measurements This prospective observational study included 447 euthyroid patients who started PD between January 2000 and December 2009. Measurement of thyroid hormones was performed at baseline. All-cause and cause-specific deaths were registered during the median 46 months of follow-up. The survival rate was compared among three groups based on tertile of T3 levels. Results In Kaplan–Meyer analysis, patients with the lowest tertile were significantly associated with higher risk of all-cause and CV mortality including sudden death (P<0.001 for trend). In Cox analyses, T3 level was a significant predictor of all-cause mortality (per 10-unit increase, adjusted hazard ratio [HR], 0.86; 95% confidence interval [95% CI], 0.78 to 0.94; P=0.002), CV death (per 10-unit increase, adjusted HR, 0.84; 95% CI, 0.75 to 0.98; P=0.01), and sudden death (per 10-unit increase, adjusted HR, 0.69; 95% CI, 0.56 to 0.86; P=0.001) after adjusting for well known risk factors including inflammation and malnutrition. The higher T3 level was also independently associated with lower risk for sudden death (per 10-unit increase, adjusted HR, 0.71; 95% CI, 0.56 to 0.90; P=0.01) even when accounting for competing risks of death from other causes. Conclusions T3 level at the initiation of PD was a strong independent predictor of long-term CV mortality, particularly sudden death, even after adjusting well known risk factors. Low T3 syndrome might represent a factor directly implicated in cardiac complications in PD patients. PMID:25979970
Sudden oak death in California: what is the potential?
Tara M. Barrett; Demetrios Gatziolis; Jeremy S. Fried; Karen L. Waddell
2006-01-01
Sudden oak death, a disease associated with the pathogen Phytophthora ramorum, has a large number of shrub and tree host species. Three of the tree species must susceptible to mortality from the disease, California black oak (Quercus kelloggii), coast live oak (Quercus agrifolia), and tanoak (...
Zhou, Jie; Ning, Xiaopeng; Nimbarte, Ashish D; Dai, Fei
2015-01-01
As a major risk factor of low back injury, sudden loading often occurs when performing manual material-handling tasks on uneven ground surfaces. Therefore, the purpose of the current study was to investigate the effects of a laterally slanted ground on trunk biomechanical responses during sudden loading events. Thirteen male subjects were subjected to suddenly released loads of 3.4 and 6.8 kg, while standing on a laterally slanted ground of 0°, 15° and 30°. The results showed that 8.3% and 5.6% larger peak L5/S1 joint compression forces were generated in the 30° condition compared with the 0° and 15° conditions, respectively. The increase of L5/S1 joint moment in the 30° condition was 8.5% and 5.0% greater than the 0° and 15° conditions, respectively. Findings of this study suggest that standing on a laterally slanted ground could increase mechanical loading on the spine when experiencing sudden loading. Practitioner Summary: Sudden loading is closely related to occupational low back injuries. The results of this study showed that the increase of slanted ground angle and magnitude of load significantly increase the mechanical loading on the spine during sudden loading. Therefore, both of these two components should be controlled in task design.
1999-11-01
comparison between their products , whereby increased stress upon the diagnostical value of magnesium dynamics could be helpful. Such an agreement would...as sudden cardiac death when magnesium (Mg) deficiency exists. The stress hormones mediate release and utilization of substrates for production of...would be increased [28]. Since insulin sensitivity relates to mi- crovascular function, the presence of insulin resistance during space flights
Causes of sudden death in young female military recruits.
Eckart, Robert E; Scoville, Stephanie L; Shry, Eric A; Potter, Robert N; Tedrow, Usha
2006-06-15
This study sought to examine the incidence of sudden death in a large, multiethnic cohort of young women. Approximately 852,300 women entered basic military training from 1977 to 2001. During this period, there were 15 sudden deaths in female recruits (median age 19 years, 73% African-American), occurring at a median of 25 days after arrival for training. Of the sudden deaths, 13 (81%) were due to reasons that may have been cardiac in origin. Presumed arrhythmic sudden death in the setting of a structurally normal heart was seen in 8 recruits (53%), and anomalous coronary origins were found in 2 recruits (13%). The mortality rate was 11.4 deaths per 100,000 recruit-years (95% confidence interval 6.9 to 18.9). The rate was significantly higher for African-American female recruits (risk ratio 10.2, p <0.001). Sudden death with a structurally normal heart was the leading cause of death in female recruits during military training.
NASA Astrophysics Data System (ADS)
Kohler, Susanna
2015-09-01
At the end of last year, the Suns large-scale magnetic field suddenly strengthened, reaching its highest value in over two decades. Here, Neil Sheeley and Yi-Ming Wang (both of the Naval Research Laboratory) propose an explanation for why this happened and what it predicts for the next solar cycle.Magnetic StrengtheningUntil midway through 2014, solar cycle 24 the current solar cycle was remarkably quiet. Even at its peak, it averaged only 79 sunspots per year, compared to maximums of up to 190 in recent cycles. Thus it was rather surprising when, toward the end of 2014, the Suns large-scale magnetic field underwent a sudden rejuvenation, with its mean field leaping up to its highest values since 1991 and causing unprecedentedly large numbers of coronal loops to collapse inward.Yet in spite of the increase we observed in the Suns open flux (the magnetic flux leaving the Suns atmosphere, measured from Earth), there was not a significant increase in solar activity, as indicated by sunspot number and the rate of coronal mass ejections. This means that the number of sources of magnetic flux didnt increase so Sheeley and Wang conclude that flux must instead have been emerging from those sources in a more efficient way! But how?Aligned ActivityWSO open flux and the radial component of the interplanetary magnetic field (measures of the magnetic flux leaving the Suns photosphere and heliosphere, respectively), compared to sunspot number (in units of 100 sunspots). A sudden increase in flux is visible after the peak of each of the last four sunspot cycles. Click for a larger view! [Sheeley Wang 2015]The authors show that the active regions on the solar surface in late 2014 lined up in such a way that the emerging flux was enhanced, forming a strong equatorial dipole field that accounts for the sudden rejuvenation observed.Interestingly, this rejuvenation of the Suns open flux wasnt just a one-time thing; similar bursts have occurred shortly after the peak of every sunspot cycle that we have flux measurements for. The authors find that three factors (how the active regions are distributed longitudinally, their sizes, and the contribution of the axisymmetric component of the magnetic field) determine the strength of this rejuvenation. All three of these factors happened to contribute optimally in 2014.As a final note, Sheeley and Wang suggest that the current strength of the axisymmetric component of the magnetic field can be used to provide an early indication of how active the next solar cycle might be. Using this method, they predict that solar cycle 25 will be similar to the current cycle in amplitude.CitationN. R. Sheeley Jr. and Y.-M. Wang2015 ApJ 809 113. doi:10.1088/0004-637X/809/2/113
ERIC Educational Resources Information Center
de Guzman, Allan B.; Lacorte, Jeremy C.; Lacsamana, Andrea Keith G.; Lagac, Mark Lawrence M.; Laguador, Jobel M.; Lapid, Jazminn Jessica R.; Lee, Lyndcie Miriele C.
2012-01-01
Cases of abandoned elderly are increasing worldwide. By and large, this group struggles with the sudden change in living arrangement as well as abandonment by their families. Consequently, many elderly are forced into living in nursing homes for the remainder of their lives. Abandonment among these elderly negatively affects how they view…
Sudden oak death effects on the dynamics of dead wood
Richard C. Cobb; Jo& atilde; o Filipe A.N.; Margaret R. Metz; Ross K. Meentemeyer; David M. Rizzo
2013-01-01
Sudden oak death has impacted forests notable for high-fire risk and contiguous host communities in California and Oregon coastal forest ecosystems. The disease continues to emerge in stands and landscapes with a large biomass of tanoak (Notholithocarpus densiflorus (Hook.&Arn.) Manos, Cannon & S.H.Oh), and we show that woody debris also...
Sudden Infant Death Syndrome, FY 1983. Special Report to Congress.
ERIC Educational Resources Information Center
National Inst. of Child Health and Human Development (NIH), Bethesda, MD.
This report describes research programs focusing on the sudden infant death syndrome (SIDS) and indicates some presently available results. Specific attention is given to research on sleep apnea, respiratory control, and hypoxia, as well as to infectious disease processes and immunology. Findings of a large-scale multidisciplinary SIDS project are…
Innovation on Energy Power Technology (1)
NASA Astrophysics Data System (ADS)
Nagano, Susumu; Kakishima, Masayoshi
After the last war, the output of single Steam Turbine Generator produced by the own technology in Japan returned to a prewar level. Electric power companies imported the large-capacity high efficiency Steam Turbine Generator from the foreign manufacturers in order to support the sudden increase of electric power demand. On the other hand, they decided to produce those in our own country to improve industrial technology. The domestic production of large-capacity 125MW Steam Turbine Generator overcome much difficulty and did much contribution for the later domestic technical progress.
Structural imaging biomarkers of sudden unexpected death in epilepsy
Wandschneider, Britta; Koepp, Matthias; Scott, Catherine; Micallef, Caroline; Balestrini, Simona; Sisodiya, Sanjay M.; Thom, Maria; Harper, Ronald M.; Sander, Josemir W.; Vos, Sjoerd B.; Duncan, John S.; Lhatoo, Samden
2015-01-01
Sudden unexpected death in epilepsy is a major cause of premature death in people with epilepsy. We aimed to assess whether structural changes potentially attributable to sudden death pathogenesis were present on magnetic resonance imaging in people who subsequently died of sudden unexpected death in epilepsy. In a retrospective, voxel-based analysis of T1 volume scans, we compared grey matter volumes in 12 cases of sudden unexpected death in epilepsy (two definite, 10 probable; eight males), acquired 2 years [median, interquartile range (IQR) 2.8] before death [median (IQR) age at scanning 33.5 (22) years], with 34 people at high risk [age 30.5 (12); 19 males], 19 at low risk [age 30 (7.5); 12 males] of sudden death, and 15 healthy controls [age 37 (16); seven males]. At-risk subjects were defined based on risk factors of sudden unexpected death in epilepsy identified in a recent combined risk factor analysis. We identified increased grey matter volume in the right anterior hippocampus/amygdala and parahippocampus in sudden death cases and people at high risk, when compared to those at low risk and controls. Compared to controls, posterior thalamic grey matter volume, an area mediating oxygen regulation, was reduced in cases of sudden unexpected death in epilepsy and subjects at high risk. The extent of reduction correlated with disease duration in all subjects with epilepsy. Increased amygdalo-hippocampal grey matter volume with right-sided changes is consistent with histo-pathological findings reported in sudden infant death syndrome. We speculate that the right-sided predominance reflects asymmetric central influences on autonomic outflow, contributing to cardiac arrhythmia. Pulvinar damage may impair hypoxia regulation. The imaging findings in sudden unexpected death in epilepsy and people at high risk may be useful as a biomarker for risk-stratification in future studies. PMID:26264515
Tedmund J. Swiecki; Elizabeth Bernhardt; Christiana Drake; Laurence R. Costello
2006-01-01
In autumn 2002, we conducted a retrospective study on coast live oak (Quercus agrifolia) failures in Marin County, California, woodlands affected by Phytophthora ramorum canker (sudden oak death). The objectives of this case-control study were to quantify levels of bole, large branch, and root failure in these woodlands and...
Advanced Electrocardiographic Predictors of Sudden Death in Familial Dysautonomia
NASA Technical Reports Server (NTRS)
Solaimanzadeh, I.; Schlegel, T. T.; Greco, E. C.; DePalma, J. L.; Starc, V.; Marthol, H.; Tutaj, M.; Buechner, S.; Axelrod, F. B.; Hilz, M. J.
2007-01-01
To identify accurate predictors for the risk of sudden death in patients with familial dysautonomia (FD). Ten-minute resting high-fidelity 12-lead ECGs were obtained from 14 FD patients and 14 age/gender-matched healthy subjects. Multiple conventional and advanced ECG parameters were studied for their ability to predict sudden death in FD over a subsequent 4.5-year period, including multiple indices of linear and non-linear heart rate variability (HRV); QT variability; waveform complexity; high frequency QRS; and derived Frank-lead parameters. Four of the 14 FD patients died suddenly during the follow-up period, usually with concomitant pulmonary disorder. The presence of low vagally-mediated HRV was the ECG finding most predictive of sudden death. Concomitant left ventricular hypertrophy and other ECG abnormalities such as increased QTc and JTc intervals, spatial QRS-T angles, T-wave complexity, and QT variability were also present in FD patients, suggesting that structural heart disease is fairly common in FD. Although excessive or unopposed cardiac vagal (relative to sympathetic) activity has been postulated as a contributor to sudden death in FD, the presence of low vagally-mediated HRV was paradoxically the best predictor of sudden death. However, we suggest that low vagally-mediated HRV be construed not as a direct cause of sudden death in FD, but rather as an effect of concurrent pathological processes, especially hypoxia due to pulmonary disorders and sleep apnea, that themselves increase the risk of sudden death in FD and simultaneously diminish HRV. We speculate that adenosine may play a role in sudden death in FD, possibly independently of vagal activity, and that adenosine inhibitors such as theophylline might therefore be useful as prophylaxis in this disorder.
Hess, Paul L; Al-Khalidi, Hussein R; Friedman, Daniel J; Mulder, Hillary; Kucharska-Newton, Anna; Rosamond, Wayne R; Lopes, Renato D; Gersh, Bernard J; Mark, Daniel B; Curtis, Lesley H; Post, Wendy S; Prineas, Ronald J; Sotoodehnia, Nona; Al-Khatib, Sana M
2017-08-23
Prior studies have demonstrated a link between the metabolic syndrome and increased risk of cardiovascular mortality. Whether the metabolic syndrome is associated with sudden cardiac death is uncertain. We characterized the relationship between sudden cardiac death and metabolic syndrome status among participants of the ARIC (Atherosclerosis Risk in Communities) Study (1987-2012) free of prevalent coronary heart disease or heart failure. Among 13 168 participants, 357 (2.7%) sudden cardiac deaths occurred during a median follow-up of 23.6 years. Participants with the metabolic syndrome (n=4444) had a higher cumulative incidence of sudden cardiac death than those without it (n=8724) (4.1% versus 2.3%, P <0.001). After adjustment for participant demographics and clinical factors other than components of the metabolic syndrome, the metabolic syndrome was independently associated with sudden cardiac death (hazard ratio, 1.70, 95% confidence interval, 1.37-2.12, P <0.001). This relationship was not modified by sex (interaction P =0.10) or race (interaction P =0.62) and was mediated by the metabolic syndrome criteria components. The risk of sudden cardiac death varied according to the number of metabolic syndrome components (hazard ratio 1.31 per additional component of the metabolic syndrome, 95% confidence interval, 1.19-1.44, P <0.001). Of the 5 components, elevated blood pressure, impaired fasting glucose, and low high-density lipoprotein were independently associated with sudden cardiac death. We observed that the metabolic syndrome was associated with a significantly increased risk of sudden cardiac death irrespective of sex or race. The risk of sudden cardiac death was proportional to the number of metabolic syndrome components. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
Solberg, E E; Borjesson, M; Sharma, S; Papadakis, M; Wilhelm, M; Drezner, J A; Harmon, K G; Alonso, J M; Heidbuchel, H; Dugmore, D; Panhuyzen-Goedkoop, N M; Mellwig, K-P; Carre, F; Rasmusen, H; Niebauer, J; Behr, E R; Thiene, G; Sheppard, M N; Basso, C; Corrado, D
2016-04-01
There are large variations in the incidence, registration methods and reported causes of sudden cardiac arrest/sudden cardiac death (SCA/SCD) in competitive and recreational athletes. A crucial question is to which degree these variations are genuine or partly due to methodological incongruities. This paper discusses the uncertainties about available data and provides comprehensive suggestions for standard definitions and a guide for uniform registration parameters of SCA/SCD. The parameters include a definition of what constitutes an 'athlete', incidence calculations, enrolment of cases, the importance of gender, ethnicity and age of the athlete, as well as the type and level of sporting activity. A precise instruction for autopsy practice in the case of a SCD of athletes is given, including the role of molecular samples and evaluation of possible doping. Rational decisions about cardiac preparticipation screening and cardiac safety at sport facilities requires increased data quality concerning incidence, aetiology and management of SCA/SCD in sports. Uniform standard registration of SCA/SCD in athletes and leisure sportsmen would be a first step towards this goal. © The European Society of Cardiology 2015.
Coronal hole evolution by sudden large scale changes
NASA Technical Reports Server (NTRS)
Nolte, J. T.; Gerassimenko, M.; Krieger, A. S.; Solodyna, C. V.
1978-01-01
Sudden shifts in coronal-hole boundaries observed by the S-054 X-ray telescope on Skylab between May and November, 1973, within 1 day of CMP of the holes, at latitudes not exceeding 40 deg, are compared with the long-term evolution of coronal-hole area. It is found that large-scale shifts in boundary locations can account for most if not all of the evolution of coronal holes. The temporal and spatial scales of these large-scale changes imply that they are the results of a physical process occurring in the corona. It is concluded that coronal holes evolve by magnetic-field lines' opening when the holes are growing, and by fields' closing as the holes shrink.
Compressing turbulence and sudden viscous dissipation with compression-dependent ionization state
DOE Office of Scientific and Technical Information (OSTI.GOV)
Davidovits, Seth; Fisch, Nathaniel J.
Turbulent plasma flow, amplified by rapid three-dimensional compression, can be suddenly dissipated under continuing compression. Furthermore, this effect relies on the sensitivity of the plasma viscosity to the temperature, μ ~ T 5 / 2 . The plasma viscosity is also sensitive to the plasma ionization state. Here, we show that the sudden dissipation phenomenon may be prevented when the plasma ionization state increases during compression, and we demonstrate the regime of net viscosity dependence on compression where sudden dissipation is guaranteed. In addition, it is shown that, compared to cases with no ionization, ionization during compression is associated withmore » larger increases in turbulent energy and can make the difference between growing and decreasing turbulent energy.« less
Compressing turbulence and sudden viscous dissipation with compression-dependent ionization state
Davidovits, Seth; Fisch, Nathaniel J.
2016-11-14
Turbulent plasma flow, amplified by rapid three-dimensional compression, can be suddenly dissipated under continuing compression. Furthermore, this effect relies on the sensitivity of the plasma viscosity to the temperature, μ ~ T 5 / 2 . The plasma viscosity is also sensitive to the plasma ionization state. Here, we show that the sudden dissipation phenomenon may be prevented when the plasma ionization state increases during compression, and we demonstrate the regime of net viscosity dependence on compression where sudden dissipation is guaranteed. In addition, it is shown that, compared to cases with no ionization, ionization during compression is associated withmore » larger increases in turbulent energy and can make the difference between growing and decreasing turbulent energy.« less
Evolution of IPv6 Internet topology with unusual sudden changes
NASA Astrophysics Data System (ADS)
Ai, Jun; Zhao, Hai; Kathleen, M. Carley; Su, Zhan; Li, Hui
2013-07-01
The evolution of Internet topology is not always smooth but sometimes with unusual sudden changes. Consequently, identifying patterns of unusual topology evolution is critical for Internet topology modeling and simulation. We analyze IPv6 Internet topology evolution in IP-level graph to demonstrate how it changes in uncommon ways to restructure the Internet. After evaluating the changes of average degree, average path length, and some other metrics over time, we find that in the case of a large-scale growing the Internet becomes more robust; whereas in a top—bottom connection enhancement the Internet maintains its efficiency with links largely decreased.
Takayasu Arteritis of the Coronary Arteries Presenting as Sudden Death in a White Teenager.
Hlavaty, Leigh; Diaz, Francisco; Sung, LokMan
2015-09-01
Takayasu arteritis is a rare disease that expresses chronic, large vessel inflammation. The etiology remains unclear and its presentation depends on the affected arteries. With coronary artery involvement, manifestations range from chest pain and shortness of breath to sudden death. We report a case of a 15-year-old white girl who presented with syncope immediately before passing. On autopsy, all 3 major coronary arteries grossly contained multiple proximal lesions that were consistent with Takayasu arteritis, microscopically. Takayasu arteritis solely affecting multiple coronary arteries is exceedingly rare. This report discusses the significance of coronary involvement in Takayasu arteritis at autopsy and sudden death.
[Sudden death in Versailles: A review of a cardiovascular treatrise by Dionis (1710)].
Charlier, P
2018-02-01
In 1710, the surgeon Pierre Dionis publishes a Dissertation on sudden death. Echoing and expanding the work of his Roman colleague Jean Marie Lancisi, he describes and analyzes dozens of cases of sudden death observed by him. A large number of cases was followed by autopsies allowing clinicopathological confrontation. Are proposed causes of death (pulmonary embolism, myocardial infarction, hemorrhagic stroke, arterial rupture, etc.), pathophysiological mechanisms based on the ancient theory of humors, and preventive actions to avoid these unexpected deaths. In this article, we oppose these old data to those of current literature. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Decrease of Nitrate Reductase Activity in Spinach Leaves during a Light-Dark Transition 1
Riens, Burgi; Heldt, Hans Walter
1992-01-01
In leaves of spinach plants (Spinacia oleracea L.) performing CO2 and NO3− assimilation, at the time of sudden darkening, which eliminates photosystem I-dependent nitrite reduction, only a minor temporary increase of the leaf nitrite content is observed. Because nitrate reduction does not depend on redox equivalents generated by photosystem I activity, a continuation of nitrate reduction after darkening would result in a large accumulation of nitrite in the leaves within a very short time, which is not observed. Measurements of the extractable nitrate reductase activity from spinach leaves assayed under standard conditions showed that in these leaves the nitrate reductase activity decreased during darkening to 15% of the control value with a half-time of only 2 minutes. Apparently, in these leaves nitrate reductase is very rapidly inactivated at sudden darkness avoiding an accumulation of the toxic nitrite in the cells. PMID:16668679
The case for extraterrestrial causes of extinction
NASA Technical Reports Server (NTRS)
Raup, D. M.
1989-01-01
The dramatic increase in our knowledge of large-body impacts that have occurred in Earth's history has led to strong arguments for the plausibility of meteorite impact as a cause of extinction. Proof of causation is often hampered, however, by our inability to demonstrate the synchronism of specific impacts and extinctions. A central problem is range truncation: the last reported occurrences of fossil taxa generally underestimate the true times of extinction. Range truncation, because of gaps in sedimentation, lack of preservation, or lack of discovery, can make sudden extinctions appear gradual and gradual extinctions appear sudden. Also, stepwise extinction may appear as an artefact of range truncation. These effects are demonstrated by experiments performed on data from field collections of Cretaceous ammonities from Zumaya (Spain). The challenge for future research is to develop a new calculus for treating biostratigraphic data so that fossils can provide more accurate assessments of the timing of extinctions.
Nik J. Cunniffe; Richard C. Cobb; Ross K. Meentemeyer; David M. Rizzo; Christopher A. Gilligan
2016-01-01
Sudden oak death, caused by Phytophthora ramorum, has killed millions of oak and tanoak in California since its first detection in 1995. Despite some localized small-scale management, there has been no large-scale attempt to slow the spread of the pathogen in California. Here we use a stochastic spatially-explicit model parameterized using data on...
Brian L. Anacker; Nathan E. Rank; Daniel Hüberli; Matteo Garbelotto; Sarah Gordon; Rich Whitkus; Tami Harnik; Matthew Meshriy; Lori Miles; Ross K. Meentemeyer
2008-01-01
Sudden oak death, caused by the water mold Phytophthora ramorum, is a plant disease responsible for the death of hundreds of thousands of oak and tanoak trees. Some foliar hosts play a major role in the epidemiology of this disease. Upon infection by P. ramorum, these foliar hosts express non-fatal leaf lesions from which large...
Zhu, Lingwei; Zhou, Wei; Wang, Tiecheng; Xiang, Haiyang; Ji, Xue; Han, Yixiao; Tian, Yuan; Sun, Yang; Liu, Jun; Guo, Xuejun
2017-04-01
Dozens of wild bharals died suddenly in Tibet. Necropsy showed severe congestion and hemorrhage in multiple organs, with large numbers of Gram-positive bacilli. Strains of Clostridium perfringens type A were isolated from the different organs and the intestinal contents. The other possible pathogens were ruled out by PCR. Copyright © 2017 Elsevier Ltd. All rights reserved.
Cerebral Paragonimiasis Presenting with Sudden Death
Amaro, Deirdre E.; Cowell, Annie; Tuohy, Marion J.; Procop, Gary W.; Morhaime, Jacquelyn; Reed, Sharon L.
2016-01-01
A 58-year-old Korean-born woman with a history of seizures and psychiatric issues was found dead at home. Autopsy was notable for large, calcified nodules that had nearly replaced her right temporal lobe. Histologic examination revealed the presence of Paragonimus eggs. This case demonstrates a rare manifestation of an aberrantly migrated lung fluke that resulted in epilepsy and sudden death years after the initial infection. PMID:27928089
Chugh, Sumeet S; Chung, Kiyon; Zheng, Zhi-Jie; John, Benjamin; Titus, Jack L
2003-10-01
Between 1989 and 1998 there was a 21% increase in estimated sudden cardiac death among US women aged 35 to 44 years. In contrast, the sudden cardiac death rate in age-matched men showed a decreasing trend (-2.8%). Due to under-representation of younger adults in published autopsy series, etiologies of sudden cardiac death merit further investigation. We reviewed autopsy and detailed cardiac pathologic findings in younger women (age 35-44 years) from a 270-patient, 13-year (1984-1996) autopsy series of sudden cardiac death, and performed comparisons with findings in age-matched men. Women aged 35 to 44 years constituted 32% of all women in the series compared to men, who constituted 24% of total men (P =.004 vs women). A presumptive cause of sudden cardiac death could not be determined in 13 women (50%). Among women, 6 cases (22%) had significant coronary artery disease. Findings in others included coronary artery anomalies (n = 3), myocarditis (n = 2), hypertrophic cardiomyopathy (n = 1), coronary artery dissection (n = 1) and accessory pathway (n = 1). In younger men, a presumptive cause of sudden cardiac death remained undetermined in only 24% (P =.025 vs younger women), and coronary artery disease accounted for 40% of cases. In younger women, despite autopsy and detailed cardiac pathologic examination, an attributable cause of sudden cardiac death was not determined in 50% of cases; a 2-fold increase compared to men of the same age. Given the dynamic and multifactorial nature of sudden cardiac death, comprehensive population-based investigations are likely to be necessary to further investigate this unexpected sex-based disparity.
Sudden death in eating disorders
Jáuregui-Garrido, Beatriz; Jáuregui-Lobera, Ignacio
2012-01-01
Eating disorders are usually associated with an increased risk of premature death with a wide range of rates and causes of mortality. “Sudden death” has been defined as the abrupt and unexpected occurrence of fatality for which no satisfactory explanation of the cause can be ascertained. In many cases of sudden death, autopsies do not clarify the main cause. Cardiovascular complications are usually involved in these deaths. The purpose of this review was to report an update of the existing literature data on the main findings with respect to sudden death in eating disorders by means of a search conducted in PubMed. The most relevant conclusion of this review seems to be that the main causes of sudden death in eating disorders are those related to cardiovascular complications. The predictive value of the increased QT interval dispersion as a marker of sudden acute ventricular arrhythmia and death has been demonstrated. Eating disorder patients with severe cardiovascular symptoms should be hospitalized. In general, with respect to sudden death in eating disorders, some findings (eg, long-term eating disorders, chronic hypokalemia, chronically low plasma albumin, and QT intervals >600 milliseconds) must be taken into account, and it must be highlighted that during refeeding, the adverse effects of hypophosphatemia include cardiac failure. Monitoring vital signs and performing electrocardiograms and serial measurements of plasma potassium are relevant during the treatment of eating disorder patients. PMID:22393299
Female employment reduces fertility in rural Senegal.
Van den Broeck, Goedele; Maertens, Miet
2015-01-01
Economic growth and modernization of society are generally associated with fertility rate decreases but which forces trigger this is unclear. In this paper we assess how fertility changes with increased labor market participation of women in rural Senegal. Evidence from high-income countries suggests that higher female employment rates lead to reduced fertility rates but evidence from developing countries at an early stage of demographic transition is largely absent. We concentrate on a rural area in northern Senegal where a recent boom in horticultural exports has been associated with a sudden increase in female off-farm employment. Using survey data we show that employed women have a significantly higher age at marriage and at first childbirth, and significantly fewer children. As causal identification strategy we use instrumental variable and difference-in-differences estimations, combined with propensity score matching. We find that female employment reduces the number of children per woman by 25%, and that this fertility-reducing effect is as large for poor as for non-poor women and larger for illiterate than for literate women. Results imply that female employment is a strong instrument for empowering rural women, reducing fertility rates and accelerating the demographic transition in poor countries. The effectiveness of family planning programs can increase if targeted to areas where female employment is increasing or to female employees directly because of a higher likelihood to reach women with low-fertility preferences. Our results show that changes in fertility preferences not necessarily result from a cultural evolution but can also be driven by sudden and individual changes in economic opportunities.
Female Employment Reduces Fertility in Rural Senegal
2015-01-01
Economic growth and modernization of society are generally associated with fertility rate decreases but which forces trigger this is unclear. In this paper we assess how fertility changes with increased labor market participation of women in rural Senegal. Evidence from high-income countries suggests that higher female employment rates lead to reduced fertility rates but evidence from developing countries at an early stage of demographic transition is largely absent. We concentrate on a rural area in northern Senegal where a recent boom in horticultural exports has been associated with a sudden increase in female off-farm employment. Using survey data we show that employed women have a significantly higher age at marriage and at first childbirth, and significantly fewer children. As causal identification strategy we use instrumental variable and difference-in-differences estimations, combined with propensity score matching. We find that female employment reduces the number of children per woman by 25%, and that this fertility-reducing effect is as large for poor as for non-poor women and larger for illiterate than for literate women. Results imply that female employment is a strong instrument for empowering rural women, reducing fertility rates and accelerating the demographic transition in poor countries. The effectiveness of family planning programs can increase if targeted to areas where female employment is increasing or to female employees directly because of a higher likelihood to reach women with low-fertility preferences. Our results show that changes in fertility preferences not necessarily result from a cultural evolution but can also be driven by sudden and individual changes in economic opportunities. PMID:25816301
The decline of adult smallpox in eighteenth-century London.
Davenport, Romola; Schwarz, Leonard; Boulton, Jeremy
2011-01-01
Smallpox was probably the single most lethal disease in eighteenth-century Britain, but was a minor cause of death by the mid-nineteenth century. Although vaccination was crucial to the decline of smallpox, especially in urban areas, from the beginning of the nineteenth century, it remains disputed the extent to which smallpox mortality declined before vaccination. Analysis of age-specific changes in smallpox burials within the large west London parish of St Martin-in-the-Fields revealed a precipitous reduction in adult smallpox risk from the 1770s, and this pattern was duplicated in the east London parish of St Dunstan's. Most adult smallpox victims were rural migrants, and such a drop in their susceptibility is consistent with a sudden increase in exposure to smallpox in rural areas. We investigated whether this was due to the spread of inoculation, or an increase in smallpox transmission, using changes in the age patterns of child smallpox burials. Smallpox mortality rose among infants, and smallpox burials became concentrated at the youngest ages, suggesting a sudden increase in infectiousness of the smallpox virus. Such a change intensified the process of smallpox endemicization in the English population, but also made cities substantially safer for young adult migrants.
Interaction of Comets and the Solar Wind
NASA Technical Reports Server (NTRS)
Wagner, William (Technical Monitor); Raymond, John C.
2004-01-01
The analysis of Comet Kudo-Fujikawa at perihelion was published and picked up by Der Spiegel. Besides a large and rapidly increasing water outgassing rate, we detected a bright tail in doubly ionized carbon. The amount of carbon was greater than could be accounted for by CO photodissociation, and we attribute it to evaporation of organics from dust. A spectacular disconnection event was apparent in the C III tail, and it coincides within the uncertainties to the position of the heliospheric current sheet. The analysis of the sungrazing comet C2001 C2 is in press. It showed evidence for subfragments and for a very long lasting source of neutrals, which we identify as evaporation of pyroxene dust grains. Results were also presented at COSPAR. We are working on observations of another sungrazer, comet C2002 S2, which shows a sudden 2 magnitude drop in optical brightness and an equally sudden recovery. UVCS observations during that time show a steadily increasing outgassing rate. We have derived solar wind densities for both comets, but we are still sorting out the ambiguities involving the fragmentation and optical behavior.
Hepatic Hemangioendothelioma Presenting as Sudden Unexpected Death in Infancy: A Case Report
Dempers, Johan; Wadee, Shabbir Ahmed; Boyd, Theonia; Wright, Colleen; OdendaaL, Hein J; Sens, Mary Ann
2014-01-01
The classification of an unexpected infant death as the sudden infant death syndrome (SIDS) depends upon a complete autopsy, death scene investigation and review of medical history to exclude known causes of death. Death from occult neoplastic disease in infancy is extremely rare but is within the broad differential of SIDS. We report the sudden and unexpected death of a one-month-old infant from a hepatic (infantile) hemangioendothelioma. The physiologic mechanism of death was likely cardiac failure induced by the circulatory demands of this large vascular tumor and respiratory compromise from diaphragmatic thoracic incursion. The clinical progression and pathology of these relatively common tumors of infant livers are extremely variable. This case dramatically illustrates the potential for fatal outcome of this tumor, as well as the need for the autopsy to determine the cause of sudden and unexpected death in an infant PMID:20465426
2012-05-17
and the Northern Sea Route, extraction of potential oil and gas resources, and expanded fishing and tourism .‖ 6 The Arctic‘s vast natural resources...sudden and substantial increase in commercial shipping, marine tourism , and large passenger vessels in the Arctic poses significant challenges to the...security,‖ Huebert states that, ―Canada, Denmark, Norway, Russia and the United States have all either begun to rebuild their Arctic capabilities
NASA Technical Reports Server (NTRS)
Friis-Christensen, E.; Vennerstrom, S.; Mchenry, M. A.; Clauer, C. R.
1988-01-01
Analysis of 20-second resolution magnetometer data from an array of temporary stations operated around Sondre Stromfjord, Greenland, during the summer of 1986 shows the signatures of localized ionospheric traveling convection vortices. An example of an isolated event of this kind observed near 08 local time is presented in detail. This event consists of a twin vortex pattern of convection consistent with the presence of two field-aligned current filaments separated by about 600 km in the east-west direction. This system of currents is observed to move westward (tailward) past the array of stations at about 4 km/sec. The event is associated with relative quiet time ionospheric convection and occurs during an interval of northward IMF. It is, however, associated with a large fluctuation in both the Z and Y components of the IMF and with a large sudden decrease in the solar wind number density. The propagation of the system is inconsistent with existing models of FTE current systems, but nevertheless appears to be related to a readjustment of the magnetopause boundary to a sudden change in the solar wind dynamic pressure and/or to a change in reconnection brought about by a sudden reorientation of the IMF.
Effects of Simulated Heat Waves with Strong Sudden Cooling Weather on ApoE Knockout Mice
Zhang, Shuyu; Kuang, Zhengzhong; Zhang, Xiakun
2015-01-01
This study analyzes the mechanism of influence of heat waves with strong sudden cooling on cardiovascular diseases (CVD) in ApoE−/− mice. The process of heat waves with strong sudden cooling was simulated with a TEM1880 meteorological-environment simulation chamber according to the data obtained at 5 a.m. of 19 June 2006 to 11 p.m. of 22 June 2006. Forty-eight ApoE−/− mice were divided into six blocks based on their weight. Two mice from each block were randomly assigned to control, heat wave, temperature drop, and rewarming temperature groups. The experimental groups were transferred into the climate simulator chamber for exposure to the simulated heat wave process with strong sudden temperature drop. After 55, 59, and 75 h of exposure, the experimental groups were successively removed from the chamber to monitor physiological indicators. Blood samples were collected by decollation, and the hearts were harvested in all groups. The levels of heat stress factors (HSP60, SOD, TNF, sICAM-1, HIF-1α), cold stress factors (NE, EPI), vasoconstrictor factors (ANGII, ET-1, NO), and four items of blood lipid (TC, TG, HDL-C, and LDL-C) were measured in each ApoE−/− mouse. Results showed that the heat waves increased the levels of heat stress factors except SOD decreased, and decreased the levels of vasoconstrictor factors and blood lipid factors except TC increased. The strong sudden temperature drop in the heat wave process increased the levels of cold stress factors, vasoconstrictor factors and four blood lipid items (except the level of HDL-C which decreased) and decreased the levels of heat stress factors (except the level of SOD which increased). The analysis showed that heat waves could enhance atherosclerosis of ApoE−/− mice. The strong sudden temperature drop during the heat wave process increased the plasma concentrations of NE and ANGII, which indicates SNS activation, and resulted in increased blood pressure. NE and ANGII are vasoconstrictors involved in systemic vasoconstriction especially in the superficial areas of the body and conducive to increased blood pressure. The increase in the blood lipid levels of TG, LDL-C, TC, and LDL-C/HDL-C further aggravated CVD. This paper explored the influence mechanism of the heat waves with sudden cooling on CVD in ApoE−/− mice. PMID:26016434
Effects of Simulated Heat Waves with Strong Sudden Cooling Weather on ApoE Knockout Mice.
Zhang, Shuyu; Kuang, Zhengzhong; Zhang, Xiakun
2015-05-26
This study analyzes the mechanism of influence of heat waves with strong sudden cooling on cardiovascular diseases (CVD) in ApoE-/- mice. The process of heat waves with strong sudden cooling was simulated with a TEM1880 meteorological-environment simulation chamber according to the data obtained at 5 a.m. of 19 June 2006 to 11 p.m. of 22 June 2006. Forty-eight ApoE-/- mice were divided into six blocks based on their weight. Two mice from each block were randomly assigned to control, heat wave, temperature drop, and rewarming temperature groups. The experimental groups were transferred into the climate simulator chamber for exposure to the simulated heat wave process with strong sudden temperature drop. After 55, 59, and 75 h of exposure, the experimental groups were successively removed from the chamber to monitor physiological indicators. Blood samples were collected by decollation, and the hearts were harvested in all groups. The levels of heat stress factors (HSP60, SOD, TNF, sICAM-1, HIF-1α), cold stress factors (NE, EPI), vasoconstrictor factors (ANGII, ET-1, NO), and four items of blood lipid (TC, TG, HDL-C, and LDL-C) were measured in each ApoE-/- mouse. Results showed that the heat waves increased the levels of heat stress factors except SOD decreased, and decreased the levels of vasoconstrictor factors and blood lipid factors except TC increased. The strong sudden temperature drop in the heat wave process increased the levels of cold stress factors, vasoconstrictor factors and four blood lipid items (except the level of HDL-C which decreased) and decreased the levels of heat stress factors (except the level of SOD which increased). The analysis showed that heat waves could enhance atherosclerosis of ApoE-/- mice. The strong sudden temperature drop during the heat wave process increased the plasma concentrations of NE and ANGII, which indicates SNS activation, and resulted in increased blood pressure. NE and ANGII are vasoconstrictors involved in systemic vasoconstriction especially in the superficial areas of the body and conducive to increased blood pressure. The increase in the blood lipid levels of TG, LDL-C, TC, and LDL-C/HDL-C further aggravated CVD. This paper explored the influence mechanism of the heat waves with sudden cooling on CVD in ApoE-/- mice.
Catastrophic global-avalanche of a hollow pressure filament
NASA Astrophysics Data System (ADS)
van Compernolle, B.; Poulos, M. J.; Morales, G. J.
2017-10-01
New results are presented of a basic heat transport experiment performed in the Large Plasma Device at UCLA. A ring-shaped electron beam source injects low energy electrons along a strong magnetic field into a preexisting, large and cold plasma. The injected electrons are thermalized by Coulomb collisions within a short distance and provide an off-axis heat source that results in a long, hollow, cylindrical region of elevated plasma pressure. The off-axis source is active for a period long compared to the density decay time, i.e., as time progresses the power per particle increases. Two distinct regimes are observed to take place, an early regime dominated by multiple avalanches, identified as a sudden intermittent rearrangement of the pressure profile that repeats under sustained heating, and a second regime dominated by broadband drift-Alfvén fluctuations. The transition between the two regimes is sudden and global, both radially and axially. The initial regime is characterized by peaked density and temperature profiles, while only the peaked temperature profile survives in the second regime. Recent measurements at multiple axial locations provide new insight into the axial dynamics of the global avalanche. Sponsored by NSF Grant 1619505 and by DOE/NSF at BaPSF.
Solar wind driven empirical forecast models of the time derivative of the ground magnetic field
NASA Astrophysics Data System (ADS)
Wintoft, Peter; Wik, Magnus; Viljanen, Ari
2015-03-01
Empirical models are developed to provide 10-30-min forecasts of the magnitude of the time derivative of local horizontal ground geomagnetic field (|dBh/dt|) over Europe. The models are driven by ACE solar wind data. A major part of the work has been devoted to the search and selection of datasets to support the model development. To simplify the problem, but at the same time capture sudden changes, 30-min maximum values of |dBh/dt| are forecast with a cadence of 1 min. Models are tested both with and without the use of ACE SWEPAM plasma data. It is shown that the models generally capture sudden increases in |dBh/dt| that are associated with sudden impulses (SI). The SI is the dominant disturbance source for geomagnetic latitudes below 50° N and with minor contribution from substorms. However, at occasions, large disturbances can be seen associated with geomagnetic pulsations. For higher latitudes longer lasting disturbances, associated with substorms, are generally also captured. It is also shown that the models using only solar wind magnetic field as input perform in most cases equally well as models with plasma data. The models have been verified using different approaches including the extremal dependence index which is suitable for rare events.
Shukla, Rakesh; Wexler, Laura
2012-01-01
Background: Excess sudden death due to ventricular tachyarrhythmias remains a major mode of mortality in patients with systolic heart failure. The aim of this study was to determine the association of nocturnal ventricular arrhythmias in patients with low ejection fraction heart failure. We incorporated a large number of known pathophysiologic triggers to identify potential targets for therapy to reduce the persistently high incidence of sudden death in this population despite contemporary treatment. Methods: Eighty-six ambulatory male patients with stable low (≤ 45%) ejection fraction heart failure underwent full-night attendant polysomnography and simultaneous Holter recordings. Patients were divided into groups according to the presence or absence of couplets (paired premature ventricular excitations) and ventricular tachycardia (VT) (at least three consecutive premature ventricular excitations) during sleep. Results: In multiple regression analysis, four variables (current smoking status, increased number of arousals, plasma alkalinity, and old age) were associated with VT and two variables (apnea-hypopnea index and low right ventricular ejection fraction) were associated with couplets during sleep. Conclusions: We speculate that cessation of smoking, effective treatment of sleep apnea, and plasma alkalosis could collectively decrease the incidence of nocturnal ventricular tachyarrhythmias and the consequent risk of sudden death, which remains high despite the use of β blockades. PMID:22172636
WOMEN’S SUFFRAGE, POLITICAL RESPONSIVENESS, AND CHILD SURVIVAL IN AMERICAN HISTORY*
Miller, Grant
2010-01-01
Women’s choices appear to emphasize child welfare more than those of men. This paper presents new evidence on how suffrage rights for American women helped children to benefit from the scientific breakthroughs of the bacteriological revolution. Consistent with standard models of electoral competition, suffrage laws were followed by immediate shifts in legislative behavior and large, sudden increases in local public health spending. This growth in public health spending fueled large-scale door-to-door hygiene campaigns, and child mortality declined by 8-15% (or 20,000 annual child deaths nationwide) as cause-specific reductions occurred exclusively among infectious childhood killers sensitive to hygienic conditions. PMID:21373369
Kleĭmenova, N G; Kozyreva, O V; Breus, T K; Rapoport, S I
2007-01-01
The analysis of the ambulance calls in Moscow, related to myocardial infarction (85.000 events), sudden death (71.700 events), and hypertension crises (165.500 events) over the period of 1979-1981 demonstrated their clear seasonal variations with a profound summer minimum and a winter maximum. The same results were obtained in the analysis of statistical monthly data on sudden death from infarction in Bulgaria over the period of 15 years (1970-1985). However, there are a great number of clinical and statistical studies confirming the rises in the incidence of myocardial infarction, hypertension crise, and sudden death during geomagnetic disturbances, which have maximum occurrence near equinox, not in winter. In order to explain this contradiction, we suggested that one of critical factors that affect the human cardiovascular system is geomagnetic micropulsations Pc1 having the frequency comparable with the frequency of heart rate beatings and winter maximum in their occurrence. The results of a comparative analysis of data of ambulance calls in Moscow related to myocardial infarction and sudden death and the catalog of Pc1 observations at the geophysical observatory "Borok" (Yaroslavl region) are presented. It is shown that in approximately 70% of days with an anomalously large number of ambulance calls related to myocardial infarction, Pc1 micropulsations have been registered. The probability of simultaneous occurrence of myocardial infarction and Pc1 in the winter season was 1.5 times greater than their accidental coincidence. Moreover, it was found that in winter the effects of magnetic storms and Pc1 IM(A) were much higher than in summer. We suggested that one of possible reasons for the seasonal variations in the occurrence of myocardial infarction is an increase in the production of the pineal hormone melatonin in winter which leads to an unstable state of the human organism and an increase in its sensitivity to the effect of geomagnetic pulsations.
Tanaka, Shin-ichiro; Yasuda, Tomoyuki; Ishida, Tatsuro; Fujioka, Yoshio; Tsujino, Takeshi; Miki, Tetsuo; Hirata, Ken-ichi
2013-05-01
Lecithin:cholesterol acyltransferase (LCAT) is thought to be important in reverse cholesterol transport. However, its association with coronary heart disease (CHD) and sudden death is controversial. We prospectively studied 1927 individuals from the general population. Serum concentrations of apolipoprotein A-I, A-II, B, C-II, C-III, E, and LCAT activity measured as a serum cholesterol esterification rate were evaluated. We documented 61 events of CHD and sudden death during 10.9 years of follow-up. After adjustment for age and sex, LCAT activity was significantly associated with the risk of CHD and sudden death (hazard ratio, 3.02; 95% confidence interval, 1.49-6.12; P=0.002). In multivariate analysis adjusted for age, sex, current smoking status, history of diabetes mellitus, body mass index, systolic blood pressure, serum total cholesterol, and serum high-density lipoprotein cholesterol concentrations, the hazard ratio of LCAT activity for the risk of CHD and sudden death remained significant (hazard ratio, 3.07; 95% confidence interval, 1.35-7.01; P=0.008). However, when it was analyzed for men and women separately, this association remained significant only in women. Increased LCAT activity measured as a serum cholesterol esterification rate was a risk for CHD and sudden death in a Japanese general population.
Cerebral Paragonimiasis Presenting with Sudden Death.
Amaro, Deirdre E; Cowell, Annie; Tuohy, Marion J; Procop, Gary W; Morhaime, Jacquelyn; Reed, Sharon L
2016-12-07
A 58-year-old Korean-born woman with a history of seizures and psychiatric issues was found dead at home. Autopsy was notable for large, calcified nodules that had nearly replaced her right temporal lobe. Histologic examination revealed the presence of Paragonimus eggs. This case demonstrates a rare manifestation of an aberrantly migrated lung fluke that resulted in epilepsy and sudden death years after the initial infection. © The American Society of Tropical Medicine and Hygiene.
Spencer, Robert; Leach, Paul
2017-08-01
Chiari type I malformation (CM-I) is characterised by caudal displacement of the cerebellar tonsils through the foramen magnum, crowding the craniocervical junction. It is being increasingly diagnosed in asymptomatic patients due to the widespread availability of MRI, and there are case reports of these patients suffering sudden death or neurological injury following head or neck trauma, raising the issue of whether they should be prohibited from contact sport participation, given the likelihood of frequent trauma. General neurosurgical opinion is that patients who are symptomatic and those with an associated spinal cord syrinx should be offered foramen magnum decompression, however asymptomatic patients without syringomyelia are not offered this in the majority of cases. The authors performed a full review of the published literature, including all case reports, case series, studies and literature reviews regarding CM-I and either contact sports or trauma, excluding patients that had undergone surgical intervention and those becoming symptomatic in circumstances other than head or neck trauma. 21 case reports of CM-I patients deteriorating following trauma were identified, including four cases of sudden death following head or neck injury. However, studies of large samples of CM-I patients are yet to capture an incident of sudden death or acute neurological deterioration, suggesting that the risk is very low. CM-I patients may have an increased risk of concussion and post-concussion syndrome compared to the background population however. Overall, the authors feel that there should be no restriction of sports participation for CM-I patients, but a discussion to make them and their families aware of the possible increased risks is important.
Koo, Malcolm; Chen, Jin-Cherng; Hwang, Juen-Haur
2016-01-01
Cochleovestibular symptoms, such as vertigo, tinnitus, and sudden deafness, are common manifestations of microvascular diseases. However, it is unclear whether these symptoms occurred preceding the diagnosis of peripheral artery occlusive disease (PAOD). Therefore, the aim of this case-control study was to investigate the risk of PAOD among patients with vertigo, tinnitus, and sudden deafness using a nationwide, population-based health claim database in Taiwan. We identified 5,340 adult patients with PAOD diagnosed between January 1, 2006 and December 31, 2010 and 16,020 controls, frequency matched on age interval, sex, and year of index date, from the Taiwan National Health Insurance Research Database. Risks of PAOD in patients with vertigo, tinnitus, or sudden deafness were separately evaluated with multivariate logistic regression analyses. Of the 5,340 patients with PAOD, 12.7%, 6.7%, and 0.3% were diagnosed with vertigo, tinnitus, and sudden deafness, respectively. In the controls, 10.6%, 6.1%, and 0.3% were diagnosed with vertigo (P < 0.001), tinnitus (P = 0.161), and sudden deafness (P = 0.774), respectively. Results from the multivariate logistic regression analyses showed that the risk of PAOD was significantly increased in patients with vertigo (adjusted odds ratio = 1.12, P = 0.027) but not in those with tinnitus or sudden deafness. A modest increase in the risk of PAOD was observed among Taiwanese patients with vertigo, after adjustment for comorbidities.
Thyroid gland and cerebella lesions: New risk factors for sudden cardiac death in schizophrenia?
Scorza, Fulvio A; Cavalheiro, Esper A; de Albuquerque, Marly; de Albuquerque, Juliana; Cysneiros, Roberta M; Terra, Vera C; Arida, Ricardo M
2011-02-01
People with schizophrenia show a two to threefold increased risk to die prematurely than those without schizophrenia. Patients' life style, suicide, premature development of cardiovascular disease, high prevalence of metabolic syndrome and sudden cardiac death are well-known causes of the excess mortality. The exact pathophysiological cause of sudden death in schizophrenia is unknown, but it is likely that cardiac arrhythmia and respiratory abnormalities play potential role. Some antipsychotics may be associated with cardiovascular adverse events (e.g., QT interval prolongation) and lesions in specific brain regions, such as cerebella may be associated with respiratory abnormalities, suggesting that metabolic and brain dysfunction could lead to sudden cardiac death in patients with schizophrenia. However, exact knowledge regarding the association of these findings and schizophrenia is lacking. As subclinical hyperthyroidism has been linked with increased risk of cardiovascular disease and cerebella progressive atrophy has been observed in patients with schizophrenia, we propose in this paper that subclinical thyroid dysfunction and cerebella volume loss could be considered as new risk factor for sudden cardiac death in schizophrenia. Copyright © 2010 Elsevier Ltd. All rights reserved.
Bedsharing at home, breastfeeding and sudden infant death.Recommendations for health professionals
Jenik, Alejandro; Conti, Roxana
2017-10-01
The Sudden and Unexpected Infant Death Task Force together with the Subcommittee on Breastfeeding of the Sociedad Argentina de Pediatría have issued updated recommendations on bedsharing with the parents, a practice which remains controversial. Sleeping with the mother maximizes breastfeeding, which is protective against Sudden Infant Death. There is a small group of infants that have been associated with an increased risk of Sudden Infant Death and fatal sleeping accidents in certain circumstances. These hazards include parental smoking, sedating drugs or medication and alcohol consumption prior to sleep and sofa sharing situations. Bedsharing by breastfeeding mothers with their infants, in the absence of the above-mentioned risk factors, and with parents aware of how to ensure a safe infant sleep environment has not been shown to be associated with increased risk of Sudden Infant Death. This guidance does not advise on telling parents that they must never sleep with the baby, but rather instructs health professionals to give parents balanced advice to allow informed decision making, emphasizing the concept that parental room sharing without bedsharing is the safest place for the babies to sleep
A review of patients who suddenly deteriorate in the presence of paramedics.
Boyle, Malcolm J; Smith, Erin C; Archer, Frank
2008-07-26
The report of the Ministerial Review of Trauma and Emergency Services in Victoria, Australia, recommended that paramedics be permitted to divert to the closest hospital in incidences of life threatening situations prior to and during transport. An audit of patients that suddenly deteriorated in paramedic care was recommended by the Ministerial Review. The objective of the study was to identify the number and outcome of patients who suddenly deteriorated in the presence of paramedics. A retrospective cohort study of trauma patients who suddenly deteriorated in the presence of paramedics during 2002. As there was no standard definition, sudden deterioration was defined using a predetermined set of physiological criteria. Patient care record data of patients who suddenly deteriorated were compared with the State Trauma Registry to determine those who sustained hospital defined major trauma. Patient care records where hospital bypass was undertaken were identified and analysed. Ethics committee approval was obtained. There were 2,893 patients that suddenly deteriorated according to predefined criteria. 2,687 (5.1% of the total trauma patients for 2002) were suitable for further analysis. The majority of patients had a sudden decrease in BP (n = 2,463) with 4.3% having hospital defined major trauma. For patients with a sudden decrease in conscious state or a total GCS score of less than 13 (n = 77), 37.7% had hospital defined major trauma; and a sudden increase/decrease in pulse rate and sudden decrease in BP (n = 65), 26.2% had hospital defined major trauma. Only 28 documented incidents of hospital bypass were identified. This study suggests that the incidents of patients suddenly deteriorating in the presence of paramedics are low and the incidence of hospital bypass is not well documented.
A morphological study of vertical ionospheric flows in the high-latitude F region
DOE Office of Scientific and Technical Information (OSTI.GOV)
Loranc, M.; St.-Maurice, J.P.; Hanson, W.B.
1991-03-01
The authors have studied the vertical bulk ion drift data recorded by the DE 2 satellite between 200 and 1,000 km altitudes. For this data set, they have found that field-aligned ion flows between 100 m s{sup {minus}1} and 3 km s{sup {minus}1} are a common occurence in the high-latitude F region. The flows are predominantly upward near the cusp region and throughout the auroral zone. Strong downward flows of somewhat smaller magnitude are also recorded but mostly over the polar cap. These statements are true for all drift speeds in excess of 50 m s{sup {minus}1} and for allmore » altitudes and magnetic activity levels sampled. The morphology of low-altitude upward flowing ions agrees well with the morphology of outflowing ions, ion beams, and ion conics observed at much higher altitudes, but the low-altitude fluxes are often considerably greater. This suggests that a large fraction of the upflowing ions actually returns to the ionosphere, to be observed as large downward ion fluxes. They propose that upflowing ion events are generated by sudden large changes in the ion temperature below the neutral exobase, where ion frictional heating dominates the ion energy balance. The sudden changes in temperature occur when the horizontal velocity of a convecting field tube increases rapidly in regions like the cusp.« less
The serotonin axis: Shared mechanisms in seizures, depression and SUDEP
Richerson, George B.; Buchanan, Gordon F.
2010-01-01
Summary There is a growing appreciation that patients with seizures are also affected by a number of co-morbid conditions, including an increase in prevalence of depression (Kanner, 2009), sleep apnea (Chihorek et al, 2007), and sudden death (Ryvlin et al, 2006; Tomson et al, 2008). The mechanisms responsible for these associations are unclear. Here we discuss the possibility that underlying pathology in the serotonin (5-HT) system of epilepsy patients lowers the threshold for seizures, while also increasing the risk of depression and sudden death. We propose that post-ictal dysfunction of 5-HT neurons causes depression of breathing and arousal in some epilepsy patients, and this can lead to sudden unexpected death in epilepsy (SUDEP). We further draw parallels between SUDEP and sudden infant death syndrome (SIDS), which may share pathophysiological mechanisms, and which have both been linked to defects in the 5-HT system. PMID:21214537
DOE Office of Scientific and Technical Information (OSTI.GOV)
Jyegal, Jang, E-mail: jjyegal@inu.ac.kr
Velocity overshoot is a critically important nonstationary effect utilized for the enhanced performance of submicron field-effect devices fabricated with high-electron-mobility compound semiconductors. However, the physical mechanisms of velocity overshoot decay dynamics in the devices are not known in detail. Therefore, a numerical analysis is conducted typically for a submicron GaAs metal-semiconductor field-effect transistor in order to elucidate the physical mechanisms. It is found that there exist three different mechanisms, depending on device bias conditions. Specifically, at large drain biases corresponding to the saturation drain current (dc) region, the velocity overshoot suddenly begins to drop very sensitively due to the onsetmore » of a rapid decrease of the momentum relaxation time, not the mobility, arising from the effect of velocity-randomizing intervalley scattering. It then continues to drop rapidly and decays completely by severe mobility reduction due to intervalley scattering. On the other hand, at small drain biases corresponding to the linear dc region, the velocity overshoot suddenly begins to drop very sensitively due to the onset of a rapid increase of thermal energy diffusion by electrons in the channel of the gate. It then continues to drop rapidly for a certain channel distance due to the increasing thermal energy diffusion effect, and later completely decays by a sharply decreasing electric field. Moreover, at drain biases close to a dc saturation voltage, the mechanism is a mixture of the above two bias conditions. It is suggested that a large secondary-valley energy separation is essential to increase the performance of submicron devices.« less
Dynamic interneuron-principal cell interplay leads to a specific pattern of in vitro ictogenesis.
Lévesque, Maxime; Chen, Li-Yuan; Hamidi, Shabnam; Avoli, Massimo
2018-07-01
Ictal discharges induced by 4-aminopyridine in the in vitro rodent entorhinal cortex present with either low-voltage fast or sudden onset patterns. The role of interneurons in initiating low-voltage fast onset ictal discharges is well established but the processes leading to sudden onset ictal discharges remain unclear. We analysed here the participation of interneurons (n = 75) and principal cells (n = 13) in the sudden onset pattern by employing in vitro tetrode wire recordings in the entorhinal cortex of brain slices from Sprague-Dawley rats. Ictal discharges emerged from a background of frequently occurring interictal spikes that were associated to a specific interneuron/principal cell interplay. High rates of interneuron firing occurred 12 ms before interictal spike onset while principal cells fired later during low interneuron firing. In contrast, the onset of sudden ictal discharges was characterized by increased firing from principal cells 627 ms before ictal onset whereas interneurons increased their firing rates 161 ms before ictal onset. Our data show that sudden onset ictogenesis is associated with frequently occurring interictal spikes resting on the interplay between interneurons and principal cells while ictal discharges stem from enhanced principal cell firing leading to increased interneuron activity. These findings indicate that specific patterns of interactions between interneurons and principal cells shape interictal and ictal discharges with sudden onset in the rodent entorhinal cortex. We propose that specific neuronal interactions lead to the generation of distinct onset patterns in focal epileptic disorders. Copyright © 2018 Elsevier Inc. All rights reserved.
The molecular autopsy: an indispensable step following sudden cardiac death in the young?
Boczek, Nicole J.; Tester, David J.; Ackerman, Michael J.
2013-01-01
Annually thousands of sudden deaths involving young individuals (< 35 years of age) remain unexplained following a complete medicolegal investigation that includes an autopsy. In fact, epidemiological studies have estimated that over half of sudden deaths involving previously healthy young individuals have no morphological abnormalities identifiable at autopsy. Cardiac channelopathies associated with structurally normal hearts such as long QT syndrome (LQTS), catecholaminergic polymorphic ventricular tachycardia (CPVT), and Brugada syndrome (BrS), leave no evidence to be found at autopsy, leaving investigators to only speculate that a lethal arrhythmia might lie at the heart of a sudden unexplained death (SUD). In cases of autopsy-negative SUD, continued investigation, through the use of a cardiological and genetic evaluation of first- or second-degree relatives and/or a molecular autopsy, may pinpoint the underlying mechanism attributing to the sudden death and allow for the identification of living family members with the pathogenic substrate that renders them vulnerable to an increased risk for cardiac events, including sudden death. PMID:22993115
Prevention of sudden cardiac death in young athletes: controversies and conundrums.
Rowland, Thomas
2011-01-01
Strategies for preventing sudden cardiac death in young athletes are predicated on the assumption that: (1) these events reflect pre-existing, clinically silent heart disease, and (2) means for detecting these abnormalities on the pre-participation evaluation are both feasible and accurate. Recent controversy has surrounded both of these presumptions. Some evidence suggests that the myocardial hypertrophy accompanying sports training itself might serve as a substrate for fatal arrhythmias. As well, vigorous debate has arisen over the optimal content of the pre-participation evaluation, particularly regarding the inclusion of routine screening electrocardiograms. As the rarity of these fatal events does not lend itself to an experimental approach, such disagreements are not easily resolved. Consequently, it is expected that decisions regarding approaches to prevention of sudden death in athletes will be dictated largely by region-specific financial, political, and cultural factors. This chapter examines the aetiologies of sudden cardiac death in young athletes as well as the controversies surrounding the prevention of these tragedies. Copyright © 2011 S. Karger AG, Basel.
Utilization implications for hardwoods susceptible to sudden oak death
John R. Shelly
2002-01-01
The number of woody species succumbing to Sudden Oak Death (SOD) infections and the number of counties where the pathogen has been reported continue to increase. One result is that the hazards related to falling trees and high levels of fuel hazard conditions are also increasing dramatically. The removal of infected, dead and dying trees creates numerous handling and...
Daly, Kevin P; Chakravarti, Sujata B; Tresler, Margaret; Naftel, David C; Blume, Elizabeth D; Dipchand, Anne I; Almond, Christopher S
2011-12-01
Sudden death is a well-recognized complication of heart transplantation. Little is known about the incidence and risk factors for sudden death after transplant in children. The purpose of this study was to determine the incidence of and risk factors for sudden death. This retrospective multicenter cohort study used the Pediatric Heart Transplant Study Group (PHTS) database, an event-driven registry of children aged <18 at listing undergoing heart transplantation between 1993 and 2007. Standard Kaplan-Meier and parametric analyses were used for survival analysis. Multivariate analysis in the hazard-function domain was used to identify risk factors for sudden death after transplant. Of 604 deaths in 2,491 children who underwent heart transplantation, 94 (16%) were classified as sudden. Freedom from sudden death was 97% at 5 years, and the hazard for sudden death remained constant over time at 0.01 deaths/year. Multivariate risk factors associated with sudden death included black race (hazard ratio [HR], 2.6; p < 0.0001), United Network of Organ Sharing (UNOS) status 2 at transplant (HR, 1.8; p = 0.008), older age (HR, 1.4/10 years of age; p = 0.03), and an increased number of rejection episodes in the first post-transplant year (HR, 1.6/episode; p = 0.03). Sudden death accounts for 1 in 6 deaths after heart transplant in children. Older recipient age, recurrent rejection within the first year, black race, and UNOS status 2 at listing were associated with sudden death. Patients with 1 or more of these risk factors may benefit from primary prevention efforts. Copyright © 2011 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.
Haloperidol and sudden cardiac death in dementia: autopsy findings in psychiatric inpatients.
Ifteni, Petru; Grudnikoff, Eugene; Koppel, Jeremy; Kremen, Neil; Correll, Christoph U; Kane, John M; Manu, Peter
2015-12-01
Treatment with haloperidol has been shown, in studies using death certificates and prescription files, to be associated with an excess of sudden cardiac deaths, and regulatory warnings highlight this risk in patients with dementia. We used autopsy findings to determine whether the rate of sudden cardiac death is greater in cases of unexpected deaths of patients with dementia treated with haloperidol. From 1989 through 2013, 1219 patients with a primary diagnosis of dementia with behavioral disturbance were admitted to a psychiatric hospital, and 65 (5.3%) died suddenly. Sixty-five patients (5.3%) died unexpectedly. Complete post-mortem examinations after the sudden death were performed in 55 (84.6%) patients. Twenty-seven of the autopsied cases (49.1%) had been treated with haloperidol orally (2.2 mg ± 2.1 mg/day), the only antipsychotic used in this cohort. Univariable comparisons and multivariable regression analyses compared the groups of patients with or without sudden cardiac death. The leading causes of death were sudden cardiac death (32.7%), myocardial infarction (25.5% of patients), pneumonia (23.6%), and stroke (10.9%). Patients with sudden cardiac death and those with anatomically established cause of death were similar regarding the use of haloperidol (p = 0.5). Sudden cardiac death patients were more likely to suffer from Alzheimer's dementia (p = 0.027) and to have a past history of heart disease (p = 0.0094), and less likely to have been treated with a mood stabilizer (p = 0.024), but none of these variables were independent predictors of sudden cardiac death. Autopsy data suggest that oral haloperidol is not associated with increased risk of sudden cardiac death in psychiatric inpatients with dementia. Copyright © 2015 John Wiley & Sons, Ltd.
Shimizu, Michiru; Ishida, Atsushi; Tange, Takeshi; Yagi, Hisayoshi
2006-04-01
We tested the hypothesis that sapling growth following a sudden increase in solar irradiance is related to recovery from photoinhibition and the balance between rate of production of new leaves and rate of abscision of old leaves. Leaf gas exchange, chlorophyll fluorescence and relative growth rate (RGR) of stem basal area were measured following the sudden exposure of shade-grown (7% of full sunlight) saplings of four Shorea species to full sunlight. Sudden exposure to full sunlight resulted in an immediate and substantial reduction in dark-adapted quantum yield of photosystem II (Fv/Fm), followed by a gradual recovery in all species. Near light-saturated net assimilation rate (A max) and area-based leaf chlorophyll concentration ([Chl area]) also declined immediately after exposure. Eleven days after exposure, A max had recovered to pre-exposure values in all species, whereas [Chl area] had not recovered. Across species, RGR of stem basal area increased with increasing RGR of the number of leaves following exposure to full sunlight. The interspecific variations in RGR of stem basal area suggest that new leaf production is crucial for determining the potential growth of saplings following gap formation.
Hwang, Juen-Haur
2016-01-01
Background Cochleovestibular symptoms, such as vertigo, tinnitus, and sudden deafness, are common manifestations of microvascular diseases. However, it is unclear whether these symptoms occurred preceding the diagnosis of peripheral artery occlusive disease (PAOD). Therefore, the aim of this case-control study was to investigate the risk of PAOD among patients with vertigo, tinnitus, and sudden deafness using a nationwide, population-based health claim database in Taiwan. Methods We identified 5,340 adult patients with PAOD diagnosed between January 1, 2006 and December 31, 2010 and 16,020 controls, frequency matched on age interval, sex, and year of index date, from the Taiwan National Health Insurance Research Database. Risks of PAOD in patients with vertigo, tinnitus, or sudden deafness were separately evaluated with multivariate logistic regression analyses. Results Of the 5,340 patients with PAOD, 12.7%, 6.7%, and 0.3% were diagnosed with vertigo, tinnitus, and sudden deafness, respectively. In the controls, 10.6%, 6.1%, and 0.3% were diagnosed with vertigo (P < 0.001), tinnitus (P = 0.161), and sudden deafness (P = 0.774), respectively. Results from the multivariate logistic regression analyses showed that the risk of PAOD was significantly increased in patients with vertigo (adjusted odds ratio = 1.12, P = 0.027) but not in those with tinnitus or sudden deafness. Conclusions A modest increase in the risk of PAOD was observed among Taiwanese patients with vertigo, after adjustment for comorbidities. PMID:27631630
Superradiance in a Large and Dilute Cloud of Cold Atoms in the Linear-Optics Regime.
Araújo, Michelle O; Krešić, Ivor; Kaiser, Robin; Guerin, William
2016-08-12
Superradiance has been extensively studied in the 1970s and 1980s in the regime of superfluorescence, where a large number of atoms are initially excited. Cooperative scattering in the linear-optics regime, or "single-photon superradiance," has been investigated much more recently, and superradiant decay has also been predicted, even for a spherical sample of large extent and low density, where the distance between atoms is much larger than the wavelength. Here, we demonstrate this effect experimentally by directly measuring the decay rate of the off-axis fluorescence of a large and dilute cloud of cold rubidium atoms after the sudden switch off of a low-intensity laser driving the atomic transition. We show that, at large detuning, the decay rate increases with the on-resonance optical depth. In contrast to forward scattering, the superradiant decay of off-axis fluorescence is suppressed near resonance due to attenuation and multiple-scattering effects.
Respiratory difficulties and breathing disorders in achondroplasia.
Afsharpaiman, S; Saburi, A; Waters, Karen A
2013-12-01
Respiratory difficulties and breathing disorders in achondroplasia are thought to underlie the increased risk for sudden infant death and neuropsychological deficits seen in this condition. This review evaluates literature regarding respiratory dysfunctions and their sequelae in patients with achondroplasia. The limited number of prospective studies of respiratory disease in achondroplasia means that observational studies and case series provide a large proportion of the data regarding the spectrum of respiratory diseases in achondroplasia and their treatments. Amongst clinical respiratory problems described, snoring is the commonest observed abnormality, but the reported incidence of obstructive sleep apnoea (OSA) shows wide variance (10% to 75%). Reported treatments of OSA include adenotonsillectomy, the use of CPAP, and surgical improvement of the airway, including mid-face advancement. Otolaryngologic manifestations are also common. Respiratory failure due to small thoracic volumes is reported, but uncommon. Mortality rate at all ages was 2.27 (CI: 1.7-3.0) with age-specific mortality increased at all ages. Sudden death was most common in infants and children. Cardiovascular events are the main cause of mortality in adults. Despite earlier recognition and treatment of respiratory complications of achondroplasia, increased mortality rates and other complications remain high. Future and ongoing evaluation of the prevalence and impact of respiratory disorders, particularly OSA, in achondroplasia is recommended. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.
HYDROSTATIC PRESSURE AND TEMPERATURE IN RELATION TO STIMULATION AND CYCLOSIS IN NITELLA FLEXILIS
Harvey, E. Newton
1942-01-01
Nitella flexilis cells are not stimulated to "shock stoppage" of cyclosis by suddenly evacuating the air over the water or on sudden readmission of air, or on suddenly striking a piston in the water-filled chamber in which they are kept with a ball whose energy is 7.6 joules, provided the Nitella cell is not moved by currents against the side of the chamber. Sudden increases in hydrostatic pressure from zero to 1000 lbs. or 0 to 5000 lbs. per square inch or 5000 to 9000 lbs. per square inch usually do not stimulate to "shock stoppage" of cyclosis, but some cells are stimulated. Sudden decreases of pressure are more likely to stimulate, again with variation depending on the cell. In the absence of stimulation, the cyclosis velocity at 23°C. slows as the pressure is increased in steps of 1000 lbs. per square inch. In some cells a regular slowing is observed, in others there is little slowing until 4000 to 6000 lbs. per square inch, when a rapid slowing appears, with only 50 per cent to 30 per cent of the original velocity at 9000 lbs. per square inch. The cyclosis does not completely stop at 10000 lbs. per square inch. The pressure effect is reversible unless the cells have been kept too long at the high pressure. At low temperatures (10°C.) and at temperatures near and above (32°–38°C.) the optimum temperature for maximum cyclosis (35–36°C.) pressures of 3000 to 6000 lbs. per square inch cause only further slowing of cyclosis, with no reversal of the temperature effect, such as has been observed in pressure-temperature studies on the luminescence of luminous bacteria. Sudden increase in temperature may cause shock stoppage of cyclosis as well as sudden decrease in temperature. PMID:19873318
Sudden Cardiac Arrest in Athletic Medicine
Kyle, James M.; Ellis, James M.; Cantwell, John; Courson, Ron; Medlin, Ron
2001-01-01
Objective: To emphasize the importance of decreasing the response time by a trained target responder to increase the survival rate among athletes experiencing sudden cardiac arrest at an athletic event. Background: Death due to sudden cardiac arrest that is witnessed is preventable in many cases. However, most people who experience this condition die because of a prolonged response time from onset of the fatal arrhythmia to defibrillation by trained treatment providers. If athletic trainers or other members of the athletic care medical team are trained as target responders and equipped with automated electronic defibrillators, they can immediately treat an athlete who experiences a sudden, life-threatening tachyarrhythmia. This prompt response to the life-threatening emergency should result in a higher survival rate. Description: We review the causes of sudden cardiac arrest during athletic events, note some unusual clinical presentations, discuss improved methods of response and new equipment for treatment, and define the athletic trainer's role as a target responder trained to treat people experiencing sudden cardiac arrest at an athletic event. Clinical Advantages: An athletic care team willing to become part of an emergency response team can help improve the survival rate of athletes experiencing sudden cardiac arrest at an athletic event. PMID:12937464
Observation and Modeling of the Generation Mechanism of Ion Upflow during Sudden Commencement
NASA Astrophysics Data System (ADS)
Zou, S.; Ozturk, D. S.; Li, C.; Varney, R. H.; Reimer, A.
2017-12-01
Sudden commencement (SC) induced by solar wind pressure enhancement can produce significant global impact on the coupled magnetosphere-ionosphere (MI) system, and its effects have been studied extensively using ground magnetometers and coherent scatter radars. However, very limited observations have been reported about the effects of SC on the ionospheric plasma. We study the ionosphere response to the SC using the Poker Flat incoherent scatter radar (PFISR) and numerical simulations. A detailed case study of SC during the 17 March 2015 storm was conducted. PFISR observed lifting of the F region ionosphere, transient field-aligned ion upflow, prompt but short-lived ion temperature increase, subsequent F region density decrease, and persistent electron temperature increase. A global magnetohydrodynamic (MHD) simulation has been carried out to characterize the SC-induced current, convection, and magnetic perturbations. Simulated magnetic perturbations at Poker Flat show a satisfactory agreement with observations. The simulation provides a global context for linking localized PFISR observations to large-scale dynamic processes in the MI system. Following the case study, we also perform a statistical study of the effects of SC on the ionosphere focusing on the magnetic local time and latitudinal asymmetries using PFISR and GPS TEC.
CKD and Sudden Cardiac Death: Epidemiology, Mechanisms, and Therapeutic Approaches
Whitman, Isaac R.; Feldman, Harold I.
2012-01-01
Multiple studies demonstrate a strong independent association between CKD and cardiovascular events including death, heart failure, and myocardial infarction. This review focuses on recent clinical studies that expand this spectrum of adverse cardiovascular events to include ventricular arrhythmias and sudden cardiac death. In addition, experimental models suggest structural remodeling of the heart and electrophysiologic changes in this population. These processes may explain the increased arrhythmic risk in kidney disease and aid in identifying patients who are at higher risk for sudden cardiac death. Finally, we review here the data to support the use of pharmacologic and device-based therapies for both the primary and secondary prevention of sudden cardiac death. PMID:23100219
Non-linear effects of soda taxes on consumption and weight outcomes.
Fletcher, Jason M; Frisvold, David E; Tefft, Nathan
2015-05-01
The potential health impacts of imposing large taxes on soda to improve population health have been of interest for over a decade. As estimates of the effects of existing soda taxes with low rates suggest little health improvements, recent proposals suggest that large taxes may be effective in reducing weight because of non-linear consumption responses or threshold effects. This paper tests this hypothesis in two ways. First, we estimate non-linear effects of taxes using the range of current rates. Second, we leverage the sudden, relatively large soda tax increase in two states during the early 1990s combined with new synthetic control methods useful for comparative case studies. Our findings suggest virtually no evidence of non-linear or threshold effects. Copyright © 2014 John Wiley & Sons, Ltd.
Kellogg, Marissa; Liang, Conrad W; Liebeskind, David S
2016-01-01
Clinicians treating sudden neurologic deficit are being faced with an increasing number of available imaging modalities. In this chapter we discuss a general approach to acute neuroimaging and weigh the considerations that determine which modality or modalities should be utilized. © 2016 Elsevier B.V. All rights reserved.
Crises in national leadership?
Mahathir, M
1998-01-01
In Asia, an economic crisis has occurred simultaneously with an immense increase in the prevalence of HIV/AIDS fueled by inadequate responses to the epidemic. This response has been further weakened by sudden budget cuts and changes in government priorities, and the situation has been exacerbated by its suddenness and by the fact that large numbers of people are at risk and are unemployed. Also, Asian countries are now seeking entry into the pool of countries where donors support HIV/AIDS prevention and treatment programs just as donors are reducing their aid budgets. Prevention programs are being severely compromised even before they became effective, and efforts to secure treatment are hindered by high prices, by devalued national currencies, and by an increasing trend towards the privatization of health care. In the long run, efforts to restore economic stability will be hindered by the socioeconomic impact of the HIV/AIDS pandemic. In order to improve future prospects, the leadership of all national AIDS programs must reexamine the cost effectiveness of their priorities. Such a move would target marginalized groups, reduce use of expensive mass media campaigns, increase international cooperation over issues dealing with migrant workers, create programs recognizing the crucial role of women, increase the involvement of infected people in prevention programs, recognize the long-term socioeconomic benefits of providing adequate and equitable care and treatment, and recognize the benefits of prioritizing HIV/AIDS funding.
Acute otitis media associated bilateral sudden hearing loss: case report and literature review.
Smith, A; Gutteridge, I; Elliott, D; Cronin, M
2017-07-01
Sudden sensorineural hearing loss is a rare otological condition with potential for dire outcomes including permanent hearing loss. Although the majority of cases are deemed idiopathic, bilateral sudden sensorineural hearing loss represents a rare subset typically related to systemic conditions, with higher morbidity and mortality. A controversial association with acute otitis media has been reported, with few bilateral cases published in the literature. A very rare case of bilateral sudden sensorineural hearing loss associated with acute otitis media is described, with a review of the literature. The limited evidence available suggests that acute otitis media with tinnitus and/or bacterial pathology may have an increased risk of sudden sensorineural hearing loss, which is consistent with the case described. Although there is no sufficiently powered published evidence to provide definitive treatment guidelines, the literature reviewed suggests that early myringotomy and antibiotics may greatly improve treatment outcomes.
Fleming, P J; Gilbert, R; Azaz, Y; Berry, P J; Rudd, P T; Stewart, A; Hall, E
1990-01-01
OBJECTIVE--To determine the relation between sleeping position and quantity of bedding and the risk of sudden unexpected infant death. DESIGN--A study of all infants dying suddenly and unexpectedly and of two controls matched for age and date with each index case. The parents of control infants were interviewed within 72 hours of the index infant's death. Information was collected on bedding, sleeping position, heating, and recent signs of illness for index and control infants. SETTING--A defined geographical area comprising most of the county of Avon and part of Somerset. SUBJECTS--72 Infants who had died suddenly and unexpectedly (of whom 67 had died from the sudden infant death syndrome) and 144 control infants. RESULTS--Compared with the control infants the infants who had died from the sudden infant death syndrome were more likely to have been sleeping prone (relative risk 8.8; 95% confidence interval 7.0 to 11.0; p less than 0.001), to have been more heavily wrapped (relative risk 1.14 per tog above 8 tog; 1.03 to 1.28; p less than 0.05), and to have had the heating on all night (relative risk 2.7; 1.4 to 5.2; p less than 0.01). These differences were less pronounced in the younger infants (less than 70 days) than the older ones. The risk of sudden unexpected death among infants older than 70 days, nursed prone, and with clothing and bedding of total thermal resistance greater than 10 tog was increased by factors of 15.1 (2.6 to 89.6) and 25.2 (3.7 to 169.0) respectively compared with the risk in infants of the same age nursed supine or on their side and under less than 6 tog of bedding. CONCLUSIONS--Overheating and the prone position are independently associated with an increased risk of sudden unexpected infant death, particularly in infants aged more than 70 days. Educating parents about appropriate thermal care and sleeping position of infants may help to reduce the incidence of the sudden infant death syndrome. PMID:2390588
NASA Astrophysics Data System (ADS)
Cheng, Jianbo; Min, Li; Zheng, Nan; Fan, Caiyun; Zhao, Shengguo; Zhang, Yangdong; Wang, Jiaqi
2018-02-01
This study was designed to investigate the effects of sudden cooling on the physiological responses of 12 heat-stressed Holstein dairy cows using an isobaric tags for relative and absolute quantification (iTRAQ) labeling approach. Plasma samples were collected from these cows during heat stress (HS), and after strong, sudden cooling in the summer (16 days later). We compared plasma proteomic data before and after sudden cooling to identify the differentially abundant proteins. The results showed that sudden cooling in summer effectively alleviated the negative consequences of HS on body temperature and production variables. Expressions of plasma hemoglobin alpha and hemoglobin beta were upregulated, whereas lipopolysaccharide-binding protein (LBP) and haptoglobin were downregulated in this process. The increase of hemoglobin after cooling may improve oxygen transport and alleviate the rise in respiration rates in heat-stressed dairy cows. The decrease of LBP and haptoglobin suggests that the inflammatory responses caused by HS are relieved after cooling. Our findings provide new insight into the physiological changes that occur when heat-stressed dairy cows experience strong, sudden cooling.
Lee, Yun-Ju; Hoozemans, Marco J M; van Dieën, Jaap H
2012-01-01
Unexpected sudden (un)loading of the trunk may induce inadequate responses of trunk muscles and uncontrolled trunk motion. These unexpected perturbations may occur in pushing tasks, when the cart suddenly starts moving (unloading) or is blocked by an obstacle (loading). In pushing, handle height affects the user's working posture, which may influence trunk muscle activity and trunk movement in response to the perturbation. Eleven healthy male subjects pushed a 200 kg cart with handles at shoulder and hip height in a start condition (sudden release of brakes) and a stop condition (bumping into an obstacle). Before the perturbation, the baseline of the trunk inclination, internal moment and trunk extensor muscle activity were significantly higher when pushing at hip height than at shoulder height. After the perturbation, the changes in trunk inclination and internal moment were significantly larger when pushing at shoulder height than at hip height in both conditions. The opposite directions of changes in trunk inclination and internal moment suggest that the unexpected perturbations caused uncontrolled trunk motion. Pushing at shoulder height may impose a high risk of low-back injury due to the low trunk stiffness and large involuntary trunk motion occurring after carts suddenly move or stop.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Feng, Liefeng, E-mail: fengliefeng@tju.edu.cn, E-mail: lihongru@nankai.edu.cn; Yang, Xiufang; Wang, Cunda
2015-04-15
The junction behavior of different narrow band-gap multi-quantum-well (MQW) laser diodes (LDs) confirmed that the jump in the junction voltage in the threshold region is a general characteristic of narrow band-gap LDs. The relative change in the 1310 nm LD is the most obvious. To analyze this sudden voltage change, the threshold region is divided into three stages by I{sub th}{sup l} and I{sub th}{sup u}, as shown in Fig. 2; I{sub th}{sup l} is the conventional threshold, and as long as the current is higher than this threshold, lasing exists and the IdV/dI-I plot drops suddenly; I{sub th}{sup u}more » is the steady lasing point, at which the separation of the quasi-Fermi levels of electron and holes across the active region (V{sub j}) is suddenly pinned. Based on the evolutionary model of dissipative structure theory, the rate equations of the photons in a single-mode LD were deduced in detail at I{sub th}{sup l} and I{sub th}{sup u}. The results proved that the observed behavior of stimulated emission suddenly substituting for spontaneous emission, in a manner similar to biological evolution, must lead to a sudden increase in the injection carriers in the threshold region, which then causes the sudden increase in the junction voltage in this region.« less
Indirect evidence of calcitonin secretion in man.
Caniggia, A; Gennari, C; Vattimo, A; Nardi, P; Nuti, R
1976-09-01
1. The effect of calcitonin, a large amount of calcium given orally, pentagastrin and glucagon on plasma 47Ca radioactivity curves in subjects pretreated with 47Ca was examined. 2. A sudden increase of plasma radioactivity after intravenous administration of calcitonin and pentagastrin and after the oral calcium load was observed in normal subjects; the intravenous infusion of glucagon was less effective. 3. Two thyroparathyroidectomized patients who responded to the calcitonin infusion did not respond to the oral calcium load. 4. These data may be considered to offer indirect evidence of endogenous calcitonin secretion in man.
Kaada, B
1994-05-01
A number of recent reports have indicated a higher risk of sudden infant death syndrome (SIDS) in the prone sleeping position, compared with the supine position. However, the biological mechanisms for this increased risk have not been established. For this report, two biological explanations are proposed, each of which may be influenced by altered sleeping position in such a way that they may create conditions for increased triggering of SIDS.
The Course of Grief in Children Bereaved by Sudden Parental Death
Melhem, Nadine M.; Porta, Giovanna; Shamseddeen, Wael; Payne, Monica Walker; Brent, David A.
2014-01-01
Context There have been major advances in our understanding of the phenomenology and course of grief in adults. However, little is known about the course of grief in children. Objective We report on course and impact of children’s grief reactions following parental sudden death on subsequent psychiatric and functional status. Design Longitudinal study of bereaved children and families with yearly comprehensive assessments up to three years after parental death. Setting Bereaved children and their surviving parents recruited through the coroners’ records and advertisement. Participants 182 parentally bereaved children between 7 and 18 years of age whose parent died from suicide, accident, or sudden natural deaths. Main Exposure Sudden parental death. Main Outcome Measures Grief, functional impairment, incident depression. Results There were 3 distinct trajectories of grief reactions with a group, consisting of 10.4% of the sample, with increased grief reactions that showed no change 33 months post-death. Youths with prolonged grief reactions had higher rates of previous personal history of depression. Prolonged grief made unique contribution to increased levels of functional impairment even after controlling for clinical characteristics antecedent and following the death. Conversely, prolonged grief, both in youths and the surviving caregiver, predisposed to an increased hazard of incident depression. Another group (30%) showed increased grief reactions 9 months following the death, which gradually decreased over time. Despite this, grief reactions in this group were also associated with functional impairment and increased risk of incident depression. Conclusions Grief reactions abate over time for most children bereaved by sudden parental death; however, a subset show increased or prolonged grief reactions, which in turn increases the risk for functional impairment and depression. Research on interventions designed to relieve the burden of grief in bereaved children are needed. Such efforts should also assess and address grief reactions in the surviving parent. PMID:21893658
Ghostly grazers and Sky Islands
Paul S. Martin
2005-01-01
The evolution of the western range involves millions of years of coexistence of herbaceous plants with a great many kinds of large herbivores, most of the latter suddenly removed around 13,000 years ago. The fossil record indicates more diversity of large herbivores before this time, not less, and with more taxa of large herbivores consuming more forage than livestock...
Back muscle response to sudden trunk loading can be modified by training among healthcare workers.
Pedersen, Mogens Theisen; Essendrop, Morten; Skotte, Jørgen H; Jørgensen, Kurt; Schibye, Bente; Fallentin, Nils
2007-06-01
Experimental study of the effect of physical training on the reaction to sudden back loading. To investigate the effect and sustainability of "on the job training" on the reaction to sudden back loading among employees at a geriatric ward. Available data suggest that a delayed muscle reflex response to sudden trunk loading may increase the risk of low back injuries. We have previously shown that training may alter the response to sudden trunk loading in healthy subjects and decrease the time elapsed until stopping of the forward movement of the trunk (stopping time). Data on the possibilities of a training-induced improvement in the reflex response among workers exposed to sudden trunk loading on the job are, however, nonexistent, and there is no evidence of long-term benefits, i.e., the sustainability of a positive training effect. The study included 23 participants and 14 controls. All were healthy without prior history of low back pain (LBP). The training group participated in a total of 18 training sessions during a 9-week period. The training focused on reactions to a variety of sudden trunk loadings. Before and after the training intervention and at a 1-year follow-up, all subjects were tested for their reaction to expected and unexpected sudden trunk loading by applying a horizontal force of 58 N to the upper back of the subjects and measuring the electromyographic (EMG) response from the erector spinae muscles. In the training group, the stopping time and the distance moved after unexpected sudden trunk loading decreased significantly (13%-19%, P = 0.02). The improved stopping time was associated with marked changes in the time-wise distribution of the EMG signal after training. In addition, the follow-up study showed a high sustainability of the training effect. The results demonstrated a training-induced improvement of the response to sudden trunk loading that may be beneficial in workers, such as nurses, who are exposed to sudden trunk perturbations during patient handling.
Sudden generalized lung atelectasis during thoracotomy following thoracic lavage in 3 dogs.
Drynan, Eleanor; Musk, Gabrielle; Raisis, Anthea
2012-08-01
To describe sudden onset of generalized pulmonary atelectasis following thoracic lavage in 3 dogs. Thoracic lavage was performed following ligation of a patent ductus arteriosus in case 1, prior to closure of a large traumatic full thickness wound in the chest wall in case 2, and during investigation of an idiopathic spontaneous pneumothorax in case 3. In each case anesthesia and surgery were uneventful until thoracic lavage was performed, after which sudden generalized pulmonary atelectasis was observed. The atelectasis was visualized and was associated with oxyhemoglobin desaturation, decreased end-tidal carbon dioxide partial pressure (ETCO(2)), and a marked increase in the peak inspiratory pressure (PIP) required to achieve visible lung inflation. Occlusion of the endotracheal tube and cervical trachea was directly eliminated as the cause of atelectasis in cases 1 and 2, and indirectly eliminated in case 3. Improvement in pulmonary function occurred in all cases in response to increased PIP ± positive end expiratory pressure (PEEP). Generalized atelectasis should be considered a possible complication of thoracic lavage performed during thoracotomy. In the cases presented here, it is suspected that pre-existing reduction in lung volume (due to inadequate ventilation, surgical compression, absorption atelectasis) was exacerbated by the addition of the lavage fluid to the thoracic cavity. This pre-existing lung collapse is believed to have resulted in reduction of lung volume and that further reduction below the critical closing volume occurred following instillation of saline into the thorax resulting in the subsequent development of generalized atelectasis. The performance of regular arterial blood gas analyses and different ventilation protocols may have prevented the marked atelectasis that was observed in these cases. © Veterinary Emergency and Critical Care Society 2012.
Yau, James M; Singh, Rajiv; Halpern, Ethan J; Fischman, David
2011-04-01
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital coronary abnormality associated with early infant mortality and adult sudden death. As it predominantly presents in the first year of life, diagnosis in living adults is extremely rare. Current management is based on limited case series or extrapolated from pediatric cases. Modern advances in noninvasive cardiac imaging have substantially increased the number of diagnoses, uncovering a large adult population that has not been reviewed. The availability of newer diagnostic modalities correlates with an increasing incidence in an older cohort, and true association between sudden death and ALCAPA may be lower, especially among older patients. A comprehensive literature search was performed for all case reports of ALCAPA on MEDLINE and PubMed using the keywords ALCAPA, Bland-White-Garland, and coronary anomaly; and augmented by references from published case reports from 1908 to 2008. All adult cases, defined by age 18 years and older, were reviewed for this article. One hundred fifty-one adult cases of ALCAPA are described, in addition to the case of an asymptomatic 53-year-old woman. The average reported age was 41 years old with the oldest being 83. Sixty-six percent of the patients presented with symptoms of angina, dyspnea, palpitations, or fatigue; 17% presented with ventricular arrhythmia, syncope, or sudden death; and 14% were asymptomatic. Twelve percent were diagnosed at autopsy. The majority had some form of surgical correction during their clinical course. ALCAPA is a rare and life-threatening condition in adults. The availability of newer, less invasive diagnostic modalities has resulted in more frequent identification of this condition in an older cohort. © 2011 Wiley Periodicals, Inc.
Drug and Alcohol Abuse in Booming and Depressed Communities. Services Research Report.
ERIC Educational Resources Information Center
Milkman, Raymond H.; And Others
Boom towns appear to have greater problems of substance abuse associated with economic change indicators than communities suffering from sudden economic declines. A study of 14 communities experiencing sudden economic dislocations revealed a lack of consistent trends, although some depressed communities experienced increases in alcohol abuse. In…
Effect of Fungicide Seed Treatments on Fusarium virguliforme and Sudden Death Syndrome of Soybean
USDA-ARS?s Scientific Manuscript database
Sudden death syndrome (SDS) is a yield reducing disease increasing in prevalence across soybean producing states. Recent research indicates the SDS pathogen, Fusarium virguliforme, can infect as early as initial radicle emergence. This suggests fungicide seed treatments could offer some protection a...
Localized sudden changes in the geomagnetic secular variation.
Alldredge, L.R.
1987-01-01
There is much debate as to whether there was a worldwide geomagnetic jerk in 1969 or 1970. It is agreed that there was an unusual sharp change in the secular variation in the east component, Y, in Europe at that time. This note points out how a localized sudden change in the secular variation pattern of one component in Europe can occur without having any large worldwide effects in any of the components. The accompanying changes in the spherical harmonic coefficients for such a localized change are also discussed. -after Author
Pitman, Alexandra; Rantell, Khadija; Marston, Louise; King, Michael; Osborn, David
2017-03-09
The sudden death of a friend or relative, particularly by suicide, is a risk factor for suicide. People who experience sudden bereavement report feeling highly stigmatised by the loss, potentially influencing access to support. We assessed whether perceived stigma following sudden bereavement is associated with suicidal thoughts and suicide attempt. We analysed cross-sectional survey data on 3387 young adults bereaved by the sudden death of a close contact. We tested the association of high versus low perceived stigma (on the stigma sub-scale of the Grief Experience Questionnaire) with post-bereavement suicidal ideation and suicide attempt, using random effects logistic regression, adjusting for socio-demographic factors, pre-bereavement psychopathology, and mode of sudden bereavement (natural causes/unnatural causes/suicide). Subjects with high perceived stigma scores were significantly more likely to report post-bereavement suicidal thoughts (adjusted odds ratio (AOR) = 2.74; 95% confidence interval (CI) = 1.93-3.89) and suicide attempt (AOR = 2.73; 95% CI = 2.33-3.18) than those with low stigma scores. People who feel highly stigmatised by a sudden bereavement are at increased risk of suicidal thoughts and suicide attempt, even taking into account prior suicidal behaviour. General practitioners, bereavement counsellors, and others who support people bereaved suddenly, should consider inquiring about perceived stigma, mental wellbeing, and suicidal thoughts, and directing them to appropriate sources of support.
NASA Astrophysics Data System (ADS)
Li, Huanhuan; Chen, Diyi; Zhang, Hao; Wang, Feifei; Ba, Duoduo
2016-12-01
In order to study the nonlinear dynamic behaviors of a hydro-turbine governing system in the process of sudden load increase transient, we establish a novel nonlinear dynamic model of the hydro-turbine governing system which considers the elastic water-hammer model of the penstock and the second-order model of the generator. The six nonlinear dynamic transfer coefficients of the hydro-turbine are innovatively proposed by utilizing internal characteristics and analyzing the change laws of the characteristic parameters of the hydro-turbine governing system. Moreover, from the point of view of engineering, the nonlinear dynamic behaviors of the above system are exhaustively investigated based on bifurcation diagrams and time waveforms. More importantly, all of the above analyses supply theoretical basis for allowing a hydropower station to maintain a stable operation in the process of sudden load increase transient.
... an inflammation of one or both of your sacroiliac joints — situated where your lower spine and pelvis ... climbing Running Taking large strides Causes Causes for sacroiliac joint dysfunction include: Traumatic injury. A sudden impact, ...
... Over time, weak connective tissue can cause the aorta, the large artery that carries blood away from ... DYE-late), or widen. If not treated, the aorta can suddenly tear, causing blood to leak out. ...
Laryngeal dystonia gravidarum: sudden onset of adductor spasmodic dysphonia in pregnancy.
Ankola, Ashish; Sulica, Lucian; Murry, Thomas
2013-12-01
The purpose of this study was to identify the presence or absence of known factors related to onset of adductor spasmodic dysphonia (ADSD) in a population with sudden onset during or after pregnancy. Retrospective review. A review of 350 patient records identified five patients with sudden onset of ADSD related to pregnancy. An age-matched group with sudden onset of ADSD not related to pregnancy served as controls. All subjects completed a 20-question survey of risk factors relevant to ADSD. The average age of onset in both groups was 31 years. Three had onset of ADSD in the postpartum period, the other two during pregnancy. Significantly increased avocational voice use was found in the pregnant group compared to the control group. There was a significant difference in the two groups regarding cumulative risk factors traditionally associated with ADSD. Sudden onset of ADSD can occur in pregnancy in women with clinical profiles that differ from traditional ADSD patients. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.
Kozuka, Y.; Tsukazaki, A.; Maryenko, D.; ...
2012-02-03
We investigate the spin susceptibility (g*m*) of dilute two-dimensional (2D) electrons confined at the Mg xZn 1-xO/ZnO heterointerface. Magnetotransport measurements show a four-fold enhancement of g*m*, dominated by the increase in the Landé g-factor. The g-factor enhancement leads to a ferromagnetic instability of the electron gas as evidenced by sharp resistance spikes. At high magnetic field, the large g*m* leads to full spin polarization, where we found sudden increase in resistance around the filling factors of half-integer, accompanied by complete disappearance of fractional quantum Hall (QH) states. Along with its large effective mass and the high electron mobility, our resultmore » indicates that the ZnO 2D system is ideal for investigating the effect of electron correlations in the QH regime.« less
Gorter, Florien A; Derks, Martijn F L; van den Heuvel, Joost; Aarts, Mark G M; Zwaan, Bas J; de Ridder, Dick; de Visser, J Arjan G M
2017-10-01
The rate of directional environmental change may have profound consequences for evolutionary dynamics and outcomes. Yet, most evolution experiments impose a sudden large change in the environment, after which the environment is kept constant. We previously cultured replicate Saccharomyces cerevisiae populations for 500 generations in the presence of either gradually increasing or constant high concentrations of the heavy metals cadmium, nickel, and zinc. Here, we investigate how each of these treatments affected genomic evolution. Whole-genome sequencing of evolved clones revealed that adaptation occurred via a combination of SNPs, small indels, and whole-genome duplications and other large-scale structural changes. In contrast to some theoretical predictions, gradual and abrupt environmental change caused similar numbers of genomic changes. For cadmium, which is toxic already at comparatively low concentrations, mutations in the same genes were used for adaptation to both gradual and abrupt increase in concentration. Conversely, for nickel and zinc, which are toxic at high concentrations only, mutations in different genes were used for adaptation depending on the rate of change. Moreover, evolution was more repeatable following a sudden change in the environment, particularly for nickel and zinc. Our results show that the rate of environmental change and the nature of the selection pressure are important drivers of evolutionary dynamics and outcomes, which has implications for a better understanding of societal problems such as climate change and pollution. © The Author 2017. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Jones, Christopher L; Kamper, Derek G
2018-01-01
Finger-thumb coordination is crucial to manual dexterity but remains incompletely understood, particularly following neurological injury such as stroke. While being controlled independently, the index finger and thumb especially must work in concert to perform a variety of tasks requiring lateral or palmar pinch. The impact of stroke on this functionally critical sensorimotor control during dynamic tasks has been largely unexplored. In this study, we explored finger-thumb coupling during close-open pinching motions in stroke survivors with chronic hemiparesis. Two types of perturbations were applied randomly to the index with a novel Cable-Actuated Finger Exoskeleton: a sudden joint acceleration stretching muscle groups of the index finger and a sudden increase in impedance in selected index finger joint(s). Electromyographic signals for specific thumb and index finger muscles, thumb tip trajectory, and index finger joint angles were recorded during each trial. Joint angle perturbations invoked reflex responses in the flexor digitorum superficialis (FDS), first dorsal interossei (FDI), and extensor digitorum communis muscles of the index finger and heteronymous reflex responses in flexor pollicis brevis of the thumb ( p < 0.017). Phase of movement played a role as a faster peak reflex response was observed in FDI during opening than during closing ( p < 0.002) and direction of perturbations resulted in shorter reflex times for FDS and FDI ( p < 0.012) for extension perturbations. Surprisingly, when index finger joint impedance was suddenly increased, thumb tip movement was substantially increased, from 2 to 10 cm ( p < 0.001). A greater effect was seen during the opening phase ( p < 0.044). Thus, involuntary finger-thumb coupling was present during dynamic movement, with perturbation of the index finger impacting thumb activity. The degree of coupling modulated with the phase of motion. These findings reveal a potential mechanism for direct intervention to improve poststroke hand mobility and provide insight on prospective neurologically oriented therapies.
Jones, Christopher L.; Kamper, Derek G.
2018-01-01
Finger–thumb coordination is crucial to manual dexterity but remains incompletely understood, particularly following neurological injury such as stroke. While being controlled independently, the index finger and thumb especially must work in concert to perform a variety of tasks requiring lateral or palmar pinch. The impact of stroke on this functionally critical sensorimotor control during dynamic tasks has been largely unexplored. In this study, we explored finger–thumb coupling during close–open pinching motions in stroke survivors with chronic hemiparesis. Two types of perturbations were applied randomly to the index with a novel Cable-Actuated Finger Exoskeleton: a sudden joint acceleration stretching muscle groups of the index finger and a sudden increase in impedance in selected index finger joint(s). Electromyographic signals for specific thumb and index finger muscles, thumb tip trajectory, and index finger joint angles were recorded during each trial. Joint angle perturbations invoked reflex responses in the flexor digitorum superficialis (FDS), first dorsal interossei (FDI), and extensor digitorum communis muscles of the index finger and heteronymous reflex responses in flexor pollicis brevis of the thumb (p < 0.017). Phase of movement played a role as a faster peak reflex response was observed in FDI during opening than during closing (p < 0.002) and direction of perturbations resulted in shorter reflex times for FDS and FDI (p < 0.012) for extension perturbations. Surprisingly, when index finger joint impedance was suddenly increased, thumb tip movement was substantially increased, from 2 to 10 cm (p < 0.001). A greater effect was seen during the opening phase (p < 0.044). Thus, involuntary finger–thumb coupling was present during dynamic movement, with perturbation of the index finger impacting thumb activity. The degree of coupling modulated with the phase of motion. These findings reveal a potential mechanism for direct intervention to improve poststroke hand mobility and provide insight on prospective neurologically oriented therapies. PMID:29545767
Asynchronous vibration problem of centrifugal compressor
NASA Technical Reports Server (NTRS)
Fujikawa, T.; Ishiguro, N.; Ito, M.
1980-01-01
An unstable asynchronous vibration problem in a high pressure centrifugal compressor and the remedial actions against it are described. Asynchronous vibration of the compressor took place when the discharge pressure (Pd) was increased, after the rotor was already at full speed. The typical spectral data of the shaft vibration indicate that as the pressure Pd increases, pre-unstable vibration appears and becomes larger, and large unstable asynchronous vibration occurs suddenly (Pd = 5.49MPa). A computer program was used which calculated the logarithmic decrement and the damped natural frequency of the rotor bearing systems. The analysis of the log-decrement is concluded to be effective in preventing unstable vibration in both the design stage and remedial actions.
A New Background Stratospheric Aerosol Model for Use in Atmospheric Radiation Models
1988-07-30
I. Soufriere 1979 event, J. Atmos. Terr. Phy, 43:1127- 1131. 19. Hirono, M., Fujiwara, M.,and Shibata, T. (1982) Lidar observation of sudden... Soufriere 1979 event, J. Atmos. Terr. Phy, 43:1127- 1131. 19. Hirono, M., Fujiwara, M.,and Shibata, T. (1982) Lidar observation of sudden increases
77 FR 2521 - Integrated System Power Rates
Federal Register 2010, 2011, 2012, 2013, 2014
2012-01-18
... experienced due to a sudden loss of generation or load. 1.1.5. Supplemental Operating Reserve Service provides... experienced due to a sudden loss of generation or load. 1.1.5. Supplemental Operating Reserve Service provides... Secretary has approved and placed into effect on an interim basis Rate Order No. SWPA-63, which increases...
Autopsies of sudden infant death syndrome--classification and epidemiology.
Hatton, F; Bouvier-Colle, M H; Barois, A; Imbert, M C; Leroyer, A; Bouvier, S; Jougla, E
1995-12-01
An enquiry into sudden infant death syndrome (SIDS) in 1987 furnished us with detailed epidemiological data for 281 cases that underwent a thorough post-mortem examination. This analysis uses these data to evaluate the role the autopsy plays in explaining sudden death. The cases were classified into three diagnostic groups: explained causes of death (group 1), unexplained deaths with anomalies (group 2), and no anomaly (group 3). These 281 cases show the three essential features that characterize SIDS: over-representation of males, increased deaths during the second and third months of life, and increased deaths during winter. The autopsy examination revealed that many of these deaths had a medical explanation. Almost half were assigned to group 1. At the time of autopsy, no precise pathology could be diagnosed for 147 deaths; of these, 140 showed histological anomalies. There were only seven sudden deaths for which no abnormal sign was evident at the autopsy. These results are compared with those of similar studies and discussed in connection with three factors: the initial selection of cases, the nature and degree of the investigations, and the possible interpretations of the symptoms uncovered.
Beer tapping: dynamics of bubbles after impact
NASA Astrophysics Data System (ADS)
Mantič-Lugo, V.; Cayron, A.; Brun, P.-T.; Gallaire, F.
2015-12-01
Beer tapping is a well known prank where a bottle of beer is impacted from the top by a solid object, usually another bottle, leading to a sudden foam overflow. A description of the shock-driven bubble dynamics leading to foaming is presented based on an experimental and numerical study evoking the following physical picture. First, the solid impact produces a sudden downwards acceleration of the bottle creating a strong depression in the liquid bulk. The existing bubbles undergo a strong expansion and a sudden contraction ending in their collapse and fragmentation into a large amount of small bubbles. Second, the bubble clouds present a large surface area to volume ratio, enhancing the CO2 diffusion from the supersaturated liquid, hence growing rapidly and depleting the CO2. The clouds of bubbles migrate upwards in the form of plumes pulling the surrounding liquid with them and eventually resulting in the foam overflow. The sudden pressure drop that triggers the bubble dynamics with a collapse and oscillations is modelled by the Rayleigh-Plesset equation. The bubble dynamics from impact to collapse occurs over a time (tb ≃ 800 μs) much larger than the acoustic time scale of the liquid bulk (tac = 2H/c ≃ 80 μs), for the experimental container of height H = 6 cm and a speed of sound around c ≃ 1500 m/s. This scale separation, together with the comparison of numerical and experimental results, suggests that the pressure drop is controlled by two parameters: the acceleration of the container and the distance from the bubble to the free surface.
Life-Threatening Hypokalemic Paralysis in a Young Bodybuilder
Cheung, Kitty K. T.; So, Wing-Yee; Kong, Alice P. S.; Ma, Ronald C. W.; Chow, Francis C. C.
2014-01-01
We report a case of life-threatening hypokalemia in a 28-year-old bodybuilder who presented with sudden onset bilateral lower limbs paralysis few days after his bodybuilding competition. His electrocardiogram (ECG) showed typical u-waves due to severe hypokalemia (serum potassium 1.6 mmol/L, reference range (RR) 3.5–5.0 mmol/L). He was admitted to the intensive care unit (ICU) and was treated with potassium replacement. The patient later admitted that he had exposed himself to weight loss agents of unknown nature, purchased online, and large carbohydrate loads in preparation for the competition. He made a full recovery after a few days and discharged himself from the hospital against medical advice. The severe hypokalemia was thought to be caused by several mechanisms to be discussed in this report. With the ever rising number of new fitness centers recently, the ease of online purchasing of almost any drug, and the increasing numbers of youngsters getting into the bodybuilding arena, clinicians should be able to recognize the possible causes of sudden severe hypokalemia in these patients in order to revert the pathophysiology. PMID:24660073
Life-threatening hypokalemic paralysis in a young bodybuilder.
Cheung, Kitty K T; So, Wing-Yee; Kong, Alice P S; Ma, Ronald C W; Chow, Francis C C
2014-01-01
We report a case of life-threatening hypokalemia in a 28-year-old bodybuilder who presented with sudden onset bilateral lower limbs paralysis few days after his bodybuilding competition. His electrocardiogram (ECG) showed typical u-waves due to severe hypokalemia (serum potassium 1.6 mmol/L, reference range (RR) 3.5-5.0 mmol/L). He was admitted to the intensive care unit (ICU) and was treated with potassium replacement. The patient later admitted that he had exposed himself to weight loss agents of unknown nature, purchased online, and large carbohydrate loads in preparation for the competition. He made a full recovery after a few days and discharged himself from the hospital against medical advice. The severe hypokalemia was thought to be caused by several mechanisms to be discussed in this report. With the ever rising number of new fitness centers recently, the ease of online purchasing of almost any drug, and the increasing numbers of youngsters getting into the bodybuilding arena, clinicians should be able to recognize the possible causes of sudden severe hypokalemia in these patients in order to revert the pathophysiology.
Turbulent transport models for scramjet flowfields
NASA Technical Reports Server (NTRS)
Sindir, M. M.; Harsha, P. T.
1984-01-01
Turbulence modeling approaches were examined from the standpoint of their capability to predict the complex flowfield features observed in scramjet combustions. Thus, for example, the accuracy of each turbulence model, with respect to the prediction of recirculating flows, was examined. It was observed that for large diameter ratio axisymmetric sudden expansion flows, a choice of turbulence model was not critical because of the domination of their flowfields by pressure forces. For low diameter ratio axisymmetric sudden expansions and planar backward-facing steps flows, where turbulent shear stresses are of greater significance, the algebraic Reynolds stress approach, modified to increase its sensitivity to streamline curvature, was found to provide the best results. Results of the study also showed that strongly swirling flows provide a stringent test of turbulence model assumptions. Thus, although flows with very high swirl are not of great practical interest, they are useful for turbulence model development. Finally, it was also noted that numerical flowfields solution techniques have a strong interrelation with turbulence models, particularly with the turbulent transport models which involve source-dominated transport equations.
Acid rock drainage and climate change
Nordstrom, D. Kirk
2009-01-01
Rainfall events cause both increases and decreases in acid and metals concentrations and their loadings from mine wastes, and unmined mineralized areas, into receiving streams based on data from 3 mines sites in the United States and other sites outside the US. Gradual increases in concentrations occur during long dry spells and sudden large increases are observed during the rising limb of the discharge following dry spells (first flush). By the time the discharge peak has occurred, concentrations are usually decreased, often to levels below those of pre-storm conditions and then they slowly rise again during the next dry spell. These dynamic changes in concentrations and loadings are related to the dissolution of soluble salts and the flushing out of waters that were concentrated by evaporation. The underlying processes, pyrite oxidation and host rock dissolution, do not end until the pyrite is fully weathered, which can take hundreds to thousands of years. These observations can be generalized to predict future conditions caused by droughts related to El Ni??o and climate change associated with global warming. Already, the time period for dry summers is lengthening in the western US and rainstorms are further apart and more intense when they happen. Consequently, flushing of inactive or active mine sites and mineralized but unmined sites will cause larger sudden increases in concentrations that will be an ever increasing danger to aquatic life with climate change. Higher average concentrations will be observed during longer low-flow periods. Remediation efforts will have to increase the capacity of engineered designs to deal with more extreme conditions, not average conditions of previous years.
Interaction of Comets and the Solar Wind
NASA Technical Reports Server (NTRS)
Wagner, William (Technical Monitor); Raymond, John C.
2003-01-01
We had originally planned to analyze UVCS observations of Comet Machholz, but we obtained higher quality observations of Comet Kudo-Fujikawa in January 2003 at its 0.19 AU perihelion. Besides a large and rapidly increasing water outgassing rate, we detected a bright tail in doubly ionized carbon. The amount of carbon was greater than could be accounted for by GO photodissociation, and we attribute the carbon to evaporation of organics from dust. A spectacular disconnection event was apparent in the C III tail, and it coincides within the uncertainties with the position of the heliospheric current sheet. A paper is in press in Science, and it will be the subject of a press release. We are also analyzing two sungrazing comets. Comet C/2001 C2 shows evidence for sub-fragments and for a very long lasting source of neutrals, which we tentatively identify as evaporation of pyroxene dust grains. Comet C/2002 S2 shows a sudden 2 magnitude drop in optical brightness and an equally sudden recovery. UVCS observations during that time show a steadily increasing outgassing rate. We have derived solar wind densities for both comets, but we are still sorting out the ambiguities involving the fragmentation and optical behavior. We are collaborating with Philippe Lamy on the LASCO measurements.
NASA Technical Reports Server (NTRS)
Kramer, Max
1932-01-01
Wind-tunnel tests are described, in which the angle of attack of a wing model was suddenly increased (producing the effect of a vertical gust) and the resulting forces were measured. It was found that the maximum lift coefficient increases in proportion to the rate of increase in the angle of attack. This fact is important for the determination of the gust stresses of airplanes with low wing loading. The results of the calculation of the corrective factor are given for a high-performance glider and a light sport plane of conventional type.
Tereshchenko, Larisa G.; Cygankiewicz, Iwona; McNitt, Scott; Vazquez, Rafael; Bayes-Genis, Antoni; Han, Lichy; Sur, Sanjoli; Couderc, Jean-Philippe; Berger, Ronald D.; de Luna, Antoni Bayes; Zareba, Wojciech
2012-01-01
Background The goal of this study was to determine the predictive value of beat-to-beat QT variability in heart failure (HF) patients across the continuum of left ventricular dysfunction. Methods and Results Beat-to-beat QT variability index (QTVI), heart rate variance (LogHRV), normalized QT variance (QTVN), and coherence between heart rate variability and QT variability have been measured at rest during sinus rhythm in 533 participants of the Muerte Subita en Insuficiencia Cardiaca (MUSIC) HF study (mean age 63.1±11.7; males 70.6%; LVEF >35% in 254 [48%]) and in 181 healthy participants from the Intercity Digital Electrocardiogram Alliance (IDEAL) database. During a median of 3.7 years of follow-up, 116 patients died, 52 from sudden cardiac death (SCD). In multivariate competing risk analyses, the highest QTVI quartile was associated with cardiovascular death [hazard ratio (HR) 1.67(95%CI 1.14-2.47), P=0.009] and in particular with non-sudden cardiac death [HR 2.91(1.69-5.01), P<0.001]. Elevated QTVI separated 97.5% of healthy individuals from subjects at risk for cardiovascular [HR 1.57(1.04-2.35), P=0.031], and non-sudden cardiac death in multivariate competing risk model [HR 2.58(1.13-3.78), P=0.001]. No interaction between QTVI and LVEF was found. QTVI predicted neither non-cardiac death (P=0.546) nor SCD (P=0.945). Decreased heart rate variability (HRV) rather than increased QT variability was the reason for increased QTVI in this study. Conclusions Increased QTVI due to depressed HRV predicts cardiovascular mortality and non-sudden cardiac death, but neither SCD nor excracardiac mortality in HF across the continuum of left ventricular dysfunction. Abnormally augmented QTVI separates 97.5% of healthy individuals from HF patients at risk. PMID:22730411
Maron, Barry J; Rowin, Ethan J; Casey, Susan A; Lesser, John R; Garberich, Ross F; McGriff, Deepa M; Maron, Martin S
2016-01-05
Youthful age has been considered the time of greatest risk for patients with hypertrophic cardiomyopathy (HCM), largely because of the possibility of sudden death. The last 2 decades have witnessed more reliable identification of at-risk patients and utilization of implantable cardioverter-defibrillators for prevention of sudden death, and other contemporary treatment options. Whether such management advances have significantly altered the considerable mortality rate for young HCM patients remains unresolved. We studied long-term outcome in 474 consecutive HCM patients between 7 and 29 years of age presenting at 2 referral institutions. Over 7.1±5.1 years of follow-up (6.0 [3.0, 10.0]), 452 patients (95%) survived, with 95% experiencing no or mild symptoms. HCM-related death occurred in 18 patients (3%; 0.54%/y): arrhythmic sudden death (n=12), progressive heart failure and heart transplant complications (n=5), or postoperatively (n=1). In contrast, aborted life-threatening events occurred in 63 other high-risk patients (13%) with implantable cardioverter-defibrillator interventions for ventricular tachyarrhythmias (n=31), resuscitated out-of-hospital cardiac arrest (n=20), or heart transplant for advanced heart failure (n=12), 1.8%/y, 3-fold higher than HCM mortality. Five- and 10-year survival (considering only HCM deaths) was high (97% and 94%, respectively), virtually identical to that reported in middle-aged adult HCM patients (98% and 94%, P=0.23). In a large hospital-based cohort of young HCM patients, representing an age group considered at greatest risk, low mortality rates can be achieved with the application of contemporary cardiovascular treatment strategies, largely because of reliable identification of high-risk patients who benefited from implantable cardioverter-defibrillators for sudden death prevention, thereby creating the opportunity for extended longevity and good quality of life. © 2015 American Heart Association, Inc.
Racial differences in sudden cardiac death
Fender, Erin A.; Henrikson, Charles A.; Tereshchenko, Larisa
2014-01-01
There is an increased risk of sudden cardiac death (SCD) and sudden cardiac arrest (SCA), in African Americans, the basis of which is likely multifactorial. African Americans have higher rates of traditional cardiac risk factors including hypertension, left ventricular hypertrophy, diabetes, coronary heart disease, and heart failure. There are also significant disparities in health care delivery. While these factors undoubtedly affect health outcomes, there is also growing evidence that genetics may have a significant impact as well. In this paper, we discuss data and hypotheses in support of both sides of the controversy around racial differences in SCD/SCA. PMID:25155390
Perry, Matthew D.; Abi‐Gerges, Najah; Couderc, Jean‐Philippe; Fermini, Bernard; Hancox, Jules C.; Knollmann, Bjorn C.; Mirams, Gary R.; Skinner, Jon; Zareba, Wojciech; Vandenberg, Jamie I.
2016-01-01
Abstract Risk stratification in the context of sudden cardiac death has been acknowledged as one of the major challenges facing cardiology for the past four decades. In recent years, the advent of high performance computing has facilitated organ‐level simulation of the heart, meaning we can now examine the causes, mechanisms and impact of cardiac dysfunction in silico. As a result, computational cardiology, largely driven by the Physiome project, now stands at the threshold of clinical utility in regards to risk stratification and treatment of patients at risk of sudden cardiac death. In this white paper, we outline a roadmap of what needs to be done to make this translational step, using the relatively well‐developed case of acquired or drug‐induced long QT syndrome as an exemplar case. PMID:27060987
Successful Surgical Excision of a Large Cardiac Fibroma in an Asymptomatic Child.
Borodinova, Olga; Ostras, Oleksii; Raad, Tammo; Yemets, Illya
2017-03-01
Cardiac fibroma is a rare disease, and the management of asymptomatic patients is controversial. We report a case of successful surgical excision of a large cardiac fibroma in an asymptomatic child. Surgery should be considered for such a patient, as sudden cardiac death may occur in the absence of premonitory symptoms.
Sudden aspen decline in southwest Colorado
J. J. Worrall; R. A. Mask; T. Eager; L. Egeland; W. D. Shepperd
2008-01-01
Sudden aspen decline (SAD) has increased rapidly in recent years, approaching 350,000 acres in Colorado in 2007, or 13% of the aspen cover type. We investigated the severity, site/stand factors and causes associated with SAD in southwest Colorado. First, we documented landscape (GIS-DEM analyses) and stand factors (stand exams). There was a strong inverse relationship...
Ceelen, Manon; van der Werf, Christian; Hendrix, Anneke; Naujocks, Tatjana; Woonink, Frits; de Vries, Philip; van der Wal, Allard; Das, Kees
2015-08-01
The goal of this study was to ascertain accordance between cause of death established by the forensic physician and autopsy results in young sudden death victims in the Netherlands. Sudden death victims aged 1-45 years examined by forensic physicians operating in the participating regions which also underwent an autopsy between January 2006 and December 2011 were included (n = 70). Cause of death established by the forensic physician based on the external medicolegal examination was compared with autopsy findings using the ICD10-classification. Autopsy findings revealed that the majority of sudden death victims have died from a cardiac disease (n = 51, 73%). Most of the presumed heart disease related cases were confirmed by autopsy (n = 13, 87%). On the contrary, a large number of deaths caused by circulatory diseases were not recognised by the forensic physician (n = 38, 75%). In most of these cases, the forensic physician was forced to report an undetermined cause due to the lack of a solid explanation for death. Cause of death reported by the forensic physician appeared to be in agreement with the autopsy results in 12 cases (17%). Cause of death determination in young sudden death victims is a difficult task for forensic physicians due to the limited tools available during the medicolegal examination. An effort should be made to standardize extensive post-mortem investigation after sudden death in the young. Autopsy can provide valuable information regarding the cause of death, which is of great importance in view of the identification of inheritable diseases among decedents and their families. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
The Molecular Autopsy: Should the Evaluation Continue After the Funeral?
Tester, David J.; Ackerman, Michael J.
2012-01-01
Sudden cardiac death (SCD) is one of the most common causes of death in developed countries, with most SCDs involving the elderly, and structural heart disease evident at autopsy. Each year, however, thousands of sudden deaths involving individuals younger than 35 years of age remain unexplained after a comprehensive medicolegal investigation that includes an autopsy. In fact, several epidemiologic studies have estimated that at least 3% and up to 53% of sudden deaths involving previously healthy children, adolescents, and young adults show no morphologic abnormalities identifiable at autopsy. Cardiac channelopathies associated with structurally normal hearts such as long QT syndrome (LQTS), catecholaminergic polymorphic ventricular tachycardia (CPVT), and Brugada syndrome (BrS) yield no evidence to be found at autopsy, leaving coroners, medical examiners, and forensic pathologists only to speculate that a lethal arrhythmia might lie at the heart of a sudden unexplained death (SUD). In cases of autopsy-negative SUD, continued investigation through either a cardiologic and genetic evaluation of first- or second-degree relatives or a molecular autopsy may elucidate the underlying mechanism contributing to the sudden death and allow for identification of living family members with the pathogenic substrate that renders them vulnerable, with an increased risk for cardiac events including syncope, cardiac arrest, and sudden death. PMID:22307399
Sudden cardiac death in adults with congenital heart disease.
Yap, Sing-Chien; Harris, Louise
2009-12-01
Sudden cardiac death is one of the leading causes of death in patients with congenital heart disease, especially in patients with repaired cyanotic and left heart obstructive lesions. While the overall annual incidence of sudden cardiac death is relatively low, estimated at 0.09% per year, this nonetheless represents a many-fold increase over that of comparable age-matched control populations. The most frequent cause of sudden cardiac death is believed to be arrhythmic, usually ventricular arrhythmia. Most studies investigating risk factors for ventricular arrhythmia and/or sudden cardiac death have focused on patients with repaired tetralogy of Fallot and patients with Mustard/Senning repair for complete transposition of the great arteries. Despite a multitude of risk factors, their predictive value for the occurrence of sudden cardiac death is relatively low. Current experience with implantable cardioverter defibrillators in this patient population is limited to observational studies and the selection of patients for prophylactic implantable cardioverter defibrillator implantation is impeded both by the absence of randomized trials and weak predictors. Catheter ablation of ventricular tachycardia has emerged as a promising therapy for abolishing or reducing the burden of arrhythmia but experience is still limited and the impact on long-term outcome uncertain. Future studies will have to focus on improving risk stratification of patients with congenital heart disease.
Turillazzi, Emanuela; Frati, Paola; Pascale, Natascha; Pomara, Cristoforo; Grilli, Giampaolo; Viola, Rocco Valerio; Fineschi, Vittorio
2016-01-01
Multi-phase post-mortem CT-angiography (MPMCTA) has the great potential to increase the quality of the post-mortem investigation, especially in the area of sudden death; however, its role as routine complement to the pathology toolbox is still questioned as it needs to be further standardized. The aim of this study is to investigate the contribution of MPMCTA in cases of sudden unexplained death in adults and in particular in sudden cardiovascular death. Sixty-eight sudden unexpected deaths of adults were investigated at our institution between 2012 and 2013. Ten cases underwent MPMCTA and autopsy and were included in the study. Before the angiographic step by complete filling of the vascular system, prior to any manipulation of the body, a non-contrast CT-scan was carried out. Image reconstructions were performed on a CT workstation (Vitrea) and two radiologists experienced with post mortem imaging interpreted the MPMCTA findings. In all 10 cases, we could state a good correlation between combination of post-mortem CT and MPMCTA and autopsy procedures, confirming a high diagnostic sensitivity. With this case series we want to illustrate the advantages offered by performing MPMCTA when facing a sudden death, regardless of specific suspicion for acute coronary syndrome or other vascular or ischemic disease. PMID:27928228
Laukkanen, Jari A.; Mäkikallio, Timo H.; Rauramaa, Rainer; Kurl, Sudhir
2009-01-01
Aims Silent electrocardiographic ST change predicts future coronary events in patients with coronary heart disease (CHD), but the prognostic significance of asymptomatic ST-segment depression with respect to sudden cardiac death in subjects without apparent CHD is not well known. Methods and results We investigated the association between silent ST-segment depression during and after maximal symptom-limited exercise test and the risk of sudden cardiac death in a population-based sample of 1769 men without evident CHD. A total of 72 sudden cardiac death occurred during the median follow-up of 18 years. The risk of sudden cardiac death was increased among men with asymptomatic ST-segment depression during exercise [hazard ratio (HR) 2.1, 95% confidence interval (CI) 1.2–3.9] as well as among those with asymptomatic ST-segment depression during recovery period (HR 3.2, 95% CI 1.7–6.0). Asymptomatic ST-depression during exercise testing was a stronger predictor for the risk of sudden cardiac death especially among smokers as well as in hypercholesterolaemic and hypertensive men than in men without these risk factors. Conclusion Asymptomatic ST-segment depression was a very strong predictor of sudden cardiac death in men with any conventional risk factor but no previously diagnosed CHD, emphasizing the value of exercise testing to identify asymptomatic high-risk men who could benefit from preventive measures. PMID:19168533
Risk factors and causes of sudden noncardiac death: A nationwide cohort study in Denmark.
Risgaard, Bjarke; Lynge, Thomas Hadberg; Wissenberg, Mads; Jabbari, Reza; Glinge, Charlotte; Gislason, Gunnar Hilmar; Haunsø, Stig; Winkel, Bo Gregers; Tfelt-Hansen, Jacob
2015-05-01
On the performance of an autopsy, sudden deaths may be divided into 2 classifications: (1) sudden cardiac deaths and (2) sudden noncardiac deaths (SNCDs). Families of SNCD victims should not be followed up as a means of searching for cardiac disease. The purpose of this study was to report the risk factors and causes of SNCD. We conducted a retrospective, nationwide study including all deaths between 2000 and 2006 of individuals aged 1-35 years and all deaths between 2007 and 2009 of individuals aged 1-49 years. Two physicians identified all sudden death cases through review of death certificates. Autopsy reports were collected. A multivariable logistic regression model was used to identify both clinical characteristics and risk factors associated with SNCD. We identified 1039 autopsied cases of sudden death, of which 286 (28%) were classified as SNCD. The median age in the SNCD death population was 32 years. Increasing age was inversely associated with SNCD (odds ratio [OR] 0.93, 95% confidence interval [CI] 0.87-0.98). Female sex, in-hospital location, and the absence of cardiac comorbidities were positively associated with SNCD (OR 1.7, 95% CI 1.3-2.3; OR 3.0, 95% CI 2.0-4.4; and OR 4.3, 95% CI 2.5-7.4, respectively). The most common cause of SNCD was pulmonary disease (n = 115 [40%]). Sudden death among individuals aged <50 years was caused by noncardiac diseases in 28% of cases. Risk factors were female sex, age, and the absence of cardiac comorbidities. These data may guide future strategies for the follow-up of family members of nonautopsied sudden death victims, improve risk stratification, and influence public health strategies. Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
Racial differences in sudden cardiac death.
Fender, Erin A; Henrikson, Charles A; Tereshchenko, Larisa
2014-01-01
There is an increased risk of sudden cardiac death (SCD) and sudden cardiac arrest (SCA), in African Americans, the basis of which is likely multifactorial. African Americans have higher rates of traditional cardiac risk factors including hypertension, left ventricular hypertrophy, diabetes, coronary heart disease, and heart failure. There are also significant disparities in health care delivery. While these factors undoubtedly affect health outcomes, there is also growing evidence that genetics may have a significant impact as well. In this paper, we discuss data and hypotheses in support of both sides of the controversy around racial differences in SCD/SCA. Copyright © 2014 Elsevier Inc. All rights reserved.
Comprehensive Assessment of Coronary Artery Disease in Sports-Related Sudden Cardiac Arrest.
Karam, Nicole; Pechmajou, Louis; Dumas, Florence; Bougouin, Wulfran; Sharifzadehgan, Ardalan; Beganton, Frankie; Bonnet, Guillaume; Jost, Daniel; Lamhaut, Lionel; Varenne, Olivier; Aubry, Pierre; Sideris, Georgios; Spaulding, Christian; Cariou, Alain; Marijon, Eloi; Jouven, Xavier
2018-05-02
Despite the cardiovascular benefits of regular sports, sudden cardiac arrest (SCA) risk is increased during or shortly after exercise. Association with coronary artery disease (CAD) has been described in small studies, mainly autopsic with potential bias given the high sports-related SCA survival, and focusing on young competitive athletes, whereas sports-related SCA occurs mostly in recreational athletes. 1-5 Through the Paris Sudden Death Expertise Center prospective registry that includes all SCAs in Paris and suburbs since May 2011, we performed the first broad comprehensive CAD description in sports-related SCAs, with a comparison with matched non-sports-related SCAs.
Schweitzer, P
2006-12-01
The management of ventricular tachyarrhythmias and prevention of sudden cardiac death after acute myocardial infarction (AMI) underwent important evolution. In the CAST study, encanaide and other antiarrhythmic drugs were not only ineffective but also increased mortality after myocardial infarction. Amiodarone had some beneficial effect on arrhythmic events without improving survival, and ICDs failed to improve outcome early after AMI. In comparison, short and long term survival benefits of beta blockers, angiotensine converting enzyme inhibitors and aldosterone antagonists after AMI is well established. This review discusses the role of non-arrhythmic therapy in the prevention of ventricular tachyarrhythmia's and sudden cardiac death after AMI.
Large intraparotid facial nerve schwannoma: case report and review of the literature.
Salemis, N S; Karameris, A; Gourgiotis, S; Stavrinou, P; Nazos, K; Vlastarakos, P; Tsiambas, E; Tsohataridis, E
2008-07-01
Here is reported an extremely rare case of a large intraparotid facial nerve schwannoma in a 32-year-old female who presented with a parotid mass. There had been a long clinical course and sudden onset of facial weakness. Diagnostic evaluation and surgical management are discussed along with a brief review of the literature.
Fire behavioral changes as a result of sudden oak death in coastal California forests
Y. Vlachovic; C. Lee; H. Scanlon; J.M. Varner; R. Glebocki; B.D. Graham; D.M. Rizzo
2013-01-01
Field observations and anecdotal evidence suggest that sudden oak death (SOD), a disease caused by the pathogen Phytophthora ramorum, may alter fuel loading in affected forests. Though it is reasonable to assume that a disease resulting in leaf blight, dead branches, and tree mortality would increase forest fuels, little work has been done to...
Effects of Sudden Oak Death on the crown fire ignition potential of tanoak (Lithocarpus densiflorus)
Howard Kuljian; J. Morgan Varner
2010-01-01
In the face of the sudden oak death (SOD) epidemic, decreasing foliar moisture content (FMC) of tanoak (Lithocarpus densiflorus) has land managers, fire managers, and property owners concerned with the increased possibility of crown fire in affected areas. A need exists to link local SOD-affected foliar moisture content (FMC) values and current FMC...
Risk stratification for sudden death in arrhythmogenic right ventricular cardiomyopathy.
Cadrin-Tourigny, Julia; Tadros, Rafik; Talajic, Mario; Rivard, Lena; Abadir, Sylvia; Khairy, Paul
2015-06-01
Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC) is an uncommon but increasingly recognized inherited cardiomyopathy that is associated with malignant ventricular arrhythmias and sudden cardiac death, particularly in young individuals. The implantable cardioverter-defibrillator (ICD) is widely regarded as the only treatment modality with evidence to support improved survival in patients with ARVC and secondary prevention indications. In contrast, there is no universally accepted risk stratification scheme to guide ICD therapy for primary prevention against sudden cardiac death. Potential benefits must be weighed against the considerable risks of complications and inappropriate shocks in this young patient population. This article tackles the challenges of risk stratification for sudden cardiac death in ARVC and critically appraises available evidence for various proposed risk factors. The authors' over-arching objective is to provide the clinician with evidence-based guidance to inform decisions regarding the selection of appropriate candidates with ARVC for ICD therapy.
Sudden death in Lesch-Nyhan disease.
Neychev, Vladimir Kostadinov; Jinnah, H A
2006-11-01
To increase awareness of sudden and unexpected death in Lesch-Nyhan disease (LND) and to explore its potential causes, we report the anteceding clinical features and laboratory evaluations of five males with LND who ultimately experienced sudden and unexpected death, along with three additional males who suffered serious respiratory events during life. The ages of patients ranged from 2 to 45 years. The cause of sudden death in LND appears to have a respiratory rather than a cardiogenic basis. All cases cannot be linked readily with a single respiratory process. Instead, different respiratory processes appear to operate in different cases. These may include aspiration, laryngospasm, central apnea, cyanotic breath-holding spells, and high cervical spine damage. Better recognition of these processes will help to guide appropriate workup and management that could include chest imaging, endoscopy of the airways, polysomnography, electroencephalogram, and brain and/or spine imaging.
Stratification of the Risk of Sudden Death in Nonischemic Heart Failure
Pimentel, Maurício; Zimerman, Leandro Ioschpe; Rohde, Luis Eduardo
2014-01-01
Despite significant therapeutic advancements, heart failure remains a highly prevalent clinical condition associated with significant morbidity and mortality. In 30%-40% patients, the etiology of heart failure is nonischemic. The implantable cardioverter-defibrillator (ICD) is capable of preventing sudden death and decreasing total mortality in patients with nonischemic heart failure. However, a significant number of patients receiving ICD do not receive any kind of therapy during follow-up. Moreover, considering the situation in Brazil and several other countries, ICD cannot be implanted in all patients with nonischemic heart failure. Therefore, there is an urgent need to identify patients at an increased risk of sudden death because these would benefit more than patients at a lower risk, despite the presence of heart failure in both risk groups. In this study, the authors review the primary available methods for the stratification of the risk of sudden death in patients with nonischemic heart failure. PMID:25352509
Wood, Angela M; Pasupathy, Dharmintra; Pell, Jill P; Fleming, Michael
2012-01-01
Objectives To compare changes in inequalities in sudden infant death syndrome with other causes of infant mortality and stillbirth in Scotland, 1985-2008. Design Retrospective cohort study. Setting Scotland 1985-2008, analysed by four epochs of six years. Participants Singleton births of infants with birth weight >500 g born at 28-43 weeks’ gestation. Main outcome measures Sudden infant death syndrome, other causes of postneonatal infant death, neonatal death, and stillbirth. Odds ratios expressed as the association across the range of seven categories of Carstairs deprivation score. Results The association between deprivation and the risk of all cause stillbirth and infant death varied between the four epochs (P=0.04). This was wholly explained by variation in the risk of sudden infant death syndrome (P<0.001 for interaction). Among women living in areas of low deprivation, there was a sharp decline in the rate of sudden infant death syndrome from 1990 to 1993. Among women living in areas of high deprivation, there was a slower decline in sudden infant death syndrome rates between 1992 and 2004. Consequently, the odds ratio for the association between socioeconomic deprivation and sudden infant death syndrome increased from 2.04 (95% confidence interval 1.53 to 2.72) in 1985-90, to 7.52 (4.62 to 12.25) in 1991-6, and 9.50 (5.46 to 16.53) in 1997-2002 but fell to 1.78 (0.87 to 3.65) in 2002-8. The interaction remained significant after adjustment for maternal characteristics. Conclusion The rate of sudden infant death syndrome declined throughout Scotland in the early 1990s. The decline had a later onset and was slower among women living in areas of high deprivation, probably because of slower uptake of recommended changes in infant sleeping position. The effect was to create a strong independent association between deprivation and sudden infant death syndrome where one did not exist before. PMID:22427307
Wood, Angela M; Pasupathy, Dharmintra; Pell, Jill P; Fleming, Michael; Smith, Gordon C S
2012-03-16
To compare changes in inequalities in sudden infant death syndrome with other causes of infant mortality and stillbirth in Scotland, 1985-2008. Retrospective cohort study. Scotland 1985-2008, analysed by four epochs of six years. Singleton births of infants with birth weight >500 g born at 28-43 weeks' gestation. Sudden infant death syndrome, other causes of postneonatal infant death, neonatal death, and stillbirth. Odds ratios expressed as the association across the range of seven categories of Carstairs deprivation score. The association between deprivation and the risk of all cause stillbirth and infant death varied between the four epochs (P=0.04). This was wholly explained by variation in the risk of sudden infant death syndrome (P<0.001 for interaction). Among women living in areas of low deprivation, there was a sharp decline in the rate of sudden infant death syndrome from 1990 to 1993. Among women living in areas of high deprivation, there was a slower decline in sudden infant death syndrome rates between 1992 and 2004. Consequently, the odds ratio for the association between socioeconomic deprivation and sudden infant death syndrome increased from 2.04 (95% confidence interval 1.53 to 2.72) in 1985-90, to 7.52 (4.62 to 12.25) in 1991-6, and 9.50 (5.46 to 16.53) in 1997-2002 but fell to 1.78 (0.87 to 3.65) in 2002-8. The interaction remained significant after adjustment for maternal characteristics. The rate of sudden infant death syndrome declined throughout Scotland in the early 1990s. The decline had a later onset and was slower among women living in areas of high deprivation, probably because of slower uptake of recommended changes in infant sleeping position. The effect was to create a strong independent association between deprivation and sudden infant death syndrome where one did not exist before.
Field-aligned particle currents near an auroral arc.
NASA Technical Reports Server (NTRS)
Choy, L. W.; Arnoldy, R. L.; Potter, W.; Kintner, P.; Cahill, L. J., Jr.
1971-01-01
A Nike-Tomahawk rocket equipped to measure electric and magnetic fields and charged particles from a few eV to several hundred keV energy was flown into an auroral band on April 11, 1970. The purpose of this flight was to obtain evidence of the low-energy electrons and protons that constitute a field-aligned sheet current, and also to obtain the magnetic signature of such a current and the electric field in and near the auroral-arc electric current system. Particular attention was given to a sudden increase in the field-aligned current associated with a prior sudden increase in the electric field and a sudden change in the magnetic field, all occurring near the edge of a visual auroral arc. Data obtained are discussed and analyzed; they present an important contribution to the problem of mapping of atmospheric auroral phenomena to the magnetospheric equatorial plane.
An Analysis of the Second Project High Water Data
NASA Technical Reports Server (NTRS)
Woodbridge, David D.; Lasater, James A.; Fultz, Bennett M.; Clark, Richard E.; Wylie, Nancy
1963-01-01
Early in 1962 NASA established "Project High Water" to investigate the sudden release of large quantities of water into the upper atmosphere. The primary objectives of these experiments were to obtain information on the behavior of liquids released in the ionosphere and the localized effects on the ionosphere produced by the injection of large quantities of water. The data obtained in the two (2) Project High Water experiments have yielded an extensive amount of information concerning the complex phenomena associated with the sudden release of liquids in the Ionosphere. The detailed analysis of data obtained during the second Project High Water experiment (i.e., the third Saturn I vehicle test or SA-3) presented in this report demonstrates that the objectives of the Project High Water were achieved. In addition, the Project High Water has provided essential information relevant to a number of problems vital to manned explorations of space.
NASA Astrophysics Data System (ADS)
Wang, Hao; Todo, Yasushi; Ido, Takeshi; Suzuki, Yasuhiro
2018-04-01
Energetic-particle-driven geodesic acoustic modes (EGAMs) observed in a Large Helical Device experiment are investigated using a hybrid simulation code for energetic particles interacting with a magnetohydrodynamic (MHD) fluid. The frequency chirping of the primary mode and the sudden excitation of the half-frequency secondary mode are reproduced for the first time with the hybrid simulation using the realistic physical condition and the three-dimensional equilibrium. Both EGAMs have global spatial profiles which are consistent with the experimental measurements. For the secondary mode, the bulk pressure perturbation and the energetic particle pressure perturbation cancel each other out, and thus the frequency is lower than the primary mode. It is found that the excitation of the secondary mode does not depend on the nonlinear MHD coupling. The secondary mode is excited by energetic particles that satisfy the linear and nonlinear resonance conditions, respectively, for the primary and secondary modes.
Wang, Hao; Todo, Yasushi; Ido, Takeshi; Suzuki, Yasuhiro
2018-04-27
Energetic-particle-driven geodesic acoustic modes (EGAMs) observed in a Large Helical Device experiment are investigated using a hybrid simulation code for energetic particles interacting with a magnetohydrodynamic (MHD) fluid. The frequency chirping of the primary mode and the sudden excitation of the half-frequency secondary mode are reproduced for the first time with the hybrid simulation using the realistic physical condition and the three-dimensional equilibrium. Both EGAMs have global spatial profiles which are consistent with the experimental measurements. For the secondary mode, the bulk pressure perturbation and the energetic particle pressure perturbation cancel each other out, and thus the frequency is lower than the primary mode. It is found that the excitation of the secondary mode does not depend on the nonlinear MHD coupling. The secondary mode is excited by energetic particles that satisfy the linear and nonlinear resonance conditions, respectively, for the primary and secondary modes.
Hypertrophic Cardiomyopathy: Clinical Update.
Geske, Jeffrey B; Ommen, Steve R; Gersh, Bernard J
2018-05-01
Hypertrophic cardiomyopathy (HCM) is the most common heritable cardiomyopathy, manifesting as left ventricular hypertrophy in the absence of a secondary cause. The genetic underpinnings of HCM arise largely from mutations of sarcomeric proteins; however, the specific underlying mutation often remains undetermined. Patient presentation is phenotypically diverse, ranging from asymptomatic to heart failure or sudden cardiac death. Left ventricular hypertrophy and abnormal ventricular configuration result in dynamic left ventricular outflow obstruction in most patients. The goal of therapeutic interventions is largely to reduce dynamic obstruction, with treatment modalities spanning lifestyle modifications, pharmacotherapies, and septal reduction therapies. A small subset of patients with HCM will experience sudden cardiac death, and risk stratification remains a clinical challenge. This paper presents a clinical update for diagnosis, family screening, clinical imaging, risk stratification, and management of symptoms in patients with HCM. Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Type II Radio Bursts as Indicators of Space Weather Drivers
NASA Astrophysics Data System (ADS)
Gopalswamy, N.
2015-12-01
Interplanetary type II radio bursts are important indicators of shock-driving coronal mass ejections (CMEs). CME-driven shocks are responsible for large solar energetic particle (SEP) events and sudden commencement/sudden impulse events recorded by ground magnetometers. The excellent overlap of the spatial domains probed by SOHO/STEREO coronagraphs with the spectral domains of Wind/WAVES and STEREO/WAVES has contributed enormously in understanding CMEs and shocks as space weather drivers. This paper is concerned with type II bursts of solar cycle 23 and 24 that had emission components down to kilometric wavelengths. CMEs associated with these bursts seem to be the best indicators of large SEP events, better than the halo CMEs. However, there are some differences between the type II bursts of the two cycles, which are explained based on the different states of the heliosphere in the two cycles. Finally, the type II burst characteristics of some recent extreme events are discussed.
Ahmad, Tariq; Fiuzat, Mona; Neely, Ben; Neely, Megan; Pencina, Michael J.; Kraus, William E.; Zannad, Faiez; Whellan, David J.; Donahue, Mark; Piña, Ileana L.; Adams, Kirkwood; Kitzman, Dalane W.; O’Connor, Christopher M.; Felker, G. Michael
2014-01-01
Objective To determine whether biomarkers of myocardial stress and fibrosis improve prediction of mode of death in patients with chronic heart failure. Background The two most common modes of death in patients with chronic heart failure are pump failure and sudden cardiac death. Prediction of mode of death may facilitate treatment decisions. The relationship between NT-proBNP, galectin-3, and ST2, biomarkers that reflect different pathogenic pathways in heart failure (myocardial stress and fibrosis), and mode of death is unknown. Methods HF-ACTION was a randomized controlled trial of exercise training vs. usual care in patients with chronic heart failure due to left ventricular systolic dysfunction (LVEF<35%). An independent clinical events committee prospectively adjudicated mode of death. NT-proBNP, galectin-3, and ST2 levels were assessed at baseline in 813 subjects. Associations between biomarkers and mode of death were assessed using cause-specific Cox-proportional hazards modeling, and interaction testing was used to measure differential association between biomarkers and pump failure versus sudden cardiac death. Discrimination and risk reclassification metrics were used to assess the added value of galectin-3 and ST2 in predicting mode of death risk beyond a clinical model that included NT-proBNP. Results After a median follow up of 2.5 years, there were 155 deaths: 49 from pump failure 42 from sudden cardiac death, and 64 from other causes. Elevations in all biomarkers were associated with increased risk of both pump failure and sudden cardiac death in both adjusted and unadjusted analyses. In each case, increases in the biomarker had a stronger association with pump failure than sudden cardiac death but this relationship was attenuated after adjustment for clinical risk factors. Clinical variables along with NT-proBNP levels were stronger predictors of pump failure (C statistic: 0.87) than sudden cardiac death (C statistic: 0.73). Addition of ST2 and galectin-3 led to improved net risk classification of 11% for sudden cardiac death, but not pump failure. Conclusions Clinical predictors along with NT-proBNP levels were strong predictors of pump failure risk, with insignificant incremental contributions of ST2 and galectin-3. Predictability of sudden cardiac death risk was less robust and enhanced by information provided by novel biomarkers. PMID:24952693
Santhanam, Rakesh; Luu, Van Thi; Weinhold, Arne; Goldberg, Jay; Oh, Youngjoo; Baldwin, Ian T.
2015-01-01
Plants maintain microbial associations whose functions remain largely unknown. For the past 15 y, we have planted the annual postfire tobacco Nicotiana attenuata into an experimental field plot in the plant’s native habitat, and for the last 8 y the number of plants dying from a sudden wilt disease has increased, leading to crop failure. Inadvertently we had recapitulated the common agricultural dilemma of pathogen buildup associated with continuous cropping for this native plant. Plants suffered sudden tissue collapse and black roots, symptoms similar to a Fusarium–Alternaria disease complex, recently characterized in a nearby native population and developed into an in vitro pathosystem for N. attenuata. With this in vitro disease system, different protection strategies (fungicide and inoculations with native root-associated bacterial and fungal isolates), together with a biochar soil amendment, were tested further in the field. A field trial with more than 900 plants in two field plots revealed that inoculation with a mixture of native bacterial isolates significantly reduced disease incidence and mortality in the infected field plot without influencing growth, herbivore resistance, or 32 defense and signaling metabolites known to mediate resistance against native herbivores. Tests in a subsequent year revealed that a core consortium of five bacteria was essential for disease reduction. This consortium, but not individual members of the root-associated bacteria community which this plant normally recruits during germination from native seed banks, provides enduring resistance against fungal diseases, demonstrating that native plants develop opportunistic mutualisms with prokaryotes that solve context-dependent ecological problems. PMID:26305938
DOE Office of Scientific and Technical Information (OSTI.GOV)
Sheeley, N. R. Jr.; Wang, Y.-M.
The quiet nature of sunspot cycle 24 was disrupted during the second half of 2014 when the Sun’s large-scale field underwent a sudden rejuvenation: the solar mean field reached its highest value since 1991, the interplanetary field strength doubled, and galactic cosmic rays showed their strongest 27-day modulation since neutron-monitor observations began in 1957; in the outer corona, the large increase of field strength was reflected by unprecedentedly large numbers of coronal loops collapsing inward along the heliospheric current sheet. Here, we show that this rejuvenation was not caused by a significant increase in the level of solar activity asmore » measured by the smoothed sunspot number and CME rate, but instead was caused by the systematic emergence of flux in active regions whose longitudinal distribution greatly increased the Sun’s dipole moment. A similar post-maximum increase in the dipole moment occurred during each of the previous three sunspot cycles, and marked the start of the declining phase of each cycle. We note that the north–south component of this peak dipole moment provides an early indicator of the amplitude of the next cycle, and conclude that the amplitude of cycle 25 may be comparable to that of cycle 24, and well above the amplitudes obtained during the Maunder Minimum.« less
Investigation of GICs Associated with Large dB/dt Variations in Space
NASA Astrophysics Data System (ADS)
Dimitrakoudis, S.; Mann, I. R.; Murphy, K. R.; Rae, J.; Denton, M.; Milling, D. K.
2016-12-01
Geomagnetically induced currents (GICs) can be driven in terrestrial electrical power grids as a result of the induced electric fields arising from magnetic field changes driven in the coupled magnetosphere-ionosphere-ground system. Substorms are often hypothesised to be associated with the largest GIC effects on the ground, especially at higher latitudes. However, recent studies have suggested that other dayside phenomena such as sudden impulses and even ULF wave trains might also drive significant GICs. Using data from the CARISMA ground-based magnetometer network we examine the GIC response driven from a variety of magnetospheric processes. In particular we focus on events where large dB/dt is observed in-situ on GOES East and West satellites. Auroras, resulting from magnetospheric substorms, give us a dynamical view of sudden destabilizations in the nightside magnetosphere, of large spatial and temporal extent, that can drive large and potentially damaging geomagnetically induced currents (GICs) in terrestrial power grids. Since ground dB/dt can be used as a GIC proxy, we have surveyed GOES data since 2011 for the largest dB/dT events, and found some to be of the order of hundreds of nT in the span of a few seconds. These are observed in both the nightside and dayside, and, as such, we seek to establish connections to drivers affecting both sides of the terminator; tail activations and substorms on the nightside, large amplitude ULF waves, solar wind sudden impulses, and rapid changes in MIC current systems on the dayside. The short duration of these events, coupled with the use of conjugate satellite measurements and ground magnetometer arrays when possible, allows us to investigate their localization and the latitudinal extent of their effects and to further examine the potential role of non-substorm phenomena in generating GICs which may have adverse impacts in electrical power grids.
NASA Astrophysics Data System (ADS)
Buckley, Bruce W.; Leslie, Lance M.
2000-03-01
The accurate prediction of sudden large changes in the maximum temperature from one day to the next remains one of the major challenges for operational forecasters. It is probably the meteorological parameter most commonly verified and used as a measure of the skill of a meteorological service and one that is immediately evident to the general public. Marked temperature changes over a short period of time have widespread social, economic, health and safety effects on the community. The first part of this paper describes a 40-year climatology for Sydney, Australia, of sudden temperature rises and falls, defined as maximum temperature changes of 5°C or more from one day to the next, for the months of September and October. The nature of the forecasting challenge during the period of the Olympic and Paralympic Games to be held in Sydney in the year 2000 will be described as a special application. The international importance of the accurate prediction of all types of significant weather phenomena during this period has been recognized by the World Meteorological Organisation's Commission for Atmospheric Science. The first World Weather Research Program forecast demonstration project is to be established in the Sydney Office of the Bureau of Meteorology over this period in order to test the ability of existing systems to predict such phenomena. The second part of this study investigates two case studies from the Olympic months in which there were both abrupt temperature rises and falls over a 4-day interval. Currently available high resolution numerical weather prediction systems are found to have significant skill several days ahead in predicting a large amount of the detail of these events, provided they are run at an appropriate resolution. The limitations of these systems are also discussed, with areas requiring further development being identified if the desired levels of accuracy of predictions are to be reliably delivered. Differences between the predictability of sudden temperature rises and sudden temperature falls are also explored.
The eastern front of the Sierra Nevada; prone to earthquakes and volcanic eruption
Rinehart, C.D.; Smith, W.C.
1981-01-01
On Sunday morning, May 25, 1980, the weather at Mammoth Lakes, Calif., was sunny and brisk. Suddenly, just before 9:33 a.m, the world became a jarring, lurching, unstable place. Along the front of the Sierra Nevada, the muffled thunder of rockfalls and avalanches prolonged the confusion of sound and motion and added the spectacle of large, rising dust clouds. Three geysers, one 30 ft high, suddenly roared into the air at Hot Creek, although none survived more than a few hours. Some new boiling pools appeared, while many existing hot springs and pools became hotter and more active.
Seasonal Timing of Infant Bronchiolitis, Apnea and Sudden Unexplained Infant Death
Sloan, Chantel D.; Gebretsadik, Tebeb; Rosas-Salazar, Christian; Wu, Pingsheng; Carroll, Kecia N.; Mitchel, Edward; Anderson, Larry J.; Larkin, Emma K.; Hartert, Tina V.
2016-01-01
Rates of Sudden Unexplained Infant Death (SUID), bronchiolitis, and central apnea increase in winter in temperate climates. Though associations between these three conditions are suggested, more work is required to establish if there is a causal pathway linking bronchiolitis to SUID through inducing central apnea. Utilizing a large population-based cohort of infants studied over a 20-year period (n = 834,595, from birth years 1989–2009)), we analyzed ecological associations between timing of SUID cases, bronchiolitis, and apnea healthcare visits. Data were analyzed between 2013 and 2015. We used a Cox Proportional Hazards model to analyze possible interactions between maternal smoking and maternal asthma with infant bronchiolitis on time to SUID. SUID and bronchiolitis both occurred more frequently in winter. An increase in bronchiolitis clinical visits occurred within a few days prior to apnea visits. We found a temporal relationship between infant bronchiolitis and apnea. In contrast, no peak in SUID cases was seen during peaks of bronchiolitis. Among those without any bronchiolitis visits, maternal smoking was associated with an increased risk of SUID: Hazard Ratio (HR) of 2.38 (95% CI: 2.11, 2.67, p-value <0.001). Maternal asthma was associated with an increased risk of SUID among infants with at least one bronchiolitis visit: HR of 2.40 (95% CI: 1.04, 5.54, p-value = 0.04). Consistent trends between bronchiolitis, apnea, and SUID were not established due to small numbers of SUID cases. However, interaction analysis revealed potential differential associations of bronchiolitis and SUID by maternal smoking, maternal asthma status. PMID:27404386
Potential asphyxia and brainstem abnormalities in sudden and unexpected death in infants.
Randall, Bradley B; Paterson, David S; Haas, Elisabeth A; Broadbelt, Kevin G; Duncan, Jhodie R; Mena, Othon J; Krous, Henry F; Trachtenberg, Felicia L; Kinney, Hannah C
2013-12-01
Sudden and unexplained death is a leading cause of infant mortality. Certain characteristics of the sleep environment increase the risk for sleep-related sudden and unexplained infant death. These characteristics have the potential to generate asphyxial conditions. We tested the hypothesis that infants may be exposed to differing degrees of asphyxia in sleep environments, such that vulnerable infants with a severe underlying brainstem deficiency in serotonergic, γ-aminobutyric acid-ergic, or 14-3-3 transduction proteins succumb even without asphyxial triggers (e.g., supine), whereas infants with intermediate or borderline brainstem deficiencies require asphyxial stressors to precipitate death. We classified cases of sudden infant death into categories relative to a "potential asphyxia" schema in a cohort autopsied at the San Diego County Medical Examiner's Office. Controls were infants who died with known causes of death established at autopsy. Analysis of covariance tested for differences between groups. Medullary neurochemical abnormalities were present in both infants dying suddenly in circumstances consistent with asphyxia and infants dying suddenly without obvious asphyxia-generating circumstances. There were no differences in the mean neurochemical measures between these 2 groups, although mean measures were both significantly lower (P < .05) than those of controls dying of known causes. We found no direct relationship between the presence of potentially asphyxia conditions in the sleep environment and brainstem abnormalities in infants dying suddenly and unexpectedly. Brainstem abnormalities were associated with both asphyxia-generating and non-asphyxia generating conditions. Heeding safe sleep messages is essential for all infants, especially given our current inability to detect underlying vulnerabilities.
Potential Asphyxia and Brainstem Abnormalities in Sudden and Unexpected Death in Infants
Randall, Bradley B.; Paterson, David S.; Haas, Elisabeth A.; Broadbelt, Kevin G.; Duncan, Jhodie R.; Mena, Othon J.; Krous, Henry F.; Trachtenberg, Felicia L.
2013-01-01
OBJECTIVE: Sudden and unexplained death is a leading cause of infant mortality. Certain characteristics of the sleep environment increase the risk for sleep-related sudden and unexplained infant death. These characteristics have the potential to generate asphyxial conditions. We tested the hypothesis that infants may be exposed to differing degrees of asphyxia in sleep environments, such that vulnerable infants with a severe underlying brainstem deficiency in serotonergic, γ-aminobutyric acid-ergic, or 14-3-3 transduction proteins succumb even without asphyxial triggers (eg, supine), whereas infants with intermediate or borderline brainstem deficiencies require asphyxial stressors to precipitate death. METHODS: We classified cases of sudden infant death into categories relative to a “potential asphyxia” schema in a cohort autopsied at the San Diego County Medical Examiner’s Office. Controls were infants who died with known causes of death established at autopsy. Analysis of covariance tested for differences between groups. RESULTS: Medullary neurochemical abnormalities were present in both infants dying suddenly in circumstances consistent with asphyxia and infants dying suddenly without obvious asphyxia-generating circumstances. There were no differences in the mean neurochemical measures between these 2 groups, although mean measures were both significantly lower (P < .05) than those of controls dying of known causes. CONCLUSIONS: We found no direct relationship between the presence of potentially asphyxia conditions in the sleep environment and brainstem abnormalities in infants dying suddenly and unexpectedly. Brainstem abnormalities were associated with both asphyxia-generating and non–asphyxia generating conditions. Heeding safe sleep messages is essential for all infants, especially given our current inability to detect underlying vulnerabilities. PMID:24218471
Is there an association between depression and cardiovascular mortality or sudden death?
Alboni, Paolo; Favaron, Elisa; Paparella, Nelly; Sciammarella, Massimo; Pedaci, Mario
2008-04-01
The results of many studies and recent meta-analyses strongly suggest that depression is a risk factor for total and cardiovascular mortality, both in the general population and in patients with known heart disease. By contrast, the association between depression and sudden death or cardiac arrest has received little attention. This issue has been investigated in three recent studies; two were carried out in the general population and showed depression to be a independent risk factor for sudden death. The other study was carried out in patients with acute myocardial infarction (AMI); the adjusted relative risk (RR) of sudden death was significantly increased in depressed patients but, after adjustment for dyspnea/fatigue (a common symptom for heart disease and depression), the RR was no longer statistically significant. However, when the cognitive-affective depressive symptoms were examined separately from the somatic ones (dyspnea/fatigue, etc.), there was a clear trend for an association between cognitive-affective symptoms and sudden death. Because a risk factor can be defined as 'independent' only in a multivariate analysis in which variables are dichotomized, the presence of common symptoms between heart disease and depression represents a very difficult problem. However, taken together, the results of studies carried out in the general population and in patients with AMI strongly suggest that depression is a significant risk factor for sudden death.
Accounting Profession: Oversight, Auditor Independence, and Financial Reporting Issues
2002-05-03
oversight of the accounting profession, auditor independence, and selected financial reporting matters. The sudden and largely unexpected bankruptcy of the...Enron Corporation (Enron) and other large corporations financial reporting restatements have raised questions about the soundness of the current self...regulatory and financial reporting systems and resulted in substantial losses to employees, shareholders, and other investors. These events have also
... headaches, increased thirst or urination, vision changes, decreased sex drive fast heartbeat, increased appetite, sudden weight loss, feeling hot, mood changes muscle weakness, numbness or tingling in ...
Hill, Adam P; Perry, Matthew D; Abi-Gerges, Najah; Couderc, Jean-Philippe; Fermini, Bernard; Hancox, Jules C; Knollmann, Bjorn C; Mirams, Gary R; Skinner, Jon; Zareba, Wojciech; Vandenberg, Jamie I
2016-12-01
Risk stratification in the context of sudden cardiac death has been acknowledged as one of the major challenges facing cardiology for the past four decades. In recent years, the advent of high performance computing has facilitated organ-level simulation of the heart, meaning we can now examine the causes, mechanisms and impact of cardiac dysfunction in silico. As a result, computational cardiology, largely driven by the Physiome project, now stands at the threshold of clinical utility in regards to risk stratification and treatment of patients at risk of sudden cardiac death. In this white paper, we outline a roadmap of what needs to be done to make this translational step, using the relatively well-developed case of acquired or drug-induced long QT syndrome as an exemplar case. © 2016 The Authors. The Journal of Physiology published by John Wiley & Sons Ltd on behalf of The Physiological Society.
Sudden spreading of infections in an epidemic model with a finite seed fraction
NASA Astrophysics Data System (ADS)
Hasegawa, Takehisa; Nemoto, Koji
2018-03-01
We study a simple case of the susceptible-weakened-infected-removed model in regular random graphs in a situation where an epidemic starts from a finite fraction of initially infected nodes (seeds). Previous studies have shown that, assuming a single seed, this model exhibits a kind of discontinuous transition at a certain value of infection rate. Performing Monte Carlo simulations and evaluating approximate master equations, we find that the present model has two critical infection rates for the case with a finite seed fraction. At the first critical rate the system shows a percolation transition of clusters composed of removed nodes, and at the second critical rate, which is larger than the first one, a giant cluster suddenly grows and the order parameter jumps even though it has been already rising. Numerical evaluation of the master equations shows that such sudden epidemic spreading does occur if the degree of the underlying network is large and the seed fraction is small.
NASA Astrophysics Data System (ADS)
Terekhov, V. I.; Pakhomov, M. A.
2011-12-01
Flow, particles dispersion and heat transfer of dilute gas-droplet turbulent flow downstream of a pipe sudden expansion have been numerically investigated for the conditions of heated dry wall. An Euler two-fluid model with additional turbulence transport equations for gas and particulate phases was employed in the study. Gas phase turbulence was modelled using the elliptic blending Reynolds stress model of Fadai-Ghotbi et al. (2008). Two-way coupling is achieved between the dispersed and carrier phases. The partial equations of Reynolds stresses and temperature fluctuations, and the turbulent heat flux equations in dispersed phase by Zaichik (1999) were applied. Fine droplets get readily entrained with the detached flow, spread throughout the whole pipe cross-section. On the contrary, large particles, due to their inertia, do not appear in the recirculation zone and are presented only in the shear layer region. The presence of fine dispersed droplets in the flow attenuates the gas phase turbulence of up 25 %. Heat transfer in the mist flow increased (more than twice in comparison with the single-phase air flow). Intensification of heat transfer is observed both in the recirculation zone and flow development region in the case of fine particles. Large particles enhanced heat transfer only in the reattachment zone. Comparison between simulated results and experimental data of Hishida et al. (1995) for mist turbulent separated flow behind a backward-facing step shows quite good agreement.
Study of Geomagnetic Field Response to Solar Wind Forcing
NASA Astrophysics Data System (ADS)
Kim, S.; Li, X.; Damas, M. C.; Ngwira, C.
2017-12-01
The solar wind is an integral component of space weather that has a huge impact on the near-Earth space conditions, which can in turn adversely impact technological infrastructure. By analyzing solar wind data, we can investigate the response of the Earth's magnetic field to changes in solar wind conditions, such as dynamic pressure, speed, and interplanetary magnetic fields (IMF). When a coronal mass ejection (CME) hits the Earth's magnetosphere, it compresses the dayside magnetosphere, which leads to SSC (Sudden Storm Commencement) seen in Dst or SYM-H index. Dst and SYM-H index are a measure of geomagnetic storm intensity that represents the magnetic field perturbations in the equatorial region originating from ring current. In this study, we focused on SSC intervals with sudden density increase, density, greater than 10 n/cc from 2000 to 2015 using data obtained from the NASA CDAWEB service. A total of 1,049 events were picked for this project. Then using INTERMAGNET service, corresponding horizontal component of magnetic field data were collected from several stations located in equatorial region, mid-latitude region, high-latitude region on the day-side and night-side of Earth. Using MATLAB, we calculated the rate of change of magnetic fields (dB/dt) for each station and each event. We found that in most cases, the sudden increase in proton density is associated with large changes in magnetic fields, dB/dt. The largest magnetic field changes were observed on the day-side than night-side at high latitudes. Interestingly, some exceptions were found such that greater dB/dt was found on night-side than day-side during some events, particularly at high latitudes. We suspect these are driven by magnetospheric substorms, which are manifested by an explosive release of energy in the local midnight sector. The next step will be creating the statistical form to see the correlation between proton density changes and magnetic field changes.
Exploring links between greenspace and sudden unexpected death: A spatial analysis.
Wu, Jianyong; Rappazzo, Kristen M; Simpson, Ross J; Joodi, Golsa; Pursell, Irion W; Mounsey, J Paul; Cascio, Wayne E; Jackson, Laura E
2018-04-01
Greenspace has been increasingly recognized as having numerous health benefits. However, its effects are unknown concerning sudden unexpected death (SUD), commonly referred to as sudden cardiac death, which constitutes a large proportion of mortality in the United States. Because greenspace can promote physical activity, reduce stress and buffer air pollutants, it may have beneficial effects for people at risk of SUD, such as those with heart disease, hypertension, and diabetes mellitus. Using several spatial techniques, this study explored the relationship between SUD and greenspace. We adjudicated 396 SUD cases that occurred from March 2013 to February 2015 among reports from emergency medical services (EMS) that attended out-of-hospital deaths in Wake County (central North Carolina, USA). We measured multiple greenspace metrics in each census tract, including the percentages of forest, grassland, average tree canopy, tree canopy diversity, near-road tree canopy and greenway density. The associations between SUD incidence and these greenspace metrics were examined using Poisson regression (non-spatial) and Bayesian spatial models. The results from both models indicated that SUD incidence was inversely associated with both greenway density (adjusted risk ratio [RR] = 0.82, 95% credible/ confidence interval [CI]: 0.69-0.97) and the percentage of forest (adjusted RR = 0.90, 95% CI: 0.81-0.99). These results suggest that increases in greenway density by 1 km/km 2 and in forest by 10% were associated with a decrease in SUD risk of 18% and 10%, respectively. The inverse relationship was not observed between SUD incidence and other metrics, including grassland, average tree canopy, near-road tree canopy and tree canopy diversity. This study implies that greenspace, specifically greenways and forest, may have beneficial effects for people at risk of SUD. Further studies are needed to investigate potential causal relationships between greenspace and SUD, and potential mechanisms such as promoting physical activity and reducing stress. Copyright © 2018 Elsevier Ltd. All rights reserved.
Field-Aligned Current at Plasma Sheet Boundary Layers During Storm Time: Cluster Observation
NASA Astrophysics Data System (ADS)
Shi, J.; Cheng, Z.; Zhang, T.; Dunlop, M.; Liu, Z.
2007-05-01
The magnetic field data from the FGM instruments on board the four Cluster spacecrafts were used to study Field Aligned Current (FAC) at the Plasma Sheet Boundary Layers (PSBLs) with the so called "curlometer technique". We analyzed the date obtained in 2001 in the magnetotail and only two cases were found in the storm time. One (August 17, 2001) occurred from sudden commencement to main phase, and the other (October 1, 2001) lay in the main phase and recovery phase. The relationship between the FAC density and the AE index was studied and the results are shown as follows. (1) In the sudden commencement and the main phase the density of the FAC increases obviously, in the recovery phase the density of the FAC increases slightly. (2) From the sudden commencement to the initial stage of the main phase the FAC increases with decreasing AE index and decreases with increasing AE index. From the late stage of the main phase to initial stage of the recovery phase, the FAC increases with increasing AE index and decreases with decreasing AE index. In the late stage of the recovery phase the disturbance of the FAC is not so violent, so that the FAC varying with the AE index is not very obvious.
Electrophysiological evaluation of Wolff-Parkinson-White Syndrome
Brembilla-Perrot, Beatrice
2002-01-01
Sudden death might complicate the follow-up of symptomatic patients with the Wolff-Parkinson-White syndrome (WPW) and might be the first event in patients with asymptomatic WPW. The risk of sudden death is increased in some clinical situations. Generally, the noninvasive studies are unable to predict the risk of sudden death correctly . The electrophysiological study is the best means to detect the risk of sudden death and to evaluate the nature of symptoms. Methods used to define the prognosis of WPW are well-defined. At first the maximal rate of conduction through the accessory pathway is evaluated; programmed atrial stimulation using 1 and 2 extrastimuli delivered at different cycle lengths is then used to determine the accessory pathway refractory period and to induce a supraventricular tachycardia. These methods should be performed in the control state and repeated in adrenergic situations either during exercise test or more simply during a perfusion of small doses of isoproterenol. The induction of an atrial fibrillation with rapid conduction through the accessory pathway (> 240/min in control state, > 300/min after isoproterenol) is the sign of a form of WPW at risk of sudden death. PMID:16951730
Tribukait, Arne; Eiken, Ola
2017-11-01
An aircraft's orientation relative to the ground cannot be perceived via the sense of balance or the somatosensory system. When devoid of external visual references, the pilot must rely on instruments. A sudden unexpected instrument indication is a challenge to the pilot, who might have to question the instrument instead of responding with the controls. In this case report we analyze, from a human-factors perspective, how a limited instrument failure led to a fatal accident. During straight-ahead level flight in darkness, at 33,000 ft, the commander of a civil cargo airplane was suddenly confronted by an erroneous pitch-up indication on his primary flight display. He responded by pushing the control column forward, making a bunt maneuver with reduced/negative Gz during approximately 15 s. The pilots did not communicate rationally or cross-check instruments. Recordings of elevator and aileron positions suggest that the commander made intense efforts to correct for several extreme and erroneous roll and pitch indications. Gz displayed an increasing trend with rapid fluctuations and peaks of approximately 3 G. After 50 s the aircraft entered a turn with decreasing radius and finally hit the ground in an inverted attitude. A precipitate maneuvring response can, even if occurring in a large aircraft at high altitude, result in a seemingly inexorable course of events, ending with a crash. In the present case both pilots were probably incapacitated by acute psychological stress and spatial disorientation. Intense variations in Gz may have impaired the copilot's reading of the functioning primary flight display.Tribukait A, Eiken O. Instrument failure, stress, and spatial disorientation leading to a fatal crash with a large aircraft. Aerosp Med Hum Perform. 2017; 88(11):1043-1048.
Doubled heterogeneous crystal nucleation in sediments of hard sphere binary-mass mixtures
NASA Astrophysics Data System (ADS)
Löwen, Hartmut; Allahyarov, Elshad
2011-10-01
Crystallization during the sedimentation process of a binary colloidal hard spheres mixture is explored by Brownian dynamics computer simulations. The two species are different in buoyant mass but have the same interaction diameter. Starting from a completely mixed system in a finite container, gravity is suddenly turned on, and the crystallization process in the sample is monitored. If the Peclet numbers of the two species are both not too large, crystalline layers are formed at the bottom of the cell. The composition of lighter particles in the sedimented crystal is non-monotonic in the altitude: it is first increasing, then decreasing, and then increasing again. If one Peclet number is large and the other is small, we observe the occurrence of a doubled heterogeneous crystal nucleation process. First, crystalline layers are formed at the bottom container wall which are separated from an amorphous sediment. At the amorphous-fluid interface, a secondary crystal nucleation of layers is identified. This doubled heterogeneous nucleation can be verified in real-space experiments on colloidal mixtures.
Risk of population extinction from fixation of deleterious and reverse mutations.
Lande, R
1998-01-01
A model is developed for alternate fixations of mildly deleterious and wild-type alleles arising by forward and reverse mutation in a finite population. For almost all parameter values, this gives an equilibrium load that agrees closely with the general expression derived from diffusion theory. Nearly neutral mutations with selection coefficient a few times larger than 1/(2N(e)) do the most damage by increasing the equilibrium load. The model of alternate fixations facilitates dynamical analysis of the expected load and the mean time to extinction in a population that has been suddenly reduced from a very large size to a small size. Reverse mutation can substantially improve population viability, increasing the mean time to extinction by an order of magnitude or more, but because many mutations are irreversible the effects may not be large. Populations with initially high mean fitness and small effective size, N(e) below a few hundred individuals, may be at serious risk of extinction from fixation of deleterious mutations within 10(3) to 10(4) generations.
Role of mutual punishment in the snowdrift game
NASA Astrophysics Data System (ADS)
Yang, Han-Xin; Wang, Zhen
2015-09-01
The effects of punishment on cooperation have drawn increasing attention. In this paper, we propose a new mechanism of punishment, in which an individual will punish each neighbor if their strategies are different, and vice versa. We incorporate the mutual punishment into the snowdrift game. Results for well-mixed and structured populations have shown that, for no punishment or small values of punishment fine, the fraction of cooperators continuously decreases with the temptation to defect. However, for large values of punishment fine, there exists an abrupt transition point, at which the fraction of cooperators suddenly drops from 1 to 0. Compared to no punishment, mutual punishment promotes cooperation when the temptation to defect is small but inhibits cooperation when the temptation to defect is large. For weak (strong) temptation to defect, the cooperation level increases (decreases) with the punishment fine. For moderate temptation to defect, there exists an optimal value of the punishment fine that leads to the highest cooperation level.
Rewriting Ice Sheet "Glacier-ology"
NASA Astrophysics Data System (ADS)
Bindschadler, R.
2006-12-01
The revolution in glaciology driven by the suite of increasingly sophisticated satellite instruments has been no more extreme than in the area of ice dynamics. Years ago, glaciologists were (probably unwittingly) selective in what properties of mountain glaciers were also applied to ice sheets. This reinforced the view that they responded slowly to their environment. Notions of rapid response driven by the ideas of John Mercer, Bill Budd and Terry Hughes were politely rejected by the centrists of mainstream glaciological thought. How the tables have turned--and by the ice sheets themselves, captured in the act of rapidly changing by modern remote sensors! The saw-toothed record of sea-level change over past glacial-interglacial cycles required the existence of rapid ice loss processes. Satellite based observations, supported by hard-earned field observations have extended the time scale over which ice sheets can suddenly change to ever shorter intervals: from centuries, to decades, to years to even minutes. As changes continue to be observed, the scientific community is forced to consider new or previously ignored processes to explain these observations. The penultimate goal of ice-sheet dynamics is to credibly predict the future of both the Greenland and Antarctic ice sheets. In this important endeavor, there is no substitute for our ability to observe. Without the extensive data sets provided by remote sensing, numerical models can be neither tested nor improved. The impact of remote sensing on our existing ability to predict the future must be compared to our probable state of knowledge and ability were these data never collected. Among many satellite observed phenomena we would be largely or wholly ignorant of are the recent acceleration of ice throughout much of coastal Greenland; the sudden disintegration of multiple ice shelves along the Antarctic Peninsula; and the dramatic thinning and acceleration of the Amundsen Sea sector of West Antarctica. These observations are driving increased concern about rapidly increasing sea level, a process dominated by ice-sheet dynamics and largely identified, quantified, studied and monitored by satellite sensors.
Coastal estuaries and lagoons: The delicate balance at the edge of the sea
Conrads, Paul A.; Rodgers, Kirk D.; Passeri, Davina L.; Prinos, Scott T.; Smith, Christopher; Swarzenski, Christopher M.; Middleton, Beth A.
2018-04-19
Coastal communities are increasingly concerned about the dynamic balance between freshwater and saltwater because of its implications for societal, economic, and ecological resources. While the mixing of freshwater and saltwater sources defines coastal estuaries and lagoons, sudden changes in this balance can have a large effect on critical ecosystems and infrastructure. Any change to the delivery of water from either source has the potential to affect the health of both humans and natural biota and also to damage coastal infrastructure. This fact sheet discusses the potential of major shifts in the dynamic freshwater-saltwater balance to alter the environment and coastal stability.
NASA Astrophysics Data System (ADS)
Chen, Yu; Zou, Jian; Yang, Zi-Yi; Li, Longwu; Li, Hai; Shao, Bin
2016-08-01
The dynamics of N-qubit GHZ state quantum Fisher information (QFI) under phase noise lasers (PNLs) driving is investigated in terms of non-Markovian master equation. We first investigate the non-Markovian dynamics of the QFI of N-qubit GHZ state and show that when the ratio of the PNL rate and the system-environment coupling strength is very small, the oscillations of the QFIs decay slower which corresponds to the non-Markovian region; yet when it becomes large, the QFIs monotonously decay which corresponds to the Markovian region. When the atom number N increases, QFIs in both regions decay faster. We further find that the QFI flow disappears suddenly followed by a sudden birth depending on the ratio of the PNL rate and the system-environment coupling strength and the atom number N, which unveil a fundamental connection between the non-Markovian behaviors and the parameters of system-environment couplings. We discuss two optimal positive operator-valued measures (POVMs) for two different strategies of our model and find the condition of the optimal measurement. At last, we consider the QFI of two atoms with qubit-qubit interaction under random telegraph noises (RTNs).
Neural Activity When People Solve Verbal Problems with Insight
Bowden, Edward M; Haberman, Jason; Frymiare, Jennifer L; Arambel-Liu, Stella; Greenblatt, Richard; Reber, Paul J
2004-01-01
People sometimes solve problems with a unique process called insight, accompanied by an “Aha!” experience. It has long been unclear whether different cognitive and neural processes lead to insight versus noninsight solutions, or if solutions differ only in subsequent subjective feeling. Recent behavioral studies indicate distinct patterns of performance and suggest differential hemispheric involvement for insight and noninsight solutions. Subjects solved verbal problems, and after each correct solution indicated whether they solved with or without insight. We observed two objective neural correlates of insight. Functional magnetic resonance imaging (Experiment 1) revealed increased activity in the right hemisphere anterior superior temporal gyrus for insight relative to noninsight solutions. The same region was active during initial solving efforts. Scalp electroencephalogram recordings (Experiment 2) revealed a sudden burst of high-frequency (gamma-band) neural activity in the same area beginning 0.3 s prior to insight solutions. This right anterior temporal area is associated with making connections across distantly related information during comprehension. Although all problem solving relies on a largely shared cortical network, the sudden flash of insight occurs when solvers engage distinct neural and cognitive processes that allow them to see connections that previously eluded them. PMID:15094802
Goldstein, Benjamin A; Chang, Tara I; Mitani, Aya A; Assimes, Themistocles L; Winkelmayer, Wolfgang C
2014-01-01
Sudden cardiac death is the most common cause of death among individuals undergoing hemodialysis. The epidemiology of sudden cardiac death has been well studied, and efforts are shifting to risk assessment. This study aimed to test whether assessment of acute changes during hemodialysis that are captured in electronic health records improved risk assessment. Data were collected from all hemodialysis sessions of patients 66 years and older receiving hemodialysis from a large national dialysis provider between 2004 and 2008. The primary outcome of interest was sudden cardiac death the day of or day after a dialysis session. This study used data from 2004 to 2006 as the training set and data from 2007 to 2008 as the validation set. The machine learning algorithm, Random Forests, was used to derive the prediction model. In 22 million sessions, 898 people between 2004 and 2006 and 826 people between 2007 and 2008 died on the day of or day after a dialysis session that was serving as a training or test data session, respectively. A reasonably strong predictor was derived using just predialysis information (concordance statistic=0.782), which showed modest but significant improvement after inclusion of postdialysis information (concordance statistic=0.799, P<0.001). However, risk prediction decreased the farther out that it was forecasted (up to 1 year), and postdialytic information became less important. Subtle changes in the experience of hemodialysis aid in the assessment of sudden cardiac death and are captured by modern electronic health records. The collected data are better for the assessment of near-term risk as opposed to longer-term risk.
Lavezzi, Anna Maria; Mecchia, Donatella; Matturri, Luigi
2012-01-26
The area postrema is a densely vascularized small protuberance at the inferoposterior limit of the fourth ventricle, outside of the blood-brain barrier. This structure, besides to induce emetic reflex in the presence of noxious chemical stimulation, has a multifunctional integrative capacity to send major and minor efferents to a variety of brain centers particularly involved in autonomic control of the cardiovascular and respiratory activities. In this study we aimed to focus on the area postrema, which is so far little studied in humans, in a large sample of subjects aged from 25 gestational weeks to 10 postnatal months, who died of unknown (sudden unexplained perinatal and infant deaths) and known causes (controls). Besides we investigated a possible link between alterations of this structure, sudden unexplained fetal and infant deaths and maternal smoking. By the application of morphological and immunohistochemical methods, we observed a significantly high incidence of alterations of the area postrema in fetal and infant victims of sudden death as compared with age-matched controls. These pathological findings, including hypoplasia, lack of vascularization, cystic formations and reactive gliosis, were related to maternal smoking. We hypothesize that components from maternal cigarette smoke, particularly in pregnancy, could affect neurons of the area postrema connected with specific nervous centers involved in the control of vital functions. In conclusion, we suggest that the area postrema should be in depth examined particularly in victims of sudden fetal or infant death with smoker mothers. Copyright © 2011 Elsevier B.V. All rights reserved.
A Discussion of SY-101 Crust Gas Retention and Release Mechanisms
DOE Office of Scientific and Technical Information (OSTI.GOV)
SD Rassat; PA Gauglitz; SM Caley
1999-02-23
The flammable gas hazard in Hanford waste tanks was made an issue by the behavior of double-shell Tank (DST) 241-SY-101 (SY-101). Shortly after SY-101 was filled in 1980, the waste level began rising periodically, due to the generation and retention of gases within the slurry, and then suddenly dropping as the gases were released. An intensive study of the tank's behavior revealed that these episodic releases posed a safety hazard because the released gas was flammable, and, in some cases, the volume of gas released was sufficient to exceed the lower flammability limit (LFL) in the tank headspace (Allemann etmore » al. 1993). A mixer pump was installed in SY-101 in late 1993 to prevent gases from building up in the settled solids layer, and the large episodic gas releases have since ceased (Allemann et al. 1994; Stewart et al. 1994; Brewster et al. 1995). However, the surface level of SY-101 has been increasing since at least 1995, and in recent months the level growth has shown significant and unexpected acceleration. Based on a number of observations and measurements, including data from the void fraction instrument (VFI), we have concluded that the level growth is caused largely by increased gas retention in the floating crust. In September 1998, the crust contained between about 21 and 43% void based on VFI measurements (Stewart et al. 1998). Accordingly, it is important to understand the dominant mechanisms of gas retention, why the gas retention is increasing, and whether the accelerating level increase will continue, diminish or even reverse. It is expected that the retained gas in the crust is flammable, with hydrogen as a major constituent. This gas inventory would pose a flammable gas hazard if it were to release suddenly. In May 1997, the mechanisms of bubble retention and release from crust material were the subject of a workshop. The evaluation of the crust and potential hazards assumed a more typical void of roughly 15% gas. It could be similar to percolati on in single-shell tank (SST) waste forms. The much higher void being currently observed in SY-101 represents essentially a new crust configuration, and the mechanisms for sudden gas release need to be evaluated. The purpose of this study is to evaluate the situation of gas bubbles in crust based on the previous work on gas bubble retention, migration, and release in simulants and actual waste. We have also conducted some visual observations of bubble migration through simulated crusts to help understand the interaction of the various mechanisms.« less
Distribution of HLA-A, -B and -DRB1 alleles in patients with sudden sensorineural hearing loss.
Yeo, S W; Chang, K H; Suh, B D; Kim, T G; Han, H
2000-09-01
This study was performed to investigate the association between human leukocyte antigen (HLA) and susceptibility to sudden sensorineural hearing loss in the Korean population. HLA-A and HLA-B typing using a standard microlymphocytotoxicity technique and HLA-DRB1 genotyping were performed in 35 patients with sudden sensorineural hearing loss and in 206 healthy controls. Prednisone (usual dose 60 mg/day) was administered for 6 days and tapered for an additional 4-6 days. Both initial hearing levels at the onset of deafness and final hearing levels after treatment were examined and evaluated for association with HLA alleles. The frequency of HLA-DRB1*14 was increased in patients with sudden sensorineural hearing loss compared with controls (relative risk [RR] = 2.7, p = 0.016). The frequencies of HLA-A2, -A31, -B52, -B61, -DRB1*04, -DRB1*11 and -DRB1*12 were slightly higher than in the controls, but did not reach statistical significance. When an association between the treatment results and HLA alleles was also evaluated, the frequency of HLA-DRB1*04 was found to be increased in the patients who did not respond to steroid treatment compared with both patients who responded well to steroid (50%, vs 16%, p = 0.034) and controls (RR = 3.0, p = 0.046). These results suggest that there is an association between HLA-DRB1*14 and disease susceptibility and that the presence of HLA-DRB1*04 may be an useful marker for predicting a poor prognosis in Korean patients with sudden sensorineural hearing loss.
NASA Astrophysics Data System (ADS)
Persinger, M. A.; McKay, B. E.; O'Donovan, C. A.; Koren, S. A.
2005-03-01
To test the hypothesis that sudden unexplained death (SUD) in some epileptic patients is related to geomagnetic activity we exposed rats in which limbic epilepsy had been induced to experimentally produced magnetic fields designed to simulate sudden storm commencements (SSCs). Prior studies with rats had shown that sudden death in groups of rats in which epilepsy had been induced months earlier was associated with the occurrence of SSCs and increased geomagnetic activity during the previous night. Schnabel et al. [(2000) Neurology 54:903 908) found no relationship between SUD in human patients and geomagnetic activity. A total of 96 rats were exposed to either 500, 50, 10 40 nT or sham (less than 10 nT) magnetic fields for 6 min every hour between midnight and 0800 hours (local time) for three successive nights. The shape of the complex, amplitude-modulated magnetic fields simulated the shape and structure of an average SSC. The rats were then seized with lithium and pilocarpine and the mortality was monitored. Whereas 10% of the rats that had been exposed to the sham field died within 24 h, 60% of the rats that had been exposed to the experimental magnetic fields simulating natural geomagnetic activity died (P<.001) during this period. These results suggest that correlational analyses between SUD in epileptic patients and increased geomagnetic activity can be simulated experimentally in epileptic rats and that potential mechanisms might be testable directly.
Aerobic exercise conditioning: a nonpharmacological antiarrhythmic intervention.
Billman, George E
2002-02-01
Sudden, unexpected cardiac death due to ventricular fibrillation is the leading cause of death in most industrially developed countries. Yet, despite the enormity of this problem, the development of safe and effective antiarrhythmic therapies has proven to be an elusive goal. In fact, many initially promising antiarrhythmic medications were subsequently found to increase rather than to decrease cardiac mortality. It is now known that cardiac disease alters cardiac autonomic balance and that the patients with the greatest changes in this cardiac neural regulation (i.e., decreased parasympathetic coupled with increased sympathetic activity) are also the patients at the greatest risk for sudden death. A growing body of experimental and epidemiological data demonstrates that aerobic exercise conditioning can dramatically reduce cardiac mortality, even in patients with preexisting cardiac disease. Conversely, the lack of exercise is strongly associated with an increased incidence of many chronic debilitating diseases, including coronary heart disease. Because it is well established that aerobic exercise conditioning can alter autonomic balance (increasing parasympathetic tone and decreasing sympathetic activity), a prudently designed exercise program could prove to be an effective and nonpharmacological way to enhance cardiac electrical stability, thereby protecting against sudden cardiac death.
Shocks and storm sudden commencements
NASA Technical Reports Server (NTRS)
Smith, E. J.; Slavin, J. A.; Zwickl, R. D.; Bame, S. J.
1986-01-01
Recent gains in understanding the relationship between shocks and storm sudden commencements (SSCs) are reviewed with emphasis on spacecraft observations in general and ISEE-3 observations in particular. The topics discussed include the relation of SSC amplitude to increase in solar wind pressure, the inference of shock properties from SSC amplitudes, SSCs as representative of the transient response of the magnetosphere to a step function input, and magnetic storms accompanying shocks.
Triggers for an episode of sudden onset low back pain: study protocol
2012-01-01
Background Most research on risk factors for low back pain has focused on long term exposures rather than factors immediately preceding the onset of low back pain. The aim of this study is to quantify the transient increase in risk of a sudden episode of low back pain associated with acute exposure to a range of common physical and psychological factors. Methods/design This study uses a case-crossover design. One thousand adults with a sudden onset of low back pain presenting to primary care clinicians will be recruited. Basic demographic and clinical information including exposure to putative triggers will be collected using a questionnaire. These triggers include exposure to hazardous manual tasks, physical activity, a slip/trip or fall, consumption of alcohol, sexual activity, being distracted, and being fatigued or tired. Exposures in the case window (0-2 hours from the time when participants first notice their back pain) will be compared to exposures in two control time-windows (one 24-26 hours and another 48-50 hours before the case window). Discussion The completion of this study will provide the first-research based estimates of the increase in risk of a sudden episode of acute low back pain associated with transient exposure to a range of common factors thought to trigger low back pain. PMID:22273001
Intramyocardial arterial narrowing in dogs with subaortic stenosis.
Falk, T; Jönsson, L; Pedersen, H D
2004-09-01
Earlier studies have described intramyocardial arterial narrowing based on hyperplasia and hypertrophy of the vessel wall in dogs with subaortic stenosis (SAS). In theory, such changes might increase the risk of sudden death, as they seem to do in heart disease in other species. This retrospective pathological study describes and quantifies intramyocardial arterial narrowing in 44 dogs with naturally occurring SAS and in eight control dogs. The majority of the dogs with SAS died suddenly (n=27); nine had died or been euthanased with signs of heart failure and eight were euthanased without clinical signs. Dogs with SAS had significantly narrower intramyocardial arteries (P<0.001) and more myocardial fibrosis (P<0.001) than control dogs. Male dogs and those with more severe hypertrophy had more vessel narrowing (P=0.02 and P=0.02, respectively), whereas dogs with dilated hearts had slightly less pronounced arterial thickening (P=0.01). Arterial narrowing was not related to age, but fibrosis increased with age (P=0.047). Dogs that died suddenly did not have a greater number of arterial changes than other dogs with SAS. This study suggests that most dogs with SAS have intramyocardial arterial narrowing and that the risk of dying suddenly is not significantly related to the overall degree of vessel obliteration.
Piccirillo, Gianfranco; Magrì, Damiano; Matera, Sabrina; Magnanti, Marzia; Torrini, Alessia; Pasquazzi, Eleonora; Schifano, Erika; Velitti, Stefania; Marigliano, Vincenzo; Quaglione, Raffaele; Barillà, Francesco
2007-06-01
The most widely accepted marker for stratifying the risk of sudden cardiac death (SCD) in post myocardial infarction patients is a depressed left ventricular function. Left ventricular ejection fractions (EF) of 35% or less increase the risk of sudden death but values between 35 and 40% raise concern. The underlying pathophysiological mechanism is sustained ventricular tachycardia or fibrillation, both associated with increased cardiac repolarization variability. We assessed whether the indices of QT variability from a short-term electrocardiographic (ECG) recording predict sudden death. A total of 396 subjects with chronic heart failure (CHF) due to post-ischaemic cardiomyopathy, with an EF between 35 and 40% and in NYHA class I, underwent a 5 min ECG recording to calculate the following variables: QT variance (QT(v)), QT normalized for the square of the mean QT (QTVN), and QT variability index (QTVI). Corrected QT (QT(c)) was calculated from a 12-lead ECG recording. All participants were followed for 5 years. A multivariable survival model indicated that a QTVI greater than or equal to the 80th percentile indicated a high risk of SCD [hazards ratio (HR) 4.6, 95% confidence interval (CI) 1.5-13.4, P = 0.006] and, though to a lesser extent, a high risk of total mortality (HR 2.4, 95% CI 1.2-4.9, P = 0.017). The model including QTVI as a continuous variable confirmed a similar high risk for SCD (HR 2.9, 95% CI 1.3-6.5, P = 0.01) and for total mortality (HR 2.6, 95% CI 1.3-5.2, P = 0.008). Although asymptomatic patients with CHF who have a slightly depressed EF are at low risk of sudden death, the category is extraordinarily numerous. The QTVI could be helpful in stratifying the risk of sudden death in this otherwise undertreated population.
[Psychological stress and sudden death].
Pignalberi, Carlo; Ricci, Renato; Santini, Massimo
2002-10-01
Recent studies provide relevant evidence that psychological stress significantly influences the pathogenesis of sudden cardiac death. Psychological stress expresses a situation of imbalance, derived from a real or perceived disparity between environmental demands and the individual's ability to cope with these demands. A situation of psychological stress may include different components: personality factors and character traits, anxiety and depression, social isolation and acute or chronic adverse life events. In particular, it has been documented that a sudden extremely hard event, such as an earthquake or a war strike, can significantly increase the incidence of sudden death. Nevertheless, each one of these factors, if not present, can balance a partially unfavorable situation; this overview suggests a multifactorial situation where almost all elements are present and in which the relative influence of each one varies according to the individual examined. Sudden death occurs when a transient disruption (such as acute myocardial ischemia, platelet activation or neuroendocrine variations), occurring in a patient with a diseased myocardium (such as one with a post-necrotic scar or hypertrophy), triggers a malignant arrhythmia. Psychological stress acts at both levels: by means of a "chronic" action it contributes to create the myocardial background, while by means of an acute action it can create the transient trigger precipitating sudden death. In the chronic action two possible mechanisms can be detected: the first is a direct interaction, which contributes to cause a hypertension status or to exacerbate coronary atherosclerosis consequent to endothelial dysfunction; the second one acts through adverse health behaviors, such as a poor diet, alcohol consumption or smoking. In case of acute psychological stress, the mechanisms involved are mainly the ability to trigger myocardial ischemia, to promote arrhythmogenesis, to stimulate platelet function, and to increase blood viscosity. Finally, some individuals have a sympathetic nervous system hyper-responsitivity, manifesting as exaggerated heart rate and blood pressure responses which result in accelerated atherosclerosis.
The sudden death and sudden birth of quantum discord.
Xia, Wei; Hou, Jin-Xing; Wang, Xiao-Hui; Liu, Si-Yuan
2018-03-28
The interaction of quantum system and its environment brings out abundant quantum phenomenons. The sudden death of quantum resources, including entanglement, quantum discord and coherence, have been studied from the perspective of quantum breaking channels (QBC). QBC of quantum resources reveal the common features of quantum resources. The definition of QBC implies the relationship between quantum resources. However, sudden death of quantum resources can also appear under some other quantum channels. We consider the dynamics of Bell-diagonal states under a stochastic dephasing noise along the z-direction, and the sudden death and sudden birth of quantum discord are investigated. Next we explain this phenomenon from the geometric structure of quantum discord. According to the above results, the states with sudden death and sudden birth can be filtered in three-parameter space. Then we provide two necessary conditions to judge which kind of noise channels can make Bell-diagonal states sudden death and sudden birth. Moreover, the relation between quantum discord and coherence indicates that the sudden death and sudden birth of quantum discord implies the sudden death and sudden birth of coherence in an optimal basis.
Myerburg, Robert J; Ullmann, Steven G
2015-04-01
Although identification and management of cardiovascular risk markers have provided important population risk insights and public health benefits, individual risk prediction remains challenging. Using sudden cardiac death risk as a base case, the complex epidemiology of sudden cardiac death risk and the substantial new funding required to study individual risk are explored. Complex epidemiology derives from the multiple subgroups having different denominators and risk profiles, while funding limitations emerge from saturation of conventional sources of research funding without foreseeable opportunities for increases. A resolution to this problem would have to emerge from new sources of funding targeted to individual risk prediction. In this analysis, we explore the possibility of a research funding strategy that would offer business incentives to the insurance industries, while providing support for unresolved research goals. The model is developed for the case of sudden cardiac death risk, but the concept is applicable to other areas of the medical enterprise. © 2015 American Heart Association, Inc.
NASA Technical Reports Server (NTRS)
Bravo, S.
1995-01-01
Coronal holes are the sources of the solar wind and, according to recent YOKOH observations, may undergo rapid changes which are associated with manifestations of explosive solar activity. Rapid changes in a hole's structure will produce rapid changes in the characteristics of the wind emerging from it and, in the particular c se of a sudden increase in wind velocity, this may lead to the formation of an interplanetary shock. We discuss the characteristics of shocks formed in such a way and compare them with interplanetary observations.
High-Dose Citalopram and Escitalopram and the Risk of Out-of-Hospital Death.
Ray, Wayne A; Chung, Cecilia P; Murray, Katherine T; Hall, Kathi; Stein, C Michael
2017-02-01
Studies demonstrating that higher doses of citalopram (> 40 mg) and escitalopram (> 20 mg) prolong the corrected QT interval prompted regulatory agency warnings, which are controversial, given the absence of confirmatory clinical outcome studies. We compared the risk of potential arrhythmia-related deaths for high doses of these selective serotonin reuptake inhibitors (SSRIs) to that for equivalent doses of fluoxetine, paroxetine, and sertraline. The Tennessee Medicaid retrospective cohort study included 54,220 persons 30-74 years of age without cancer or other life-threatening illness who were prescribed high-dose SSRIs from 1998 through 2011. The mean age was 47 years, and 76% were female. Demographic characteristics and comorbidity for individual SSRIs were comparable. Because arrhythmia-related deaths are typically sudden and occur outside the hospital, we analyzed out-of-hospital sudden unexpected death as well as sudden cardiac deaths, a more specific indicator of proarrhythmic effects. The adjusted risk of sudden unexpected death for citalopram did not differ significantly from that for the other SSRIs. The respective hazard ratios (HRs) for citalopram versus escitalopram, fluoxetine, paroxetine, and sertraline were 0.84 (95% CI, 0.40-1.75), 1.24 (95% CI, 0.75-2.05), 0.75 (95% CI, 0.45-1.24), and 1.53 (95% CI, 0.91-2.55). There were no significant differences for sudden cardiac death or all study deaths, nor were there significant differences among high-risk patients (≥ 60 years of age, upper quartile baseline cardiovascular risk). Escitalopram users had no significantly increased risk for any study end point. We found no evidence that risk of sudden unexpected death, sudden cardiac death, or total mortality for high-dose citalopram and escitalopram differed significantly from that for comparable doses of fluoxetine, paroxetine, and sertraline. © Copyright 2016 Physicians Postgraduate Press, Inc.
High-Dose Citalopram and Escitalopram and the Risk of Out-of-Hospital Death
Ray, Wayne A.; Chung, Cecilia P.; Murray, Katherine T.; Hall, Kathi; Stein, C. Michael
2018-01-01
Objective Studies demonstrating higher doses of citalopram (>40mg) and escitalopram (>20mg) prolong the QTc interval prompted regulatory agency warnings, which are controversial, given the absence of confirmatory clinical outcome studies. We compared the risk of potential arrhythmia-related deaths for high doses of these SSRIs to that for equivalent doses of fluoxetine, paroxetine, and sertraline. Method The Tennessee Medicaid retrospective cohort study included 54,220 persons 30–74 years of age without cancer or other life-threatening illness prescribed high-dose SSRIs. The mean age was 47 years and 76% were female. Demographic characteristics and comorbidity for individual SSRIs were comparable. Because arrhythmia-related deaths are typically sudden and occur outside the hospital, we analyzed out-of-hospital sudden unexpected death as well as sudden cardiac deaths, a more specific indicator of pro-arrhythmic effects. Results The adjusted risk of sudden unexpected death for citalopram did not differ significantly from that for the other SSRIs. The respective hazard ratios (HRs) for citalopram versus escitalopram, fluoxetine, paroxetine, and sertraline were 0.84 (95% confidence interval [CI], 0.40–1.75), 1.24 (0.75–2.05), 0.75 (0.45–1.24), and 1.53 (0.91–2.55). There were no significant differences for sudden cardiac death or all study deaths, nor were there significant differences among high-risk patients (≥60 years of age, upper quartile baseline cardiovascular risk). Escitalopram users had no significantly increased risk for any study endpoint. Conclusions We found no evidence that risk of sudden unexpected death, sudden cardiac death, or total mortality for high-dose citalopram and escitalopram differed significantly from that for comparable doses of fluoxetine, paroxetine, and sertraline. PMID:27736049
Santos Mateo, Juan José; Sabater Molina, María; Gimeno Blanes, Juan Ramón
2018-06-08
Hypertrophic cardiomyopathy is the most common inherited cardiovascular disease. It is characterized by increased ventricular wall thickness and is highly complex due to its heterogeneous clinical presentation, several phenotypes, large number of associated causal mutations and broad spectrum of complications. It is caused by mutations in sarcomeric proteins, which are identified in up to 60% of cases of the disease. Clinical manifestations of Hypertrophic Cardiomyopathy include shortness of breath, chest pain, palpitations and syncope, which are related to the onset of diastolic dysfunction, left ventricular outflow tract obstruction, ischemia, atrial fibrillation and abnormal vascular responses. It is associated with an increased risk of sudden cardiac death, heart failure and thromboembolic events. In this article, we discuss the diagnostic and therapeutic aspects of this disease. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.
Hall effect within the colossal magnetoresistive semimetallic state of MoTe2
NASA Astrophysics Data System (ADS)
Zhou, Qiong; Rhodes, D.; Zhang, Q. R.; Tang, S.; Schönemann, R.; Balicas, L.
2016-09-01
Here, we report a systematic study on the Hall effect of the semimetallic state of bulk MoTe2, which was recently claimed to be a candidate for a novel type of Weyl semimetallic state. The temperature (T ) dependence of the carrier densities and of their mobilities, as estimated from a numerical analysis based on the isotropic two-carrier model, indicates that its exceedingly large and nonsaturating magnetoresistance may be attributed to a near perfect compensation between the densities of electrons and holes at low temperatures. A sudden increase in hole density, with a concomitant rapid increase in the electron mobility below T ˜40 K, leads to comparable densities of electrons and holes at low temperatures suggesting a possible electronic phase transition around this temperature.
Ahmad, Tariq; Fiuzat, Mona; Neely, Benjamin; Neely, Megan L; Pencina, Michael J; Kraus, William E; Zannad, Faiez; Whellan, David J; Donahue, Mark P; Piña, Ileana L; Adams, Kirkwood F; Kitzman, Dalane W; O'Connor, Christopher M; Felker, G Michael
2014-06-01
The aim of this study was to determine whether biomarkers of myocardial stress and fibrosis improve prediction of the mode of death in patients with chronic heart failure. The 2 most common modes of death in patients with chronic heart failure are pump failure and sudden cardiac death. Prediction of the mode of death may facilitate treatment decisions. The relationship between amino-terminal pro-brain natriuretic peptide (NT-proBNP), galectin-3, and ST2, biomarkers that reflect different pathogenic pathways in heart failure (myocardial stress and fibrosis), and mode of death is unknown. HF-ACTION (Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training) was a randomized controlled trial of exercise training versus usual care in patients with chronic heart failure due to left ventricular systolic dysfunction (left ventricular ejection fraction ≤35%). An independent clinical events committee prospectively adjudicated mode of death. NT-proBNP, galectin-3, and ST2 levels were assessed at baseline in 813 subjects. Associations between biomarkers and mode of death were assessed using cause-specific Cox proportional hazards modeling, and interaction testing was used to measure differential associations between biomarkers and pump failure versus sudden cardiac death. Discrimination and risk reclassification metrics were used to assess the added value of galectin-3 and ST2 in predicting mode of death risk beyond a clinical model that included NT-proBNP. After a median follow-up period of 2.5 years, there were 155 deaths: 49 from pump failure, 42 from sudden cardiac death, and 64 from other causes. Elevations in all biomarkers were associated with increased risk for both pump failure and sudden cardiac death in both adjusted and unadjusted analyses. In each case, increases in the biomarker had a stronger association with pump failure than sudden cardiac death, but this relationship was attenuated after adjustment for clinical risk factors. Clinical variables along with NT-proBNP levels were stronger predictors of pump failure (C statistic: 0.87) than sudden cardiac death (C statistic: 0.73). Addition of ST2 and galectin-3 led to improved net risk classification of 11% for sudden cardiac death, but not pump failure. Clinical predictors along with NT-proBNP levels were strong predictors of pump failure risk, with insignificant incremental contributions of ST2 and galectin-3. Predictability of sudden cardiac death risk was less robust and enhanced by information provided by novel biomarkers. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Fluidic self-actuating control assembly
Grantz, Alan L.
1979-01-01
A fluidic self-actuating control assembly for use in a reactor wherein no external control inputs are required to actuate (scram) the system. The assembly is constructed to scram upon sensing either a sudden depressurization of reactor inlet flow or a sudden increase in core neutron flux. A fluidic control system senses abnormal flow or neutron flux transients and actuates the system, whereupon assembly coolant flow reverses, forcing absorber balls into the reactor core region.
Blunt trauma to large vessels: a mathematical study
Ismailov, Rovshan M; Shevchuk, Nikolai A; Schwerha, Joseph; Keller, Lawrence; Khusanov, Higmat
2004-01-01
Background Blunt trauma causes short-term compression of some or all parts of the chest, abdomen or pelvis and changes hemodynamics of the blood. Short-term compression caused by trauma also results in a short-term decrease in the diameter of blood vessels. It has been shown that with a sudden change in the diameter of a tube or in the direction of the flow, the slower-moving fluid near the wall stops or reverses direction, which is known as boundary layer separation (BLS). We hypothesized that a sudden change in the diameter of elastic vessel that results from compression may lead not only to BLS but also to other hemodynamic changes that can damage endothelium. Methods We applied Navier-Stokes, multiphase and boundary layer equations to examine such stress. The method of approximation to solve the BL equations was used. Experiments were conducted in an aerodynamic tube, where incident flow velocity and weight of carriage with particles before and after blowing were measured. Results We found that sudden compression resulting from trauma leads to (1) BLS on the curved surface of the vessel wall; (2) transfer of laminar boundary layer into turbulent boundary layer. Damage to the endothelium can occur if compression is at least 25% and velocity is greater than 2.4 m/s or if compression is at least 10% and velocity is greater than 2.9 m/s. Conclusion Our research may point up new ways of reducing the damage from blunt trauma to large vessels. It has the potential for improvement of safety features of motor vehicles. This work will better our understanding of the precise mechanics and critical variables involved in diagnosis and prevention of blunt trauma to large vessels. PMID:15153246
Association of Subway Driver's Depressive Symptoms and Experience of Work-Related Problems.
Jo, Sun-Jin; Yim, Hyeon Woo; Kim, Hyoung-Ryoul; Lee, Kang Sook; Park, Jong-Ik; Chang, Sung Man
2010-12-03
Subway drivers experience various types of work-related problems during their driving, and those experiences can act as risk factors for depressive symptoms. This study was conducted to investigate the association between work-related problems and subway driver's depressive symptoms. We recruited all of the 961 current subway drivers of a subway company located in Seoul, South Korea and conducted a survey of their socio-demographic and vocational characteristics, hospital visits as an outpatient or inpatient, and work-related problem experiences during the last year. Work-related problems included an accident resulting in death or injury, a conflict with a customer, a sudden stop from an emergency bell, or a near accident. Depressive symptoms were measured with the Center for Epidemiologic Studies-Depression (CES-D) instrument. The survey was performed using a self-report questionnaire from April 16 to July 13, 2007. The data of 827 drivers (86.2%) were analyzed. Experience of a conflict with a passenger (p=0.011), a sudden stop from an emergency bell (p=0.001), or a near accident (p=0.001) increased the prevalence of depressive symptoms among subway drivers. A multiple logistic regression analysis revealed that a sudden stop from an emergency bell increased the risk of depressive symptoms significantly (OR=2.59, p=0.026). Near accidents were marginally associated with a higher risk for depressive symptoms (OR=1.62, p=0.062). The experience of a sudden stop from an emergency bell increased subway driver's depressive symptoms, and near accidents may increase the risk of depressive symptoms. Therefore, interventions for the drivers who had experienced these work-related problems are needed.
Causes of sudden death in Addis Ababa, Ethiopia.
Schneider, J; Bezabih, K
2001-10-01
The aim of this study was to evaluate the causes of death in individuals who died suddenly in Addis Ababa, Ethiopia. The selection of the cases was based on police reports, which contained a description of sudden unexpected or instantaneous death. The study was performed on necropsies of the Medico legal Department of Menelik II Hospital, in Addis Ababa during the years 1998 and 1999. According to the pathological features of the heart, we classified 92 dead bodies in 3 groups: Group A: Hearts showing adequate morphological changes to explain sudden death (n = 63). Group B: Hearts showing some structural changes, but inadequate to explain sudden death (n = 20). Group C: Normal hearts (n = 7). In two bodies the general autopsy revealed an extra cardiac cause of death. The single most relevant cause of death in group A was coronary artery disease (44 cases) followed by excessive myocardial hypertrophy due to post-rheumatic valvular lesions (7 cases). While the high prevalence of rheumatic heart disease in Ethiopia is well known, the proportion of cases who died due to coronary heart disease is surprising. Though during the last years some African authors assumed that coronary atherosclerosis is on the increase in developing countries the percentage is higher than expected and higher than in other countries where similar studies exist.
NASA Astrophysics Data System (ADS)
Pinto, Victor A.; Kim, Hee-Jeong; Lyons, Larry R.; Bortnik, Jacob
2018-02-01
We have identified 61 relativistic electron enhancement events and 21 relativistic electron persistent depletion events during 1996 to 2006 from the Geostationary Operational Environmental Satellite (GOES) 8 and 10 using data from the Energetic Particle Sensor (EPS) >2 MeV fluxes. We then performed a superposed epoch time analysis of the events to find the characteristic solar wind parameters that determine the occurrence of such events, using the OMNI database. We found that there are clear differences between the enhancement events and the persistent depletion events, and we used these to establish a set of threshold values in solar wind speed, proton density and interplanetary magnetic field (IMF) Bz that can potentially be useful to predict sudden increases in flux. Persistent depletion events are characterized by a low solar wind speed, a sudden increase in proton density that remains elevated for a few days, and a northward turning of IMF Bz shortly after the depletion starts. We have also found that all relativistic electron enhancement or persistent depletion events occur when some geomagnetic disturbance is present, either a coronal mass ejection or a corotational interaction region; however, the storm index, SYM-H, does not show a strong connection with relativistic electron enhancement events or persistent depletion events. We have tested a simple threshold method for predictability of relativistic electron enhancement events using data from GOES 11 for the years 2007-2010 and found that around 90% of large increases in electron fluxes can be identified with this method.
Testing for thresholds of ecosystem collapse in seagrass meadows.
Connell, Sean D; Fernandes, Milena; Burnell, Owen W; Doubleday, Zoë A; Griffin, Kingsley J; Irving, Andrew D; Leung, Jonathan Y S; Owen, Samuel; Russell, Bayden D; Falkenberg, Laura J
2017-10-01
Although the public desire for healthy environments is clear-cut, the science and management of ecosystem health has not been as simple. Ecological systems can be dynamic and can shift abruptly from one ecosystem state to another. Such unpredictable shifts result when ecological thresholds are crossed; that is, small cumulative increases in an environmental stressor drive a much greater change than could be predicted from linear effects, suggesting an unforeseen tipping point is crossed. In coastal waters, broad-scale seagrass loss often occurs as a sudden event associated with human-driven nutrient enrichment (eutrophication). We tested whether the response of seagrass ecosystems to coastal nutrient enrichment is subject to a threshold effect. We exposed seagrass plots to different levels of nutrient enrichment (dissolved inorganic nitrogen) for 10 months and measured net production. Seagrass response exhibited a threshold pattern when nutrient enrichment exceeded moderate levels: there was an abrupt and large shift from positive to negative net leaf production (from approximately 0.04 leaf production to 0.02 leaf loss per day). Epiphyte load also increased as nutrient enrichment increased, which may have driven the shift in leaf production. Inadvertently crossing such thresholds, as can occur through ineffective management of land-derived inputs such as wastewater and stormwater runoff along urbanized coasts, may account for the widely observed sudden loss of seagrass meadows. Identification of tipping points may improve not only adaptive-management monitoring that seeks to avoid threshold effects, but also restoration approaches in systems that have crossed them. © 2017 Society for Conservation Biology.
Identifying the determinants of premature mortality in Russia: overcoming a methodological challenge
Tomkins, Susannah; Shkolnikov, Vladimir; Andreev, Evgueni; Kiryanov, Nikolay; Leon, David A; McKee, Martin; Saburova, Lyudmila
2007-01-01
Background It is thought that excessive alcohol consumption is related to the high mortality among working age men in Russia. Moreover it has been suggested that alcohol is a key proximate driver of the very sharp fluctuations in mortality seen in this group since the mid-1980s. Designing an individual-level study suitable to address the potential acute effects of alcohol consumption on mortality in Russia has posed a challenge to epidemiologists, especially because of the need to identify factors that could underlie the rapid changes up and down in mortality rates that have been such a distinctive feature of the Russian mortality crisis. In order to address this study question which focuses on exposures acting shortly before sudden death, a cohort would be unfeasibly large and would suffer from recruitment bias. Methods Although the situation in Russia is unusual, with a very high death rate characterised by many sudden and apparently unexpected deaths in young men, the methodological problem is common to research on any cause of death where many deaths are sudden. Results We describe the development of an innovative approach that has overcome some of these challenges: a case-control study employing proxy informants and external data sources to collect information about proximate determinants of mortality. Conclusion This offers a set of principles that can be adopted by epidemiologists studying sudden and unexpected deaths in other settings. PMID:18045487
Tomkins, Susannah; Shkolnikov, Vladimir; Andreev, Evgueni; Kiryanov, Nikolay; Leon, David A; McKee, Martin; Saburova, Lyudmila
2007-11-28
It is thought that excessive alcohol consumption is related to the high mortality among working age men in Russia. Moreover it has been suggested that alcohol is a key proximate driver of the very sharp fluctuations in mortality seen in this group since the mid-1980s. Designing an individual-level study suitable to address the potential acute effects of alcohol consumption on mortality in Russia has posed a challenge to epidemiologists, especially because of the need to identify factors that could underlie the rapid changes up and down in mortality rates that have been such a distinctive feature of the Russian mortality crisis. In order to address this study question which focuses on exposures acting shortly before sudden death, a cohort would be unfeasibly large and would suffer from recruitment bias. Although the situation in Russia is unusual, with a very high death rate characterised by many sudden and apparently unexpected deaths in young men, the methodological problem is common to research on any cause of death where many deaths are sudden. We describe the development of an innovative approach that has overcome some of these challenges: a case-control study employing proxy informants and external data sources to collect information about proximate determinants of mortality. This offers a set of principles that can be adopted by epidemiologists studying sudden and unexpected deaths in other settings.
Childs, Lesley; Rickert, Scott; Murry, Thomas; Blitzer, Andrew; Sulica, Lucian
2011-10-01
Spasmodic dysphonia (SD) is an idiopathic voice disorder that is characterized by either a strained, strangled voice quality or a breathy voice with aphonic segments of connected speech. It has been suggested that environmental factors play a role in triggering the onset. Clinical observation suggests that some patients associate onset with specific events or factors while others do not. The purpose of this study was to examine a large database of SD patients to determine if specific triggers are associated with the onset of SD. Retrospective chart review. A total of 350 charts of patients with SD were identified and were categorized as either "sudden onset" or "gradual onset." One hundred sixty-nine recalled their circumstances surrounding onset. Forty-five percent of these patients described the onset as sudden. Patient perceptions of inciting events in the sudden onset group were identified 77% of the time and 2% of the time in the gradual onset group. The most common factors identified were stress (42%), upper respiratory infection (33%), and pregnancy and parturition (10%). Thirty-five percent of SD patients perceive their disorder to have a sudden onset with identified inciting events. This prevalence raises questions regarding possible behavioral and environmental factors surrounding the onset of this disorder. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.
Secrest, A M; Becker, D J; Kelsey, S F; Laporte, R E; Orchard, T J
2011-03-01
Type 1 diabetes mellitus increases the risk for sudden unexplained death, generating concern that diabetes processes and/or treatments underlie these deaths. Young (< 50 years) and otherwise healthy patients who are found dead in bed have been classified as experiencing 'dead-in-bed' syndrome. We thus identified all unwitnessed deaths in two related registries (the Children's Hospital of Pittsburgh and Allegheny County) yielding 1319 persons with childhood-onset (age < 18 years) Type 1 diabetes diagnosed between 1965 and 1979. Cause of death was determined by a Mortality Classification Committee (MCC) of at least two physician epidemiologists, based on the death certificate and additional records surrounding the death. Of the 329 participants who had died, the Mortality Classification Committee has so far reviewed and assigned a final cause of death to 255 (78%). Nineteen (8%) of these were sudden unexplained deaths (13 male) and seven met dead-in-bed criteria. The Mortality Classification Committee adjudicated cause of death in the seven dead-in-bed persons as: diabetic coma (n =4), unknown (n=2) and cardiomyopathy (n=1, found on autopsy). The three dead-in-bed individuals who participated in a clinical study had higher HbA(1c) , lower BMI and higher daily insulin dose compared with both those dying from other causes and those surviving. Sudden unexplained death in Type 1 diabetes seems to be increased 10-fold and associated with male sex, while dead-in-bed individuals have a high HbA(1c) and insulin dose and low BMI. Although sample size is too small for definitive conclusions, these results suggest specific sex and metabolic factors predispose to sudden unexplained death and dead-in-bed death. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.
Shank Muscle Strength Training Changes Foot Behaviour during a Sudden Ankle Supination
Hagen, Marco; Lescher, Stephanie; Gerhardt, Andreas; Lahner, Matthias; Felber, Stephan; Hennig, Ewald M.
2015-01-01
Background The peroneal muscles are the most effective lateral stabilisers whose tension braces the ankle joint complex against excessive supination. The purpose of this study was to identify the morphological and biomechanical effects of two machine-based shank muscle training methods. Methods Twenty-two healthy male recreationally active sports students performed ten weeks of single-set high resistance strength training with 3 training sessions per week. The subjects conducted subtalar pronator/supinator muscle training (ST) with the right leg by using a custom-made apparatus; the left foot muscles were exercised with machine-based talocrural plantar and dorsiflexor training (TT). Muscle strength (MVIC), muscle volume and foot biomechanics (rearfoot motion, ground reaction forces, muscle reaction times) during a sudden ankle supination were recorded before and after the intervention. Results Compared to TT, ST resulted in significantly higher pronator (14% vs. 8%, P<0.01) and supinator MVIC (25% vs. 12%, P<0.01). During sudden foot inversions, both ST and TT resulted in reduced supination velocity (-12%; P<0.01). The muscle reaction onset time was faster after the training in peroneus longus (PL) (P<0.01). Muscle volume of PL (P<0.01) and TA (P<0.01) increased significantly after both ST and TT. Conclusion After both ST and TT, the ankle joint complex is mechanically more stabilised against sudden supinations due to the muscle volume increase of PL and TA. As the reduced supination velocities indicate, the strength training effects are already present during free-fall. According to a sudden ankle supination in standing position, both machine-based dorsiflexor and pronator strength training is recommended for enhancing the mechanical stability of the ankle. PMID:26110847
Sudden Cardiac and Noncardiac Death in Sports: Epidemiology, Causes, Pathogenesis, and Prevention.
Lippi, Giuseppe; Favaloro, Emmanuel J; Sanchis-Gomar, Fabian
2018-06-04
Although few doubts remain that physical exercise should be widely promoted for maintenance of health and fitness, the risk of adverse events such as sudden death (especially due to cardiac causes, i.e., sudden cardiac death [SCD]) during exercise remains tangible. The overall risk of sudden death in athletes is relatively low (i.e., usually comprised between 0.1 and 38/100,000 person-years), and globally comparable to that of the general population. However, up to 20% of all sudden death cases are still recorded while exercising. The most frequent underlying disorders encountered in SCD are hypertrophic cardiomyopathy and coronary artery disease (CAD), representing three quarters of all conditions. The risk related to CAD increases with aging (>35 years old), while that attributable to cardiomyopathies or fatal arrhythmias is especially frequent among young people (<35 years old). Taken together, these findings would lead to the conclusion that physical exercise may be seen as an acute trigger of myocardial ischemia or arrhythmias in some predisposed individuals. Nonetheless, the prevalence of coronary atherosclerosis seems to be higher in athletes than in sedentary subjects with comparable risk profile. On the contrary, coronary plaques in physically active subjects appear more stable, thereby attenuating the risk of rupture and subsequent myocardial ischemia. These findings, along with evidence of a considerable increase of peak coronary blood flow during exercise, make it very likely that an imbalance between oxygen demand and supply may be the most frequent cause of myocardial ischemia in athletes suffering SCD and/or cardiac arrest. Therefore, all subjects who wish to practice moderate- to high-intensity exercise are recommended to undergo preparticipation screening and annual follow-up. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Consequences of Phytophthora ramorum infection in coast live oaks
Brice McPherson; David L. Wood; Sylvia R. Mori; Pavel Svihra; Richard B. Standiford; N. Maggi. Kelly
2008-01-01
Sudden oak death, caused by Phytophthora ramorum, has infected and killed large numbers of oaks (Quercus spp.) and tanoaks (Lithocarpus densiflorus) in California since the mid 1990s. Since March 2000 we have been investigating the interactions between patterns of disease progression and...
Raknes, Guttorm; Småbrekke, Lars
2017-02-01
Following a TV documentary in 2013, there was a tremendous increase in low dose naltrexone (LDN) use in a wide range of unapproved indications in Norway. We aim to describe the extent of this sudden and unprecedented increase in LDN prescribing, to characterize patients and LDN prescribers, and to estimate LDN dose sizes. LDN prescriptions recorded in the Norwegian Prescription Database (NorPD) in 2013 and 2014, and sales data not recorded in NorPD from the only Norwegian LDN manufacturer were included in the study. According to NorPD, 15 297 patients (0.3% of population) collected at least one LDN prescription. The actual number of users was higher as at least 23% of total sales were not recorded in NorPD. After an initial wave, there was a steady stream of new and persistent users throughout the study period. Median patient age was 52 years, and 74% of patients were female. Median daily dose was 3.7 mg. Twenty percent of all doctors and 71% of general medicine practitioners registered in Norway in 2014 prescribed LDN at least once. The TV documentary on LDN in Norway was followed by a large increase in LDN prescribing, and the proportion of LDN users went from an insignificant number to 0.3% of the population. There was a high willingness to use and prescribe off label despite limited evidence. Observed median LDN dose, and age and gender distribution were as expected in typical LDN using patients. © 2016 The Authors. Pharmacoepidemiology and Drug Safety Published by John Wiley & Sons Ltd. © 2016 The Authors. Pharmacoepidemiology and Drug Safety Published by John Wiley & Sons Ltd.
Gudmundsson, M; Perchiazzi, G; Pellegrini, M; Vena, A; Hedenstierna, G; Rylander, C
2018-01-01
In mechanically ventilated, lung injured, patients without spontaneous breathing effort, atelectasis with shunt and desaturation may appear suddenly when ventilator pressures are decreased. It is not known how such a formation of atelectasis is related to transpulmonary pressure (P L ) during weaning from mechanical ventilation when the spontaneous breathing effort is increased. If the relation between P L and atelectasis were known, monitoring of P L might help to avoid formation of atelectasis and cyclic collapse during weaning. The main purpose of this study was to determine the relation between P L and atelectasis in an experimental model representing weaning from mechanical ventilation. Dynamic transverse computed tomography scans were acquired in ten anaesthetized, surfactant-depleted pigs with preserved spontaneous breathing, as ventilator support was lowered by sequentially reducing inspiratory pressure and positive end expiratory pressure in steps. The volumes of gas and atelectasis in the lungs were correlated with P L obtained using oesophageal pressure recordings. Work of breathing (WOB) was assessed from Campbell diagrams. Gradual decrease in P L in both end-expiration and end-inspiration caused a proportional increase in atelectasis and decrease in the gas content (linear mixed model with an autoregressive correlation matrix; P < 0.001) as the WOB increased. However, cyclic alveolar collapse during tidal ventilation did not increase significantly. We found a proportional correlation between atelectasis and P L during the 'weaning process' in experimental mild lung injury. If confirmed in the clinical setting, a gradual tapering of ventilator support can be recommended for weaning without risk of sudden formation of atelectasis. © 2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
Wave vector modification of the infinite order sudden approximation
DOE Office of Scientific and Technical Information (OSTI.GOV)
Sachs, J.G.; Bowman, J.M.
1980-10-15
A simple method is proposed to modify the infinite order sudden approximation (IOS) in order to extend its region of quantitative validity. The method involves modifying the phase of the IOS scattering matrix to include a part calculated at the outgoing relative kinetic energy as well as a part calculated at the incoming kinetic energy. An immediate advantage of this modification is that the resulting S matrix is symmetric. We also present a closely related method in which the relative kinetic energies used in the calculation of the phase are determined from quasiclassical trajectory calculations. A set of trajectories ismore » run with the initial state being the incoming state, and another set is run with the initial state being the outgoing state, and the average final relative kinetic energy of each set is obtained. One part of the S-operator phase is then calculated at each of these kinetic energies. We apply these methods to vibrationally inelastic collinear collisions of an atom and a harmonic oscillator, and calculate transition probabilities P/sub n/1..-->..nf for three model systems. For systems which are sudden, or nearly so, the agreement with exact quantum close-coupling calculations is substantially improved over standard IOS ones when ..delta..n=such thatub f/-n/sub i/ is large, and the corresponding transition probability is small, i.e., less than 0.1. However, the modifications we propose will not improve the accuracy of the IOS transition probabilities for any collisional system unless the standard form of IOS already gives at least qualitative agreement with exact quantal calculations. We also suggest comparisons between some classical quantities and sudden predictions which should help in determining the validity of the sudden approximation. This is useful when exact quantal data is not available for comparison.« less
Wave vector modification of the infinite order sudden approximation
NASA Astrophysics Data System (ADS)
Sachs, Judith Grobe; Bowman, Joel M.
1980-10-01
A simple method is proposed to modify the infinite order sudden approximation (IOS) in order to extend its region of quantitative validity. The method involves modifying the phase of the IOS scattering matrix to include a part calculated at the outgoing relative kinetic energy as well as a part calculated at the incoming kinetic energy. An immediate advantage of this modification is that the resulting S matrix is symmetric. We also present a closely related method in which the relative kinetic energies used in the calculation of the phase are determined from quasiclassical trajectory calculations. A set of trajectories is run with the initial state being the incoming state, and another set is run with the initial state being the outgoing state, and the average final relative kinetic energy of each set is obtained. One part of the S-operator phase is then calculated at each of these kinetic energies. We apply these methods to vibrationally inelastic collinear collisions of an atom and a harmonic oscillator, and calculate transition probabilities Pn1→nf for three model systems. For systems which are sudden, or nearly so, the agreement with exact quantum close-coupling calculations is substantially improved over standard IOS ones when Δn=‖nf-ni‖ is large, and the corresponding transition probability is small, i.e., less than 0.1. However, the modifications we propose will not improve the accuracy of the IOS transition probabilities for any collisional system unless the standard form of IOS already gives at least qualitative agreement with exact quantal calculations. We also suggest comparisons between some classical quantities and sudden predictions which should help in determining the validity of the sudden approximation. This is useful when exact quantal data is not available for comparison.
Emergence and epidemiology of ciguatera in the coastal cities of southern China.
Chan, Thomas Y K
2015-03-02
In the present review of 23 published case studies, the main objective is to report the emergence and epidemiology of ciguatera in the coastal cities of southern China. There was a sudden surge in ciguatera outbreaks in 2004. Ciguatera mostly occurred in the Guangdong Province. In Shenzhen, the incidence of ciguatera in 2004 was estimated to be over 7.5 per million people. In Foshan and Zhongshan, three large outbreaks each affecting over 100-200 subjects (caused by tiger grouper served at banquets) accounted for the much higher incidence of ciguatera in 2004 (>48.7 and >129.9 per million people). Humphead wrasse and areolated coral grouper were the other important ciguatoxic fish. In some subjects, risk factors for increased likelihood of (severe) ciguatera were present, namely concomitant alcohol consumption and ingestion of large reef fishes and CTX-rich fish parts. To prevent large outbreaks and severe illness, large apex predators from coral reefs should never be served at banquets and the public should realize the increased risk of severe symptoms due to ingestion of CTX-rich fish parts with alcohol. The systematic collection of accurate details, implementation of risk assessment process and continuing education for the public on prevention are of obvious importance.
Emergence and Epidemiology of Ciguatera in the Coastal Cities of Southern China
Chan, Thomas Y. K.
2015-01-01
In the present review of 23 published case studies, the main objective is to report the emergence and epidemiology of ciguatera in the coastal cities of southern China. There was a sudden surge in ciguatera outbreaks in 2004. Ciguatera mostly occurred in the Guangdong Province. In Shenzhen, the incidence of ciguatera in 2004 was estimated to be over 7.5 per million people. In Foshan and Zhongshan, three large outbreaks each affecting over 100–200 subjects (caused by tiger grouper served at banquets) accounted for the much higher incidence of ciguatera in 2004 (>48.7 and >129.9 per million people). Humphead wrasse and areolated coral grouper were the other important ciguatoxic fish. In some subjects, risk factors for increased likelihood of (severe) ciguatera were present, namely concomitant alcohol consumption and ingestion of large reef fishes and CTX-rich fish parts. To prevent large outbreaks and severe illness, large apex predators from coral reefs should never be served at banquets and the public should realize the increased risk of severe symptoms due to ingestion of CTX-rich fish parts with alcohol. The systematic collection of accurate details, implementation of risk assessment process and continuing education for the public on prevention are of obvious importance. PMID:25738329
Lichtenfeld, Jana; Deal, Barbara J; Crawford, Susan
2016-06-01
Anabolic androgenic steroids are synthetic derivatives of testosterone that promote the growth of skeletal muscles and have many recognised cardiovascular effects. We report the clinical presentation and pathological findings of an adolescent male whose sudden cardiac arrest following ventricular fibrillation was attributed to anabolic androgenic steroid use. The age of our patient reflects the usage of anabolic androgenic steroids among younger athletes and highlights the need for increased awareness among practitioners.
Sudden gains in cognitive therapy and interpersonal therapy for social anxiety disorder.
Bohn, Christiane; Aderka, Idan M; Schreiber, Franziska; Stangier, Ulrich; Hofmann, Stefan G
2013-02-01
The present study examined the effects of sudden gains on treatment outcome in a randomized controlled trial including individual cognitive therapy (CT) and interpersonal therapy (IPT) for social anxiety disorder (SAD). Participants were 67 individuals with SAD who received 16 treatment sessions. Symptom severity at each session was assessed using the Social Phobia Weekly Summary Scale (Clark et al., 2003). Results indicate that 22.4% of participants experienced a sudden gain during treatment. Individuals with sudden gains had significantly lower social anxiety symptoms at post-treatment and follow-up compared to individuals without sudden gains. Sudden gains in CT and IPT had similar magnitudes, frequencies, and timings. However, sudden gains resulted in lower levels of post-treatment symptoms in CT compared to IPT. Cognitive changes did not precede sudden gains, but sudden gains resulted in cognitive changes. Sudden gains in CT and IPT for SAD are predictive of long-term outcome. In addition, the effect of sudden gains may be greater in CT compared to IPT.
Imaging shear strength along subduction faults
Bletery, Quentin; Thomas, Amanda M.; Rempel, Alan W.; Hardebeck, Jeanne L.
2017-01-01
Subduction faults accumulate stress during long periods of time and release this stress suddenly, during earthquakes, when it reaches a threshold. This threshold, the shear strength, controls the occurrence and magnitude of earthquakes. We consider a 3-D model to derive an analytical expression for how the shear strength depends on the fault geometry, the convergence obliquity, frictional properties, and the stress field orientation. We then use estimates of these different parameters in Japan to infer the distribution of shear strength along a subduction fault. We show that the 2011 Mw9.0 Tohoku earthquake ruptured a fault portion characterized by unusually small variations in static shear strength. This observation is consistent with the hypothesis that large earthquakes preferentially rupture regions with relatively homogeneous shear strength. With increasing constraints on the different parameters at play, our approach could, in the future, help identify favorable locations for large earthquakes.
"Driverless" Shocks in the Interplanetary Medium
NASA Technical Reports Server (NTRS)
Gopalswamy, N.; Kaiser, M. L.; Lara, A.
1999-01-01
Many interplanetary shocks have been detected without an obvious driver behind them. These shocks have been thought to be either blast waves from solar flares or shocks due to sudden increase in solar wind speed caused by interactions between large scale open and closed field lines of the Sun. We investigated this problem using a set of interplanetary shock detected {\\it in situ} by the Wind space craft and tracing their solar origins using low frequency radio data obtained by the Wind/WAVES experiment. For each of these "driverless shocks" we could find a unique coronal mass ejections (CME) event observed by the SOHO (Solar and Heliospheric Observatory) coronagraphs. We also found that these CMEs were ejected at large angles from the Sun-Earth line. It appears that the "driverless shocks" are actually driver shocks, but the drivers were not intercepted by the spacecraft. We conclude that the interplanetary shocks are much more extended than the driving CMEs.
Improved phase shift approach to the energy correction of the infinite order sudden approximation
DOE Office of Scientific and Technical Information (OSTI.GOV)
Chang, B.; Eno, L.; Rabitz, H.
1980-07-15
A new method is presented for obtaining energy corrections to the infinite order sudden (IOS) approximation by incorporating the effect of the internal molecular Hamiltonian into the IOS wave function. This is done by utilizing the JWKB approximation to transform the Schroedinger equation into a differential equation for the phase. It is found that the internal Hamiltonian generates an effective potential from which a new improved phase shift is obtained. This phase shift is then used in place of the IOS phase shift to generate new transition probabilities. As an illustration the resulting improved phase shift (IPS) method is appliedmore » to the Secrest--Johnson model for the collinear collision of an atom and diatom. In the vicinity of the sudden limit, the IPS method gives results for transition probabilities, P/sub n/..-->..n+..delta..n, in significantly better agreement with the 'exact' close coupling calculations than the IOS method, particularly for large ..delta..n. However, when the IOS results are not even qualitatively correct, the IPS method is unable to satisfactorily provide improvements.« less
Labrecque, Manon
2012-04-01
To describe the recent insights into the definition, causes, natural outcome, and key elements of irritant-induced asthma (IIA) management. IIA is a subtype of occupational asthma without immunologic sensitization and includes the typical reactive airway dysfunction syndrome (RADS) and a more gradual form called not-so-sudden IIA, when onset of asthma follows repeated low-dose exposure to irritants. The World Trade Center tragedy brought new insight in the understanding of IIA, suggesting that it can exhibit a prolonged interval between exposure and recognition of clinical symptoms and disease. Dimethyl sulfate has been recently reported to cause RADS and repeated diesel exhaust exposure to cause not-so-sudden IIA in patients who worked in a bus garage. Cleaning workers who are exposed to a large variety of irritants and sensitizers are especially at risk of occupational asthma and IIA. IIA includes RADS and not-so-sudden IIA. Outcome of IIA is as poor as occupational asthma with sensitization. Treatment of IIA does not differ from standard asthma treatment, but high-dose vitamin D could be assessed further for possible therapeutic benefit.
Lightning jump as a nowcast predictor: Application to severe weather events in Catalonia
NASA Astrophysics Data System (ADS)
Farnell, C.; Rigo, T.; Pineda, N.
2017-01-01
Several studies reported sudden increases in the total lightning flash rate (intra-cloud+cloud-to-ground) preceding the occurrence of severe weather (large hail, wind gusts associated to thunderstorms and/or tornadoes). Named ;Lightning Jump;, this pattern has demonstrated to be of operational applicability in the forecasting of severe weather phenomena. The present study introduces the application of a lightning jump algorithm, with an identification of cells based solely on total lightning data, revealing that there is no need of radar data to trigger severe weather warnings. The algorithm was validated by means of a dataset severe weather events occurred in Catalonia in the period 2009-2014. Results obtained revealed very promising.
Non-invasive measurement of proppant pack deformation
Walsh, Stuart D. C.; Smith, Megan; Carroll, Susan A.; ...
2016-05-26
In this study, we describe a method to non-invasively study the movement of proppant packs at the sub-fracture scale by applying three-dimensional digital image correlation techniques to X-ray tomography data. Proppant movement is tracked in a fractured core of Marcellus shale placed under a series of increasing confining pressures up to 10,000 psi. The analysis reveals the sudden failure of a region of the proppant pack, accompanied by the large-scale rearrangement of grains across the entire fracture surface. The failure of the pack coincides with the appearance of vortex-like grain motions similar to features observed in biaxial compression of twomore » dimensional granular assemblies.« less
Sestini, S; Gisabella, M; Pastorino, U; Billé, A
2016-05-01
Lipomas of the gastrointestinal tract are rare, slow-growing lesions that comprise 0.4% of all gastrointestinal neoplasms. They can cause dysphagia, dyspnoea or sudden choking. Due to rarity of this condition and its uncommon presentation, a literature review was carried out (PubMed). This search revealed 290 articles, of which 74 were considered pertinent and were evaluated. We report a case of a 13cm pedunculated oesophageal lipoma that presented with increasing dysphagia and two episodes of suffocation. The patient underwent curative resection through a cervical approach. Resection is recommended for large (>5 cm) or symptomatic polyps. Outcomes are excellent given that lesions are universally benign and oesophageal resection is not required.
Seismicity remotely triggered by the magnitude 7.3 landers, california, earthquake
Hill, D.P.; Reasenberg, P.A.; Michael, A.; Arabaz, W.J.; Beroza, G.; Brumbaugh, D.; Brune, J.N.; Castro, R.; Davis, S.; Depolo, D.; Ellsworth, W.L.; Gomberg, J.; Harmsen, S.; House, L.; Jackson, S.M.; Johnston, M.J.S.; Jones, L.; Keller, Rebecca Hylton; Malone, S.; Munguia, L.; Nava, S.; Pechmann, J.C.; Sanford, A.; Simpson, R.W.; Smith, R.B.; Stark, M.; Stickney, M.; Vidal, A.; Walter, S.; Wong, V.; Zollweg, J.
1993-01-01
The magnitude 7.3 Landers earthquake of 28 June 1992 triggered a remarkably sudden and widespread increase in earthquake activity across much of the western United States. The triggered earthquakes, which occurred at distances up to 1250 kilometers (17 source dimensions) from the Landers mainshock, were confined to areas of persistent seismicity and strike-slip to normal faulting. Many of the triggered areas also are sites of geothermal and recent volcanic activity. Static stress changes calculated for elastic models of the earthquake appear to be too small to have caused the triggering. The most promising explanations involve nonlinear interactions between large dynamic strains accompanying seismic waves from the mainshock and crustal fluids (perhaps including crustal magma).
Menezes, Ritesh G; Fatima, Huda; Hussain, Syed Ather; Ahmed, Saba; Singh, Pankaj Kumar; Kharoshah, Magdy A; Madadin, Mohammed; Ram, Pradhum; Pant, Sadip; Luis, Sushil Allen
2017-07-01
Commotio cordis is an increasingly reported fatal mechano-electric syndrome and is the second most common cause of sudden cardiac death in young athletes. It is most commonly associated with a sports-related injury, wherein, there is a high-velocity impact between a projectile and the precordium. By virtue of this impact, malignant arrhythmias consequently develop leading to the individual's immediate demise, accompanied by a relatively normal post-mortem analysis. The importance of an autopsy remains paramount to exclude other causes of sudden death. With increasing awareness and reporting, survival rates are beginning to improve; however, prevention of the development of this condition remains the best approach for survival.
NASA Astrophysics Data System (ADS)
Etilé, A.; Verney, D.; Arsenyev, N. N.; Bettane, J.; Borzov, I. N.; Cheikh Mhamed, M.; Cuong, P. V.; Delafosse, C.; Didierjean, F.; Gaulard, C.; Van Giai, Nguyen; Goasduff, A.; Ibrahim, F.; Kolos, K.; Lau, C.; Niikura, M.; Roccia, S.; Severyukhin, A. P.; Testov, D.; Tusseau-Nenez, S.; Voronov, V. V.
2015-06-01
The β decay of 82Ge Ge was re-investigated using the newly commissioned tape station BEDO at the electron-driven ISOL (isotope separation on line) facility ALTO operated by the Institut de Physique Nucléaire, Orsay. The original motivation of this work was focused on the sudden occurrence in the light N =49 odd-odd isotonic chain of a large number of J ≤1 states (positive or negative parity) in 80Ga by providing a reliable intermediate example, viz., 82As. The extension of the 82As level scheme towards higher energies from the present work has revealed three potential 1+ states above the already known one at 1092 keV. In addition our data allow ruling out the hypothesis that the 843 keV level could be a 1+ state. A detailed analysis of the level scheme using both an empirical core-particle coupling model and a fully microscopic treatment within a Skyrme-QRPA (quasiparticle random-phase approximation) approach using the finite-rank separable approximation was performed. From this analysis two conclusions can be drawn: (i) the presence of a large number of low-lying low-spin negative parity states is due to intruder states stemming from above the N =50 shell closure, and (ii) the sudden increase, from 82As to 80Ga, of the number of low-lying 1+ states and the corresponding Gamow-Teller fragmentation are naturally reproduced by the inclusion of tensor correlations and couplings to 2p-2h excitations.
Cosmic Influence on the Sun-Earth Environment
Mukherjee, Saumitra
2008-01-01
SOHO satellite data reveals geophysical changes before sudden changes in the Earth's Sun-Earth environment. The influence of extragalactic changes on the Sun as well as the Sun-Earth environment seems to be both periodic and episodic. The periodic changes in terms of solar maxima and minima occur every 11 years, whereas the episodic changes can happen at any time. Episodic changes can be monitored by cosmic ray detectors as a sudden increase or decrease of activity. During these solar and cosmic anomaly periods the environment of the Earth is affected. The Star-Sun-Earth connection has the potential to influence the thermosphere, atmosphere, ionosphere and lithosphere. Initial correlation of the cosmic and Sun-Earth connection has shown the possibility of predicting earthquakes, sudden changes in atmospheric temperatures and erratic rainfall/snowfall patterns. PMID:27873955
Roohi, Fereydoon; Gropen, Toby; Kula, Roger W.
2014-01-01
Background: Chiari malformation type 1 (CM1) is a common congenital anomaly of the craniocervical junction. CM1 is reported to run a usually benign course and patients typically experience no symptoms or chronic, slowly progressive symptoms. However, recent reports indicate that a subset of patients with CM1 may present with acute deterioration and sudden unexpected death (SUD). We report a case of SUD during sleep in a young man with CM1, which we believe was related to the administration of common and therapeutic doses of narcotic analgesics for the management of pain. We will clarify the pathophysiology of acute deterioration and SUD in CM1 and the possibility that the adverse effects of opiate analgesics likely were the leading cause of death in our patient. Case Description: In this review, we present a 29-year-old male with worsening headache secondary to previously diagnosed CM1. The patient died suddenly and unexpectedly after administration of common and therapeutic doses of narcotic analgesics for the management of pain. Conclusion: The mechanism(s) of acute neurological deterioration and sudden death in patients with CM1 remains poorly understood. We believe the rapid fatal deterioration in our patient following administration of opioids suggests that this category of medication may cause sudden unexpected “neurogenic” cardiac death in CM1 patients by inducing sleep-related breathing difficulties and associated hypercapnia. Hypercapnia by further increasing intracranial pressure can result in a sudden pressure-induced decompensation of the cardiopulmonary control centers in the brain stem and cause instantaneous cardiorespiratory arrest. PMID:24778905
Ned B. Klopfenstein; Brian W. Geils
2011-01-01
Invasive fungal pathogens have caused immeasurably large ecological and economic damage to forests. It is well known that invasive fungal pathogens can cause devastating forest diseases (e.g., white pine blister rust, chestnut blight, Dutch elm disease, dogwood anthracnose, butternut canker, Scleroderris canker of pines, sudden oak death, pine pitch canker) (Maloy 1997...
Evolution of large body size in abalones (Haliotis): Patterns and implications
Estes, J.A.; Lindberg, D.R.; Wray, C.
2005-01-01
Kelps and other fleshy macroalgae - dominant reef-inhabiting organisms in cool - seasmay have radiated extensively following late Cenozoic polar cooling, thus triggering a chain of evolutionary change in the trophic ecology of nearshore temperate ecosystems. We explore this hypothesis through an analysis of body size in the abalones (Gastropoda; Haliotidae), a widely distributed group in modern oceans that displays a broad range of body sizes and contains fossil representatives from the late Cretaceous (60-75 Ma). Geographic analysis of maximum shell length in living abalones showed that small-bodied species, while most common in the Tropics, have a cosmopolitan distribution, whereas large-bodied species occur exclusively in cold-water ecosystems dominated by kelps and other macroalgae. The phylogeography of body size evolution in extant abalones was assessed by constructing a molecular phylogeny in a mix of large and small species obtained from different regions of the world. This analysis demonstrates that small body size is the plesiomorphic state and largeness has likely arisen at least twice. Finally, we compiled data on shell length from the fossil record to determine how (slowly or suddenly) and when large body size arose in the abalones. These data indicate that large body size appears suddenly at the Miocene/Pliocene boundary. Our findings support the view that fleshy-algal dominated ecosystems radiated rapidly in the coastal oceans with the onset of the most recent glacial age. We conclude with a discussion of the broader implications of this change. ?? 2005 The Paleontological Society. All rights reserved.
Van Hoang, Vo; Teboul, Victor; Odagaki, Takashi
2015-12-24
Via analysis of spatiotemporal arrangements of atoms based on their dynamics in supercooled liquid and glassy states of a 2D monatomic system with a double-well Lennard-Jones-Gauss (LJG) interaction potential, we find a new scenario of dynamical heterogeneity. Atoms with the same or very close mobility have a tendency to aggregate into clusters. The number of atoms with high mobility (and size of their clusters) increases with decreasing temperature passing over a maximum before decreasing down to zero. Position of the peak moves toward a lower temperature if mobility of atoms in clusters is lower together with an enhancement of height of the peak. In contrast, the number of atoms with very low mobility or solidlike atoms (and size of their clusters) has a tendency to increase with decreasing temperature and then it suddenly increases in the vicinity of the glass transition temperature leading to the formation of a glassy state. A sudden increase in the number of strongly correlated solidlike atoms in the vicinity of a glass transition temperature (Tg) may be an origin of a drastical increase in viscosity of the glass-forming systems approaching the glass transition. In fact, we find that the diffusion coefficient decays exponentially with a fraction of solidlike atoms exhibiting a sudden decrease in the vicinity of the glass transition region.
Quantum entanglement in three accelerating qubits coupled to scalar fields
NASA Astrophysics Data System (ADS)
Dai, Yue; Shen, Zhejun; Shi, Yu
2016-07-01
We consider quantum entanglement of three accelerating qubits, each of which is locally coupled with a real scalar field, without causal influence among the qubits or among the fields. The initial states are assumed to be the GHZ and W states, which are the two representative three-partite entangled states. For each initial state, we study how various kinds of entanglement depend on the accelerations of the three qubits. All kinds of entanglement eventually suddenly die if at least two of three qubits have large enough accelerations. This result implies the eventual sudden death of all kinds of entanglement among three particles coupled with scalar fields when they are sufficiently close to the horizon of a black hole.
2017-05-01
SUDDEN EXPANSION 5a. CONTRACT NUMBER In-house 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 62203F 6. AUTHOR(S) Joseph Michael Cronin 5d. PROJECT ...heat transfer in order to manage the ever-increasing airframe and engine heat loads. Two-phase liquid-vapor refrigerant systems are one solution for...were compared with pressure drop correlations. 15. SUBJECT TERMS thermal management , two-phase flow, flow visualization, electric capacitance
Sudden bending of a cracked laminate
NASA Technical Reports Server (NTRS)
Sih, G. C.; Chen, E. P.
1981-01-01
The intensification of stresses near a through crack in the laminate that suddenly undergoes bending is investigated. A dynamic plate theory is developed which includes the effects of material inhomogeneity in the thickness direction and realistic crack edge stress singularity and distribution. Numerical examples indicate that (1) the crack moment intensity tends to decrease as the crack length to laminate thickness is increased, and (2) the average load intensity transmitted to a through crack can be reduced by making the inner layers to be stiffer than the outer layers.
Acute Myocardial Infarction following Naltrexone Consumption; a Case Report.
Dadpour, Bita; Gholoobi, Arash; Tajoddini, Shahrad; Habibi, Amir
2017-01-01
Cardiovascular effects of opioid withdrawal have long been studied. It was reported that patients with underlying ischemic heart disease and atherosclerotic vessels may be complicated by a sudden physical and emotional stress due to withdrawal syndrome. But some other believes sudden increase in catecholamine level as a sympathetic overflow might effect on heart with and without underlying ischemia. In the current study, a patient on methadone maintenance therapy (MMT) who experienced myocardial infarction (MI) after taking naltrexone was described.
Assessing aspen using remote sensing
Randy Hamilton; Kevin Megown; Jeff DiBenedetto; Dale Bartos; Anne Mileck
2009-01-01
Large areas of aspen (Populus tremuloides) have disappeared and continue to disappear from western forests due to successional decline and sudden aspen decline (SAD). This loss of aspen ecosystems negatively impacts watersheds, wildlife, plants, and recreation. Much can still be done to restore aspen if timely and appropriate action is taken. However, land managers...
Low-energy proton increases associated with interplanetary shock waves.
NASA Technical Reports Server (NTRS)
Palmeira, R. A. R.; Allum, F. R.; Rao, U. R.
1971-01-01
Impulsive increases in the low energy proton flux observed by the Explorer 34 satellite, in very close time association with geomagnetic storm sudden commencements are described. It is shown that these events are of short duration (20-30 min) and occur only during the decay phase of a solar cosmic-ray flare event. The differential energy spectrum and the angular distribution of the direction of arrival of the particles are discussed. Two similar increases observed far away from the earth by the Pioneer 7 and 8 deep-space probes are also presented. These impulsive increases are compared with Energetic Storm Particle events and their similarities and differences are discussed. A model is suggested to explain these increases, based on the sweeping and trapping of low energy cosmic rays of solar origin by the advancing shock front responsible for the sudden commencement detected on the earth.
NASA Astrophysics Data System (ADS)
Shan, Chuan-Jia; Chen, Tao; Liu, Ji-Bing; Cheng, Wei-Wen; Liu, Tang-Kun; Huang, Yan-Xia; Li, Hong
2010-06-01
In this paper, we investigate the dynamical behaviour of entanglement in terms of concurrence in a bipartite system subjected to an external magnetic field under the action of dissipative environments in the extended Werner-like initial state. The interesting phenomenon of entanglement sudden death as well as sudden birth appears during the evolution process. We analyse in detail the effect of the purity of the initial entangled state of two qubits via Heisenberg XY interaction on the apparition time of entanglement sudden death and entanglement sudden birth. Furthermore, the conditions on the conversion of entanglement sudden death and entanglement sudden birth can be generalized when the initial entangled state is not pure. In particular, a critical purity of the initial mixed entangled state exists, above which entanglement sudden birth vanishes while entanglement sudden death appears. It is also noticed that stable entanglement, which is independent of different initial states of the qubits (pure or mixed state), occurs even in the presence of decoherence. These results arising from the combination of the extended Werner-like initial state and dissipative environments suggest an approach to control and enhance the entanglement even after purity induced sudden birth, death and revival.
NASA Astrophysics Data System (ADS)
Li, D.
2016-12-01
Sudden water pollution accidents are unavoidable risk events that we must learn to co-exist with. In China's Taihu River Basin, the river flow conditions are complicated with frequently artificial interference. Sudden water pollution accident occurs mainly in the form of a large number of abnormal discharge of wastewater, and has the characteristics with the sudden occurrence, the uncontrollable scope, the uncertainty object and the concentrated distribution of many risk sources. Effective prevention of pollution accidents that may occur is of great significance for the water quality safety management. Bayesian networks can be applied to represent the relationship between pollution sources and river water quality intuitively. Using the time sequential Monte Carlo algorithm, the pollution sources state switching model, water quality model for river network and Bayesian reasoning is integrated together, and the sudden water pollution risk assessment model for river network is developed to quantify the water quality risk under the collective influence of multiple pollution sources. Based on the isotope water transport mechanism, a dynamic tracing model of multiple pollution sources is established, which can describe the relationship between the excessive risk of the system and the multiple risk sources. Finally, the diagnostic reasoning algorithm based on Bayesian network is coupled with the multi-source tracing model, which can identify the contribution of each risk source to the system risk under the complex flow conditions. Taking Taihu Lake water system as the research object, the model is applied to obtain the reasonable results under the three typical years. Studies have shown that the water quality risk at critical sections are influenced by the pollution risk source, the boundary water quality, the hydrological conditions and self -purification capacity, and the multiple pollution sources have obvious effect on water quality risk of the receiving water body. The water quality risk assessment approach developed in this study offers a effective tool for systematically quantifying the random uncertainty in plain river network system, and it also provides the technical support for the decision-making of controlling the sudden water pollution through identification of critical pollution sources.
Sewage-treatment under substantial load variations in winter tourism areas--a full case study.
Winkler, S; Matsché, N; Gamperer, T; Dum, M
2004-01-01
The sewage-load variations in winter tourism areas are characterized by sudden increases--in the range of a factor two to three--within only a few days at the start and the end of the tourist season, especially at Christmas. The sudden load increases occur during periods of low wastewater temperatures, which is an additional demanding factor with respect to nitrogen removal. A full case study was carried out at WWTP Saalfelden, which is located near one of Austria's largest skiing resorts. The plant is designed for 80,000 PE and built according to the HYBRID-concept, which is a special two stage activated sludge process for extensive nutrient removal.
Aune, Dagfinn; Schlesinger, Sabrina; Norat, Teresa; Riboli, Elio
2018-06-01
Smoking is an established risk factor for cardiovascular disease including coronary heart disease and stroke, however, data regarding smoking and sudden cardiac death have not been summarized in a meta-analysis previously. We therefore conducted a systematic review and meta-analysis to clarify this association. We searched the PubMed and Embase databases for studies of smoking and sudden cardiac death up to July 20th 2017. Prospective studies were included if they reported adjusted relative risk (RR) estimates and 95% confidence intervals (CIs) for smoking and sudden cardiac death. Summary RRs were estimated by use of a random effects model. Twelve prospective studies were included. The summary RR was 3.06 (95% CI 2.46-3.82, I 2 = 41%, p heterogeneity = 0.12, n = 7) for current smokers and 1.38 (95% CI 1.20-1.60, I 2 = 0%, p heterogeneity = 0.55, n = 7) for former smokers compared to never smokers. For four studies using non-current (never + former) smokers as the reference category the summary RR among current smokers was 2.08 (95% CI 1.70-2.53, I 2 = 18%, p heterogeneity = 0.30). The results persisted in most of the subgroup analyses. There was no evidence of publication bias. These results confirm that smoking increases the risk of sudden cardiac death. Any further studies should investigate in more detail the effects of duration of smoking, number of cigarettes per day, pack-years, and time since quitting smoking and sudden cardiac death.
Gas dispersal potential of bedding as a cause for sudden infant death.
Sakai, Jun; Kanetake, Jun; Takahashi, Shirushi; Kanawaku, Yoshimasa; Funayama, Masato
2008-09-18
We assessed the gas dispersal potential of bedding articles used by 14 infants diagnosed with sudden unexpected infant death at autopsy. Of these cases, eight exhibited FiCO(2) values greater than 10% within 2.5 min, six of which were found prone and two supine. The results demonstrated that these eight beddings had a high rebreathing potential if they covered the babies' faces. We did not, however, take into account in our model the large tissue stores of CO(2). As some bicarbonate pools will delay or suppress the increase of FiCO(2), the time-FiCO(2) graphs of this study are not true for living infants. This model, however, demonstrated the potential gas dispersal ability of bedding. The higher the FiCO(2) values, the more dangerous the situation for rebreathing infants. In addition, FiO(2) in the potential space around the model's face can be estimated mathematically using FiCO(2) values. The FiO(2) graph pattern for each bedding item corresponded roughly to the inverse of the FiCO(2) time course. The FiO(2) of the above eight cases decreased by 8.5% within 2.5 min. Recent studies using living infants placed prone to sleep reported that some babies exhibited larger decreases in FiO(2) than increases observed in FiCO(2). While the decrease of FiO(2) in our model is still theoretical, CO(2) accumulation and O(2) deprivation are closely related. If a striking O(2) deficiency occurs in a short period, babies can lose consciousness before an arousal response is evoked and all infants could be influenced by the poor gas dispersal of bedding; the main cause of sudden death in infancy would thus be asphyxia. When the bedding is soft, the potential for trapping CO(2) seems to be high; however, it is impossible to assess it by appearance alone. We sought to provide some objective indices for the assessment of respiratory compromise in relation to bedding using our model. When a baby is found unresponsive with his/her face covered with poor gas dispersal bedding, we should consider the possibility of asphyxia.
Sudden gains in exposure therapy for obsessive-compulsive disorder.
Collins, Lindsey M; Coles, Meredith E
2017-06-01
Prior research in the treatment of depression and anxiety has demonstrated that a sudden reduction in symptoms between two consecutive sessions (sudden gain) is related to lower post-treatment symptom severity (e.g. Hofmann, Schulz, Meuret, Moscovitch, & Suvak, 2006; Tang & DeRubeis, 1999). However, only one study has examined sudden gains in the treatment of obsessive compulsive disorder (OCD). In that study, one-third of the patients with OCD experienced a sudden gain (Aderka et al., 2012). Further, patients who had a sudden gain had lower clinician-rated OCD symptom severity post-treatment (Aderka et al., 2012). In replication, the current study examined the frequency, characteristics, and clinical impact of sudden gains in 27 OCD patients during exposure and response prevention (ERP) therapy. Fifty two percent of patients experienced a sudden gain. The mean magnitude of a sudden gain represented, on average, 61.4% of total symptom reduction. Following treatment, individuals who had experienced a sudden gain were rated as less severe on the clinical global impression scale, but they did not experience a greater reduction in OCD symptoms (pre-to post-treatment) than those without a sudden gain. None of the pre-treatment characteristics tested were found to significantly predict whether a patient would have a sudden gain. Additional research examining predictors of, and patterns of, change in OCD symptoms is warranted. Copyright © 2017 Elsevier Ltd. All rights reserved.
Moritz, Max A; Odion, Dennis C
2005-06-01
Fire can be a dominant process in the ecology of forest vegetation and can also affect forest disease dynamics. Little is known about the relationship between fire and an emerging disease epidemic called Sudden Oak Death, which is caused by a new pathogen, Phytophthora ramorum. This disease has spread across a large, fire-prone portion of California, killing great numbers of oaks and tanoaks and infecting most associated woody plants. Suitable hosts cover a much broader geographic range, raising concern over where the disease may spread. To understand the strength and potential sensitivities of a fire-disease relationship, we examined geographic patterns of confirmed P. ramorum infections in relation to past fire history. We found these infections to be extremely rare within the perimeter of any area burned since 1950. This finding is not caused by spatial bias in sampling for the disease, and is robust to variation in host abundance scenarios and to aggregation of closely spaced sampling locations. We therefore investigated known fire-related factors that could result in significantly lower incidence of the disease in relatively recently burned landscapes. Chemical trends in post-fire environments can influence the success of pathogens like P. ramorum, either by increasing plant nutrient stress or by reducing the occurrence of chemicals antagonistic to Phytophthoras. Succession in the absence of fire leads to greater abundance of host species, which will provide increased habitat for P. ramorum; this will also increase intraspecific competition where these trees are abundant, and other density-dependent effects (e.g. shading) can reduce resource allocation to defenses. Despite these findings about a fire-disease relationship, a much deeper understanding is necessary before fire can be actively used as a tool in slowing the epidemic.
Circumstances and toxicology of sudden or unnatural deaths involving alprazolam.
Darke, Shane; Torok, Michelle; Duflou, Johan
2014-05-01
There has been a great deal of clinical concern regarding alprazolam abuse. This paper reported on alprazolam positive cases of sudden or unnatural deaths presenting to the New South Wales Department of Forensic Medicine (DOFM), 1/1/1997-31/12/2012. Case series. 412 cases were identified. There was a large increase in the annual number of cases, from 3 in 1997 to 86 in 2012. By 2012, 4.5% of all DOFM case presentations involved alprazolam. The mean age was 41.3 years, and 66.5% were male. Circumstances of death were: accidental drug toxicity (57.0%), deliberate drug toxicity (10.4%), suicide by means other than drug overdose (12.6%), disease (10.0%), accident (5.1%), homicide (2.4%). The major factor driving the increase in cases was accidental drug toxicity involving alprazolam, rising from 0 in 1997 to 58 in 2012. A history of drug/alcohol problems was noted in 80.4%, and 56.6% were injecting drug users. The median alprazolam concentration was 0.08 mg/L (range 0.005-2.10mg/L), with 37.4% of cases having concentrations of ≥ 0.1 mg/L. In 94.9% of cases, drugs other than alprazolam and its metabolites were present, including all accidental overdoses. The most commonly detected drugs were opioids (64.6%), other benzodiazepines (44.4%) and alcohol (34.5%). A third (31.8%) of cases were HCV positive. Cases involving alprazolam increased markedly, driven mostly by toxicity deaths amongst people with known drug and alcohol problems. Caution in prescribing alprazolam would appear appropriate, particularly to those with known drug dependence. Copyright © 2014. Published by Elsevier Ireland Ltd.
Sudden changes in environmental conditions do not increase invasion risk in grassland
NASA Astrophysics Data System (ADS)
Ruprecht, Eszter; Fenesi, Annamária; Nijs, Ivan
2013-02-01
After direct habitat transformation, biological invasions are considered to be the second most important threat to biodiversity. A better understanding of the factors affecting invasion success in new areas is crucial, and may provide insight into potential control actions. We hypothesized that invasion risk increases in habitats undergoing a sudden change in the disturbance regime or environmental conditions. For testing this assumption we initiated a seed sowing experiment while introducing two novel treatments, mowing twice and fertilizer application, in two grassland sites (one dryer and one mesic) in Romania. The seeds of two invasive species, Solidago canadensis and Rudbeckia laciniata, and two resident natives of similar seed sizes, life-forms and strategies were sowed in treated and control plots, and seed germination, seedling establishment and growth were followed during four months. Contrary to our expectations, there was no difference in the treatment effects on seed germination and seedling establishment between species, while there was on seedling vigour of the larger seeded species in the dryer grassland site, where the native had a higher performance especially in increased nutrient conditions. Indifferently from applied treatments, invasive species had greater cumulative germination in the mesic site, while natives were far more successful in seedling establishment in the drier site. At the same time, seed size was found to be a very important factor explaining germination and establishment success, with large seeded species outperforming small seeded species in any circumstances. Our results call the attention upon management interventions in mesic, productive grassland sites opening colonization windows for the recruitment of those invasive species of which ecological requirements correspond to local environmental conditions.
Vecchio, Nicolás; Belardi, Diego; Benzadón, Mariano; Seoane, Leonardo; Daquarti, Gustavo; Scazzuso, Fernando
2018-06-01
Despite the well-documented benefit of implantable cardioverter defibrillator (ICD) in patients with severe left ventricular dysfunction, there is a large number of patients who had not been offered this therapy. The aim of this study is to evaluate the utility of a hybrid decision support system (hCDSS) to improve the adherence to indicate ICD therapy in our institution. We conducted a retrospective, observational and single-center study. An hCDSS focused on patients with severe deterioration of the left ventricular function was implemented, creating a mandatory field containing the value of left ejection fraction and three options to choose: >35%, ≤ 35% or unknown. When the option ≤ 35% is checked, an email is automatically sent to the electrophysiology section where the staff can contact the treating physician to discuss the indication of ICD therapy. We measured the number of ICDs implanted before the alert (month 1-21), immediate post and late post alert (month 22-27 and 28-48 months respectively) RESULTS: The rate of ICD implantation increased from 1.76% per month in the pre-intervention period to 4.48% after the intervention (p < 0.001). This increase in the rate of ICD implantation remained stable between the immediate and late post-intervention period (4.6 vs. 4.4; p = .8) CONCLUSION: The implementation of a hybrid decision support system was associated with improved adherence to clinical guidelines for prevention of sudden cardiac death, as evidenced by a rapid and sustained increase in the number of ICD implants in patients with severe left ventricular dysfunction. Copyright © 2018 Elsevier B.V. All rights reserved.
Stress-mediated Allee effects can cause the sudden collapse of honey bee colonies.
Booton, Ross D; Iwasa, Yoh; Marshall, James A R; Childs, Dylan Z
2017-05-07
The recent rapid decline in global honey bee populations could have significant implications for ecological systems, economics and food security. No single cause of honey bee collapse has yet to be identified, although pesticides, mites and other pathogens have all been shown to have a sublethal effect. We present a model of a functioning bee hive and introduce external stress to investigate the impact on the regulatory processes of recruitment to the forager class, social inhibition and the laying rate of the queen. The model predicts that constant density-dependent stress acting through an Allee effect on the hive can result in sudden catastrophic switches in dynamical behaviour and the eventual collapse of the hive. The model proposes that around a critical point the hive undergoes a saddle-node bifurcation, and that a small increase in model parameters can have irreversible consequences for the entire hive. We predict that increased stress levels can be counteracted by a higher laying rate of the queen, lower levels of forager recruitment or lower levels of natural mortality of foragers, and that increasing social inhibition can not maintain the colony under high levels of stress. We lay the theoretical foundation for sudden honey bee collapse in order to facilitate further experimental and theoretical consideration. Copyright © 2017 Elsevier Ltd. All rights reserved.
NASA Astrophysics Data System (ADS)
Sauter, Daniel; Cannat, Mathilde; Meyzen, Christine; Bezos, Antoine; Patriat, Philippe; Humler, Eric; Debayle, Eric
2009-11-01
Regional axial depths, mantle Bouguer anomaly values, geochemical proxies for the extent of partial melting and tomographic models along the Southwest Indian Ridge (SWIR) all concur in indicating the presence of thicker crust and hotter mantle between the Indomed and Gallieni transform faults (TFs; 46°E and 52°20'E) relative to the neighbouring ridge sections. Accreted seafloor between these TFs over the past ~10 Myr is also locally much shallower (>1000 m) and corresponds to thicker crust (>1.7 km) than previously accreted seafloor along the same ridge region. Two large outward facing topographic gradients mark the outer edges of two anomalously shallow off-axis domains on the African and Antarctic plates. Their vertical relief (>2000 m locally) and their geometry, parallel to the present-day axis along a >210-km-long ridge section, suggest an extremely sudden and large event dated between ~8 (magnetic anomaly C4n) and ~11 Ma (magnetic anomaly C5n). Asymmetric spreading and small ridge jumps occur at the onset of the formation of the anomalously shallow off-axis domains, leading to a re-organization of the ridge segmentation. We interpret these anomalously shallow off-axis domains as the relicts of a volcanic plateau due to a sudden increase of the magma supply. This event of enhanced magmatism started in the central part of the ridge section and then propagated along axis to the east and probably also to the west. However, it did not cross the Gallieni and Indomed TFs suggesting that large offsets can curtail or even block along-axis melt flow. We propose that this melting anomaly may be ascribed to a regionally higher mantle temperature provided by mantle outpouring from the Crozet hotspot towards the SWIR.
Barigye, Robert; Schamber, Ev; Newell, Teresa K; Dyer, Neil W
2007-11-01
Routine postmortem examination and histologic evaluation of tissue sections demonstrated hepatic lipidosis (HL) in 2 adult captive porcupines with a history of sudden death. The male porcupine had a markedly enlarged pale liver that microscopically showed large unilocular vacuoles within hepatocellular cytoplasm. The periparturient female had similar but less marked hepatic lesions and an incidental pulmonary mycosis. These findings suggest HL as an important differential of spontaneous death in captive porcupines. It is hypothesized that in addition to the widely documented causes, HL in captive porcupines may be specifically associated with nutritional imbalances caused by the feeding of unsuitable commercial diets. The possible association of the condition with dietary and other factors in captive porcupines needs to be thoroughly investigated.
The prevalence of childhood traumatic grief--a comparison of violent/sudden and expected loss.
McClatchy, Irene Searles; Vonk, M Elizabeth; Palardy, Gregory
2009-01-01
The purpose of this study was to examine the prevalence of childhood traumatic grief (CTG) and posttraumatic stress disorder (PTSD) symptoms in parentally bereaved children and compare scores between those who had lost a parent to a sudden/violent death and those who had lost a parent to an expected death. A sample of 158 parentally bereaved children ages 7-16 completed the Extended Grief Inventory (EGI); 127 of those also completed the UCLA PTSD Index. A large number of children were experiencing CTG symptoms at moderate and severe levels. There was no significant difference in EGI or UCLA PTSD Index scores between the two types of losses. Findings are discussed in relation to trauma theory, research on parentally bereaved children and implications for practice.
Gannon, J.L.
2012-01-01
Statistics on geomagnetic storms with minima below -50 nanoTesla are compiled using a 25-year span of the 1-minute resolution disturbance index, U.S. Geological Survey Dst. A sudden commencement, main phase minimum, and time between the two has a magnitude of 35 nanoTesla, -100 nanoTesla, and 12 hours, respectively, at the 50th percentile level. The cumulative distribution functions for each of these features are presented. Correlation between sudden commencement magnitude and main phase magnitude is shown to be low. Small, medium, and large storm templates at the 33rd, 50th, and 90th percentile are presented and compared to real examples. In addition, the relative occurrence of rates of change in Dst are presented.
Grabau, John C; Hughes, Stephen E; Rodriguez, Edwin M; Sommer, Jamie N; Troy, Eleanor T
2004-01-01
A 60 year-old man born in Central America died suddenly in the hallway of his residence on the grounds of a resort hotel where he worked as a dishwasher. The dishwashing station was in a large, poorly ventilated area where a substantial number of food service workers (cooks, wait staff, bus persons, dishwashers, supervisors, etc.) shared air space with the index patient. Several social contacts of the patient reported that he had been coughing for many months before his death. The County Department Of Health conducted a contact investigation, which identified 171 individuals in need of follow-up. Thirty-six percent of those tested in the first round were tuberculin skin test-positive; a second round of testing yielded a 15% (8 of 52) conversion rate.
Information jet: Handling noisy big data from weakly disconnected network
NASA Astrophysics Data System (ADS)
Aurongzeb, Deeder
Sudden aggregation (information jet) of large amount of data is ubiquitous around connected social networks, driven by sudden interacting and non-interacting events, network security threat attacks, online sales channel etc. Clustering of information jet based on time series analysis and graph theory is not new but little work is done to connect them with particle jet statistics. We show pre-clustering based on context can element soft network or network of information which is critical to minimize time to calculate results from noisy big data. We show difference between, stochastic gradient boosting and time series-graph clustering. For disconnected higher dimensional information jet, we use Kallenberg representation theorem (Kallenberg, 2005, arXiv:1401.1137) to identify and eliminate jet similarities from dense or sparse graph.
Torsion of Abdominal Organs in Sows: A Report of 36 Cases
Morin, M.; Sauvageau, R.; Phaneuf, J.-B.; Teuscher, E.; Beauregard, M.; Lagacé, A.
1984-01-01
Necropsy records of 36 sows with torsion of abdominal organs involving individually the stomach, the spleen, a liver lobe or the intestine were reviewed for the years 1970 to 1983, and the age, the clinical signs and the gross lesions were recorded. These acute abdominal accidents were characterized clinically by sudden death. Dry sows from large breeding units were affected. Twenty-six cases were diagnosed between January 1981 and December 1983 while only ten cases had been seen between 1970 and 1980. Gastric torsion was the most common condition (40% of the cases) and the other three conditions were equally represented (20% each). Management practises that could be responsible for the apparent increase in occurrence of this problem are discussed. PMID:17422483
What's Wrong with Youth Service? Occasional Papers.
ERIC Educational Resources Information Center
Halperin, Samuel
The resurgence of national interest in youth service is due, in large part, to the national organizations that have grown so vigorously in recent years. Some explanations for the almost sudden reappearance of youth service as a nationwide issue are: (1) many Americans are fed up with narcissism, personal gratification, and me-centered pursuits;…
Summer survival of Phytophthora ramorum in forest soils
Elizabeth J. Fichtner; Shannon C. Lynch; David M. Rizzo
2006-01-01
Recovery of Phytophthora ramorum from soils throughout Sudden Oak Death-affected regions of California illustrates that soil serves as an inoculum reservoir for the pathogen, but the potential for survival in soils throughout the summer is largely unknown. In this study we assess pathogen survival in infected leaf tissue in the upper soil profile in...
Biomarkers identify coast live oaks that are resistant to the invasive pathogen Phytophthora ramorum
Brice A. McPherson; Sylvia R. Mori; Anna O. Conrad; Stephen Opiyo; Pierluigi Bonello; David L. Wood
2015-01-01
California coast live oaks (Quercus agrifolia) trees have suffered large losses from sudden oak death, caused by the introduced oomycete Phytophthora ramorum. In this review paper, we discuss oak plant chemistry as a potential predictor of disease susceptibility. We have recorded an annual mortality rate of three percent in...
Pressure Distribution Over Airfoils at High Speeds
NASA Technical Reports Server (NTRS)
Briggs, L J; Dryden, H L
1927-01-01
This report deals with the pressure distribution over airfoils at high speeds, and describes an extension of an investigation of the aerodynamic characteristics of certain airfoils which was presented in NACA Technical Report no. 207. The results presented in report no. 207 have been confirmed and extended to higher speeds through a more extensive and systematic series of tests. Observations were also made of the air flow near the surface of the airfoils, and the large changes in lift coefficients were shown to be associated with a sudden breaking away of the flow from the upper surface. The tests were made on models of 1-inch chord and comparison with the earlier measurements on models of 3-inch chord shows that the sudden change in the lift coefficient is due to compressibility and not to a change in the Reynolds number. The Reynolds number still has a large effect, however, on the drag coefficient. The pressure distribution observations furnish the propeller designer with data on the load distribution at high speeds, and also give a better picture of the air-flow changes.
Wu, M-F; Nienhuis, R; Maidment, N; Lam, H A; Siegel, J M
2011-11-07
Hypocretin (Hcrt) has been implicated in the control of motor activity and in respiration and cardiovascular changes. Loss of Hcrt in narcolepsy is linked to sleepiness and to cataplexy, a sudden loss of muscle tone which is triggered by sudden strong emotions. In the current study we have compared the effects of treadmill running, to yard play on cerebrospinal fluid (CSF) Hcrt level in normal dogs. We find that treadmill locomotion, at a wide range of speeds, does not increase Hcrt level beyond baseline, whereas yard play produces a substantial increase in Hcrt, even though both activities produce comparable increases in heart rate, respiration and body temperature. We conclude that motor and cardiovascular changes are not sufficient to elevate CSF levels of Hcrt and we hypothesize that the emotional aspects of yard play account for the observed increase in Hcrt.
Effect of temperature on motility and chemotaxis of Escherichia coli.
Maeda, K; Imae, Y; Shioi, J I; Oosawa, F
1976-01-01
The swimming velocity of Escherichia coli at various constant temperatures was found to increase with increasing temperature. The frequency of tumbling had a peak at 34 degrees C and was very low both at 20 and at 39 degrees C. The swimming tracks near the surface of a slide glass showed curves, and the curvature increased the temperature. When the temperature of a bacterial suspension was suddenly changed, a transient change of the tumbling frequency was observed. A temperature drop induced a temporary increase in the tumbling frequency, and a quick rise of temperature, on the other hand, resulted in a temporary suppression of the tumbling. These dynamic responses to sudden changes of temperature was not observed in the smoothly swimming nonchemotactic strains bearing the mutations cheA and cheC and also in a mutant with the metF mutation under a smooth swimming condition. Images PMID:783127
Sudden Failure of Swimming in Cold Water
Keatinge, W. R.; Prys-Roberts, C.; Cooper, K. E.; Honour, A. J.; Haight, J.
1969-01-01
To investigate the effect of cold water on swimming four men who declared themselves good swimmers were immersed fully clothed on separate days in water at 23·7° and 4·7° C. The time that they were able to swim in the cold water was much shorter than in the warm. The two shortest swims ended after 1·5 and 7·6 minutes, before rectal temperature fell, when the men suddenly floundered after developing respiratory distress with breathing rates of 56–60/min. The other cold swims, by the two fattest men, ended less abruptly with signs of general and peripheral hypothermia. It is concluded that swimming in cold water was stopped partly by respiratory reflexes in the thin men and hypothermia in the fat, and partly by the cold water's high viscosity. The longer swimming times of the fat men are attributed largely to their greater buoyancy enabling them to keep their heads above water during the early hyperventilation. The findings explain some reports of sudden death in cold water. It is clearly highly dangerous to attempt to swim short distances to shore without a life-jacket in water near 0° C. PMID:5764250
NASA Astrophysics Data System (ADS)
Savenkova, E. N.; Gavrilov, N. M.; Pogoreltsev, A. I.; Manuilova, R. O.
2017-05-01
Using the data of meteorological information reanalysis, a statistical analysis of dates of the main sudden stratospheric warmings observed in 1958-2014 has been performed and their inhomogeneous distribution in winter months with maximums in the beginning of January, from the end of January to the beginning of February, and in the end of February has been shown. To explain these regularities, a climatological analysis of variations in the amplitudes and vertical components of Eliassen-Palm fluxes created by large-scale planetary waves (PWs), as well as of zonal-mean winds and deviations of temperature from their winter-average values in high northern latitudes at heights of up to 50 km from the surface has been carried out using the 20-year (1995-2014) collection of daily meteorological information from the UK Met Office database. During the aforementioned intervals of observing more frequent sudden stratospheric warmings, climatological maximums of temperature perturbations, local minimums of eastward winds, and local maximums of the amplitude and Eliassen-Palm fluxes of PWs with a zonal wavenumber of 1 in the high-latitude northern stratosphere were found. Distinctions between atmospheric characteristics averaged over two last decades have been revealed.
Not a slippery slope or sudden subversion: German medicine and national socialism in 1933.
Hanauske-Abel, H M
1996-12-07
The history of medicine this century is darkened by the downfall of the German medical profession, exposed during the doctors' trial at Nuremberg in 1946. Relying largely on documents published during 1933 in German medical journals, this paper examines two widely accepted notions of those events, metaphorically termed "slippery slope" and "sudden subversion." The first connotes a gradual slide over infinitesimal steps until, suddenly, all footing is lost; the second conveys forced take over of the profession's leadership and values. Both concepts imply that the medical profession itself became the victim of circumstances. The slippery slope concept is a prominent figure of argument in the current debate on bioethics. The evidence presented here, however, strongly suggests that the German medical community set its own course in 1933. In some respects this course even outpaced the new government, which had to rein in the profession's eager pursuit of enforced eugenic sterilizations. In 1933 the convergence of political, scientific, and economic forces dramatically changed the relationship between the medical community and the government. That same convergence is occurring again and must be approached with great caution if medicine is to remain focused on the preservation of physical and medical integrity.
No Flares from Gamma-Ray Burst Afterglow Blast Waves Encountering Sudden Circumburst Density Change
NASA Astrophysics Data System (ADS)
Gat, Ilana; van Eerten, Hendrik; MacFadyen, Andrew
2013-08-01
Afterglows of gamma-ray bursts are observed to produce light curves with the flux following power-law evolution in time. However, recent observations reveal bright flares at times on the order of minutes to days. One proposed explanation for these flares is the interaction of a relativistic blast wave with a circumburst density transition. In this paper, we model this type of interaction computationally in one and two dimensions, using a relativistic hydrodynamics code with adaptive mesh refinement called RAM, and analytically in one dimension. We simulate a blast wave traveling in a stellar wind environment that encounters a sudden change in density, followed by a homogeneous medium, and compute the observed radiation using a synchrotron model. We show that flares are not observable for an encounter with a sudden density increase, such as a wind termination shock, nor for an encounter with a sudden density decrease. Furthermore, by extending our analysis to two dimensions, we are able to resolve the spreading, collimation, and edge effects of the blast wave as it encounters the change in circumburst medium. In all cases considered in this paper, we find that a flare will not be observed for any of the density changes studied.
Association of the genetic markers for myocardial infarction with sudden cardiac death.
Ivanova, Anastasiya A; Maksimov, Vladimir N; Orlov, Pavel S; Ivanoshchuk, Dinara E; Savchenko, Sergei V; Voevoda, Mikhail I
2017-04-01
Investigate the association of rs17465637 gene MIAF3 (1q41), rs1376251 gene TAS2R50 (12p13), rs4804611 gene ZNF627 (19p13), rs619203 gene ROS1 (6q22), rs1333049 (9p21), rs10757278 (9p21), rs2549513 (16q23), rs499818 (6p24) associated with myocardial infarction available from the international genome-wide studies with sudden cardiac death (SCD) in a case-control study. A sample of SCD cases (n=285) was formed using the WHO criteria; the control sample (n=421) was selected according to sex and age. DNA was isolated by phenol-chloroform extraction from the myocardial tissue of SCD cases and blood of control cases. The groups were genotyped for the selected SNPs by real-time PCR using TaqMan probes (Applied Biosystems, United States). No statistically significant differences in the genotype and allelic frequencies of studied single nucleotide polymorphisms between sudden cardiac death cases and control were detectable in general group. By separating the groups of sex and age differences in the genotype frequencies of rs1333049, rs10757278 and rs499818 are statistical significance. Genotypes CC of rs1333049 and GG of rs10757278 are associated with an increased sudden cardiac death risk in men (p=0.019, OR=1.7, 95% CI 1.1-2.8; p=0.011, OR=1.8, 95% CI 1.2-2.8, respectively). Genotype AG of rs499818 is associated with an increased sudden cardiac death risk in the women over 50 years old (p=0.009, OR=2.4, 95% CI 1.3-4.6). Polymorphisms rs1333049 and rs10757278 are associated with SCD in men and rs499818 in the women aged over 50 years. Copyright © 2016. Published by Elsevier B.V.
Recent and future warm extreme events and high-mountain slope stability.
Huggel, C; Salzmann, N; Allen, S; Caplan-Auerbach, J; Fischer, L; Haeberli, W; Larsen, C; Schneider, D; Wessels, R
2010-05-28
The number of large slope failures in some high-mountain regions such as the European Alps has increased during the past two to three decades. There is concern that recent climate change is driving this increase in slope failures, thus possibly further exacerbating the hazard in the future. Although the effects of a gradual temperature rise on glaciers and permafrost have been extensively studied, the impacts of short-term, unusually warm temperature increases on slope stability in high mountains remain largely unexplored. We describe several large slope failures in rock and ice in recent years in Alaska, New Zealand and the European Alps, and analyse weather patterns in the days and weeks before the failures. Although we did not find one general temperature pattern, all the failures were preceded by unusually warm periods; some happened immediately after temperatures suddenly dropped to freezing. We assessed the frequency of warm extremes in the future by analysing eight regional climate models from the recently completed European Union programme ENSEMBLES for the central Swiss Alps. The models show an increase in the higher frequency of high-temperature events for the period 2001-2050 compared with a 1951-2000 reference period. Warm events lasting 5, 10 and 30 days are projected to increase by about 1.5-4 times by 2050 and in some models by up to 10 times. Warm extremes can trigger large landslides in temperature-sensitive high mountains by enhancing the production of water by melt of snow and ice, and by rapid thaw. Although these processes reduce slope strength, they must be considered within the local geological, glaciological and topographic context of a slope.
Spontaneous Coronary Artery Dissection: Current State of the Science
Hayes, Sharonne N.; Kim, Esther S.H.; Saw, Jacqueline; Adlam, David; Arslanian-Engoren, Cynthia; Economy, Katherine E.; Ganesh, Santhi K.; Gulati, Rajiv; Lindsay, Mark E.; Mieres, Jennifer H.; Naderi, Sahar; Shah, Svati; Thaler, David E.; Tweet, Marysia S.; Wood, Malissa J.
2018-01-01
Spontaneous coronary artery dissection (SCAD) has emerged as an important cause of acute coronary syndrome, myocardial infarction, and sudden death, particularly among young women and individuals with few conventional atherosclerotic risk factors. Patient-initiated research has spurred increased awareness of SCAD, and improved diagnostic capabilities and findings from large case series have led to changes in approaches to initial and long-term management and increasing evidence that SCAD not only is more common than previously believed but also must be evaluated and treated differently from atherosclerotic myocardial infarction. High rates of recurrent SCAD; its association with female sex, pregnancy, and physical and emotional stress triggers; and concurrent systemic arteriopathies, particularly fibromuscular dysplasia, highlight the differences in clinical characteristics of SCAD compared with atherosclerotic disease. Recent insights into the causes of, clinical course of, treatment options for, outcomes of, and associated conditions of SCAD and the many persistent knowledge gaps are presented. PMID:29472380
Triggers and maintenance of multiple shifts in the state of a natural community
Schmitt, Russell J.; Holbrook, Sally J.
2010-01-01
Ecological communities can undergo sudden and dramatic shifts between alternative persistent community states. Both ecological prediction and natural resource management rely on understanding the mechanisms that trigger such shifts and maintain each state. Differentiating between potential mechanisms is difficult, however, because shifts are often recognized only in hindsight and many occur on such large spatial scales that manipulative experiments to test their causes are difficult or impossible. Here we use an approach that focuses first on identifying changes in environmental factors that could have triggered a given state change, and second on examining whether these changes were sustained (and thus potentially maintained the new state) or transitory (explaining the shift but not its persistence). We use this approach to evaluate a community shift in which a benthic marine species of filter feeding sea cucumber (Pachythyone rubra) suddenly came to dominate subtidal rocky reefs that had previously supported high abundances of macroalgae, persisted for more than a decade, then abruptly declined. We found that a sustained period without large wave events coincided with the shift to sea cucumber dominance, but that the sea cucumbers persisted even after the end of this low wave period, indicating that different mechanisms maintained the new community. Additionally, the period of sea cucumber dominance occurred when their predators were rare, and increases in the abundance of these predators coincided with the end of sea cucumber dominance. These results underscore the complex nature of regime shifts and illustrate that focusing separately on the causes and maintenance of state change can be a productive first step for analyzing these shifts in a range of systems. PMID:20526781
Sudden gains in group cognitive-behavioral therapy for panic disorder.
Clerkin, Elise M; Teachman, Bethany A; Smith-Janik, Shannan B
2008-11-01
The current study investigates sudden gains (rapid symptom reduction) in group cognitive-behavioral therapy for panic disorder. Sudden gains occurring after session 2 of treatment predicted overall symptom reduction at treatment termination and some changes in cognitive biases. Meanwhile, sudden gains occurring immediately following session 1 were not associated with symptom reduction or cognitive change. Together, this research points to the importance of examining sudden gains across the entire span of treatment, as well as the potential role of sudden gains in recovery from panic disorder.
Sudden Gains in Group Cognitive-Behavioral Therapy for Panic Disorder
Clerkin, Elise M.; Teachman, Bethany A.; Smith-Janik, Shannan B.
2008-01-01
The current study investigates sudden gains (rapid symptom reduction) in group cognitive-behavioral therapy for panic disorder. Sudden gains occurring after session 2 of treatment predicted overall symptom reduction at treatment termination and some changes in cognitive biases. Meanwhile, sudden gains occurring immediately following session 1 were not associated with symptom reduction or cognitive change. Together, this research points to the importance of examining sudden gains across the entire span of treatment, as well as the potential role of sudden gains in recovery from panic disorder. PMID:18804199
Sudden Death in Young People--Heart Problems Often Blamed
Sudden death in young people: Heart problems often blamed Sudden death in young people is rare, but those at ... causes and treatments. By Mayo Clinic Staff Sudden death in people younger than 35, often due to ...
Geomagnetic sudden impulses and storm sudden commencements - A note on terminology
NASA Technical Reports Server (NTRS)
Joselyn, J. A.; Tsurutani, B. T.
1990-01-01
The definitions of and distinctions between storm sudden commencements (SSCs) and geomagnetic sudden impulses (SIs) are examined and present definitions of SIs and SSCs are modernized. Quantitative definitions of the two terms are recommended.
Variational principle model for the nuclear caloric curve
DOE Office of Scientific and Technical Information (OSTI.GOV)
Das Gupta, S.
2005-12-15
Following the lead of a recent work, I perform a variational principle model calculation for the nuclear caloric curve. A Skyrme-type interaction with and without momentum dependence is used. The calculation is done for a large nucleus, i.e., in the nuclear matter limit. Thus I address the issue of volume fragmentation only. Nonetheless, the results are similar to the previous, largely phenomenological calculation for a finite nucleus. I find that the onset of fragmentation can be sudden as a function of temperature or excitation energy.
Cohen, Jeremy D; Bolstad, Mark; Lee, Albert K
2017-01-01
The hippocampus is critical for producing stable representations of familiar spaces. How these representations arise is poorly understood, largely because changes to hippocampal inputs have not been measured during spatial learning. Here, using intracellular recording, we monitored inputs and plasticity-inducing complex spikes (CSs) in CA1 neurons while mice explored novel and familiar virtual environments. Inputs driving place field spiking increased in amplitude – often suddenly – during novel environment exploration. However, these increases were not sustained in familiar environments. Rather, the spatial tuning of inputs became increasingly similar across repeated traversals of the environment with experience – both within fields and throughout the whole environment. In novel environments, CSs were not necessary for place field formation. Our findings support a model in which initial inhomogeneities in inputs are amplified to produce robust place field activity, then plasticity refines this representation into one with less strongly modulated, but more stable, inputs for long-term storage. DOI: http://dx.doi.org/10.7554/eLife.23040.001 PMID:28742496
Neubauer, Jacqueline; Lecca, Maria Rita; Russo, Giancarlo; Bartsch, Christine; Medeiros-Domingo, Argelia; Berger, Wolfgang; Haas, Cordula
2017-04-01
Sudden infant death syndrome (SIDS) is described as the sudden and unexplained death of an apparently healthy infant younger than one year of age. Genetic studies indicate that up to 35% of SIDS cases might be explained by familial or genetic diseases such as cardiomyopathies, ion channelopathies or metabolic disorders that remained undetected during conventional forensic autopsy procedures. Post-mortem genetic testing by using massive parallel sequencing (MPS) approaches represents an efficient and rapid tool to further investigate unexplained death cases and might help to elucidate pathogenic genetic variants and mechanisms in cases without a conclusive cause of death. In this study, we performed whole-exome sequencing (WES) in 161 European SIDS infants with focus on 192 genes associated with cardiovascular and metabolic diseases. Potentially causative variants were detected in 20% of the SIDS cases. The majority of infants had variants with likely functional effects in genes associated with channelopathies (9%), followed by cardiomyopathies (7%) and metabolic diseases (1%). Although lethal arrhythmia represents the most plausible and likely cause of death, the majority of SIDS cases still remains elusive and might be explained by a multifactorial etiology, triggered by a combination of different genetic and environmental risk factors. As WES is not substantially more expensive than a targeted sequencing approach, it represents an unbiased screening of the exome, which could help to investigate different pathogenic mechanisms within the genetically heterogeneous SIDS cohort. Additionally, re-analysis of the datasets provides the basis to identify new candidate genes in sudden infant death.
The sudden removal of user fees: the perspective of a frontline manager in Burundi.
Nimpagaritse, Manassé; Bertone, Maria Paola
2011-11-01
In May 2006, the President of Burundi announced the removal of user fees in all health centres and hospitals for children under 5 and women giving birth. As other studies also point out, the policy was adopted extremely suddenly, without much reflection on its ultimate aims and on the operational dimension of its implementation. From the perspective of a frontline manager, this paper provides a descriptive case study of the abolition of user fees in the Muramvya District and a first-hand account of the effects of the sudden reform in the management of a district and a district hospital. The analysis highlights the challenges that the district and hospital teams faced. The main issues were: the reduction of financial flows, which prevented the possibility of investments and caused frequent drugs stock-outs; the reduced quality of the services and the disruption of the referral system; the motivation of the health staff who saw the administrative workload increase (not necessarily because of increased utilization) and faced 'ethical dilemmas' caused by the imprecise targeting of the reform. Undoubtedly, the removal of user fees for certain groups was an equitable and necessary measure in an extremely poor country such as Burundi. However, the suddenness of the decision and the lack of preparation had critical and long-lasting consequences for the entire health system. This analysis, performed from the frontline perspective, clarifies the importance of a rigorous planning of any reform, as well as of involving peripheral actors and understanding the complex challenges that they face.
Quantum Correlation Properties in Two Qubits One-axis Spin Squeezing Model
NASA Astrophysics Data System (ADS)
Guo-Hui, Yang
2017-02-01
Using the concurrence (C) and quantum discord (QD) criterions, the quantum correlation properties in two qubits one-axis spin squeezing model with an external magnetic field are investigated. It is found that one obvious difference in the limit case T → 0 (ground state) is the sudden disappearance phenomenon (SDP) occured in the behavior of C, while not in QD. In order to further explain the SDP, we obtain the analytic expressions of ground state C and QD which reveal that the SDP is not really "entanglement sudden disappeared", it is decayed to zero very quickly. Proper tuning the parameters μ(the spin squeezing interaction in x direction) and Ω(the external magnetic field in z direction) not only can obviously broaden the scope of ground state C exists but also can enhance the value of ground state QD. For the finite temperature case, one evident difference is that the sudden birth phenomenon (SBP) is appeared in the evolution of C, while not in QD, and decreasing the coupling parameters μ or Ω can obviously prolong the time interval before entanglement sudden birth. The value of C and QD are both enhanced by increasing the parameters μ or Ω in finite temperature case. In addition, through investigating the effects of temperature T on the quantum correlation properties with the variation of Ω and μ, one can find that the temperature scope of C and QD exists are broadened with increasing the parameters μ or Ω, and one can obtain the quantum correlation at higher temperature through changing these parameters.
NASA Technical Reports Server (NTRS)
Schlegel, T. T.; Marthol, H.; Bucchner, S.; Tutaj, M.; Berlin, D.; Axelrod, F. B.; Hilz, M. J.
2004-01-01
Patients with familial dysautonomia (FD) have an increased risk of sudden death, but sensitive and specific predictors of sudden death in FD are lacking. Methods. We recorded 10-min resting high-fidelity 12-lead ECGs in 14 FD patients and in 14 age/gender-matched healthy subjects and studied 25+ different heart rate variability (HRV) indices for their ability to predict sudden death in the FD patients. Indices studied included those from 4 "nonlinear" HRV techniques (detrended fluctuation analysis, approximate entropy, correlation dimension, and PoincarC analyses). The predictive value of PR, QRS, QTc and JTc intervals, QT dispersion (QTd), beat-to-beat QT and PR interval variability indices (QTVI and PRVI) and 12- lead high frequency QRS ECG (150-250 Hz) were also studied. FD patients and controls (C) differed (Pless than 0.0l) with respect to 20+ of the HRV indices (FD less than C) and with respect to QTVI and PRVI (FDBC) and HF QRS- related root mean squared voltages (FDBC) and reduced amplitude zone counts (FD less than C). They differed less with respect to PR intervals (FD less than C) and JTc intervals (FD greater than C) (P less than 0.05 for both) and did not differ at all with respect to QRS and QTc intervals and to QTd. Within 12 months after study, 2 of the 14 patients succumbed to sudden cardiac arrest. The best predictor of sudden death was the degree of diminution in HRV vagal-cardiac (parasympathetic) parameters such as RMSSD, the SDl of Poincare plots, and HF spectral power. Excluding the two FD patients who had resting tachycardia (HR greater than 100, which confounds traditional HRV analyses), the following criteria were independently 100% sensitive and 100% specific for predicting sudden death in the remaining 12 FD patients during spontaneous breathing: RMSSD less than 13 ms and/or PoincarC SD1 less than 9 ms. In FD patients without supine tachycardia, the degree of diminution in parasympathetic HRV parameters (by high-fidelity ECG) predicts incipient death.
Tanaka, Kumiko; Nakada, Taka-Aki; Fukuma, Hiroshi; Nakao, Shota; Masunaga, Naohisa; Tomita, Keisuke; Matsumura, Yosuke; Mizushima, Yasuaki; Matsuoka, Tetsuya
2017-01-23
A sudden shortage of physician resources due to overwhelming patient needs can affect the quality of care in the emergency department (ED). Developing effective response strategies remains a challenging research area. We created a novel system using information and communication technology (ICT) to respond to a sudden shortage, and tested the system to determine whether it would compensate for a shortage. Patients (n = 4890) transferred to a level I trauma center in Japan during 2012-2015 were studied. We assessed whether the system secured the necessary physicians without using other means such as phone or pager, and calculated fulfillment rate by the system as a primary outcome variable. We tested for the difference in probability of multiple casualties among total casualties transferred to the ED as an indicator of ability to respond to excessive patient needs, in a secondary analysis before and after system introduction. The system was activated 24 times (stand-by request [n = 12], attendance request [n = 12]) in 24 months, and secured the necessary physicians without using other means; fulfillment rate was 100%. There was no significant difference in the probability of multiple casualties during daytime weekdays hours before and after system introduction, while the probability of multiple casualties during night or weekend hours after system introduction significantly increased compared to before system introduction (4.8% vs. 12.9%, P < 0.0001). On the whole, the probability of multiple casualties increased more than 2 times after system introduction 6.2% vs. 13.6%, P < 0.0001). After introducing the system, probability of multiple casualties increased. Thus the system may contribute to improvement in the ability to respond to sudden excessive patient needs in multiple causalities. A novel system using ICT successfully secured immediate responses from needed physicians outside the hospital without increasing user workload, and increased the ability to respond to excessive patient needs. The system appears to be able to compensate for a shortage of physician in the ED due to excessive patient transfers, particularly during off-hours.
Shamsuzzaman, Abu S; Somers, Virend K; Knilans, Timothy K; Ackerman, Michael J; Wang, Yu; Amin, Raouf S
2015-07-01
Congenital long QT syndrome (LQTS) is a familial arrhythmogenic cardiac channelopathy characterized by prolonged ventricular repolarization and increased risk of torsades de pointes-mediated syncope, seizures, and sudden cardiac death (SCD). QT prolongation corrected for heart rate (QTc) is an important diagnostic and prognostic feature in LQTS. Obstructive sleep apnea (OSA) has been increasingly implicated in the pathogenesis of cardiovascular disease, including arrhythmias and SCD. We tested the hypothesis that the presence of concomitant OSA in patients with LQTS is associated with increased QT intervals, both during sleep and while awake. Polysomnography with simultaneous overnight 12-lead electrocardiography (ECG) was recorded in 54 patients with congenital LQTS and 67 control subjects. OSA was diagnosed as apnea-hypopnea index (AHI) ≥ 5 events/h for adults and AHI > 1 event/h for children. RR and QT intervals were measured from the 12-lead surface ECG. QTc was determined by the Bazett formula. Respiratory disturbance index, AHI, and arousal index were significantly increased in patients with LQTS and with OSA compared to those without OSA and control subjects. QTc during different sleep stages and while awake was also significantly increased in patients with LQTS and OSA compared to those without OSA. Severity of OSA in patients with LQTS was directly associated with the degree of QTc. The presence and severity of obstructive sleep apnea (OSA) in patients with congenital long QT syndrome (LQTS) is associated with increased QT prolongation corrected for heart rate, which is an important biomarker of sudden cardiac death (SCD). Treatment of OSA in LQTS patients may reduce QT prolongation, thus reducing the risk of LQT-triggered SCD. © 2015 Associated Professional Sleep Societies, LLC.
... and gradually increase your dose, depending on your response to this medication.Do not stop taking tizanidine without talking to your doctor. If you suddenly stop taking tizanidine, your heart may beat faster and you may have increased blood pressure or tightness in your muscles. Your doctor will ...
The Right to Education of Children and Youngsters from Refugee Families in Europe
ERIC Educational Resources Information Center
Essomba, Miquel Àngel
2017-01-01
The right to education of children and youth from asylum seeker and refugee families is currently being threatened in Europe. Two factors explain this: the sudden and disorganised arrival of large numbers of asylum seeker families, and the inconsistent integration of those seeking refugee status and those who have gained such status. The actual…
Progress Report Number 2 for Contract Number N00014-93-C-0051, April 16 thru May 15, 1993
1993-05-26
accompanied with subhar the modulation frequency is further decreased to 375 Hz , the signal intensity suddenly shows large f and the frequency spectrum...ccrrespondinrg Pbase p•,tra a strange attracwor (Fig. 3d) at this modulation frequency of 375 Hz . SUMMARY: * A new technique has been developed to create
SOD-induced changes in foraging and nesting behavior of insectivorous, cavity-nesting birds
Kyle Apigian; Barbara Allen-Diaz
2006-01-01
Sudden oak death (SOD) is a tree disease caused by a recently described pathogen, Phytophthora ramorum. The disease affects dozens of plant species, but its effects are particularly pronounced in stands of coast live oak (Quercus agrifolia), often resulting in large stands with dead canopies and many downed trees. Such disease-...
Effects of individual, community and landscape drivers on the dynamics of a wildland forest epidemic
Sarah E. Haas; J. Hall Cushman; Whalen W. Dillon; Nathan E. Rank; David M. Rizzo; Ross K. Meentemeyer
2016-01-01
The challenges posed by observing host-pathogen-environment interactions across large geographic extents and over meaningful time scales limit our ability to understand and manage wildland epidemics. We conducted a landscape-scale, longitudinal study designed to analyze the dynamics of sudden oak death (an emerging forest disease caused by Phytophthora...
Au Contraire: Gifted in a Flash (Mob)
ERIC Educational Resources Information Center
Delisle, James R.
2012-01-01
A "flash mob" is defined by Wikipedia as "a large group of people who assemble suddenly in a public place, perform an unusual and pointless act for a brief time, then disperse." Fueled by social media and Smartphones, flash mobs have been used, primarily, as entertaining diversions by addicted techies with (apparently) tons of time on their hands.…
NASA Astrophysics Data System (ADS)
Martineau, Patrick; Son, Seok-Woo; Taguchi, Masakazu; Butler, Amy H.
2018-05-01
The agreement between reanalysis datasets, in terms of the zonal-mean momentum budget, is evaluated during sudden stratospheric warming (SSW) events. It is revealed that there is a good agreement among datasets in the lower stratosphere and troposphere concerning zonal-mean zonal wind, but less so in the upper stratosphere. Forcing terms of the momentum equation are also relatively similar in the lower atmosphere, but their uncertainties are typically larger than uncertainties of the zonal-wind tendency. Similar to zonal-wind tendency, the agreement among forcing terms is degraded in the upper stratosphere. Discrepancies among reanalyses increase during the onset of SSW events, a period characterized by unusually large fluxes of planetary-scale waves from the troposphere to the stratosphere, and decrease substantially after the onset. While the largest uncertainties in the resolved terms of the momentum budget are found in the Coriolis torque, momentum flux convergence also presents a non-negligible spread among the reanalyses. Such a spread is reduced in the latest reanalysis products, decreasing the uncertainty of the momentum budget. It is also found that the uncertainties in the Coriolis torque depend on the strength of SSW events: the SSW events that exhibit the most intense deceleration of zonal-mean zonal wind are subject to larger discrepancies among reanalyses. These uncertainties in stratospheric circulation, however, are not communicated to the troposphere.
Iloprost-induced sudden hearing loss.
Dursun, E; Dogru, S; Cincik, H; Cekin, E; Gungor, A; Poyrazoglu, E
2007-06-01
We report a patient who developed sudden, bilateral, sensorineural hearing loss during therapeutic use of iloprost for Raynaud's phenomenon. The sudden hearing loss was attributed to iloprost use and completely reversed in eight days with conservative therapy. Iloprost may be a potentially ototoxic drug, causing sudden hearing loss.
Sudden Event Recognition: A Survey
Suriani, Nor Surayahani; Hussain, Aini; Zulkifley, Mohd Asyraf
2013-01-01
Event recognition is one of the most active research areas in video surveillance fields. Advancement in event recognition systems mainly aims to provide convenience, safety and an efficient lifestyle for humanity. A precise, accurate and robust approach is necessary to enable event recognition systems to respond to sudden changes in various uncontrolled environments, such as the case of an emergency, physical threat and a fire or bomb alert. The performance of sudden event recognition systems depends heavily on the accuracy of low level processing, like detection, recognition, tracking and machine learning algorithms. This survey aims to detect and characterize a sudden event, which is a subset of an abnormal event in several video surveillance applications. This paper discusses the following in detail: (1) the importance of a sudden event over a general anomalous event; (2) frameworks used in sudden event recognition; (3) the requirements and comparative studies of a sudden event recognition system and (4) various decision-making approaches for sudden event recognition. The advantages and drawbacks of using 3D images from multiple cameras for real-time application are also discussed. The paper concludes with suggestions for future research directions in sudden event recognition. PMID:23921828
Sudden unexpected death in epilepsy genetics: Molecular diagnostics and prevention.
Goldman, Alica M; Behr, Elijah R; Semsarian, Christopher; Bagnall, Richard D; Sisodiya, Sanjay; Cooper, Paul N
2016-01-01
Epidemiologic studies clearly document the public health burden of sudden unexpected death in epilepsy (SUDEP). Clinical and experimental studies have uncovered dynamic cardiorespiratory dysfunction, both interictally and at the time of sudden death due to epilepsy. Genetic analyses in humans and in model systems have facilitated our current molecular understanding of SUDEP. Many discoveries have been informed by progress in the field of sudden cardiac death and sudden infant death syndrome. It is becoming apparent that SUDEP genomic complexity parallels that of sudden cardiac death, and that there is a pauci1ty of analytically useful postmortem material. Because many challenges remain, future progress in SUDEP research, molecular diagnostics, and prevention rests in international, collaborative, and transdisciplinary dialogue in human and experimental translational research of sudden death. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.
NASA Astrophysics Data System (ADS)
Ward, P. L.
2008-12-01
The atmosphere cleans itself by oxidizing pollutants. The primary oxidant is the hydroxyl radical (OH) formed by photodissociation of ozone in the near ultra-violet. Ozone and OH are in limited supply. Sulfur dioxide (SO2) absorbs near ultraviolet light limiting production of OH and reacts immediately with any available OH, forming sulfuric acid. Methane reacts more slowly with OH and will typically not be oxidized until there is little SO2. Thus a high concentration of methane indicates low oxidizing capacity. The rate at which SO2 is injected into the atmosphere controls oxidizing capacity and climate change in four ways: 1. Moderate rate: Large volcanic eruptions (VEI >=6) lower global temperatures for a few years when they are separated by years to decades so the oxidizing capacity of the atmosphere can fully recover. In 1991, Pinatubo volcano in the Philippines erupted 20 Mt SO2 and 491 Mt H2O, the largest volcanic eruption since 1912. The SO2 was oxidized primarily by OH to form a 99% pure aerosol of sulfuric acid and water at an elevation of 20-23 km. This aerosol reflected sunlight, lowering the world's temperature on average 0.4°C for three years. Ozone levels were reduced by 10%. Methane increased by 15 ppb for a year. The e-folding time for SO2 was 35 days. 2. High rate: When large eruptions occur once to several times per year, there is insufficient oxidizing capacity leading to increases in methane and other greenhouse gases and global warming. There were 15 times in the Holocene when large volcanoes erupted on average at least every year for 7 to 21 years. Man is now putting as much SO2 from burning fossil fuels into the atmosphere every year as one large volcano, causing current global warming. The two previous times were from 818-838 AD, the onset of the Medieval Warming Period, and from 180-143 BC, the onset of the Roman Warm Period. 3. Low rate: When there are no large eruptions for decades, the oxidizing capacity can catch up, cleaning the atmosphere, removing most of the methane and other pollutants. A clean atmosphere leads to cooling and drought. The 8.2 ka event is a classic example, but similar decadal droughts around 6.2, 5.8, 5.4, 4.2, and 2.9 ka caused the demise of major civilizations. 4. Extreme rate: Whereas large volcanic eruptions produce 10-1000 km3 of andesitic and silicic tephra, flood basalt eruptions produce as much as 3,000,000 km3 of basalt containing 10 to 100 times more SO2 per km3. The result is runaway global warming, widespread acid rain, and mass extinctions. The link between SO2 and global warming is good news because we have developed many efficient technologies that burn fossil fuels with less SO2 emission and scrub SO2 out of smoke stacks. Efforts to reduce acid rain have been successful in reducing manmade emissions of SO2 by >20% since 1980 and thereby reducing methane concentrations. Sudden increases in methane during the Pleistocene Dansgaard-Oeschger events follow sudden increases in volcanism. High rainfall especially in the Sahara and high methane concentrations in the early Holocene are clearly related to increased volcanism that brought about the end of the Ice Age. Increases in global warming at 3170 BC, 161 BC, and 828 AD are contemporaneous with short-term increases in methane. The rapid increase in SO2 from burning fossil fuels since 1850 can explain much of the corresponding rapid increase in methane. But during the last 5000 years, volcanism has been relatively constant and thus it can not explain the observed gradual increase in methane.
The transition of North Atlantic dust deposition and Saharan landscape during the Holocene
NASA Astrophysics Data System (ADS)
Egerer, S.; Claussen, M.; Stanelle, T.; Reick, C. H.
2017-12-01
The sudden increase in North Atlantic dust deposition about 5 ka BP indicated by sediment records along the West African margin has been associated with an abrupt end of the African Humid Period (AHP). We perform several time slice simulations from 8 ka BP until the pre-industrial era to explore changes in the Holocene dust cycle. To do so, we use the coupled aerosol-climate model ECHAM6-HAM2 including interactive vegetation and dust, whereas ocean conditions and lakes are prescribed. The interactive coupling of vegetation, dust and atmosphere allows to set the dynamics of North Atlantic dust deposition in context to Holocene climate and landscape change in North Africa.In agreement with marine sediment records, we find an abrupt increase in simulated dust deposition at the location of the core sites roughly between 6 and 4 ka BP. Accordingly, dust emission in the North-west Sahara increases rapidly indicating that dust was transported by the same wind systems throughout the Holocene. The sudden increase in dust emission in the North-west Sahara is partly a consequence of a fast decline of vegetation cover from 22°N to 18°N due to vegetation-climate feedbacks and the rapid replacement of shrubs by grasses. Additionally, the prescribed strong but gradual reduction of lake surface area enforces accelerated dust release as former areas covered by lakes turn into highly productive dust sources. Changes in the Saharan landscape and dust emission south of 18°N and in the eastern Sahara as well as changes in atmospheric circulation play a minor role in driving the dynamics of North Atlantic dust deposition at the specific core sites. Our study emphasizes spatial and temporal differences in the transition of North African landscape implying that implications from local data records to large scales have to be treated with caution.
Enhancing the Communication Process of Suddenly Speechless Patients in the Critical Care Setting
Rowe, Meredeth; Thomas, Loris; Shuster, Jonathan; Koeppel, Brent; Cairns, Paula
2015-01-01
Background Sudden speechlessness is common in critically ill patients with airway intubation or head and neck cancer surgery. Sudden inability to speak poses significant challenges for hospitalized patients as strategies to facilitate communication are often limited and unreliable. Technology- based communication interventions have the potential to facilitate the communication process of hospitalized patients experiencing health events resulting in sudden speechlessness. Methods A quasi-experimental, 4-cohort (control and intervention) repeated measures design was used, with data points occurring daily up to 10 days. The study was conducted in adult critical care units and participants were followed as they were transferred to other units within institutions selected for the study. The impact of a technology-based communication system (intervention) in comparison with a control group (Usual care + Urgent Button) was evaluated. Patient communication outcomes pertinent to communication with nursing staff evaluated in this study included: perception of communication ease, satisfaction with methods used for communication, and frustration with communication. Results A comparison of the intervention and control group indicates that subjects in the intervention group reported lower mean frustration levels (-2.68, SE=0.17; 95% CI -3.02 to -2.34, p=<0.001), and a higher mean satisfaction level (0.59, SE=0.16; 95% CI 0.27 to 0.91; p<0.0001) with use of the communication intervention. Consistent increase of perception of communication ease over the hospital stay was reported by subjects in the intervention group. Conclusions This study facilitated the evaluation of a bedside technology-based communication intervention tailored to the needs of critically ill suddenly speechless patients. PMID:27134237
Ramalho, Diogo; Freitas, João
2018-05-01
Sudden cardiac death is a major public health challenge, which can be caused by genetic or acquired structural or electrophysiological abnormalities. These abnormalities include hereditary channelopathies: long QT, short QT and Brugada syndromes. These syndromes are a notable concern, particularly in young people, due to their high propensity for severe ventricular arrhythmias and sudden cardiac death. Current evidence suggests the involvement of an increasing number of drugs in acquired forms of long QT and Brugada syndromes. However, drug-induced short QT syndrome is still a rarely reported condition. Therefore, there has been speculation on its clinical significance, since few fatal arrhythmias and sudden cardiac death cases have been described so far. Drug-induced proarrhythmia is a growing challenge for physicians, regulatory agencies and the pharmaceutical industry. Physicians should weigh the risks of potentially fatal outcomes against the therapeutic benefits, when making decisions about drug prescriptions. Growing concerns about its safety and the need for more accurate predictive models for drug-induced fatal outcomes justify further research in these fields. The aim of this article is to comprehensively and critically review the recently published evidence with regard to drug-induced life-threatening arrhythmias and sudden cardiac death. This article will take into account the provision of data to physicians that are useful in the identification of the culprit drugs, and thus, contribute to the prompt recognition and management of these serious clinical conditions. Copyright © 2018 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.
Gao, Ying; Shi, Jian-guo; Ye, Hong; Liu, Zhi-rong; Zheng, Long-bao; Ni, Zhi-ming; Fan, Liang-quan; Wang, Jian; Hou, Zhen-hai
2014-11-01
This study aims to investigate the effects of sudden load changes (expected and unexpected imbalance) on the activity of muscles of the lumbar spine and their central motor control strategy in military personnel with or without chronic low back pain (LBP). Bilateral sudden imbalance was examined (2 × 2 factorial design). The 117th PLA Hospital, Hangzhou, China Twenty-one male subjects with lower back pain and 21 male healthy control subjects were active members of the Nanjing Military Region land forces. Independent variables: LBP vs. healthy controls and imbalance anticipation (expected and unexpected imbalance). rapid reaction time (RRT) and intensity of rapid reaction (IRR) of bilateral lumbar (L3-L4) erector spinae (ES), lumbar (L5-S1) multifidus (MF), and abdominal external oblique muscles. Results Under expected or unexpected sudden imbalance conditions, subjects with LBP demonstrated significantly greater IRR than healthy controls in ipsilateral and contralateral ES and MF, respectively (P < 0.05 for all). IRR of contralateral ES was significantly larger than that of the ipsilateral ES. A significant group effect of RRT of both ipsilateral and contralateral ES muscles and a significant time expectation effect on RRT of contralateral MF muscles were also observed. RRT of the contralateral ES muscles was significantly lower than that of the ipsilateral ES muscles (P < 0.001). Sudden imbalance prolonged RRT of selected trunk muscles in patients with chronic LBP. The activation amplitude increased. The results may provide a theoretical basis for a study on the pathogenesis of chronic LBP.
Proceedings of the Sudden Oak Death Fourth Science Symposium
Susan J. Frankel; John T. Kliejunas; Katharine M. Palmieri
2010-01-01
The Sudden Oak Death Fourth Science Symposium provided a forum for current research on sudden oak death, caused by the exotic, quarantine pathogen, Phytophthora ramorum. Ninety submissions describing papers or posters on the following sudden oak death/P. ramorum topics are included: biology, genetics, nursery and wildland...
Proceedings of the sudden oak death third science symposium
Susan J. Frankel; John T. Kliejunas; Katharine M. Palmieri
2008-01-01
The Sudden Oak Death Third Science Symposium provided a forum for current research on sudden oak death, caused by the exotic, quarantine pathogen, Phytophthora ramorum. One hundred and seventeen submissions describing papers and posters on the following sudden oak death/ P. ramorum topics are included: biology, genetics, nursery,...
Proceedings of the sudden oak death sixth science symposium
Susan J. Frankel; Katharine M. Harrell
2017-01-01
The Sudden Oak Death Sixth Science Symposium provided a forum for current research on sudden oak death, caused by the exotic quarantine pathogen Phytophthora ramorum. More than 50 submissions describing papers or posters on the following sudden oak death/P. ramorum topics are included: biology, genetics, nursery and wildland...
Sudden Death in Sleep of Laotian-Hmong Refugees in Thailand: A Case-Control Study.
ERIC Educational Resources Information Center
Munger, Ronald G.
1987-01-01
Surveillance for sudden deaths conducted among Laotian-Hmong refugees in Thailand revealed associations between sudden death in sleep and membership in the Green-Hmong subgroup, a family history of sudden death, and previous non-fatal sleep disturbances. Most victims are young men. (PS)
Sudden cardiac arrest as a rare presentation of myxedema coma: case report.
Salhan, Divya; Sapkota, Deepak; Verma, Prakash; Kandel, Saroj; Abdulfattah, Omar; Lixon, Antony; Zwenge, Deribe; Schmidt, Frances
2017-01-01
Myxedema coma is a decompensated hypothyroidism which occurs due to long-standing, undiagnosed, or untreated hypothyroidism. Untreated hypothyroidism is known to affect almost all organs including the heart. It is associated with a decrease in cardiac output, stroke volume due to decreased myocardial contractility, and an increase in systemic vascular resistance. It can cause cardiac arrhythmias and the most commonly seen conduction abnormalities are sinus bradycardia, heart block, ventricular tachycardia, and torsade de pointes. The authors report a case of an elderly man who presented with sudden cardiac arrest and myxedema coma and who was successfully revived.
Sudden cardiac death: epidemiology and risk factors
Adabag, A. Selcuk; Luepker, Russell V.; Roger, Véronique L.; Gersh, Bernard J.
2016-01-01
Sudden cardiac death (SCD) is an important public-health problem with multiple etiologies, risk factors, and changing temporal trends. Substantial progress has been made over the past few decades in identifying markers that confer increased SCD risk at the population level. However, the quest for predicting the high-risk individual who could be a candidate for an implantable cardioverter-defibrillator, or other therapy, continues. In this article, we review the incidence, temporal trends, and triggers of SCD, and its demographic, clinical, and genetic risk factors. We also discuss the available evidence supporting the use of public-access defibrillators. PMID:20142817
Changes in the mean hearing threshold levels in military aircraft maintenance conscripts.
Park, Won-Ju; Moon, Jai-Dong
2016-11-01
Aircraft maintenance crews are constantly exposed to severe aircraft noise. The purpose of this study was to verify whether noise from aircraft adversely affects the hearing threshold levels (HTLs) of aircraft maintenance conscripts during their 2 years of mandatory military service. This study included 3,000 male aircraft maintenance conscripts who work in the military runway area. We measured and analyzed HTLs at 2-4 kHz. The duration of exposure to noise increased with an increase in rank; however, HTLs showed a tendency to decrease. We attributed such contradicting results to the learning effect and adaptation to military service. However, we suspected that sudden deafness in 6 conscripts (0.2%) was due to loud noise in the runway area during military service. The effectiveness of the hearing conservation program for short-term military service personnel could be increased by focusing on preventing sudden deafness and preenlistment baseline audiogram tests.
Genetic investigation of 100 heart genes in sudden unexplained death victims in a forensic setting
Christiansen, Sofie Lindgren; Hertz, Christin Løth; Ferrero-Miliani, Laura; Dahl, Morten; Weeke, Peter Ejvin; LuCamp; Ottesen, Gyda Lolk; Frank-Hansen, Rune; Bundgaard, Henning; Morling, Niels
2016-01-01
In forensic medicine, one-third of the sudden deaths remain unexplained after medico-legal autopsy. A major proportion of these sudden unexplained deaths (SUD) are considered to be caused by inherited cardiac diseases. Sudden cardiac death (SCD) may be the first manifestation of these diseases. The purpose of this study was to explore the yield of next-generation sequencing of genes associated with SCD in a cohort of SUD victims. We investigated 100 genes associated with cardiac diseases in 61 young (1–50 years) SUD cases. DNA was captured with the Haloplex target enrichment system and sequenced using an Illumina MiSeq. The identified genetic variants were evaluated and classified as likely, unknown or unlikely to have a functional effect. The criteria for this classification were based on the literature, databases, conservation and prediction of the effect of the variant. We found that 21 (34%) individuals carried variants with a likely functional effect. Ten (40%) of these variants were located in genes associated with cardiomyopathies and 15 (60%) of the variants in genes associated with cardiac channelopathies. Nineteen individuals carried variants with unknown functional effect. Our findings indicate that broad genetic investigation of SUD victims increases the diagnostic outcome, and the investigation should comprise genes involved in both cardiomyopathies and cardiac channelopathies. PMID:27650965
Erskine, Kathleen E.; Hidayatallah, Nadia Z.; Walsh, Christine A.; McDonald, Thomas V.; Cohen, Lilian; Marion, Robert W.; Dolan, Siobhan M.
2014-01-01
Genetic testing is becoming increasingly available for cardiac channelopathies, such as long QT syndrome and Brugada syndrome, which can lead to sudden cardiac death. Test results can be used to shape an individual’s medical management and to identify at-risk family members. In our qualitative study, all participants had a personal or family history of a diagnosed cardiac arrhythmia syndrome or sudden cardiac death. Open-ended interviews were conducted individually and in focus groups. Interviews were audio recorded, transcribed verbatim, and analyzed using a qualitative grounded-theory approach. Of 50 participants, 37 described their motivations for pursuing genetic testing for long QT syndrome or another cardiac channelopathy. Participants’ motivations included: to find an explanation for a family member’s sudden death, to relieve uncertainty regarding a diagnosis, to guide future medical management, to allay concern about children or other family members, and to comply with recommendations of physicians or family members. Perceived reasons not to pursue genetic testing included denial, fear, and lack of information. The genetic counseling and informed consent process can be enhanced by understanding and addressing an individual’s internal and external motivations either for or against pursuing genetic testing. PMID:24664857
Genetic investigation of 100 heart genes in sudden unexplained death victims in a forensic setting.
Christiansen, Sofie Lindgren; Hertz, Christin Løth; Ferrero-Miliani, Laura; Dahl, Morten; Weeke, Peter Ejvin; LuCamp; Ottesen, Gyda Lolk; Frank-Hansen, Rune; Bundgaard, Henning; Morling, Niels
2016-12-01
In forensic medicine, one-third of the sudden deaths remain unexplained after medico-legal autopsy. A major proportion of these sudden unexplained deaths (SUD) are considered to be caused by inherited cardiac diseases. Sudden cardiac death (SCD) may be the first manifestation of these diseases. The purpose of this study was to explore the yield of next-generation sequencing of genes associated with SCD in a cohort of SUD victims. We investigated 100 genes associated with cardiac diseases in 61 young (1-50 years) SUD cases. DNA was captured with the Haloplex target enrichment system and sequenced using an Illumina MiSeq. The identified genetic variants were evaluated and classified as likely, unknown or unlikely to have a functional effect. The criteria for this classification were based on the literature, databases, conservation and prediction of the effect of the variant. We found that 21 (34%) individuals carried variants with a likely functional effect. Ten (40%) of these variants were located in genes associated with cardiomyopathies and 15 (60%) of the variants in genes associated with cardiac channelopathies. Nineteen individuals carried variants with unknown functional effect. Our findings indicate that broad genetic investigation of SUD victims increases the diagnostic outcome, and the investigation should comprise genes involved in both cardiomyopathies and cardiac channelopathies.
NO FLARES FROM GAMMA-RAY BURST AFTERGLOW BLAST WAVES ENCOUNTERING SUDDEN CIRCUMBURST DENSITY CHANGE
DOE Office of Scientific and Technical Information (OSTI.GOV)
Gat, Ilana; Van Eerten, Hendrik; MacFadyen, Andrew
2013-08-10
Afterglows of gamma-ray bursts are observed to produce light curves with the flux following power-law evolution in time. However, recent observations reveal bright flares at times on the order of minutes to days. One proposed explanation for these flares is the interaction of a relativistic blast wave with a circumburst density transition. In this paper, we model this type of interaction computationally in one and two dimensions, using a relativistic hydrodynamics code with adaptive mesh refinement called RAM, and analytically in one dimension. We simulate a blast wave traveling in a stellar wind environment that encounters a sudden change inmore » density, followed by a homogeneous medium, and compute the observed radiation using a synchrotron model. We show that flares are not observable for an encounter with a sudden density increase, such as a wind termination shock, nor for an encounter with a sudden density decrease. Furthermore, by extending our analysis to two dimensions, we are able to resolve the spreading, collimation, and edge effects of the blast wave as it encounters the change in circumburst medium. In all cases considered in this paper, we find that a flare will not be observed for any of the density changes studied.« less
[Forensic Analysis of 6 Cases of Sudden Death due to Hyperthyroid Heart Disease].
Zhang, M Z; Li, B X; Zhao, R; Guan, D W; Zhang, G H; Wu, X; Zhu, B L; Li, R B
2017-10-01
To analyse the cases of sudden death due to hyperthyroid heart disease, and explore the general information of deaths and the forensic pathological characteristics to provide reference evidence for forensic identification of such cases. Six cases of sudden death due to hyperthyroid heart disease between 2001 and 2016 were selected from School of Forensic Medicine, China Medical University. The general information (gender and age), clinical manifestations, medical history, anatomical and histopathological findings, biochemical parameters and cause of death were analysed retrospectively. Most of the 6 patients had definite history of hyperthyroidism, and they all showed certain degrees of symptoms of cardiovascular disease; had obvious incentive factors of death; histopathological examination of thyroid conformed to the performances of diffuse toxic goiter; with increase of cardiac weight, dilatation of cardiac chambers, myocardial hypertrophy and focal necrosis; postmortem biochemical analyses of pericardial fluid could be used as an additional method for diagnostic of sudden death due to hyperthyroid heart disease. The identification of death due to hyperthyroid heart disease should be based on the clinical history and the results of autopsy, histopathological examination, postmortem toxicology tests. The postmortem biochemical detection of thyroid and cardiac function should be performed if necessary. Copyright© by the Editorial Department of Journal of Forensic Medicine
Veselka, Josef; Zemánek, David; Jahnlová, Denisa; Krejčí, Jan; Januška, Jaroslav; Dabrowski, Maciej; Bartel, Thomas; Tomašov, Pavol
2015-10-01
Because the final myocardial scar might be theoretically associated with an increased risk of sudden cardiac death, the long-term clinical course of patients who undergo alcohol septal ablation (ASA) is still a matter of debate. In this retrospective multicentre study, we report outcomes after ASA, including survival, analysis of causes of deaths, and association between time and cause of death. We enrolled 366 consecutive patients (58 ± 12 years, 54% women) who were treated using ASA and followed-up for 5.1 ± 4.5 years. The in-hospital and 30-day mortality were 0.5% and 0.8%, respectively; the ASA-related morbidity was < 20%. Overall, 52 patients died during 1867 patient-years, which means the all-cause mortality rate was 2.8% per year. The mortality rates of sudden death and sudden death with an appropriate implantable cardioverter-defibrillator (ICD) discharge were 0.4% and 1% per year, respectively. Patients with sudden death or appropriate ICD discharge experienced these mortality events at younger age than patients who died of other hypertrophic obstructive cardiomyopathy-related causes (60.8 years [range, 52-71.5 years] vs 72.4 years [range, 64.2-75.2 years]; P = 0.048). A total of 292 patients (80%) had an outflow gradient ≤ 30 mm Hg, and 327 patients (89%) were in New York Heart Association class ≤ II at the last clinical check-up. ASA had low procedure-related mortality, with subsequent 1% occurrence of sudden mortality events per year and 2.8% mortality rate per year in the long-term follow-up. Patients with sudden death or ICD discharge experienced the mortality events approximately 1 decade earlier than patients who died from other causes not related to hypertrophic cardiomyopathy. Copyright © 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
Howard, Virginia J; McClure, Leslie A; Meschia, James F; Pulley, Leavonne; Orr, Sean C; Friday, Gary H
2006-10-09
A substantial portion of the general population has clinically silent stroke on brain imaging. These lesions may cause symptoms. This study assessed the prevalence of stroke symptoms in a stroke- and transient ischemic attack (TIA)-free population and the association of symptoms with risk factors indexed by the Framingham Stroke Risk Score. We performed a cross-sectional analysis from a randomly sampled national cohort enrolled from January 25, 2003, through November 30, 2005, with oversampling from the southeastern stroke belt and African American populations. The main outcome measure was stroke symptoms assessed by validated questionnaire. The study included 18 462 (41% African American; 51% female; mean age, 65.8 years) participants who reported no stroke or TIA. The prevalence of stroke symptoms was 5.8% for sudden painless hemibody weakness, 8.5% for sudden hemibody numbness, 4.6% for sudden painless loss of vision in one or both eyes, 3.1% for sudden hemifield visual loss, 2.7% for sudden inability to understand speech, and 3.8% for sudden inability of linguistic expression. The prevalence of 1 or more symptoms was 17.8%. Relative to the first quartile of the Framingham Stroke Risk Score, the adjusted odds ratio for 1 or more stroke symptoms increased from 1.0 (95% confidence interval [CI], 0.90-1.2) in the second quartile to 1.2 (95% CI, 1.1-1.5) and 1.5 (95% CI, 1.3-1.6) in successive quartiles. Symptoms were more prevalent among African American compared with white participants and among those with lower income, lower educational level, and fair to poor perceived health status. The general population without prior diagnosed stroke or TIA has a high prevalence of stroke symptoms. The relationship between symptoms and risk factors suggests that some symptomatic individuals may have had clinically undetected cerebrovascular events and may benefit from aggressive stroke prophylaxis.
Effects of hypoxia on the closing pressure of the canine systemic arterial circulation.
Sylvester, J T; Gilbert, R D; Traystman, R J; Permutt, S
1981-10-01
We studied the relationships among closing pressure (Pc) and indices of systemic arterial resistance (Ra) and compliance (Ca) during hypoxic hypoxia (HH) and carbon monoxide hypoxia (COH) in anesthetized dogs with cardiac bypass and constant ventilation. Closing pressure was measured as the lowest level to which arterial pressure (Pa) fell after inflow to the arterial bed was reduced suddenly to zero. Since the fall of Pa to Pc could be well-described as a single exponential function of time and since Pc was always greater than outflow (venous) pressure. Ra and CA were determined by applying a "vascular waterfall" model to the arterial bed. During HH, Pc increased while Ra and Ca decreased. During COH, Pc and Ra decreased, but Ca did not change. The Pc results indicate that during HH, but not COH, a large portion of the systemic arterial bed experienced a marked increase in vasomotor tone, a qualitative difference that would have been missed if Pc had not been measured. The relationship among Pc, Ra, and Ca during hypoxia suggest these indices may have been determined largely by different portions of the arterial bed in which tone changed independently.
... sudden increase of very watery output. Drinking hot tea and other liquids may flush any foods that ... Pedialyte contain electrolytes. Drinking soda, milk, juice, or tea will help you get enough liquids. Try to ...
Multiple Motor Learning Strategies in Visuomotor Rotation
Saijo, Naoki; Gomi, Hiroaki
2010-01-01
Background When exposed to a continuous directional discrepancy between movements of a visible hand cursor and the actual hand (visuomotor rotation), subjects adapt their reaching movements so that the cursor is brought to the target. Abrupt removal of the discrepancy after training induces reaching error in the direction opposite to the original discrepancy, which is called an aftereffect. Previous studies have shown that training with gradually increasing visuomotor rotation results in a larger aftereffect than with a suddenly increasing one. Although the aftereffect difference implies a difference in the learning process, it is still unclear whether the learned visuomotor transformations are qualitatively different between the training conditions. Methodology/Principal Findings We examined the qualitative changes in the visuomotor transformation after the learning of the sudden and gradual visuomotor rotations. The learning of the sudden rotation led to a significant increase of the reaction time for arm movement initiation and then the reaching error decreased, indicating that the learning is associated with an increase of computational load in motor preparation (planning). In contrast, the learning of the gradual rotation did not change the reaction time but resulted in an increase of the gain of feedback control, suggesting that the online adjustment of the reaching contributes to the learning of the gradual rotation. When the online cursor feedback was eliminated during the learning of the gradual rotation, the reaction time increased, indicating that additional computations are involved in the learning of the gradual rotation. Conclusions/Significance The results suggest that the change in the motor planning and online feedback adjustment of the movement are involved in the learning of the visuomotor rotation. The contributions of those computations to the learning are flexibly modulated according to the visual environment. Such multiple learning strategies would be required for reaching adaptation within a short training period. PMID:20195373
Sudden Gains During Therapy of Social Phobia
Hofmann, Stefan G.; Schulz, Stefan M.; Meuret, Alicia E.; Moscovitch, David A.; Suvak, Michael
2007-01-01
The present study investigated the phenomenon of sudden gains in 107 participants with social phobia (social anxiety disorder) who received either cognitive–behavioral group therapy or exposure group therapy without explicit cognitive interventions, which primarily used public speaking situations as exposure tasks. Twenty-two out of 967 session-to-session intervals met criteria for sudden gains, which most frequently occurred in Session 5. Individuals with sudden gains showed similar improvements in the 2 treatment groups. Although cognitive–behavioral therapy was associated with more cognitive changes than exposure therapy, cognitive changes did not precede sudden gains. In general, the results of this study question the clinical significance of sudden gains in social phobia treatment. PMID:16881776
Zhao, Peng; Wang, Ji-Gang; Gao, Peng; Li, Xia; Brewer, Rubell
2016-01-01
The aim of this study is to identify and subclassify sudden natural death (sudden death from natural diseases) cases in Seychelles. A total of 484 sudden natural death cases with autopsy at the Clinical Pathology Laboratory, Victoria Hospital, Seychelles between 1997 through 2012 were retrospectively reviewed. Among them, 363 cases (75%) were male and 121 (25%) were female. The most frequent sudden deaths were attributed to cardiovascular diseases (78.5%), and then followed by infectious diseases (9.9%), and gastrointestinal diseases (9.1%). This is the largest population-based study on sudden natural deaths in Seychelles. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
An on/off Berry phase switch in circular graphene resonators
NASA Astrophysics Data System (ADS)
Ghahari, Fereshte; Walkup, Daniel; Gutiérrez, Christopher; Rodriguez-Nieva, Joaquin F.; Zhao, Yue; Wyrick, Jonathan; Natterer, Fabian D.; Cullen, William G.; Watanabe, Kenji; Taniguchi, Takashi; Levitov, Leonid S.; Zhitenev, Nikolai B.; Stroscio, Joseph A.
2017-05-01
The phase of a quantum state may not return to its original value after the system’s parameters cycle around a closed path; instead, the wave function may acquire a measurable phase difference called the Berry phase. Berry phases typically have been accessed through interference experiments. Here, we demonstrate an unusual Berry phase-induced spectroscopic feature: a sudden and large increase in the energy of angular-momentum states in circular graphene p-n junction resonators when a relatively small critical magnetic field is reached. This behavior results from turning on a π Berry phase associated with the topological properties of Dirac fermions in graphene. The Berry phase can be switched on and off with small magnetic field changes on the order of 10 millitesla, potentially enabling a variety of optoelectronic graphene device applications.
Solar Eruptions, CMEs and Space Weather
NASA Technical Reports Server (NTRS)
Gopalswamy, Nat
2011-01-01
Coronal mass ejections (CMEs) are large-scale magnetized plasma structures ejected from the Sun and propagate far into the interplanetary medium. CMEs represent energy output from the Sun in the form of magnetized plasma and electromagnetic radiation. The electromagnetic radiation suddenly increases the ionization content of the ionosphere, thus impacting communication and navigation systems. The plasma clouds can drive shocks that accelerate charged particles to very high energies in the interplanetary space, which pose radiation hazard to astronauts and space systems. The plasma clouds also arrive at Earth in about two days and impact Earth's magnetosphere, producing geomagnetic storms. The magnetic storms result in a number of effects including induced currents that can disrupt power grids, railroads, and underground pipelines. This lecture presents an overview of the origin, propagation, and geospace consequences of solar storms.
NASA Astrophysics Data System (ADS)
Arp, Trevor; Pleskot, Dennis; Gabor, Nathaniel
We have developed a new photoresponse imaging technique that utilizes extensive data acquisition over a large parameter space. By acquiring a multi-dimensional data set, we fully capture the intrinsic optoelectronic response of two-dimensional heterostructure devices. Using this technique we have investigated the behavior of heterostructures consisting of molybdenum ditelluride (MoTe2) sandwiched between graphene top and bottom contacts. Under near-infrared optical excitation, the ultra-thin heterostructure devices exhibit sub-linear photocurrent response that recovers within several dozen picoseconds. As the optical power increases, the dynamics of the photoresponse, consistent with 3-body annihilation, precede a sudden suppression of photocurrent. The observed dynamics near the threshold to photocurrent suppression may indicate the onset to a strongly interacting population of electrons and holes.
Gastric cancer in FAP: a concerning rise in incidence.
Mankaney, Gautam; Leone, Pamela; Cruise, Michael; LaGuardia, Lisa; O'Malley, Margaret; Bhatt, Amit; Church, James; Burke, Carol A
2017-07-01
The highest cancer risks in familial adenomatous polyposis (FAP) include colorectal, duodenal, and thyroid for which surveillance is recommended. Nearly all patients with FAP have gastric fundic gland polyposis (FGP), but gastric cancers are rarely reported with a similar incidence as the general population. We describe a recent, sudden increase in the incidence of gastric cancer in FAP. Seven of the ten cases were diagnosed in the last 20 months. Comparing our population to the SEER database for gastric cancer, the standardized incidence ratio is 140. All cases arose in patients with a carpeting of FGP and associated with large mounds of proximal gastric polyps. Nearly all patients were under upper endoscopic surveillance. This is a concerning observation and reflects a change in the phenotypic presentation of FAP in Western patients.
Chroni, M; Prappa, E; Kokkevi, I
2018-04-01
Septic emboli are an unusual cause of sudden sensorineural hearing loss, for which few reports exist in the literature. This paper presents two cases of sudden sensorineural hearing loss, initially considered as idiopathic, but which were caused by septic emboli. Hearing loss in these cases was bilateral, sequential and total. The first patient had mild fever one week prior to their presentation with sudden sensorineural hearing loss; the other patient had no additional symptoms at presentation. These patients were later diagnosed with infective endocarditis, at two and seven months following the sudden sensorineural hearing loss respectively, showing that septic emboli had been the cause of sudden sensorineural hearing loss. Septic emboli should be considered as a possible cause of sudden sensorineural hearing loss in cases of total hearing loss. This form of hearing loss should prompt the otolaryngologist to further investigate for infective endocarditis.
Association between bilirubin and mode of death in severe systolic heart failure.
Wu, Audrey H; Levy, Wayne C; Welch, Kathleen B; Neuberg, Gerald W; O'Connor, Christopher M; Carson, Peter E; Miller, Alan B; Ghali, Jalal K
2013-04-15
The bilirubin level has been associated with worse outcomes, but it has not been studied as a predictor for the mode of death in patients with systolic heart failure. The Prospective Randomized Amlodipine Evaluation Study (PRAISE) cohort (including New York Heart Association class IIIB-IV patients with left ventricular ejection fraction <30%, n = 1,135) was analyzed, divided by bilirubin level: ≤0.6 mg/dl, group 1; >0.6 to 1.2 mg/dl, group 2; and >1.2 mg/dl, group 3. Multivariate Cox proportional hazards models were used to determine the association of bilirubin with the risk of sudden or pump failure death. Total bilirubin was entered as a base 2 log-transformed variable (log2 bilirubin), indicating doubling of the bilirubin level corresponding to each increase in variable value. The higher bilirubin groups had a lower ejection fraction (range 19% to 21%), sodium (range 138 to 139 mmol/L), and systolic blood pressure (range 111 to 120 mm Hg), a greater heart rate (range 79 to 81 beats/min), and greater diuretic dosages (range 86 to 110 furosemide-equivalent total daily dose in mg). The overall survival rates declined with increasing bilirubin (24.3, 31.3, and 44.3 deaths per 100 person-years, respectively, for groups 1, 2, and 3). Although a positive relation was seen between log2 bilirubin and both pump failure risk and sudden death risk, the relation in multivariate modeling was significant only for pump failure mortality (hazard ratio 1.47, 95% confidence interval 1.19 to 1.82, p = 0.0004), not for sudden death mortality (hazard ratio 1.21, 95% confidence interval 0.98 to 1.49, p = 0.08). In conclusion, an increasing bilirubin level was significantly associated with the risk of pump failure death but not for sudden death in patients with severe systolic heart failure. Copyright © 2013 Elsevier Inc. All rights reserved.
Proceedings of the sudden oak death second science symposium: the state of our knowledge
Susan J. Frankel; Patrick J. Shea; Michael I. Haverty
2006-01-01
The Sudden Oak Death Second Science Symposium provided a forum for current research on sudden oak death, caused by the exotic, quarantine pathogen, Phytophthora ramorum. Ninety papers and forty-six posters on the following sudden oak death/P. ramorum topics are included: biology, genetics, nursery and wildland management,...
Remittances as aid following major sudden-onset natural disasters.
Bragg, Catherine; Gibson, Glenn; King, Haleigh; Lefler, Ashley A; Ntoubandi, Faustin
2018-01-01
There is a general assumption, based on macroeconomic studies, that remittances will rise following major sudden-onset natural disasters. This is confirmed by a few assessments involving country-specific research, and usually short-term data. This study, questioning conventional wisdom, reviewed and graphed annual and quarterly remittance flows using International Monetary Fund and World Bank data from 2000-14 for 12 countries that confronted 18 major natural disasters. It found that, regardless of event type, annual remittances rose steadily from 2000-14 except for after the 2008-09 financial crisis. Post disaster, there was a quarterly increase in the majority of cases (confirming previous research) but there was seldom an annual increase in the year of the disaster greater than the average annual increase in 2000-14. It appears that remittance senders rush to provide assistance after a natural disaster, but since their own financial situation has not changed, the immediate increase is compensated by a later decrease. © 2018 The Author(s). Disasters © Overseas Development Institute, 2018.
Understanding Loss Deductions For Yard Trees
John Greene
1998-01-01
The sudden destruction of trees or other yard plants due to a fire, storm, or massive insect attack qualifies for a casualty loss deduction. Unfortnately, the casualty loss rules for personal use property allow deductions only for large losses. To calculate your deduction, start with the lesser of the decrease in fair market value of your property caused by the loss of...
Inherited cardiomyopathies and sports participation.
Zorzi, A; Pelliccia, A; Corrado, D
2018-03-01
Competitive sports activity is associated with an increased risk of sudden cardiovascular death in adolescents and young adults with inherited cardiomyopathies. Many young subjects aspire to continue competitive sport after a diagnosis of cardiomyopathy and the clinician is frequently confronted with the problem of eligibility and the request of designing specific exercise programs. Since inherited cardiomyopathies are the leading cause of sudden cardiovascular death during sports performance, a conservative approach implying disqualification of affected athletes from most competitive athletic disciplines is recommended by all the available international guidelines. On the other hand, we know that the health benefits of practicing recreational sports activity can overcome the potential arrhythmic risk in these patients, provided that the type and level of exercise are tailored on the basis of the specific risk profile of the underlying cardiomyopathy. This article will review the available evidence on the sports-related risk of sudden cardiac death and the recommendations regarding eligibility of individuals affected by inherited cardiomyopathies for sports activities.
Sudden acquired retinal degeneration syndrome in western Canada: 93 cases.
Leis, Marina L; Lucyshyn, Danica; Bauer, Bianca S; Grahn, Bruce H; Sandmeyer, Lynne S
2017-11-01
This study reviewed clinical data from dogs diagnosed with sudden acquired retinal degeneration syndrome (SARDS) in western Canada. Medical records from the Western College of Veterinary Medicine from 2002 to 2016 showed that 93 cases of SARDS were diagnosed based on presentation for sudden blindness and a bilaterally extinguished electroretinogram. The most common pure breeds were the miniature schnauzer, dachshund, and pug. The mean age at diagnosis was 8.1 years and males and females were equally affected. Most of the dogs were presented with normal non-chromatic, but abnormal chromatic pupillary light reflexes. The incidence of retinal degeneration as detected via ophthalmoscopy increased over time after SARDS diagnosis. Polyuria, polydipsia, polyphagia, weight gain, elevated liver enzyme values, isosthenuria, and proteinuria were common clinical and laboratory findings. Chromatic pupillary light reflex testing may be more valuable than non-chromatic pupillary light testing in detecting pupil response abnormalities in dogs with SARDS, although electroretinography remains the definitive diagnostic test.
Sudden death and paroxysmal autonomic dysfunction in stiff-man syndrome.
Mitsumoto, H; Schwartzman, M J; Estes, M L; Chou, S M; La Franchise, E F; De Camilli, P; Solimena, M
1991-04-01
Two women with typical stiff-man syndrome (SMS) developed increasingly frequent attacks of muscle spasms with severe paroxysmal autonomic dysfunctions such as transient hyperpyrexia, diaphoresis, tachypnea, tachycardia, pupillary dilation, and arterial hypertension. Autoantibodies to GABA-ergic neurons were identified in the serum of both patients and in the cerebrospinal fluid of one. Both died suddenly and unexpectedly. General autopsy did not reveal the cause of death. Neuropathological studies revealed perivascular gliosis in the spinal cord and brain stem of one patient and lymphocytic perivascular infiltration in the spinal cord, brain stem, and basal ganglia of the other. The occurrence of a chronic inflammatory reaction in one of the two patients supports the idea that an autoimmune disease against GABA-ergic neurons may be involved in SMS. A review of the literature indicates that functional impairment in SMS is severe and prognosis is unpredictable because of the potential for sudden and unexpected death. Both muscular abnormalities and autonomic dysfunctions may result from autoimmunity directed against GABA-ergic neurons.
Sudden acquired retinal degeneration syndrome in western Canada: 93 cases
Leis, Marina L.; Lucyshyn, Danica; Bauer, Bianca S.; Grahn, Bruce H.; Sandmeyer, Lynne S.
2017-01-01
This study reviewed clinical data from dogs diagnosed with sudden acquired retinal degeneration syndrome (SARDS) in western Canada. Medical records from the Western College of Veterinary Medicine from 2002 to 2016 showed that 93 cases of SARDS were diagnosed based on presentation for sudden blindness and a bilaterally extinguished electroretinogram. The most common pure breeds were the miniature schnauzer, dachshund, and pug. The mean age at diagnosis was 8.1 years and males and females were equally affected. Most of the dogs were presented with normal non-chromatic, but abnormal chromatic pupillary light reflexes. The incidence of retinal degeneration as detected via ophthalmoscopy increased over time after SARDS diagnosis. Polyuria, polydipsia, polyphagia, weight gain, elevated liver enzyme values, isosthenuria, and proteinuria were common clinical and laboratory findings. Chromatic pupillary light reflex testing may be more valuable than non-chromatic pupillary light testing in detecting pupil response abnormalities in dogs with SARDS, although electroretinography remains the definitive diagnostic test. PMID:29089658
[Sudden cardiac death in individuals with normal hearts: an update].
González-Melchor, Laila; Villarreal-Molina, Teresa; Iturralde-Torres, Pedro; Medeiros-Domingo, Argelia
2014-01-01
Sudden death (SD) is a tragic event and a world-wide health problem. Every year, near 4-5 million people experience SD. SD is defined as the death occurred in 1h after the onset of symptoms in a person without previous signs of fatality. It can be named "recovered SD" when the case received medical attention, cardiac reanimation effective defibrillation or both, surviving the fatal arrhythmia. Cardiac channelopathies are a group of diseases characterized by abnormal ion channel function due to genetic mutations in ion channel genes, providing increased susceptibility to develop cardiac arrhythmias and SD. Usually the death occurs before 40 years of age and in the autopsy the heart is normal. In this review we discuss the main cardiac channelopathies involved in sudden cardiac death along with current management of cases and family members that have experienced such tragic event. Copyright © 2014 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.
Utility of the exercise electrocardiogram testing in sudden cardiac death risk stratification.
Refaat, Marwan M; Hotait, Mostafa; Tseng, Zian H
2014-07-01
Sudden cardiac death (SCD) remains a major public health problem. Current established criteria identifying those at risk of sudden arrhythmic death, and likely to benefit from implantable cardioverter defibrillators (ICDs), are neither sensitive nor specific. Exercise electrocardiogram (ECG) testing was traditionally used for information concerning patients' symptoms, exercise capacity, cardiovascular function, myocardial ischemia detection, and hemodynamic responses during activity in patients with hypertrophic cardiomyopathy. We conducted a systematic review of MEDLINE on the utility of exercise ECG testing in SCD risk stratification. Exercise testing can unmask suspected primary electrical diseases in certain patients (catecholaminergic polymorphic ventricular tachycardia or concealed long QT syndrome) and can be effectively utilized to risk stratify patients at an increased (such as early repolarization syndrome and Brugada syndrome) or decreased risk of SCD, such as the loss of preexcitation on exercise testing in asymptomatic Wolff-Parkinson-White syndrome. Exercise ECG testing helps in SCD risk stratification in patients with and without arrhythmogenic hereditary syndromes. © 2014 Wiley Periodicals, Inc.
Shen, Hai-Ying; Li, Tianfu; Boison, Detlev
2010-03-01
Sudden unexpected death in epilepsy (SUDEP) is a significant cause of mortality in people with epilepsy. Two postulated causes for SUDEP, cardiac and respiratory depression, can both be explained by overstimulation of adenosine receptors. We hypothesized that SUDEP is a consequence of a surge in adenosine as a result of prolonged seizures combined with deficient adenosine clearance; consequently, blockade of adenosine receptors should prevent SUDEP. Here we induced impaired adenosine clearance in adult mice by pharmacologic inhibition of the adenosine-removing enzymes, adenosine kinase and deaminase. Combination of impaired adenosine clearance with kainic acid-induced seizures triggered sudden death in all animals. Most importantly, the adenosine receptor antagonist caffeine, when given after seizure onset, increased survival from 23.75 +/- 1.35 min to 54.86 +/- 6.59 min (p < 0.01). Our data indicate that SUDEP is due to overactivation of adenosine receptors and that caffeine treatment after seizure onset might be beneficial.
Birati, Edo Y; Mathelier, Hansie; Molina, Maria; Hanff, Thomas C; Mazurek, Jeremy A; Atluri, Pavan; Acker, Michael A; Rame, J Eduardo; Margulies, Kenneth B; Goldberg, Lee R; Jessup, Mariell
2016-04-15
Sudden cardiac death (SCD) is a common cause of death in the general population, occurring in 300,000 to 350,000 people in the United States alone. Currently, there are no data supporting implantable cardioverter-defibrillator therapy in patients who underwent orthotopic heart transplant (OHT) with low left ventricular ejection fraction (LVEF). In this retrospective study, we included all patients who underwent primary OHT at our institution from 2007 to 2013. We compared the cause of death in patients who underwent OHT and evaluated the correlation of the cause of death and the patients' LVEF. Our objectives were to determine whether patients who underwent OHT with LVEF <35% are at increased risk for SCD compared with those who underwent OHT with normal LVEF. To summarize our results, a total of 345 patients were included in our study (mean age 50 ± 14 years, 68% men). The mean follow-up was 1,260 ± 698 days. Forty patients (11.5%) died >6 months after OHT. Surviving patients had higher LVEF compared with deceased patients (64 ± 7% and 50 ± 24%, respectively, p ≤0.001). In all, 10 (25%) of the deceased patients died suddenly, 9 (23%) from sepsis, and 8 (20%) from malignancy. Of the 11 deceased patients with LVEF ≤35%, 2 patients (18%) died suddenly compared with 9 SCDs among the 29 deceased patients (31%) with LVEF >35% (p = 0.54). In conclusion, patients who underwent OHT who died were more likely to have LVEF <35%, and a quarter of the deceased patients who underwent OHT died suddenly. A reduced LVEF was not associated with an increased risk of SCD. Copyright © 2016 Elsevier Inc. All rights reserved.
van Oort, Ralph J; McCauley, Mark D; Dixit, Sayali S; Pereira, Laetitia; Yang, Yi; Respress, Jonathan L; Wang, Qiongling; De Almeida, Angela C; Skapura, Darlene G; Anderson, Mark E; Bers, Donald M; Wehrens, Xander H T
2010-12-21
approximately half of patients with heart failure die suddenly as a result of ventricular arrhythmias. Although abnormal Ca(2+) release from the sarcoplasmic reticulum through ryanodine receptors (RyR2) has been linked to arrhythmogenesis, the molecular mechanisms triggering release of arrhythmogenic Ca(2+) remain unknown. We tested the hypothesis that increased RyR2 phosphorylation by Ca(2+)/calmodulin-dependent protein kinase II is both necessary and sufficient to promote lethal ventricular arrhythmias. mice in which the S2814 Ca(2+)/calmodulin-dependent protein kinase II site on RyR2 is constitutively activated (S2814D) develop pathological sarcoplasmic reticulum Ca(2+) release events, resulting in reduced sarcoplasmic reticulum Ca(2+) load on confocal microscopy. These Ca(2+) release events are associated with increased RyR2 open probability in lipid bilayer preparations. At baseline, young S2814D mice have structurally and functionally normal hearts without arrhythmias; however, they develop sustained ventricular tachycardia and sudden cardiac death on catecholaminergic provocation by caffeine/epinephrine or programmed electric stimulation. Young S2814D mice have a significant predisposition to sudden arrhythmogenic death after transverse aortic constriction surgery. Finally, genetic ablation of the Ca(2+)/calmodulin-dependent protein kinase II site on RyR2 (S2814A) protects mutant mice from pacing-induced arrhythmias versus wild-type mice after transverse aortic constriction surgery. our results suggest that Ca(2+)/calmodulin-dependent protein kinase II phosphorylation of RyR2 Ca(2+) release channels at S2814 plays an important role in arrhythmogenesis and sudden cardiac death in mice with heart failure.
Álvarez-Álvarez, Belén; Bouzas-Cruz, Noelia; Abu-Assi, Emad; Raposeiras-Roubin, Sergio; López-López, Andrea; González Cambeiro, María Cristina; Peña-Gil, Carlos; García-Acuña, José María; González-Juanatey, José Ramón
2015-10-01
There is little information on the effect of acute coronary syndrome complicated by ventricular fibrillation on the long-term incidence of sudden cardiac death. We analyzed this effect in a contemporary cohort of patients with acute coronary syndrome. We studied 5302 consecutive patients with acute coronary syndrome between December 2003 and December 2012. We compared mortality during and after hospitalization according to the presence or absence of ventricular fibrillation. Ventricular fibrillation was observed in 163 (3.1%) patients, and was early onset in 72.4% of these patients. In-hospital mortality was 36.2% in the group with ventricular fibrillation and 4.7% in the group without (p<.001). After a mean follow-up of 4.7 years (standard deviation, 2.6 years), mortality was 30.7% in the ventricular fibrillation group and 24.7% in the other group (P=.23). After adjusting for confounding variables, the presence of ventricular fibrillation was not associated with an increased risk of death in the follow-up period (hazard ratio=1.29; 95% confidence interval, 0.90-1.87). The cause of death was established in 72% of patients. The incidence of sudden death was 12.9% in the ventricular fibrillation group and 11.9% in the other group (P=.71). Cardiovascular-cause mortality was also similar between the 2 groups (35.5% and 34.4%, respectively. Patients with acute coronary syndrome complicated by ventricular fibrillation who survive the in-hospital phase do not appear to be at an increased risk of sudden cardiac death or other cardiovascular-cause death. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.
Monitoring plant response to environmental stimuli by ultrasonic sensing of the leaves.
Fariñas, Maria Dolores; Sancho Knapik, Domingo; Peguero Pina, Jose Javier; Gil Pelegrin, Eustaquio; Gómez Álvarez-Arenas, Tomás E
2014-09-01
Described here is the application of a technique based on the excitation, sensing and spectral analysis of thickness resonances of plant leaves using air-coupled and wide-band ultrasound pulses (150-900 kHz) to monitor variations in leaf properties caused by plant responses to different environmental stimuli, such as a sudden variation in light intensity (from 2000 to 150 μmol m(-2) s(-1)), sudden watering after a drought period, and along the diurnal cycle (3-5 days, with continuous variation in light intensity from 150 to 2000 μmol m(-2) s(-1) and change in temperature of about 5°C). Four different widely available species, both monocots and dicots and evergreen and deciduous, with different leaf features (shape, size, thickness, flatness, vascular structure), were selected to test the technique. After a sudden decrease in light intensity, and depending on the species, there was a relative increase in the thickness resonant frequency from 8% to 12% over a 25- to 50-min period. After sudden watering, the relative increase in the resonant frequency varied from 5% to 30% and the period from 10 to 400 min. Finally, along the diurnal cycle, the measured relative variation is between 4% and 10%. The technique revealed differences in both the amplitude of the frequency oscillations and the kinetics of the leaf response for different species and also within the same species, but for specimens grown under different conditions that present different cell structures at the tissue level. The technique can be equally applied to the leaves of any species that present thickness resonances. Copyright © 2014 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.
Incidence of sudden unexpected death in epilepsy in community-based cohort in China.
Ge, Yan; Ding, Ding; Zhang, Qing; Yang, Bin; Wang, Taiping; Li, Beixu; Wang, Jie; Luo, Jianfeng; Kwan, Patrick; Wang, Wenzhi; Hong, Zhen; Sander, Josemir W
2017-11-01
Sudden unexpected death in epilepsy (SUDEP) is associated with the high premature mortality observed among people with epilepsy. It is, however, considered a rare event in China, probably because of lack of awareness and limitation of studies in the country. We aimed to provide some initial estimation of the burden of SUDEP in China. We established a large Chinese community-based cohort of people with epilepsy between January 2010 and December 2011. For any participant who died during follow-up, detailed information on cause of death was obtained using a specifically designed Verbal Autopsy Questionnaire. All cases were reviewed by a multidisciplinary expert panel and reinvestigated if necessary. Sudden unexpected death in epilepsy incidence rates were estimated and case details provided. The cohort consisted of 1562 people and during a median 5years follow-up, 72 deaths were reported. The all-causes death incidence was 11.23 (95% CI 8.86-14.07) per 1000 person-years. Fifteen died suddenly and unexpectedly in a reasonable state of health in the week preceding death. We recorded detailed information of these 15 deaths. Thirteen were considered to be probable SUDEP and two possible SUDEP. The incidence of probable SUDEP was 2.03 (95% CI 1.13-3.38) per 1000 person-years, and the incidence of all suspected (probable and possible) SUDEP was 2.34 (95% CI 1.36-3.77) per 1000 person-years. The incidence of SUDEP was relatively high among Chinese people with epilepsy when compared with that in previous community-based studies from high-income countries. The burden of SUDEP in China requires further assessments. Copyright © 2017 Elsevier Inc. All rights reserved.
Muñoz-Esparza, Carmen; García-Molina, Esperanza; Salar-Alcaraz, Mariela; Peñafiel-Verdú, Pablo; Sánchez-Muñoz, Juan J; Martínez Sánchez, Juan; Cabañas-Perianes, Valentín; Valdés Chávarri, Mariano; García Alberola, Arcadio; Gimeno-Blanes, Juan R
2015-10-01
Long QT syndrome is an inherited ion channelopathy that leads to syncope and sudden death. Because of the heterogeneous phenotype of this disease, genetic testing is fundamental to detect individuals with concealed long QT syndrome. In this study, we determined the features of a family with 13 carriers of the KCNH2-H562R missense mutation, which affects the pore region of the HERG channel. We identified the KCNH2-H562R mutation in a 65-year-old man with a prolonged QTc interval who had experienced an episode of torsade de pointes. Subsequently, a total of 13 mutation carriers were identified in the family. Carriers (age 48 [26] years; 46% males) underwent clinical evaluation, electrocardiography and echocardiography. The mean (standard deviation) QTc in carriers was 493 (42) ms (3 [23%] showed normal QTc); 6 (46%) had symptoms (4, syncope; 1, sudden death; 1, aborted sudden death [proband]). While under treatment with beta-blockers, 11 of 12 carriers (92%) remained asymptomatic at 5 years of follow-up (1 patient required left cardiac sympathectomy). The QTc shortening with beta-blockers was 50 (37) ms. There was 1 sudden death in a patient who refused treatment. Family study is essential in the interpretation of a genetic testing result. This article describes the heterogeneous and variable phenotype of a large family with the KCNH2-H562R mutation and highlights the role of genetic study for the appropriate identification of at-risk individuals who would benefit from treatment. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.
Cardiovascular benefits of omega-3 fatty acids.
von Schacky, Clemens; Harris, William S
2007-01-15
Cardiac societies recommend the intake of 1 g/day of the two omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) for cardiovascular disease prevention, treatment after a myocardial infarction, prevention of sudden death, and secondary prevention of cardiovascular disease. These recommendations are based on a body of scientific evidence that encompasses literally thousands of publications. Of four large scale intervention studies three also support the recommendations of these cardiac societies. One methodologically questionable study with a negative result led a Cochrane meta-analysis to a null conclusion. This null conclusion, however, has not swayed the recommendations of the cardiac societies mentioned, and has been refuted with good reason by scientific societies. Based on the scientific evidence just mentioned, we propose a new risk factor to be considered for sudden cardiac death, the omega-3 index. It is measured in red blood cells, and is expressed as a percentage of EPA + DHA of total fatty acids. An omega-3 index of >8% is associated with 90% less risk for sudden cardiac death, as compared to an omega-3 index of <4%. The omega-3 index as a risk factor for sudden cardiac death has striking similarities to LDL as a risk factor for coronary artery disease. Moreover, the omega-3 index reflects the omega-3 fatty acid status of a given individual (analogous to HbA1c reflecting glucose homeostasis). The omega-3 index can therefore be used as a goal for treatment with EPA and DHA. As is the case now for LDL, in the future, the cardiac societies might very well recommend treatment with EPA and DHA to become goal oriented (e.g. an omega-3 index>8%).
Natural history of Wolff-Parkinson-White syndrome diagnosed in childhood.
Cain, Nicole; Irving, Claire; Webber, Steven; Beerman, Lee; Arora, Gaurav
2013-10-01
Wolff-Parkinson-White (WPW) syndrome carries a risk for symptomatic arrhythmias and sudden death. The aim of this study was to examine the natural history of patients with Wolff-Parkinson-White syndrome diagnosed in childhood followed longitudinally at a single institution. The study population consisted of 446 patients. The median age of diagnosis was 7 years, and 61% were male. Associated heart disease was present in 40 patients (9%). Modes of presentation included supraventricular tachycardia (38%), palpitations (22%), chest pain (5%), syncope (4%), atrial fibrillation (0.4%), sudden death (0.2%), and incidental findings (26%); data were unavailable in 4%. During the study period, a total of 243 patients (54%) had supraventricular tachycardia, and 7 patients (1.6%) had atrial fibrillation. Of patients who presented at ≤3 months of age, 35% had resolution of manifest preexcitation compared with 5.8% who presented at >3 months of age (p <0.0001). There were 6 sudden deaths (1.3%), with an incidence of 2.8 per 1,000 patient-years. Two of these patients had structurally normal hearts (incidence 1.1 per 1,000 patient-years). Four of these patients had associated heart disease (incidence 27 per 1,000 patient-years) (p <0.01). In conclusion, in a large population of patients with Wolff-Parkinson-White syndrome diagnosed in childhood, 64% had symptoms at presentation, and an additional 20% developed symptoms during follow-up. There were 6 sudden deaths (1.3%), with an overall incidence of 1.1 per 1,000 patient-years in patients with structurally normal hearts and 27 per 1,000 patient-years in patients with associated heart disease. Copyright © 2013 Elsevier Inc. All rights reserved.
du Toit-Prinsloo, L; Dempers, J J; Wadee, S A; Saayman, G
2011-03-01
Sudden Infant Death Syndrome (SIDS) has been reported to be the leading cause of death in infants under 1 year of age in many countries. Unfortunately, a paucity of published research data exists in South Africa, with regard to the incidence of and investigation into the circumstances surrounding Sudden Unexplained Deaths in Infants (SUDI) and/or SIDS. Currently, even though most academic centers conform to a protocol consistent with internationally accepted standards, there exists no nationally accepted infant death investigation protocol in South Africa. It is the aim of this study to review the current practice of infant death investigation in two representative but geographically and demographically distinct centers. Retrospective case audit over a five-year period (2000-2004) was conducted at two large medico-legal mortuaries in Pretoria (Gauteng) and Tygerberg (Cape Town). Case files on all infants younger than 1 year of age were reviewed. The outcome measures included number of deaths, demographic details and the nature and final outcome of the post mortem examinations. A total of 512 cases were identified as possible SIDS cases and of these, 171 was classified as SIDS. The study showed marked inter-case and inter-divisional variation in terms of the investigation of infant deaths at the two institutions. It is envisaged that this study will focus attention on the current lack of usable data regarding sudden/unexplained/unexpected infant deaths in South Africa, and aid in the formulation and implementation of a practical (yet internationally accountable) infant death investigation protocol, which could facilitate comparisons with other countries and initiate further structured research in this field.
NASA Astrophysics Data System (ADS)
Morita, Written By Ichiko; Matsumura, Translated By Tamiko
Libraries in the United States are now experiencing another phase of rapid change brought by the sudden invasion of micro-computers. Their versatility has made available not only capabilities for word processing and producing spread sheets but also introduced new approaches to large research libraries’ information networks. OCLC’s microenhancers are one example of what is now available. They can be used for retrospective conversion, provide instruction for the use of and function as front end terminals for large online catalogs. Various new ideas for the application of micro-computers will bring interesting developments in library automation.
... The Marfan Foundation Marfan & Related Disorders What is Marfan Syndrome? What are Related Disorders? What are the Signs? ... Emergencies Lung Emergencies Surgeries Lung Emergencies People with Marfan syndrome can be at increased risk of sudden lung ...
QT prolongation and sudden cardiac death risk in hypertrophic cardiomyopathy.
Patel, Salma I; Ackerman, Michael J; Shamoun, Fadi E; Geske, Jeffrey B; Ommen, Steve R; Love, William T; Cha, Stephen S; Bos, Johan M; Lester, Steven J
2018-03-07
Risk assessment for sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM) remains complex. The goal of this study was to assess electrocardiogram (ECG)-derived risk factors on SCD in a large HCM population Methods: Retrospective review of adults with HCM evaluated at Mayo Clinic, Rochester, MN from 1 December 2002 to 31 December 2012 was performed. Data inclusive of ECG and 24-hour ambulatory Holter monitor were assessed. SCD events were documented by ventricular fibrillation (VF) noted on implantable cardioverter defibrillator (ICD), or appropriate VT or VF-terminating ICD shock. Overall, 1615 patients (mean age 53.7 ± 15.2 years; 943 males, 58.4%) were assessed, with mean follow-up 2.46 years and 110 SCD events. Via logistic regression (n = 820), the odds of SCD increased with increasing number of conventional risk factors. With one risk factor the OR was 4.88 (p < .0001; CI 2.22-10.74), two risk factors the OR was 6.922 (p < .0001; CI 2.94-16.28) and three or more risk factors, the OR was 13.997 (p < .0001; CI 5.649-34.68). Adding QTc > 450 to this logistic regression model had OR 1.722 (p = .04, CI 1.01-2.937) to predict SCD. QTc ≥ 450 was a significant predictor for death (HR 1.88, p = .021, CI 1.10-3.20). There was no correlation between sinus bradycardia, sinus tachycardia, first degree AV block, atrial fibrillation, left bundle branch block, right bundle branch block, premature atrial complexes, premature ventricular complexes, supraventricular tachycardia, PR interval, QRS interval and SCD. Prolonged QTc was a risk factor for SCD and death even when controlling for typical risk factors.
Gennaro, Massimiliano; Di Cosimo, Serena; Ardoino, Ilaria; Veneroni, Silvia; Mariani, Luigi; Agresti, Roberto; Daidone, Maria Grazia; de Braud, Filippo; Apolone, Giovanni; Biganzoli, Elia; Demicheli, Romano
2018-05-14
Breast cancer (BC) patients with ipsilateral breast tumor recurrence (IBTR) are at high risk of developing distant metastases (DM). We aimed to evaluate the risk pattern of developing DM, with respect to the occurrence of IBTR, in a large series of patients homogeneously treated by conservative surgery (QUART) with a considerably long follow-up. Piecewise exponential model was used to investigate DM dynamics conditioning on known prognostic factors and IBTR occurrence as time dependent covariate. The model was extended to account for the timescale induced by IBTR, namely the time elapsed since IBTR to the endpoint. Among 2851 BCE patients receiving QUART, 209 were assessable for IBTR. After a median follow-up of 129 months, 588 patients presented DM (CCI = 27.3%) as first event and 92 (CCI = 48.8%) following IBTR. Primary tumor size and nodal status confirmed their prognostic value. The hazard for DM was early and high in Estrogen Receptor (ER) negative BC patients; while it was initially low but increases during follow-up in ER positive cases. Patients experiencing IBTR showed DM dynamic similar to that following primary tumor, with a sudden increased risk within 24 months from surgery, regardless the time elapsed since QUART. BC patients experiencing IBTR showed a sudden and sustained risk of DM following surgery. Our findings are consistent with the hypothesis that IBTR occurrence might act as a "time resector" for risk of DM, and provide a rationale for proper surveillance guidelines and systemic therapy for optimizing BC recurrence and appropriate choice of treatment. Copyright © 2018 Elsevier Ltd. All rights reserved.
Cloud Formation and Water Transport on Mars after Major Outflow Events
NASA Technical Reports Server (NTRS)
Santiago, D. L.; Colaprete, A.; Kreslavsky, M.; Kahre, M. A.; Asphaug, E.
2012-01-01
The triggering of a robust water cycle on Mars might have been caused by the gigantic flooding events evidenced by outflow channels. We use the Ames Mars General Circulation Model (MGCM) to test this hypothesis, studying how these presumably abrupt eruptions of water might have affected the climate of Mars in the past. We model where the water ultimately went as part of a transient atmospheric water cycle, to answer questions including: (1) Can sudden introductions of large amounts of water on the Martian surface lead to a new equilibrated water cycle? (2) What are the roles of water vapor and water ice clouds to sudden changes in the water cycle on Mars? (3) How are radiative feedbacks involved with this? (4) What is the ultimate fate of the outflow water? (5) Can we tie certain geological features to outflow water redistributed by the atmosphere?
NASA Technical Reports Server (NTRS)
Rao, D. M.; Goglia, G. L.
1981-01-01
Accomplishments in vortex flap research are summarized. A singular feature of the vortex flap is that, throughout the range of angle of attack range, the flow type remains qualitatively unchanged. Accordingly, no large or sudden change in the aerodynamic characteristics, as happens when forcibly maintained attached flow suddenly reverts to separation, will occur with the vortex flap. Typical wind tunnel test data are presented which show the drag reduction potential of the vortex flap concept applied to a supersonic cruise airplane configuration. The new technology offers a means of aerodynamically augmenting roll-control effectiveness on slender wings at higher angles of attack by manipulating the vortex flow generated from leading edge separation. The proposed manipulator takes the form of a flap hinged at or close to the leading edge, normally retracted flush with the wing upper surface to conform to the airfoil shape.
... SCA. Physical stress, which can cause the heart’s electrical system to stop working. In people who already ... the heart’s structure may cause problems with its electrical system, increasing the risk of arrhythmias. What are ...
Sudden transition and sudden change from open spin environments
DOE Office of Scientific and Technical Information (OSTI.GOV)
Hu, Zheng-Da; School of Science, Jiangnan University, Wuxi 214122; Xu, Jing-Bo, E-mail: xujb@zju.edu.cn
2014-11-15
We investigate the necessary conditions for the existence of sudden transition or sudden change phenomenon for appropriate initial states under dephasing. As illustrative examples, we study the behaviors of quantum correlation dynamics of two noninteracting qubits in independent and common open spin environments, respectively. For the independent environments case, we find that the quantum correlation dynamics is closely related to the Loschmidt echo and the dynamics exhibits a sudden transition from classical to quantum correlation decay. It is also shown that the sudden change phenomenon may occur for the common environment case and stationary quantum discord is found at themore » high temperature region of the environment. Finally, we investigate the quantum criticality of the open spin environment by exploring the probability distribution of the Loschmidt echo and the scaling transformation behavior of quantum discord, respectively. - Highlights: • Sudden transition or sudden change from open spin baths are studied. • Quantum discord is related to the Loschmidt echo in independent open spin baths. • Steady quantum discord is found in a common open spin bath. • The probability distribution of the Loschmidt echo is analyzed. • The scaling transformation behavior of quantum discord is displayed.« less
Sudden Infant Death Syndrome: Facts for Caregivers.
ERIC Educational Resources Information Center
Texas Child Care, 2000
2000-01-01
Presents risk factors and prevention measures related to Sudden Infant Death Syndrome. Offers infant sleep recommendations and five discussion questions to test knowledge of Sudden Infant Death Syndrome. (DLH)
Gao, Ying; Shi, Jian-guo; Ye, Hong; Liu, Zhi-rong; Zheng, Long-bao; Ni, Zhi-ming; Fan, Liang-quan; Wang, Jian; Hou, Zhen-hai
2014-01-01
Objective This study aims to investigate the effects of sudden load changes (expected and unexpected imbalance) on the activity of muscles of the lumbar spine and their central motor control strategy in military personnel with or without chronic low back pain (LBP). Design Bilateral sudden imbalance was examined (2 × 2 factorial design). Setting The 117th PLA Hospital, Hangzhou, China Participants Twenty-one male subjects with lower back pain and 21 male healthy control subjects were active members of the Nanjing Military Region land forces. Outcome measures Independent variables: LBP vs. healthy controls and imbalance anticipation (expected and unexpected imbalance). Dependent variables: rapid reaction time (RRT) and intensity of rapid reaction (IRR) of bilateral lumbar (L3–L4) erector spinae (ES), lumbar (L5–S1) multifidus (MF), and abdominal external oblique muscles. Results Under expected or unexpected sudden imbalance conditions, subjects with LBP demonstrated significantly greater IRR than healthy controls in ipsilateral and contralateral ES and MF, respectively (P < 0.05 for all). IRR of contralateral ES was significantly larger than that of the ipsilateral ES. A significant group effect of RRT of both ipsilateral and contralateral ES muscles and a significant time expectation effect on RRT of contralateral MF muscles were also observed. RRT of the contralateral ES muscles was significantly lower than that of the ipsilateral ES muscles (P < 0.001). Conclusions Sudden imbalance prolonged RRT of selected trunk muscles in patients with chronic LBP. The activation amplitude increased. The results may provide a theoretical basis for a study on the pathogenesis of chronic LBP. PMID:24621023
Cygankiewicz, Iwona; Zareba, Wojciech; Vazquez, Rafael; Vallverdu, Montserrat; Gonzalez-Juanatey, Jose R; Valdes, Mariano; Almendral, Jesus; Cinca, Juan; Caminal, Pere; de Luna, Antoni Bayes
2008-08-01
Abnormal heart rate turbulence (HRT) has been documented as a strong predictor of total mortality and sudden death in postinfarction patients, but data in patients with congestive heart failure (CHF) are limited. The aim of this study was to evaluate the prognostic significance of HRT for predicting mortality in CHF patients in New York Heart Association (NYHA) class II-III. In 651 CHF patients with sinus rhythm enrolled into the MUSIC (Muerte Subita en Insuficiencia Cardiaca) study, the standard HRT parameters turbulence onset (TO) and slope (TS), as well as HRT categories, were assessed for predicting total mortality and sudden death. HRT was analyzable in 607 patients, mean age 63 years (434 male), 50% of ischemic etiology. During a median follow up of 44 months, 129 patients died, 52 from sudden death. Abnormal TS and HRT category 2 (HRT2) were independently associated with increased all-cause mortality (HR: 2.10, CI: 1.41 to 3.12, P <.001 and HR: 2.52, CI: 1.56 to 4.05, P <.001; respectively), sudden death (HR: 2.25, CI: 1.13 to 4.46, P = .021 for HRT2), and death due to heart failure progression (HR: 4.11, CI: 1.84 to 9.19, P <.001 for HRT2) after adjustment for clinical covariates in multivariate analysis. The prognostic value of TS for predicting total mortality was similar in various groups dichotomized by age, gender, NYHA class, left ventricular ejection fraction, and CHF etiology. TS was found to be predictive for total mortality only in patients with QRS > 120 ms. HRT is a potent risk predictor for both heart failure and arrhythmic death in patients with class II and III CHF.
Sudden cardiac death in adults: causes, incidence and interventions.
Walker, Wendy Marina
Many nurses will be familiar with the unexpected death of an adult patient following a sudden, life-threatening cardiac event. It is a situation that demands sensitive nursing care and skilled interventions to provide a foundation for recovery and promote healthy bereavement. This article examines the causes and incidence of sudden cardiac death in adults. Possible reactions of those who are suddenly bereaved are described and immediate care interventions aimed at dealing with the grief process are discussed. The article concludes by identifying ways in which the incidence of sudden cardiac death may be reduced.
Wearable cardioverter defibrillator: Bridge or alternative to implantation?
Barraud, Jeremie; Cautela, Jennifer; Orabona, Morgane; Pinto, Johan; Missenard, Olivier; Laine, Marc; Thuny, Franck; Paganelli, Franck; Bonello, Laurent; Peyrol, Michael
2017-01-01
The implantable cardioverter-defibrillator (ICD) is effective to prevent sudden cardiac death (SCD) in selected patients with heart disease known to be at high risk for ventricular arrhythmia. Nevertheless, this invasive and definitive therapy is not indicated in patients with potentially transient or reversible causes of sudden death, or in patients with temporary contra-indication for ICD placement. The wearable cardioverter defibrillator (WCD) is increasingly used for SCD prevention both in patients awaiting ICD implantation or with an estimated high risk of ventricular arrhythmia though to be transient. We conducted a review of current clinical uses and benefits of the WCD, and described its technical aspects, limitations and perspectives. PMID:28706588
Crib death; SIDS ... However, SIDS is still a major cause of death in infants under 1 year old. Thousands of ... affects boys more often than girls. Most SIDS deaths occur in the winter. The following may increase ...
Risk Factors and Causes of Syncope
... Risk Factors & Causes of Syncope Risk Factors for Cardiovascular Syncope The risk of cardiovascular syncope increases with ... Long QT syndrome and Brugada Syndrome Signs of Cardiovascular Syncope Cardiovascular syncope usually is sudden. There may ...
Age-related changes in human posture control: Motor coordination tests
NASA Technical Reports Server (NTRS)
Peterka, R. J.; Black, F. O.
1989-01-01
Postural responses to support surface displacements were measured in 214 normal human subjects ranging in age from 7 to 81 years. Motor tests measured leg muscle Electromyography (EMG) latencies, body sway, and the amplitude and timing of changes in center of pressure displacements in response to sudden forward and backward horizontal translations of the support surface upon which the subjects stood. There were small increases in both EMG latencies and the time to reach the peak amplitude of center of pressure responses with increasing age. The amplitude of center of pressure responses showed little change with age if the amplitude measures were normalized by a factor related to subject height. In general, postural responses to sudden translations showed minimal changes with age, and all age related trends which were identified were small relative to the variability within the population.
Towards a Structural View of Drug Binding to hERG K+ Channels.
Vandenberg, Jamie I; Perozo, Eduardo; Allen, Toby W
2017-10-01
The human ether-a-go-go-related gene (hERG) K + channel is of great medical and pharmaceutical relevance. Inherited mutations in hERG result in congenital long-QT syndrome which is associated with a markedly increased risk of cardiac arrhythmia and sudden death. hERG K + channels are also remarkably susceptible to block by a wide range of drugs, which in turn can cause drug-induced long-QT syndrome and an increased risk of sudden death. The recent determination of the near-atomic resolution structure of the hERG K + channel, using single-particle cryo-electron microscopy (cryo-EM), provides tremendous insights into how these channels work. It also suggests a way forward in our quest to understand why these channels are so promiscuous with respect to drug binding. Copyright © 2017 Elsevier Ltd. All rights reserved.
Janz, David R.; Hollenbeck, Ryan D.; Pollock, Jeremy S.; McPherson, John A.; Rice, Todd W.
2012-01-01
Objective To determine if higher levels of partial pressure of arterial oxygen are associated with in-hospital mortality and poor neurologic status at hospital discharge in patients treated with mild therapeutic hypothermia after sudden cardiac arrest. Design Retrospective analysis of a prospective cohort study Patients A total of 170 consecutive patients treated with therapeutic hypothermia in the cardiovascular care unit of an academic tertiary care hospital. Interventions None. Measurements and Main Results Of 170 patients, 77 (45.2%) survived to hospital discharge. Survivors had a significantly lower maximum partial pressure of arterial oxygen(198 mmHg, IQR 152.5–282) measured in the first 24 hours following cardiac arrest compared to nonsurvivors (254 mmHg, IQR 172–363, p = .022). A multivariable analysis including age, time to return of spontaneous circulation, the presence of shock, bystander CPR, and initial rhythm revealed that higher levels of the partial pressure of arterial oxygen were significantly associated with increased in-hospital mortality (odds ratio 1.439, 95% confidence interval 1.028–2.015, p = 0.034) and poor neurologic status at hospital discharge (odds ratio 1.485, 95% confidence interval 1.032–2.136, p = 0.033). Conclusions Higher levels of the maximum measured partial pressure of arterial oxygen are associated with increased in-hospital mortality and poor neurologic status on hospital discharge in patients treated with mild therapeutic hypothermia after sudden cardiac arrest. PMID:22971589
Entanglement spreading after a geometric quench in quantum spin chains
NASA Astrophysics Data System (ADS)
Alba, Vincenzo; Heidrich-Meisner, Fabian
2014-08-01
We investigate the entanglement spreading in the anisotropic spin-1/2 Heisenberg (XXZ) chain after a geometric quench. This corresponds to a sudden change of the geometry of the chain or, in the equivalent language of interacting fermions confined in a box trap, to a sudden increase of the trap size. The entanglement dynamics after the quench is associated with the ballistic propagation of a magnetization wave front. At the free fermion point (XX chain), the von Neumann entropy SA exhibits several intriguing dynamical regimes. Specifically, at short times a logarithmic increase is observed, similar to local quenches. This is accurately described by an analytic formula that we derive from heuristic arguments. At intermediate times partial revivals of the short-time dynamics are superposed with a power-law increase SA˜tα, with α <1. Finally, at very long times a steady state develops with constant entanglement entropy, apart from oscillations. As expected, since the model is integrable, we find that the steady state is nonthermal, although it exhibits extensive entanglement entropy. We also investigate the entanglement dynamics after the quench from a finite to the infinite chain (sudden expansion). While at long times the entanglement vanishes, we demonstrate that its relaxation dynamics exhibits a number of scaling properties. Finally, we discuss the short-time entanglement dynamics in the XXZ chain in the gapless phase. The same formula that describes the time dependence for the XX chain remains valid in the whole gapless phase.
Extreme Family Poverty Rises in the Midst of a Strong Economy. Family Review.
ERIC Educational Resources Information Center
Lindjord, Denise
2000-01-01
Discusses the sudden increase of families with incomes below 50 percent of the poverty line, noting particularly the impact on children. Notes a direct link between increased family poverty and the decreasing protective role of cash welfare and food stamp benefits. Describes federal proposals to increase minimum wage and cut taxes; makes…
USDA-ARS?s Scientific Manuscript database
Purpose: This study examined how a sudden increase in exercise energy expenditure affected whole body protein turnover and nitrogen balance in people of differing aerobic fitness. We hypothesized that whole-body protein turnover would be attenuated, and nitrogen balance would be preserved, in aerobi...
USDA-ARS?s Scientific Manuscript database
During the last decade, populations of flightless Mormon crickets Anabrus simplex (Orthoptera: Tettigoniidae) increased suddenly over vast areas of the western United States, suggesting that climate is an important factor driving outbreaks. Moreover summer temperatures are predicted to increase and...
Declining Risk of Sudden Death in Heart Failure.
Shen, Li; Jhund, Pardeep S; Petrie, Mark C; Claggett, Brian L; Barlera, Simona; Cleland, John G F; Dargie, Henry J; Granger, Christopher B; Kjekshus, John; Køber, Lars; Latini, Roberto; Maggioni, Aldo P; Packer, Milton; Pitt, Bertram; Solomon, Scott D; Swedberg, Karl; Tavazzi, Luigi; Wikstrand, John; Zannad, Faiez; Zile, Michael R; McMurray, John J V
2017-07-06
The risk of sudden death has changed over time among patients with symptomatic heart failure and reduced ejection fraction with the sequential introduction of medications including angiotensin-converting-enzyme inhibitors, angiotensin-receptor blockers, beta-blockers, and mineralocorticoid-receptor antagonists. We sought to examine this trend in detail. We analyzed data from 40,195 patients who had heart failure with reduced ejection fraction and were enrolled in any of 12 clinical trials spanning the period from 1995 through 2014. Patients who had an implantable cardioverter-defibrillator at the time of trial enrollment were excluded. Weighted multivariable regression was used to examine trends in rates of sudden death over time. Adjusted hazard ratios for sudden death in each trial group were calculated with the use of Cox regression models. The cumulative incidence rates of sudden death were assessed at different time points after randomization and according to the length of time between the diagnosis of heart failure and randomization. Sudden death was reported in 3583 patients. Such patients were older and were more often male, with an ischemic cause of heart failure and worse cardiac function, than those in whom sudden death did not occur. There was a 44% decline in the rate of sudden death across the trials (P=0.03). The cumulative incidence of sudden death at 90 days after randomization was 2.4% in the earliest trial and 1.0% in the most recent trial. The rate of sudden death was not higher among patients with a recent diagnosis of heart failure than among those with a longer-standing diagnosis. Rates of sudden death declined substantially over time among ambulatory patients with heart failure with reduced ejection fraction who were enrolled in clinical trials, a finding that is consistent with a cumulative benefit of evidence-based medications on this cause of death. (Funded by the China Scholarship Council and the University of Glasgow.).
Sudden Death After Febrile Seizure Case Report: Cerebral Suppression Precedes Severe Bradycardia.
Myers, Kenneth A; McPherson, Robyn E; Clegg, Robin; Buchhalter, Jeffrey
2017-11-01
A 20-month-old girl with a complex chromosomal disorder had first presentation of febrile status epilepticus and was admitted to the hospital. Two days after her initial seizure, she died suddenly and unexpectedly during a video EEG monitoring study. An advanced analysis of the physiologic changes in the hours and minutes leading up to death was undertaken. The electrocardiography over the last 19 minutes of life was reviewed, and the R-R intervals were manually measured. Heart rate variability was assessed through calculation of the SD of the R-R intervals and the root mean square of successive differences over successive 100 beat periods. Instantaneous heart rate, SD of the R-R intervals, the root mean square of successive differences, and oxygen saturation were plotted against time over the last 19 minutes of life. Diffuse cerebral suppression on EEG was observed 10 minutes before death, followed minutes later by severe bradycardia and increased heart rate variability. Although the child did not meet criteria for a diagnosis of epilepsy, the sequence of physiologic changes leading up to death suggests a pathophysiology similar to sudden unexplained death in epilepsy. A comparable pattern of diffuse cerebral suppression preceding parasympathetic overactivity has been suggested in some rare cases of adults who have experienced sudden unexplained death in epilepsy during video EEG monitoring. Copyright © 2017 by the American Academy of Pediatrics.
Transgressive Hybrids as Hopeful Monsters.
Dittrich-Reed, Dylan R; Fitzpatrick, Benjamin M
2013-06-01
The origin of novelty is a critical subject for evolutionary biologists. Early geneticists speculated about the sudden appearance of new species via special macromutations, epitomized by Goldschmidt's infamous "hopeful monster". Although these ideas were easily dismissed by the insights of the Modern Synthesis, a lingering fascination with the possibility of sudden, dramatic change has persisted. Recent work on hybridization and gene exchange suggests an underappreciated mechanism for the sudden appearance of evolutionary novelty that is entirely consistent with the principles of modern population genetics. Genetic recombination in hybrids can produce transgressive phenotypes, "monstrous" phenotypes beyond the range of parental populations. Transgressive phenotypes can be products of epistatic interactions or additive effects of multiple recombined loci. We compare several epistatic and additive models of transgressive segregation in hybrids and find that they are special cases of a general, classic quantitative genetic model. The Dobzhansky-Muller model predicts "hopeless" monsters, sterile and inviable transgressive phenotypes. The Bateson model predicts "hopeful" monsters with fitness greater than either parental population. The complementation model predicts both. Transgressive segregation after hybridization can rapidly produce novel phenotypes by recombining multiple loci simultaneously. Admixed populations will also produce many similar recombinant phenotypes at the same time, increasing the probability that recombinant "hopeful monsters" will establish true-breeding evolutionary lineages. Recombination is not the only (or even most common) process generating evolutionary novelty, but might be the most credible mechanism for sudden appearance of new forms.
Christopher A. Lee; Janice M. Alexander; Susan J. Frankel; Yana Valachovic
2012-01-01
We conducted a research needs assessment (RNA) in 2010 to gather opinions of "experts" and a larger public on research priorities for Phytophthora ramorum, the pathogen that causes sudden oak death in forest trees and Ramorum blight in ornamental plants. We place these 2010 findings in context with findings of similar P. ramorum...
[EPIDEMIOLOGY OF SUDDEN CARDIAC DEATH: DATA FROM THE PARIS SUDDEN DEATH EXPERTISE CENTER REGISTRY].
Jouven, Xavier; Bougouin, Wulfran; Karam, Nicole; Marijon, Eloi
2015-09-01
Sudden cardiac death is an unexpected cardiac arrest without obvious extra-cardiac cause. Epidemiology of sudden cardiac death has been poorly documented in France, mainly because of challenging requirement in order to capture all cases in a specific area. The Parisian registry (Sudden Death Expertise Center, European Georges Pompidou Hospital, Paris) was initiated in May 2011 and analyzed data of all sudden death in Paris and suburbs (6.6 millions inhabitants). Over 3 years, the annual incidence estimated to 50-70 per 100,000. Those occurred mainly in men (69%), with a mean age of 65 year, and at home (75%). The event was witnessed in 80% of cases, but bystander cardiopulmonary resuscitation was initiated in only half of cases. Initial cardiac rhythm was ventricular fibrillation in 25%. Survival to hospital discharge remains low (8%).
Benito Bartolomé, F; Sánchez Fernández-Bernal, C
2001-04-01
Sudden death may be the first manifestation of the Wolff-Parkinson-White syndrome, especially in children and adolescents. The aim of this study was to evaluate the usefulness of radiofrequency catheter ablation in children with Wolff-Parkinson-White syndrome with aborted sudden death. We report four patients with Wolff-Parkinson-White syndrome who survived cardiac arrest. The patients were aged from 2.5 months to 16 years. The two first patients were lactating infants; in the first sudden death occurred during digoxin treatment for supraventricular tachycardia secondary to Wolff-Parkinson-White syndrome and in the second the syndrome was diagnosed after an episode of sudden death. In these patients a free wall accessory pathway (left posterior and left lateral, respectively) was successfully ablated using a transseptal approach. The third patient was diagnosed with asymptomatic Wolff-Parkinson-White syndrome; sudden death occurred during exercise. In the fourth patient, sudden death occurred after intravenous therapy with adenosine triphosphate and amiodarone for rapid atrial fibrillation. In both patients, one accessory pathway, located in right posteroseptal and right anterior free wall, respectively, was ablated. After a mean follow-up of 43.5 26.4 months, no recurrence of sudden death had occurred and electrocardiogram showed sinus rhythm without delta wave. The third patient presented severe sequelae of hypoxemic encephalopathy, which persisted during the follow-up. Radiofrequency catheter ablation is the treatment of choice in Wolff-Parkinson-White syndrome with episodes of aborted sudden death.
The cardiovascular and cardiac actions of ecstasy and its metabolites.
Shenouda, S K; Carvalho, F; Varner, K J
2010-08-01
The recreational use of 3, 4 methylenedioxymethamphetamine (ecstasy or MDMA) has increased dramatically over the past thirty years due to its ability to increase stamina and produce feelings of emotional closeness and wellbeing. In spite of the popular perception that MDMA is a safe drug, there is a large literature documenting that the drug can produce significant neurotoxicity, especially in serotonergic and catecholaminergic systems. There are also experimental and clinical data which document that MDMA can alter cardiovascular function and produce cardiac toxicity, including rhythm disturbances, infarction and sudden death. This manuscript will review the literature documenting the cardiovascular responses elicited by MDMA in humans and experimental animals and will examine the underlying mechanisms mediating these responses. We will also review the available clinical, autopsy and experimental data linking MDMA with cardiac toxicity. Most available data indicate that oxidative stress plays an important role in the cardiotoxic actions of MDMA. Moreover, new data indicates that redox active metabolites of MDMA may play especially important roles in MDMA induced toxicity.
Hayes, Sharonne N; Kim, Esther S H; Saw, Jacqueline; Adlam, David; Arslanian-Engoren, Cynthia; Economy, Katherine E; Ganesh, Santhi K; Gulati, Rajiv; Lindsay, Mark E; Mieres, Jennifer H; Naderi, Sahar; Shah, Svati; Thaler, David E; Tweet, Marysia S; Wood, Malissa J
2018-05-08
Spontaneous coronary artery dissection (SCAD) has emerged as an important cause of acute coronary syndrome, myocardial infarction, and sudden death, particularly among young women and individuals with few conventional atherosclerotic risk factors. Patient-initiated research has spurred increased awareness of SCAD, and improved diagnostic capabilities and findings from large case series have led to changes in approaches to initial and long-term management and increasing evidence that SCAD not only is more common than previously believed but also must be evaluated and treated differently from atherosclerotic myocardial infarction. High rates of recurrent SCAD; its association with female sex, pregnancy, and physical and emotional stress triggers; and concurrent systemic arteriopathies, particularly fibromuscular dysplasia, highlight the differences in clinical characteristics of SCAD compared with atherosclerotic disease. Recent insights into the causes of, clinical course of, treatment options for, outcomes of, and associated conditions of SCAD and the many persistent knowledge gaps are presented. © 2018 American Heart Association, Inc.
On flares, substorms, and the theory of impulsive flux transfer events
NASA Technical Reports Server (NTRS)
Bratenahl, A.; Baum, P. J.
1976-01-01
Solar flares and magnetospheric substorms are discussed in the context of a general theory of impulsive flux transfer events (IFTE). IFTE theory, derived from laboratory observations in the Double Inverse Pinch Device (DIPD), provides a quantitative extension of 'neutral sheet' theories to include nonsteady field line reconnection. Current flow along the reconnection line increases with magnetic flux storage. When flux build-up exceeds the level corresponding to a critical limit on the current, instabilities induce a sudden transition in the mode of conduction. The resulting IFTE, indifferent to the specific modes and instabilities involved, is the more energetic, the lower the initial resistivity. It is the more violent, the greater the resulting resistivity increase and the faster its growth. Violent events can develop very large voltage transients along the reconnection line. Persistent build-up promoting conditions produce relaxation oscillations in the quantity of flux and energy stored (build-up-IFTE cycles). It is difficult to avoid the conclusion: flares and substorms are examples of IFTE.
Noise as a Health Hazard for Children, Time to Make a Noise about it.
Thakur, Neha; Batra, Prerna; Gupta, Piyush
2016-02-01
Noise, a modern day curse of advancing infrastructure and technology, has emerged as an important public health problem. Exposure to noise during pregnancy may result in high-frequency hearing loss in newborns, growth retardation, cochlear damage, prematurity and birth defects. Newborns exposed to sound above 45 decibels may experience increase in blood pressure, heart rate, respiratory rate; decreased oxygen saturation; and increased caloric consumption. Noise exposure in older children may result in learning disabilities, attention difficulties, insulin resistance, hypertension, stress ulcers and cardiovascular diseases. Sudden exposure to loud noise can lead to rupture of eardrum. The damaging effects of noise pollution are more noticeable in large metropolitan cities, the hubs of urban settlements and industrial growth. Another concern is noise pollution inside the hospitals (particularly intensive care areas) that can lead to serious health consequences both for caregivers and for children. The issue needs to be addressed by both researchers and policy makers on an urgent basis.
Detection of convulsive seizures using surface electromyography.
Beniczky, Sándor; Conradsen, Isa; Wolf, Peter
2018-06-01
Bilateral (generalized) tonic-clonic seizures (TCS) increase the risk of sudden unexpected death in epilepsy (SUDEP), especially when patients are unattended. In sleep, TCS often remain unnoticed, which can result in suboptimal treatment decisions. There is a need for automated detection of these major epileptic seizures, using wearable devices. Quantitative surface electromyography (EMG) changes are specific for TCS and characterized by a dynamic evolution of low- and high-frequency signal components. Algorithms targeting increase in high-frequency EMG signals constitute biomarkers of TCS; they can be used both for seizure detection and for differentiating TCS from convulsive nonepileptic seizures. Two large-scale, blinded, prospective studies demonstrated the accuracy of wearable EMG devices for detecting TCS with high sensitivity (76%-100%). The rate of false alarms (0.7-2.5/24 h) needs further improvement. This article summarizes the pathophysiology of muscle activation during convulsive seizures and reviews the published evidence on the accuracy of EMG-based seizure detection. Wiley Periodicals, Inc. © 2018 International League Against Epilepsy.
McGregor, Maurice; Chen, Jun
2004-10-01
New evidence suggests that the implantable cardiac defibrillator (ICD) may be effective for primary prevention of sudden death. High instrumental cost and the potentially large number of candidates will significantly impact hospital budgets. To review the information relevant to hospital policy decisions on the use of ICDs for primary prevention. Modelling based on an evaluation of reported studies and Canadian costs, detailed in a comprehensive review available at
Phillips, Susie B; Batlivala, Sarosh; Knudson, Jarrod D
2015-10-01
Common aetiologies of sudden cardiac death in children include coronary anomalies, channelopathies, and cardiomyopathies. Less frequently, hypercoagulable states cause sudden arrest. We report an unusual case of aborted sudden cardiac death in a teenager, ultimately found to have homozygosity for the 4G allele of the plasminogen activase inhibitor type 1 gene.
Olutoye, Oluyinka O; Johnson, Mark P; Coleman, Beverly G; Crombleholme, Timothy M; Adzick, N Scott; Flake, Alan W
2004-01-01
To identify factors predictive of fetal demise in fetuses with sacrococcygeal teratoma (SCT). The recent management of monochorionic twins discordant for a large SCT and a singleton with a large SCT was reviewed. Serial fetal echocardiography and ultrasonography with Doppler flow measurements documented rapid growth of the SCT in both cases with a relatively modest increase in combined cardiac output. No placentomegaly or hydrops was observed at any time. In both fetuses with SCT, evolution of abnormal umbilical artery waveforms was observed with the ultimate development of reversed end-diastolic umbilical arterial flow that was followed by sudden fetal demise. Death in these 2 fetuses with large SCTs in the absence of placentomegaly/hydrops or hemodynamic changes suggestive of evolving high-output failure suggests a previously unrecognized mechanism of death in fetuses with large rapidly growing SCTs. In these cases, fetal demise may only be heralded by abnormal umbilical artery waveforms that progress to the premorbid observation of reversed diastolic umbilical artery blood flow. Umbilical artery waveform analysis should be closely monitored with other hemodynamic parameters in fetuses with large SCTs. In such fetuses, depending on the gestational age, abnormalities in umbilical artery waveform should be considered indications for early delivery or in utero intervention to prevent fetal demise. Copyright 2004 S. Karger AG, Basel
Olutoye, Oluyinka O; Johnson, Mark P; Coleman, Beverly G; Crombleholme, Timothy M; Adzick, N Scott; Flake, Alan W
2003-01-01
To identify factors predictive of fetal demise in fetuses with sacrococcygeal teratoma (SCT). The recent management of monochorionic twins discordant for a large SCT and a singleton with a large SCT were reviewed. Serial fetal echocardiography and ultrasonography with Doppler flow measurements documented rapid growth of the SCT in both cases with a relatively modest increase in combined cardiac output. No placentomegaly or hydrops was observed at any time. In both fetuses with SCT, evolution of abnormal umbilical artery waveforms was observed with the ultimate development of reversed end-diastolic umbilical arterial flow that was followed by sudden fetal demise. Death in these 2 fetuses with large SCTs in the absence of placentomegaly/hydrops or hemodynamic changes suggestive of evolving high-output failure suggests a previously unrecognized mechanism of death in fetuses with large rapidly growing SCTs. In these cases, fetal demise may only be heralded by abnormal umbilical artery waveforms that progress to the premorbid observation of reversed diastolic umbilical artery blood flow. Umbilical artery waveform analysis should be closely monitored with other hemodynamic parameters in fetuses with large SCTs. In such fetuses, depending on the gestational age, abnormalities in umbilical artery waveform should be considered indications for early delivery or in utero intervention to prevent fetal demise. Copyright 2003 S. Karger AG, Basel
Sudden death: bereavement sequelae and interventions.
Davidson, G P
1981-10-14
Just the phrase "sudden death' carries its sense of trepidation and even horror. So fear-inducing is its reality and prospect, that we have attempted to sanitise it by the colloquialisms such as a "sudden death play off' in sport, and even (recalling my days in military service) as the name of a particularly ferocious mix of alcoholic beverage. One of the reasons why the phrase is so evocative is the force of the unexpected bereavement that follows sudden death. This paper purports to examine, using a systems approach, the psychological sequelae of the emotionally involved survivors of sudden death, and to relate this to possible intervention strategies.
Notes about the Armenia earthquake, 7 December 1988
Kerr, R. A.
1989-01-01
Whenever the plates moving beneath Armenia interlock, pressure builds. The stress increases, the pressure continues to climb and finally there is a fracture-a sudden release of energy we know as an earthquake.
Sudden Cardiac Arrest (SCA) Risk Assessment
... HRS Find a Specialist Share Twitter Facebook SCA Risk Assessment Sudden Cardiac Arrest (SCA) occurs abruptly and without ... people of all ages and health conditions. Start Risk Assessment The Sudden Cardiac Arrest (SCA) Risk Assessment Tool ...
Shanlin, R J; Sole, M J; Rahimifar, M; Tator, C H; Factor, S M
1988-09-01
Intracranial pressure was increased in 59 rats by inflating a subdural balloon to a total mass volume of 0.3 ml. The increase in intracranial pressure ranged from 75 to greater than 500 mm Hg. With few exceptions, mean arterial pressure increased to as high as 227 mm Hg during the increase in intracranial pressure. Significant increases in plasma catecholamines, major electrocardiographic changes and a considerably shortened survival time were observed only in the rats that demonstrated an increase in mean arterial pressure greater than 50 mm Hg. A perfusion study with liquid silicone rubber (Microfil) revealed dilated irregular myocardial vessels with areas of focal constriction consistent with microvascular spasm. Histologic examination of the myocardium revealed widespread patches of contraction band necrosis and occasional contraction bands in the smooth muscle media of large coronary arteries. These observations suggest that myocardial damage after suddenly increased intracranial pressure resulted both from exposure to toxic levels of catecholamines and from myocardial reperfusion. Extension of these studies to humans suggests that a detailed assessment of myocardial function should be performed in victims of severe brain injury. Myocardial dysfunction may be a major determinant of the patient's prognosis or may render the heart unsuitable for transplantation.
Factitious aortic dissection leading to thoracotomy in a 20-year-old man.
Chambers, Elise; Yager, Joel; Apfeldorf, William; Camps-Romero, Eduardo
2007-01-01
A 20-year-old man presented to an emergency department with dramatic, sudden-onset, tearing chest pain. He also claimed to have been previously diagnosed with Ehler-Danlos syndrome and a previous Type I aortic dissection (intimal tear of ascending aorta), rapidly increasing his treating physician's suspicion of an emergent aortic dissection. The patient was quickly transferred to a large university hospital, where he underwent a median sternotomy and thoracotomy, with no aortic pathology found on operation and biopsy. After the patient's postoperative recovery, he was treated at a mental health facility, where he remained ambivalent about his psychiatric condition and did not respond well to treatment. This case report describes a unique case of factitious disorder that led to a serious operative intervention and subsequent psychiatric care and assesses factors that might have contributed to his hospital course.
BACKWARD ESTIMATION OF STOCHASTIC PROCESSES WITH FAILURE EVENTS AS TIME ORIGINS1
Gary Chan, Kwun Chuen; Wang, Mei-Cheng
2011-01-01
Stochastic processes often exhibit sudden systematic changes in pattern a short time before certain failure events. Examples include increase in medical costs before death and decrease in CD4 counts before AIDS diagnosis. To study such terminal behavior of stochastic processes, a natural and direct way is to align the processes using failure events as time origins. This paper studies backward stochastic processes counting time backward from failure events, and proposes one-sample nonparametric estimation of the mean of backward processes when follow-up is subject to left truncation and right censoring. We will discuss benefits of including prevalent cohort data to enlarge the identifiable region and large sample properties of the proposed estimator with related extensions. A SEER–Medicare linked data set is used to illustrate the proposed methodologies. PMID:21359167
A mechanism for sustained groundwater pressure changes induced by distant earthquakes
Brodsky, E.E.; Roeloffs, E.; Woodcock, D.; Gall, I.; Manga, M.
2003-01-01
Large sustained well water level changes (>10 cm) in response to distant (more than hundreds of kilometers) earthquakes have proven enigmatic for over 30 years. Here we use high sampling rates at a well near Grants Pass, Oregon, to perform the first simultaneous analysis of both the dynamic response of water level and sustained changes, or steps. We observe a factor of 40 increase in the ratio of water level amplitude to seismic wave ground velocity during a sudden coseismic step. On the basis of this observation we propose a new model for coseismic pore pressure steps in which a temporary barrier deposited by groundwater flow is entrained and removed by the more rapid flow induced by the seismic waves. In hydrothermal areas, this mechanism could lead to 4 ?? 10-2 MPa pressure changes and triggered seismicity.
Acute and subchronic administration of anandamide or oleamide increases REM sleep in rats.
Herrera-Solís, Andrea; Vásquez, Khalil Guzmán; Prospéro-García, Oscar
2010-03-01
Anandamide and oleamide, induce sleep when administered acutely, via the CB1 receptor. Their subchronic administration must be tested to demonstrate the absence of tolerance to this effect, and that the sudden withdrawal of these endocannabinoids (eCBs) does not affect sleep negatively. The sleep-waking cycle of rats was evaluated for 24h, under the effect of an acute or subchronic administration of eCBs, and during sudden eCBs withdrawal. AM251, a CB1 receptor antagonist (CB1Ra) was utilized to block eCBs effects. Our results indicated that both acute and subchronic administration of eCBs increase REMS. During eCBs withdrawal, rats lack the expression of an abstinence-like syndrome. AM251 was efficacious to prevent REMS increase caused by both acute and subchronic administration of these eCBs, suggesting that this effect is mediated by the CB1 receptor. Our data further support a role of the eCBs in REMS regulation. (c) 2009 Elsevier Inc. All rights reserved.
Mobile phone usage does not affect sudden sensorineural hearing loss.
Sagiv, D; Migirov, L; Madgar, O; Nakache, G; Wolf, M; Shapira, Y
2018-01-01
Recent studies found that mobile phone users had a significantly greater risk of having elevated thresholds in speech frequencies. This study investigated the correlation between the laterality of sudden sensorineural hearing loss, handedness and the preferred ear for mobile phone use. The study included all patients who presented with sudden sensorineural hearing loss to the Department of Otolaryngology - Head and Neck Surgery in our tertiary referral medical centre between 2014 and 2016. Patients were asked to indicate their dominant hand and preferred ear for mobile phone use. The study comprised 160 patients. No correlation was found between the dominant hand or preferred ear for mobile phone use and the side of sudden sensorineural hearing loss. There was no correlation between the side of the sudden sensorineural hearing loss (preferable or non-preferable for mobile phone use) and audiometric characteristics. No correlation was found between the laterality of ears used for mobile phone and sudden sensorineural hearing loss.
Prestes, Rosilene A; Colnago, Luiz A; Forato, Lucimara A; Carrilho, Emanuel; Bassanezi, Renato B; Wulff, Nelson A
2009-01-01
Citrus sudden death (CSD) is a new disease of sweet orange and mandarin trees grafted on Rangpur lime and Citrus volkameriana rootstocks. It was first seen in Brazil in 1999, and has since been detected in more than four million trees. The CSD causal agent is unknown and the current hypothesis involves a virus similar to Citrus tristeza virus or a new virus named Citrus sudden death-associated virus. CSD symptoms include generalized foliar discoloration, defoliation and root death, and, in most cases, it can cause tree death. One of the unique characteristics of CSD disease is the presence of a yellow stain in the rootstock bark near the bud union. This region also undergoes profound anatomical changes. In this study, we analyse the metabolic disorder caused by CSD in the bark of sweet orange grafted on Rangpur lime by nuclear magnetic resonance (NMR) spectroscopy and imaging. The imaging results show the presence of a large amount of non-functional phloem in the rootstock bark of affected plants. The spectroscopic analysis shows a high content of triacylglyceride and sucrose, which may be related to phloem blockage close to the bud union. We also propose that, without knowing the causal CSD agent, the determination of oil content in rootstock bark by low-resolution NMR can be used as a complementary method for CSD diagnosis, screening about 300 samples per hour.
Bayesian Classification Models for Premature Ventricular Contraction Detection on ECG Traces.
Casas, Manuel M; Avitia, Roberto L; Gonzalez-Navarro, Felix F; Cardenas-Haro, Jose A; Reyna, Marco A
2018-01-01
According to the American Heart Association, in its latest commission about Ventricular Arrhythmias and Sudden Death 2006, the epidemiology of the ventricular arrhythmias ranges from a series of risk descriptors and clinical markers that go from ventricular premature complexes and nonsustained ventricular tachycardia to sudden cardiac death due to ventricular tachycardia in patients with or without clinical history. The premature ventricular complexes (PVCs) are known to be associated with malignant ventricular arrhythmias and sudden cardiac death (SCD) cases. Detecting this kind of arrhythmia has been crucial in clinical applications. The electrocardiogram (ECG) is a clinical test used to measure the heart electrical activity for inferences and diagnosis. Analyzing large ECG traces from several thousands of beats has brought the necessity to develop mathematical models that can automatically make assumptions about the heart condition. In this work, 80 different features from 108,653 ECG classified beats of the gold-standard MIT-BIH database were extracted in order to classify the Normal, PVC, and other kind of ECG beats. Three well-known Bayesian classification algorithms were trained and tested using these extracted features. Experimental results show that the F1 scores for each class were above 0.95, giving almost the perfect value for the PVC class. This gave us a promising path in the development of automated mechanisms for the detection of PVC complexes.
Gimeno-Blanes, Francisco J.; Blanco-Velasco, Manuel; Barquero-Pérez, Óscar; García-Alberola, Arcadi; Rojo-Álvarez, José L.
2016-01-01
Great effort has been devoted in recent years to the development of sudden cardiac risk predictors as a function of electric cardiac signals, mainly obtained from the electrocardiogram (ECG) analysis. But these prediction techniques are still seldom used in clinical practice, partly due to its limited diagnostic accuracy and to the lack of consensus about the appropriate computational signal processing implementation. This paper addresses a three-fold approach, based on ECG indices, to structure this review on sudden cardiac risk stratification. First, throughout the computational techniques that had been widely proposed for obtaining these indices in technical literature. Second, over the scientific evidence, that although is supported by observational clinical studies, they are not always representative enough. And third, via the limited technology transfer of academy-accepted algorithms, requiring further meditation for future systems. We focus on three families of ECG derived indices which are tackled from the aforementioned viewpoints, namely, heart rate turbulence (HRT), heart rate variability (HRV), and T-wave alternans. In terms of computational algorithms, we still need clearer scientific evidence, standardizing, and benchmarking, siting on advanced algorithms applied over large and representative datasets. New scenarios like electronic health recordings, big data, long-term monitoring, and cloud databases, will eventually open new frameworks to foresee suitable new paradigms in the near future. PMID:27014083
Alattar, A; Maffulli, N
2015-01-01
Objective: To review the available evidence establishing the validity of adding electrocardiogram to the preparticipation cardiac screening in athletes. Data Sources: MEDLINE and CINAHL databases were searched. Additional references from the bibliographies of retrieved articles were also reviewed and experts in the area were contacted. Selection Criteria: Only original research articles seeking to establish the use of electrocardiography followed by second line investigations in athletes under 36 years of age were reviewed. Search Result and Quality Assessment: The initial literature search identified 226 papers. Of these, 16 original articles (all type II evidence—population-based clinical studies) met the selection criteria and directly related to the use of electrocardiography in athletes cardiac screening. The methodological qualities of included studies were assessed using the Downs and Black checklist. Conclusion: Screening with electrocardiography represents best clinical practice to prevent or reduce the risk of sudden cardiac death in athletes. It significantly improves the sensitivity of history and physical examination alone; it has reasonable specificity and excellent negative predictive value; and it is cost-effective. Future studies must be large, multicentre, multination, prospective trials powered to determine how different screening options affect the incidence of sudden cardiac death. Efforts should also be targeted toward secondary prevention of sudden cardiac death with pitch side cardiac resuscitation and the immediate use of defibrillator. PMID:25674543
Not a slippery slope or sudden subversion: German medicine and national socialism in 1933.
Hanauske-Abel, H. M.
1996-01-01
The history of medicine this century is darkened by the downfall of the German medical profession, exposed during the doctors' trial at Nuremberg in 1946. Relying largely on documents published during 1933 in German medical journals, this paper examines two widely accepted notions of those events, metaphorically termed "slippery slope" and "sudden subversion." The first connotes a gradual slide over infinitesimal steps until, suddenly, all footing is lost; the second conveys forced take over of the profession's leadership and values. Both concepts imply that the medical profession itself became the victim of circumstances. The slippery slope concept is a prominent figure of argument in the current debate on bioethics. The evidence presented here, however, strongly suggests that the German medical community set its own course in 1933. In some respects this course even outpaced the new government, which had to rein in the profession's eager pursuit of enforced eugenic sterilizations. In 1933 the convergence of political, scientific, and economic forces dramatically changed the relationship between the medical community and the government. That same convergence is occurring again and must be approached with great caution if medicine is to remain focused on the preservation of physical and medical integrity. Images p1456-a p1457-a p1457-b p1458-a p1459-a p1459-b Fig 1 PMID:8973235
Vertical motions of the Puerto Rico Trench and Puerto Rico and their cause
ten Brink, Uri S.
2005-01-01
The Puerto Rico trench exhibits great water depth, an extremely low gravity anomaly, and a tilted carbonate platform between (reconstructed) elevations of +1300 m and -4000 m. I argue that these features are manifestations of large vertical movements of a segment of the Puerto Rico trench, its forearc, and the island of Puerto Rico that took place 3.3 m.y. ago over a time period as short as 14-40 kyr. I explain these vertical movements by a sudden increase in the slab's descent angle that caused the trench to subside and the island to rise. The increased dip could have been caused by shearing or even by a complete tear of the descending North American slab, although the exact nature of this deformation is unknown. The rapid (14-40 kyr) and uniform tilt along a 250 km long section of the trench is compatible with scales of mantle flow and plate bending. The proposed shear zone or tear is inferred from seismic, morphological, and gravity observations to start at the trench at 64.5??W and trend southwestwardly toward eastern Puerto Rico. The tensile stresses necessary to deform or tear the slab could have been generated by increased curvature of the trench following a counterclockwise rotation of the upper plate and by the subduction of a large seamount.
Shi, J R; Tian, C J; Zeng, Q; Guo, X J; Lu, J; Gao, C R
2016-06-01
To explore the value of mast cell tryptase and brain natriuretic peptide(BNP) in the differential diagnostic of sudden death due to hypersensitivity and coronary atherosclerotic heart disease. Totally 30 myocardial samples were collected from the autopsy cases in the Department of Forensic Pathology, Shanxi Medical University during 2010-2015. All samples were divided into three groups: death of craniocerebral injury group, sudden death of hypersensitivity group and sudden death of coronary atherosclerotic heart disease group, 10 cases in each group. Mast cell tryptase and BNP in myocardium were detected by immunofluorescence staining and Western Blotting. Immunofluorescence staining showed that the positive staining mast cell tryptase appeared in myocardium of sudden death of hypersensitivity group and coronary atherosclerotic heart disease group. Among the three groups, the expression of mast cell tryptase showed significantly differences through pairwise comparison ( P <0.05); The expression level of BNP in sudden death of coronary atherosclerotic heart disease group were significantly higher than the sudden death of hypersensitivity group and death of craniocerebral injury group ( P <0.05). The difference of the expression level of BNP between the sudden death of hypersensitivity group and the death of craniocerebral injury group had no statistical significance ( P >0.05). The combined detection of the mast cell tryptase and BNP in myocardium is expected to provide help for the forensic differential diagnosis of sudden death due to hypersensitivity and coronary atherosclerotic heart disease. Copyright© by the Editorial Department of Journal of Forensic Medicine
Genetics Home Reference: sudden infant death with dysgenesis of the testes syndrome
... Facebook Twitter Home Health Conditions SIDDT Sudden infant death with dysgenesis of the testes syndrome Printable PDF ... view the expand/collapse boxes. Description Sudden infant death with dysgenesis of the testes syndrome ( SIDDT ) is ...
Features of polar cusp electron precipitation associated with a large magnetic storm
NASA Technical Reports Server (NTRS)
Berko, F. W.
1974-01-01
Measurements of precipitating electrons made by the OGO-4 satellite reveal several interesting phenomena in the polar cusp. Extremely high fluxes of 0.7 keV electrons were observed in the polar cusp ninety minutes following the sudden commencement of a very large magnetic storm. Structured, fairly high fluxes of 7.3 keV electrons were also observed in the cusp region, accompanied by very strong search coil magnetometer fluctuations, indicative of strong field-aligned currents. The observations confirm previously reported latitudinal shifts in the location of the polar cusp in response to southward interplanetary magnetic fields.
Pulsed beam of extremely large helium droplets
NASA Astrophysics Data System (ADS)
Kuma, Susumu; Azuma, Toshiyuki
2017-12-01
We generated a pulsed helium droplet beam with average droplet diameters of up to 2 μ m using a solenoid pulsed valve operated at temperatures as low as 7 K. The droplet diameter was controllable over two orders of magnitude, or six orders of the number of atoms per droplet, by lowering the valve temperature from 21 to 7 K. A sudden droplet size change attributed to the so-called ;supercritical expansion; was firstly observed in pulsed mode, which is necessary to obtain the micrometer-scale droplets. This beam source is beneficial for experiments that require extremely large helium droplets in intense, pulsed form.
Do prescription stimulants increase the risk of adverse cardiovascular events?: A systematic review
2012-01-01
Background There is increasing concern that prescription stimulants may be associated with adverse cardiovascular events such as stroke, myocardial infarction, and sudden death. Public health concerns are amplified by increasing use of prescription stimulants among adults. Methods The objective of this study was to conduct a systematic review of the evidence of an association between prescription stimulant use and adverse cardiovascular outcomes. PUBMED, MEDLINE, EMBASE and Google Scholar searches were conducted using key words related to these topics (MESH): ADHD; Adults; Amphetamine; Amphetamines; Arrhythmias, Cardiac; Cardiovascular Diseases; Cardiovascular System; Central Nervous Stimulants; Cerebrovascular; Cohort Studies; Case–control Studies; Death; Death, Sudden, Cardiac; Dextroamphetamine; Drug Toxicity; Methamphetamine; Methylphenidate; Myocardial Infarction; Stimulant; Stroke; Safety. Eligible studies were population-based studies of children, adolescents, or adults using prescription stimulant use as the independent variable and a hard cardiovascular outcome as the dependent variable. Results Ten population-based observational studies which evaluated prescription stimulant use with cardiovascular outcomes were reviewed. Six out of seven studies in children and adolescents did not show an association between stimulant use and adverse cardiovascular outcomes. In contrast, two out of three studies in adults found an association. Conclusions Findings of an association between prescription stimulant use and adverse cardiovascular outcomes are mixed. Studies of children and adolescents suggest that statistical power is limited in available study populations, and the absolute risk of an event is low. More suggestive of a safety signal, studies of adults found an increased risk for transient ischemic attack and sudden death/ventricular arrhythmia. Interpretation was limited due to differences in population, cardiovascular outcome selection/ascertainment, and methodology. Accounting for confounding and selection biases in these studies is of particular concern. Future studies should address this and other methodological issues. PMID:22682429
NASA Astrophysics Data System (ADS)
Uchiyama, Ryunosuke; Okochi, Hiroshi; Katsumi, Naoya; Ogata, Hiroko
2017-06-01
In order to clarify the impact of air pollution on the formation of sudden and locally distributed heavy rain in urban areas (hereafter UHR = urban-induced heavy rain), we analyzed inorganic ions in rainwater samples collected on an event basis over 5 years from October 2012 to December 2016 in Shinjuku, Tokyo. Hourly rainfall amounts and wet deposition fluxes of acidic components (the sum of H+, NH4+, NO3-, and nonsea-salt SO42-) in UHR were 13.1 and 17.8 times larger than those in normal rainfall, respectively, indicating that large amount of air pollutants were scavenged and deposited by UHR with large amounts of rainfall. The level of air pollutants, such as NO2, SO2, and potential ozone, in the ambient air increased just before the formation of UHR and decreased sharply at the end of the UHR event. These results indicate that NO2, which was formed secondarily by oxidants, was further oxidized by HO radicals and formed HNO3 just before the formation of UHR, which was subsequently scavenged by UHR.
Jou, Yingtzy; Chiang, Chih-Pin; Yen, Hungchen Emilie
2013-01-01
Halophyte Mesembryanthemum crystallinum L. (ice plant) rapidly responds to sudden increases in salinity in its environment by activating specific salt-tolerant mechanisms. One major strategy is to regulate a series of ion transporters and proton pumps to maintain cellular Na+/K+ homeostasis. Plant SKD1 (suppressor of K+ transport growth defect 1) proteins accumulate in cells actively engaged in the secretory processes, and play a critical role in intracellular protein trafficking. Ice plant SKD1 redistributes from the cytosol to the plasma membrane hours after salt stressed. In combination with present knowledge of this protein, we suggest that stress facilitates SKD1 movement to the plasma membrane where ADP/ATP exchange occurs, and functions in the regulation of membrane components such as ion transporters to avoid ion toxicity. PMID:24390077
On the impact of cloudiness on the characteristics of nocturnal downslope flows
NASA Astrophysics Data System (ADS)
Ye, Z. J.; Segal, M.; Garratt, J. R.; Pielke, R. A.
1989-10-01
The effects of cloud cover amount and the height of cloud base on nighttime thermally induced downslope flow were investigated using analytical and numerical model approaches. The conclusions obtained with the analytical and the numerical model evaluations agreed. It was concluded that, (i) as cloud cover increases and/or the height of cloud base decreases, the depth and the intensity of nighttime thermally-induced downslope flows may decrease by a factor reaching one sixth and one tenth, respectively, in the case of overcast low cloud; (ii) when skies suddenly cloud over around midnight, the development of the downslope flow is altered in different ways: a reduction in intensity; or a cessation of further development, depending on the fraction of cloud coverage, and (iii) with a sudden clearing of overcast low cloud around midnight, the depth and the intensity of the downslope flow increases significantly.
van der Wel, Robrecht P; Welsh, Timothy; Böckler, Anne
2018-01-01
The direction of gaze towards or away from an observer has immediate effects on attentional processing in the observer. Previous research indicates that faces with direct gaze are processed more efficiently than faces with averted gaze. We recently reported additional processing advantages for faces that suddenly adopt direct gaze (abruptly shift from averted to direct gaze) relative to static direct gaze (always in direct gaze), sudden averted gaze (abruptly shift from direct to averted gaze), and static averted gaze (always in averted gaze). Because changes in gaze orientation in previous study co-occurred with changes in head orientation, it was not clear if the effect is contingent on face or eye processing, or whether it requires both the eyes and the face to provide consistent information. The present study delineates the impact of head orientation, sudden onset motion cues, and gaze cues. Participants completed a target-detection task in which head position remained in a static averted or direct orientation while sudden onset motion and eye gaze cues were manipulated within each trial. The results indicate a sudden direct gaze advantage that resulted from the additive role of motion and gaze cues. Interestingly, the orientation of the face towards or away from the observer did not influence the sudden direct gaze effect, suggesting that eye gaze cues, not face orientation cues, are critical for the sudden direct gaze effect.
State of the art in forensic investigation of sudden cardiac death.
Oliva, Antonio; Brugada, Ramon; D'Aloja, Ernesto; Boschi, Ilaria; Partemi, Sara; Brugada, Josep; Pascali, Vincenzo L
2011-03-01
The sudden death of a young person is a devastating event for both the family and community. Over the last decade, significant advances have been made in understanding both the clinical and genetic basis of sudden cardiac death. Many of the causes of sudden death are due to genetic heart disorders, which can lead to both structural (eg, hypertrophic cardiomyopathy) and arrhythmogenic abnormalities (eg, familial long QT syndrome, Brugada syndrome). Most commonly, sudden cardiac death can be the first presentation of an underlying heart problem, leaving the family at a loss as to why an otherwise healthy young person has died. Not only is this a tragic event for those involved, but it also presents a great challenge to the forensic pathologist involved in the management of the surviving family members. Evaluation of families requires a multidisciplinary approach, which should include cardiologists, a clinical geneticist, a genetic counselor, and the forensic pathologist directly involved in the sudden death case. This multifaceted cardiac genetic service is crucial in the evaluation and management of the clinical, genetic, psychological, and social complexities observed in families in which there has been a young sudden cardiac death. The present study will address the spectrum of structural substrates of cardiac sudden death with particular emphasis given to the possible role of forensic molecular biology techniques in identifying subtle or even merely functional disorders accounting for electrical instability.
Long QT syndrome unmasked in an adult subject presenting with excited delirium.
Bozeman, William P; Ali, Karim; Winslow, James E
2013-02-01
Excited delirium is increasingly recognized as a risk factor for sudden death, though the specific pathophysiology of these deaths is typically unclear. We describe a survivor of excited delirium that displayed a transient severe prolongation of the QT interval, suggesting unmasking of long QT syndrome as a possible mechanism of sudden death. A 30-year-old man was arrested by police for violent assaultive behavior. Officers at the scene noted confusion, nonsensical speech, sweating, and bizarre agitated behavior; he was transported to the Emergency Department for medical evaluation of possible excited delirium. His initial electrocardiogram revealed a markedly prolonged corrected QT interval of over 600 ms. Intravenous hydration and sodium bicarbonate were administered, with normalization of the QT; he was admitted and recovered uneventfully. We discuss the possible association between long QT syndrome and unexplained sudden deaths seen with excited delirium. Sodium bicarbonate may be considered when long QT syndrome is identified during or after agitated delirium, though its routine use cannot be recommended based on a case report. Copyright © 2013 Elsevier Inc. All rights reserved.
Anomalous Aortic Origin of a Coronary Artery is Always a Surgical Disease.
Vouhé, Pascal R
2016-01-01
Anomalous aortic origin of a coronary artery is a congenital anomaly in which a major coronary artery arises from the wrong sinus of Valsalva (left coronary from right sinus or right coronary from left sinus) and courses between the great arteries before reaching its normal epicardial course. Although the risk of sudden death is clearly established, the indications for surgery remain controversial. The risk of sudden death is increased in symptomatic patients, in anomalous left coronary artery, as well as in the presence of some risk factors (intense physical activity, young age [<35 years], aggravating anatomical features [intramural interarterial course, slit-like ostium, acute angle of take-off]). As far as is currently known, surgical management using an anatomical repair can prevent sudden death, provided that normal coronary anatomy and function are achieved and that extensive return-to-play testing is performed. A precise evaluation of the benefit/risk ratio is mandatory on an individual basis, but surgery may be indicated in the vast majority of patients. Copyright © 2016 Elsevier Inc. All rights reserved.
Rotational polarities of sudden impulses in the magnetotail lobe
NASA Technical Reports Server (NTRS)
Kawano, H.; Yamamoto, T.; Kokubun, S.; Lepping, R. P.
1992-01-01
A sudden impulse (SI) is a sudden change in the magnetic field strength which is caused by a change in the solar wind pressure and is observed throughout the magnetosphere. In this report we have examined the rotations of the magnetic field vectors at times of SIs in the magnetotail lobe, by using IMP 6, 7, and 8 magnetometer data. The following properties have been found: (1) at the time of SI the arrowhead of the magnetic vector tends to rotate in one plane; (2) the plane of rotation tends to include the unperturbed magnetic field vector; (3) the plane of rotation tends to be aligned with the radial direction from the magnetotail axis; and (4) the magnetic vectors have a particular rotational polarity: when the plane of rotation is viewed so that the Sun is to the right of the viewed plane and the magnetotail axis is to the bottom, the arrowhead of the vector tends to rotate counterclockwise in this plane. These magnetic vector properties are consistent with those expected when part of an increase in solar wind lateral pressure squeezes the magnetotail axisymmetrically while moving tailward.
[The wearable cardioverter/defibrillator : Temporary protection from sudden cardiac death].
Duncker, D; Bauersachs, J; Veltmann, C
2016-09-01
In the majority of cases sudden cardiac death (SCD) is caused by ventricular tachyarrhythmia. Implantable cardioverter-defibrillators (ICD) represent an evidence-based and established method for prevention of SCD. For patients who do not fulfill the criteria for guideline-conform implantation of an ICD but still have an increased, e.g. transient risk for SCD, a wearable cardioverter-defibrillator (WCD) vest was developed to temporarily prevent SCD. Numerous studies have shown the safety and efficacy of the WCD, although there is still a gap in evidence concerning a reduction in overall mortality and improvement in prognosis. This article gives an overview on the currently available literature on WCD, the indications, potential risks and complications.
[A Method Research on Environmental Damage Assessment of a Truck Rollover Pollution Incident].
Cai, Feng; Zhao, Shi-ho; Chen, Gang-cai; Xian, Si-shu; Yang, Qing-ling; Zhou, Xian-jie; Yu, Hai
2015-05-01
With high occurrence of sudden water pollution incident, China faces an increasingly severe situation of water environment. In order to deter the acts of environmental pollution, ensure the damaged resources of environment can be restored and compensated, it is very critical to quantify the economic losses caused by the sudden water pollution incident. This paper took truck rollover pollution incidents in Chongqing for an example, established a set of evaluation method for quantifying the environmental damage, and then assessed the environmental damage by the method from four aspects, including the property damage, ecological environment and resources damages, the costs of administrative affairs in emergency disposal, and the costs of investigation and evaluation.
Burch, Thomas M; McGowan, Francis X; Kussman, Barry D; Powell, Andrew J; DiNardo, James A
2008-12-01
Patients with congenital supravalvular aortic stenosis and associated peripheral pulmonary artery stenoses, the majority of whom have Williams-Beuren syndrome, are inherently at risk for development of myocardial ischemia. This is particularly true in the setting of procedural sedation and anesthesia. The biventricular hypertrophy that accompanies these lesions increases myocardial oxygen consumption and compromises oxygen delivery. In addition, these patients often have direct, multifactorial compromise of coronary blood flow. In this article, we review both the pathophysiology of congenital supravalvular aortic stenosis and the literature regarding sudden death in association with sedation and anesthesia. Recommendations as to preoperative assessment and management of these patients are made based on the best available evidence.
B. Makaske; E. De Vries; J. A. Tainter; R. J. McIntosh
2007-01-01
The Méma is a semi-arid region in central Mali with a rich archaeological heritage indicating the former existence of large urban settlements. The archaeological data suggest millennia of occupation history of the Méma preceding relatively sudden abandonment by the 14th or 15th century AD. Population numbers have remained low since then and today...
Baker, Michael S
2007-03-01
How do we train for the entire spectrum of potential emergency and crisis scenarios? Will we suddenly face large numbers of combat casualties, an earthquake, a plane crash, an industrial explosion, or a terrorist bombing? The daily routine can suddenly be complicated by large numbers of patients, exceeding the ability to treat in a routine fashion. Disaster events can result in patients with penetrating wounds, burns, blast injuries, chemical contamination, or all of these at once. Some events may disrupt infrastructure or result in loss of essential equipment or key personnel. The chaos of a catastrophic event impedes decision-making and effective treatment of patients. Disasters require a paradigm shift from the application of unlimited resources for the greatest good of each individual patient to the allocation of care, with limited resources, for the greatest good for the greatest number of patients. Training and preparation are essential to remain effective during crises and major catastrophic events. Disaster triage and crisis management represent a tactical art that incorporates clinical skills, didactic information, communication ability, leadership, and decision-making. Planning, rehearsing, and exercising various scenarios encourage the flexibility, adaptability, and innovation required in disaster settings. These skills can bring order to the chaos of overwhelming disaster events.
Mesoscale Simulations of Gravity Waves During the 2008-2009 Major Stratospheric Sudden Warming
NASA Technical Reports Server (NTRS)
Limpasuvan, Varavut; Alexander, M. Joan; Orsolini, Yvan J.; Wu, Dong L.; Xue, Ming; Richter, Jadwiga H.; Yamashita, Chihoko
2011-01-01
A series of 24 h mesoscale simulations (of 10 km horizontal and 400 m vertical resolution) are performed to examine the characteristics and forcing of gravity waves (GWs) relative to planetary waves (PWs) during the 2008-2009 major stratospheric sudden wam1ing (SSW). Just prior to SSW occurrence, widespread westward propagating GWs are found along the vortex's edge and associated predominantly with major topographical features and strong near-surface winds. Momentum forcing due to GWs surpasses PW forcing in the upper stratosphere and tends to decelerate the polar westerly jet in excess of 30 m/s/d. With SSW onset, PWs dominate the momentum forcing, providing decelerative effects in excess of 50 m/s/d throughout the upper polar stratosphere. GWs related to topography become less widespread largely due to incipient wind reversal as the vortex starts to elongate. During the SSW maturation and early recovery, the polar vortex eventually splits and both wave signatures and forcing greatly subside. Nonetheless, during SSW, westward and eastward propagating GWs are found in the polar region and may be generated in situ by flow adjustment processes in the stratosphere or by secondary GW breaking. The simulated large-scale features agree well with those resolved in satellite observations and analysis products.
Mesopause Jumps: Observations and Explanation
NASA Astrophysics Data System (ADS)
Luebken, F. J.; Becker, E.; Höffner, J.; Viehl, T. P.; Latteck, R.
2017-12-01
Recent high resolution temperature measurements by resonance lidar at Davis (69°S) occasionally showed a sudden mesopause altitude increase by 5km and an associated mesopause temperature decrease by 10K. We present further observations which are closely related to this `mesopause jump', namely the increase of mean height of polar mesospheric summer echoes (PMSE) observed by a VHF radar, very strong westward winds in the upper mesosphere measured by an MF radar, and relatively large eastward winds in the stratosphere taken from reanalysis. We compare to similar observations in the Northern Hemisphere, namely at ALOMAR (69°N) where such mesopause jumps have never been observed. We present a detailed explanation of mesopause jumps. They occur only when stratospheric winds are moderately eastward and mesospheric winds are very large (westward). Under these conditions, gravity waves with comparatively large eastward phase speeds can pass the stratosphere and propagate to the lower thermosphere because their vertical wavelengths in the mesosphere are rather large which implies reduced dynamical stability. When finally breaking in the lower thermosphere, these waves drive an enhanced residual circulation that causes a cold and high-altitude mesopause. The conditions for a mesopause jump occur only in the Southern Hemisphere (SH) and are associated with the late breakdown of the polar vortex.Mesopause jumps are primarily, but not only, observed prior and close to solstice. We also show that during the onset of PMSE in the SH, stratospheric zonal winds are still eastward (up to 30m/s), and that the onset is not closely related to the transition of the stratospheric circulation.
Gastrointestinal causes of sudden unexpected death: A review.
Menezes, Ritesh G; Ahmed, Saba; Pasha, Syed Bilal; Hussain, Syed Ather; Fatima, Huda; Kharoshah, Magdy A; Madadin, Mohammed
2018-01-01
Gastrointestinal conditions are a less common cause of sudden unexpected death when compared to other conditions such as cardiovascular conditions, but they are equally important. Various congenital and acquired gastrointestinal conditions that have resulted in sudden unexpected death are discussed. The possible lethal mechanisms behind each condition, along with any associated risk factors or secondary diseases, have been described. Through this article, we aim to highlight the need for physicians to prevent death in such conditions by ensuring that subclinical cases are diagnosed correctly before it is too late and by providing timely and efficacious treatment to the patient concerned. In addition, this review would certainly benefit the forensic pathologist while dealing with cases of sudden unexpected death due to gastrointestinal causes. This article is a review of the major gastrointestinal causes of sudden unexpected death. In addition, related fatal cases encountered occasionally in forensic autopsy practice are also included. There are several unusual and rare causes of life-threatening gastrointestinal bleeding that may lead to sudden unexpected death to cover all the entities in detail. Nevertheless, this article is a general guide to the topic of gastrointestinal causes of sudden unexpected death.
F-MARC: promoting the prevention and management of sudden cardiac arrest in football
Kramer, Efraim Benjamin; Dvorak, J; Schmied, C; Meyer, T
2015-01-01
Sudden cardiac death is the most common cause of unnatural death in football. To prevent and urgently manage sudden cardiac arrest on the football field-of-play, F-MARC (FIFA Medical and Research Centre) has been fully committed to a programme of research, education, standardisation and practical implementation. This strategy has detected football players at medical risk during mandatory precompetition medical assessments. Additionally, FIFA has (1) sponsored internationally accepted guidelines for the interpretation of an athlete's ECG, (2) developed field-of-play-specific protocols for the recognition, response, resuscitation and removal of a football player having sudden cardiac arrest and (3) introduced and distributed the FIFA medical emergency bag which has already resulted in the successful resuscitation of a football player who had a sudden cardiac arrest on the field-of-play. Recently FIFA, in association with the Institute of Sports and Preventive Medicine in Saarbrücken, Germany, established a worldwide Sudden Death Registry with a view to documenting fatal events on the football field-of-play. These activities by F-MARC are testimony to FIFA's continued commitment to minimising sudden cardiac arrest while playing football. PMID:25878076
Brent, David; Melhem, Nadine; Donohoe, M Bertille; Walker, Monica
2009-07-01
This study examined effects of bereavement 21 months after a parent's death, particularly death by suicide. The participants were 176 offspring, ages 7-25, of parents who died by suicide, accident, or sudden natural death. They were assessed 9 and 21 months after the death, along with 168 nonbereaved subjects. Major depression and alcohol or substance abuse 21 months after the parent's death were more common among bereaved youth than among comparison subjects. Offspring with parental suicide or accidental death had higher rates of depression than comparison subjects; those with parental suicide had higher rates of alcohol or substance abuse. Youth with parental suicide had a higher incidence of depression than those bereaved by sudden natural death. Bereavement and a past history of depression increased depression risk in the 9 months following the death, which increased depression risk between 9 and 21 months. Losing a mother, blaming others, low self-esteem, negative coping, and complicated grief were associated with depression in the second year. Youth who lose a parent, especially through suicide, are vulnerable to depression and alcohol or substance abuse during the second year after the loss. Depression risk in the second year is mediated by the increased incidence of depression within the first 9 months. The most propitious time to prevent or attenuate depressive episodes in bereaved youth may be shortly after the parent's death. Interventions that target complicated grief and blaming of others may also improve outcomes in symptomatic youth with parental bereavement.
Karamatic, S L; Anderson, G A; Parry, B W; Slocombe, R F; Mansfield, C S
2018-04-01
A prospective, observational study to determine the prevalence of post-exercise conditions at Australian Greyhound race meetings and to assess association with race performance and other environmental, race- and dog-related factors was undertaken. A total of 4020 starters were observed (2813 Greyhounds, 1009 trainers, 536 races, 52 race meets, 48 race dates and 11 race tracks) following a race. The presence of diaphragmatic flutter (DF), ataxia, seizure, collapse or sudden death was recorded. Risk factors were screened by univariable logistic regression prior to multivariable backward stepwise model building. In this study, 962 starters (n = 768 dogs) had DF (23.9%), 16 starters were ataxic (0.4%) and there were no observed cases of collapse, seizure or sudden death. Race track location, increasing race distance, race grade based on increasing 1st place prize value, lower (earlier) race number at the meeting, age, a previous observation of DF at the last start, females, colour (white) and better finishing position were all associated with an increased risk of a Greyhound being observed with DF. However, when logistic regression assessing the random effect of dog was performed, the presence of previous DF was not significant. In this cohort, DF was common following strenuous exercise in Greyhounds and on its own does not appear to result in reduced performance or distress to the animal. The incidence of ataxia was low and collapse, seizure and sudden death were not observed. However, even though uncommon, ataxia has welfare concerns for racing Greyhounds that warrants further investigation. © 2018 Australian Veterinary Association.
Waxman, D
2012-06-01
A fundamental result of population genetics states that a new mutation, at an unlinked neutral locus in a randomly mating diploid population, has a mean time of fixation of ∼4N(e) generations, where N(e) is the effective population size. This result is based on an assumption of fixed population size, which does not universally hold in natural populations. Here, we analyze such neutral fixations in populations of changing size within the framework of the diffusion approximation. General expressions are derived for the mean and variance of the fixation time in changing populations. Some explicit results are given for two cases: (i) the effective population size undergoes a sudden change, representing a sudden population expansion or a sudden bottleneck; (ii) the effective population changes linearly for a limited period of time and then remains constant. Additionally, a lower bound for the mean time of fixation is obtained for an effective population size that increases with time, and this is applied to exponentially growing populations. The results obtained in this work show, among other things, that for populations that increase in size, the mean time of fixation can be enhanced, sometimes substantially so, over 4N(e,0) generations, where N(e,0) is the effective population size at the time the mutation arises. Such an enhancement is associated with (i) an increased probability of neutral polymorphism in a population and (ii) an enhanced persistence of high-frequency neutral variation, which is the variation most likely to be observed.
Walsh, Paul; Vieth, Teri; Rodriguez, Carolina; Lona, Nicole; Molina, Rogelio; Habebo, Emnet; Caldera, Enrique; Garcia, Cynthia; Veazey, Gregory
2014-01-01
Background. Pacifier use decreases the risk of sudden infant death syndrome (SIDS). An emergency department (ED) visit may provide an opportunistic 'teachable moment' for parents. Objectives. To test the hypotheses (1) that caregivers were less familiar with the role of pacifiers in sudden infant death (SIDS) prevention than other recommendations, and (2) that an ED educational intervention would increase pacifier use in infants younger than six months, and (3) that otitis media would not occur more frequently in pacifier users. Methods. We did an intervention-group-only longitudinal study in a county hospital ED. We measured pacifier use infants and baseline knowledge of SIDs prevention recommendations in caregivers. We followed up three months later to determine pacifier use, and 12 months later to determine episodes of otitis media. Results. We analyzed data for 780 infants. Parents knew of advice against co-sleeping in 469/780 (60%), smoking in 660/776 (85%), and prone sleeping in 613/780 (79%). Only 268/777 (35%) knew the recommendation to offer a pacifier at bedtime. At enrollment 449/780 (58%) did not use a pacifier. Of 210/338 infants aged less than 6 months followed up 41/112 (37%) non-users had started using a pacifier at bedtime (NNT 3). Over the same period, 37/98 (38%) users had discontinued their pacifier. Otitis media did not differ between users and non-users at 12 months. Conclusion. Caregiver knowledge of the role of pacifiers in SIDS prevention was less than for other recommendations. Our educational intervention appeared to increase pacifier use. Pacifier use was not associated with increased otitis media.
Residual entanglement and sudden death: A direct connection
NASA Astrophysics Data System (ADS)
de Oliveira, J. G. G.; Peixoto de Faria, J. G.; Nemes, M. C.
2011-11-01
We explore the results of [V. Coffman, et al., Phys. Rev. A 61 (2000) 052306] derived for general tripartite states in a dynamical context. We study a class of physically motivated tripartite systems. We show that whenever entanglement sudden death occurs in one of the partitions residual entanglement will appear. For fourpartite systems however, the appearance of residual entanglement is not conditioned by sudden death of entanglement. We can only say that if sudden death of entanglement occurs in some partition there will certainly be residual entanglement.
Epidemiological characteristics of sudden cardiac arrest in schools.
Nishiuchi, Tatsuya; Hayashino, Yasuaki; Iwami, Taku; Kitamura, Tetsuhisa; Nishiyama, Chika; Kajino, Kentaro; Nitta, Masahiko; Hayashi, Yasuyuki; Hiraide, Atsushi
2014-08-01
The present study aimed to clarify the incidence and outcomes of sudden cardiac arrests in schools and the clinically relevant characteristics of individuals who experienced sudden cardiac arrests. We obtained data on sudden cardiac arrests that occurred in schools between January 1, 2005 and December 31, 2009 from the database of the Utstein Osaka Project, a population-based observational study on out-of-hospital cardiac arrests in Osaka, Japan. The data were analyzed to show the epidemiological features of sudden cardiac arrests in schools in conjunction with prehospital documentation. In total, 44 cases were registered as sudden cardiac arrests in schools during the study period. Of these, 34 cases had nontraumatic cardiac arrests. Twenty-one cases (62%) had pre-existing cardiac diseases and/or collapsed during physical exercise. Twenty-three cases (68%) presented with ventricular fibrillation or pulseless ventricular tachycardia, with cases of survival 1 month after cardiac arrest and those having favourable neurological outcome (Cerebral Performance Category 1 or 2) being 12 (52%) and 10 (43%), respectively. The incidence of sudden cardiac arrests in students was 0.23 per 100,000 persons per year, ranging from 0.08 in junior high school to 0.64 in high school. The incidence of sudden cardiac arrests in school faculty and staff was 0.51 per 100,000 persons per year, a rate approximately 2 times of that observed in the students. Although sudden cardiac arrests in schools is rare, they majorly occurred in individuals with cardiac diseases and/or during physical exercise and presented as ventricular fibrillation or pulseless ventricular tachycardia observed initially as cardiac arrhythmia. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Le, Hai-Ha; Subtil, Fabien; Cerou, Marc; Marchant, Ivanny; Al-Gobari, Muaamar; Fall, Mor; Mimouni, Yanis; Kassaï, Behrouz; Lindholm, Lars; Thijs, Lutgarde; Gueyffier, François
2017-11-01
To construct a sudden death risk score specifically for hypertension (HYSUD) patients with or without cardiovascular history. Data were collected from six randomized controlled trials of antihypertensive treatments with 8044 women and 17 604 men differing in age ranges and blood pressure eligibility criteria. In total, 345 sudden deaths (1.35%) occurred during a mean follow-up of 5.16 years. Risk factors of sudden death were examined using a multivariable Cox proportional hazards model adjusted on trials. The model was transformed to an integer system, with points added for each factor according to its association with sudden death risk. Antihypertensive treatment was not associated with a reduction of the sudden death risk and had no interaction with other factors, allowing model development on both treatment and placebo groups. A risk score of sudden death in 5 years was built with seven significant risk factors: age, sex, SBP, serum total cholesterol, cigarette smoking, diabetes, and history of myocardial infarction. In terms of discrimination performance, HYSUD model was adequate with areas under the receiver operating characteristic curve of 77.74% (confidence interval 95%, 74.13-81.35) for the derivation set, of 77.46% (74.09-80.83) for the validation set, and of 79.17% (75.94-82.40) for the whole population. Our work provides a simple risk-scoring system for sudden death prediction in hypertension, using individual data from six randomized controlled trials of antihypertensive treatments. HYSUD score could help assessing a hypertensive individual's risk of sudden death and optimizing preventive therapeutic strategies for these patients.
Preprohypocretin polymorphisms in Parkinson disease patients reporting "sleep attacks".
Rissling, Ida; Körner, Yvonne; Geller, Frank; Stiasny-Kolster, Karin; Oertel, Wolfgang H; Möller, J Carsten
2005-07-01
Previously, we found a significant association between the dopamine D2 receptor gene polymorphism Taq IA and sudden onset of sleep in patients with Parkinson disease. Here we evaluated the association between the preprohypocretin (-909T/C), (-22C/T), and (-20C/A) polymorphisms and sudden onset of sleep in the same population of patients with Parkinson disease. We conducted an association study analyzing the distribution of preprohypocretin polymorphisms in Germanic, caucasian Parkinson disease patients with and without sudden onset of sleep, matched according to drug therapy, disease duration, sex, and age. Movement disorders section at a university hospital. 132 Parkinson disease patients with sudden onset of sleep and 132 Parkinson disease patients without sudden onset of sleep. Blood samples were taken from each participant and used for DNA extraction. Polymorphisms were analyzed by established polymerase chain reaction protocols or direct sequencing. The variant allele T of the (-909T/C) preprohypocretin polymorphism was more commonly found in Parkinson disease patients with sudden onset of sleep. Statistical analysis showed that there were significant differences in the genotype (P = .024) and allele (P = .018) distribution between both groups. For heterozygous and homozygous carriers of allele T, the genotype relative-risk estimates for the presence of sudden onset of sleep were 2.01 (95% confidence interval: 0.76-5.34) and 2.81 (95% confidence interval: 1.09-7.25), respectively. Our results show a significant association between the (-909T/C) preprohypocretin polymorphism and sudden onset of sleep in Parkinson disease. However, we could not demonstrate any interaction between the Taq IA and (-909T/C) polymorphisms with respect to the occurrence of sudden onset of sleep, suggesting that multiple genetic factors may contribute to the pathogenesis of this phenomenon.
Enhancing the Communication of Suddenly Speechless Critical Care Patients.
Rodriguez, Carmen S; Rowe, Meredeth; Thomas, Loris; Shuster, Jonathan; Koeppel, Brent; Cairns, Paula
2016-05-01
Sudden speechlessness is common in critically ill patients who are intubated or have had surgery for head and neck cancer. Sudden inability to speak poses challenges for hospitalized patients because strategies to facilitate communication are often limited and unreliable. To determine the impact of a technology-based communication intervention on patients' perception of communication difficulty, satisfaction with communication methods, and frustration with communication. A quasi-experimental, 4-cohort (control and intervention) repeated-measures design was used. Data were collected daily for up to 10 days. Patients in adult critical care units were followed up as they were transferred to other units within the institutions selected for the study. The impact of a technology-based communication system (intervention) was compared with usual care (control). Patients' communication outcomes pertinent to communication with nursing staff that were evaluated included perception of communication ease, satisfaction with methods used for communication, and frustration with communication. Compared with participants in the control group, participants in the intervention group reported lower mean frustration levels (-2.68; SE, 0.17; 95% CI, -3.02 to -2.34; P < .001) and higher mean satisfaction levels (0.59; SE, 0.16; 95% CI, 0.27 to 0.91; P < .001) with use of the communication intervention. Participants in the intervention group reported a consistent increase in perception of communication ease during the hospital stay. The results facilitated evaluation of a bedside technology-based communication intervention tailored to the needs of suddenly speechless critically ill patients. ©2016 American Association of Critical-Care Nurses.
Lung Ultrasound for Diagnosing Pneumothorax in the Critically Ill Neonate.
Raimondi, Francesco; Rodriguez Fanjul, Javier; Aversa, Salvatore; Chirico, Gaetano; Yousef, Nadya; De Luca, Daniele; Corsini, Iuri; Dani, Carlo; Grappone, Lidia; Orfeo, Luigi; Migliaro, Fiorella; Vallone, Gianfranco; Capasso, Letizia
2016-08-01
To evaluate the accuracy of lung ultrasound for the diagnosis of pneumothorax in the sudden decompensating patient. In an international, prospective study, sudden decompensation was defined as a prolonged significant desaturation (oxygen saturation <65% for more than 40 seconds) and bradycardia or sudden increase of oxygen requirement by at least 50% in less than 10 minutes with a final fraction of inspired oxygen ≥0.7 to keep stable saturations. All eligible patients had an ultrasound scan before undergoing a chest radiograph, which was the reference standard. Forty-two infants (birth weight = 1531 ± 812 g; gestational age = 31 ± 3.5 weeks) were enrolled in 6 centers; pneumothorax was detected in 26 (62%). Lung ultrasound accuracy in diagnosing pneumothorax was as follows: sensitivity 100%, specificity 100%, positive predictive value 100%, and negative predictive value 100%. Clinical evaluation of pneumothorax showed sensitivity 84%, specificity 56%, positive predictive value 76%, and negative predictive value 69%. After sudden decompensation, a lung ultrasound scan was performed in an average time of 5.3 ± 5.6 minutes vs 19 ± 11.7 minutes required for a chest radiography. Emergency drainage was performed after an ultrasound scan but before radiography in 9 cases. Lung ultrasound shows high accuracy in detecting pneumothorax in the critical infant, outperforming clinical evaluation and reducing time to imaging diagnosis and drainage. Copyright © 2016 Elsevier Inc. All rights reserved.
Sickle cell anemia mice develop a unique cardiomyopathy with restrictive physiology
Bakeer, Nihal; James, Jeanne; Roy, Swarnava; Wansapura, Janaka; Shanmukhappa, Shiva Kumar; Lorenz, John N.; Osinska, Hanna; Backer, Kurt; Huby, Anne-Cecile; Shrestha, Archana; Niss, Omar; Fleck, Robert; Quinn, Charles T.; Taylor, Michael D.; Purevjav, Enkhsaikhan; Aronow, Bruce J.; Towbin, Jeffrey A.; Malik, Punam
2016-01-01
Cardiopulmonary complications are the leading cause of mortality in sickle cell anemia (SCA). Elevated tricuspid regurgitant jet velocity, pulmonary hypertension, diastolic, and autonomic dysfunction have all been described, but a unifying pathophysiology and mechanism explaining the poor prognosis and propensity to sudden death has been elusive. Herein, SCA mice underwent a longitudinal comprehensive cardiac analysis, combining state-of-the-art cardiac imaging with electrocardiography, histopathology, and molecular analysis to determine the basis of cardiac dysfunction. We show that in SCA mice, anemia-induced hyperdynamic physiology was gradually superimposed with restrictive physiology, characterized by progressive left atrial enlargement and diastolic dysfunction with preserved systolic function. This phenomenon was absent in WT mice with experimentally induced chronic anemia of similar degree and duration. Restrictive physiology was associated with microscopic cardiomyocyte loss and secondary fibrosis detectable as increased extracellular volume by cardiac-MRI. Ultrastructural mitochondrial changes were consistent with severe chronic hypoxia/ischemia and sarcomere diastolic-length was shortened. Transcriptome analysis revealed up-regulation of genes involving angiogenesis, extracellular-matrix, circadian-rhythm, oxidative stress, and hypoxia, whereas ion-channel transport and cardiac conduction were down-regulated. Indeed, progressive corrected QT prolongation, arrhythmias, and ischemic changes were noted in SCA mice before sudden death. Sudden cardiac death is common in humans with restrictive cardiomyopathies and long QT syndromes. Our findings may thus provide a unifying cardiac pathophysiology that explains the reported cardiac abnormalities and sudden death seen in humans with SCA. PMID:27503873
Sudden post-traumatic sciatica caused by a thoracic spinal meningioma.
Mariniello, Giuseppe; Malacario, Francesca; Dones, Flavia; Severino, Rocco; Ugga, Lorenzo; Russo, Camilla; Elefante, Andrea; Maiuri, Francesco
2016-10-01
Spinal meningiomas usually present with slowly progressive symptoms of cord and root compression, while a sudden clinical onset is very rare. A 35-year-old previously symptom-free woman presented sudden right sciatica and weakness of her right leg following a fall with impact to her left foot. A neurological examination showed paresis of the right quadriceps, tibial and sural muscles, increased bilateral knee and ankle reflexes and positive Babinski sign. Magnetic resonance imaging (MRI) revealed the presence of a spinal T11 meningioma in the left postero-lateral compartment of the spinal canal; at this level, the spinal cord was displaced to the contralateral side with the conus in the normal position. At surgery, a meningioma with dural attachment of the left postero-lateral dural surface was removed. The intervention resulted in rapid remission of both pain and neurological deficits. Spinal meningiomas may exceptionally present with sudden pain and neurological deficits as result of tumour bleeding or post-traumatic injury of the already compressed nervous structures, both in normal patients and in those with conus displacement or tethered cord. In this case, the traumatic impact of the left foot was transmitted to the spine, resulting in stretching of the already compressed cord and of the contralateral lombosacral roots. This case suggests that low thoracic cord compression should be suspected in patients with post-traumatic radicular leg pain with normal lumbar spine MRI. © The Author(s) 2016.
Association between histological alterations in the thymus and sudden infant death syndrome.
Varga, Ivan; Bódi, Ildikó; Mešťanová, Veronika; Kováč, Martin; Klein, Martin
2018-04-01
Sudden infant death syndrome (SIDS) involves the death of an infant during the first year of life and it is among the leading causes of infant mortality worldwide. One hypothesis regarding the pathogenesis of SIDS is that it results from a combination of three independent factors: endogenous vulnerability, a critical time window during postnatal development, and exogenous stressors. This hypothesis is known as the "triple-risk model". In this study, we used an immunohistological approach to compare the cellular microenvironments of thymuses from 19 infants whose sudden death was classified as SIDS and a control group, which consisted of thymuses from age-matched children undergoing surgery for various congenital heart defects. We hypothesized that morphological signs of stress-related thymic involution would be present. Based on our observations, we found evidence that the proliferation and maturation of T-lymphocytes in the thymuses of infants with SIDS were suppressed. We observed enhanced macrophage activity, suggesting an increase in the apoptosis of lymphocytes and decrease in number of thymic dendritic cells and myoid cells. Significant apoptosis of thymic lymphocytes without cell regeneration typically leads to atrophy of the thymus. All cellular events we observed resemble the initial stage of stress-related thymic involution. These results support the "triple-risk model," suggesting that certain exogenous stressors might be involved in the pathogenesis of SIDS. This was probably not recognized during the autopsies of infants who died suddenly. Copyright © 2018 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
Thermodynamic Analysis of a Coupled Chemical Reaction.
ERIC Educational Resources Information Center
Trimm, Harold; And Others
1979-01-01
Describes a typical relaxation kinetic experiment using a sudden increase in the temperature of the system. Time involved is described as minimal and the approach as quicker, more accurate, sensitive, and producing simultaneous determination of several thermodynamic parameters. (Author/SA)
Major Life Events as Potential Triggers of Sudden Cardiac Arrest
Wicks, April F; Lumley, Thomas; Lemaitre, Rozenn N; Sotoodehnia, Nona; Rea, Thomas D; McKnight, Barbara; Strogatz, David S; Bovbjerg, Viktor E; Siscovick, David S
2012-01-01
Background We investigated recent loss of or separation from afamily member or friend and risk of sudden cardiac arrest. Methods Our case-crossover study included 490 apparently-healthy married residents of King County, Washington, who suffered sudden cardiac arrest between 1988 and 2005. We compared exposure to spouse-reported family/friend events occurring ≤ 1 month before sudden cardiac arrest with events occurring n the previous 5 months. We evaluated potential effect modification by habitual vigorous physical activity. Results Recent family/friend events were associated with a higher risk of sudden cardiac arrest (odds ratio (OR) = 1.6 [95% confidence interval (CI) = 1.1-2.4]). ORs for cases with and without habitual vigorous physical activity were 1.1 (0.6-2.2) and 2.0 (1.2-3.1), respectively, (interaction P = 0.02). Conclusions These results suggest family/friend events may trigger sudden cardiac arrest and raise the hypothesis that habitual vigorous physical activity may lower susceptibility to these potential triggers. PMID:22415111
Major life events as potential triggers of sudden cardiac arrest.
Wicks, April F; Lumley, Thomas; Lemaitre, Rozenn N; Sotoodehnia, Nona; Rea, Thomas D; McKnight, Barbara; Strogatz, David S; Bovbjerg, Viktor E; Siscovick, David S
2012-05-01
We investigated the risk of sudden cardiac arrest in association with the recent loss of, or separation from, a family member or friend. Our case-crossover study included 490 apparently healthy married residents of King County, Washington, who suffered sudden cardiac arrest between 1988 and 2005. We compared exposure to spouse-reported family/friend events occurring ≤ 1 month before sudden cardiac arrest with events occurring in the previous 5 months. We evaluated potential effect modification by habitual vigorous physical activity. Recent family/friend events were associated with a higher risk of sudden cardiac arrest (odds ratio [OR] = 1.6; 95% confidence interval [CI] = 1.1-2.4). ORs for cases with and without habitual vigorous physical activity were 1.1 (0.6-2.2) and 2.0 (1.2-3.1), respectively (interaction P = 0.02). These results suggest family/friend events may trigger sudden cardiac arrest and raise the hypothesis that habitual vigorous physical activity may lower susceptibility to these potential triggers.
Sudden cardiac death in haemodialysis: clinical epidemiology and mechanisms.
Banerjee, Debasish
Sudden cardiac death, which causes premature loss of lives on haemodialysis of the elderly, youths and even children; cannot be prevented, because the aetiology is poorly understood and effective interventions are yet unknown. Improving our knowledge of mechanisms causing sudden cardiac death in haemodialysis patients may help us to design better interventions; and clinical epidemiology of sudden cardiac death could be an important tool to further guide human and animal studies. This review researches the clinical epidemiology of sudden cardiac death to suggest possible mechanisms, although they require further studies. The research shows how traditional cardiovascular risk factors such as age, diabetes and smoking have an impact; non-traditional risk factors such as inflammation, mineral-bone disease and even uraemia itself have higher impact; and how cardiac structural, functional and electrocardiographic markers predict sudden cardiac death in dialysis patients. More in-depth human and animal studies, guided with existing knowledge, are necessary to better understand the mechanisms and design successful interventions. Copyright © 2016 Elsevier Inc. All rights reserved.
Sudden oronasal bleeding in a young child.
Hey, Edmund
2008-10-01
Sudden severe upper-airway obstruction occurring in a hospital setting can sometimes precipitate an episode of acute haemorrhagic pulmonary oedema. A review of 197 published case reports shows that the presenting feature is almost always the sudden appearance of blood stained fluid coming up through the larynx or out through the mouth and nose of an adult or child in obvious respiratory distress. Such overt features are seen in 10-15% of cases of sudden severe, but sub-lethal, upper-airway obstruction. Signs normally appear within minutes once the obstruction is relieved but are occasionally only recognized after 1-4 h. All signs and symptoms usually resolve within 12-24 h. Other causes of acute pulmonary haemorrhage are rare in young children. If what looks like blood is seen in, or coming from, the mouth or nose of a previously healthy young child who has suddenly become distressed and started to struggle for breath, that child has most probably suffered an episode of acute pulmonary oedema, and the commonest precipitating cause is sudden upper-airway obstruction.
Toroidal standing waves excited by a storm sudden commencement - DE 1 observations
NASA Technical Reports Server (NTRS)
Cahill, L. J., Jr.; Lin, N. G.; Engebretson, M. J.; Waite, J. H.; Sugiura, M.
1990-01-01
A 74-nT sudden commencement on July 13, 1982, was observed in the magnetosphere, with instruments on the Dynamics Explorer 1 satellite. Inbound, near L = 4.5, the satellite was located at 1524 magnetic local time and 20 deg magnetic latitude. The sudden commmencement established a strong, east-west oscillation, with 100-s period, which was observed in the magnetic field, the electric field, and the plasma flow velocity records. There was also a compressional component of this 100-s oscillation and a rapidly damped 300-s compressional pulsation. The compressional oscillations may be an evidence of cavity resonances, excited by the sudden commencement. The cavity waves may, in turn, couple to toroidal waves in field line resonance at the satellite location. In addition, the sudden commencement caused the onset of waves with frequencies from 0.1 up to at least 0.5 Hz. The observations are compared with similar reports from earlier pulsations related to sudden commencements.
Sudden cardiac death and sarcoidosis of the heart in a young patient.
Jotterand, Morgane; Grabherr, Silke; Lobrinus, Johannes Alexandre; Michaud, Katarzyna
Sarcoidosis is a granulomatous disease of unknown etiology affecting any organ, microscopically characterized by noncaseating granulomata. Cardiac involvement in sarcoidosis has been reported. It might be symptomatic or not and even revealed by sudden death. Heart conduction system is rarely investigated at autopsy, even in cases of sudden cardiac death. We present a case of a 32-year-old woman who died suddenly. The examination of the heart conduction system revealed a cardiac sarcoidosis that could explain the sudden death. The review of clinical data of the patient revealed some symptoms consistent/in agreement with this hypothesis. Cardiac sarcoidosis remains a diagnostic challenge and can be easily missed, clinically and pathologically. The retrospective analysis of clinical data and autopsy results of fatal and unusual cases might help to better understand sarcoidosis and its clinical presentations. Examination of the cardiac conduction system is crucial in selected cases of sudden cardiac death. Copyright © 2017 Elsevier Inc. All rights reserved.
NASA Astrophysics Data System (ADS)
Sahai, R.; Vlemmings, W. H. T.; Gledhill, T.; Sánchez Contreras, C.; Lagadec, E.; Nyman, L.-Å; Quintana-Lacaci, G.
2017-01-01
We have mapped 12CO J = 3-2 and other molecular lines from the “water fountain” bipolar pre-planetary nebula (PPN) IRAS 16342-3814 with ˜0.″35 resolution using Atacama Large Millimeter/submillimeter Array. We find (I) two very high-speed knotty, jet-like molecular outflows; (II) a central high-density (> {few}× {10}6 cm-3), expanding torus of diameter 1300 au; and (III) the circumstellar envelope of the progenitor AGB, generated by a sudden, very large increase in the mass-loss rate to > 3.5× {10}-4 M⊙ yr-1 in the past ˜455 years. Strong continuum emission at 0.89 mm from a central source (690 mJy), if due to thermally emitting dust, implies a substantial mass (0.017 M⊙) of very large (˜millimeter-sized) grains. The measured expansion ages of the above structural components imply that the torus (age ˜160 years) and the younger high-velocity outflow (age ˜110 years) were formed soon after the sharp increase in the AGB mass-loss rate. Assuming a binary model for the jets in IRAS 16342, the high momentum rate for the dominant jet-outflow in IRAS 16342 implies a high minimum accretion rate, ruling out standard Bondi-Hoyle-Lyttleton wind accretion and wind Roche-lobe overflow (RLOF) models with white-dwarf or main-sequence companions. Most likely, enhanced RLOF from the primary or accretion modes operating within common-envelope evolution are needed.
Nonesterified fatty acids and risk of sudden cardiac death in older adults.
Djoussé, Luc; Biggs, Mary L; Ix, Joachim H; Kizer, Jorge R; Lemaitre, Rozenn N; Sotoodehnia, Nona; Zieman, Susan J; Mozaffarian, Dariush; Tracy, Russell P; Mukamal, Kenneth J; Siscovick, David S
2012-04-01
Although nonesterified fatty acids (NEFA) have been positively associated with coronary heart disease risk factors, limited and inconsistent data are available on the relation between NEFA and sudden cardiac death. Using a prospective design, we studied 4657 older men and women (mean age, 75 years) from the Cardiovascular Health Study (1992-2006) to evaluate the association between plasma NEFA and the risk of sudden cardiac death in older adults. Plasma concentrations of NEFA were measured using established enzymatic methods, and sudden death was adjudicated using medical records, death certificates, proxy interview, and autopsy reports. We used Cox proportional hazard models to estimate multivariable-adjusted relative risks. During a median follow-up of 10.0 years, 221 new cases of sudden cardiac death occurred. In a multivariable model adjusting for age, sex, race, clinic site, alcohol intake, smoking, prevalent coronary heart disease and heart failure, and self-reported health status, relative risks (95% confidence interval) for sudden cardiac death were 1.0 (ref), 1.15 (0.81-1.64), 1.06 (0.72-1.55), and 0.91 (0.60-1.38) across consecutive quartiles of NEFA concentration. In secondary analyses restricted to the first 5 years of follow-up, we also did not observe a statistically significant association between plasma NEFA and sudden cardiac death. Our data do not provide evidence for an association between plasma NEFA measured late in life and the risk of sudden cardiac death in older adults.
Sudden Unexpected Death in Fetal Life Through Early Childhood
Kinney, Hannah C.; Willinger, Marian
2016-01-01
In March 2015, the Eunice Kennedy Shriver National Institute of Child Health and Human Development held a workshop entitled “Sudden Unexpected Death in Fetal Life Through Early Childhood: New Opportunities.” Its objective was to advance efforts to understand and ultimately prevent sudden deaths in early life, by considering their pathogenesis as a potential continuum with some commonalities in biological origins or pathways. A second objective of this meeting was to highlight current issues surrounding the classification of sudden infant death syndrome (SIDS), and the implications of variations in the use of the term “SIDS” in forensic practice, and pediatric care and research. The proceedings reflected the most current knowledge and understanding of the origins and biology of vulnerability to sudden unexpected death, and its environmental triggers. Participants were encouraged to consider the application of new technologies and “omics” approaches to accelerate research. The major advances in delineating the intrinsic vulnerabilities to sudden death in early life have come from epidemiologic, neural, cardiac, metabolic, genetic, and physiologic research, with some commonalities among cases of unexplained stillbirth, SIDS, and sudden unexplained death in childhood observed. It was emphasized that investigations of sudden unexpected death are inconsistent, varying by jurisdiction, as are the education, certification practices, and experience of death certifiers. In addition, there is no practical consensus on the use of “SIDS” as a determination in cause of death. Major clinical, forensic, and scientific areas are identified for future research. PMID:27230764
Mehboob, Riffat
2017-01-01
Sudden demise of a healthy fetus or a neonate is a very tragic episode in the life of parents. These deaths have been a mystery since ages but still remain unexplained. This review proposes the involvement of trigeminal nerve, neurotransmitter substance P (SP), and its receptor neurokinin 1 (NK-1R) in regulation of cardiorespiratory control in fetuses and newborns. Anomalies and immaturity of neuroregulatory systems such as trigeminal system in medulla oblongata of brainstem may provide a possible mechanism of sudden perinatal deaths. Vulnerable infants are born with respiratory center immaturity which in combination with any stressor such as cold, hypoxia, and smoking may lead to cessation of breathing and ventilatory response. SP/NK-1R may be involved in regulating the ventilatory control in neonates while it is decreased in fetal and adult life in humans, and any alterations from these may lead to irreversible sleep apnea and fatal breathing, ultimately sudden death. This review summarizes the studies performed to highlight the expression of SP or NK-1R in sudden perinatal deaths and proposes the involvement of trigeminal ganglion along with its nerve and SP/NK-1R expression alteration as one of the possible pathophysiological underlying mechanism. However, further studies are required to explore the role of SP, NK-1R, and trigeminal system in the pathogenesis of sudden infant deaths, sudden intrauterine deaths, stillbirths, and sudden deaths later in human life. PMID:28348544
Mehboob, Riffat
2017-01-01
Sudden demise of a healthy fetus or a neonate is a very tragic episode in the life of parents. These deaths have been a mystery since ages but still remain unexplained. This review proposes the involvement of trigeminal nerve, neurotransmitter substance P (SP), and its receptor neurokinin 1 (NK-1R) in regulation of cardiorespiratory control in fetuses and newborns. Anomalies and immaturity of neuroregulatory systems such as trigeminal system in medulla oblongata of brainstem may provide a possible mechanism of sudden perinatal deaths. Vulnerable infants are born with respiratory center immaturity which in combination with any stressor such as cold, hypoxia, and smoking may lead to cessation of breathing and ventilatory response. SP/NK-1R may be involved in regulating the ventilatory control in neonates while it is decreased in fetal and adult life in humans, and any alterations from these may lead to irreversible sleep apnea and fatal breathing, ultimately sudden death. This review summarizes the studies performed to highlight the expression of SP or NK-1R in sudden perinatal deaths and proposes the involvement of trigeminal ganglion along with its nerve and SP/NK-1R expression alteration as one of the possible pathophysiological underlying mechanism. However, further studies are required to explore the role of SP, NK-1R, and trigeminal system in the pathogenesis of sudden infant deaths, sudden intrauterine deaths, stillbirths, and sudden deaths later in human life.
ERIC Educational Resources Information Center
Maloney, Michael J.
2004-01-01
Objectives: To ascertain whether the number of sudden infant deaths as a result of suffocation in cribs, in adult beds, on sofas or chairs, and on other sleep surfaces was increasing whether attributable to increased reporting, diagnostic shift, or an actual increase in suffocation deaths and to compare the risk of reported accidental suffocation…
Tester, David J.; Benton, Amber J.; Train, Laura; Deal, Barbara; Baudhuin, Linnea M.; Ackerman, Michael J.
2010-01-01
Long QT Syndrome (LQTS) is a cardiac channelopathy associated with syncope, seizures, and sudden death. Approximately 75% of LQTS is due to mutations in genes encoding for three cardiac ion channel alpha-subunits (LQT1-3). However, traditional mutational analyses have limited detection capabilities for atypical mutations such as large gene rearrangements. Here, we set out to determine the prevalence and spectrum of large deletions/duplications in the major LQTS-susceptibility genes among unrelated patients who were mutation-negative following point mutation analysis of LQT1-12-susceptibility genes. Forty-two unrelated clinically strong LQTS patients were analyzed using multiplex ligation-dependent probe amplification (MLPA), a quantitative fluorescent technique for detecting multiple exon deletions and duplications. The SALSA-MLPA LQTS Kit from MRC-Holland was used to analyze the three major LQTS-associated genes: KCNQ1, KCNH2, and SCN5A and the two minor genes: KCNE1 and KCNE2. Overall, 2 gene rearrangements were found in 2/42 (4.8%, CI, 1.7–11%) unrelated patients. A deletion of KCNQ1 exon 3 was identified in a 10 year-old Caucasian boy with a QTc of 660 milliseconds (ms), a personal history of exercise-induced syncope, and a family history of syncope. A deletion of KCNQ1 exon 7 was identified in a 17 year-old Caucasian girl with a QTc of 480 ms, a personal history of exercise-induced syncope, and a family history of sudden cardiac death. In conclusion, since nearly 5% of patients with genetically elusive LQTS had large genomic rearrangements involving the canonical LQTS-susceptibility genes, reflex genetic testing to investigate genomic rearrangements may be of clinical value. PMID:20920651
Lessons from the Tōhoku tsunami: A model for island avifauna conservation prioritization.
Reynolds, Michelle H; Berkowitz, Paul; Klavitter, John L; Courtot, Karen N
2017-08-01
Earthquake-generated tsunamis threaten coastal areas and low-lying islands with sudden flooding. Although human hazards and infrastructure damage have been well documented for tsunamis in recent decades, the effects on wildlife communities rarely have been quantified. We describe a tsunami that hit the world's largest remaining tropical seabird rookery and estimate the effects of sudden flooding on 23 bird species nesting on Pacific islands more than 3,800 km from the epicenter. We used global positioning systems, tide gauge data, and satellite imagery to quantify characteristics of the Tōhoku earthquake-generated tsunami (11 March 2011) and its inundation extent across four Hawaiian Islands. We estimated short-term effects of sudden flooding to bird communities using spatially explicit data from Midway Atoll and Laysan Island, Hawai'i. We describe variation in species vulnerability based on breeding phenology, nesting habitat, and life history traits. The tsunami inundated 21%-100% of each island's area at Midway Atoll and Laysan Island. Procellariformes (albatrosses and petrels) chick and egg losses exceeded 258,500 at Midway Atoll while albatross chick losses at Laysan Island exceeded 21,400. The tsunami struck at night and during the peak of nesting for 14 colonial seabird species. Strongly philopatric Procellariformes were vulnerable to the tsunami. Nonmigratory, endemic, endangered Laysan Teal ( Anas laysanensis ) were sensitive to ecosystem effects such as habitat changes and carcass-initiated epizootics of avian botulism, and its populations declined approximately 40% on both atolls post-tsunami. Catastrophic flooding of Pacific islands occurs periodically not only from tsunamis, but also from storm surge and rainfall; with sea-level rise, the frequency of sudden flooding events will likely increase. As invasive predators occupy habitat on higher elevation Hawaiian Islands and globally important avian populations are concentrated on low-lying islands, additional conservation strategies may be warranted to increase resilience of island biodiversity encountering tsunamis and rising sea levels.
Lessons from the Tōhoku tsunami: A model for island avifauna conservation prioritization
Reynolds, Michelle H.; Berkowitz, Paul; Klavitter, John; Courtot, Karen
2017-01-01
Earthquake-generated tsunamis threaten coastal areas and low-lying islands with sudden flooding. Although human hazards and infrastructure damage have been well documented for tsunamis in recent decades, the effects on wildlife communities rarely have been quantified. We describe a tsunami that hit the world's largest remaining tropical seabird rookery and estimate the effects of sudden flooding on 23 bird species nesting on Pacific islands more than 3,800 km from the epicenter. We used global positioning systems, tide gauge data, and satellite imagery to quantify characteristics of the Tōhoku earthquake-generated tsunami (11 March 2011) and its inundation extent across four Hawaiian Islands. We estimated short-term effects of sudden flooding to bird communities using spatially explicit data from Midway Atoll and Laysan Island, Hawai'i. We describe variation in species vulnerability based on breeding phenology, nesting habitat, and life history traits. The tsunami inundated 21%–100% of each island's area at Midway Atoll and Laysan Island. Procellariformes (albatrosses and petrels) chick and egg losses exceeded 258,500 at Midway Atoll while albatross chick losses at Laysan Island exceeded 21,400. The tsunami struck at night and during the peak of nesting for 14 colonial seabird species. Strongly philopatric Procellariformes were vulnerable to the tsunami. Nonmigratory, endemic, endangered Laysan Teal (Anas laysanensis) were sensitive to ecosystem effects such as habitat changes and carcass-initiated epizootics of avian botulism, and its populations declined approximately 40% on both atolls post-tsunami. Catastrophic flooding of Pacific islands occurs periodically not only from tsunamis, but also from storm surge and rainfall; with sea-level rise, the frequency of sudden flooding events will likely increase. As invasive predators occupy habitat on higher elevation Hawaiian Islands and globally important avian populations are concentrated on low-lying islands, additional conservation strategies may be warranted to increase resilience of island biodiversity encountering tsunamis and rising sea levels.
Morentin, Benito; Ballesteros, Javier; Callado, Luis F; Meana, J Javier
2014-12-01
The aims of the present study were to: (i) evaluate the prevalence of recent cocaine use in adolescents and young adults who had died by sudden cardiovascular death (SCVD); (ii) assess if recent cocaine use was associated with an increased risk of SCVD; and (iii) determine the demographic, clinical-pathological and toxicological characteristics of SCVD related to recent cocaine use. This was a case-control autopsy-based observational retrospective study. Cases were all SCVD in individuals aged between 15 and 49 years during the period ranging from 1 January 2003 to 31 December 2009, with autopsies performed in Biscay, Spain. Medico-legal sudden deaths not due to cardiovascular diseases (SnoCVD) were used as the control group. In all deaths a complete autopsy and toxicological and histopathological studies were carried out. Recent cocaine use was considered when cocaine and/or benzoylecgonine were detected in blood. The risk for SCVD according to demographic variables (sex and age), cardiovascular risk factors (obesity, hypertension, diabetes and smoking) and toxicological variables (opioids, benzodiazepines, amphetamines, cannabis and alcohol) was analysed using three logistic regression models. We also estimated the prevalence of recent cocaine use in the general population aged 15-49 years based on the projection of population surveys. Recent cocaine use was significantly higher in the SCVD group (27 of 311 subjects, 9%) than in the SnoCVD group (three of 126 subjects, 2%). In a full logistic regression controlling for all recorded covariates, the main risk factor for SCVD was recent cocaine use (odds ratio 4.10; 95% confidence interval 1.12-15.0). Compared with the estimated data in the general population, the prevalence of recent cocaine use was 13-58 times higher in people with SCVD. Recent cocaine use is associated significantly with an increased risk for sudden cardiovascular death in people aged 15-49 years. © 2014 Society for the Study of Addiction.
Proceedings of the sudden oak death fifth science symposium
Susan J. Frankel; John T. Kliejunas; Katharine M. Palmieri; Janice M. Alexander
2013-01-01
The Proceedings of the Sudden Oak Death Fifth Science Symposium provides an update on research to address sudden oak death, caused by the exotic, quarantine pathogen, Phytophthora ramorum. Over 60 submissions present national and international investigations covering pathogen biology, biosecurity, genetics, monitoring, fire ecology, and diagnostics...
ERIC Educational Resources Information Center
Tindall, James
Initially an assignment for a library science class, this paper presents various definitions of the current creative writing phenomenon called "sudden fiction" (very short short stories with concise character sketches, and terse tales limited in length to several pages). The paper includes: (1) a list of well regarded sudden fiction…
Residential Segregation and the Transformation of Home Mortgage Lending
ERIC Educational Resources Information Center
Bond, Carolyn; Williams, Richard
2007-01-01
This article shows that, after decades of inequality, the 1990s saw sudden and dramatic increases in lending to low income and minority groups. Drawing in part on the work of Williams, Nesiba and McConnell (2005), we argue that government deregulation, industry restructuring and government-insured loans all fueled this growth by increasing the…
Requirements for Information Professionals in a Digital Environment: Some Thoughts
ERIC Educational Resources Information Center
Ataman, Bekir Kemal
2009-01-01
Purpose: The purpose of this paper is to point out the increasing need to provide information professionals with a sound grounding in the technological aspects of their profession. Design/methodology/approach: The paper sets out by describing the sudden increase in volumes of information that confront our society, and then looks at how the younger…
Fisher information due to a phase noisy laser under non-Markovian environment
DOE Office of Scientific and Technical Information (OSTI.GOV)
Abdel-Khalek, S., E-mail: sayedquantum@yahoo.co.uk
2014-12-15
More recently, K. Berrada [Annals of Physics 340 (2014) 60-69] [1] studied the geometric phase of a two-level atom system driven by a phase noise laser under non-Markovian dynamics in terms of different parameters involved in the whole system, and collapse and revival phenomena were found for large class of states. In this paper, using this noise effect, we study the quantum fisher information (QFI) for a two-level atom system driven by a phase noise laser under non-Markovian dynamics. A new quantity, called QFI flow is used to characterize the damping effect and unveil a fundamental connection between non-Markovian behaviormore » and dynamics of system–environment correlations under phase noise laser. It is shown that QFI flow has disappeared suddenly followed by a sudden birth depending on the kind of the environment damping. QFI flow provides an indicator to characterize the dissipative quantum system’s decoherence by analyzing the behavior of the dynamical non-Markovian coefficients.« less
Early signatures of regime shifts in gene expression dynamics
NASA Astrophysics Data System (ADS)
Pal, Mainak; Pal, Amit Kumar; Ghosh, Sayantari; Bose, Indrani
2013-06-01
Recently, a large number of studies have been carried out on the early signatures of sudden regime shifts in systems as diverse as ecosystems, financial markets, population biology and complex diseases. The signatures of regime shifts in gene expression dynamics are less systematically investigated. In this paper, we consider sudden regime shifts in the gene expression dynamics described by a fold-bifurcation model involving bistability and hysteresis. We consider two alternative models, models 1 and 2, of competence development in the bacterial population B. subtilis and determine some early signatures of the regime shifts between competence and noncompetence. We use both deterministic and stochastic formalisms for the purpose of our study. The early signatures studied include the critical slowing down as a transition point is approached, rising variance and the lag-1 autocorrelation function, skewness and a ratio of two mean first passage times. Some of the signatures could provide the experimental basis for distinguishing between bistability and excitability as the correct mechanism for the development of competence.
Leon-Ariza, Daniel S.; Leon-Ariza, Juan S.; Leon-Sarmiento, Fidias E.
2015-01-01
We report a 33-year-old female patient, who arrived to the emergency ward with an abdominal pain that suddenly started 10 days before admission. Simultaneously, the patient developed sudden arterial hypertension and smell disturbances. Conventional medical treatment for pain and arterial hypertension was effortless. Laboratory tests ruled out pancreatitis. Metanephrines in her urine were also normal. A dual-phase intravenous contrast computed tomography of the abdomen showed a large mass within left adrenal gland. Adrenocortical adenoma was diagnosed. The mass was not hypervascularized but positive for synaptophysin and chromogranin A. Importantly, these proteins are heavily involved with acetylcholine metabolism. The triad of olfactory disorders, pain and arterial hypertension normalized after surgically extracting the adrenal mass. To our knowledge, this medical case is the first reported patient exhibiting immediate recovery of such unclassical triad of local and remote findings. The function and dysfunction of key nanocholinergic pathways involved with smell, blood pressure and nociception would explain the pathophysiology of this unique medical case. PMID:26688704
Wani, Abdul Majid; Hussain, Waleed Mohd; Mejally, Mousa Ali Al; Ali, Khaled Shawkat; Raja, Sadeya Hanif; Maimani, Wael Al; Bafaraj, Mazen G; Bashraheel, Ashraf; Akhtar, Mubeena; Khoujah, Amer Mohd
2010-01-01
Catastrophic antiphospholipid syndrome (APS) is caused by thrombotic vascular occlusions that affect both small and large vessels, producing ischaemia in the affected organs. The “catastrophic” variant of the antiphospholipid syndrome (cAPS) develops over a short period of time. Although patients with cAPS represent <1% of all patients with APS, they are usually life threatening with a 50% mortality rate. A strong association with concomitant infection is thought to act as the main trigger of microthromboses in cAPS. Several theories have been proposed to explain these physiopathological features. Some of them suggest the possibility of molecular mimicry between components of infectious microorganisms and natural anticoagulants, which might be involved in the production of cross-reacting antiphospholipid antibodies. We present a case of catastrophic cerebral APS characterised by massive temporal lobe infarction and subsequent haemorrhagic transformation after sudden withdrawal of warfarin. PMID:22242060
Density functional study of structural and electronic properties of Al{sub n}@C{sub 60}
DOE Office of Scientific and Technical Information (OSTI.GOV)
Dhiman, Shobhna, E-mail: s-dhiman@hotmail.com; Kumar, Ranjan; Dharamvir, Keya
2014-04-24
Fullerene derivatives have been shown to make contributions in many types of applications. Ab initio investigation of structural and electronic properties of aluminum doped endohedral fullerene has been performed using numerical atomic orbital density functional theory. We have obtained ground state structures for Al{sub n}@C{sub 60} (n=1–10). Which shows that C{sub 60} molecule can accommodate maximum of nine aluminum atoms, for n > 9 the cage eventually break. Encapsulated large number of aluminum atoms leads to deformation of cage with diameter varies from 7.16Å to 7.95Å. Binding energy/Al atom is found to increase till n = 4 and after thatmore » it decreases with the number of Al atoms with a sudden increase for n=10 due to breakage of C{sub 60} cage and electronic affinity first increases till n=4 then it decreases up to n=9 with a sharp increase for n=10. Ionization potential also first increases and then decreases. Homo-Lumo gap decreases till n=3 with a sharp increase for n=4, after that it shows an oscillatory nature. The results obtained are consistent with available theoretical and experimental results. The ab-initio calculations were performed using SIESTA code with generalized gradient approximation (GGA)« less
Malaria epidemic and drug resistance, Djibouti.
Rogier, Christophe; Pradines, Bruno; Bogreau, H; Koeck, Jean-Louis; Kamil, Mohamed-Ali; Mercereau-Puijalon, Odile
2005-02-01
Analysis of Plasmodium falciparum isolates collected before, during, and after a 1999 malaria epidemic in Djibouti shows that, despite a high prevalence of resistance to chloroquine, the epidemic cannot be attributed to a sudden increase in drug resistance of local parasite populations.
Why do these issues constitute problems? Pathogen indicators
The Water Environment Research Foundation funded a collaborative effort designed to better understand the factors affecting regrowth, odors and the sudden increase of bacterial indicators in heat treated biosolids. As part of this effort the Principal Investigators developed a w...
DOE Office of Scientific and Technical Information (OSTI.GOV)
Thachuk, M.; McCourt, F.R.W.
1991-09-15
A series of centrifugal sudden (CS) and infinite-order sudden (IOS) approximations together with their corrected versions, respectively, the corrected centrifugal sudden (CCS) and corrected infinite-order sudden (CIOS) approximations, originally introduced by McLenithan and Secrest (J. Chem. Phys. {bold 80}, 2480 (1987)), have been compared with the close-coupled (CC) method for the N{sub 2}--He interaction. This extends previous work using the H{sub 2}--He system (J. Chem. Phys. {bold 93}, 3931 (1990)) to an interaction which is more anisotropic and more classical in nature. A set of eleven energy dependent cross sections, including both relaxation and production types, has been calculated usingmore » the {ital LF}- and {ital LA}-labeling schemes for the CS approximation, as well as the {ital KI}-, {ital KF}-, {ital KA}-, and {ital KM}-labeling schemes for the IOS approximation. The latter scheme is defined as {ital KM}={ital K}=max({ital k}{sub {ital j}},{ital k}{sub {ital j}{sub {ital I}}}). Further, a number of temperature dependent cross sections formed from thermal averages of the above set have also been compared at 100 and 200 K. These comparisons have shown that the CS approximation produced accurate results for relaxation type cross sections regardless of the {ital L}-labeling scheme chosen, but inaccurate results for production type cross sections. Further, except for one particular cross section, the CCS approximation did not generally improve the accuracy of the CS results using either the {ital LF}- or {ital LA}-labeling schemes. The accuracy of the IOS results vary greatly between the cross sections with the most accurate values given by the {ital KM}-labeling scheme. The CIOS approximation generally increases the accuracy of the corresponding IOS results but does not completely eliminate the errors associated with them.« less
A cause of Sudden Cardiac Deaths on Autopsy Findings; a Four-Year Report.
Rao, Dinesh; Sood, Divya; Pathak, P; Dongre, Sudhir D
2014-01-01
Incidence of sudden cardiac death (SCD) has been steadily increasing all over the world. While knowing the cause of SCD is one of the favorites of the physicians involved with these cases, it is very difficult and challenging task for the forensic physician. The present report is a prospective study regarding cause of SCDs on autopsy examination in four-year period, Bangalore, India. The present prospective study is based on autopsy observations, carried out for four-year period from 2008 to 2011, and analyzed for cause of SCDs. The cases were chosen as per the definition of sudden death and autopsied. The material was divided into natural and unnatural groups. Finally, on histopathology, gross examination, hospital details, circumstantial, and police reports the cause of death was inferred. A total of 2449 autopsy was conducted of which 204 cases were due to SCD. The highest SCDs were reported in 50-60 years age group (62.24%; n-127), followed closely by the age group 60-69 (28.43%; n-58). Male to female ratio was around 10:1. The maximum number of deaths (n=78) was within few hours (6 hours) after the onset of signs and symptoms. In 24 (11.8%) cases major narrowing was noted in both the main coronaries, in 87 (42.6%) cases in the left anterior descending coronary artery (LAD), and in 18 (51.5%) cases in the right coronary artery (RCA). The major cardiac pathology resulting in sudden death was coronary artery disease (n-116; 56.86%) and myocardial infarction (n-104; 50.9%). most of the SCDs occurred in the place of residence (n-80; 39.2%) followed closely by death in hospital (n-49; 24.01%). Coronary occlusion was the major contributory cause of sudden death with cardiac origin and the highest number of deaths were reported in the age 50-59 years with male to female ratio of 10:1.
Global public health problem of sudden cardiac death.
Mehra, Rahul
2007-01-01
Cardiovascular disease is a leading cause of global mortality, accounting for almost 17 million deaths annually or 30% of all global mortality. In developing countries, it causes twice as many deaths as HIV, malaria and TB combined. It is estimated that about 40-50% of all cardiovascular deaths are sudden cardiac deaths (SCDs) and about 80% of these are caused by ventricular tachyarrhythmias. Therefore, about 6 million sudden cardiac deaths occur annually due to ventricular tachyarrhythmias. The survival rate from sudden cardiac arrest is less than 1% worldwide and close to 5% in the US. Prevention of cardiovascular disease by increasing awareness of risk factors such as lack of exercise, inappropriate diet and smoking has reduced cardiovascular mortality in the US over the past few decades. However, there is still a huge cardiovascular disease burden globally as well as in the US. Therefore, there is a need to develop complementary strategies for management of sudden cardiac death. The data from several trials conclusively indicate that implantable defibrillators improve mortality in patients who have experienced an episode or are at high risk of developing ventricular tachyarrhythmias. These devices are reimbursed and are being used frequently in the developed economies for management of SCD. However, due to that low level of public and private health spending in developing economies and the relatively high cost of ICDs, their implant rates are very low there. The Automatic External Defibrillators and Emergency Medical Response Services equipped with AEDs provide complementary as well as alternative opportunities for management of SCD. There are several challenges associated with the adoption of these strategies. The efficacy and cost-effectiveness of these strategies need to be compared with ICDs to determine the appropriate strategy for various geographies. The global problem of SCD as well as the various options for its management will be discussed in the presentation.
Risk Stratification in Arrhythmogenic Right Ventricular Cardiomyopathy.
Calkins, Hugh; Corrado, Domenico; Marcus, Frank
2017-11-21
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited cardiomyopathy characterized by ventricular arrhythmias and an increased risk of sudden cardiac death. Although structural abnormalities of the right ventricle predominate, it is well recognized that left ventricular involvement is common, particularly in advanced disease, and that left-dominant forms occur. The pathological characteristic of ARVC is myocyte loss with fibrofatty replacement. Since the first detailed clinical description of the disorder in 1982, significant advances have been made in understanding this disease. Once the diagnosis of ARVC is established, the single most important clinical decision is whether a particular patient's sudden cardiac death risk is sufficient to justify placement of an implantable cardioverter-defibrillator. The importance of this decision reflects the fact that ARVC is a common cause of sudden death in young people and that sudden death may be the first manifestation of the disease. This decision is particularly important because these are often young patients who are expected to live for many years. Although an implantable cardioverter-defibrillator can save lives in individuals with this disease, it is also well recognized that implantable cardioverter-defibrillator therapy is associated with both short- and long-term complications. Decisions about the placement of an implantable cardioverter-defibrillator are based on an estimate of a patient's risk of sudden cardiac death, as well as their preferences and values. The primary purpose of this article is to provide a review of the literature that concerns risk stratification in patients with ARVC and to place this literature in the framework of the 3 authors' considerable lifetime experiences in caring for patients with ARVC. The most important parameters to consider when determining arrhythmic risk include electric instability, including the frequency of premature ventricular contractions and sustained ventricular arrhythmia; proband status; extent of structural disease; cardiac syncope; male sex; the presence of multiple mutations or a mutation in TMEM43; and the patient's willingness to restrict exercise and to eliminate participation in competitive or endurance exercise. © 2017 American Heart Association, Inc.
Colloid cyst of the third ventricle, hypothalamus, and heart: a dangerous link for sudden death
2012-01-01
Abstract Colloid cysts are rare congenital, intracranial neoplasms, commonly located in the third ventricle. Colloid cysts are endodermal congenital malformations. The cysts commonly range in size from 1–2 cm in diameter, although large cysts >3 cm in size have been reported. The components of the cyst include an outer fibrous capsule over an inner epithelium. The epithelium is usually a single layer of mucin-producing or ciliated cells. Such cysts contain mucoid and gelatinous material, which is positive for both Periodic acid Schiff (PAS) and mucicarmen staining. Although colloid cysts usually represent histopathologically benign neoplasms, they can result in sudden, unexpected and potentially lethal complications. The mechanism(s) of death is still a controversial subject and several mechanisms have been postulated to explain the sudden onset of severe symptoms and of fatal rapid deterioration in patients with colloid cysts. In this case, macroscopic and histological findings addressed the diagnosis of colloid cyst of the third ventricle with diffuse myocardial injury (coagulative myocytolysis or contraction band necrosis, CBN) and led us to conclude that acute cardiac arrest due to hypothalamus stimulation in the context of colloid cyst of the third ventricle was the cause of death. As the hypothalamic structures which are involved in neuroendocrine and autonomic regulation playing a key role in cardiovascular control are located close to the walls of the third ventricle which is the most frequent anatomical site of colloid cyst, this may suggest that reflex cardiac effects due to the compression of the hypothalamic cardiovascular regulatory centers by the cyst explain the sudden death in patients harboring a colloid cyst when signs of hydrocephalus or brain herniation are lacking. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/4915842848034158 PMID:23078815
Correlations between topography and intraflow width behavior in Martian and terrestrial lava flows
NASA Astrophysics Data System (ADS)
Peitersen, Matthew N.; Crown, David A.
2000-02-01
Local correlations between topography and width behavior within lava flows at Puu Oo, Mount Etna, Glass Mountain, Cerro Bayo, Alba Patera, Tyrrhena Patera, Elysium Mons, and Olympus Mons were investigated. For each flow, width and slope data were both referenced via downflow distance as a sequence of points; the data were then divided into collections of adjacent three-point features and two-point segments. Four discrete types of analyses were conducted: (1) Three-point analysis examined positional correlations between width and slope features, (2) two-point analysis did the same for flow segments, (3) mean slope analysis included segment slope comparisons, and (4) sudden width behavior analysis measured abruptness of width changes. The distribution of types of correlations compared to random combinations of features and segments does not suggest a significant correlation between flow widths and local underlying slopes and indicates that for these flows at least, other factors have more influence on changes in width than changes in underlying topography. Mean slopes underlying narrowing, widening, and constant flow width segments were calculated. An inverse correlation between slope and width was found only at Mount Etna, where slopes underlying narrowing segments were greater than those underlying widening in 62% of the examined flows. For the majority of flows at Mount Etna, Puu Oo, and Olympus Mons, slopes were actually greatest under constant width segments; this may imply a topographically dependent resistance to width changes. The rate of change of width was also examined. Sudden width changes are relatively common at Puu Oo, Mount Etna, Elysium Mons, and Tyrrhena Patera and relatively rare at Glass Mountain, Cerro Bayo, Olympus Mons, and Alba Patera. After correction for mapping scale, Puu Oo, Mount Etna, Olympus Mons, and Alba Patera appear to fall on the same trend; Glass Mount exhibits unusually small amounts of sudden width behavior, and Tyrrhena Patera exhibits a relatively large number of sudden width behavior occurrences.
Sudden Oak Death - Western (Pest Alert)
Susan Frankel
2002-01-01
Tens of thousands of tanoak (Lithocarpus densiflorus), coast live oak (Quercus agrifolia), California black oak (Quercus kelloggii), Shreve oak (Quercus parvula var. shrevei), and madrone (Arbutus menziesii) have been killed by a newly identified species, Phytophthora ramorum, which causes Sudden Oak Death. Sudden Oak Death was first reported in 1995 in central coastal...
Sudden oak death and Phytophthora ramorum: a summary of the literature
John T. Kliejunas
2010-01-01
Sudden oak death and Phytophthora ramorum, both first recognized about a decade ago, have been the subject of hundreds of scientific and popular press articles. This document presents a comprehensive, concise summary of sudden oak death and P. ramorum research findings and management activities. Topics covered include...
ERIC Educational Resources Information Center
Barnett, Henry L.; And Others
There is a growing body of evidence that Sudden Infant Death Syndrome (SIDS) victims are not completely normal and healthy, as was once believed. A variety of new information from several disciplines strongly suggests that the infant who dies suddenly and unexpectedly may do so because of subtle developmental, neurologic, cardiorespiratory, and…
Athletes at Risk for Sudden Cardiac Death
ERIC Educational Resources Information Center
Subasic, Kim
2010-01-01
High school athletes represent the largest group of individuals affected by sudden cardiac death, with an estimated incidence of once or twice per week. Structural cardiovascular abnormalities are the most frequent cause of sudden cardiac death. Athletes participating in basketball, football, track, soccer, baseball, and swimming were found to…
Bechtel, Kirsten
2012-10-01
Sudden unexpected infant deaths (SUIDs) are deaths in infants younger than 12 months that occur suddenly, unexpectedly, and without obvious cause in the emergency department (ED). Sudden infant death syndrome, the leading cause of SUID in the United States, is much more common, but fatal child abuse and neglect have been sometimes mistaken for sudden infant death syndrome. The distinction between these 2 entities can only be made after a thorough investigation of the scene, interview of caregivers, and a complete forensic autopsy. Development of ED guidelines for the reporting and evaluation of SUID, in collaboration with the local medical examiner and child death review teams, will enable ED practitioners to collect important information in a compassionate manner that will be valuable to the investigating personnel.
Relationship between sudden natural death and abdominal fat evaluated on postmortem CT scans.
Kaichi, Y; Sakane, H; Higashibori, H; Honda, Y; Tatsugami, F; Baba, Y; Iida, M; Awai, K
2017-06-01
This study examined the association between sudden natural death and abdominal fat using postmortem computed tomography (CT) scans. Postmortem CT images at the umbilical level of 241 subjects were used to measure abdominal areas of subcutaneous- and visceral fat, the rate of visceral fat and the waist circumference. Of the study subjects, 174 died of sudden natural death (130 men and 44 women), and 67 died of different causes (46 men and 21 women). All were between 40 and 75 years of age. Logistic regression analysis was performed to identify independent abdominal parameters associated with sudden natural death. By univariate analysis, the areas of subcutaneous and visceral fat were significantly larger in sudden natural death than who died of different causes (subcutaneous fat, odds ratio [OR] = 1.004, 95% confidence interval [CI] = 1.000-1.007, p = 0.03; visceral fat, OR = 1.008, 95% CI = 1.003-1.013, p < 0.01). Multivariate analysis showed that the area of visceral fat was an independent factor associated with the risk of sudden natural death (OR = 1.008, 95% CI = 1.002-1.015, p = 0.02). Postmortem CT revealed that sudden natural death was related to abdominal fat deposits.
F-MARC: promoting the prevention and management of sudden cardiac arrest in football.
Kramer, Efraim Benjamin; Dvorak, J; Schmied, C; Meyer, T
2015-05-01
Sudden cardiac death is the most common cause of unnatural death in football. To prevent and urgently manage sudden cardiac arrest on the football field-of-play, F-MARC (FIFA Medical and Research Centre) has been fully committed to a programme of research, education, standardisation and practical implementation. This strategy has detected football players at medical risk during mandatory precompetition medical assessments. Additionally, FIFA has (1) sponsored internationally accepted guidelines for the interpretation of an athlete's ECG, (2) developed field-of-play-specific protocols for the recognition, response, resuscitation and removal of a football player having sudden cardiac arrest and (3) introduced and distributed the FIFA medical emergency bag which has already resulted in the successful resuscitation of a football player who had a sudden cardiac arrest on the field-of-play. Recently FIFA, in association with the Institute of Sports and Preventive Medicine in Saarbrücken, Germany, established a worldwide Sudden Death Registry with a view to documenting fatal events on the football field-of-play. These activities by F-MARC are testimony to FIFA's continued commitment to minimising sudden cardiac arrest while playing football. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Prolapse of inverted ileal loops through a patent vitellointestinal duct
Pathak, Ashish; Agarwal, Nitin; Singh, Poonam; Dhaneria, Mamta
2015-01-01
We report a case of a prolapsed patent vitellointestinal duct (PVID) in a 2-month-old girl child who presented with sudden increase in size of a polypoidal lesion into a large, ‘Y’-shaped reddish, prolapsing lesion, discharging gaseous and faecal matter at her umbilicus. The lesion was diagnosed as a prolapse of inverted ileal loops through the PVID. The child had no associated congenital anomalies. A transumbilical exploration was performed, followed by wedge resection and anastomosis. The child tolerated the procedure well and the postoperative course was uneventful. If the omphalomesenteric duct fails to obliterate a range of congenital defects related to the umbilicus, it can become clinically apparent. Meckel's diverticulum is the commonest of these defects but is most often asymptomatic. PVID is the most common symptomatic anomaly of the patent omphalomesenteric duct and requires prompt surgical correction to avoid complications. PMID:26494719
Prolapse of inverted ileal loops through a patent vitellointestinal duct.
Pathak, Ashish; Agarwal, Nitin; Singh, Poonam; Dhaneria, Mamta
2015-10-22
We report a case of a prolapsed patent vitellointestinal duct (PVID) in a 2-month-old girl child who presented with sudden increase in size of a polypoidal lesion into a large, 'Y'-shaped reddish, prolapsing lesion, discharging gaseous and faecal matter at her umbilicus. The lesion was diagnosed as a prolapse of inverted ileal loops through the PVID. The child had no associated congenital anomalies. A transumbilical exploration was performed, followed by wedge resection and anastomosis. The child tolerated the procedure well and the postoperative course was uneventful. If the omphalomesenteric duct fails to obliterate a range of congenital defects related to the umbilicus, it can become clinically apparent. Meckel's diverticulum is the commonest of these defects but is most often asymptomatic. PVID is the most common symptomatic anomaly of the patent omphalomesenteric duct and requires prompt surgical correction to avoid complications. 2015 BMJ Publishing Group Ltd.
Archetypes of famine and response.
Howe, Paul
2010-01-01
Famines have long been characterised by rapidly shifting dynamics: sudden price spirals, sharp increases in mortality, the media frenzy that often accompanies such spikes, the swift scaling up of aid flows, and a subsequent decline in interest. In arguing that these aspects of famine have been largely ignored in recent years due to attention to the famine process', this paper attempts to make these dynamics more explicit by applying systems thinking. It uses standard archetypes of systems thinking to explain six situations--watch, price spiral, aid magnet, media frenzy, overshoot, and peaks--that are present in many famine contexts. It illustrates their application with examples from crises in Ethiopia, Malawi, Niger, and Sudan. The paper contends that the systems approach offers a tool for analysing the larger patterns in famines and for pinpointing the most appropriate responses to them, based on an awareness of the dynamics of the crises.
NASA Technical Reports Server (NTRS)
Thiemann, H.; Schunk, R. W.
1990-01-01
The interaction between satellite solar arrays and the LEO plasma is presently studied with particle-in-cell simulations in which an electrical potential was suddenly applied to the solar cell interconnector. The consequent temporal response was followed for the real O(+)-electron mass ratio in the cases of 100- and 250-V solar cells, various solar cell thicknesses, and solar cells with secondary electron emission. Larger applied potentials and thinner solar cells lead to greater initial polarization surface charges, and therefore longer discharging and shielding times. When secondary electron emission from the cover glass is brought to bear, however, the potential structure is nearly planar, allowing constant interaction between plasma electrons and cover glass; a large fraction of the resulting secondary electrons is collected by the interconnector, constituting an order-of-magnitude increase in collected current.
Disintegration phenomena in Comet West
NASA Technical Reports Server (NTRS)
Sekanina, Z.
1976-01-01
Two peculiarities of Comet West, the multiple splitting of the nucleus as seen in telescope observations and the complex structure of the dust tail, are discussed. A method of analysis based on the premise that the observed rate of separation of a fragment from the principal nucleus is determined by the difference in effective solar attraction acting on the bodies is applied to investigate the motion of the four fragments that separated from the nucleus of Comet West. The predicted motion of the fragments is in good agreement with available observations. It is suggested that the 'synchronic' bands of the dust tail consist of tiny fragments from relatively large particles that burst after release from the comet. The unusual orientation of these bands and their high surface brightness relative to the diffuse tail are explained by a sudden increase in the particle acceleration and in the total scattering surface as the result of the disintegration of the larger particles.
Analysis of angle effect on particle flocculation in branch flow
NASA Astrophysics Data System (ADS)
Prasad, Karthik; Fink, Kathryn; Liepmann, Dorian
2014-11-01
Hollow point microneedle drug delivery systems are known to be highly susceptible to blockage, owing to their very small structures. This problem has been especially noted when delivering suspended particle solutions, such as vaccines. Attempts to reduce particle flocculation in such devices through surface treatments of the particles have been largely unsuccessful. Furthermore, the particle clog only forms at the mouths of the microneedle structures, leaving the downstream walls clear. This implies that the sudden change in length scales alter the hydrodynamic interactions, creating the conditions for particle flocculation. However, while it is known that particle flocculation occurs, the physics behind the event are obscure. We utilize micro-PIV to observe how the occurrence and formation of particle flocculation changes in relation to the angle encountered by particle laden flow into microfluidic branch structures. The results offer the ability to optimize particle flocculation in MEMS devices, increasing device efficacy and longevity.
Observing the Anthropocene from Space: Challenges and Needs
NASA Astrophysics Data System (ADS)
Burrows, John
2016-07-01
The rapid growth of human population since the industrial revolution has been coupled with a much increased standard of living and bountiful production of food. The dominant energy source sustaining this development has been fossil fuel combustion. However this has resulted in pollution which now spans all scales. There have significant impacts on air quality, water quality, stratospheric ozone and climate. The impacts can sudden and large and also slowly accumulate over time in the long term. The first decades of the space age resulted in pioneering efforts to establish adequate measurement capability. This process is continuing to evolve. Over the past two decades there have been a number of efforts to define the contribution and needs for a space segment which can separate anthropogenic form natural changes in the earth system. This talk introduces this topic of the use of the space segment to deconvolve change from anthropogenic activity and natural phenomena.
Household Financial Distress and Initial Endowments: Evidence from the 2008 Financial Crisis.
Olafsson, Arna
2016-11-01
This paper studies in utero exposure to the 2008 financial crisis. Exploiting the sudden and unexpected collapse of the Icelandic economy, I find that first-trimester exposure to the crisis led to a sizable and significant reduction in birth weight, increased the probability of a low birth weight ( < 2500 g), and decreased the probability of a high birth weight ( > 4000 g). I also find evidence that the collapse reduced the sex ratio, indicating selection in utero due to maternal prenatal stress exposure. My results imply large welfare losses from financial distress that have hitherto been ignored - because children with worse health at birth can expect substantially lower lifetime earnings - and suggest that economic hardships may in general exacerbate income inequalities in the long run as low-income households are typically more exposed to financial distress. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
Negative differential conductance in doped-silicon nanoscale devices with superconducting electrodes
NASA Astrophysics Data System (ADS)
Shapovalov, A.; Shaternik, V.; Suvorov, O.; Zhitlukhina, E.; Belogolovskii, M.
2018-02-01
We present a proof-of-concept nanoelectronics device with a negative differential conductance, an attractive from the applied viewpoint functionality. The device, characterized by the decreasing current with increasing voltage in a certain voltage region above a threshold bias of about several hundred millivolts, consists of two superconducting electrodes with an amorphous 10-nm-thick silicon interlayer doped by tungsten nano-inclusions. We show that small changes in the W content radically modify the shape of the trilayer current-voltage dependence and identify sudden conductance switching at a threshold voltage as an effect of Andreev fluctuators. The latter entities are two-level systems at the superconductor-doped silicon interface where a Cooper pair tunnels from a superconductor and occupies a pair of localized electronic states. We argue that in contrast to previously proposed devices, our samples permit very large-scale integration and are practically feasible.
NASA Astrophysics Data System (ADS)
Bigl, M.; Kelly, M. A.
2012-12-01
Subsequent to the last glacial maximum, the Laurentide Ice Sheet retreated northward through New England and New York and large glacial lakes formed in the Hudson, Connecticut and Merrimack Valleys. Varved sediments in these former lake basins preserve an incredible record of the timing and rates of ice sheet recession as well as regional climatic conditions. Here, we test the hypothesis that these varves also preserve a history of the lowering and drainage of the lakes. We present evidence of sudden increases in varve thicknesses within the former Glacial Lake Hitchcock (GLH) basin in the Connecticut River Valley of New Hampshire and Vermont and test the hypothesis that these result from lake-level lowering events. GLH existed in the Connecticut Valley due to a sediment dam at its southern end near Rocky Hill, CT. At its maximum, it may have extended from Rocky Hill to near Lyndon, VT. A breach of the Rocky Hill dam at ~13.5 ka caused the drainage of the southern basin of GLH, located south of the Holyoke Range in Massachusetts, but the northern basin of GLH (in the Upper Valley region of New Hampshire and Vermont) retained water until ~11.5 ka (Stone, 1999). However, no studies have focused on lake level fluctuation, exact timing of GLH drainage, and whether the lake drained in one episode or as a longer sequence of drainage events. We use sediment cores from modern lake basins to examine the lowering and final drainage of GLH in the Upper Valley region. As GLH lowered, these modern basins emerged (with higher elevation basins emerging first) and deposition in each basin transitioned from glacial varves to non-varved and organic-rich sediments. We hypothesize that during a lowering event a basin submerged by GLH would have received an increase in sediment flux from deposits exposed at the lakeshore and, thus, a sudden thickening of varves would occur. We test this hypothesis by comparing the age of the transition from glacial varves to non-varved and organic-rich sediments in higher elevation basins with the age of the sudden thickening of varves in lower elevation basins. An alternative hypothesis is that a sudden thickening of varves results from a colder or wetter climatic conditions that caused an increased sediment flux to GLH. In winter 2012, we obtained sediment cores using a modified Livingstone corer from six modern lake basins in the Upper Valley region. All of these basins are located beneath the level of GLH and contain glacial varved sediments below ~6-9 m of Holocene organic-rich sediments. On an isostatically depressed landscape reconstructed for this study, the modern basins occur over a range of ~80 m of elevation, from near the highest level of GLH to near the modern elevation of the Connecticut River. We are using high-resolution line-scan images obtained at the Limnological Research Center (LRC) at the University of Minnesota to measure varve thicknesses in the sediment cores and correlate these with the North American Varve Chronology (NAVC). This method of correlation has been used successfully with varved sediments in the Hudson, Connecticut, and Merrimack Valleys to develop the NAVC. Where possible, we will use radiocarbon dating of terrestrial macrofossils within varved sediment and organic-rich sediment to test the varve correlations.
Multiple roles of connexins in atherosclerosis- and restenosis-induced vascular remodelling.
Morel, Sandrine
2014-01-01
Endothelial dysfunction is the initial step in atherosclerotic plaque development in large- and medium-sized arteries. This progressive disease, which starts during childhood, is characterized by the accumulation of lipids, macrophages, neutrophils, T lymphocytes and smooth muscle cells in the intima of the vessels. Erosion and rupture of the atherosclerotic plaque may induce myocardial infarction and cerebrovascular accidents, which are responsible for a large percentage of sudden deaths. The most common treatment for atherosclerosis is angioplasty and stent implantation, but these surgical interventions favour a vascular reaction called restenosis and the associated de-endothelialization increases the risk of thrombosis. This review provides an overview of the role of connexins, a large family of transmembrane proteins, in vascular remodelling associated with atherosclerosis and restenosis. The connexins expressed in the vascular wall are Cx37, Cx40, Cx43 and Cx45; their expressions vary with vascular territory and species. Connexins form hemichannels or gap junction channels, allowing the exchange of ions and small metabolites between the cytosol and extracellular space or between neighbouring cells, respectively. Connexins have important roles in vascular physiology; they support radial and longitudinal cell-to-cell communication in the vascular wall, and significant changes in their expression patterns have been described during atherosclerosis and restenosis.
The combustion behavior of large scale lithium titanate battery
Huang, Peifeng; Wang, Qingsong; Li, Ke; Ping, Ping; Sun, Jinhua
2015-01-01
Safety problem is always a big obstacle for lithium battery marching to large scale application. However, the knowledge on the battery combustion behavior is limited. To investigate the combustion behavior of large scale lithium battery, three 50 Ah Li(NixCoyMnz)O2/Li4Ti5O12 batteries under different state of charge (SOC) were heated to fire. The flame size variation is depicted to analyze the combustion behavior directly. The mass loss rate, temperature and heat release rate are used to analyze the combustion behavior in reaction way deeply. Based on the phenomenon, the combustion process is divided into three basic stages, even more complicated at higher SOC with sudden smoke flow ejected. The reason is that a phase change occurs in Li(NixCoyMnz)O2 material from layer structure to spinel structure. The critical temperatures of ignition are at 112–121°C on anode tab and 139 to 147°C on upper surface for all cells. But the heating time and combustion time become shorter with the ascending of SOC. The results indicate that the battery fire hazard increases with the SOC. It is analyzed that the internal short and the Li+ distribution are the main causes that lead to the difference. PMID:25586064
Sudden Cardiac Arrest during Participation in Competitive Sports.
Landry, Cameron H; Allan, Katherine S; Connelly, Kim A; Cunningham, Kris; Morrison, Laurie J; Dorian, Paul
2017-11-16
The incidence of sudden cardiac arrest during participation in sports activities remains unknown. Preparticipation screening programs aimed at preventing sudden cardiac arrest during sports activities are thought to be able to identify at-risk athletes; however, the efficacy of these programs remains controversial. We sought to identify all sudden cardiac arrests that occurred during participation in sports activities within a specific region of Canada and to determine their causes. In this retrospective study, we used the Rescu Epistry cardiac arrest database (which contains records of every cardiac arrest attended by paramedics in the network region) to identify all out-of-hospital cardiac arrests that occurred from 2009 through 2014 in persons 12 to 45 years of age during participation in a sport. Cases were adjudicated as sudden cardiac arrest (i.e., having a cardiac cause) or as an event resulting from a noncardiac cause, on the basis of records from multiple sources, including ambulance call reports, autopsy reports, in-hospital data, and records of direct interviews with patients or family members. Over the course of 18.5 million person-years of observation, 74 sudden cardiac arrests occurred during participation in a sport; of these, 16 occurred during competitive sports and 58 occurred during noncompetitive sports. The incidence of sudden cardiac arrest during competitive sports was 0.76 cases per 100,000 athlete-years, with 43.8% of the athletes surviving until they were discharged from the hospital. Among the competitive athletes, two deaths were attributed to hypertrophic cardiomyopathy and none to arrhythmogenic right ventricular cardiomyopathy. Three cases of sudden cardiac arrest that occurred during participation in competitive sports were determined to have been potentially identifiable if the athletes had undergone preparticipation screening. In our study involving persons who had out-of-hospital cardiac arrest, the incidence of sudden cardiac arrest during participation in competitive sports was 0.76 cases per 100,000 athlete-years. The occurrence of sudden cardiac arrest due to structural heart disease was uncommon during participation in competitive sports. (Funded by the National Heart, Lung, and Blood Institute and others.).
Sudden cardiac death in the young
Ackerman, Michael; Atkins, Dianne L; Triedman, John K
2016-01-01
Although the occurrence of sudden cardiac death (SCD) in a young person is a rare event, it is traumatic and often widely publicized. In recent years, SCD in this population has been increasingly seen as a public health and safety issue. This review presents current knowledge relevant to the epidemiology of SCD and to strategies for prevention, resuscitation and identification of those at greatest risk. Areas of active research and controversy include the development of best practices in screening, risk stratification approaches and post-mortem evaluation, and identification of modifiable barriers to providing better outcomes after resuscitation of young SCD victims. Institution of a national registry of SCD in the young will provide data that will help to answer these questions. PMID:26951821