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Sample records for affording myocardial survival

  1. Survival and cause of death after myocardial infarction

    DEFF Research Database (Denmark)

    Brønnum-Hansen, H; Jørgensen, Torben; Davidsen, M;

    2001-01-01

    As part of the Danish WHO MONICA study, a register of patients with myocardial infarction was established in 1982, covering 11 municipalities in the western part of Copenhagen County, Denmark. During the period 1982-91, all cases of myocardial infarction among citizens aged 25-74 years were...... registered and validated according to the criteria set up for the WHO MONICA project. Short-term (28 days) and long-term (up to 15 years) survival in three periods were compared. The rate of mortality after a non-fatal myocardial infarction was compared with that of the general population, and causes...

  2. Affordance

    DEFF Research Database (Denmark)

    Olesen, Mogens

    2016-01-01

    This entry presents the concept of affordances as part of an ecological approach to understanding how agents interact with objects in their environment. It examines some of the central developments of the concept, from J. J. Gibson’s original definition within psychology and Donald Norman’s design...

  3. History of Depression and Survival After Acute Myocardial Infarction

    NARCIS (Netherlands)

    Carney, Robert M.; Freedland, Kenneth E.; Steinmeyer, Brian; Blumenthal, James A.; de Jonge, Peter; Davidson, Karina W.; Czajkowski, Susan M.; Jaffe, Allan S.

    2009-01-01

    Objective: To compare survival in post-myocardial (MI) participants from the Enhancing Recovery In Coronary Heart Disease (ENRICHD) clinical trial with a first episode of major depression (MD) and those with recurrent MID, which is a risk factor for mortality after acute MI. Recent reports suggest t

  4. Myocardial contractile function in survived neonatal piglets after cardiopulmonary bypass

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    Popov Aron-Frederik

    2010-11-01

    Full Text Available Abstract Background Hemodynamic function may be depressed in the early postoperative stages after cardiac surgery. The aim of this study was the analysis of the myocardial contractility in neonates after cardiopulmonary bypass (CPB and mild hypothermia. Methods Three indices of left ventricular myocardial contractile function (dP/dt, (dP/dt/P, and wall thickening were studied up to 6 hours after CPB in neonatal piglets (CPB group; n = 4. The contractility data were analysed and then compared to the data of newborn piglets who also underwent median thoracotomy and instrumentation for the same time intervals but without CPB (non-CPB group; n = 3. Results Left ventricular dP/dtmax and (dP/dtmax/P remained stable in CPB group, while dP/dtmax decreased in non-CPB group 5 hours postoperatively (1761 ± 205 mmHg/s at baseline vs. 1170 ± 205 mmHg/s after 5 h; p max and (dP/dtmax/P there were no statistically significant differences between the two groups. Comparably, although myocardial thickening decreased in the non-CPB group the differences between the two groups were not statistically significant. Conclusions The myocardial contractile function in survived neonatal piglets remained stable 6 hours after cardiopulmonary bypass and mild hypothermia probably due to regional hypercontractility.

  5. Two Survival Tree Models for Myocardial Infarction Patients

    OpenAIRE

    Pashova, Victoria; Ulm, Kurt

    2000-01-01

    In the search of a better prognostic survival model for post-acute myocardial infarction patients, the scientists at the Technical University of Munich's "Klinikum rechts der Isar" and the German Heart Center in Munich have developed some new parameters using 24-hour ECG (Schmidt et al 1999). A series of investigations were done using these parameters on different data sets and the Cox-PH model (Schmidt et al 1999, Ulm et al 2000). This paper is a response to the discussion paper by Ulm et ...

  6. Implications of myocardial reperfusion on survival in women versus men with acute myocardial infarction undergoing primary coronary intervention.

    Science.gov (United States)

    Meller, Stephanie M; Lansky, Alexandra J; Costa, Ricardo A; Soffler, Morgan; Costantini, Costantino O; Brodie, Bruce R; Cox, David A; Stuckey, Thomas D; Fahy, Martin; Grines, Cindy L; Stone, Gregg W

    2013-10-15

    We evaluated the effects of myocardial perfusion after primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) on gender-based mortality rates. Research has demonstrated a gender-specific response of cardiomyocytes to ischemia and a potential increase in myocardial salvage in women compared with men. Myocardial blush grade (MBG), an angiographic surrogate of myocardial perfusion, is an independent predictor of early and late survival after AMI. Whether the incidence and prognosis of myocardial perfusion differs according to gender among patients with AMI undergoing PCI is unknown. MBG and short- and long-term mortality were evaluated in 1,301 patients (male = 935; female = 366) with AMI randomized to primary angioplasty ± abciximab versus stent ± abciximab. Following PCI, >96% of patients achieved final Thrombolysis In Myocardial Infarction 3 flow, of which MBG 2/3 was present in 58.3% of women versus 51.1% of men (p = 0.02). Worse MBG was an independent predictor of mortality in women at 30 days (7.4% for MBG 0/1 vs 2.4% for MBG 2/3, p = 0.04) and at 1-year (11.0% for MBG 0/1 vs 3.4% for MBG 2/3, p = 0.01); however, MBG was not associated with differences in mortality for men. In conclusion, impaired myocardial perfusion following PCI for AMI, indicated by worse MBG, is an independent predictor of early and late mortality in women but not in men. These findings imply an enhanced survival benefit from restoring myocardial perfusion for women compared with men during primary angioplasty and may have clinical implications for interventional strategies in women.

  7. Ascorbic acid improves embryonic cardiomyoblast cell survival and promotes vascularization in potential myocardial grafts in vivo

    OpenAIRE

    Martinez, E. C.; Wang, J; Gan, S U; Singh, R.; Lee, C. N.; Kofidis, T

    2010-01-01

    Organ restoration via cell therapy and tissue transplantation is limited by impaired graft survival. We tested the hypothesis that ascorbic acid (AA) reduces cell death in myocardial grafts both in vitro and in vivo and introduced a new model of autologous graft vascularization for later transplantation. Luciferase (Fluc)- and green fluorescent protein (GFP)-expressing H9C2 cardiomyoblasts were seeded in gelatin scaffolds to form myocardial artificial grafts (MAGs). MAGs were supplemented wit...

  8. Mechanisms of post-myocardial infarction healing : from acute survival to chronic remodeling

    OpenAIRE

    Hunt, Darlene L.

    2009-01-01

    Acute survival and chronic healing after myocardial infarction (MI) depend on a myriad of processes that begin within hours of the injury and can continue in the form of remodeling even years thereafter. The myocardium has very little self-renewal capability, and tissue lost to MI is replaced with a collagenous scar. There are currently no clinical therapies that directly target myocardial healing, due in part to the pleiotropic effects and redundancy of signaling factors released after injur...

  9. Does the electrocardiographic presence of Q waves influence the survival of patients with acute myocardial infarction?

    DEFF Research Database (Denmark)

    Abdulla, J; Brendorp, B; Torp-Pedersen, C;

    2001-01-01

    , electrocardiographic diagnosis of Q wave and non-Q wave myocardial infarction, echocardiographic estimation of left ventricular systolic function determined as wall motion index, infarct complications, and survival were documented. The factors influencing the postmyocardial infarction outcome of these patients were.......9-1.1)]. The result was the same in univariate and multivariate analyses. Subgroup analysis defined by age, sex, wall motion index, presence of congestive heart failure, diabetes mellitus, arterial hypertension, subsequent myocardial infarctions and use of thrombolytic therapy did not disclose importance of Q waves...

  10. Socioeconomic Status, Functional Recovery, and Long-Term Mortality among Patients Surviving Acute Myocardial Infarction

    OpenAIRE

    Alter, David A.; Barry Franklin; Ko, Dennis T; Austin, Peter C.; Lee, Douglas S.; Oh, Paul I.; Stukel, Therese A; Tu, Jack V.

    2013-01-01

    OBJECTIVES: To examine the relationship between socio-economic status (SES), functional recovery and long-term mortality following acute myocardial infarction (AMI). BACKGROUND: The extent to which SES mortality disparities are explained by differences in functional recovery following AMI is unclear. METHODS: We prospectively examined 1368 patients who survived at least one-year following an index AMI between 1999 and 2003 in Ontario, Canada. Each patient was linked to administrative data and...

  11. Oxygen cycling to improve survival of stem cells for myocardial repair: A review.

    Science.gov (United States)

    Dall, Christopher; Khan, Mahmood; Chen, Chun-An; Angelos, Mark G

    2016-05-15

    Heart disease represents the leading cause of death among Americans. There is currently no clinical treatment to regenerate viable myocardium following myocardial infarction, and patients may suffer progressive deterioration and decreased myocardial function from the effects of remodeling of the necrotic myocardium. New therapeutic strategies hold promise for patients who suffer from ischemic heart disease by directly addressing the restoration of functional myocardium following death of cardiomyocytes. Therapeutic stem cell transplantation has shown modest benefit in clinical human trials with decreased fibrosis and increased functional myocardium. Moreover, autologous transplantation holds the potential to implement these therapies while avoiding the immunomodulation concerns of heart transplantation. Despite these benefits, stem cell therapy has been characterized by poor survival and low engraftment of injected stem cells. The hypoxic tissue environment of the ischemic/infracting myocardium impedes stem cell survival and engraftment in myocardial tissue. Hypoxic preconditioning has been suggested as a viable strategy to increase hypoxic tolerance of stem cells. A number of in vivo and in vitro studies have demonstrated improved stem cell viability by altering stem cell secretion of protein signals and up-regulation of numerous paracrine signaling pathways that affect inflammatory, survival, and angiogenic signaling pathways. This review will discuss both the mechanisms of hypoxic preconditioning as well as the effects of hypoxic preconditioning in different cell and animal models, examining the pitfalls in current research and the next steps into potentially implementing this methodology in clinical research trials. PMID:27091653

  12. The effect of referral for cardiac rehabilitation on survival following acute myocardial infarction

    DEFF Research Database (Denmark)

    Lewinter, Christian; Bland, John M; Crouch, Simon;

    2014-01-01

    BACKGROUND: International guidelines recommend referral for cardiac rehabilitation (CR) after acute myocardial infarction (AMI). However, the impact on long-term survival after CR referral has not been adjusted by time-variance. We compared the effects of CR referral after hospitalization for AMI...... in two consecutive decades. METHODS AND RESULTS: A total of 2196 and 2055 patients were recruited in the prospective observational studies of the Evaluation of the Methods and Management of Acute Coronary Events (EMMACE) -1 and 2 in 1995 and 2003, (1995: median age 72 years, 39% women, 74% referred vs...... 2003: median age 71 years, 36% women, 64% referred) and followed up through September 2010. Survival functions showed CR referral to be an independent predictor for survival in 2003, but not in 1995 (hazard ratio (HR), 0.90; 95% confidence interval [CI]; 0.70 to 1.17, p = 0.44 in 1995 vs HR, 0.80; 95...

  13. Involvement of Proteasome and Macrophages M2 in the Protection Afforded by Telmisartan against the Acute Myocardial Infarction in Zucker Diabetic Fatty Rats with Metabolic Syndrome

    Directory of Open Access Journals (Sweden)

    C. Di Filippo

    2014-01-01

    Full Text Available This study investigated the involvement of proteasome and macrophages M2 in the protection afforded by telmisartan against the acute myocardial infarction in Zucker diabetic fatty (ZDF rats with metabolic syndrome. ZDF rats were treated for three weeks with telmisartan at doses of 7 and 12 mg/kg/day. After treatment, rats were subjected to a 25 min occlusion of the left descending coronary artery followed by 2 h reperfusion (I/R. At the end of the I/R period, biochemical, immunohistochemical, and echocardiographic evaluations were done. Telmisartan treatment (7 mg/kg and 12 mg/kg reduced the myocardial infarct size, the expression of proteasome subunits 20S and 26S, and the protein ubiquitin within the heart. The compound has led to an increased M2 macrophage phenotype within the cardiac specimens and a modification of the cardiac cytokine and chemokine profile. This was functionally translated in improved cardiac performance as evidenced by echography after 2 h reperfusion. 7 mg/kg/day telmisartan was sufficient to improve the left ventricular ejection fraction LVEF of the rat heart recorded after I/R (e.g., vehicle 38 ± 2.2%; telmisartan 54 ± 2.7% and was sufficient to improve the diastolic function and the myocardial performance index up to values of 0.6 ± 0.01 measured after I/R.

  14. Evaluation of Survival Rate and Effective Factors in Acute Myocardial Infarction Patients in Emam Hospital (Year 2000)

    OpenAIRE

    B Nabaei; M Maghsoodloo; S Dabiran

    2002-01-01

    Introduction: For the time being we have considered that the myocardial infarction is an increasing event in Islamic Republic of Iran and there are many procedures and methods which can help us to diminish the number of death from this ongoing event. The main aim of this research is to determine the survival rate in those patients who have had acute myocardial infarction and the association of it with different variables. Methods and Materials: The present research is a descriptive case-serie...

  15. Survival Rate and its Related Factors in Patients with Acute Myocardial Infarction

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    H Ghaffarian Shirazi

    2006-04-01

    Full Text Available ABSTRACT: Introduction & Objective: It has been noted that the myocardial infarction is an increasing episode in Islamic Republic of Iran and there are many procedures and methods which can help to reduce the number of death from this ongoing event. The aim of this study was to determine the survival rate in those patients who have had acute myocardial infarction and its association with different variables. Materials & Methods: This descriptive analytic study evaluates 111 cases of acute myocardial infarction admitted in Yasuj Imam Sajjad hospital during the year 2004 and 2005. Data were collected using a questionnaire which was completed through direct interviewing by trained personnel. The data were analyzed by standard statistical tests using SPSS software. Results: The mean age of patients was 57± 12 years. The mean time of having access to physician after MI was 4 ± 2.2 hours. The mean time of reaching hospital after physician order was 5 ± 4.9 hours. The mean time of hospitalization was 4 ± 1.67 days. Considering the past history of these patients revealed that 31 percent were smokers, 16 percent had the history of previous ischemic heart disease, 63 percent had hypertension, 8 percent had diabetes mellitus, 95 percent had clip I, 95 percent had no previous block, 82 percent had MI with Q wave. The survival rate in our study was found to be 0.91 in the first 10 hours, 0.847 in the first day, 0.829 in the first 28 days, 0.820 in the first third months, 0.792 in the first six months and 0.771 in the first 10 months of disease. Conclusion: The mortality rate during the first month among the patients with heart failure turned out to be higher than that of the other similar studies performed in other parts of the country however, the annual survival rate proved to be less. The most important causes of survival after the stroke are being single, smoking, fatness and angina pain

  16. Evaluation of 1-Year Survival Rate and Effective Factors in Patients with Acute Myocardial Infarction

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    Ahmad Khosravi

    2008-01-01

    Full Text Available Introduction: Myocardial infarction (MI with 25- 30% mortality rate is one of the most common causes of death in most countries. According to recent data, MI is an increasing event in Iran. The aims of this study were to determine the 1-year survival rate and its correlates with MI among patients. Methods: This nonconcurrent cohort study was done on 113 patients with first acute MI who had been admitted in Imam Hossein hospital during the year 2004. Kaplan-Maier product limit and log rank test for survival analysis were used. Results: From 113 patients studied, there were 73(64.6% males and their mean age was 63.9±13.1 (range 16-89. According to of the past history of these patients relived that 23.9% had been smokers. The most frequent risk factors were hypertensions (53.1%, history of previous ischemic heart disease (35.4%, diabetes mellitus (24.8% and heart block (6.2%. Thirty six (31.9% of them died in first one-year after admission. The 1-year survival rate was 69 percent. Significant predictors of 1-year survival in our study were administration of streptokinase and use of ß-blockers after discharge. Conclusion: We concluded that mortality in first year after MI has been significantly reduced because of therapies including thrombolysis and ß-blockers

  17. Histamine reverses IL-5-Afforded human eosinophil survival by inducing apoptosis: Pharmacological evidence for a novel mechanism of action of histamine

    OpenAIRE

    Hasala, Hannele; Giembycz, Mark A.; Janka-Junttila, Mirkka; Moilanen, Eeva; Kankaanranta, Hannu

    2008-01-01

    Histamine reverses IL-5-Afforded human eosinophil survival by inducing apoptosis: Pharmacological evidence for a novel mechanism of action of histamine correspondence: Corresponding author. Tel.: +358335517318; fax: +358335518082. (Kankaanranta, Hannu) (Kankaanranta, Hannu) The Immunopharmacology Research Group--> , Medical School--> , University of Tampere--> , Tampere--> - FINLAND (Hasala, H...

  18. Redox activation of Ref-1 potentiates cell survival following myocardial ischemia reperfusion injury.

    Science.gov (United States)

    Gurusamy, Narasimman; Malik, Gautam; Gorbunov, Nikolai V; Das, Dipak K

    2007-08-01

    A recent study showed that cardiac adaptation could potentiate translocation of thioredoxin-1 (Trx-1) into the nucleus, which then interacted with Ref-1, resulting in a survival signal. Here, we present evidence that such adaptation also causes nuclear translocation of Ref-1, which is almost completely inhibited when the hearts were pretreated with antisense Ref-1 that also abolished the cardioprotective adaptive response. Significant amounts of NFkappaB and Nrf2 were found to be associated with Ref-1 when the nuclear extract obtained from the left ventricle was immunoprecipitated with Ref-1. Such Ref-1-NFkappaB and Ref-1-Nrf2 interactions were significantly inhibited with antisense Ref-1. However, immunoprecipitation of nuclear extract with NFkappaB showed that the association of Trx-1 with NFkappaB is increased in the adapted heart, which was again significantly blocked by antisense Ref-1. Nrf2 was also associated with NFkappaB; however, such association appeared to be independent of Ref-1. In contrast, myocardial adaptation to ischemia inhibited the ischemia reperfusion-induced loss of Nrf2 from the nucleus, which was inhibited by antisense Ref-1. The nuclear translocation and activation of Ref-1 appeared to generate a survival signal as evidenced by the increased phosphorylation of Akt that was inhibited with antisense Ref-1. Finally, confocal microscopy confirmed the results of immunoblotting, clearly showing the nuclear translocation of Ref-1 and nuclear 3D colocalization of Ref-1 with NFkappaB in the adapted heart and its inhibition with antisense Ref-1. Our results show that PC potentiates a survival signal through the phosphorylation of Akt by causing nuclear translocation and activation of Ref-1, where significant interaction among NFkappaB and Ref-1, Trx-1, and Nrf2 appears to regulate Ref-1-induced survival signal.

  19. Patient-reported outcomes as predictors of 10-year survival in women after acute myocardial infarction

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    Segadal Leidulf

    2010-11-01

    Full Text Available Abstract Background Patient-reported outcomes are increasingly seen as complementary to biomedical measures. However, their prognostic importance has yet to be established, particularly in female long-term myocardial infarction (MI survivors. We aimed to determine whether 10-year survival in older women after MI relates to patient-reported outcomes, and to compare their survival with that of the general female population. Methods We included all women aged 60-80 years suffering MI during 1992-1997, and treated at one university hospital in Norway. In 1998, 145 (60% of those alive completed a questionnaire package including socio-demographics, the Sense of Coherence Scale (SOC-29, the World Health Organization Quality of Life Instrument Abbreviated (WHOQOL-BREF and an item on positive effects of illness. Clinical information was based on self-reports and hospital medical records data. We obtained complete data on vital status. Results The all-cause mortality rate during the 1998-2008 follow-up of all patients was 41%. In adjusted analysis, the conventional predictors s-creatinine (HR 1.26 per 10% increase and left ventricular ejection fraction below 30% (HR 27.38, as well as patient-reported outcomes like living alone (HR 6.24, dissatisfaction with self-rated health (HR 6.26, impaired psychological quality of life (HR 0.60 per 10 points difference, and experience of positive effects of illness (HR 6.30, predicted all-cause death. Major adverse cardiac and cerebral events were also significantly associated with both conventional predictors and patient-reported outcomes. Sense of coherence did not predict adverse events. Finally, 10-year survival was not significantly different from that of the general female population. Conclusion Patient-reported outcomes have long-term prognostic importance, and should be taken into account when planning aftercare of low-risk older female MI patients.

  20. Myocardial autophagy activation and suppressed survival signaling is associated with insulin resistance in fructose-fed mice.

    Science.gov (United States)

    Mellor, Kimberley M; Bell, James R; Young, Morag J; Ritchie, Rebecca H; Delbridge, Lea M D

    2011-06-01

    Fructose intake is linked with the increasing prevalence of insulin resistance and there is now evidence for a specific insulin-resistant cardiomyopathy. The aim of this study was to determine the cardiac-specific myocardial remodeling effects of high fructose dietary intake. Given the links between insulin signaling, reactive oxygen species generation and autophagy induction, we hypothesized that autophagy contributes to pathologic remodeling in the insulin-resistant heart, and in particular may be a feature of high fructose diet-induced cardiac phenotype. Male C57Bl/6 mice were fed a high fructose (60%) diet or nutrient-matched control diet for 12 weeks. Systemic and myocardial insulin-resistant status was characterized. Superoxide production (lucigenin) and cellular growth and death signaling pathways were examined in myocardial tissue. Myocardial structural remodeling was evaluated by measurement of heart weight indices and histological analysis of collagen deposition (picrosirius red). Fructose-fed mice exhibited hyperglycemia and glucose intolerance, but plasma insulin and blood pressure were unchanged. High fructose intake suppressed the myocardial Akt cell survival signaling coincident with increased cardiac superoxide generation (21% increase, pFructose feeding induced elevated autophagy (LC3B-II: LC3B-I ratio: 46% increase, pfructose-fed mice. We provide the first evidence that myocardial autophagy activation is associated with systemic insulin resistance, and that high level fructose intake inflicts direct cardiac damage. Upregulated autophagy is associated with elevated cardiac superoxide production, suppressed cell survival signaling and fibrotic infiltration in fructose-fed mice. The novel finding that autophagy contributes to cardiac pathology in insulin resistance identifies a new therapeutic target for diabetic cardiomyopathy.

  1. Protein kinase G1 α overexpression increases stem cell survival and cardiac function after myocardial infarction.

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    Linlin Wang

    Full Text Available BACKGROUND: We hypothesized that overexpression of cGMP-dependent protein kinase type 1α (PKG1α could mimic the effect of tadalafil on the survival of bone marrow derived mesenchymal stem cells (MSCs contributing to regeneration of the ischemic heart. METHODS AND RESULTS: MSCs from male rats were transduced with adenoviral vector encoding for PKG1α ((PKG1αMSCs.Controls included native MSCs ((NatMSCs and MSCs transduced with an empty vector ((NullMSCs. PKG1α activity was increased approximately 20, 5 and 16 fold respectively in (PKG1αMSCs. (PKG1αMSCs showed improved survival under oxygen and glucose deprivation (OGD which was evidenced by lower LDH release, caspase-3/7 activity and number of positive TUNEL cells. Anti-apoptotic proteins pAkt, pGSK3β, and Bcl-2 were significantly increased in (PKG1αMSCs compared to (NatMSCs and (NullMSCs. Higher release of multiple prosurvival and angiogenic factors such as HGF, bFGF, SDF-1 and Ang-1 was observed in (PKG1αMSCs before and after OGD. In a female rat model of acute myocardial infarction, (PKG1αMSCs group showed higher survival compared with (NullMSCs group at 3 and 7 days after transplantation as determined by TUNEL staining and sry-gene quantitation by real-time PCR. Increased anti-apoptotic proteins and paracrine factors in vitro were also identified. Immunostaining for cardiac troponin I combined with GFP showed increased myogenic differentiation of (PKG1αMSCs. At 4 weeks after transplantation, compared to DMEM group and (NullMSCs group, (PKG1αMSCs group showed increased blood vessel density in infarct and peri-infarct areas (62.5±7.7; 68.8±7.3 per microscopic view, p<0.05 and attenuated infarct size (27.2±2.5%, p<0.01. Heart function indices including ejection fraction (52.1±2.2%, p<0.01 and fractional shortening (24.8%±1.3%, p<0.01 were improved significantly in (PKG1αMSCs group. CONCLUSION: Overexpression of PKG1α transgene could be a powerful approach to improve MSCs

  2. Impact of diabetes mellitus on long term survival after acute myocardial infarction in patients with single vessel disease

    OpenAIRE

    Ishihara, M; SATO, H; Kawagoe, T; Shimatani, Y; Kurisu, S; Nishioka, K.; Kouno, Y; Umemura, T.; Nakamura, S.

    2001-01-01

    OBJECTIVE—To assess the influence of diabetes on long term prognosis after reperfusion treatment and its interaction with multivessel disease.
DESIGN—A retrospective observational study.
SETTING—Hiroshima City Hospital.
PATIENTS—1660 consecutive patients with acute myocardial infarction who underwent coronary angiography within 24 hours after the onset of chest pain.
MAIN OUTCOME MEASURES—Influence of diabetes on 10 year survival after infarction was assessed using the generalised Wilcoxon te...

  3. Evaluation of Survival Rate and Effective Factors in Acute Myocardial Infarction Patients in Emam Hospital (Year 2000

    Directory of Open Access Journals (Sweden)

    M Maghsoodloo

    2002-09-01

    Full Text Available Introduction: For the time being we have considered that the myocardial infarction is an increasing event in Islamic Republic of Iran and there are many procedures and methods which can help us to diminish the number of death from this ongoing event. The main aim of this research is to determine the survival rate in those patients who have had acute myocardial infarction and the association of it with different variables. Methods and Materials: The present research is a descriptive case-series study which evaluates the 100 cases of acute myocardial infarction who had been admitted in Tehran Emam Khomeini Hospital during the year 1999. Results: The mean age of patients was 57 years. The peak of attack rates was in spring and autumn. Investigating of the past history of these patients reviled that 41 percent had been smokers, 63.5 percent have had the history of previous ischemic heart disease, 41 percent have had hyper cholestrolemia, 34 percent had hypertension, 18 percent had diabetes mellitus, 9 percent had mitral rigurgitation and 9 percent had heart block. The Survival rate in our study has been calculated 68 percent in first 28 days of disease. Conclusion: In our study we concluded that there is significant correlation between survival rate and past history of hypertension, ischemic heart disease, tobacco smoking and clip classification.

  4. The Effect of Xin Mai Tong Capsules in Protecting Survival Cardiac Muscles of the Patients with Acute Myocardial Infarction

    Institute of Scientific and Technical Information of China (English)

    Qiu Ruixiang; Feng Jun; Meng Jun

    2005-01-01

    To study the effect of Composite Xin Mai Tong capsules (复方心脉通胶囊 CXMT) in protecting survival cardiac muscles in patients with acute myocardial infarction (AMI) after percutaneous transluminal coronary angioplasty (PTCA) operation. The treatment with Composite XMT capsules started 3 days prior to the operation and continued for a period of 4 weeks; and its effect on the number of segments of nuclide resting ventricular myocardial imaging, the nuclide defect extension score (ES) and nuclide defect severity score (SS),and the level of vascular endothelial growth factor (VEGF) of circulatory blood were determined and compared with that of the control group. More segments originally scored 1 turning to be scored 2 in nuclide imaging were seen in the treatment group than in the control group; and smaller ES and less SS seen in the former than in the latter group (P<0.05). Composite XMT capsules play an active role in myocardial salvage by promoting its metabolism and expression of circulatory VEGF. Its angiogenesis-like action helps establish collateral flow and has a positive role in myocardial salvage.

  5. Improving long-term survival of patients with acute myocardial infarction from 1977-1988 in a region of Denmark

    DEFF Research Database (Denmark)

    Torp-Pedersen, C; Hildebrandt, P; Køber, L;

    1995-01-01

    The aim of this investigation was to study secular trends in long-term survival following myocardial infarction (MI). Five thousand one hundred and fifty-seven consecutive cases of MI in 3942 patients were recorded in a well-defined region in the study period 1977-1988. The study period ended...... significant (P infarction was an independent predictor of survival. Patients were subdivided into a high risk group suffering from either congestive heart failure or cardiac arrest during hospitalization, and a low risk group without these complications....... Year of infarction was without importance in the high risk group but highly significant in the low risk group. Long-term survival following MI gradually improved prior to the introduction of thrombolytic therapy. The improvement was confined to low risk patients without cardiac arrest or congestive...

  6. THE ANGIOTENSIN CONVERTING-ENZYME-INHIBITOR PERINDOPRIL IMPROVES SURVIVAL AFTER EXPERIMENTAL MYOCARDIAL-INFARCTION IN PIGS

    NARCIS (Netherlands)

    TOBE, TJM; DELANGEN, CDJ; WEERSINK, EGL; VANWIJNGAARDEN, J; BEL, KJ; DEGRAEFF, PA; VANGILST, WH; WESSELING, H

    1992-01-01

    In this randomized, blinded study the effect of the angiotensin converting enzyme inhibitor perindopril on electrical stability after myocardial infarction in pigs was compared to placebo. The left anterior descending artery was occluded for 45 min. Perindoprilat (0.06 mg/kg, n = 12) or saline (n =

  7. The affordances of broken affordances

    DEFF Research Database (Denmark)

    Grünbaum, Martin Gielsgaard; Simonsen, Jakob Grue

    2015-01-01

    important: how users may (i) achieve their goals in the presence of such broken affordances, and may (ii) repurpose or otherwise interact with artefacts with broken affordances. We argue that (A) thorough analyses of breakdowns of affordances and their associated signifiers and feedbacks have implication...

  8. The association between socioeconomic position, use of revascularization procedures and five-year survival after recovery from acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Lindström Martin

    2008-02-01

    Full Text Available Abstract Background Patients living under better socioeconomic circumstances often receive more active treatments after an acute myocardial infarction (AMI compared to less affluent patients. However, most previous studies were performed in countries with less comprehensive coverage for medical services. In this Swedish nation-wide longitudinal study we wanted to evaluate long-term survival after AMI in relation to socioeconomic position (SEP and use of revascularization. Methods From the Swedish Myocardial Infarction Register we identified all 45 to 84-year-old patients (16,041 women and 30,366 men alive 28 days after their first AMI during the period 1993 to 1996. We obtained detailed information on the use of revascularization, cumulative household income from the 1975 and 1990 censuses and 5-year survival after the AMI. Results Patients with the highest cumulative income (adding the values of the quartile categories of income in 1975 and 1990 underwent a revascularization procedure within one month after their first AMI two to three times as often as patients with the lowest cumulative income and had half the risk of death within five years. The socioeconomic differences in the use of revascularization procedures could not be explained by differences in co-morbidity or type of hospital at first admission. Patients who underwent revascularization showed a similar lowered mortality risk in the different income groups, while there were strong socioeconomic differences in long-term mortality among patients who did not undergo revascularization. Conclusion This nationwide Swedish study showed that patients with high income had a better long-term survival after recovery from their AMI compared to patients with low income. Furthermore, even though the use of revascularization procedures is beneficial, low SEP groups receive it less often than high SEP groups.

  9. Network Affordances

    DEFF Research Database (Denmark)

    Samson, Audrey; Soon, Winnie

    2015-01-01

    and computational parameters of unpredictability. We illustrate the notion of unpredictability by considering four specific works that were included in a network art exhibiton, SPEED SHOW [2.0] Hong Kong. The paper discusses how the artworks are contingent upon the parameteric relations (Parisi, 2013......), of the network. We introduce network affordance as a dynamic framework that could articulate the experienced tension arising from the (visible) symbolic representation of computational processes and its hidden occurrences. We base our proposal on the experience of both organising the SPEED SHOW and participating......This paper examines the notion of network affordance within the context of network art. Building on Gibson's theory (Gibson, 1979) we understand affordance as the perceived and actual parameters of a thing. We expand on Gaver's affordance of predictability (Gaver, 1996) to include ecological...

  10. Are the myocardial infarction risk factors the same in survived and dead patients

    International Nuclear Information System (INIS)

    Coronary heart disease is one of the most common diseases causing mortality and morbidity in industrialized and developing countries. The first presentation in 25% of cases is sudden cardiac death. The most common risk factors in dead people are hypercholesterolemia. This study was carried out to compare the prevalence of risk factors in patients hospitalized in CCU's and cardiology departments (case group) and people who died because of sudden death myocardial infarction before arriving at hospitals (control group). This study was a case-control one, carried out on 154 patients and 112 dead persons. The questionnaires were completed after referring to their first relatives and the documents, in control group and in case group, were completed from patients and their records in hospitals. Then history of risk factor were compared. The ratio of men/women in the first group (hospitalized patients) was 3 and the second group (dead patients) were 1.7 (P=0.000). The peak ages in men of both groups were 60 to 69 years old, 2-3 times more than women in both groups. The most prevalent risk factor in women of both groups was hypertension, the same as in men of the control group. But the most prevalent risk factor in men of the case group was smoking (P=0.000). So, primary prevention which has a great role in controlling coronary artery disease is suggested

  11. Protein Kinase G1 α Overexpression Increases Stem Cell Survival and Cardiac Function after Myocardial Infarction

    OpenAIRE

    Linlin Wang; Zeeshan Pasha; Shuyun Wang; Ning Li; Yuliang Feng; Gang Lu; Millard, Ronald W.; Muhammad Ashraf

    2013-01-01

    BACKGROUND: We hypothesized that overexpression of cGMP-dependent protein kinase type 1α (PKG1α) could mimic the effect of tadalafil on the survival of bone marrow derived mesenchymal stem cells (MSCs) contributing to regeneration of the ischemic heart. METHODS AND RESULTS: MSCs from male rats were transduced with adenoviral vector encoding for PKG1α ((PKG1α)MSCs).Controls included native MSCs ((Nat)MSCs) and MSCs transduced with an empty vector ((Null)MSCs). PKG1α activity was increased appr...

  12. Survival curves to support quality improvement in hospitals with excess 30-day mortality after acute myocardial infarction, cerebral stroke and hip fracture: a before–after study

    OpenAIRE

    Kristoffersen, Doris Tove; Helgeland, Jon; Waage, Halfrid Persdatter; Thalamus, Jacob; Clemens, Dirk; Lindman, Anja Schou; Rygh, Liv Helen; Tjomsland, Ole

    2015-01-01

    Objectives To evaluate survival curves (Kaplan-Meier) as a means of identifying areas in the clinical pathway amenable to quality improvement. Design Observational before–after study. Setting In Norway, annual public reporting of nationwide 30-day in-and-out-of-hospital mortality (30D) for three medical conditions started in 2011: first time acute myocardial infarction (AMI), stroke and hip fracture; reported for 2009. 12 of 61 hospitals had statistically significant lower/higher mortality co...

  13. Enhanced cell survival and paracrine effects of mesenchymal stem cells overexpressing hepatocyte growth factor promote cardioprotection in myocardial infarction.

    Science.gov (United States)

    Zhao, Liyan; Liu, Xiaolin; Zhang, Yuelin; Liang, Xiaoting; Ding, Yue; Xu, Yan; Fang, Zhen; Zhang, Fengxiang

    2016-05-15

    Poor cell survival post transplantation compromises the therapeutic benefits of mesenchymal stem cells (MSCs) in myocardial infarction (MI). Hepatocyte growth factor (HGF) is an important cytokine for angiogenesis, anti-inflammation and anti-apoptosis. This study aimed to evaluate the cardioprotective effects of MSCs overexpressing HGF in a mouse model of MI. The apoptosis of umbilical cord-derived MSCs (UC-MSCs) and HGF-UC-MSCs under normoxic and hypoxic conditions was detected. The conditioned medium (CdM) of UC-MSCs and HGF-UC-MSCs under a hypoxic condition was harvested and its protective effect on neonatal cardiomyocytes (NCMs) exposed to a hypoxic challenge was examined. UC-MSCs and HGF-UC-MSCs were transplanted into the peri-infarct region in mice following MI and heart function assessed 4 weeks post transplantation. The apoptosis of HGF-UC-MSCs under hypoxic conditions was markedly decreased compared with that of UC-MSCs. NCMs treated with HGF-UC-MSC hypoxic CdM (HGF-UC-MSCs-hy-CdM) exhibited less cell apoptosis in response to hypoxic challenge than those treated with UC-MSC hypoxic CdM (UC-MSCs-hy-CdM). HGF-UC-MSCs-hy-CdM released the inhibited p-Akt and lowered the enhanced ratio of Bax/Bcl-2 induced by hypoxia in the NCMs. HGF-UC-MSCs-hy-CdM expressed higher levels of HGF, EGF, bFGF and VEGF than UC-MSCs-hy-CdM. Transplantation of HGF-UC-MSCs or UC-MSCs greatly improved heart function in the mouse model of MI. Compared with UC-MSCs, transplantation of HGF-UC-MSCs was associated with less cardiomyocyte apoptosis, enhanced angiogenesis and increased proliferation of cardiomyocytes. This study may provide a novel therapeutic strategy for MSC-based therapy in cardiovascular disease. PMID:27025401

  14. Efficient long-term survival of cell grafts after myocardial infarction with thick viable cardiac tissue entirely from pluripotent stem cells.

    Science.gov (United States)

    Matsuo, Takehiko; Masumoto, Hidetoshi; Tajima, Shuhei; Ikuno, Takeshi; Katayama, Shiori; Minakata, Kenji; Ikeda, Tadashi; Yamamizu, Kohei; Tabata, Yasuhiko; Sakata, Ryuzo; Yamashita, Jun K

    2015-11-20

    Poor engraftment of cells after transplantation to the heart is a common and unresolved problem in the cardiac cell therapies. We previously generated cardiovascular cell sheets entirely from pluripotent stem cells with cardiomyocytes, endothelial cells and vascular mural cells. Though sheet transplantation showed a better engraftment and improved cardiac function after myocardial infarction, stacking limitation (up to 3 sheets) by hypoxia hampered larger structure formation and long-term survival of the grafts. Here we report an efficient method to overcome the stacking limitation. Insertion of gelatin hydrogel microspheres (GHMs) between each cardiovascular cell sheet broke the viable limitation via appropriate spacing and fluid impregnation with GHMs. Fifteen sheets with GHMs (15-GHM construct; >1 mm thickness) were stacked within several hours and viable after 1 week in vitro. Transplantation of 5-GHM constructs (≈2 × 10(6) of total cells) to a rat myocardial infarction model showed rapid and sustained functional improvements. The grafts were efficiently engrafted as multiple layered cardiovascular cells accompanied by functional capillary networks. Large engrafted cardiac tissues (0.8 mm thickness with 40 cell layers) successfully survived 3 months after TX. We developed an efficient method to generate thicker viable tissue structures and achieve long-term survival of the cell graft to the heart.

  15. Eplerenone survival benefits in heart failure patients post-myocardial infarction are independent from its diuretic and potassium-sparing effects. Insights from an EPHESUS (Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study) substudy

    DEFF Research Database (Denmark)

    Rossignol, Patrick; Ménard, Joël; Fay, Renaud;

    2011-01-01

    The purpose of this study was to determine whether a diuretic effect may be detectable in patients treated with eplerenone, a mineralocorticoid receptor antagonist, as compared with placebo during the first month of EPHESUS (Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy...

  16. Effects of Long-term Ramipril on Ventricular Remodeling, Cardiac Function and Survival in Rat Congestive Heart Failure after Myocardial Infarction

    Institute of Scientific and Technical Information of China (English)

    陶则伟; 黄元伟

    2004-01-01

    Objectives The purpose of this study was to investigate the effects of long-term ramipril on ventricular remodeling, cardiac function and survival in rat congestive heart failure after myocardial infarction. Methods Myocardial infarction (MI) was caused by ligation of the left anterior descending coronary artery in rats. 7 days after the surgery, the surviving rats were randomly assigned to the following treatment protocols: 1) MI rats with no therapy, 2) MI rats treated with ramipril 3 mg/kg per day, 3) Sham-operated control rats, and 4) Sham-operated rats treated with ramipril 3 mg/kg per day. At 22 weeks, cardiac hemodynamic parameters such as MAP, LVSP, ±dP/dtmax and LVEDP were measured,and cardiac morphometric parameters such as HW,LVW and LVCA were measured, mRNA of cardiacmolecule genes, such as βMHC, BNP, collagen Ⅰ and Ⅲ, and TGF-β1, were quantified, and survival rates were calculated. Results Compared with sham-operated rats, MI rats without therapy showed significant increases in cardiac morphological parameters as well as in mRAN expressions of cardiac molecule genes (P<0.01); while their hemodynamic parameters were significantly impaired (P<0.01), and survival rate shortened (P<0.05). Compared with MI rats with no therapy, MI rats treated with ramipril showed significant attenuation of mRAN expressions of cardiac molecule genes (P<0.01); while their hemodynamic parameters were significantly impaired (P<0.01), and survival rate shortened (P<0.05). Compared with MI rats with no therapy, MI rats treated with ramipril showed significant attenuation of mRAN expressions of cardiac molecule genes (P<0.01); while their hemodynamic parameters were significantly improved (P<0.05 or P<0.01), and survival rates prolonged (P<0.05). Conclusions Treatment with long-term ramipril may improve LV remodeling, cardiac function and survival in rat congestive heart failure after MI.

  17. Longitudinal monitoring adipose-derived stem cell survival by PET imaging hexadecyl-4-124I-iodobenzoate in rat myocardial infarction model

    International Nuclear Information System (INIS)

    Highlights: • We developed a safe, simple and appropriate stem cell labeling method with 124I-HIB. • ADSC survival can be monitored with PET in MI model via direct labeling. • Tracking of ADSC labeled with 124I-HIB was possible for 3 days in MI model using PET. • ADSC viability and differentiation were not affected by 124I-HIB labeling. • Survival of ADSC in living bodies can be longitudinally tracked with PET imaging. - Abstract: This study aims to monitor how the change of cell survival of transplanted adipose-derived stem cells (ADSCs) responds to myocardial infarction (MI) via the hexadecyl-4-124I-iodobenzoate (124I-HIB) mediated direct labeling method in vivo. Stem cells have shown the potential to improve cardiac function after MI. However, monitoring of the fate of transplanted stem cells at target sites is still unclear. Rat ADSCs were labeled with 124I-HIB, and radiolabeled ADSCs were transplanted into the myocardium of normal and MI model. In the group of 124I-HIB-labeled ADSC transplantation, in vivo imaging was performed using small-animal positron emission tomography (PET)/computed tomography (CT) for 9 days. Twenty-one days post-transplantation, histopathological analysis and apoptosis assay were performed. ADSC viability and differentiation were not affected by 124I-HIB labeling. In vivo tracking of the 124I-HIB-labeled ADSCs was possible for 9 and 3 days in normal and MI model, respectively. Apoptosis of transplanted cells increased in the MI model compared than that in normal model. We developed a direct labeling agent, 124I-HIB, and first tried to longitudinally monitor transplanted stem cell to MI. This approach may provide new insights on the roles of stem cell monitoring in living bodies for stem cell therapy from pre-clinical studies to clinical trials

  18. Longitudinal monitoring adipose-derived stem cell survival by PET imaging hexadecyl-4-{sup 124}I-iodobenzoate in rat myocardial infarction model

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Min Hwan [Molecular Imaging Research Center, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); School of Life Sciences and Biotechnology, Korea University, Seoul (Korea, Republic of); Woo, Sang-Keun; Lee, Kyo Chul; An, Gwang Il [Molecular Imaging Research Center, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Pandya, Darpan [Department of Molecular Medicine, BK21 Plus KNU Biomedical Convergence Program, Kyungpook National University, Daegu (Korea, Republic of); Park, Noh Won; Nahm, Sang-Soep; Eom, Ki Dong [College of Veterinary Medicine, Konkuk University, Seoul (Korea, Republic of); Kim, Kwang Il; Lee, Tae Sup [Molecular Imaging Research Center, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Kim, Chan Wha [School of Life Sciences and Biotechnology, Korea University, Seoul (Korea, Republic of); Kang, Joo Hyun [Molecular Imaging Research Center, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Yoo, Jeongsoo, E-mail: yooj@knu.ac.kr [Department of Molecular Medicine, BK21 Plus KNU Biomedical Convergence Program, Kyungpook National University, Daegu (Korea, Republic of); Lee, Yong Jin, E-mail: yjlee@kirams.re.kr [Molecular Imaging Research Center, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of)

    2015-01-02

    Highlights: • We developed a safe, simple and appropriate stem cell labeling method with {sup 124}I-HIB. • ADSC survival can be monitored with PET in MI model via direct labeling. • Tracking of ADSC labeled with {sup 124}I-HIB was possible for 3 days in MI model using PET. • ADSC viability and differentiation were not affected by {sup 124}I-HIB labeling. • Survival of ADSC in living bodies can be longitudinally tracked with PET imaging. - Abstract: This study aims to monitor how the change of cell survival of transplanted adipose-derived stem cells (ADSCs) responds to myocardial infarction (MI) via the hexadecyl-4-{sup 124}I-iodobenzoate ({sup 124}I-HIB) mediated direct labeling method in vivo. Stem cells have shown the potential to improve cardiac function after MI. However, monitoring of the fate of transplanted stem cells at target sites is still unclear. Rat ADSCs were labeled with {sup 124}I-HIB, and radiolabeled ADSCs were transplanted into the myocardium of normal and MI model. In the group of {sup 124}I-HIB-labeled ADSC transplantation, in vivo imaging was performed using small-animal positron emission tomography (PET)/computed tomography (CT) for 9 days. Twenty-one days post-transplantation, histopathological analysis and apoptosis assay were performed. ADSC viability and differentiation were not affected by {sup 124}I-HIB labeling. In vivo tracking of the {sup 124}I-HIB-labeled ADSCs was possible for 9 and 3 days in normal and MI model, respectively. Apoptosis of transplanted cells increased in the MI model compared than that in normal model. We developed a direct labeling agent, {sup 124}I-HIB, and first tried to longitudinally monitor transplanted stem cell to MI. This approach may provide new insights on the roles of stem cell monitoring in living bodies for stem cell therapy from pre-clinical studies to clinical trials.

  19. Survival and cardioprotective benefits of long-term blueberry enriched diet in dilated cardiomyopathy following myocardial infarction in rats.

    Directory of Open Access Journals (Sweden)

    Ismayil Ahmet

    Full Text Available BACKGROUND: Despite remarkable progress in treatment of chronic heart failure (CHF over the last two decades, mortality, personal suffering and cost remain staggering, and effective interventions are still a challenge. Previously we reported that a blueberry-enriched diet (BD attenuated necroapoptosis and inflammation in periinfarct area in a rat model of myocardial infarction (MI. OBJECTIVES: To test the hypothesis that BD will attenuate the course of CHF, including mortality and cardiac remodeling during the first year after induction of MI in rats. METHOD AND RESULTS: Two weeks after coronary artery ligation, rats were divided into two groups of similar average MI size, measured by echocardiography, and then 12-mo dietary regimens were initiated as follows: ad libitum regular diet (control, CD, n = 27 and isocaloric food with 2% blueberry supplement (BD, n = 27 also available ad libitum. These dietary groups were compared to each other and to sham group (SH. Mortality over the 12 mo was reduced by 22% in BD compared with CD (p<0.01. In the course of developing CHF, BD had no effect on the body weight, heart rate or blood pressure. Bi-monthly Echo revealed significant attenuation of the LV chamber remodeling, LV posterior wall thinning, and MI expansion in BD compared with CD. In fact, BD arrested the MI expansion. CONCLUSION: This is the first experimental evidence that a blueberry-enriched diet has positive effects on the course of CHF and thus warrants consideration for clinical evaluation.

  20. Revascularization and cardioprotective drug treatment in myocardial infarction patients: how do they impact on patients' survival when delivered as usual care

    Directory of Open Access Journals (Sweden)

    Courteau Josiane

    2006-05-01

    Full Text Available Abstract Background Randomized clinical trials showed the benefit of pharmacological and revascularization treatments in secondary prevention of myocardial infarction (MI, in selected population with highly controlled interventions. The objective of this study is to measure these treatments' impact on the cardiovascular (CV mortality rate among patients receiving usual care in the province of Quebec. Methods The study population consisted of a "naturalistic" cohort of all patients ≥ 65 years old living in the Quebec province, who survived a MI (ICD-9: 410 in 1998. The studied dependant variable was time to death from a CV disease. Independent variables were revascularization procedure and cardioprotective drugs. Death from a non CV disease was also studied for comparison. Revascularization procedure was defined as percutaneous transluminal coronary angioplasty (PTCA or coronary artery bypass graft (CABG. The exposure to cardioprotective drugs was defined as the number of cardioprotective drug classes (Acetylsalicylic Acid (ASA, Beta-Blockers, Angiotensin-Converting Enzyme (ACE Inhibitors, Statins claimed within the index period (first 30 days after the index hospitalization. Age, gender and a comorbidity index were used as covariates. Kaplan-Meier survival curves, Cox proportional hazard models, logistic regressions and regression trees were used. Results The study population totaled 5596 patients (3206 men; 2390 women. We observed 1128 deaths (20% within two years following index hospitalization, of them 603 from CV disease. The CV survival rate at two years is much greater for patients with revascularization, regardless of pharmacological treatments. For patients without revascularization, the CV survival rate increases with the number of cardioprotective drug classes claimed. Finally, Cox proportional hazard models, regression tree and logistic regression analyses all revealed that the absence of revascularization and, to a lower extent

  1. Affordable Care Act (ACA)

    Data.gov (United States)

    Social Security Administration — The Affordable Care Act (ACA) is a federal statute enacted with a goal of increasing the quality and affordability of health insurance. Through a web service, CMS...

  2. Living arrangements as determinants of myocardial infarction incidence and survival: A prospective register study of over 300,000 Finnish men and women.

    Science.gov (United States)

    Kilpi, Fanny; Konttinen, Hanna; Silventoinen, Karri; Martikainen, Pekka

    2015-05-01

    Living with a spouse is associated with a reduced risk of coronary heart disease mortality in middle age, but it remains unclear whether marriage and other living arrangements are important both for the development of the disease and the survival following incidence. Cohabitation and living alone have also become more common in many Western societies and thus warrant further study. We explored the association between living arrangements and myocardial infarction (MI) incidence and fatality. We used a population-based register sample of adults aged 40-60 in Finland in 1995 (n = 302,885) followed up until the end of 2007. MI incidence and mortality were identified from hospital discharge records and cause of death register (5917 incident cases in men and 1632 in women). Living with a marital partner was contrasted to three alternatives: cohabiting with non-marital partner, co-residence with persons other than a partner and living alone. MI incidence and long-term fatality were analysed with Cox proportional hazards regression with time-varying covariates and first-day fatality with logistic regression. Men who were married had a lower risk of MI incidence even after adjusting for socioeconomic factors - i.e. education, occupation, income, wealth and employment status - with small differences between the other living arrangement groups. For women the effects of living arrangements on incidence were fully explained by the same socioeconomic factors. However, our findings revealed that living arrangements were strong determinants for survival after MI independent of other socio-demographic factors. The results demonstrate greater fatality associated with living alone in men and suggest that cohabitation in midlife may be associated with a greater fatality risk in women. The social support and control offered by a marital relationship may protect from MI fatality in particular. PMID:25863724

  3. Influence of age on the prognostic importance of left ventricular dysfunction and congestive heart failure on long-term survival after acute myocardial infarction. TRACE Study Group

    DEFF Research Database (Denmark)

    Køber, L; Torp-Pedersen, C; Ottesen, M;

    1996-01-01

    The aim of this study was to assess the importance of congestive heart failure and left ventricular (LV) systolic dysfunction after an acute myocardial infarction (AIM) on long-term mortality in different age groups. A total of 7,001 consecutive enzyme-confirmed AMIs (6,676 patients) were screened...... for entry into the TRAndolapril Cardiac Evaluation (TRACE) study. Medical history, echocardiographic estimation of LV systolic function determined as wall motion index, infarct complications, and survival were documented for all patients. To study the importance of congestive heart failure and wall motion......%, and 55%, respectively. The risk ratios (and 95% confidence limits) associated with congestive heart failure in the same 4 age strata were 1.9 (1.3 to 2.9), 2.8 (2.1 to 3.7), 1.8 (1.5 to 2.2) and 1.8 (1.5 to 2.2), respectively. The risk ratios associated with decreasing wall motion index were 6.5 (3...

  4. Canonical affordances in context

    Directory of Open Access Journals (Sweden)

    Alan Costall

    2012-12-01

    Full Text Available James Gibson’s concept of affordances was an attempt to undermine the traditional dualism of the objective and subjective. Gibson himself insisted on the continuity of “affordances in general” and those attached to human artifacts. However, a crucial distinction needs to be drawn between “affordances in general” and the “canonical affordances” that are connected primarily to artifacts. Canonical affordances are conventional and normative. It is only in such cases that it makes sense to talk of the affordance of the object. Chairs, for example, are for sitting-on, even though we may also use them in many other ways. A good deal of confusion has arisen in the discussion of affordances from (1 the failure to recognize the normative status of canonical affordances and (2 then generalizing from this special case.

  5. Outcome of the HORIZONS-AMI trial: bivalirudin enhances long-term survival in patients with ST-elevation myocardial infarction undergoing angioplasty

    Directory of Open Access Journals (Sweden)

    Feldman DN

    2012-02-01

    Full Text Available Ashish Shah, Dmitriy N FeldmanGreenberg Division of Cardiology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, NY, USAAbstract: Cardiovascular disease is the leading cause of death in the US. For patients with ST-elevation myocardial infarction (STEMI, urgent reperfusion of the culprit arterial occlusion, often achieved via primary percutaneous coronary intervention (PCI, reduces post-MI mortality and other major adverse cardiovascular events (MACE. Adjunctive antithrombotic and antiplatelet therapies are used during PCI to reduce MACE rates. Currently, a variety of antithrombotic options are available for peri-procedural use. The most commonly used agents include unfractionated heparin or low molecular weight heparin ± glycoprotein IIb/IIIa inhibitors (GPI. These agents reduce the rates of peri-procedural ischemic and thrombotic events, though these benefits come at the cost of an increase in bleeding complications. Bivalirudin is a direct thrombin inhibitor with a short half-life and linear pharmacokinetics, which results in predictable serum concentrations and anticoagulant effect. Bivalirudin has emerged as an efficacious and safe alternative to heparin plus GP IIb/IIIa inhibitors in both stable coronary artery disease and acute coronary syndrome patients. In the HORIZONS-AMI trial, monotherapy with bivalirudin was compared with the combination of heparin and a GPI in a large population of patients with STEMI who underwent primary PCI. Bivalirudin treatment was associated with improved event-free survival at 30 days and reduced rates of major bleeding. Based on the results of the trial, the American College of Cardiology/American Heart Association and European Society of Cardiology guidelines have incorporated recommendations for bivalirudin use in the setting of STEMI. Recently, 3-year follow-up data from the HORIZONS-AMI cohort were published, demonstrating sustained benefits in patients treated with bivalirudin

  6. Application of Random Forest Survival Models to Increase Generalizability of Decision Trees: A Case Study in Acute Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Iman Yosefian

    2015-01-01

    Full Text Available Background. Tree models provide easily interpretable prognostic tool, but instable results. Two approaches to enhance the generalizability of the results are pruning and random survival forest (RSF. The aim of this study is to assess the generalizability of saturated tree (ST, pruned tree (PT, and RSF. Methods. Data of 607 patients was randomly divided into training and test set applying 10-fold cross-validation. Using training sets, all three models were applied. Using Log-Rank test, ST was constructed by searching for optimal cutoffs. PT was selected plotting error rate versus minimum sample size in terminal nodes. In construction of RSF, 1000 bootstrap samples were drawn from the training set. C-index and integrated Brier score (IBS statistic were used to compare models. Results. ST provides the most overoptimized statistics. Mean difference between C-index in training and test set was 0.237. Corresponding figure in PT and RSF was 0.054 and 0.007. In terms of IBS, the difference was 0.136 in ST, 0.021 in PT, and 0.0003 in RSF. Conclusion. Pruning of tree and assessment of its performance of a test set partially improve the generalizability of decision trees. RSF provides results that are highly generalizable.

  7. Restoration of glucose metabolism in leptin-resistant mouse hearts after acute myocardial infarction through the activation of survival kinase pathways.

    Science.gov (United States)

    Witham, William; Yester, Keith; O'Donnell, Christopher P; McGaffin, Kenneth R

    2012-07-01

    In the normal heart, leptin modulates cardiac metabolism. It is unknown, however, what effect leptin has on cardiac metabolism and outcomes in acute myocardial infarction (MI). This study was performed to test the hypothesis that leptin signaling increases glucose metabolism and attenuates injury in the acutely infarcted heart. Mice with (ObR(+/+)) and without (ObR(-/-)) cardiomyocyte specific expression of leptin receptor (ObR) were randomly assigned to experimental MI or sham procedure, and studied 3 days later. ObR(+/+) and ObR(-/-) sham mice were not significantly different in any measured outcome. However, after MI, ObR(-/-) mice had greater cardiac dysfunction, left ventricular dilation, and levels of oxidative stress. These worse indices of cardiac injury in ObR(-/-) mice were associated with attenuated signal transducer and activator of transcription (STAT) 3, phosphatidylinositol-3-kinase (PI3K), and Akt signaling, decreased malonyl CoA content, and reduced mitochondrial pyruvate dehydrogenase and electron transport Complex I, II and IV activities. Furthermore, ObR(-/-) mice maintained high rates of cardiac fatty acid oxidation after MI, whereas ObR(+/+) mice demonstrated a switch away from fatty acid oxidation to glucose metabolism. Restoration of cardiac STAT3, PI3K and Akt activity and mitochondrial function in ObR(-/-) mice post-MI was accomplished by ciliary neurotrophic factor (CNTF), an established STAT3 activator, administered immediately after MI. Moreover, CNTF therapy resulted in mitigation of cardiac structural and functional injury, attenuated levels of oxidative stress, and rescued glucose metabolism in the infarcted ObR(-/-) heart. These data demonstrate that impaired cardiac leptin signaling results in metabolic inflexibility for glucose utilization in the face of cardiac stress, and greater morbidity after MI. Further, these studies show that cardiac glucose metabolism can be restored in leptin-resistant hearts by CNTF-mediated activation

  8. Assuring Access to Affordable Coverage

    Data.gov (United States)

    U.S. Department of Health & Human Services — Under the Affordable Care Act, millions of uninsured Americans will gain access to affordable coverage through Affordable Insurance Exchanges and improvements in...

  9. Secondary prevention with calcium antagonists after acute myocardial infarction

    DEFF Research Database (Denmark)

    Hansen, J F

    1992-01-01

    Experimental studies have demonstrated that the 3 calcium antagonists nifedipine, diltiazem, and verapamil have a comparable effect in the prevention of myocardial damage during ischaemia. Secondary prevention trials after acute myocardial infarction, which aimed at improving survival...

  10. Myocardial Bridging

    Directory of Open Access Journals (Sweden)

    Shi-Min Yuan

    2016-02-01

    Full Text Available Abstract Myocardial bridging is rare. Myocardial bridges are most commonly localized in the middle segment of the left anterior descending coronary artery. The anatomic features of the bridges vary significantly. Alterations of the endothelial morphology and the vasoactive agents impact on the progression of atherosclerosis of myocardial bridging. Patients may present with chest pain, myocardial infarction, arrhythmia and even sudden death. Patients who respond poorly to the medical treatment with β-blockers warrant a surgical intervention. Myotomy is a preferred surgical procedure for the symptomatic patients. Coronary stent deployment has been in limited use due to the unsatisfactory long-term results.

  11. Myocardial Bridge

    Science.gov (United States)

    ... Myocarditis Obstructive Sleep Apnea Pericarditis Peripheral Vascular Disease Rheumatic ... Related terms: myocardium, coronary arteries, myocardial ischemia Your heart is made of muscle, called the myocardium. The ...

  12. Learning Grasp Affordance Densities

    DEFF Research Database (Denmark)

    Detry, Renaud; Kraft, Dirk; Kroemer, Oliver;

    2011-01-01

    We address the issue of learning and representing object grasp affordance models. We model grasp affordances with continuous probability density functions (grasp densities) which link object-relative grasp poses to their success probability. The underlying function representation is nonparametric...... these and records their outcomes. When a satisfactory number of grasp data is available, an importance-sampling algorithm turns these into a grasp density. We evaluate our method in a largely autonomous learning experiment run on three objects of distinct shapes. The experiment shows how learning increases success...... and relies on kernel density estimation to provide a continuous model. Grasp densities are learned and refined from exploration, by letting a robot “play” with an object in a sequence of graspand-drop actions: The robot uses visual cues to generate a set of grasp hypotheses; it then executes...

  13. Thrombolysis significantly reduces transient myocardial ischaemia following first acute myocardial infarction

    DEFF Research Database (Denmark)

    Mickley, H; Pless, P; Nielsen, J R;

    1992-01-01

    In order to investigate whether thrombolysis affects residual myocardial ischaemia, we prospectively performed a predischarge maximal exercise test and early out-of-hospital ambulatory ST segment monitoring in 123 consecutive men surviving a first acute myocardial infarction (AMI). Seventy...... less than 0.02). Thrombolysis resulted in a non-significant reduction in exercise-induced ST segment depression: prevalence 43% vs 62% in controls. However, during ambulatory monitoring the duration of transient myocardial ischaemia was significantly reduced in thrombolysed patients: 322 min vs 1144...... myocardial ischaemia. This may explain the improvement in myocardial function during physical activities, which was also observed in this study....

  14. Intracoronary artery transplantation of cardiomyoblast-like cells from human adipose tissue-derived multi-lineage progenitor cells improve left ventricular dysfunction and survival in a swine model of chronic myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Okura, Hanayuki [The Center for Medical Engineering and Informatics, Osaka University, 2-2 Yamada-oka, Suita, Osaka 565-0879 (Japan); Department of Somatic Stem Cell Therapy and Health Policy, Institute of Biomedical Research and Innovation, Foundation for Biomedical Research and Innovation, 2-2 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo 650-0047 (Japan); Saga, Ayami; Soeda, Mayumi [Department of Somatic Stem Cell Therapy and Health Policy, Institute of Biomedical Research and Innovation, Foundation for Biomedical Research and Innovation, 2-2 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo 650-0047 (Japan); Miyagawa, Shigeru; Sawa, Yoshiki [Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0879 (Japan); Daimon, Takashi [Division of Biostatistics, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501 (Japan); Ichinose, Akihiro [Department of Plastic Surgery, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo (Japan); Matsuyama, Akifumi, E-mail: akifumi-matsuyama@umin.ac.jp [The Center for Medical Engineering and Informatics, Osaka University, 2-2 Yamada-oka, Suita, Osaka 565-0879 (Japan); Department of Plastic Surgery, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo (Japan); RIKEN Program for Drug Discovery and Medical Technology Platforms, 1-7-22 Suehiro-cho, Tsurumi-ku, Yokohama, Kanagawa 230-0045 (Japan)

    2012-09-07

    Highlights: Black-Right-Pointing-Pointer We administered human CLCs in a swine model of MI via intracoronary artery. Black-Right-Pointing-Pointer Histological studies demonstrated engraftment of hCLCs into the scarred myocardium. Black-Right-Pointing-Pointer Echocardiography showed rescue of cardiac function in the hCLCs transplanted swine. Black-Right-Pointing-Pointer Transplantation of hCLCs is an effective therapeutics for cardiac regeneration. -- Abstract: Transplantation of human cardiomyoblast-like cells (hCLCs) from human adipose tissue-derived multi-lineage progenitor cells improved left ventricular function and survival of rats with myocardial infarction. Here we examined the effect of intracoronary artery transplantation of human CLCs in a swine model of chronic heart failure. Twenty-four pigs underwent balloon-occlusion of the first diagonal branch followed by reperfusion, with a second balloon-occlusion of the left ascending coronary artery 1 week later followed by reperfusion. Four weeks after the second occlusion/reperfusion, 17 of the 18 surviving animals with severe chronic MI (ejection fraction <35% by echocardiography) were immunosuppressed then randomly assigned to receive either intracoronary artery transplantation of hCLCs hADMPCs or placebo lactic Ringer's solution with heparin. Intracoronary artery transplantation was followed by the distribution of DiI-stained hCLCs into the scarred myocardial milieu. Echocardiography at post-transplant days 4 and 8 weeks showed rescue and maintenance of cardiac function in the hCLCs transplanted group, but not in the control animals, indicating myocardial functional recovery by hCLCs intracoronary transplantation. At 8 week post-transplantation, 7 of 8 hCLCs transplanted animals were still alive compared with only 1 of the 5 control (p = 0.0147). Histological studies at week 12 post-transplantation demonstrated engraftment of the pre DiI-stained hCLCs into the scarred myocardium and their expression of

  15. Intracoronary artery transplantation of cardiomyoblast-like cells from human adipose tissue-derived multi-lineage progenitor cells improve left ventricular dysfunction and survival in a swine model of chronic myocardial infarction

    International Nuclear Information System (INIS)

    Highlights: ► We administered human CLCs in a swine model of MI via intracoronary artery. ► Histological studies demonstrated engraftment of hCLCs into the scarred myocardium. ► Echocardiography showed rescue of cardiac function in the hCLCs transplanted swine. ► Transplantation of hCLCs is an effective therapeutics for cardiac regeneration. -- Abstract: Transplantation of human cardiomyoblast-like cells (hCLCs) from human adipose tissue-derived multi-lineage progenitor cells improved left ventricular function and survival of rats with myocardial infarction. Here we examined the effect of intracoronary artery transplantation of human CLCs in a swine model of chronic heart failure. Twenty-four pigs underwent balloon-occlusion of the first diagonal branch followed by reperfusion, with a second balloon-occlusion of the left ascending coronary artery 1 week later followed by reperfusion. Four weeks after the second occlusion/reperfusion, 17 of the 18 surviving animals with severe chronic MI (ejection fraction <35% by echocardiography) were immunosuppressed then randomly assigned to receive either intracoronary artery transplantation of hCLCs hADMPCs or placebo lactic Ringer’s solution with heparin. Intracoronary artery transplantation was followed by the distribution of DiI-stained hCLCs into the scarred myocardial milieu. Echocardiography at post-transplant days 4 and 8 weeks showed rescue and maintenance of cardiac function in the hCLCs transplanted group, but not in the control animals, indicating myocardial functional recovery by hCLCs intracoronary transplantation. At 8 week post-transplantation, 7 of 8 hCLCs transplanted animals were still alive compared with only 1 of the 5 control (p = 0.0147). Histological studies at week 12 post-transplantation demonstrated engraftment of the pre DiI-stained hCLCs into the scarred myocardium and their expression of human specific alpha-cardiac actin. Human alpha cardiac actin-positive cells also expressed cardiac

  16. Clinical characteristics, left and right ventricular ejection fraction, and long-term prognosis in patients with non-insulin-dependent diabetes surviving an acute myocardial infarction

    DEFF Research Database (Denmark)

    Melchior, T; Gadsbøll, N; Hildebrandt, P;

    1996-01-01

    (with diabetes: median 46% vs without diabetes: median 43%; p = 0.89). Median right ventricular ejection fraction (62%) was within normal limits in both groups and did not differ statistically. Survival data were obtained for all patients. The 5-year mortality was increased in patients with diabetes...

  17. The Concept of Disciplinary Affordance

    OpenAIRE

    Airey, John; Eriksson, Urban; Fredlund, Tobias; Linder, Cedric

    2014-01-01

    Since its introduction by Gibson (1979) the concept of affordance has been discussed at length by a number of researchers. Most famous, perhaps is the disagreement between Gibson and Norman (1988) about whether affordances are inherent properties of objects or are only present when perceived by an organism. More recently, affordance has been drawn on in the educational arena, particularly with respect to multimodality (see Linder (2013) for a recent example). Here, Kress et al (2001) claim th...

  18. Ethnic differences in mortality of male and female patients surviving acute myocardial infarction: long-term follow-up of 5,700 patients. The Secondary Prevention Reinfarction Israeli Nifedipine Trial (SPRINT) Study Group.

    Science.gov (United States)

    Harpaz, D

    1997-10-01

    In migrant countries, ethnic origin may represent a complex of cultural, behavioral and possibly genetic differences. These have been shown to influence acute myocardial infarction (AMI) incidence. How ethnic origin may affect survival after AMI is unknown. Data from 5,692 patients included in the Secondary Prevention Reinfarction Israeli Nifedipine Trial (SPRINT) registry were analyzed. Patients were divided into eight different ethnic groups, according to birthplaces from five continents, representing major socio-economic and possibly some genetic variation. Mortality was analyzed after adjustment for baseline characteristics known to predict death from coronary artery disease (CAD) using Jews born in Israel as a reference. The odds ratio for in-hospital mortality was higher in women than in men, but unrelated to ethnic origin. The odds ratio for men ranged between 1.08 (95% confidence interval (CI): 0.67-1.73) for Jews born in Eastern Europe and 1.84 (95% CI: 1.07-3.15) for counterparts born in the Middle East. The odds ratio for women ranged between 0.73 in Jews born in Central Europe (95% CI: 0.35-1.50) and 1.45 (95% CI: 0.76-3.15) for Jewish women born in the Balkan countries. Among 4,686 patients surviving the hospital phase, long-term mortality rates (mean follow-up 7.1 +/- 3.5 years) were 43.3% in men and 57.6% in women. Among 3,586 surviving men, the adjusted risk ratios for 10-year mortality varied between 0.92 (95% CI: 0.72-1.18) for men born in Romania and 1.49 (95% CI: 1.07-2.09) for Israeli born Arabs. The variation among men is within the limits of statistical error. However, among 1,100 surviving women, the risk ratio for 10-year mortality differed significantly, from as low as 1.43 (95% CI: 0.84-2.41) in Jewish women born in Central Europe to as high as 2.83 (95% CI: 1.67-4.79) in counterparts born in the Middle East. The latter observations were consistent with the mortality after 3 years. Thus, ethnic origin of Israelis marginally influenced the

  19. Affordances theory in multilingualism studies

    Directory of Open Access Journals (Sweden)

    Larissa Aronin

    2012-10-01

    Full Text Available The concept of affordances originating in Gibson’s work (Gibson, 1977 is gaining ground in multilingualism studies (cf. Aronin and Singleton, 2010; Singleton and Aronin, 2007; Dewaele, 2010. Nevertheless, studies investigating affordances in respect of teaching, learning or using languages are still somewhat rare and tend to treat isolated aspects of multilingualism. This is despite the fact that the theory of affordances can actually provide a valuable, supplementary, up-to-date framework within which a clearer, sharper description and explication of the intriguing range of attributes of multilingual communities, educational institutions and individuals, as well as teaching practices, become feasible. It is important that not only researchers and practitioners (teachers, educators, parents, community and political actors but also language users and learners themselves should be aware of how to identify or, if necessary, design new affordances for language acquisition and learning. The aim of this article is to adapt the concept of affordances to multilingualism studies and additional language teaching, and in so doing advance theoretical understanding in this context. To this end the article contains a brief summary of the findings so far available. The article also goes further into defining the ways of how affordances work in relation to multilingualism and second language teaching and puts forward an integrated model of affordances.

  20. Affordable Access to Space (AAS): Affordable Vehicle Avionics Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Affordable Vehicle Avionics (AVA) is being developed at NASA Ames Research Center and is sponsored by Space Technology Mission Directorate (STMD) Game Changing...

  1. Myocardial Galectin-3 Expression Is Associated with Remodeling of the Pressure-Overloaded Heart and May Delay the Hypertrophic Response without Affecting Survival, Dysfunction, and Cardiac Fibrosis.

    Science.gov (United States)

    Frunza, Olga; Russo, Ilaria; Saxena, Amit; Shinde, Arti V; Humeres, Claudio; Hanif, Waqas; Rai, Vikrant; Su, Ya; Frangogiannis, Nikolaos G

    2016-05-01

    The β-galactoside-binding animal lectin galectin-3 is predominantly expressed by activated macrophages and is a promising biomarker for patients with heart failure. Galectin-3 regulates inflammatory and fibrotic responses; however, its role in cardiac remodeling remains unclear. We hypothesized that galectin-3 may be up-regulated in the pressure-overloaded myocardium and regulate hypertrophy and fibrosis. In normal mouse myocardium, galectin-3 was constitutively expressed in macrophages and was localized in atrial but not ventricular cardiomyocytes. In a mouse model of transverse aortic constriction, galectin-3 expression was markedly up-regulated in the pressure-overloaded myocardium. Early up-regulation of galectin-3 was localized in subpopulations of macrophages and myofibroblasts; however, after 7 to 28 days of transverse aortic constriction, a subset of cardiomyocytes in fibrotic areas contained large amounts of galectin-3. In vitro, cytokine stimulation suppressed galectin-3 synthesis by macrophages and cardiac fibroblasts. Correlation studies revealed that cardiomyocyte- but not macrophage-specific galectin-3 localization was associated with adverse remodeling and dysfunction. Galectin-3 knockout mice exhibited accelerated cardiac hypertrophy after 7 days of pressure overload, whereas female galectin-3 knockouts had delayed dilation after 28 days of transverse aortic constriction. However, galectin-3 loss did not affect survival, systolic and diastolic dysfunction, cardiac fibrosis, and cardiomyocyte hypertrophy in the pressure-overloaded heart. Despite its potential role as a prognostic biomarker, galectin-3 is not a critical modulator of cardiac fibrosis but may delay the hypertrophic response. PMID:26948424

  2. Housing Affordability Data System (HADS)

    Data.gov (United States)

    Department of Housing and Urban Development — The Housing Affordability Data System (HADS) is a set of files derived from the 1985 and later national American Housing Survey (AHS) and the 2002 and later Metro...

  3. Coronary-Heart-Disease-Associated Genetic Variant at the COL4A1/COL4A2 Locus Affects COL4A1/COL4A2 Expression, Vascular Cell Survival, Atherosclerotic Plaque Stability and Risk of Myocardial Infarction.

    Science.gov (United States)

    Yang, Wei; Ng, Fu Liang; Chan, Kenneth; Pu, Xiangyuan; Poston, Robin N; Ren, Meixia; An, Weiwei; Zhang, Ruoxin; Wu, Jingchun; Yan, Shunying; Situ, Haiteng; He, Xinjie; Chen, Yequn; Tan, Xuerui; Xiao, Qingzhong; Tucker, Arthur T; Caulfield, Mark J; Ye, Shu

    2016-07-01

    Genome-wide association studies have revealed an association between coronary heart disease (CHD) and genetic variation on chromosome 13q34, with the lead single nucleotide polymorphism rs4773144 residing in the COL4A2 gene in this genomic region. We investigated the functional effects of this genetic variant. Analyses of primary cultures of vascular smooth muscle cells (SMCs) and endothelial cells (ECs) from different individuals showed a difference between rs4773144 genotypes in COL4A2 and COL4A1 expression levels, being lowest in the G/G genotype, intermediate in A/G and highest in A/A. Chromatin immunoprecipitation followed by allelic imbalance assays of primary cultures of SMCs and ECs that were of the A/G genotype revealed that the G allele had lower transcriptional activity than the A allele. Electrophoretic mobility shift assays and luciferase reporter gene assays showed that a short DNA sequence encompassing the rs4773144 site interacted with a nuclear protein, with lower efficiency for the G allele, and that the G allele sequence had lower activity in driving reporter gene expression. Analyses of cultured SMCs from different individuals demonstrated that cells of the G/G genotype had higher apoptosis rates. Immunohistochemical and histological examinations of ex vivo atherosclerotic coronary arteries from different individuals disclosed that atherosclerotic plaques with the G/G genotype had lower collagen IV abundance and thinner fibrous cap, a hallmark of unstable, rupture-prone plaques. A study of a cohort of patients with angiographically documented coronary artery disease showed that patients of the G/G genotype had higher rates of myocardial infarction, a phenotype often caused by plaque rupture. These results indicate that the CHD-related genetic variant at the COL4A2 locus affects COL4A2/COL4A1 expression, SMC survival, and atherosclerotic plaque stability, providing a mechanistic explanation for the association between the genetic variant and CHD

  4. An affordable humanitarian mine detector

    Science.gov (United States)

    Daniels, David J.; Curtis, Paul; Amin, Rajan; Dittmer, Jon

    2004-09-01

    This paper describes the further development of the MINETECT affordable humanitarian mine detector produced by ERA Technology with sponsorship from the UK Department for International Development. Using a radically different patented approach from conventional ground penetrating radar (GPR) designs in terms of the man machine interface, MINETECT offers simplicity of use and affordability, both key factors in humanitarian demining operations. Following trials in 2002 and reported at SPIE 2002, further development work including research on classifying mines, based on data from planned trials in the United Kingdom, is presented. MINETECT has the capability of detecting completely non-metallic mines and offers a considerable improvement in hand-held mine detection.

  5. Autologous cardiomyotissue implantation promotes myocardial regeneration, decreases infarct size, and improves left ventricular function

    NARCIS (Netherlands)

    J.J. Wykrzykowska (Joanna); A. Rosinberg (Audrey); S.U. Lee (Seung); P. Voisine (Pierre); G. Wu (Guanming); E. Appelbaum (Evan); M. Boodhwani (Munir); F.W. Sellke (Frank); R.J. Laham (Roger)

    2011-01-01

    textabstractBackground-: Cell therapy for myocardial infarction (MI) may be limited by poor cell survival and lack of transdifferentiation. We report a novel technique of implanting whole autologous myocardial tissue from preserved myocardial regions into infarcted regions. Methods and results-: Fou

  6. Malaysian Affordability Housing Policies Revisited

    Directory of Open Access Journals (Sweden)

    Samad Diwa

    2016-01-01

    Full Text Available Housing has always been a significant aspiration of family expression and distinctly priciest investment by household. It plays a momentous role in the country’s economy and so central to the societal well-being that is emplaced in the United Nation Universal declaration of Human rights. Yet in developed and developing world alike, cities struggle to provide decent housing for lower and middle income population. The provision of affordable housing is a major policy concern around the world with Malaysia being no exception; rising income hardly keep pace with price hike of housing unit and housing interventions has majorly concentrated on demand side leading to a non-responsive supply sector. Therefore, this paper highlights affordable housing issues pertaining Malaysia. It formulates Malaysian Map of affordability and conducts an evaluation of global housing schemes to better identify policy priorities for Malaysia. It’s significant to harmonize supply and demand side factors in the housing market to ensure that housing supply fits the needs of citizens based on the location, price and target group. In case of Malaysia supply oriented initiative are of urgency in short and medium run. This must be supported by long term demand side schemes in parallel. Convergence of these two factors is essential for a balanced equilibrium and obtaining affordability.

  7. Myocardial contractility

    Energy Technology Data Exchange (ETDEWEB)

    Comet, M.; Machecourt, J.

    1988-01-01

    The myocardial contractility characterizes the intensity of the activation representing the globality of the processes which lead to the formation of the sites where the strength is generated. Some parameters allowing a quantification of the contractility are measured during the isovolumic phase of the ventricular contraction: they are essentially dP/dt/sub max/, and eventually V/sub max/. For the measurement of these parameters, a pressure detector needs to be introduced into the left ventricle. Other parameters are measured during the systolic ejection phase: they are the ejection fraction, which is easy to measure and is very load dependant, and the maximal elastance. This last parameter is not easy to measure, but seems load independant. With the radioisotopes, it is possible to measure the ejection fraction and the maximal elastance. Contractility measurements are of interest in the study of ischemic cardiopathies and of valvular desease.

  8. Optics learning through affordable kit

    Science.gov (United States)

    P, Anusha N.; Shaji, Chitra; Sharan, Alok

    2014-10-01

    An affordable kit which helps to understand some of the optical phenomena qualitatively and quantitatively is presented in this paper. It supplements optics taught in classes. The kit consists of equipments which are available in the market at nominal cost such as laser pointer, lenses, glass plates, razor blades, coins, ball bearing etc. Experiments which come under wave optics (interference and diffraction) and ray optics (reflection and refraction) are explained using this kit.

  9. Optics learning through affordable kit

    International Nuclear Information System (INIS)

    An affordable kit which helps to understand some of the optical phenomena qualitatively and quantitatively is presented in this paper. It supplements optics taught in classes. The kit consists of equipments which are available in the market at nominal cost such as laser pointer, lenses, glass plates, razor blades, coins, ball bearing etc. Experiments which come under wave optics (interference and diffraction) and ray optics (reflection and refraction) are explained using this kit

  10. Optics learning through affordable kit

    Energy Technology Data Exchange (ETDEWEB)

    P, Anusha N, E-mail: anushnp@gmail.com, E-mail: chitrashaji@gmail.com, E-mail: aloksharan@gmail.com; Shaji, Chitra, E-mail: anushnp@gmail.com, E-mail: chitrashaji@gmail.com, E-mail: aloksharan@gmail.com; Sharan, Alok, E-mail: anushnp@gmail.com, E-mail: chitrashaji@gmail.com, E-mail: aloksharan@gmail.com [Department of Physics, Pondicherry University, Puducherry-605014 (India)

    2014-10-15

    An affordable kit which helps to understand some of the optical phenomena qualitatively and quantitatively is presented in this paper. It supplements optics taught in classes. The kit consists of equipments which are available in the market at nominal cost such as laser pointer, lenses, glass plates, razor blades, coins, ball bearing etc. Experiments which come under wave optics (interference and diffraction) and ray optics (reflection and refraction) are explained using this kit.

  11. Biochemical Markers of Myocardial Damage.

    Science.gov (United States)

    Bodor, Geza S

    2016-04-01

    Heart diseases, especially coronary artery diseases (CAD), are the leading causes of morbidity and mortality in developed countries. Effective therapy is available to ensure patient survival and to prevent long term sequelae after an acute ischemic event caused by CAD, but appropriate therapy requires rapid and accurate diagnosis. Research into the pathology of CAD have demonstrated the usefulness of measuring concentrations of chemicals released from the injured cardiac muscle can aid the diagnosis of diseases caused by myocardial ischemia. Since the mid-1950s successively better biochemical markers have been described in research publications and applied for the clinical diagnosis of acute ischemic myocardial injury. Aspartate aminotransferase of the 1950s was replaced by other cytosolic enzymes such as lactate dehydrogenase, creatine kinase and their isoenzymes that exhibited better cardiac specificity. With the availability of immunoassays, other muscle proteins, that had no enzymatic activity, were also added to the diagnostic arsenal but their limited tissue specificity and sensitivity lead to suboptimal diagnostic performance. After the discovery that cardiac troponins I and T have the desired specificity, they have replaced the cytosolic enzymes in the role of diagnosing myocardial ischemia and infarction. The use of the troponins provided new knowledge that led to revision and redefinition of ischemic myocardial injury as well as the introduction of biochemicals for estimation of the probability of future ischemic myocardial events. These markers, known as cardiac risk markers, evolved from the diagnostic markers such as CK-MB or troponins, but markers of inflammation also belong to these groups of diagnostic chemicals. This review article presents a brief summary of the most significant developments in the field of biochemical markers of cardiac injury and summarizes the most recent significant recommendations regarding the use of the cardiac markers in

  12. Classification of myocardial infarction

    DEFF Research Database (Denmark)

    Saaby, Lotte; Poulsen, Tina Svenstrup; Hosbond, Susanne Elisabeth;

    2013-01-01

    The classification of myocardial infarction into 5 types was introduced in 2007 as an important component of the universal definition. In contrast to the plaque rupture-related type 1 myocardial infarction, type 2 myocardial infarction is considered to be caused by an imbalance between demand...... and supply of oxygen in the myocardium. However, no specific criteria for type 2 myocardial infarction have been established....

  13. Transient myocardial ischemia after myocardial infarction

    DEFF Research Database (Denmark)

    Mickley, H

    1995-01-01

    Ambulatory ST-segment monitoring is a relatively new device in the evaluation of myocardial ischemia. The method is unique in allowing us to continuously examine the patient over an extended period of time in a changing environmental milieu. In survivors of acute myocardial infarction...... the prevalence of ambulatory or transient myocardial ischemia is lower than in patients with chronic, stable coronary artery disease. A greater proportion of ischemic episodes, however, are silent than in other subgroups with ischemic heart disease. Early after the infarction, transient myocardial ischemia...... exhibits a circadian variation with a peak activity occurring in the late evening hours. Patients with non-Q wave infarction have more transient myocardial ischemia, whereas thrombolytic therapy seems to result in less residual ischemia. Exercise testing is more sensitive than ambulatory monitoring...

  14. Fisiognomica emozionale. Affordances, estasi, atmosfere

    Directory of Open Access Journals (Sweden)

    Tonino Griffero

    2015-06-01

    Full Text Available Through an atmospherological approach, primarily inspired by the so-called Aisthetik or New Aesthetics (Gernot Böhme and the New Phenomenology (Hermann Schmitz, the paper defines the atmospheric perception as a first pathemic impression and investigates the relationship between this kind of perception and the expressive qualities of the surrounding spaces. The aim is to understand atmospheres as (amodal, transmodal, sinaesthetic affordances that permeate the lived space, namely as ‘ecological’ and affective invites or meanings which are ontologically rooted in things and quasi-things.

  15. Affordable Housing: An Economic Perspective

    OpenAIRE

    John F. McDonald

    2015-01-01

    The economist's approach to social problems has two interrelated parts, consistent measurement and use of a cost-benefit test to assess alternative policies. This essay examines both parts of the economist's method, primarily in the context of the United States but with attention paid to the United Kingdom also. It will seek to demonstrate that the problem of affordable housing can be measured and is large, even in the U. S. Furthermore, it will suggest that the problem primarily is one of po...

  16. Perceiving Affordances for Fitting through Apertures

    Science.gov (United States)

    Ishak, Shaziela; Adolph, Karen E.; Lin, Grace C.

    2008-01-01

    Affordances--possibilities for action--are constrained by the match between actors and their environments. For motor decisions to be adaptive, affordances must be detected accurately. Three experiments examined the correspondence between motor decisions and affordances as participants reached through apertures of varying size. A psychophysical…

  17. Acute myocardial infarct imaging

    International Nuclear Information System (INIS)

    A brief review is presented of radiopharmaceuticals used for imaging acute myocardial infarction and instrumentation using the rectilinear scanner and the scintillation camera. Clinical experience indicates that myocardial imaging with /sup 99 m/Tc pyrophosphate is a useful adjunct to the electrocardiogram and serum enzyme activity in managing patients with myocardial infarction. The technique allows rapid diagnosis, accurate localization, and an estimate of the size of acute infarcts. It can also be used to document infarct extension and in association with myocardial perfusion imaging can help differentiate fresh from old myocardial infarction

  18. Role of myocardial perfusion single photon emission computed tomography in pediatric cardiology practice

    International Nuclear Information System (INIS)

    Diagnostic and prognostic power of myocardial perfusion imaging in patients with coronary artery disease has been demonstrated with planar imaging which was further improvised with addition of gated SPECT and newer Technetium labeled myocardial perfusion tracers like SestaMIBI, Tetrofosmin. Myocardial perfusion abnormalities at rest and after stress are considered to be the best predictors of cardiac event–free survival in adults with ischemic heart disease. This article highlights various myocardial perfusion imaging (MPI) radiopharmaceuticals, exercise procedures, pharmacological stress protocols, indications for MPI and myocardial perfusion patterns in children with some of the common congenital and acquired heart diseases

  19. Role of myocardial perfusion single photon emission computed tomography in pediatric cardiology practice

    Directory of Open Access Journals (Sweden)

    Sundaram P

    2009-01-01

    Full Text Available Diagnostic and prognostic power of myocardial perfusion imaging in patients with coronary artery disease has been demonstrated with planar imaging which was further improvised with addition of gated SPECT and newer Technetium labeled myocardial perfusion tracers like SestaMIBI, Tetrofosmin. Myocardial perfusion abnormalities at rest and after stress are considered to be the best predictors of cardiac event-free survival in adults with ischemic heart disease. This article highlights various myocardial perfusion imaging (MPIradiopharmaceuticals, exercise procedures, pharmacological stress protocols, indications for MPI and myocardial perfusion patterns in children with some of the common congenital and acquired heart diseases.

  20. Dopamine, affordance and active inference.

    Directory of Open Access Journals (Sweden)

    Karl J Friston

    2012-01-01

    Full Text Available The role of dopamine in behaviour and decision-making is often cast in terms of reinforcement learning and optimal decision theory. Here, we present an alternative view that frames the physiology of dopamine in terms of Bayes-optimal behaviour. In this account, dopamine controls the precision or salience of (external or internal cues that engender action. In other words, dopamine balances bottom-up sensory information and top-down prior beliefs when making hierarchical inferences (predictions about cues that have affordance. In this paper, we focus on the consequences of changing tonic levels of dopamine firing using simulations of cued sequential movements. Crucially, the predictions driving movements are based upon a hierarchical generative model that infers the context in which movements are made. This means that we can confuse agents by changing the context (order in which cues are presented. These simulations provide a (Bayes-optimal model of contextual uncertainty and set switching that can be quantified in terms of behavioural and electrophysiological responses. Furthermore, one can simulate dopaminergic lesions (by changing the precision of prediction errors to produce pathological behaviours that are reminiscent of those seen in neurological disorders such as Parkinson's disease. We use these simulations to demonstrate how a single functional role for dopamine at the synaptic level can manifest in different ways at the behavioural level.

  1. Thrombolytic therapy in acute myocardial infarction.

    Science.gov (United States)

    Woo, K S; White, H D

    1994-07-01

    Thrombolytic therapy has revolutionized the treatment of acute myocardial infarction by reducing mortality and preserving left ventricular function. It is relatively safe and cost-effective. However, it is currently underused in most countries. Patients in whom thrombolysis is indicated include those with ST elevation on the electrocardiogram or bundle branch block pattern who present within 12 hours of myocardial infarction; the indications should be widened to include the elderly, patients who have undergone nontraumatic cardiopulmonary resuscitation, and women during menstruation. The risk-benefit ratio should be assessed for the individual patient. Prehospital thrombolytic treatment has been shown to be feasible with the support of well-trained staff and resuscitation equipment, and may be cost-effective in communities with time delays before hospitalization greater than 1 hour. The most important strategy is to shorten the "door to needle" time in hospital. The importance of full infarct-related artery flow (Thrombolysis in Myocardial Infarction [TIMI] grade 3 flow) for preservation of ventricular function and survival has been documented in the second Thrombolysis Trial of Eminase in Acute Myocardial Infarction (TEAM 2) and the Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO) studies. Aspirin and heparin are beneficial adjunctive regimens to thrombolytic therapy but optimal epicardial reperfusion is achieved in only about half of patients. Improved thrombolytic, adjunctive antiplatelet, and antithrombotic regimens are required to achieve early full reperfusion, which is crucial to improve survival and quality of life. PMID:7919592

  2. Myocardial infarction in an urban population: worse long term prognosis for patients from less affluent residential areas

    OpenAIRE

    Tydén, Patrik; Hansen, Ole; Engström, Gunnar; Hedblad, Bo; Janzon, Lars

    2002-01-01

    STUDY OBJECTIVE: The objective in this follow up study from the Malmö myocardial infarction register has been to assess whether long term survival following discharge after first myocardial infarction has any relation with the socioeconomic environment and to assess to what extent intra-urban differences in mortality from ischaemic heart disease can be accounted for by covariance with long term survival following discharge after acute myocardial infarction. DESIGN: Register based surveillance...

  3. PERIOPERATIVE MYOCARDIAL INFRACTION

    Directory of Open Access Journals (Sweden)

    Ravindra S

    2015-10-01

    Full Text Available Perioperative myocardial ischaemia and infarction (PMI is a major cause of short and long term morbidity and mortality in the surgical population. It is estimated that more than one half of postoperative deaths are caused by cardiac events, most of which are ischaemic in origin. Over 50,000 patients each year sustain a perioperative MI . Thus prevention of a PMI is important to improve overall postoperative outcome. Myocardial ischaemia is a dual state composed of inadequate myocardial oxygenation and accu mulation of anaerobic metabolites and occurs when myocardial oxygen demand exceeds the supply. Myocardial infarction is defined as the death of myocardial myocytes due to prolonged ischaemia. In patients with, or at risk of coronary artery disease (CAD, t he reported incidence of perioperative myocardial ischaemia is 20 - 63%. Various studies have shown that postoperative myocardial ischaemia was consistently found to occur considerably more often than preoperative and intraoperative ischaemia ( R atio approxim ately 3:1 and 5:1 respectively. As more and more patients coming for non - cardiac surgeries who have already undergone coronary intervention such as balloon angioplasty, stenting or CABG, we as anaesthesiologists should have thorough knowledge of the perio perative implications of the same in a day to day practice. Secondly, as the geriatric population is increasing there are more chances of encountering patients with known or unknown ischaemic heart disease both on an emergency and elective basis.

  4. The concept of a structural affordance

    Directory of Open Access Journals (Sweden)

    Adrian Alsmith

    2012-12-01

    Full Text Available I provide an analysis of the concept of an “affordance” that enables one to conceive of “structural affordance” as a kind of affordance relation that might hold between an agent and its body. I then review research in the science of humanoid bodily movement to indicate the empirical reality of structural affordance.

  5. The concept of a structural affordance

    OpenAIRE

    Adrian Alsmith

    2012-01-01

    I provide an analysis of the concept of an “affordance” that enables one to conceive of “structural affordance” as a kind of affordance relation that might hold between an agent and its body. I then review research in the science of humanoid bodily movement to indicate the empirical reality of structural affordance.

  6. Patient and doctor delay in acute myocardial infarction: a study in Rotterdam, The Netherlands.

    OpenAIRE

    Bleeker, J K; Simoons, M. L.; Erdman, R A; Leenders, C M; Kruyssen, H A; Lamers, L M; van der Does, E

    1995-01-01

    BACKGROUND--Early thrombolytic therapy for patients having a myocardial infarct size and improves survival. AIM--A study was undertaken to examine the components of pre-hospital delay in patients with retrospectively proven myocardial infarction. METHOD--Data were gathered from 300 patients with a documented myocardial infarction admitted to three hospitals in Rotterdam, the Netherlands. Interviews were carried out with patients, questionnaires were given to their spouses or significant other...

  7. Affordability Approaches for Human Space Exploration

    Science.gov (United States)

    Holladay, Jon; Smith, David Alan

    2012-01-01

    The design and development of historical NASA Programs (Apollo, Shuttle and International Space Station), have been based on pre-agreed missions which included specific pre-defined destinations (e.g., the Moon and low Earth orbit). Due to more constrained budget profiles, and the desire to have a more flexible architecture for Mission capture as it is affordable, NASA is working toward a set of Programs that are capability based, rather than mission and/or destination specific. This means designing for a performance capability that can be applied to a specific human exploration mission/destination later (sometime years later). This approach does support developing systems to flatter budgets over time, however, it also poses the challenge of how to accomplish this effectively while maintaining a trained workforce, extensive manufacturing, test and launch facilities, and ensuring mission success ranging from Low Earth Orbit to asteroid destinations. NASA Marshall Space Flight Center (MSFC) in support of Exploration Systems Directorate (ESD) in Washington, DC has been developing approaches to track affordability across multiple Programs. The first step is to ensure a common definition of affordability: the discipline to bear cost in meeting a budget with margin over the life of the program. The second step is to infuse responsibility and accountability for affordability into all levels of the implementing organization since affordability is no single person s job; it is everyone s job. The third step is to use existing data to identify common affordability elements organized by configuration (vehicle/facility), cost, schedule, and risk. The fourth step is to analyze and trend this affordability data using an affordability dashboard to provide status, measures, and trends for ESD and Program level of affordability tracking. This paper will provide examples of how regular application of this approach supports affordable and therefore sustainable human space exploration

  8. Growth hormone and insulin-like growth factor-1 in acute myocardial infarction

    DEFF Research Database (Denmark)

    Friberg, L; Werner, S; Eggertsen, G;

    2000-01-01

    Growth hormone therapy after myocardial infarction improves cardiac function and survival in animals. Beneficial effects in humans are reported from studies where patients with idiopathic dilated cardiomyopathy were treated with growth hormone. We have studied the role of the endogenous growth...... hormone system in myocardial infarction....

  9. Rethinking Affordable Housing Delivery: An Analytical Insight

    Directory of Open Access Journals (Sweden)

    Olanrewaju Abdullateef

    2016-01-01

    Full Text Available Malaysia currently has a housing shortage of 12 million units. Towards the year 2020, this would require an annual supply of a minimum of 2 million homes. With the current production rate, the deficits will remain over the next 100 years. The crisis will lead to poor standards of living, un-affordable rental price, high mortgage payment, abandonment, and dilapidation of the existing housing stock. Lack of affordable housing is already a source of concern among many Malaysians. The middle and lower income earners spend more than 30% of their income on rent or for mortgage payment. Housing rent or mortgage is a basic need like foods, education, clothing and health. The government has introduced various measures to address the housing deficit. Despite these measures, the housing supply and distribution gaps continue to grow. To better understand the issues, there is a need to examine how the procurement planning in the affordable housing delivery supply chain and market is formulated, explore how cost of affordable housing would be reduced, identify the user value systems in affordable housing, and identify the criteria in the current regulatory framework? For these purposes, this paper reviews the relevant literature to reach preliminary findings on the stated issues. Among the factors found accounting for housing shortages, the overwhelming factors were that of poor policies, strategies, practice, management, and finance. The findings are meaningful in framing an affordable housing delivery model. It could also be useful to stakeholders involved in affordable housing delivery in Malaysia and elsewhere.

  10. Acute myocardial infarction:myocardial salvage assessment

    Institute of Scientific and Technical Information of China (English)

    NSENGIYUMVA Pierre; CHEN Li-juan; MA Gen-shan

    2015-01-01

    Primary coronary revascularization by means of percutaneous coronary intervention ( PCI) is a highly ef-fective treatment of acute myocardial infarction re-establishing coronary perfusion and stopping the ongoing necrosis in the dependent myocardium .Single-photon emission computed tomography ( SPECT) is the most widely used mo-dality assessing myocardial salvage as the difference between the acute perfusion defect before intervention and the remaining scar size measured in a second scan several days after the event .SPECT allows quantification of area at risk( AAR) and final infarct size ( FIS) by tracer injection prior to revascularization and after 1 month, respective-ly.SPECT provides the most validated measure of myocardial salvage and has been utilized in multiple randomized clinical trials.However, SPECT is logistically challenging , expensive, and includes radiation exposure .More re-cently, a large number of studies have suggested that cardiac magnetic resonance ( CMR) can determine salvage in a single examination by combining measures of myocardial oedema in the AAR exposed to ischaemia reperfusion with FIS quantification by late gadolinium enhancement .

  11. Oligophrenin1 protects mice against myocardial ischemia and reperfusion injury by modulating inflammation and myocardial apoptosis.

    Science.gov (United States)

    Niermann, Christina; Gorressen, Simone; Klier, Meike; Gowert, Nina S; Billuart, Pierre; Kelm, Malte; Merx, Marc W; Elvers, Margitta

    2016-08-01

    The Rho family of small GTPases has been analyzed in cardiac physiology and pathophysiology including myocardial infarction (MI) in the last years. Contradictory results show either a protective or a declined effect of RhoA and the RhoA effector Rho-associated protein kinase (ROCK) in myocardial ischemia and reperfusion injury that is associated with cardiomyocyte survival and caspase-3 activation. Cardiac-specific deletion of Rac1 reduced ischemia reperfusion injury in diabetic hearts, whereas cardiomyocyte specific overexpression of active Rac1 predisposes the heart to increased myocardial injury with enhanced contractile dysfunction. GTPase-activating proteins (GAPs) control the activation of Rho proteins through stimulation of GTP hydrolysis. However, the impact of GAPs in myocardial ischemia and reperfusion injury remains elusive. Here we analyzed the role of oligophrenin1 (OPHN1), a RhoGAP with Bin/Amphiphysin/Rvs (BAR) domain known to regulate the activity of RhoA, Rac1 and Cdc42 in MI. The expression of Ophn1, RhoA and Rac1 is strongly upregulated 24h after myocardial ischemia. Loss of OPHN1 induced enhanced activity of Rho effector molecules leading to elevated cardiomyocyte apoptosis and increased migration of inflammatory cells into the infarct border zone of OPHN1 deficient mice. Consequently, echocardiography 24h after myocardial ischemia revealed declined left ventricle function in OPHN1 deficient mice. Our results indicate that OPHN1 mediated regulation of RhoA, Rac1 and Cdc42 is crucial for the preservation of cardiac function after myocardial injury. PMID:27117132

  12. Smoking Bans in Affordable Housing Benefit All

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_160501.html Smoking Bans in Affordable Housing Benefit All: Study Secondhand ... housing properties in Minnesota. All the properties prohibited smoking indoors and three also banned smoking on the ...

  13. Severe postpartum sepsis with prolonged myocardial dysfunction: a case report

    Directory of Open Access Journals (Sweden)

    Chen Katherine T

    2010-10-01

    Full Text Available Abstract Introduction Severe sepsis during pregnancy or in the postpartum period is a rare clinical event. In non obstetric surviving patients, the cardiovascular changes seen in sepsis and septic shock are fully reversible five to ten days after their onset. We report a case of septic myocardial dysfunction lasting longer than ten days. To the best of our knowledge, this is the first report of prolonged septic myocardial dysfunction in a parturient. Case presentation A 24 year old Hispanic woman with no previous medical history developed pyelonephritis and severe sepsis with prolonged myocardial dysfunction after a normal spontaneous vaginal delivery. Conclusions Septic myocardial dysfunction may be prolonged in parturients requiring longer term follow up and pharmacologic treatment.

  14. 急性心肌梗死后早期他汀类药物治疗及其一年存活率%Early Statin Treatment Following Acute Myocardial Infarction and l-Year Survival

    Institute of Scientific and Technical Information of China (English)

    Ulf Stenestrand, MD; Lars Wallentin, MD, PhD; For the Swedish Register of Card ac Intensive Care

    2001-01-01

    @@ 斯堪的那维亚辛伐他汀生存研究(4S)、胆固醇和心脏病复发事件研究(CARE)及普伐他汀对缺血性心脏病的长期干预试验(LIPID)证明:在AMI发作后3~6个月使用3-羟基-3-甲基戊二酰辅酶A还原酶抑制剂(他汀类)可降低胆固醇升高患者的死亡率.对于有高胆固醇但无冠心病表现的高危患者,用他汀类药物进行一级预防,则可减少随后发生冠脉事件的危险性.尽管有证据提示,急性冠脉综合征住院期间即早期予以他汀类治疗是有益的,但是在急性冠脉综合征患者进行的早期他汀类干预临床试验仅有MIRACL(Myocardial Ischemia Reduction with Aggressive Cholesteml l owering Study ),该研究最近刚刚结束,尚未公开发表.

  15. Evaluation of Myocardial Viability after Myocardial Infarction with Intravenous Real-time Myocardial Contrast Echocardiography

    Institute of Scientific and Technical Information of China (English)

    Weihui SHENTU; Yuhan WU; Youbin DENG; Runqing HUANG; Peng LI; Xiang WEI; Haoyi YANG; Yun ZHANG; Li XIONG; Fen YU

    2008-01-01

    The myocardial viability after myocardial infarction was evaluated by intravenous myocardial contrast echocardiography. Intravenous real-time myocardial contrast echocardiography was performed on 18 patients with myocardial infarction before coronary revascularization. Follow-up echocardiography was performed 3 months after coronary revascularization. Segmental wall motion was assessed using 18-segment LV model and classified as normal, hypokinesis, akinesis and dyskinesis. Viable myocardium was defined by evident improvement of segmental wall motion 3 months after coronary revascularization. Myocardial perfusion was assessed by visual interpretation and divided into 3 conditions: homogeneous opacification; partial or reduced opaciflcation or subendocardial contrast defect; contrast defect. The former two conditions were used as the standard to define the viable myocardium. The results showed that 109 abnormal wall motion segments were detected among 18 patients with myocardial infarction, including 47 segments of hypokinesis, 56 segments of akinesis and 6 segments of dyskinesis. The wall motion of 2 segments with hypokinesis before coronary revascularization which showed homogeneous opacification, 14 of 24 segments with hypokinese and 20 of 24 segments with akinese before coronary revascularization which showed partial or reduced opaciflcation or subendocardial contrast defect was improved 3 months after coronary revascularization. In our study, the sensitivity and specificity of evaluation of myocardial viability after myocardial infarction by intravenous real-time myocardial contrast echocardiography were 94.7% and 78.9%, respectively. It was concluded that intravenous real-time myocardial contrast echocardiography could accurately evaluate myocardial viability after myocardial infarction.

  16. Heroin Abuse and Myocardial Infarction

    OpenAIRE

    Tatli, Ersan; Aktoz, Meryem

    2010-01-01

    Information concerning acute myocardial infarction after heroin usage is limited and the actual mechanism of heroin-induced myocardial infarction is not well known. Only one report has been described noting the association between usage heroin and acute myocardial infarction in a young man with normal coronary arteries. We also reported a patient with normal coronary arteries and acute myocardial infarction after heroin abuse. Eroin kullanımı sonrası akut miyokard inf...

  17. Affordances for robots: a brief survey

    Directory of Open Access Journals (Sweden)

    Thomas E. Horton

    2012-12-01

    Full Text Available In this paper, we consider the influence of Gibson's affordance theory on the design of robotic agents. Affordance theory (and the ecological approach to agent design in general has in many cases contributed to the development of successful robotic systems; we provide a brief survey of AI research in this area. However, there remain significant issues that complicate discussions on this topic, particularly in the exchange of ideas between researchers in artificial intelligence and ecological psychology. We identify some of these issues, specifically the lack of a generally accepted definition of "affordance" and fundamental differences in the current approaches taken in AI and ecological psychology. While we consider reconciliation between these fields to be possible and mutually beneficial, it will require some flexibility on the issue of direct perception.

  18. Affordances and the musically extended mind.

    Science.gov (United States)

    Krueger, Joel

    2014-01-01

    I defend a model of the musically extended mind. I consider how acts of "musicking" grant access to novel emotional experiences otherwise inaccessible. First, I discuss the idea of "musical affordances" and specify both what musical affordances are and how they invite different forms of entrainment. Next, I argue that musical affordances - via soliciting different forms of entrainment - enhance the functionality of various endogenous, emotion-granting regulative processes, drawing novel experiences out of us with an expanded complexity and phenomenal character. I argue that music therefore ought to be thought of as part of the vehicle needed to realize these emotional experiences. I appeal to different sources of empirical work to develop this idea. PMID:24432008

  19. Affordances in Mobile Augmented Reality Applications

    Directory of Open Access Journals (Sweden)

    Tor Gjøsæter

    2014-10-01

    Full Text Available This paper explores the affordances of augmented reality content in a mobile augmented reality application. A user study was conducted by performing a multi-camera video recording of seven think aloud sessions. The think aloud sessions consisted of individual users performing tasks, exploring and experiencing a mobile augmented reality (MAR application we developed for the iOS platform named ARad. We discuss the instrumental affordances we observed when users interacted with augmented reality content, as well as more complex affordances rising from conventions from media content, AR and the traditional WIMP paradigm. We find that remediation of traditional newspaper content through the MAR medium can provide engaging, pleasing and exciting user experiences. However, the some of the content still suffers from being shoveled onto the MAR platform without adapting it properly. Finally, we discuss what content was most successfully mediated to the user and how the content impacts the user experience.

  20. The Transformation of Ergonomic Affordances into Cultural Affordances: The Case of the Alnuset System

    Science.gov (United States)

    Chiappini, Giampaolo

    2012-01-01

    Is it possible to study the ergonomic affordances offered by a system designed for educational aims and their transformation into cultural affordances? To this purpose, what references can we adopt? This work describes the theoretical framework used to realise this study referring to AlNuSet, a system realised within the EC ReMath project to…

  1. Affordance Templates for Shared Robot Control

    Science.gov (United States)

    Hart, Stephen; Dinh, Paul; Hambuchen, Kim

    2014-01-01

    This paper introduces the Affordance Template framework used to supervise task behaviors on the NASA-JSC Valkyrie robot at the 2013 DARPA Robotics Challenge (DRC) Trials. This framework provides graphical interfaces to human supervisors that are adjustable based on the run-time environmental context (e.g., size, location, and shape of objects that the robot must interact with, etc.). Additional improvements, described below, inject degrees of autonomy into instantiations of affordance templates at run-time in order to enable efficient human supervision of the robot for accomplishing tasks.

  2. An activity theory approach to affordance

    DEFF Research Database (Denmark)

    Bærentsen, Klaus B.; Trettvik, J.

    2002-01-01

    the notion. Specifically we will suggest the inclusion of the ecological theory of perception in the paradigm of cultural historical psychology and activity theory developed in the former Soviet Union by most notably Lev Vygotsky, S. L. Rubinshtein, A. N. Leontjev and others. It will be suggested, that much...... of the confusion in HCI concerning the concept of affordance is a consequence of the attempt of using it inside a theoretical paradigm that is unable to capture and encompass one of the most essential aspect of Gibsons concept of affordance, that is its foundation in activity...

  3. Learning to grasp and extract affordances: the Integrated Learning of Grasps and Affordances (ILGA) model.

    Science.gov (United States)

    Bonaiuto, James; Arbib, Michael A

    2015-12-01

    The activity of certain parietal neurons has been interpreted as encoding affordances (directly perceivable opportunities) for grasping. Separate computational models have been developed for infant grasp learning and affordance learning, but no single model has yet combined these processes in a neurobiologically plausible way. We present the Integrated Learning of Grasps and Affordances (ILGA) model that simultaneously learns grasp affordances from visual object features and motor parameters for planning grasps using trial-and-error reinforcement learning. As in the Infant Learning to Grasp Model, we model a stage of infant development prior to the onset of sophisticated visual processing of hand-object relations, but we assume that certain premotor neurons activate neural populations in primary motor cortex that synergistically control different combinations of fingers. The ILGA model is able to extract affordance representations from visual object features, learn motor parameters for generating stable grasps, and generalize its learned representations to novel objects.

  4. Myocardial Viability: What We Knew and What Is New

    Directory of Open Access Journals (Sweden)

    Adel Shabana

    2012-01-01

    Full Text Available Some patients with chronic ischemic left ventricular dysfunction have shown significant improvements of contractility with favorable long-term prognosis after revascularization. Several imaging techniques are available for the assessment of viable myocardium, based on the detection of preserved perfusion, preserved glucose metabolism, intact cell membrane and mitochondria, and presence of contractile reserve. Nuclear cardiology techniques, dobutamine echocardiography and positron emission tomography are used to assess myocardial viability. In recent years, new advances have improved methods of detecting myocardial viability. This paper summarizes the pathophysiology, methods, and impact of detection of myocardial viability, concentrating on recent advances in such methods. We reviewed the literature using search engines MIDLINE, SCOUPS, and EMBASE from 1988 to February 2012. We used key words: myocardial viability, hibernation, stunning, and ischemic cardiomyopathy. Recent studies showed that the presence of viable myocardium was associated with a greater likelihood of survival in patients with coronary artery disease and LV dysfunction, but the assessment of myocardial viability did not identify patients with survival benefit from revascularization, as compared with medical therapy alone. This topic is still debatable and needs more evidence.

  5. Affordances of Instrumentation in General Chemistry Laboratories

    Science.gov (United States)

    Sherman, Kristin Mary Daniels

    2010-01-01

    The purpose of this study is to find out what students in the first chemistry course at the undergraduate level (general chemistry for science majors) know about the affordances of instrumentation used in the general chemistry laboratory and how their knowledge develops over time. Overall, students see the PASCO(TM) system as a useful and accurate…

  6. Options for Affordable Fission Surface Power Systems

    International Nuclear Information System (INIS)

    Fission surface power systems could provide abundant power anywhere on the surface of the moon or Mars. Locations could include permanently shaded regions on the moon and high latitudes on Mars. To be fully utilized, however, fission surface power systems must be safe, have adequate performance, and be affordable. This paper discusses options for the design and development of such systems. (authors)

  7. Effects of broken affordance on visual extinction.

    Science.gov (United States)

    Wulff, Melanie; Humphreys, Glyn W

    2015-01-01

    Previous studies have shown that visual extinction can be reduced if two objects are positioned to "afford" an action. Here we tested if this affordance effect was disrupted by "breaking" the affordance, i.e., if one of the objects actively used in the action had a broken handle. We assessed the effects of broken affordance on recovery from extinction in eight patients with right hemisphere lesions and left-sided extinction. Patients viewed object pairs that were or were not commonly used together and that were positioned for left- or right-hand actions. In the unrelated pair conditions, either two tools or two objects were presented. In line with previous research (e.g., Riddoch et al., 2006), extinction was reduced when action-related object pairs and when unrelated tool pairs were presented compared to unrelated object pairs. There was no significant difference in recovery rate between action-related (object-tool) and unrelated tool pairs. In addition, performance with action-related objects decreased when the tool appeared on the ipsilesional side compared to when it was on the contralesional side, but only when the tool handle was intact. There were minimal effects of breaking the handle of an object rather than a tool, and there was no effect of breaking the handle on either tools or objects on single item trials. The data suggest that breaking the handle of a tool lessens the degree to which it captures attention, with this attentional capture being strongest when the tool appears on the ipsilesional side. The capture of attention by the ipsilesional item then reduces the chance of detecting the contralesional stimulus. This attentional capture effect is mediated by the affordance to the intact tool.

  8. Effects of broken affordance on visual extinction

    Directory of Open Access Journals (Sweden)

    Melanie eWulff

    2015-09-01

    Full Text Available Previous studies have shown that visual extinction can be reduced if two objects are positioned to afford an action. Here we tested if this affordance effect was disrupted by breaking the affordance – if one of the objects actively used in the action had a broken handle. We assessed the effects of broken affordance on recovery from extinction in eight patients with right hemisphere lesions and left-sided extinction. Patients viewed object pairs that were or were not commonly used together and that were positioned for left- or right-hand actions. In the unrelated pair conditions, either two tools or two objects were presented. In line with previous research (e.g., Riddoch et al., 2006, extinction was reduced when action-related object pairs and when unrelated tool pairs were presented compared to unrelated object pairs. There was no significant difference in recovery rate between action-related (object-tool and unrelated tool-tool pairs. In addition, performance with action-related objects decreased when the tool appeared on the ipsilesional side compared to when it was on the contralesional side, but only when the tool handle was intact. There were minimal effects of breaking the handle of an object rather than a tool, and there was no effect of breaking the handle on either tools or objects on single item trials. The data suggest that breaking the handle of a tool lessens the degree to which it captures attention, with this attentional capture being strongest when the tool appears on the ipsilesional side. The capture of attention by the ipsilesional item then reduces the chance of detecting the contralesional stimulus. This attentional capture effect is mediated by the affordance to the intact tool.

  9. Depression following myocardial infarction

    DEFF Research Database (Denmark)

    Larsen, Karen Kjær

    2013-01-01

    Myocardial infarction (MI) is a severe life event that is accompanied by an increased risk of depression. Mounting evidence suggests that post-MI depression is associated with adverse outcomes, but the underlying mechanisms of this association remain unclear, and no previous studies have examined...

  10. Depression after myocardial infarction.

    Science.gov (United States)

    Ziegelstein, R C

    2001-01-01

    Depression is an independent risk factor for increased postmyocardial infarction morbidity and mortality, even after controlling for the extent of coronary artery disease, infarct size, and the severity of left ventricular dysfunction. This risk factor takes on added significance when one considers that almost half of patients recovering from a myocardial infarction have major or minor depression and that major depression alone occurs in about one in five of these individuals. Despite the well-documented risk of depression, questions remain about the mechanism of the relationship between mood disturbance and adverse outcome. The link may be explained by an association with lower levels of social support, poor adherence to recommended medical therapy and lifestyle changes intended to reduce the risk of subsequent cardiac events, disturbances in autonomic tone, enhanced platelet activation and aggregation, and systemic immune activation. Unfortunately, questions about the pathophysiologic mechanism of depression in this setting are paralleled by uncertainties about the optimal treatment of depression for patients recovering from a myocardial infarction and by a lack of knowledge about whether treating depression lowers the associated increased mortality risk. Ongoing research studies will help to determine the benefits of psychosocial interventions and of antidepressant therapy for patients soon after myocardial infarction. Although the identification of depression as a risk factor may by itself be a reason to incorporate a comprehensive psychological evaluation into the routine care of patients with myocardial infarction, this practice should certainly become standard if studies show that treating depression reduces the increased mortality risk of these patients.

  11. Trans-system mechanisms against ischemic myocardial injury.

    Science.gov (United States)

    Liu, Shu Q; Ma, Xin-Liang; Qin, Gangjian; Liu, Qingping; Li, Yan-Chun; Wu, Yu H

    2015-01-01

    A mammalian organism possesses a hierarchy of naturally evolved protective mechanisms against ischemic myocardial injury at the molecular, cellular, and organ levels. These mechanisms comprise regional protective processes, including upregulation and secretion of paracrine cell-survival factors, inflammation, angiogenesis, fibrosis, and resident stem cell-based cardiomyocyte regeneration. There are also interactive protective processes between the injured heart, circulation, and selected remote organs, defined as trans-system protective mechanisms, including upregulation and secretion of endocrine cell-survival factors from the liver and adipose tissue as well as mobilization of bone marrow, splenic, and hepatic cells to the injury site to mediate myocardial protection and repair. The injured heart and activated remote organs exploit molecular and cellular processes, including signal transduction, gene expression, cell proliferation, differentiation, migration, mobilization, and/or extracellular matrix production, to establish protective mechanisms. Both regional and trans-system cardioprotective mechanisms are mediated by paracrine and endocrine messengers and act in coordination and synergy to maximize the protective effect, minimize myocardial infarction, and improve myocardial function, ensuring the survival and timely repair of the injured heart. The concept of the trans-system protective mechanisms may be generalized to other organ systems-injury in one organ may initiate regional as well as trans-system protective responses, thereby minimizing injury and ensuring the survival of the entire organism. Selected trans-system processes may serve as core protective mechanisms that can be exploited by selected organs in injury. These naturally evolved protective mechanisms are the foundation for developing protective strategies for myocardial infarction and injury-induced disorders in other organ systems.

  12. Affordability for sustainable energy development products

    International Nuclear Information System (INIS)

    Highlights: • Clean cookstoves that also generate electricity improve affordability. • Excel spreadsheet model to assist stakeholders to choose optimum technology. • Presents views for each stakeholder villager, village and country. • By adding certain capital costs, affordability and sustainability are improved. • Affordability is highly dependent on carbon credits and social understandings. - Abstract: Clean burning products, for example cooking stoves, can reduce household air pollution (HAP), which prematurely kills 3.5 million people each year. By careful selection of components into a product package with micro-finance used for the capital payment, barriers to large-scale uptake of products that remove HAP are reduced. Such products reduce smoke from cooking and the lighting from electricity produced, eliminates smoke from kerosene lamps. A bottom-up financial model, that is cognisant of end user social needs, has been developed to compare different products for use in rural areas of developing countries. The model is freely available for use by researchers and has the ability to assist in the analysis of changing assumptions. Business views of an individual villager, the village itself and a country view are presented. The model shows that affordability (defined as the effect on household expenses as a result of a product purchase) and recognition of end-user social needs are as important as product cost. The effects of large-scale deployment (greater that 10 million per year) are described together with level of subsidy required by the poorest people. With the assumptions given, the model shows that pico-hydro is the most cost effective, but not generally available, one thermo-acoustic technology option does not require subsidy, but it is only at technology readiness level 2 (NASA definition) therefore costs are predicted and very large investment in manufacturing capability is needed to meet the cost target. Thermo-electric is currently the only

  13. Affordances and distributed cognition in museum exhibitions

    DEFF Research Database (Denmark)

    Achiam, Marianne; May, Michael; Marandino, Martha

    2014-01-01

    Exhibitions are the primary medium for the public communication of science in museums. Recently, there has been an interest in explaining the educational mechanisms of exhibitions in terms of meaning making, interaction and space; however these concepts have not yet been integrated into one...... consistent framework. Here, we invoke the notions of affordance and distributed cognition to explain in a coherent way how visitors interact with exhibits and exhibit spaces and make meaning from those interactions, and we exemplify our points using observations of twelve visitors to exhibits at a natural...... history museum. We show how differences in exhibit characteristics give rise to differences in the interpretive strategies used by visitors in their meaning-making process, and conclude by discussing how the notions of affordance and distributed cognition can be used in an exhibit design perspective....

  14. Refining Grasp Affordance Models by Experience

    DEFF Research Database (Denmark)

    Detry, Renaud; Kraft, Dirk; Buch, Anders Glent;

    2010-01-01

    We present a method for learning object grasp affordance models in 3D from experience, and demonstrate its applicability through extensive testing and evaluation on a realistic and largely autonomous platform. Grasp affordance refers here to relative object-gripper configurations that yield stable...... visual model of the object they characterize. We explore a batch-oriented, experience-based learning paradigm where grasps sampled randomly from a density are performed, and an importance-sampling algorithm learns a refined density from the outcomes of these experiences. The first such learning cycle is...... bootstrapped with a grasp density formed from visual cues. We show that the robot effectively applies its experience by downweighting poor grasp solutions, which results in increased success rates at subsequent learning cycles. We also present success rates in a practical scenario where a robot needs to...

  15. Affordances and the musically extended mind

    Directory of Open Access Journals (Sweden)

    Joel eKrueger

    2014-01-01

    Full Text Available I defend a model of the musically extended mind. I consider how acts of musicking grant access to novel emotional experiences otherwise inaccessible. First, I discuss the idea of musical affordances and specify both what musical affordances are and how they invite different forms of entrainment. Next, I argue that musical affordances—via soliciting different forms of entrainment—enhance the functionality of various endogenous, emotion-granting regulative processes, drawing novel experiences out of us with an expanded complexity and phenomenal character. I suggest that music therefore ought to be thought of as part of the vehicle needed to realize these emotional experiences. I appeal to different sources of empirical work to develop this idea.

  16. Heavy fuel oil: acceptable? available? affordable?

    International Nuclear Information System (INIS)

    Increasingly stringent environmental legislation on emissions limits poses problems for large industrial energy users, causing them to re-examine their choice of fuel source. Choice of fuel must be made flexibly, preferably in the form of a dual fuel strategy, it is argued here. This article examines the relationship between the 1995 Environment Act, the 1990 Environmental Protection Act, and the likely future of heavy fuel oils in terms of acceptability, availability and affordability. (UK)

  17. Silent myocardial ischemia.

    Science.gov (United States)

    Gutterman, David D

    2009-05-01

    Although much progress has been made in reducing mortality from ischemic cardiovascular disease, this condition remains the leading cause of death throughout the world. This might in part be due to the fact that over half of patients have a catastrophic event (heart attack or sudden death) as their initial manifestation of coronary disease. Contributing to this statistic is the observation that the majority of myocardial ischemic episodes are silent, indicating an inability or failure to sense ischemic damage or stress on the heart. This review examines the clinical characteristics of silent myocardial ischemia, and explores mechanisms involved in the generation of angina pectoris. Possible mechanisms for the more common manifestation of injurious reductions in coronary flow; namely, silent ischemia, are also explored. A new theory for the mechanism of silent ischemia is proposed. Finally, the prognostic importance of silent ischemia and potential future directions for research are discussed.

  18. Acute myocardial infarction.

    Science.gov (United States)

    Rischpler, Christoph

    2016-09-01

    Inflammatory processes after myocardial infarction have gained major interest in recent cardiovascular research. It is believed that not only the degree of cell recruitment to the heart plays a pivotal role in the quality of wound healing after myocardial infarction, but also the balance between different types or even subtypes of cells. It is also this balance which is thought to control key processes in tissue repair, such as apoptosis and neoangiogenesis. In this paper, we aim to review imaging strategies (with a special focus on nuclear molecular imaging strategies) that target cells and processes involved in postischemic inflammation and that have a high potential to be translated into clinic or that are already being used and evaluated in humans. PMID:27225319

  19. Myocardial tissue engineering using electrospun nanofiber composites

    Science.gov (United States)

    Kim, Pyung-Hwan; Cho, Je-Yoel

    2016-01-01

    Emerging trends for cardiac tissue engineering are focused on increasing the biocompatibility and tissue regeneration ability of artificial heart tissue by incorporating various cell sources and bioactive molecules. Although primary cardiomyocytes can be successfully implanted, clinical applications are restricted due to their low survival rates and poor proliferation. To develop successful cardiovascular tissue regeneration systems, new technologies must be introduced to improve myocardial regeneration. Electrospinning is a simple, versatile technique for fabricating nanofibers. Here, we discuss various biodegradable polymers (natural, synthetic, and combinatorial polymers) that can be used for fiber fabrication. We also describe a series of fiber modification methods that can increase cell survival, proliferation, and migration and provide supporting mechanical properties by mimicking micro-environment structures, such as the extracellular matrix (ECM). In addition, the applications and types of nanofiber-based scaffolds for myocardial regeneration are described. Finally, fusion research methods combined with stem cells and scaffolds to improve biocompatibility are discussed. [BMB Reports 2016; 49(1): 26-36] PMID:26497579

  20. Myocardial protection in sepsis

    OpenAIRE

    Shakar, Simon; Brian D Lowes

    2008-01-01

    Sepsis with myocardial dysfunction is seen commonly. Beta-blockers have been used successfully to treat chronic heart failure based on the premise that chronically elevated adrenergic drive is detrimental to the myocardium. However, recent reports on the acute use of beta-blockers in situations with potential hemodynamic compromise have shown the risks associated with this approach. In critical situations, the main effect of adrenergic activation is to support cardiovascular function. Caution...

  1. Acute Myocardial Infarction 19922001

    OpenAIRE

    Robert Schmitz

    2005-01-01

    Heart disease is the leading cause of hospitalization and death in the United States among persons age 65 and older. Acute myocardial infarction (AMI), more commonly known as heart attack, accounted for more than 321,000 hospitalizations among Medicare beneficiaries in 2001. This report presents trends in AMI hospitalization, readmission, and mortality rates from 1992 through 2001 among Medicare fee-for-service beneficiaries across various demographic groups.

  2. Myocardial arterial spin labeling

    OpenAIRE

    Kober, Frank; Jao, Terrence; Troalen, Thomas; Nayak, Krishna S.

    2016-01-01

    Arterial spin labeling (ASL) is a cardiovascular magnetic resonance (CMR) technique for mapping regional myocardial blood flow. It does not require any contrast agents, is compatible with stress testing, and can be performed repeatedly or even continuously. ASL-CMR has been performed with great success in small-animals, but sensitivity to date has been poor in large animals and humans and remains an active area of research. This review paper summarizes the development of ASL-CMR techniques, c...

  3. Impact of myocardial ischemia on myocardial revascularization in stable ischemic heart disease. Lessons from the COURAGE and FAME 2 trials.

    Science.gov (United States)

    Torosoff, M T; Sidhu, M S; Boden, W E

    2013-06-01

    In patients with stable ischemic heart disease (SIHD), myocardial revascularization should be performed to either improve survival or improve symptoms and functional status among patients who are not well controlled with optimal medical therapy (OMT). A general consensus exists on the core elements of OMT, which include both lifestyle intervention and intensive secondary prevention with proven pharmacotherapies. By contrast, however, there is less general agreement as to what constitutes the optimal approach to revascularization in SIHD patients. The COURAGE and FAME 2 randomized trials form the foundation of the current clinical evidence base and raise the important question: "What is the impact of myocardial ischemia on myocardial revascularization in stable ischemic heart disease?" PMID:23695652

  4. 护患沟通管理流程对提高急性心肌梗死患者抢救成功率及患者满意度的影响%IMPACT OF NURSE - PATIENT COMMUNICATION MANAGEMENT PROCESSES ON IMPROVING THE SURVIVAL RATE AND SATISFACTION OF PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

    Institute of Scientific and Technical Information of China (English)

    范春艳

    2015-01-01

    Objective To compare the differences in routine care nurse - patient communication processes and management processes for the survival rate and care satisfaction of patients with acute myocardial in‐farction ,and provide the basis for nurse - patient communication in the clinical management processes . Methods The nurse - patient communication management processes was start from the September 2013 in author's hospital ,the 43 cases of acute myocardial infarction were admitted to hospital as a control group from September 2012 to August 2013 ,another 43 cases of acute myocardial infarction were as the observa‐tion group from September 2013 to August 2014 .Control group with conventional care process ,observa‐tion group received nurse - patient communication management processes .Two groups of patients were compared with care satisfaction when they discharged ,emergency success rate ,complication rate ,depres‐sion and anxiety incidence ,nursing complaint rate ,incidence of nursing disputes ,nursing error rate ,health knowledge and so on .Results In observation group ,the attitude of patient to nurses ,nurse - patient com‐munication ,business level ,health education ,to meet the needs of the timeliness and overall satisfaction score were 13 .98 ± 2 .45 ,23 .15 ± 2 .96 ,18 .62 ± 3 .45 ,18 .55 ± 3 .26 ,18 .11 ± 3 .78 ,88 .60 ± 5 .78 ,respec‐tively ,the scores were significantly higher than control group( P < 0 .05) .Emergency survival rate and health knowledge rate of the observation group were of 100 .00% and 88 .37% ,respectively ,were signifi‐cantly higher(P < 0 .05) .Whose incidence of anxiety and depression ,the complication rate ,incidence of nursing disputes ,nursing complaint rate ,nursing error rate were 9 .30% ,6 .97% ,4 .65% ,4 .65% ,2 . 32% ,0 .00% ,significantly lower than control group (P< 0 .05) .Conclusion Nurse - patient communica‐tion management processes can improve the survival rate of patients ,reduce the risk of disputes

  5. Usefulness of myocardial perfusion SPECT after percutaneous coronary intervention (PCI)

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Jin; Lee, Dong Soo [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2005-02-15

    As the indication of percutaneous coronary intervention (PCI) has expanded to the more difficult and complicated cases, frequent restenosis is still expected after PCI. According to AHA/ACC guideline of the present time, routine use of myocardial perfusion single photon emission tomography (SPECT) is not recommended after coronary intervention, but symptom itself or exercise EKG is not enough for the detection of restensis or for the prediction of event-free survival. In high risk and/or symptomatic subjects, direct coronary angiography is required. Myocardial perfusion SPECT could detect restenosis in 79% of the patients if performed 2 to 9 months after PCI. Reversible perfusion decrease in the myocardial perfusion SPECT is known to be the major prognostic indicator of major adverse cardiac event in PCI patients and also the prognosis is benign in the patients without reversible perfusion decrease. Though the cumulated specificity is 79% in the literature and optimal timing of myocardial perfusion SPECT is in controversy, SPECT is recommended even in asymptomatic patients at 3 to 9 months after PCI. Considering the evidences recently reported in the literature, myocardial perfusion SPECT is useful for risk stratification and detection of coronary artery restenosis requiring re-intervention in the asymptomatic patients after PCI.

  6. Fractal analysis of heart rate variability and mortality after an acute myocardial infarction

    DEFF Research Database (Denmark)

    Tapanainen, Jari M; Thomsen, Poul Erik Bloch; Køber, Lars;

    2002-01-01

    in a large, consecutive series of survivors of an acute myocardial infarction (AMI). A consecutive series of 697 patients were recruited to participate 2 to 7 days after an AMI in 3 Nordic university hospitals. The conventional time-domain and spectral parameters and the newer fractal scaling indexes of HR......-term fractal scaling analysis of HR variability is a powerful predictor of mortality among patients surviving an acute myocardial infarction....

  7. Factors Associated with Delay in Thrombolytic Therapy in Patients with ST-Elevation Myocardial Infarction

    OpenAIRE

    Shahrooz Yazdani; Nazanin Kiapour; Amir Alishahi Tabriz; Mohammad-Reza Sohrabi

    2012-01-01

    Background: Treatment delay in the management of ST-elevation myocardial infarction conversely correlates with prognosis and survival of the patients. This study aimed to investigate factors associated with delay in the thrombolytic therapy of these patients in Tehran. Methods: Between 2007 and 2010, the interval between the self-reported time of the onset of symptoms and initiation of the thrombolytic agent in 513 patients with a diagnosis of acute ST-elevation myocardial infarction was reco...

  8. Pretreatment of Cardiac Stem Cells With Exosomes Derived From Mesenchymal Stem Cells Enhances Myocardial Repair

    OpenAIRE

    Zhang, Zhiwei; Yang, Junjie; Yan, Weiya; Li, Yangxin; Shen, Zhenya; Asahara, Takayuki

    2016-01-01

    Background Exosomes derived from mesenchymal stem cells (MSCs) were proved to boost cell proliferation and angiogenic potency. We explored whether cardiac stem cells (CSCs) preconditioned with MSC exosomes could survive and function better in a myocardial infarction model. Methods and Results DiI‐labeled exosomes were internalized with CSCs. They stimulated proliferation, migration, and angiotube formation of CSCs in a dose‐dependent manner. In a rat myocardial infarction model, MSC exosome–p...

  9. Active Affordance Learning in Continuous State and Action Spaces

    NARCIS (Netherlands)

    Wang, C.; Hindriks, K.V.; Babuska, R.

    2014-01-01

    Learning object affordances and manipulation skills is essential for developing cognitive service robots. We propose an active affordance learning approach in continuous state and action spaces without manual discretization of states or exploratory motor primitives. During exploration in the action

  10. Protective Effect of Thrombopoietin on Myocardial Cell in Vitro

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    To investigate the protective effect of thrombopoietin (TPO) on myocardial cells in vitro. Methods H9C2 cell line was maintained in Iscove's modified Dulbecco's medium (IMDM) supplemented with 10% calf serum.Beating cells from heart ventricles of neonatal heart were cultured at an in vitro system. Apoptosis of the cell line above was induced by treatment of doxorubicin (DOX) and was blocked by TPO. Cell survival rate of H9C2 cell was measured by the MTr assay. Changes of beating rate of neonatal myocardial cells were captured by digital camera and beating rate was calculated. Flow cytometry was employed to study anti-apoptotic effect of TPO by staining JC-1 protein to H9C2 cell. Results MTT assay demonstrated that doxorubicin reduced cell survival rate by 73.8% + 1.1%, 50 ng * a dose-dependent manner. Beating rate of primary neonatal myocardial cells also decreased to 15% ± 8% at 48 h, 100 11% ± 6% ( P< 0. 05 ). Conclusions TPO has protective effect on myocardial cells in vitro. Anti-apoptosis is one of the mechanisms by which TPO protects injured heart.

  11. Price, availability and affordability of medicines

    Directory of Open Access Journals (Sweden)

    Brenda S. Mhlanga

    2014-01-01

    Full Text Available Background: Medicines play an important role in healthcare, but prices can be a barrier to patient care. Few studies have looked at the prices of essential medicines in low- and middle-income countries in terms of patient affordability.Aim: To determine the prices, availability and affordability of medicines along the supply chain in Swaziland.Setting: Private- and public-sector facilities in Manzini, Swaziland.Methods: The standardised methodology designed by the World Health Organization and Health Action International was used to survey 16 chronic disease medicines. Data were collected in one administrative area in 10 private retail pharmacies and 10 public health facilities. Originator brand (OB and lowest-priced generic equivalent (LPG medicines were monitored and these prices were then compared with international reference prices (IRPs. Affordability was calculated in terms of the daily wage of the lowest-paid unskilled government worker.Results: Mean availability was 68% in the public sector. Private sector OB medicines were priced 32.4 times higher than IRPs, whilst LPGs were 7.32 times higher. OBs cost473% more than LPGs. The total cumulative mark-ups for individual medicines range from 190.99% – 440.27%. The largest contributor to add-on cost was the retail mark-up (31% – 53%. Standard treatment with originator brands cost more than a day’s wage.Conclusion: Various policy measures such as introducing price capping at all levels of the medicine supply chain, may increase the availability, whilst at the same time reducing the prices of essential medicines for the low income population.

  12. Dignity for all: affordable assisted living.

    Science.gov (United States)

    Janeski, James F; Pruchnicki, Alec

    2006-01-01

    In 2026, the first of the baby boomers, including Presidents Clinton and Bush, will reach the age of 80, the average age of residents currently in assisted living facilities. In her book The Denial of Aging: Perpetual Youth, Eternal Life, and Other Dangerous Fantasies, Muriel Gillick proposes that the baby boomers will seek assisted living as an alternative to nursing home care. But what about that portion of the population not able to afford the high cost of private assisted living? What option will be available to the low-asset/low-income population in lieu of nursing home care? PMID:17214248

  13. Surviving Cancer

    Science.gov (United States)

    ... his or her health status, when diagnosed with cancer may have an effect on their survival and recovery. Older adults are more likely to have other health conditions such as diabetes and heart disease. Managing these conditions can complicate ...

  14. Myocardial damage size assessment in the zone of infarction for indicating rescue percutaneous coronary intervention

    Directory of Open Access Journals (Sweden)

    Baškot Branislav

    2008-01-01

    Full Text Available Background. The most important predictors of subsequent patients outcome after acute myocardial infarction (AIM are infarct size, left ventricular ejection fraction, left ventricular volumes and presence and extent of residual myocardial ischemia. All of these variables can be directly determined through scintigraphic approaches. The presence and extent of myocardial ischemia are strong predictors for fatal and nonfatal cardiac events and improve risk statification beyond the information gleaned from clinical variables. Case report. We presented a case of 66-years-old male with myocardial infarction of anteroseptal localization. Myocardial perfusion imaging (MPI detected a large zone of residual ischemia (culprit lesion within infarction zone. It has an important role in risk stratification after myocardial infarction, and indicates subsequent therapeutic decision making, in this case rescue percutaneous coronary intervention (PCI. After PCI we followed the therapy effect by MPI, and we found practically normal perfusion with minimal zone of defect perfusion in the apex. Conclusion. Myocardial perfusion imaging has an important role in the initial evaluation and risk stratification of patients surviving myocardial infarction. It also plays a major role in guiding subsequent therapeutic decision making, and in monitoring the benefits of these therapeutic measures.

  15. [Assessing myocardial perfusion with positron emission tomography].

    Science.gov (United States)

    vom Dahl, J

    2001-11-01

    Positron emission tomography (PET) of the heart has gained widespread scientific and clinical acceptance with regard to two indications: 1) The detection of perfusion abnormalities by qualitative and semiquantitative analyses of perfusion images at rest and during physical or pharmacological stress using well-validated perfusion tracers, such as N-13 ammonia, Rb-82 rubidium chloride, or O-15 labeled water. 2) Viability imaging of myocardial regions with reduced contractility by combining perfusion measurements with substrate metabolism as assessed from F-18 deoxyglucose utilization. This overview summarizes the use of PET as a perfusion imaging method. With a sensitivity > 90% in combination with high specificity, PET is today the best-validated available nuclear imaging technique for the diagnosis of coronary artery disease (CAD). The short half-life of the perfusion tracers in combination with highly sophisticated hard- and software enables rapid PET studies with high patient throughput. The high diagnostic accuracy and the methological advantages as compared to conventional scintigraphy allows one to use PET perfusion imaging to detect subtle changes in the perfusion reserve for the detection of CAD in high risk but asymptomatic patients as well as in patients with proven CAD undergoing various treatment forms such as risk factor reduction or coronary revascularization. In patients following orthotopic heart transplantation, evolving transplant vasculopathy can be detected at an early stage. Quantitative PET imaging at rest allows for detection of myocardial viability since cellular survival is based on maintenance of a minimal perfusion and structural changes correlate to the degree of perfusion reduction. Furthermore, quantitative assessment of the myocardial perfusion reserve detects the magnitude and competence of collaterals in regions with occluded epicardial collaterals and, thus, imaging of several coronary distribution territories in one noninvasive

  16. Preconditioning of stem cells for the treatment of myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    LU Hui-he; LI Yi-fei; SHENG Zheng-qiang; WANG Yi

    2012-01-01

    Objective Poor stem cell survival is one of the obstacles for cell regeneration therapy post myocardial infarction (MI) and responsible for unsatisfactory therapeutic effectiveness.Various approaches to improve the status of these cells and increase cell survival have become research foci.The following article is a mini-review on the utilization of cell preconditioning for stem cell survival.Date sources The data used in this review were mainly from the articles in Medline and PubMed published from 1990 to 2010.The search terms included "preconditioning,stem cell and myocardial infarction".Study selection Original articles and critical reviews selected were relevant to the review's theme.Results The harsh ischemic and inflammatory microenvironment in the infarcted myocardium offers a significant challenge to the transplanted donor stem cells.Survival of stem cells following transplantation is affected by many factors,such as limited blood supply,nutritional deficiency,hypoxia,oxidative stress,and inflammation.Preconditioning methods have potent cytoprotective effects,which enables cells to maintain a "standby state" through programmed initiation of cell survival pathways.Conclusions The findings suggest that cell preconditioning can be used as an effective anti-apoptotic strategy and enable cells to withstand and survive the harsh environment after transplantation.

  17. Immunologic protection afforded by sunscreens in vitro.

    Science.gov (United States)

    Davenport, V; Morris, J F; Chu, A C

    1997-06-01

    Several studies have suggested a lack of correlation between sunscreen sun protection factor and protection of the skin immune system, potentially allowing greater damage to the skin by removing the natural protective erythemal response to sun exposure. Despite this, routine testing of immune protection afforded by sunscreens is not performed by industry. Current laboratory methods for investigating the efficacy of sunscreen protection of epidermal immune function use the induction of contact hypersensitivity or epidermal cell alloantigen presentation. Animal models, cell culture systems, and in vivo human studies are commonly employed, but all these systems have significant drawbacks for use in routine testing. The purpose of this study was to develop an in vitro system for testing the immunologic protection afforded by sunscreens in human skin. Five test sunscreens plus a vehicle control were tested in a "blind" fashion for their in vitro level of immune protection. Creams were applied in a standard manner to human whole skin explants and were irradiated over a range of physiologic doses using an Oriel solar simulator. A mixed epidermal lymphocyte reaction was used to quantify epidermal alloantigen-presenting capacity, in the presence or absence of test cream, for five explants. Results consistently demonstrated that all the test sunscreens protected beyond their designated sun protection factors, whereas the vehicle conferred no protection. The explant-mixed epidermal lymphocyte reaction system gave consistent, reproducible results and may prove useful for the allocation of an immune protection factor to all sunscreens. PMID:9182811

  18. Myocardial perfusion modeling using MRI

    DEFF Research Database (Denmark)

    Larsson, H B; Fritz-Hansen, T; Rostrup, Egill;

    1996-01-01

    In the present study, it is shown that it is possible to quantify myocardial perfusion using magnetic resonance imaging in combination with gadolinium diethylenetriaminopentaacetic acid (Gd-DTPA). Previously, a simple model and method for measuring myocardial perfusion using an inversion recovery...

  19. Long-term prognosis of women after myocardial infarction. SPRINT Study Group. Secondary Prevention Reinfarction Israeli Nifedipine Trial.

    Science.gov (United States)

    Benderly, M; Behar, S; Reicher-Reiss, H; Boyko, V; Goldbourt, U

    1997-07-15

    Women sustaining myocardial infarction fare worse than men during hospitalization. Reports on long-term survival in women surviving an acute myocardial infarction are controversial. The Secondary Prevention Reinfarction Israeli Nifedipine Trial (SPRINT) registry includes 5,839 consecutive myocardial infarction patients who were hospitalized in 13 coronary care units in Israel between 1981 and 1983. The authors examined sex differences in the long-term survival of 4,808 hospital survivors (1,120 women and 3,688 men). Women exhibited a significantly poorer long-term survival than men. After age adjustment, differences between men and women decreased, leaving a survival probability difference of 11% at the end of 12 years of follow-up. In a subgroup analysis, women exhibited poorer survival than men in a comparison of patients with and without periinfarction congestive heart failure or a history of myocardial infarction preceding the index infarction. The multivariate adjusted hazard ratios associated with female sex in diabetic and nondiabetic patients were 1.46 and 1.13, respectively. In conclusion, a cumulative survival disadvantage for women in comparison with men is still evident after 12 years of follow-up. The mortality difference is diminished but not erased after age adjustment or multivariate adjustment for confounders. The authors' results are compatible with a hypothesis that the main factor underlying the increased long-term mortality in women after myocardial infarction, besides older age, is diabetes mellitus.

  20. Measuring myocardial perfusion

    DEFF Research Database (Denmark)

    Qayyum, A A; Kastrup, J

    2015-01-01

    -pass of non-ionic and ionic contrast agents, respectively. Absolute quantification with CMR has yet to be established in routine clinical practice, while CT has yet to prove its diagnostic and prognostic value. The upcoming years may change the way we diagnose and treat patients suspected of having CAD......Recently, focus has changed from anatomical assessment of coronary arteries towards functional testing to evaluate the effect of stenosis on the myocardium before intervention. Besides positron-emission tomography (PET), cardiac MRI (CMR), and cardiac CT are able to measure myocardial perfusion...

  1. Social affordances and the possibility of ecological linguistics.

    Science.gov (United States)

    Kono, Tetsuya

    2009-12-01

    This paper includes an effort to extend the notion of affordance from a philosophical point of view the importance of ecological approach for social psychology, ethics, and linguistics. Affordances are not always merely physical but also interpersonal and social. I will conceptualize affordance in general and social affordance in particular, and will elucidate the relation between intentional action and affordances, and that between affordances and free will. I will also focus on the relation between social institution and affordance. An extended theory of affordances can provide a way to analyze in concrete ways how social institution works as an implicit background of interpersonal interactions. Ecological approach considers social institution as the producer and maintainer of affordances. Social institutions construct the niches for human beings. Finally, I will argue the possibility of the ecological linguistics. Language is a social institution. The system of signs is the way to articulate and differentiate interpersonal affordances. Language acquires its meaning, i.e. communicative power in the interpersonal interactions, and interpersonal interactions, in turn, develop and are elaborated through the usage of signs. Communication is seen as never aimed to transmit inner ideas to others, but to guide and adjust the behaviors of others thorough articulating the affordance of responsible-ness.

  2. Hierarchical nesting of affordances in a tool use task.

    Science.gov (United States)

    Wagman, Jeffrey B; Caputo, Sarah E; Stoffregen, Thomas A

    2016-10-01

    In studying the perception of affordances, researchers have typically identified a single affordance and designed experiments to evaluate the perception of that affordance. Yet in daily life, multiple affordances always exist. One consequence of this is that there may be higher order, means-ends relations between different affordances. In 4 experiments, we created situations in which lower order, subordinate affordances could affect the realization of higher order, superordinate affordances, and we asked whether participants were sensitive to these hierarchical, nested relations. Participants wielded tools that varied in length, mass, and mass distribution. In Experiments 1 and 2, we asked them to evaluate these tools in terms of their suitability for executing specific interactions with target objects (striking vs. poking) that were positioned at different distances. In Experiments 3 and 4, we asked participants to select rods and masses and then to assemble them into tools that could be used to execute specific interactions with target objects at different distances. The results were compatible with the hypothesis that participants were simultaneously sensitive to affordances for tool assembly and affordances for tool use. We argue that the nesting of affordances is characteristic of many situations in daily life and that, consequently, sensitivity to hierarchical, means-ends relations among affordances may be an essential characteristic of perceptually guided action. (PsycINFO Database Record PMID:27668424

  3. Patterns and Predictors of Fast Food Consumption After Acute Myocardial Infarction

    OpenAIRE

    Salisbury, Adam C.; Chan, Paul S.; Gosch, Kensey L; Buchanan, Donna M.; Spertus, John A.

    2011-01-01

    Although fast food is affordable and convenient, it is also high in calories, saturated fat and sodium. The frequency of fast food intake at the time of, and after, acute myocardial infarction (AMI) is modifiable. However, patterns of fast food intake and characteristics associated with its consumption among AMI patients are unknown. We studied fast food consumption at the time of AMI and 6 months later in 2481 patients from the prospective, 24-center TRIUMPH study of AMI patients. Fast food ...

  4. NASA's Space Launch System: Affordability for Sustainability

    Science.gov (United States)

    May, Todd A.; Creech, Stephen D.

    2012-01-01

    The National Aeronautics and Space Administration's (NASA) Space Launch System (SLS) Program, managed at the Marshall Space Flight Center, is charged with delivering a new capability for human exploration beyond Earth orbit in an austere economic climate. But the SLS value is clear and codified in United States (U.S.) budget law. The SLS Program knows that affordability is the key to sustainability and will provide an overview of initiatives designed to fit within the funding guidelines by using existing engine assets and hardware now in testing to meet a first launch by 2017 within the projected budget. It also has a long-range plan to keep the budget flat, yet evolve the 70-tonne (t) initial lift capability to 130-t lift capability after the first two flights. To achieve the evolved configuration, advanced technologies must offer appropriate return on investment to be selected through the competitive process. For context, the SLS will be larger than the Saturn V that took 12 men on 6 trips for a total of 11 days on the lunar surface some 40 years ago. Astronauts train for long-duration voyages on platforms such as the International Space Station, but have not had transportation to go beyond Earth orbit in modern times, until now. To arrive at the launch vehicle concept, the SLS Program conducted internal engineering and business studies that have been externally validated by industry and reviewed by independent assessment panels. In parallel with SLS concept studies, NASA is now refining its mission manifest, guided by U.S. space policy and the Global Exploration Roadmap, which reflects the mutual goals of a dozen member nations. This mission planning will converge with a flexible heavy-lift rocket that can carry international crews and the air, water, food, and equipment they need for extended trips to asteroids and Mars. In addition, the SLS capability will accommodate very large science instruments and other payloads, using a series of modular fairings and

  5. MYOCARDIAL INFARCTION TYPE 2. MYTH OR REALITY?

    OpenAIRE

    V. V. Zhelnov; N. V. Dyatlov; L. I. Dvoretsky

    2016-01-01

    According to The Third Definition of Myocardial Infarction there are five types of myocardial infarction depending on pathogenesis. This review provides actual data about myocardial infarction type 2 mechanism including diagnosis management, epidemiological characteristic and patient prognosis. Previously published data shows discordant information about myocardial infarction type 2 frequency, treatment and diagnostic options. Our clinical observation illustrates these severities in diagnosis...

  6. An Experimental Study of Myocardial Viability with Myocardial Contrast Echocardiography

    Institute of Scientific and Technical Information of China (English)

    张稳柱; 查道刚; 成官迅; 杨绍青; 刘伊丽

    2001-01-01

    Background Myocardial blood flow(MBF) can be quantified with myocardial contrast echocardiography (MCE) during a venous in fusion of microbubble. A minimal MBF is required to maintain cell membrane integrity and myocardial viability in ischemic condition. Thus, we hypothesized that MCE could be used to assess myocardial viability by the determination of MBF. Methods and Results MCE was performed at 4 hours after ligation of proximal left anterior descending coronary artery in 7dogs with constant venous infusions of microbubbles.The video intensity versus pulsing interval plots derived from each myocardial pixel were fitted to an exponential function: y=A(1-e-βt), where y is Ⅵ at pulsing interval t, A reflects rnicrovascular cross- sectional area (or myocardial blood volume), and β reflects mean myocardial microbubble velocity. The product of A · β represents MBF. MBF was also obtained by radiolabeled microsphere method servered as reference.MBF derived by radiolabeled microsphere- method in the regions of normal, ischemia and infarction was 1.5±0.3, 0.7±0.3, 0.3±0.2mL·min-1· g-1respectively. The product of A · β obtained by MCE in those regions was 52. 46 ± 15.09, 24.36 ± 3.89, 3.74± ± 3.80 respectively. There was good correlation between normalized MBF and the normalized A · β (r =0. 81, P = 0. 001 ). Conclusions MCE has an ability to determine myocardial viability in myocardial in farction canine model.

  7. Effective treatment of depression improves post-myocardial infarction survival

    Institute of Scientific and Technical Information of China (English)

    Soudabeh; Khojasteh; Banankhah; Erika; Friedmann; Sue; Thomas

    2015-01-01

    AIM: To examine the contribution of treatment resistant depression(TRD) to mortality in depressed postmyocardial infarction(MI) patients independent of biological and social predictors.METHODS: This secondary analysis study utilizes the Enhancing Recovery in Coronary Heart Disease(ENRICHD) clinical trial data.From 1834 depressed patients in the ENRICHD study,there were 770 depressed post-MI patients who were treated for depression.In this study,TRD is defined as having a less than 50% reduction in Hamilton Depression(HAM-D) score from baseline and a HAM-D score of greater than 10 in 6 mo after depression treatment began.Cox regression analysis was used to examine the independent contributions of TRD to mortality after controlling for the biological and social predictors.RESULTS: TRD occurred in 13.4%(n = 103) of the 770 patients treated for depression.Patients with TRD were significantly younger in age(P = 0.04)(mean = 57.0 years,SD = 11.7) than those without TRD(mean = 59.2 years,SD = 12.0).There was a significantly higher percentage of females with TRD(57.3%) compared to females without TRD(47.4%) [χ2(1) = 4.65,P = 0.031].There were significantly more current smokers with TRD(44.7%) than without TRD(33.0%) [χ2(1) = 7.34,P = 0.007].There were no significant differences in diabetes(P = 0.120),history of heart failure(P = 0.258),prior MI(P = 0.524),and prior stroke(P = 0.180) between patients with TRD and those without TRD.Mortality was 13%(n = 13) in patients with TRD and 7%(n = 49) in patients without TRD,with a mean follow-up of 29 mo(18 mo minimum and maximum of 4.5 years).TRD was a significant independent predictor of mortality(HR =1.995; 95%CI: 1.011-3.938,P = 0.046) after controlling for age(HR = 1.036; 95%CI: 1.011-1.061,P = 0.004),diabetes(HR = 2.912; 95%CI: 1.638-5.180,P < 0.001),heart failure(HR = 2.736; 95%CI: 1.551-4.827,P = 0.001),and smoking(HR = 0.502; 95%CI: 0.228-1.105,P = 0.087).CONCLUSION: The analysis of TRD in the ENRICHD study shows that the effective treatment of depression reduced mortality in depressed post-MI patients.It is important to monitor the effectiveness of depression treatment and change treatments if necessary to reduce depression and improve cardiac outcomes in depressed post-MI patients.

  8. Valsartan after myocardial infarction.

    Science.gov (United States)

    Güleç, Sadi

    2014-12-01

    One of the important problems of the patients undergoing acute myocardial infarction (MI) is early development of heart failure. It has been revealed in various studies that renin-angiotensin-aldosterone system (RAAS) has a significant role in this process. The studies conducted with angiotensin converting enzyme (ACE) inhibitors have resulted in decreased mortality rate. Another RAAS blocker which was discovered about ten years later than other ACE inhibitors in historical process is angiotensin receptor blockers (ARB) inhibiting the efficiency of angiotensin 2 by binding to angiotensin 1 receptor. Valsartan is one of the molecules of this group, which has higher number of large-scale randomized clinical studies. In this review, following presentation of a general overview on heart failure after acute MI, the efficiency of ARBs in this patient group will be discussed. This discussion will mostly emphasize the construction, outcomes and clinical importance of VALIANT (VALsartan In Acute myocardial iNfarcTion), which is the study on valsartan after acute MI heart failure. PMID:25604205

  9. Affordable Hybrid Heat Pump Clothes Dryer

    Energy Technology Data Exchange (ETDEWEB)

    TeGrotenhuis, Ward E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Butterfield, Andrew [Jabil, St. Petersburg, FL (United States); Caldwell, Dustin D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Crook, Alexander [Jabil, St. Petersburg, FL (United States)

    2016-06-30

    This project was successful in demonstrating the feasibility of a step change in residential clothes dryer energy efficiency by demonstrating heat pump technology capable of 50% energy savings over conventional standard-size electric dryers with comparable drying times. A prototype system was designed from off-the-shelf components that can meet the project’s efficiency goals and are affordable. An experimental prototype system was built based on the design that reached 50% energy savings. Improvements have been identified that will reduce drying times of over 60 minutes to reach the goal of 40 minutes. Nevertheless, the prototype represents a step change in efficiency over heat pump dryers recently introduced to the U.S. market, with 30% improvement in energy efficiency at comparable drying times.

  10. Achieving affordable housing through energy efficiency strategy

    International Nuclear Information System (INIS)

    Cooperation between public and private sector has achieved a remarkable widespread, in the Italian context, over the last two decades. Nevertheless, the increasing difficulty in accessing the capital market and the rising cost of funding sources, both noticeable over the past few years, led to a slowdown of Public–Private Partnership (PPP) initiatives. Meanwhile, the community is expressing new needs to be satisfied, such as the conversion of brownfields, the recovery of housing stock dating back to former times, as well as the refurbishment of public offices or schools. Emerging priorities include the supply of affordable dwellings for low to medium income households. This essay aims to examine a case study in which PPP and buildings energy efficiency have been successfully combined, in order to jointly contribute to the achievement of a social housing settlement. Thanks to energy efficiency measures—concerning building envelope insulation, heating system and other installations—the agreed rent results far higher than social rent of protected tenancies, and furthermore above the range of fair rents characterising other regulated tenancies, but mildly lower than market rents. All this allows to achieve an equity yield rate satisfying from the perspective of a venture philanthropy investment. -- Highlights: •Provision of affordable dwellings is an emerging priority within Italian context. •Lack of public funds leads to promote Public–Private Partnership schemes. •Without public grants the adoption of a venture philanthropy approach is needed. •The examined case study allows to explain the role of buildings energy efficiency. •Buildings energy efficiency may boost feasibility of social housing transactions

  11. Survival Analysis

    CERN Document Server

    Miller, Rupert G

    2011-01-01

    A concise summary of the statistical methods used in the analysis of survival data with censoring. Emphasizes recently developed nonparametric techniques. Outlines methods in detail and illustrates them with actual data. Discusses the theory behind each method. Includes numerous worked problems and numerical exercises.

  12. Physiological Implications of Myocardial Scar Structure.

    Science.gov (United States)

    Richardson, William J; Clarke, Samantha A; Quinn, T Alexander; Holmes, Jeffrey W

    2015-10-01

    Once myocardium dies during a heart attack, it is replaced by scar tissue over the course of several weeks. The size, location, composition, structure, and mechanical properties of the healing scar are all critical determinants of the fate of patients who survive the initial infarction. While the central importance of scar structure in determining pump function and remodeling has long been recognized, it has proven remarkably difficult to design therapies that improve heart function or limit remodeling by modifying scar structure. Many exciting new therapies are under development, but predicting their long-term effects requires a detailed understanding of how infarct scar forms, how its properties impact left ventricular function and remodeling, and how changes in scar structure and properties feed back to affect not only heart mechanics but also electrical conduction, reflex hemodynamic compensations, and the ongoing process of scar formation itself. In this article, we outline the scar formation process following a myocardial infarction, discuss interpretation of standard measures of heart function in the setting of a healing infarct, then present implications of infarct scar geometry and structure for both mechanical and electrical function of the heart and summarize experiences to date with therapeutic interventions that aim to modify scar geometry and structure. One important conclusion that emerges from the studies reviewed here is that computational modeling is an essential tool for integrating the wealth of information required to understand this complex system and predict the impact of novel therapies on scar healing, heart function, and remodeling following myocardial infarction. PMID:26426470

  13. Myocardial perfusion at fatal infarction

    DEFF Research Database (Denmark)

    Hvid-Jacobsen, K; Møller, J T; Kjøller, E;

    1992-01-01

    In a consecutive study of myocardial scintigraphy in acute ischemic syndrome, four patients had 99mTc-hexamibi injected intravenously before they developed fatal cardiogenic shock. Planar scintigraphy was performed after death. Slices of the hearts after autopsy were analyzed for scintigraphic......, where 83%-92% of the myocardium showed ischemia as defined by a 99mTc-hexamibi uptake below an arbitrary limit on half maximum uptake. Myocardial hypoperfusion might thus aggravate the functional impairment at myocardial infarction and lead to cardiogenic shock....

  14. Oxytocin ameliorates the immediate myocardial injury in heart transplant through down regulation of the neutrophil dependent myocardial apoptosis

    Directory of Open Access Journals (Sweden)

    F Fadhil Al-Amran

    2014-01-01

    Conclusion: Oxytocin ameliorates myocardial injury in heart transplant through down-regulation the myocardial inflammatory response, reactive oxygen species, and neutrophil-dependant myocardial apoptosis.

  15. Chronic ischemic mitral regurgitation and papillary muscle infarction detected by late gadolinium-enhanced cardiac magnetic resonance imaging in patients with ST-segment elevation myocardial infarction

    NARCIS (Netherlands)

    Bouma, Wobbe; Willemsen, Hendrik M; Lexis, Chris P H; Prakken, Niek H; Lipsic, Erik; van Veldhuisen, Dirk J; Mariani, Massimo A; van der Harst, Pim; van der Horst, Iwan C C

    2016-01-01

    BACKGROUND: Both papillary muscle infarction (PMI) and chronic ischemic mitral regurgitation (CIMR) are associated with reduced survival after myocardial infarction. The influence of PMI on CIMR and factors influencing both entities are incompletely understood. OBJECTIVES: We sought to determine the

  16. The Affordable Care Act: the ethical call to transform the organizational culture.

    Science.gov (United States)

    Piper, Llewellyn E

    2014-01-01

    The Patient Protection and Affordable Care Act will require health care leaders and managers to develop strategies and implement organizational tactics for their organization to survive and thrive under the federal mandates of this new health care law. Successful health care organizations and health care systems will be defined by their adaptability in the new value-based marketplace created by the Affordable Care Act. The most critical underlining challenge for this success will be the effective transformation of the organizational culture. Transformational value-based leadership is now needed to answer the ethical call for transforming the organizational culture. This article provides a model and recommendations to influence change in the most difficult leadership duty-transforming the organizational culture.

  17. Rethinking Space Design Standards Toward Quality Affordable Housing In Malaysia

    OpenAIRE

    Ishak Nor Haniza; Mohd Ariffin Ati Rosemary; Sulaiman Raha; Mohd Zailani Muhammad Najib

    2016-01-01

    Provision of affordable housing is important to low- and middle-income population. A fit form of house will not only fulfil a basic human need for shelter, but it also contributes to physical and psychological well-being of the occupants. Excellent quality and affordable housing is an indication of a high quality of life. While writings exist on various aspects of the quality of affordable housing in Malaysia, discussion regarding space and design standards has scarcely been given any serious...

  18. Surgical treatment of myocardial bridging: report of 31 cases

    Institute of Scientific and Technical Information of China (English)

    WU Qing-yu; XU Zhong-hua

    2007-01-01

    Background Myocardial bridging (MB) is usually considered a benign condition but may result in myocardial ischemia,myocardial infarction (MI), exercise-induced tachycardia, atrioventricular conduction block or even sudden cardiac death.This retrospective study summarizes our operative methods and outcomes for treatment of 31 cases of MB.Methods From January 1997 to December 2006, 31 consecutive patients (24 men and 7 women; aged 35-67 years;mean 52.3 years) with MB underwent surgical treatment. Thirteen patients had MB only and 18 patients had MB associated with other heart diseases. In preoperative cardiac function grading, 5 patients were in NYHA class Ⅰ and 18 in NYHA class Ⅱ and 8 in NYHA class Ⅲ. Among them, 15 underwent myotomy and 16 underwent coronary artery bypass grafting (CABG).Results All patients survived and recovered uneventfully. Neither hospital or late death nor major complications occurred. Postoperative exercise testing in all patients failed to reveal any persistent ischemia. Follow-up time was 3-115 months (mean 31 months). Follow-up angiographic studies in 21 patients (68%) demonstrated restoration of coronary blood flow and myocardial perfusion without significant residual compression of the artery. All patients were symptom-free and currently in NYHA class Ⅰ-Ⅱ.Conclusion The patients who are refractory to medication should actively undergo the surgical procedures such as myotomy and CABG. Myotomy should be advocated as the first choice because of its safety and satisfactory results.

  19. In vivo study of myocardial elastography under graded ischemia conditions

    Science.gov (United States)

    Lee, Wei-Ning; Provost, Jean; Fujikura, Kana; Wang, Jie; Konofagou, Elisa E.

    2011-02-01

    The capability of currently available echocardiography-based strain estimation techniques to fully map myocardial abnormality at early stages of myocardial ischemia is yet to be investigated. In this study, myocardial elastography (ME), a radio-frequency (RF)-based strain imaging technique that maps the full 2D transmural angle-independent strain tensor in standard echocardiographic views at both high spatial and temporal resolution is presented. The objectives were to (1) evaluate the performance of ME on mapping the onset, extent and progression of myocardial ischemia at graded coronary constriction levels (from partial to complete coronary flow reduction), and (2) validate the accuracy of the strain estimates against sonomicrometry (SM) measurements. A non-survival canine ischemic model (n = 5) was performed by gradually constricting the left anterior descending (LAD) coronary blood flow from 0% (baseline blood flow) to 100% (zero blood flow) at 20% increments. An open-architecture ultrasound system was used to acquire RF echocardiograms in a standard full short-axis view at the frame rate of 211 fps, at least twice higher than what is typically used in conventional echocardiographic systems, using a previously developed, fully automated composite technique. Myocardial deformation was estimated by ME and validated against sonomicrometry. ME estimates and maps transmural (1) 2D displacements using RF cross-correlation and recorrelation; and (2) 2D polar (radial and circumferential) strains, derived from 2D (i.e. both lateral and axial) displacement components, at high accuracy. Full-view strain images were shown and found to reliably depict decreased myocardial function in the region at risk at increased levels of coronary flow reduction. The ME radial strain was deemed to be a more sensitive, quantitative, regional measure of myocardial ischemia as a result of coronary flow reduction when compared to the conventional wall motion score index and ejection fraction

  20. In vivo study of myocardial elastography under graded ischemia conditions

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Wei-Ning; Provost, Jean; Konofagou, Elisa E [Department of Biomedical Engineering, Columbia University, New York, NY (United States); Fujikura, Kana [Department of Radiology, Columbia University, New York, NY (United States); Wang Jie, E-mail: ek2191@columbia.edu [Department of Medicine, Columbia University, New York, NY (United States)

    2011-02-21

    The capability of currently available echocardiography-based strain estimation techniques to fully map myocardial abnormality at early stages of myocardial ischemia is yet to be investigated. In this study, myocardial elastography (ME), a radio-frequency (RF)-based strain imaging technique that maps the full 2D transmural angle-independent strain tensor in standard echocardiographic views at both high spatial and temporal resolution is presented. The objectives were to (1) evaluate the performance of ME on mapping the onset, extent and progression of myocardial ischemia at graded coronary constriction levels (from partial to complete coronary flow reduction), and (2) validate the accuracy of the strain estimates against sonomicrometry (SM) measurements. A non-survival canine ischemic model (n = 5) was performed by gradually constricting the left anterior descending (LAD) coronary blood flow from 0% (baseline blood flow) to 100% (zero blood flow) at 20% increments. An open-architecture ultrasound system was used to acquire RF echocardiograms in a standard full short-axis view at the frame rate of 211 fps, at least twice higher than what is typically used in conventional echocardiographic systems, using a previously developed, fully automated composite technique. Myocardial deformation was estimated by ME and validated against sonomicrometry. ME estimates and maps transmural (1) 2D displacements using RF cross-correlation and recorrelation; and (2) 2D polar (radial and circumferential) strains, derived from 2D (i.e. both lateral and axial) displacement components, at high accuracy. Full-view strain images were shown and found to reliably depict decreased myocardial function in the region at risk at increased levels of coronary flow reduction. The ME radial strain was deemed to be a more sensitive, quantitative, regional measure of myocardial ischemia as a result of coronary flow reduction when compared to the conventional wall motion score index and ejection fraction

  1. National registry of myocardial infarction

    OpenAIRE

    Amin Daemi; Mehdi Jafari

    2016-01-01

    The Registry of Myocardial Infarctions (MI Registry) is a national registry in Iran that collects and reports the data on myocardial infarctions. Its main advantage is that it covers the whole country and is mandatory for hospitals to register the MI cases in it. Then, the qualified individuals at the provincial and national levels can get intended reports and make appropriate decisions. Such reports, further to the policy makers and managers, can be very valuable for researchers. The regi...

  2. 10.11.Myocardial disease

    Institute of Scientific and Technical Information of China (English)

    1992-01-01

    920088 Effect and significance of neuro-peptide Y on synthesis of myocardial pro-tein.WANG Tao (王涛),et al.Cardiovasc Lab,3rd Hosp,Beijing Med Univ.Chin Cir J 1991; 6 (5):354-356.The rate of myocardial protein synthesis andthe cardiac content of neuropeptide Y (NPY) inrats were measured by ~3H-leucine incorporation

  3. Intracoronary adenosine improves myocardial perfusion in late reperfused myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Background Myocardial perfusion associates with clinical syndromes and prognosis.Adenosine could improve myocardial perfusion of acute myocardial infarction within 6 hours,but few data are available on late perfusion of myocardial infarction (MI).This study aimed at quantitatively evaluating the value of intracoronary adenosine improving myocardial perfusion in late reperfused MI with myocardial contrast echocardiography(MCE).Methods Twenty-six patients with anterior wall infarcts were divided randomly into 2 groups:adenosine group(n=12) and normal saline group(n=14).Their history of myocardial infarction was about 3-12 weeks.Adenosine or normalsaline was given when the guiding wire crossed the lesion through percutaneous coronary intervention(PCI),then the balloon was dilated and stent(Cypher/Cypher select)was implanted at the lesion.Contrast pulse sequencing MCE with Sonovue contrast via the coronary route was done before PCI and 30 minutes after PCI.Video densitometry and contrast filled-blank area were calculated with the CUSQ off-line software.Heart function and cardiac events were followed up within 30 days.Results Perfusion in the segments of the criminal occlusive coronary artery in the adenosine group was better than that in the saline group(5.71±0.29 vs 4.95±1.22,P<0.05).Ischemic myocardial segment was deminished significantly afterPCI,but the meliorated area was bigger in the adenosine group than in the saline group((1.56±0.60)cm2 vs(1.02±0.56) cm2,P<0.05).The video densitometry in critical segments was also improved significantly in the adenosine group (5.53±0.36 vs 5.26±0.35,P<0.05).Left ventricular ejection fraction(LVEF)was improved in all patients after PCI,but EF was not significant between the two groups((67±6)% vs(62±7)%,P>0.05).There was no in-hospital or 30-day major adverse cardiac event(MACE)in the adenosine group but 3 MACE in the saline group in 30 days after PCI.Conclusions Adenosine could improve myocardial microvascular

  4. Empathy and the responsiveness to social affordances.

    Science.gov (United States)

    Kiverstein, Julian

    2015-11-01

    The direct perception theory of empathy claims that we can immediately experience a person's state of mind. I can see for instance that my neighbour is angry with me in his bodily countenance. I develop a version of the direct perception theory of empathy which takes this perceptual capacity to depend upon recognising in what way the other person is responsive to the affordances the environment provides. By recognising which possibilities for action are relevant to a person, I can thereby understand something about the meaning they give to the world. I come to share something of their perspective on the world, and this allows me to grasp based on my perception of them something about their current state of mind. I argue that shared affect plays a central role in this perceptual capacity. Shared affect allows me to orient my attention to possibilities for action that matter to the other person. I end by briefly discuss the implications of this view of empathy for the disturbances in so-called "cognitive empathy" that are found in people diagnosed with autism spectrum disorder.

  5. Robust, affordable, semi-direct Mars mission

    Science.gov (United States)

    Salotti, Jean-Marc

    2016-10-01

    A new architecture is proposed for the first manned Mars mission, based on current NASA developments (SLS and Orion), chemical propulsion for interplanetary transit, aerocapture for all vehicles, a split strategy, and a long stay on the surface. Two important choices make this architecture affordable and appropriate for the first mission. The first is splitting the Earth return vehicle into two parts that are launched separately and dock in Mars orbit. This is necessary to make aerocapture feasible and efficient, which considerably reduces mass. The second is reducing the crew to 3 astronauts. This simplifies the mission and reduces the SLS payload mass under the 45-metric ton limit for a direct TMI (trans-Mars injection) burn without LEO assembly. Only 4 SLS launches are required. The first takes the Mars ascent vehicle and in situ resource utilization systems to the planet's surface. The second takes the first part of the Earth return vehicle, the habitat, into Mars orbit. Two years later, two further SLS launches take a dual-use habitat (outbound trip and surface), Orion, and an enhanced service module to LEO, and then into Mars orbit, followed by the landing of the habitat on the surface. Transit time is demonstrated to be easily reduced to less than 6 months, with relatively low impact on propellant mass and none at all on the architecture.

  6. Affordable underwater wireless optical communication using LEDs

    Science.gov (United States)

    Pilipenko, Vladimir; Arnon, Shlomi

    2013-09-01

    In recent years the need for high data rate underwater wireless communication (WC) has increased. Nowadays, the conventional technology for underwater communication is acoustic. However, the maximum data rate that acoustic technology can provide is a few kilobits per second. On the other hand, emerging applications such as underwater imaging, networks of sensors and swarms of underwater vehicles require much faster data rates. As a result, underwater optical WC, which can provide much higher data rates, has been proposed as an alternative means of communication. In addition to high data rates, affordable communication systems become an important feature in the development requirements. The outcome of these requirements is a new system design based on off-the-shelf components such as blue and green light emitting diodes (LEDs). This is due to the fact that LEDs offer solutions characterized by low cost, high efficiency, reliability and compactness. However, there are some challenges to be met when incorporating LEDs as part of the optical transmitter, such as low modulation rates and non linearity. In this paper, we review the main challenges facing the incorporation of LEDs as an integral part of underwater WC systems and propose some techniques to mitigate the LED limitations in order to achieve high data rate communication

  7. Empathy and the responsiveness to social affordances.

    Science.gov (United States)

    Kiverstein, Julian

    2015-11-01

    The direct perception theory of empathy claims that we can immediately experience a person's state of mind. I can see for instance that my neighbour is angry with me in his bodily countenance. I develop a version of the direct perception theory of empathy which takes this perceptual capacity to depend upon recognising in what way the other person is responsive to the affordances the environment provides. By recognising which possibilities for action are relevant to a person, I can thereby understand something about the meaning they give to the world. I come to share something of their perspective on the world, and this allows me to grasp based on my perception of them something about their current state of mind. I argue that shared affect plays a central role in this perceptual capacity. Shared affect allows me to orient my attention to possibilities for action that matter to the other person. I end by briefly discuss the implications of this view of empathy for the disturbances in so-called "cognitive empathy" that are found in people diagnosed with autism spectrum disorder. PMID:26021190

  8. Life Expectancy after Myocardial Infarction, According to Hospital Performance.

    Science.gov (United States)

    Bucholz, Emily M; Butala, Neel M; Ma, Shuangge; Normand, Sharon-Lise T; Krumholz, Harlan M

    2016-10-01

    Background Thirty-day risk-standardized mortality rates after acute myocardial infarction are commonly used to evaluate and compare hospital performance. However, it is not known whether differences among hospitals in the early survival of patients with acute myocardial infarction are associated with differences in long-term survival. Methods We analyzed data from the Cooperative Cardiovascular Project, a study of Medicare beneficiaries who were hospitalized for acute myocardial infarction between 1994 and 1996 and who had 17 years of follow-up. We grouped hospitals into five strata that were based on case-mix severity. Within each case-mix stratum, we compared life expectancy among patients admitted to high-performing hospitals with life expectancy among patients admitted to low-performing hospitals. Hospital performance was defined by quintiles of 30-day risk-standardized mortality rates. Cox proportional-hazards models were used to calculate life expectancy. Results The study sample included 119,735 patients with acute myocardial infarction who were admitted to 1824 hospitals. Within each case-mix stratum, survival curves of the patients admitted to hospitals in each risk-standardized mortality rate quintile separated within the first 30 days and then remained parallel over 17 years of follow-up. Estimated life expectancy declined as hospital risk-standardized mortality rate quintile increased. On average, patients treated at high-performing hospitals lived between 0.74 and 1.14 years longer, depending on hospital case mix, than patients treated at low-performing hospitals. When 30-day survivors were examined separately, there was no significant difference in unadjusted or adjusted life expectancy across hospital risk-standardized mortality rate quintiles. Conclusions In this study, patients admitted to high-performing hospitals after acute myocardial infarction had longer life expectancies than patients treated in low-performing hospitals. This survival benefit

  9. Ground Processing Affordability for Space Vehicles

    Science.gov (United States)

    Ingalls, John; Scott, Russell

    2011-01-01

    Launch vehicles and most of their payloads spend the majority of their time on the ground. The cost of ground operations is very high. So, why so often is so little attention given to ground processing during development? The current global space industry and economic environment are driving more need for efficiencies to save time and money. Affordability and sustainability are more important now than ever. We can not continue to treat space vehicles as mere science projects. More RLV's (Reusable Launch Vehicles) are being developed for the gains of reusability which are not available for ELV's (Expendable Launch Vehicles). More human-rated vehicles are being developed, with the retirement of the Space Shuttles, and for a new global space race, yet these cost more than the many unmanned vehicles of today. We can learn many lessons on affordability from RLV's. DFO (Design for Operations) considers ground operations during design, development, and manufacturing-before the first flight. This is often minimized for space vehicles, but is very important. Vehicles are designed for launch and mission operations. You will not be able to do it again if it is too slow or costly to get there. Many times, technology changes faster than space products such that what is launched includes outdated features, thus reducing competitiveness. Ground operations must be considered for the full product Lifecycle, from concept to retirement. Once manufactured, launch vehicles along with their payloads and launch systems require a long path of processing before launch. Initial assembly and testing always discover problems to address. A solid integration program is essential to minimize these impacts, as was seen in the Constellation Ares I-X test rocket. For RLV's, landing/recovery and post-flight turnaround activities are performed. Multi-use vehicles require reconfiguration. MRO (Maintenance, Repair, and Overhaul) must be well-planned--- even for the unplanned problems. Defect limits and

  10. Commercial Platforms Allow Affordable Space Research

    Science.gov (United States)

    2013-01-01

    At an altitude of about 240 miles, its orbital path carries it over 90 percent of the Earth s population. It circles the Earth in continuous free fall; its crew of six and one Robonaut pass the days, experiencing 16 sunrises and 16 sunsets every 24 hours, in microgravity, an environment in which everything from bodily functions to the physical behavior of materials changes drastically from what is common on the ground. Outside its shielded confines, temperatures cycle from one extreme to the other, radiation is rampant, and atomic oxygen corrodes everything it touches. A unique feat of engineering, the International Space Station (ISS) also represents the most remarkable platform for scientific research ever devised. In 2005, anticipating the space station s potential for NASA and non-NASA scientists alike, the NASA Authorization Act designated the US segment of the ISS as a national laboratory, instructing the Agency to "increase the utilization of the ISS by other Federal entities and the private sector." With the ISS set to maintain operations through at least 2020, the station offers an unprecedented long-term access to space conditions, enabling research not previously possible. "There will be new drug discoveries, new pharmaceuticals, a better understanding of how we affect the planet and how we can maintain it," says Marybeth Edeen, the ISS National Laboratory manager, based at Johnson Space Center. The ISS, she says, represents a major example of the government s role in making such advancements possible. "The government is key in that researchers cannot afford to build the kind of infrastructure that the government can provide. But we then have to make that infrastructure available at a reasonable cost." Enter Jeff Manber, who saw in the ISS National Lab an extraordinary opportunity to advance science, education, and business in ways never before seen.

  11. Affordable Space Tourism: SpaceStationSim

    Science.gov (United States)

    2006-01-01

    For over 5 years, people have been living and working in space on the International Space Station (ISS), a state-of-the-art laboratory complex orbiting high above the Earth. Offering a large, sustained microgravity environment that cannot be duplicated on Earth, the ISS furthers humankind s knowledge of science and how the body functions for extended periods of time in space all of which will prove vital on long-duration missions to Mars. On-orbit construction of the station began in November 1998, with the launch of the Russian Zarya Control Module, which provided battery power and fuel storage. This module was followed by additional components and supplies over the course of several months. In November 2000, the first ISS Expedition crew moved in. Since then, the ISS has continued to change and evolve. The space station is currently 240 feet wide, measured across the solar arrays, and 171 feet long, from the NASA Destiny Laboratory to the Russian Zvezda Habitation Module. It is 90 feet tall, and it weighs approximately 404,000 pounds. Crews inhabit a living space of about 15,000 cubic feet. To date, 90 scientific investigations have been conducted on the space station. New results from space station research, from basic science to exploration research, are being published each month, and more breakthroughs are likely to come. It is not all work on the space station, though. The orbiting home affords many of the comforts one finds on Earth. There is a weightless "weight room" and even a musical keyboard alongside research facilities. Holidays are observed, and with them, traditional foods such as turkey and cobbler are eaten, with lemonade to wash them down

  12. Facilitating investment in affordable housing: towards an Australian model. Draft

    NARCIS (Netherlands)

    Lawson, J.M.; Berry, M.; Milligan, V.; Yates, J.

    2009-01-01

    This paper argues that sustainable and affordable finance provides a crucial pillar to support the provision of affordable housing in the long term. This finance can take on a variety of forms, comprising grants, public loans, commercial loans as well as shareholder equity. It can be facilitated by

  13. Nurturing Opportunities for Educational Leadership: How Affordance and Leadership Interconnect

    Science.gov (United States)

    Margolin, Ilana

    2013-01-01

    This qualitative ethnographic study focused on the affordances that facilitated the emergence of leadership, capturing a range of perspectives on leadership and leadership development of four groups: district superintendents; teacher-educators; mentor-teachers and graduates. The term "affordances" implies a reciprocal relationship…

  14. Early identification of patients at low risk of death after myocardial infarction and potentially suitable for early hospital discharge.

    OpenAIRE

    Parsons, R. W.; Jamrozik, K D; Hobbs, M S; Thompson, P L; Thompson, D. L.

    1994-01-01

    OBJECTIVES--To find (a) whether data available shortly after admission for acute myocardial infarction can provide a reliable prognostic indicator of survival at 28 days, and (b) whether such an indicator might be used to identify patients at low risk of death and suitable for early discharge. DESIGN--Retrospective analysis of data collected on patients admitted to a coronary care unit for acute myocardial infarction. A validation sample was selected at random from these patients. SETTING--Co...

  15. Adenoviral short hairpin RNA targeting phosphodiesterase 5 attenuates cardiac remodeling and cardiac dysfunction following myocardial infarction in mice

    Institute of Scientific and Technical Information of China (English)

    张健

    2014-01-01

    Objective To observe the impact of PDE5shRNA on cardiac remodeling and heart function following myocardial infarction in mice.Methods Myocardial infarction(MI)was induced in mice by left coronary artery ligation.Mice were randomly assigned to sham operation group(n=6),PDE5shRNA group(n=12),common adenovirus group(n=15)and DMEM group(n=8).Four weeks post-MI,the survival rate was evaluated.

  16. An Affordability Comparison Tool (ACT) for Space Transportation

    Science.gov (United States)

    McCleskey, C. M.; Bollo, T. R.; Garcia, J. L.

    2012-01-01

    NASA bas recently emphasized the importance of affordability for Commercial Crew Development Program (CCDP), Space Launch Systems (SLS) and Multi-Purpose Crew Vehicle (MPCV). System architects and designers are challenged to come up with architectures and designs that do not bust the budget. This paper describes the Affordability Comparison Tool (ACT) analyzes different systems or architecture configurations for affordability that allows for a comparison of: total life cycle cost; annual recurring costs, affordability figures-of-merit, such as cost per pound, cost per seat, and cost per flight, as well as productivity measures, such as payload throughput. Although ACT is not a deterministic model, the paper develops algorithms and parametric factors that use characteristics of the architectures or systems being compared to produce important system outcomes (figures-of-merit). Example applications of outcome figures-of-merit are also documented to provide the designer with information on the relative affordability and productivity of different space transportation applications.

  17. Utility payments in Ukraine: Affordability, subsidies and arrears

    Energy Technology Data Exchange (ETDEWEB)

    Fankhauser, Samuel [London School of Economics, London (United Kingdom); Rodionova, Yulia [School of Slavonic and East European Studies, University College London, 16 Taviton street, London WC1H 0BW (United Kingdom)], E-mail: y.rodionova@ssees.ucl.ac.uk; Falcetti, Elisabetta [European Bank for Reconstruction and Development (EBRD), London (United Kingdom)

    2008-11-15

    The transition from a planned economy to a market economy has caused considerable hardship for the people of Eastern Europe. One important aspect of the social costs of transition is access to, and the affordability of, basic services like electricity, heat and water, which under communism had been supplied fairly cheaply and abundantly. This paper provides evidence on this issue from the Ukraine Longitudinal Monitoring Survey (ULMS). The paper identifies considerable differences in both access and affordability between different localities in Ukraine. Social protection measures can help to alleviate affordability constraints, but the analysis finds that social support is not well targeted. The currently low tariffs prevent an escalation of affordability problems but constraints nevertheless exist. Many households have accumulated substantial arrears as a consequence, although non-payment is a complex issue and not solely a function of affordability.

  18. Utility payments in Ukraine. Affordability, subsidies and arrears

    Energy Technology Data Exchange (ETDEWEB)

    Fankhauser, Samuel [London School of Economics, London (United Kingdom); Rodionova, Yulia [School of Slavonic and East European Studies, University College London, 16 Taviton street, London WC1H 0BW (United Kingdom); Falcetti, Elisabetta [European Bank for Reconstruction and Development (EBRD), London (United Kingdom)

    2008-11-15

    The transition from a planned economy to a market economy has caused considerable hardship for the people of Eastern Europe. One important aspect of the social costs of transition is access to, and the affordability of, basic services like electricity, heat and water, which under communism had been supplied fairly cheaply and abundantly. This paper provides evidence on this issue from the Ukraine Longitudinal Monitoring Survey (ULMS). The paper identifies considerable differences in both access and affordability between different localities in Ukraine. Social protection measures can help to alleviate affordability constraints, but the analysis finds that social support is not well targeted. The currently low tariffs prevent an escalation of affordability problems but constraints nevertheless exist. Many households have accumulated substantial arrears as a consequence, although non-payment is a complex issue and not solely a function of affordability. (author)

  19. Classification and Regression Trees on Aggregate Data Modeling: An Application in Acute Myocardial Infarction

    OpenAIRE

    Quantin, C.; Billard, L.; Touati, M.; Andreu, N; Cottin, Y; Zeller, M.; Afonso, F.; Battaglia, G.; Seck, D.; Le Teuff, G; Diday, E.

    2011-01-01

    International audience Cardiologists are interested in determining whether the type of hospital pathway followed by a patient is predictive of survival. The study objective was to determine whether accounting for hospital pathways in the selection of prognostic factors of one-year survival after acute myocardial infarction AMI provided a more informative analysis than that obtained by the use of a standard regression tree analysis CART method . Information on AMI was collected for 1095 hos...

  20. CAD of myocardial perfusion

    Science.gov (United States)

    Storm, Corstiaan J.; Slump, Cornelis H.

    2007-03-01

    Our purpose is in the automated evaluation of the physiological relevance of lesions in coronary angiograms. We aim to extract as much as possible quantitative information about the physiological condition of the heart from standard angiographic image sequences. Coronary angiography is still the gold standard for evaluating and diagnosing coronary abnormalities as it is able to locate precisely the coronary artery lesions. The dimensions of the stenosis can be assessed nowadays successfully with image processing based Quantitative Coronary Angiography (QCA) techniques. Our purpose is to assess the clinical relevance of the pertinent stenosis. We therefore analyze the myocardial perfusion as revealed in standard angiographic image sequences. In a Region-of-Interest (ROI) on the angiogram (without an overlaying major blood vessel) the contrast is measured as a function of time (the so-called time-density curve). The required hyperemic state of exercise is induced artificially by the injection of a vasodilator drug e.g. papaverine. In order to minimize motion artifacts we select based on the recorded ECG signal end-diastolic images in both a basal and a hyperemic run in the same projection to position the ROI. We present the development of the algorithms together with results of a small study of 20 patients which have been catheterized following the standard protocol.

  1. Rat myocardial protein degradation.

    Science.gov (United States)

    Steer, J H; Hopkins, B E

    1981-07-01

    1. Myocardial protein degradation rates were determined by following tyrosine release from rat isolated left hemi-atria in vitro. 2. After two 20 min preincubations the rate of tyrosine release from hemi-atria was constant for 4 h. 3. Skeletal muscle protein degradation was determined by following tyrosine release from rat isolated hemi-diaphragm (Fulks, Li & Goldberg, 1975). 4. Insulin (10(-7) M) inhibited tyrosine release from hemi-atria and hemi-diaphragm to a similar extent. A 48 h fast increased tyrosine release rate from hemi-diaphragm and decreased tyrosine release rate from hemi-atria. Hemi-diaphragm tyrosine release was inhibited by 15 mmol/l D-glucose but a variety of concentrations of D-glucose (0, 5, 15 mmol/l) had no effect on tyrosine release from hemi-atria. Five times the normal plasma levels of the branched-chain amino acids leucine, isoleucine and valine had no effect on tyrosine release from either hemi-atria or hemi-diaphragm.

  2. Survivability of Affordable High Temperature Polymer Matrix Composites for Propulsion Engine Components

    Science.gov (United States)

    Dean, Derrick; Haque, Anwar; Vaidya, Uday; Meador, Michael A. (Technical Monitor)

    2003-01-01

    PMR-type polyimides are regarded as state of the art high temperature polymers, due to their excellent thermo-mechanical properties and thermo-oxidative stability. One of their drawbacks, however is the inability to process them using cost-effective processing methods such as Resin Transfer Molding (RTM) and Resin Film Infusion (RFI). Development of low viscosity, high temperature polymers has been the subject of intense research. Recently, a new generation of low viscosity polyimides were synthesized by the introduction of twisted biphenyl or binapthyl groups into the backbone. This report details the progress for Year 1, which has involved acquiring samples and initiating Phases I and II of the proposed research. Specifically, studies of the process-property relationships of a series of polymers using oligomers based on 2,3,3' ,4'-biphenyltertracarboxylic dianhydride (PBDA) and a mixture of a diamine, BAX and a triamine, 1,3,5-Tris (4-aminophenoxybenzene), TAB, where the amount of TAB was varied have been initiated. The sample containing 10 percent TAB possesses a slightly higher degree of crystalline order versus that of the 20 percent TAB sample, based on x-ray diffraction studies of the b-staged oligomers. Both systems lose all of the crystalline order upon curing, however. The chemorheology has been studied as a function of the TAB content. While the magnitude of the viscosity is essentially the same for both systems, the cure kinetics of the 10 percent TAB system is faster than that for the 20 percent TAB system. The sample exhibits a melting-recrystallization-remelting behavior before the crosslinking commences. Correlation of other kinetic parameters, such as the activation energies for curing, the Tg and mechanical properties to the structure of these systems is underway. Future studies will involve characterization of mechanical and thermal properties of the pure resins and the fabrication of fiber reinforced composites using these materials.

  3. Myocardial Scintigraphy in the Evaluation of Cardiac Events in Patients without Typical Symptoms

    Energy Technology Data Exchange (ETDEWEB)

    Smanio, Paola Emanuela Poggio, E-mail: pgmsmanio@gmail.com; Silva, Juliana Horie; Holtz, João Vitor; Ueda, Leandro; Abreu, Marilia; Marques, Carlindo; Machado, Leonardo [Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brazil Mailing (Brazil)

    2015-08-15

    Cardiovascular disease is a leading cause of death in the world and in Brazil. Myocardial scintigraphy is an important noninvasive method for detecting ischemia in symptomatic patients, but its use in asymptomatic ones or those with atypical symptoms is yet to be defined. To verify the presence of major cardiac events in asymptomatic patients or those with atypical symptoms (atypical chest pain or dyspnea) that underwent myocardial scintigraphy (MS), over a period of 8 years. Secondary objectives were to identify cardiac risk factors associated with myocardial scintigraphy abnormalities and possible predictors for major cardiac events in this group. This was a retrospective, observational study using the medical records of 892 patients that underwent myocardial scintigraphy between 2005 and 2011 and who were followed until 2013 for assessment of major cardiac events and risk factors associated with myocardial scintigraphy abnormalities. Statistical analysis was performed by Fisher’s exact test, logistic regression and Kaplan-Meyer survival curves, with statistical significance being set at p ≤ 0.05. Of the total sample, 52.1% were men, 86.9% were hypertensive, 72.4% had hyperlipidemia, 33.6% were diabetic, and 12.2% were smokers; 44.5% had known coronary artery disease; and 70% had high Framingham score, 21.8% had moderate and 8% had low risk. Of the myocardial scintigraphies, 58.6% were normal, 26.1% suggestive of fibrosis and 15.3% suggestive of ischemia. At evolution, 13 patients (1.5%) had non-fatal myocardial infarction and six individuals (0.7%) died. The group with normal myocardial scintigraphy showed longer period of time free of major cardiac events, non-fatal myocardial infarction (p = 0.036) and death. Fibrosis in the myocardial scintigraphy determined a 2.4-fold increased risk of non-fatal myocardial infarction and five-fold higher risk of death (odds ratio: 2.4 and 5.7, respectively; p = 0.043). The occurrence of major cardiac events in 8 years

  4. Myocardial infarction in children: Two interesting cases

    Directory of Open Access Journals (Sweden)

    Suryawanshi Suresh

    2011-01-01

    Full Text Available Myocardial infarction in children is extremely rare and can have various etiologies. The following two case reports highlight rare but important causes of myocardial infarction in children.

  5. Cryoinjury : a model of myocardial regeneration

    NARCIS (Netherlands)

    van Amerongen, Machteld J.; Hamsen, Martin C.; Petersen, Arien H.; Popa, Eliane R.; van Luyn, Marja J. A.

    2008-01-01

    Introduction: Although traditionally adult cardiomyocytes are thought to be unable to divide, recent observations provide evidence for cardiomyocyte proliferation after myocardial injury. Myocardial cryoinjury has been shown to be followed by neovascularization. We hypothesize that, in addition to n

  6. ANGIOGRAPHIC ASPECTS OF MYOCARDIAL BRIDGES

    Directory of Open Access Journals (Sweden)

    Sujatha. M

    2015-12-01

    Full Text Available Introduction: The segment of epicardial coronary artery that traverses intramurally through the myocardium and bridged by a bunch of cardiac muscle fibers is called tunneled artery or intramural artery. The band of cardiac muscle fibers passing over the tunneled artery segment is named as myocardial bridge. During angiography milking effect is observed during systole due to the external pressure of muscle fibers on the tunneled artery that leads to narrowing of vessel lumen and further ischemia. Materials & Methods: It is a prospective study performed from 2012- 2015 in cardiac centers available around Tirupati, Andhra Pradesh, South India. A total number of 2015 adult patients who underwent diagnostic coronary angiography were evaluated to detect myocardial bridges. With the informed consent the relevant data was collected from the patients and analyzed. Results: The prevalence of myocardial bridges was 3.17%. Among the 2015 patients 70.7% are males and 29.2% are females. Among 64 myocardial bridge positive cases 62.5% were male and 37.5% were female patients. Regarding coronary dominance 84% were right dominant and 14.4% were left dominant and 1.6% are balanced. The percentage incidence of myocardial bridging according to dominance was 3.01% for right dominant patients, 4.12% for left dominant patients and 3.1% for balanced dominant patients. In all the myocardial bridge positive cases they were located on the left anterior descending artery (LAD. According to diagnosis the patients with normal coronaries were 22.6%, patients with MILD CAD were 17.9%, patients with single vessel disease were 23.4%, patients with two vessel disease were 14.7% and the patients with triple vessel disease were 21.3%. The 64 myocardial bridging cases were grouped in to three groups according to their age. Incidence of double bridges was observed in 3 cases of which 66.7% males & 33.3% in females. Conclusion: These results show that Andhra Pradesh population are

  7. Myocardial protection during heart surgery in China

    Institute of Scientific and Technical Information of China (English)

    Bingyang Ji; Jinping Liu

    2007-01-01

    @@ Myocardial protection (MP) is the key for cardiopulmonary bypass (CPB) heart surgery. MP during cardiac surgery (CS) aims to preserve myocardial function while providing a bloodless and motionless operating field. Strategies on how to attenuate or prevent post-ischemic myocardial dysfunction that occurs intra-operatively during CS have been discussed for more than half a century. In 1950, Bigelow et al1 first reported to decrease myocardial oxygen demand by means of hypothermia.

  8. Acute Myocardial Infarction Due To Electrical Injury

    OpenAIRE

    Uzkeser M et al.

    2011-01-01

    Rhythm abnormalities (conduction defects, tachycardia, and arrhythmia)due to electric shock are common. Rarely, myocardial infarction may beseen in these patients. This situation is generally caused by coronaryartery vasospasm and direct myocardial damage. In this report, wepresent a rare case of myocardial infarction due to electric shock.

  9. Myocardial perfusion modeling using MRI

    DEFF Research Database (Denmark)

    Larsson, H B; Fritz-Hansen, T; Rostrup, Egill;

    1996-01-01

    In the present study, it is shown that it is possible to quantify myocardial perfusion using magnetic resonance imaging in combination with gadolinium diethylenetriaminopentaacetic acid (Gd-DTPA). Previously, a simple model and method for measuring myocardial perfusion using an inversion recovery...... of Gd-DTPA (lambda), the vascular blood volume (Vb), and the time delay through the coronary arteries (delta T). The model was evaluated by computer simulation and used on experimental results from seven healthy subjects. The results in the healthy volunteers for a region of interest placed...... in the anterior myocardial wall were (mean +/- SD) Ki = 54 +/- 10 ml/100 g/min, lambda = 30 +/- 3 ml/100 g, Vb = 9 +/- 2 ml/100 g, delta T = 3.2 +/- 1.1 s. These results are in good agreement with similar results obtained by other methods....

  10. Criteria for Affordable Housing Performance Measurement: A Review

    Directory of Open Access Journals (Sweden)

    Esruq-Labin A.M.J.

    2014-01-01

    Full Text Available A home is one of the basic human needs, thus a new concept known as Grow Home has risen. This concept was established to encourage more families to buy their own houses. The Grow Home concept is based on the notion of affordable housing. This paper aims to explore a proposal for affordable housing measurement with six assessment components. In other words, this work intends to study factors that can affect affordable housing assessment. In this paper, we investigated the 20 criteria for affordable housing assessment given by Mulliner and Maliene in their study. Then, we rearranged these criteria into five components, and added the Grow Home component. Each component has different criteria. Finally, six affordable housing measurement components are identified, namely, income ratios, loans and accommodations, facilities and services, safety and comfort, quality management, and Grow Home. These components are also considered as main factors that directly affect affordable housing. This study aspires to contribute to existing literature by proposing six assessment components as a measurement of affordable housing.

  11. Dynamic CT myocardial perfusion imaging.

    Science.gov (United States)

    Caruso, Damiano; Eid, Marwen; Schoepf, U Joseph; Jin, Kwang Nam; Varga-Szemes, Akos; Tesche, Christian; Mangold, Stefanie; Spandorfer, Adam; Laghi, Andrea; De Cecco, Carlo N

    2016-10-01

    Non-invasive cardiac imaging has rapidly evolved during the last decade due to advancements in CT based technologies. Coronary CT angiography has been shown to reliably assess coronary anatomy and detect high risk coronary artery disease. However, this technique is limited to anatomical assessment, thus non-invasive techniques for functional assessment of the heart are necessary. CT myocardial perfusion is a new CT based technique that provides functional assessment of the myocardium and allows for a comprehensive assessment of coronary artery disease with a single modality when combined with CTA. This review aims to discuss dynamic CT myocardial perfusion as a new technique in the assessment of CAD.

  12. Situational Affordance - Appreciating human Interpretations in New Product Development

    DEFF Research Database (Denmark)

    Mathiasen, John Bang; Koch, Christian

    2009-01-01

    -technical aspects alike, while Sierra uses a CAD-system to support joint-development crossing organisational boundaries. The cases share features such as triadic relations; customer's problem, product designers and artefact. For example, a wheelchair is presented to Sierra, the result of NPD-activities carried out...... by a profes-sional golfer. Two product designers interpret the affordance of the wheelchair and com-pare it with the intended functionality explained by the golfer - we denote it intended af-fordance; the identified gap is used to rewrite the design. Next, the affordance of both pro-posals is discussed...

  13. Situational Affordance - Appreciating human Interpretations in New Product Development

    DEFF Research Database (Denmark)

    Mathiasen, John Bang; Koch, Christian

    to negotiate technical and non-technical aspects alike, while Sierra uses a CAD-system to support joint-development crossing organisational boundaries. The cases share features such as triadic relations; customer’s problem, product designers and artefact. For example, a wheelchair is presented to Sierra......, the result of NPD-activities carried out by a professional golfer. Two product designers interpret the affordance of the wheelchair and compare it with the intended functionality explained by the golfer – we denote it intended affordance; the identified gap is used to rewrite the design. Next, the affordance...

  14. Can consumers make affordable care affordable? The value of choice architecture.

    Science.gov (United States)

    Johnson, Eric J; Hassin, Ran; Baker, Tom; Bajger, Allison T; Treuer, Galen

    2013-01-01

    Tens of millions of people are currently choosing health coverage on a state or federal health insurance exchange as part of the Patient Protection and Affordable Care Act. We examine how well people make these choices, how well they think they do, and what can be done to improve these choices. We conducted 6 experiments asking people to choose the most cost-effective policy using websites modeled on current exchanges. Our results suggest there is significant room for improvement. Without interventions, respondents perform at near chance levels and show a significant bias, overweighting out-of-pocket expenses and deductibles. Financial incentives do not improve performance, and decision-makers do not realize that they are performing poorly. However, performance can be improved quite markedly by providing calculation aids, and by choosing a "smart" default. Implementing these psychologically based principles could save purchasers of policies and taxpayers approximately 10 billion dollars every year. PMID:24367484

  15. Assessment of Myocardial Infarction by Cardiac Magnetic Resonance Imaging and Long-Term Mortality

    Directory of Open Access Journals (Sweden)

    João Luiz Fernandes Petriz

    2015-02-01

    Full Text Available Background: Cardiac magnetic resonance imaging provides detailed anatomical information on infarction. However, few studies have investigated the association of these data with mortality after acute myocardial infarction. Objective: To study the association between data regarding infarct size and anatomy, as obtained from cardiac magnetic resonance imaging after acute myocardial infarction, and long-term mortality. Methods: A total of 1959 reports of “infarct size” were identified in 7119 cardiac magnetic resonance imaging studies, of which 420 had clinical and laboratory confirmation of previous myocardial infarction. The variables studied were the classic risk factors – left ventricular ejection fraction, categorized ventricular function, and location of acute myocardial infarction. Infarct size and acute myocardial infarction extent and transmurality were analyzed alone and together, using the variable named “MET-AMI”. The statistical analysis was carried out using the elastic net regularization, with the Cox model and survival trees. Results: The mean age was 62.3 ± 12 years, and 77.3% were males. During the mean follow-up of 6.4 ± 2.9 years, there were 76 deaths (18.1%. Serum creatinine, diabetes mellitus and previous myocardial infarction were independently associated with mortality. Age was the main explanatory factor. The cardiac magnetic resonance imaging variables independently associated with mortality were transmurality of acute myocardial infarction (p = 0.047, ventricular dysfunction (p = 0.0005 and infarcted size (p = 0.0005; the latter was the main explanatory variable for ischemic heart disease death. The MET-AMI variable was the most strongly associated with risk of ischemic heart disease death (HR: 16.04; 95%CI: 2.64-97.5; p = 0.003. Conclusion: The anatomical data of infarction, obtained from cardiac magnetic resonance imaging after acute myocardial infarction, were independently associated with long

  16. Assessment of Myocardial Infarction by Cardiac Magnetic Resonance Imaging and Long-Term Mortality

    Energy Technology Data Exchange (ETDEWEB)

    Petriz, João Luiz Fernandes, E-mail: jlpetriz@cardiol.br [Universidade Federal do Rio de Janeiro (UFRJ) / Instituto do Coração Edson Saad - Programa de Pós Graduação em Medicina (Cardiologia), Rio de Janeiro, RJ (Brazil); Hospital Barra D’Or, Rio de Janeiro, RJ (Brazil); Instituto D’Or de Pesquisa e Ensino, Rio de Janeiro, RJ (Brazil); Gomes, Bruno Ferraz de Oliveira; Rua, Braulio Santos [Hospital Barra D’Or, Rio de Janeiro, RJ (Brazil); Azevedo, Clério Francisco [Instituto D’Or de Pesquisa e Ensino, Rio de Janeiro, RJ (Brazil); Hadlich, Marcelo Souza [Universidade Federal do Rio de Janeiro (UFRJ) / Instituto do Coração Edson Saad - Programa de Pós Graduação em Medicina (Cardiologia), Rio de Janeiro, RJ (Brazil); Instituto D’Or de Pesquisa e Ensino, Rio de Janeiro, RJ (Brazil); Mussi, Henrique Thadeu Periard [Universidade Federal do Rio de Janeiro (UFRJ) / Instituto do Coração Edson Saad - Programa de Pós Graduação em Medicina (Cardiologia), Rio de Janeiro, RJ (Brazil); Hospital Barra D’Or, Rio de Janeiro, RJ (Brazil); Taets, Gunnar de Cunto [Instituto D’Or de Pesquisa e Ensino, Rio de Janeiro, RJ (Brazil); Nascimento, Emília Matos do; Pereira, Basílio de Bragança; Silva, Nelson Albuquerque de Souza e [Universidade Federal do Rio de Janeiro (UFRJ) / Instituto do Coração Edson Saad - Programa de Pós Graduação em Medicina (Cardiologia), Rio de Janeiro, RJ (Brazil)

    2015-02-15

    Cardiac magnetic resonance imaging provides detailed anatomical information on infarction. However, few studies have investigated the association of these data with mortality after acute myocardial infarction. To study the association between data regarding infarct size and anatomy, as obtained from cardiac magnetic resonance imaging after acute myocardial infarction, and long-term mortality. A total of 1959 reports of “infarct size” were identified in 7119 cardiac magnetic resonance imaging studies, of which 420 had clinical and laboratory confirmation of previous myocardial infarction. The variables studied were the classic risk factors – left ventricular ejection fraction, categorized ventricular function, and location of acute myocardial infarction. Infarct size and acute myocardial infarction extent and transmurality were analyzed alone and together, using the variable named “MET-AMI”. The statistical analysis was carried out using the elastic net regularization, with the Cox model and survival trees. The mean age was 62.3 ± 12 years, and 77.3% were males. During the mean follow-up of 6.4 ± 2.9 years, there were 76 deaths (18.1%). Serum creatinine, diabetes mellitus and previous myocardial infarction were independently associated with mortality. Age was the main explanatory factor. The cardiac magnetic resonance imaging variables independently associated with mortality were transmurality of acute myocardial infarction (p = 0.047), ventricular dysfunction (p = 0.0005) and infarcted size (p = 0.0005); the latter was the main explanatory variable for ischemic heart disease death. The MET-AMI variable was the most strongly associated with risk of ischemic heart disease death (HR: 16.04; 95%CI: 2.64-97.5; p = 0.003). The anatomical data of infarction, obtained from cardiac magnetic resonance imaging after acute myocardial infarction, were independently associated with long-term mortality, especially for ischemic heart disease death.

  17. Practical measurement of affordability: An application to medicines

    NARCIS (Netherlands)

    L.M. Niëns (Laurens); E. Van de Poel (Ellen); A. Cameron; M. Ewen; R. Laing; W.B.F. Brouwer (Werner)

    2012-01-01

    textabstractObjective: To develop two practical methods for measuring the affordability of medicines in developing countries. Methods The proposed methods - catastrophic and impoverishment methods - rely on easily accessible aggregated expenditure data and take into account a country's income distri

  18. Developing an Assessment Framework for Affordable and Sustainable Housing

    Directory of Open Access Journals (Sweden)

    Stephen Pullen

    2010-07-01

    Full Text Available Sustainable housing has been subject to research, practice and policy making for some considerable time. More recently attention has been drawn to the separate problem of declining affordability in housing. This paper describes research aimed at developing an assessment framework for both affordability and sustainability as part of the effort to incorporate both of these features into new housing projects. The research has a particular focus on developments aimed at urban densification. Background literature on both affordability and sustainability is reviewed as well as emerging schemes aimed at dealing with both aspects of housing developments. Performance indicators are identified and these are incorporated in an interim assessment framework which is tested using a group of industry experts. The research has highlighted areas where further development is required to attain quantitative assessments of affordable and sustainable housing developments

  19. Holmium:YAG laser coronary angioplasty in acute myocardial infarction

    Science.gov (United States)

    Topaz, On; Luxenberg, Michael; Schumacher, Audrey

    1994-07-01

    Patients who sustain complicated acute myocardial infarction in whom thrombolytic agents either fail or are contraindicated often need mechanical revascularization other than PTCA. In 24 patients with acute infarction complicated by continuous chest pain and ischemia who either received lytics or with contraindication to lytics, a holmium:YAG laser (Eclipse Surgical Technologies, Palo Alto, CA) was utilized for thrombolysis and plaque ablation. Clinical success was achieved in 23/24 patients, with 23 patients (94%) surviving the acute infarction. Holmium:YAG laser is very effective and safe in thrombolysis and revascularization in this complicated clinical setting.

  20. Learning Basic Object Affordances in a Robotic System

    OpenAIRE

    Ridge, Barry

    2014-01-01

    One of the fundamental enabling mechanisms of human and animal intelligence, and equally, one of the great challenges of modern day autonomous robotics is the ability to perceive and exploit environmental affordances. To recognise how you can interact with objects in the world, that is to recognise what they afford you, is to speak the language of cause and effect, and as with most languages, practice is one of the most important paths to understanding. This is clear from early childhood deve...

  1. Facilitating investment in affordable housing: towards an Australian model. Draft

    OpenAIRE

    Lawson, J. M.; Berry, M; Milligan, V.; Yates, J

    2009-01-01

    This paper argues that sustainable and affordable finance provides a crucial pillar to support the provision of affordable housing in the long term. This finance can take on a variety of forms, comprising grants, public loans, commercial loans as well as shareholder equity. It can be facilitated by various forms of collateral, government guarantees, mortgage insurance and tax privileges, often involving a specialist financial intermediary. Importantly, how this pillar is constructed influence...

  2. Direct subsidies and housing affordability in Australian private rental markets

    OpenAIRE

    Gavin A Wood; Matthew Forbes; Kenneth Gibb

    2005-01-01

    Many countries have undergone a broad retreat from the use of indirect (supply) subsidies to meet low-income housing-affordability problems, shifting to direct subsidies often linked to means-tested income-maintenance systems. Although the reasons for this change of direction are well documented, the efficacy of direct housing subsidies in terms of tackling affordability remains in question. The authors examine in detail one such system, Australia’s Rent Assistance (RA) programme, making use ...

  3. Dosimetry in myocardial perfusion imaging

    International Nuclear Information System (INIS)

    This paper conducts a dosimetric investigation on the myocardial perfusion image protocol, together with a literature reviewing, motivated by the significant statistic increasing on mortality, morbidity and disability associated with cardiovascular disease, surpassing infectious diseases. Nuclear Cardiology plays a role n the diagnostic functional evaluation of the heart and in the prognostic of patients with suspected or known cardiac ischemia. In the context of unstable myocardial ischemic syndrome, myocardial perfusion scintigraphy is a non-invasive procedure performed by administering a radiopharmaceutical targeted to the heart. As tool for this study are that the images obtained by thoracic angiotomography and abdominal aorta as a anatomic and functional information for model reproduction in SISCODES - System of Codes for Absorbed Dose Calculations based on Stochastic Methods. Data were manipulated in order to create a voxel computational model of the heart to be running in MCNP - Monte Carlo Neutron Particle Code. . It was assumed a homogeneous distribution of Tl-201 in cardiac muscle. Simulations of the transport of particles through the voxel and the interaction with the heart tissue were performed. As a result, the isodose curves in the heart model are displayed as well as the dose versus volume histogram of the heart muscle. We conclude that the present computational tools can generate doses distributed in myocardial perfusion. (author)

  4. Dosimetry in myocardial perfusion imaging

    Energy Technology Data Exchange (ETDEWEB)

    Toledo, Janine M.; Trindade, Bruno; Ribeiro, Tarcisio P.C. [Universidade Federal de Minas Gerais (DEN/UFMG), Belo Horizonte (Brazil). Dept. de Engenharia Nuclear. Programa de Pos-Graduacao em Ciencias e Tecnicas Nucleares

    2011-07-01

    This paper conducts a dosimetric investigation on the myocardial perfusion image protocol, together with a literature reviewing, motivated by the significant statistic increasing on mortality, morbidity and disability associated with cardiovascular disease, surpassing infectious diseases. Nuclear Cardiology plays a role n the diagnostic functional evaluation of the heart and in the prognostic of patients with suspected or known cardiac ischemia. In the context of unstable myocardial ischemic syndrome, myocardial perfusion scintigraphy is a non-invasive procedure performed by administering a radiopharmaceutical targeted to the heart. As tool for this study are that the images obtained by thoracic angiotomography and abdominal aorta as a anatomic and functional information for model reproduction in SISCODES - System of Codes for Absorbed Dose Calculations based on Stochastic Methods. Data were manipulated in order to create a voxel computational model of the heart to be running in MCNP - Monte Carlo Neutron Particle Code. . It was assumed a homogeneous distribution of Tl-201 in cardiac muscle. Simulations of the transport of particles through the voxel and the interaction with the heart tissue were performed. As a result, the isodose curves in the heart model are displayed as well as the dose versus volume histogram of the heart muscle. We conclude that the present computational tools can generate doses distributed in myocardial perfusion. (author)

  5. The Orchestra of Myocardial Regeneration

    NARCIS (Netherlands)

    Siddiqi, S.

    2014-01-01

    A glimpse on previous and current literature ignites the recognition of the luxurious era that cardiac science has reached. In particular, the past fifteen years have provided tremendous advancements in the field of myocardial biology with the characterization of cardiac stem cells, reprogramming of

  6. Spousal Adjustment to Myocardial Infarction.

    Science.gov (United States)

    Ziglar, Elisa J.

    This paper reviews the literature on the stresses and coping strategies of spouses of patients with myocardial infarction (MI). It attempts to identify specific problem areas of adjustment for the spouse and to explore the effects of spousal adjustment on patient recovery. Chapter one provides an overview of the importance in examining the…

  7. Neonatal Myocardial Infarction or Myocarditis?

    NARCIS (Netherlands)

    de Vetten, Leanne; Bergman, Klasien A.; Elzenga, Nynke J.; van Melle, Joost P.; Timmer, Albertus; Bartelds, Beatrijs

    2011-01-01

    We report a 29 week-gestation preterm infant who presented during his second week of life with cardiogenic shock. Clinical presentation and first diagnostics suggested myocardial infarction, but echocardiographic features during follow-up pointed to a diagnosis of enteroviral myocarditis. The child

  8. Affordability of alcohol and alcohol-related mortality in Belarus.

    Science.gov (United States)

    Razvodovsky, Yury E

    2013-01-01

    Alcohol abuse has numerous adverse health and social consequences. The consumer response to changes in alcohol affordability is an important issue on alcohol policy debates. Studies from many countries have shown an inverse relationship between alcohol prices and alcohol consumption in the population. There are, however, suggestions that increasing the price of alcohol by rising taxes may have limited effect on alcohol-related problems, associated with long-term heavy drinking. The aim of the present study was to evaluate the relationship between alcohol affordability and alcohol-related mortality rates in post-Soviet Belarus. For this purpose trends in alcohol-related mortality rates (mortality from liver cirrhosis, pancreatitis, alcoholism and alcohol psychoses) and affordability of vodka between 1990 and 2010 were compared. The time series analysis revealed that 1% increase in vodka affordability is associated with an increase in liver cirrhosis mortality of 0,77%, an increase in pancreatitis mortality of 0.53%, an increase in mortality from alcoholism and alcohol psychoses of 0,70%. The major conclusion emerging from this study is that affordability of alcohol is one of the most important predictor of alcohol-related problems in a population. These findings provide additional evidence that decreasing in affordability of alcohol is an effective strategy for reducing alcohol consumption and alcohol-related harm.

  9. Myocardial ischemia and angina pectoris

    International Nuclear Information System (INIS)

    Ambulatory monitoring of ST segment changes was performed in 60 patients presenting with angina, positive ECG stress tests and coronary artery disease, 85% of ischemic ECG events were asymptomatic, 37% occurred with no increase in heart rate and 15% of episodes either lasted 20 minutes or more or fluctuated in severity. A controlled pilot study in ten patients showed depression. Radionuclide studies in 50 patients with angina and coronary artery disease have shown that stress (i.e., atrial pacing) produced different patterns of disturbed regional myocardial perfusion related to the patient's exercise capacity and eventually leading to a decrease in regional myocardial perfusion during the ischemic episode. ST segment depression appeared only after the decrease in regional myocardial perfusion. These findings combined with past research suggest that patients with angina and coronary artery disease can suffer frequent asymptomatic disturbances of the regional myocardial perfusion. The frequency of these episodes and the time course for the recovery of the metabolic consequences mean that segments of ventricular myocardium may be constantly abnormal. The relative importance of changes in coronary tone and malfunction of platelets in the diseased coronary tree needs to be examined in clinical research. Pilot studies of antiplatelet agents have shown a significant beneficial effect on episodes of ischemia occurring at night and those occurring without any increase in heart rate. The techniques and observations in these patients with coronary artery disease all suggest that acute transient regional myocardial ischemia is caused by a variety of mechnisms. Further research using objective methods is required to discover the causes of ischemia and to rationalize treatment. (orig./MG)

  10. Study progress of cardiac MRI technology in assessment of myocardial viability after myocardial infarction

    International Nuclear Information System (INIS)

    Acute myocardial infarction (AMI) is one of the most common diseases that cause disability and death around the world. Correctly and effectively assessing the myocardial viability after myocardial infarction can reduce the disabled rate and mortality rate. At present, many methods could be used to assess myocardial viability. The cardiac magnetic resonance imaging (CMR) technology has a lot of advantages compared to other methods. In this paper, we reviewed the research progress of CMR in assessment of myocardial viability after myocardial infarction, and compared CMR with other technologies. (authors)

  11. Approaches to Improving Cardiac Structure and Function During and After an Acute Myocardial Infarction: Acute and Chronic Phases.

    Science.gov (United States)

    Kloner, Robert A; Dai, Wangde; Hale, Sharon L; Shi, Jianru

    2016-07-01

    While progress has been made in improving survival following myocardial infarction, this injury remains a major source of mortality and morbidity despite modern reperfusion therapy. While one approach has been to develop therapies to reduce lethal myocardial cell reperfusion injury, this concept has not translated to the clinics, and several recent negative clinical trials raise the question of whether reperfusion injury is important in humans undergoing reperfusion for acute ST segment elevation myocardial infarction. Therapy aimed at reducing myocardial cell death while the myocytes are still ischemic is more likely to further reduce myocardial infarct size. Developing new therapies to further reduce left ventricular remodeling after the acute event is another approach to preserving structure and function of the heart after infarction. Such therapy may include chronic administration of pharmacologic agents and/or therapies developed from the field of regenerative cardiology, including cellular or non-cellular materials such as extracellular matrix. The optimal therapy will be to administer agents that both reduce myocardial infarct size in the acute phase of infarction as well as reduce adverse left ventricular remodeling during the chronic or healing phase of myocardial infarction. Such a dual approach will help optimize the preservation of both cardiac structure and function.

  12. Approaches to Improving Cardiac Structure and Function During and After an Acute Myocardial Infarction: Acute and Chronic Phases.

    Science.gov (United States)

    Kloner, Robert A; Dai, Wangde; Hale, Sharon L; Shi, Jianru

    2016-07-01

    While progress has been made in improving survival following myocardial infarction, this injury remains a major source of mortality and morbidity despite modern reperfusion therapy. While one approach has been to develop therapies to reduce lethal myocardial cell reperfusion injury, this concept has not translated to the clinics, and several recent negative clinical trials raise the question of whether reperfusion injury is important in humans undergoing reperfusion for acute ST segment elevation myocardial infarction. Therapy aimed at reducing myocardial cell death while the myocytes are still ischemic is more likely to further reduce myocardial infarct size. Developing new therapies to further reduce left ventricular remodeling after the acute event is another approach to preserving structure and function of the heart after infarction. Such therapy may include chronic administration of pharmacologic agents and/or therapies developed from the field of regenerative cardiology, including cellular or non-cellular materials such as extracellular matrix. The optimal therapy will be to administer agents that both reduce myocardial infarct size in the acute phase of infarction as well as reduce adverse left ventricular remodeling during the chronic or healing phase of myocardial infarction. Such a dual approach will help optimize the preservation of both cardiac structure and function. PMID:26612091

  13. Chasing myocardial outcomes: perioperative myocardial infarction and cardiac troponin.

    Science.gov (United States)

    Royo, Marc B; Fleisher, Lee A

    2016-02-01

    Perioperative myocardial infarction represents the most common cardiovascular complication following non-cardiac surgery, but frequently presents without the usual clinical signs and symptoms consistent with acute coronary syndrome. Given the silent nature of this event, a clinician's reliance on risk stratification tools and cardiac specific biomarkers to assist in the identification of at-risk individuals is heightened in the perioperative setting. Although cardiac troponin elevations following non-cardiac surgery have been consistently linked to increased mortality, uncertainty remains over how to clinically intervene to prevent harm. This decision is further complicated by the increasing sensitivity of the newest generation of cardiac biomarker immunoassays. In this narrative review, the growing body of evidence surrounding cardiac troponin elevations in the perioperative setting, how the evidence has been integrated into recent clinical practice guidelines, and its implications for the detection of perioperative myocardial infarction are discussed. PMID:26634279

  14. Percutaneous coronary intervention for acute myocardial infarction in elderly patients with renal dysfunction: results from the Korea Acute Myocardial Infarction Registry.

    Science.gov (United States)

    Lim, Sang Yup; Bae, Eun Hui; Choi, Joon Seok; Kim, Chang Seong; Ma, Seong Kwon; Ahn, Youngkeun; Jeong, Myung Ho; Kim, Weon; Woo, Jong Shin; Kim, Young Jo; Cho, Myeong Chan; Kim, Chong Jin; Kim, Soo Wan

    2013-07-01

    This study aimed to evaluate the effects of percutaneous coronary intervention (PCI) on short- and long-term major adverse cardiac events (MACE) in elderly (>75 yr old) acute myocardial infarction (AMI) patients with renal dysfunction. As part of Korea AMI Registry (KAMIR), elderly patients with AMI and renal dysfunction (GFRrenal dysfunction, PCI therapy yields favorable in-hospital and short-term and long-term MACE-free survival.

  15. [The effect of metformin on myocardial tolerance to ischemia in rats with diabetes mellitus type 2].

    Science.gov (United States)

    Kravchuk, E N; Grineva, E N; Galagudza, M M; Bairamov, A A

    2013-01-01

    The effect of metformin on myocardial sensitivity to ischemia in rats with neonatal streptozotocin T2DM was investigated using the model of global ischemia-reperfusion in the isolated perfused heart. Metformin administration had no effect on infarct size. At the same time, infarct size in T2DM was significantly lower than in controls, which is indicative of the phenomenon of metabolic preconditioning in T2DM. The protocol of metformin administration used in this study had not afforded a significant cardioprotective effect in animals with T2DM.

  16. The Affordance Template ROS Package for Robot Task Programming

    Science.gov (United States)

    Hart, Stephen; Dinh, Paul; Hambuchen, Kimberly

    2015-01-01

    This paper introduces the Affordance Template ROS package for quickly programming, adjusting, and executing robot applications in the ROS RViz environment. This package extends the capabilities of RViz interactive markers by allowing an operator to specify multiple end-effector waypoint locations and grasp poses in object-centric coordinate frames and to adjust these waypoints in order to meet the run-time demands of the task (specifically, object scale and location). The Affordance Template package stores task specifications in a robot-agnostic XML description format such that it is trivial to apply a template to a new robot. As such, the Affordance Template package provides a robot-generic ROS tool appropriate for building semi-autonomous, manipulation-based applications. Affordance Templates were developed by the NASA-JSC DARPA Robotics Challenge (DRC) team and have since successfully been deployed on multiple platforms including the NASA Valkyrie and Robonaut 2 humanoids, the University of Texas Dreamer robot and the Willow Garage PR2. In this paper, the specification and implementation of the affordance template package is introduced and demonstrated through examples for wheel (valve) turning, pick-and-place, and drill grasping, evincing its utility and flexibility for a wide variety of robot applications.

  17. Mortality rate in type 2 myocardial infarction

    DEFF Research Database (Denmark)

    Saaby, Lotte; Poulsen, Tina Svenstrup; Diederichsen, Axel Cosmus Pyndt;

    2014-01-01

    BACKGROUND: The classification of myocardial infarction into 5 types was introduced in 2007. The prognostic impact of this universal definition, with particular focus on type 2 myocardial infarction, has not been studied prospectively in unselected hospital patients. METHODS: During a 1-year period......, all hospitalized patients having cardiac troponin I measured were considered. The diagnosis of a myocardial infarction was according to the universal definition, and specified criteria were used in the classification of type 2 myocardial infarction. Follow-up was at least 1 year, with mortality...... as the end point. RESULTS: A total of 3762 consecutive patients were studied, of whom 488 (13%) had a myocardial infarction. In 119 patients a type 2 myocardial infarction was diagnosed. After a median of 2.1 years (interquartile range, 1.6-2.5 years), 150 patients had died, with a mortality rate of 49% (58...

  18. Novel adjunctive treatments of myocardial infarction

    DEFF Research Database (Denmark)

    Schmidt, Michael Rahbek; Pryds, Kasper; Bøtker, Hans Erik

    2014-01-01

    Myocardial infarction is a major cause of death and disability worldwide and myocardial infarct size is a major determinant of prognosis. Early and successful restoration of myocardial reperfusion following an ischemic event is the most effective strategy to reduce final infarct size and improve...... by endovascular infusion of cold saline all reduce infarct size and may confer clinical benefit for patients admitted with acute myocardial infarcts. Equally promising, three follow-up studies of the effect of remote ischemic conditioning (RIC) show clinical prognostic benefit in patients undergoing coronary...... clinical outcome, but reperfusion may induce further myocardial damage itself. Development of adjunctive therapies to limit myocardial reperfusion injury beyond opening of the coronary artery gains increasing attention. A vast number of experimental studies have shown cardioprotective effects of ischemic...

  19. Depressive Symptoms Are Associated with Mental Stress-Induced Myocardial Ischemia after Acute Myocardial Infarction

    OpenAIRE

    Jingkai Wei; Pratik Pimple; Shah, Amit J.; Cherie Rooks; Douglas Bremner, J.; Nye, Jonathon A.; Ijeoma Ibeanu; Nancy Murrah; Lucy Shallenberger; Paolo Raggi; Viola Vaccarino

    2014-01-01

    Objectives Depression is an adverse prognostic factor after an acute myocardial infarction (MI), and an increased propensity toward emotionally-driven myocardial ischemia may play a role. We aimed to examine the association between depressive symptoms and mental stress-induced myocardial ischemia in young survivors of an MI. Methods We studied 98 patients (49 women and 49 men) age 38–60 years who were hospitalized for acute MI in the previous 6 months. Patients underwent myocardial perfusion ...

  20. [Myocardial infarction caused by exertion].

    Science.gov (United States)

    Bernard, F; Weber, S

    1997-01-01

    Myocardial infarction is the main cause of sudden death during physical exercise, particularly in subjects over 40 and may even occur in high-performance young athletes. Sports and physical activity have a beneficial effect in preventing cardiovascular diseases, but certain rules of prudence must be followed to avoid the risk of a severe coronary event. Myocardial infarction always occurs in particularly susceptible subjects with several risk factors, predominantly smoking, hypercholesterolemia, family history of atherosclerosis. Dietary factors, either before, during or after the exercise, are always found. Distribution of coronary lesions differs with age. Before 40 years, the coronary network is normal in 40% of the cases. The infarction is partially explained by platelet hyperaggregahility and coronary spasms at exercise or in the post-exercise period.

  1. Myocardial infarction and stem cells

    Directory of Open Access Journals (Sweden)

    K Ananda Krishna

    2011-01-01

    Full Text Available Permanent loss of cardiomyocytes and scar tissue formation after myocardial infarction (MI results in an irreversible damage to the cardiac function. Cardiac repair (replacement, restoration, and regeneration is, therefore, essential to restore function of the heart following MI. Existing therapies lower early mortality rates, prevent additional damage to the heart muscle, and reduce the risk of further heart attacks. However, there is need for treatment to improve the infarcted area by replacing the damaged cells after MI. Thus, the cardiac tissue regeneration with the application of stem cells may be an effective therapeutic option. Recently, interest is more inclined toward myocardial regeneration with the application of stem cells. However, the potential benefits and the ability to improve cardiac function with the stem cell-based therapy need to be further addressed. In this review, we focus on the clinical applications of stem cells in the cardiac repair.

  2. Myocardial infarction and subsequent pregnancy

    Directory of Open Access Journals (Sweden)

    Tedoldi Citânia Lúcia

    2000-01-01

    Full Text Available We report the case of a 40-year-old woman with 2 previous myocardial infarctions, revascularization surgery, and an ongoing pregnancy complicated with preeclampsia and fetal hypoxia. Her follow-up performed by a multidisciplinary team made possible the birth through cesarean section of a premature infant of the female sex with a very low birth weight, but without severe respiratory distress of the hyaline membrane disease type. Three months after the delivery, mother and daughter were healthy.

  3. Enteroviruses in Acute Myocardial Infarction

    OpenAIRE

    A Gholoobi; MS Nabavinia; T Mohamadpoor; MS Alavi; Z Meshkat

    2012-01-01

    Background: Human enteroviruses (EVs) may have a role as a possible risk factor in the pathogenesis of MI. The aim of this study was to evaluate the presence of enterovirus genomic RNA in peripheral blood samples of patients with acute myocardial infarction (MI). Methods: We investigated the presence of enterovirus genomic RNA in the peripheral blood of 115 patients with acute MI hospitalized in the Coronary Care Unit of Imam Reza and Ghaem University Hospitals (Mashhad, Iran) by RT-PCR using...

  4. SERUM MAGNESIUM IN ACUTE MYOCARDIAL INFARCTION

    OpenAIRE

    Nambakam Tanuja; Girish P

    2015-01-01

    BACKGROUND: In myocardial infarction, there occurs functional deficit of available magnesium due to trapping of free magnesium in adipocytes. Magnesium has been implicated in the pathogenesis of acute myocardial infarction and its complications. Magnesium ions are considered essential for the maintenance of functional integrity of myocardium. The serum magnesium concentration was found to have g reat significance in acute myocardial infarction. The present study was un...

  5. Acute myocardial involvement after heroin inhalation

    Directory of Open Access Journals (Sweden)

    Ritu Karoli

    2012-01-01

    Full Text Available Amongst the illicit drugs cocaine, amphetamines and cannabis have been studied and documented well to cause myocardial infarction by different mechanisms but there is very sparse data available on myocardial involvement after heroin abuse. We report a young man who developed acute myocardial injury after heroin inhalation and alcohol binge drinking. Heroin induced cardio toxic effect and vasospasm compounded by alcohol were suspected to be the cause of this.

  6. Leukocytosis: a risk factor for myocardial infarction

    OpenAIRE

    Kotla SK

    2012-01-01

    Suman K KotlaDepartment of Internal Medicine, Memorial Medical Center, Johnstown, PA, USAAbstract: Myocardial infarction commonly results from atherosclerotic lesions in the coronary arteries. Approximately 5% of patients with acute myocardial infarction do not have atherosclerotic disease. In this case report, we present an unusual leukostatic complication in a patient with acute myeloblastic leukemia and extreme hyperleukocytosis who presented with an acute myocardial infarction that resolv...

  7. Acute myocardial involvement after heroin inhalation

    OpenAIRE

    Ritu Karoli; Fatima, J.; Pushker Singh; Kazmi, Khursheed I.

    2012-01-01

    Amongst the illicit drugs cocaine, amphetamines and cannabis have been studied and documented well to cause myocardial infarction by different mechanisms but there is very sparse data available on myocardial involvement after heroin abuse. We report a young man who developed acute myocardial injury after heroin inhalation and alcohol binge drinking. Heroin induced cardio toxic effect and vasospasm compounded by alcohol were suspected to be the cause of this.

  8. Myocardial tissue tagging with cardiovascular magnetic resonance

    OpenAIRE

    Bluemke David A; Osman Nael F; Cheng Susan; Shehata Monda L; Lima João AC

    2009-01-01

    Abstract Cardiovascular magnetic resonance (CMR) is currently the gold standard for assessing both global and regional myocardial function. New tools for quantifying regional function have been recently developed to characterize early myocardial dysfunction in order to improve the identification and management of individuals at risk for heart failure. Of particular interest is CMR myocardial tagging, a non-invasive technique for assessing regional function that provides a detailed and compreh...

  9. Myocardial bridging as a cause of acute myocardial infarction: a case report

    Directory of Open Access Journals (Sweden)

    Emiroglu Yunus

    2002-09-01

    Full Text Available Abstract Background Systolic compression of a coronary artery by overlying myocardial tissue is termed myocardial bridging. Myocardial bridging usually has a benign prognosis, but some cases resulting in myocardial ischemia, infarction and sudden cardiac death have been reported. We are reporting a case of myocardial bridging which was complicated with acute myocardial infarction associated with inappropriate blood donation. Case presentation A 33 year-old-man was admitted to our emergency with acute anteroseptal myocardial infarction after a blood donation. The electrocardiography showed sinus rhythm and was consistent with an acute anteroseptal myocardial infarction. We decided to perform primary percutanous intervention (PCI. Myocardial bridging was observed in the mid segment of the left anterior descending coronary artery on coronary angiogram. PCI was canceled and medical follow up was decided. Blood transfusion was made because he had a deep anemia. A normal hemaglobin level and clinical reperfusion was achieved after ten hours by blood transfusion. At the one year follow up visit, our patient was healthy and had no cardiac complaints. Conclusions Myocardial bridging may cause acute myocardial infarction in various clinical conditions. Although the condition in this case caused profound anemia related acute myocardial infarction, its treatment and management was unusual.

  10. Conflict between object structural and functional affordances in peripersonal space.

    Science.gov (United States)

    Kalénine, Solène; Wamain, Yannick; Decroix, Jérémy; Coello, Yann

    2016-10-01

    Recent studies indicate that competition between conflicting action representations slows down planning of object-directed actions. The present study aims to assess whether similar conflict effects exist during manipulable object perception. Twenty-six young adults performed reach-to-grasp and semantic judgements on conflictual objects (with competing structural and functional gestures) and non-conflictual objects (with similar structural and functional gestures) presented at difference distances in a 3D virtual environment. Results highlight a space-dependent conflict between structural and functional affordances. Perceptual judgments on conflictual objects were slower that perceptual judgments on non-conflictual objects, but only when objects were presented within reach. Findings demonstrate that competition between structural and functional affordances during object perception induces a processing cost, and further show that object position in space can bias affordance competition. PMID:27327864

  11. Exploring Affordances of Social Media Use in Election Campaigns

    DEFF Research Database (Denmark)

    Dyrby, Signe; Jensen, Tina Blegind

    In recent years, social media have become omnipresent and highly important for social networking and content sharing. Lately we have witnessed how also political parties adopt social media as part of their political campaign strategy. The purpose of this work-in-progress paper is to investigate...... this tendency by posing two research questions: 1) what do political parties perceive as affordances of social media use in their campaign strategy? And 2) how are these affordances reflected in the political parties’ actual actions during the campaign? To address the two questions, we conducted a qualitative...... interaction and involvement is limited by their actions as most of them do not engage with the users’ posts and comments. The tensions between perceived affordances and actual use prompt further investigation of what political parties should consider when engaging in social media activities as part...

  12. The role of affordances in Libras acquisition as second language

    Directory of Open Access Journals (Sweden)

    Jéssica Puhl

    2016-05-01

    Full Text Available Libras is a visual-spatial language used by the Brazilian deaf community. Following the principles of spatiality and vision, the user of the sign language resorts more easily to stimuli from the environment than the user of the oral language. Thus, the hypothesis of this research is that the affordances (environmental properties that enable psychologically possible actions would be a facilitator element in the process of Libras acquisition. In this paper we use the narrative and interpretive-qualitative research to discuss the role of affordances in the listener perception, interpretation and action cycle in Libras acquisition as second language. Results show that the Libras’ iconic signs can be considered important affordances in the early stages of the acquisition. It is also observed the importance of the permanence in the niche where Libras is used for the sign language development.

  13. The Value of Full Correction: Achieving Excellent and Affordable Results.

    Science.gov (United States)

    Kaplan, Julie Bass

    2016-01-01

    Patients often come to medical aesthetic offices with hopes to fully correct lost facial volume and achieve a natural appearance. Unfortunately, the cost per syringe of dermal filler can be a barrier to desired outcomes. Many aesthetic practitioners do the best they can with the amount of product the patient can afford, often falling short of the "wow" effect for the patient. This article describes what one office implemented to solve the conundrum of affordability while still allowing offices to cover its own financial realities. This tool can help patients achieve beautiful, natural, and affordable outcomes while helping offices advance in manufacturer's tiers, improve word-of-mouth advertising, and increase job satisfaction. PMID:27606585

  14. Echocardiographic assessment of myocardial strain.

    Science.gov (United States)

    Gorcsan, John; Tanaka, Hidekazu

    2011-09-27

    Echocardiographic strain imaging, also known as deformation imaging, has been developed as a means to objectively quantify regional myocardial function. First introduced as post-processing of tissue Doppler imaging velocity converted to strain and strain rate, strain imaging has more recently also been derived from digital speckle tracking analysis. Strain imaging has been used to gain greater understanding into the pathophysiology of cardiac ischemia and infarction, primary diseases of the myocardium, and the effects of valvular disease on myocardial function, and to advance our understanding of diastolic function. Strain imaging has also been used to quantify abnormalities in the timing of mechanical activation for heart failure patients undergoing cardiac resynchronization pacing therapy. Further advances, such as 3-dimensional speckle tracking strain imaging, have emerged to provide even greater insight. Strain imaging has become established as a robust research tool and has great potential to play many roles in routine clinical practice to advance the care of the cardiovascular patient. This perspective reviews the physiology of myocardial strain, the technical features of strain imaging using tissue Doppler imaging and speckle tracking, their strengths and weaknesses, and the state-of-the-art present and potential future clinical applications.

  15. Cardiac MRI for myocardial ischemia.

    LENUS (Irish Health Repository)

    Daly, Caroline

    2013-01-01

    Proper assessment of the physiologic impact of coronary artery stenosis on the LV myocardium can affect patient prognosis and treatment decisions. Cardiac magnetic resonance imaging (CMR) assesses myocardial perfusion by imaging the myocardium during a first-pass transit of an intravenous gadolinium bolus, with spatial and temporal resolution substantially higher than nuclear myocardial perfusion imaging. Coupled with late gadolinium enhancement (LGE) imaging for infarction during the same imaging session, CMR with vasodilating stress perfusion imaging can qualitatively and quantitatively assess the myocardial extent of hypoperfusion from coronary stenosis independent of infarcted myocardium. This approach has been validated experimentally, and multiple clinical trials have established its diagnostic robustness when compared to stress single-photon emission computed tomography. In specialized centers, dobutamine stress CMR has been shown to have incremental diagnostic value above stress echocardiography due to its high imaging quality and ability to image the heart with no restriction of imaging window. This paper reviews the technical aspects, diagnostic utility, prognostic values, challenges to clinical adaptation, and future developments of stress CMR imaging.

  16. Myocardial ischaemia during tracheal intubation and extubation.

    Science.gov (United States)

    Edwards, N D; Alford, A M; Dobson, P M; Peacock, J E; Reilly, C S

    1994-10-01

    The incidence of myocardial ischaemia during tracheal intubation and extubation was compared using ambulatory ECG monitoring in 60 patients undergoing a variety of different surgical operations. Seven patients had myocardial ischaemia after tracheal intubation and seven patients during tracheal extubation. The patients who developed myocardial ischaemia during tracheal extubation had significantly greater rate-pressure products immediately before tracheal extubation (P < 0.05) and 1 min after tracheal extubation (P < 0.01) compared with those patients who did not develop myocardial ischaemia during extubation. PMID:7999498

  17. An initial study on the feasibility of diagnosing myocardial ischemia with CT first-pass myocardial perfusion imaging at rest

    Institute of Scientific and Technical Information of China (English)

    汪奇

    2013-01-01

    Objective To assess the feasibility and accuracy of CT first-pass myocardial perfusion imaging(CT first-pass MPI)at rest for diagnosis of myocardial ischemia.Results of adenosine-induced myocardial perfusion scintigraphy(MPS)

  18. Approach to an Affordable and Sustainable Space Transportation System

    Science.gov (United States)

    McCleskey, Caey M.; Rhodes, R. E.; Robinson, J. W.; Henderson, E. M.

    2012-01-01

    This paper describes an approach and a general procedure for creating space transportation architectural concepts that are at once affordable and sustainable. Previous papers by the authors and other members of the Space Propulsion Synergy Team (SPST) focused on a functional system breakdown structure for an architecture and definition of high-payoff design techniques with a technology integration strategy. This paper follows up by using a structured process that derives architectural solutions focused on achieving life cycle affordability and sustainability. Further, the paper includes an example concept that integrates key design techniques discussed in previous papers. !

  19. Affordable housing and urban regeneration in Portugal: a troubled tryst?

    DEFF Research Database (Denmark)

    Branco, Rosa; Alves, Sonia

    demographic trajectory over recent decades. Despite some signs of sporadic residential gentrification, the local social fabric continues to be characterized by an ageing population and weak educational and socio-economic capital. In the current phase of economic and social crisis, it is critical to consider...... in the analysis of the sustainability and social relevance of current strategies....... whether and how the new agents of urban regeneration, in particular the Urban Rehabilitation Societies, are providing affordable housing in these areas. In this context, it makes sense to discuss the meaning of concepts and models of social and affordable housing in Portugal since they are key elements...

  20. Evaluation of the therapeutic effect of hyperbaric oxygenation and erythropoietin in the treatment of chronic heart failure using myocardial perfusion scintigraphy G-SPECT

    OpenAIRE

    Baškot Branislav; Živković Miodrag; Tepić Sandra; Obradović Slobodan

    2009-01-01

    Background. The most important predictors of longterm survival in patients with cardiac ischemic disease are left ventricular ejection fraction, left ventricular volumes, infarction size, presence and extent of residual myocardial ischemia. One of the most important recent developments in single photon emission computed tomography (SPECT) myocardial perfusion imaging is the ability to acquire these studies in conjunction with electrocardiogram (ECG) gating (G-SPECT). The ability to asses radi...

  1. Comparison of 2-year mortality according to obesity in stabilized patients with type 2 diabetes mellitus after acute myocardial infarction: results from the DIAMOND prospective cohort registry

    OpenAIRE

    Won, Ki-Bum; Hur, Seung-Ho; Cho, Yun-Kyeong; Yoon, Hyuck-Jun; Nam, Chang-Wook; Kim, Kwon-Bae; Bae, Jang-Ho; Choi, Dong-Ju; Ahn, Young-Keun; Park, Jong-Seon; Kim, Hyo-Soo; Choi, Rak-Kyeong; Choi, Donghoon; Kim, Joon-Hong; Han, Kyoo-Rok

    2015-01-01

    Background After acute myocardial infarction (AMI), the replicated phenomenon of obesity paradox, i.e., obesity appearing to be associated with increased survival, has not been evaluated in stabilized (i.e., without clinical events within 1 month post AMI) Asian patients with diabetes mellitus (DM). Methods Among 1192 patients in the DIabetic Acute Myocardial InfarctiON Disease (DIAMOND) Korean multicenter registry between April 2010 and June 2012, 2-year cardiac and all-cause death were comp...

  2. Systemic Atherosclerotic Inflammation Following Acute Myocardial Infarction: Myocardial Infarction Begets Myocardial Infarction

    OpenAIRE

    Joshi, Nikhil V; Toor, Iqbal; Shah, Anoop S V; Carruthers, Kathryn; Alex T. Vesey; Alam, Shirjel R; Sills, Andrew; Hoo, Teng Y; Melville, Adam J; Langlands, Sarah P; Jenkins, William S A; Uren, Neal G; Mills, Nicholas L.; Fletcher, Alison M; van Beek, Edwin J.R.

    2015-01-01

    BACKGROUND: Preclinical data suggest that an acute inflammatory response following myocardial infarction (MI) accelerates systemic atherosclerosis. Using combined positron emission and computed tomography, we investigated whether this phenomenon occurs in humans.METHODS AND RESULTS: Overall, 40 patients with MI and 40 with stable angina underwent thoracic 18F-fluorodeoxyglucose combined positron emission and computed tomography scan. Radiotracer uptake was measured in aortic atheroma and nonv...

  3. Screening for silent myocardial ischemia caseof diabetics : interest of myocardial perfusion scintigraphy

    International Nuclear Information System (INIS)

    Silent myocardial ischemia is a major cause of morbidity and mortality in diabetic patients. Its diagnosis by noninvasive means such as myocardial SPECT would improve the management of these patients. The purpose of this study is to assess the frequency of silent myocardial ischemia in asymptomatic diabetics and their evolution. As a result, the myocardial SPECT is a reliable tool for screening for silent myocardial ischemia in diabetic patients. Its prognostic value allows to stratify the cardiac risk and guide therapeutic management. Its integration into a screening strategy in Tunisia seems limited by its low availability and cost. The latter could be reduced by better patient selection.

  4. 24 CFR 1000.101 - What is affordable housing?

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false What is affordable housing? 1000.101 Section 1000.101 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING...

  5. Material Affordances: The Potential of Scrapbooks in the Composition Classroom

    Science.gov (United States)

    Alexander, Kara Poe

    2013-01-01

    A multiliteracies pedagogy has renewed our interest in materiality, or how the physical text interacts with the author's choices and the context to contribute to the message, yet little attention has been paid to materiality in analog texts, such as the scrapbook, even though this medium contains affordances (capabilities and limitations) that…

  6. Affordance, Learning Opportunities, and the Lesson Plan Pro Forma

    Science.gov (United States)

    Anderson, Jason

    2015-01-01

    This article argues that the most commonly used lesson plan pro formas in language teacher education are inappropriately premised on an outcomes-based approach to teaching, one that is in conflict with what we know about how languages are learnt and how experienced teachers teach. It proposes an alternative, affordance-based approach to lesson…

  7. Learning Affordances of Language and Communication National Curricula

    Science.gov (United States)

    Scott, David

    2016-01-01

    This article focuses on the learning affordances of different language and communication curricula in the world. For reasons of space, only two national education systems (Finland and Singapore) and their language and communication curricula are referred to. The accounts of national education systems consist of the identification of mechanisms…

  8. Affordable comfort 95 - investing in our energy future

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-31

    This report describes the topics from the conference on Affordable Comfort, held March 26-31, 1995. Topics are concerned with energy efficiency in homes, retrofitting, weatherization, and monitoring of appliances, heating, and air conditioning systems for performance, as well as topics on electric utilities.

  9. 78 FR 39644 - Information Reporting for Affordable Insurance Exchanges

    Science.gov (United States)

    2013-07-02

    ... Marketplaces). Section 1401 of the Affordable Care Act enacted section 36B, allowing a refundable premium tax... of the advance payment with the amount of the premium tax credit computed on the taxpayer's income... payments also may claim the premium tax credit on the income tax return. Section 36B(f)(3)...

  10. Pedagogical Affordances of Multiple External Representations in Scientific Processes

    Science.gov (United States)

    Wu, Hsin-Kai; Puntambekar, Sadhana

    2012-12-01

    Multiple external representations (MERs) have been widely used in science teaching and learning. Theories such as dual coding theory and cognitive flexibility theory have been developed to explain why the use of MERs is beneficial to learning, but they do not provide much information on pedagogical issues such as how and in what conditions MERs could be introduced and used to support students' engagement in scientific processes and develop competent scientific practices (e.g., asking questions, planning investigations, and analyzing data). Additionally, little is understood about complex interactions among scientific processes and affordances of MERs. Therefore, this article focuses on pedagogical affordances of MERs in learning environments that engage students in various scientific processes. By reviewing literature in science education and cognitive psychology and integrating multiple perspectives, this article aims at exploring (1) how MERs can be integrated with science processes due to their different affordances, and (2) how student learning with MERs can be scaffolded, especially in a classroom situation. We argue that pairing representations and scientific processes in a principled way based on the affordances of the representations and the goals of the activities is a powerful way to use MERs in science education. Finally, we outline types of scaffolding that could help effective use of MERs including dynamic linking, model progression, support in instructional materials, teacher support, and active engagement.

  11. Monitoring the price and affordability of foods and diets globally.

    Science.gov (United States)

    Lee, A; Mhurchu, C N; Sacks, G; Swinburn, B; Snowdon, W; Vandevijvere, S; Hawkes, C; L'abbé, M; Rayner, M; Sanders, D; Barquera, S; Friel, S; Kelly, B; Kumanyika, S; Lobstein, T; Ma, J; Macmullan, J; Mohan, S; Monteiro, C; Neal, B; Walker, C

    2013-10-01

    Food prices and food affordability are important determinants of food choices, obesity and non-communicable diseases. As governments around the world consider policies to promote the consumption of healthier foods, data on the relative price and affordability of foods, with a particular focus on the difference between 'less healthy' and 'healthy' foods and diets, are urgently needed. This paper briefly reviews past and current approaches to monitoring food prices, and identifies key issues affecting the development of practical tools and methods for food price data collection, analysis and reporting. A step-wise monitoring framework, including measurement indicators, is proposed. 'Minimal' data collection will assess the differential price of 'healthy' and 'less healthy' foods; 'expanded' monitoring will assess the differential price of 'healthy' and 'less healthy' diets; and the 'optimal' approach will also monitor food affordability, by taking into account household income. The monitoring of the price and affordability of 'healthy' and 'less healthy' foods and diets globally will provide robust data and benchmarks to inform economic and fiscal policy responses. Given the range of methodological, cultural and logistical challenges in this area, it is imperative that all aspects of the proposed monitoring framework are tested rigorously before implementation. PMID:24074213

  12. Lean, Mean and Green: An Affordable Net Zero School

    Science.gov (United States)

    Stanfield, Kenneth

    2010-01-01

    From its conception, Richardsville Elementary was designed to be an affordable net zero facility. The design team explored numerous energy saving strategies to dramatically reduce energy consumption. By reducing energy use to 19.31 kBtus annually, the net zero goal could be realized through the implementation of a solar array capable of producing…

  13. 12 CFR 1291.12 - Affordable Housing Reserve Fund.

    Science.gov (United States)

    2010-01-01

    ... Affordable Housing Reserve Fund. (b) Use or commitment of funds. Approval of applications for AHP subsidies... year-end are deemed to be used or committed if, in combination with AHP subsidies that have been... highest scoring AHP application in the Bank's final funding period of the year for its...

  14. Energy affordability and the benefits system in Italy

    International Nuclear Information System (INIS)

    In this paper, we discuss a number of ways to define and measure the affordability of energy consumption, and we examine the emergence of energy poverty in Italy in the period from 1998 to 2011. The paper examines the eligibility criteria for claiming the benefits available to support energy consumption for vulnerable families and it identifies the potential beneficiaries. The study assesses the appropriateness of the eligibility criteria by comparing the population targeted by the policy with the population actually facing affordability problems. A simulation exercise, using the hypothetical scenario most likely to result in energy benefits being made available, shows that, regardless of the affordability index adopted, the provision of state energy benefits has little impact on fuel poverty. - Highlights: • The paper provides a discussion of alternative measure of energy affordability. • We examine the emergence of fuel poverty in Italy from 1998 to 2011. • We assess the appropriateness of the Italian energy benefits eligibility criteria. • A simulation shows that the energy benefits have little impact on fuel poverty

  15. Early Visual Perception Potentiated by Object Affordances: Evidence From a Temporal Order Judgment Task

    Science.gov (United States)

    Yamada, Yuki; Yamani, Yusuke

    2016-01-01

    Perceived objects automatically potentiate afforded action. Object affordances also facilitate perception of such objects, and this occurrence is known as the affordance effect. This study examined whether object affordances facilitate the initial visual processing stage, or perceptual entry processes, using the temporal order judgment task. The onset of the graspable (right-handled) coffee cup was perceived earlier than that of the less graspable (left-handled) cup for right-handed participants. The affordance effect was eliminated when the coffee cups were inverted, which presumably conveyed less affordance information. These results suggest that objects preattentively potentiate the perceptual entry processes in response to their affordances.

  16. Do episodes of anger trigger myocardial infarction?

    DEFF Research Database (Denmark)

    Möller, J; Hallqvist, J; Diderichsen, Finn;

    1999-01-01

    Our objectives were to study anger as a trigger of acute myocardial infarction (MI) and to explore potential effect modification by usual behavioral patterns related to hostility.......Our objectives were to study anger as a trigger of acute myocardial infarction (MI) and to explore potential effect modification by usual behavioral patterns related to hostility....

  17. Nifedipine for angina and acute myocardial ischemia

    NARCIS (Netherlands)

    P.G. Hugenholtz (Paul); J.W. de Jong (Jan Willem); P.D. Verdouw (Pieter); P.W.J.C. Serruys (Patrick)

    1983-01-01

    textabstractThis paper reviews the mechanisms believed to be responsible for myocardial ischaemia and the mode of action of calcium antagonist drugs. The clinical management of patients with myocardial ischaemia is discussed in the context of current knowledge about patho-physiology and drug action.

  18. Myocardial infarction and nocturnal hypoxaemia

    Directory of Open Access Journals (Sweden)

    Penčić Biljana

    2007-01-01

    Full Text Available Introduction: There is an increased risk of cardiovascular morbidity and mortality in patients with nocturnal intermittent hypoxaemia. Objecive. The aim of this study was to evalute the influence of nocturnal hypoxaemia on ventricular arrhythmias and myocardial ischaemia in patients with myocardial infarction (MI. Method. We studied 77 patients (55.8±7.9 years with MI free of complications, chronic pulmonary diseases, abnormal awake blood gases tension. All patients underwent overnight pulse oximetry and 24-hour electrocardiography. Patients were divided into two groups according to nocturnal hypoxaemia. Total number of ventricular premature complex (VPC; maximal VPC/h; incidence of VPC Lown class>2 and occurrence of ST-segment depression were analyzed for nocturnal (10 PM to 6 AM, daytime (6 AM to 22 PM periods and for the entire 24 hours. Results. Both groups were similar in age, gender, standard risk factors, myocardial infarction size and did not differ in VPC during the analyzed periods. The number of nocturnal maximal VPC/h was insignificantly greater in group 1 (with hypoxaemia compared to group 2 (without hypoxaemia, (p=0.084. Maximal VPC/h did not differ significantly either for daytime or for 24 hours among the groups. Nocturnal VPC Lown>2 were significantly more frequent in group 1 (25% vs 0%, p=0.002. The incidence of VPC Lown>2 was similar during the daytime, and during 24 hrs in both groups. Occurrence of ST-segment depression did not differ between groups 1 and 2. Conclusion. Nocturnal hypoxaemia was associated with complex nocturnal ventricular arrhythmias in patients with MI. .

  19. [Fibrinolysis in acute myocardial infarct].

    Science.gov (United States)

    Bleifeld, W

    1987-10-24

    Fibrinolysis has opened up a new avenue in the treatment of acute myocardial infarction (AMI). In principle, the rate of reperfusion depends on the type of compound used, the mode of administration and the time between onset of symptoms and the beginning of treatment. With intracoronary streptokinase the reperfusion rate is of the order of 85%. Intravenous urokinase administered as a bolus results in a reopening rate of 50-60%; a similar rate of reperfusion is achieved with rt-PA as infusion, while i.v. streptokinase produces about 50% reopened coronary vessels. The final infarct size is decreased in 70% of patients if fibrinolysis is initiated within 2.5 hours after the onset of symptoms and followed by reopening of the occluded vessel. This results in a lowering of in-hospital mortality, which in various studies is of the order of 45-60%.- Bearing in mind the contraindications, fibrinolysis should be initiated within 3 hours. Hemodynamic improvement by a decrease of infarct size may also be achieved beyond 3 hours in large anterior myocardial infarctions and in posterior infarctions with cardiogenic shock. Early initiation of thrombolysis is of major importance in improving left ventricular function and lowering mortality following acute myocardial infarction. Therefore, prehospital thrombolytic therapy should be considered. - In the postinfarction phase coronary angiography is indicated in patients with angina at rest, stable angina of ECG signs of ischemia. In this situation transfer to a specialized cardiology division for possible percutaneous transluminal angioplasty is indicated. - Reocclusion after successful thrombolysis occurs in 20-30%, and it is therefore important to avoid reinfarction to improve the long term prognosis after AMI.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3321420

  20. Optimizing the Parameters of Vagus Nerve Stimulation by Uniform Design in Rats with Acute Myocardial Infarction

    OpenAIRE

    Shan-Shan Kong; Jin-Jun Liu; Tyzh-Chang Hwang; Xiao-Jiang Yu; Mei Zhao; Ming Zhao; Bing-Xiang Yuan; Yi Lu; Yu-Ming Kang; Bing Wang; Wei-Jin Zang

    2012-01-01

    Vagus nerve stimulation (VNS) has been shown to improve left ventricular function and survival in rats with acute myocardial infarction (AMI), and this maneuver has also been adopted clinically for the treatment of patients with chronic heart failure (CHF). Recent in vitro and in vivo studies have suggested that VNS can modulate the level of pro-inflammatory factors. Despite the beneficial effects of VNS, the stimulation parameters for obtaining favorable outcomes appear highly variable. To o...

  1. Five-year prognosis in an incident cohort of people presenting with acute myocardial infarction

    OpenAIRE

    Simpson, Colin R; Buckley, Brian S; McLernon, David J.; Aziz Sheikh; Andrew Murphy; Hannaford, Philip C

    2011-01-01

    BACKGROUND: Following an AMI, it is important for patients and their physicians to appreciate the subsequent risk of death, and the potential benefits of invasive cardiac procedures and secondary preventive therapy. Studies, to-date, have focused largely on high-risk populations. We wished to determine the risk of death in a population-derived cohort of 2,887 patients after a first acute myocardial infarction (AMI). METHODS: Logistic regression and survival analysis were conducted to investig...

  2. Solar activity and myocardial infarction.

    Science.gov (United States)

    Szczeklik, E; Mergentaler, J; Kotlarek-Haus, S; Kuliszkiewicz-Janus, M; Kucharczyk, J; Janus, W

    1983-01-01

    The correlation between the incidence of myocardial infarction, sudden cardiac death, the solar activity and geomagnetism in the period 1969-1976 was studied, basing on Wrocław hospitals material registered according to WHO standards; sudden death was assumed when a person died within 24 hours after the onset of the disease. The highest number of infarctions and sudden deaths was detected for 1975, which coincided with the lowest solar activity, and the lowest one for the years 1969-1970 coinciding with the highest solar activity. Such an inverse, statistically significant correlation was not found to exist between the studied biological phenomena and geomagnetism. PMID:6851574

  3. Transplantation of neonatal cardiomyocytes plus fibrin sealant restores myocardial function in a rat model of myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    LI Yong-shun; GAO Bing-ren

    2007-01-01

    Background Most cardiac regenerative approaches can restore injured heart muscles. In this study, we investigated if fibrin sealant could help neonatal cardiomyocytes restore myocardial function in a rat model of myocardial infarction.Methods The left anterior descending artery in adult female Sprague-Dawley (SD) rats was ligated to make a myocardial infarction model. Neonatal ventricular cardiomyocytes from one-day male SD rats were isolated, labeled and cultured. The cells were injected into the infarcted area three weeks later. The animals were randomized into four recipient groups: (1) cardiomyocytes plus fibrin sealant (group CF, n=10); (2) cardiomyocytes alone (group C, n=10); (3)fibrin sealant recipients alone (group F, n=10); (4) control group (n=10). Four weeks after transplantation,echocardiography and Langerdoff model were used to assess heart function. Immunohistochemical staining and polymerase chain reaction (PCR) were performed to track the implanted cardiomyocytes and detect the sex-determining region Y gene on Y chromosome.Results Echocardiography showed the fraction shortening (FS) in groups CF, C, F and control group was (27.80±6.32)%, (22.29±4.54)%, (19.24±6.29)% and (20.36±3.29)% respectively with statistically significant differences in group CF compared with the other groups (P<0.05). The Langendoff model revealed that the left ventricular development of peak pressure (LVDPmax, mmHg) in groups CF, C, F and control group was 104.81±17.05, 80.97±21.60, 72.07±26.17 and 71.42±17.55 respectively with statistically significant differences in group CF compared with the other groups (P<0.05). Pathological examination and PCR indicated that transplanted cardiomyocytes in group CF survived better than those in the other groups.Conclusion Transplanted neonatal cardiomyocytes plus fibrin sealant can survive in myocardial infarctioned area and improve heart function greatly in rat models.

  4. An anthelmintic drug, pyrvinium pamoate, thwarts fibrosis and ameliorates myocardial contractile dysfunction in a mouse model of myocardial infarction.

    Directory of Open Access Journals (Sweden)

    Motoaki Murakoshi

    Full Text Available Metabolic adaptation to limited supplies of oxygen and nutrients plays a pivotal role in health and disease. Heart attack results from insufficient delivery of oxygen and nutrients to the heart, where cardiomyocytes die and cardiac fibroblasts proliferate--the latter causing scar formation, which impedes regeneration and impairs contractility of the heart. We postulated that cardiac fibroblasts survive metabolic stress by adapting their intracellular metabolism to low oxygen and nutrients, and impeding this metabolic adaptation would thwart their survival and facilitate the repair of scarred heart. Herein, we show that an anthelmintic drug, Pyrvinium pamoate, which has been previously shown to compromise cancer cell survival under glucose starvation condition, also disables cardiac fibroblast survival specifically under glucose deficient condition. Furthermore, Pyrvinium pamoate reduces scar formation and improves cardiac contractility in a mouse model of myocardial infarction. As Pyrvinium pamoate is an FDA-approved drug, our results suggest a therapeutic use of this or other related drugs to repair scarred heart and possibly other organs.

  5. Circadian influences on myocardial infarction.

    Science.gov (United States)

    Virag, Jitka A I; Lust, Robert M

    2014-01-01

    Components of circadian rhythm maintenance, or "clock genes," are endogenous entrainable oscillations of about 24 h that regulate biological processes and are found in the suprachaismatic nucleus (SCN) and many peripheral tissues, including the heart. They are influenced by external cues, or Zeitgebers, such as light and heat, and can influence such diverse phenomena as cytokine expression immune cells, metabolic activity of cardiac myocytes, and vasodilator regulation by vascular endothelial cells. While it is known that the central master clock in the SCN synchronizes peripheral physiologic rhythms, the mechanisms by which the information is transmitted are complex and may include hormonal, metabolic, and neuronal inputs. Whether circadian patterns are causally related to the observed periodicity of events, or whether they are simply epi-phenomena is not well established, but a few studies suggest that the circadian effects likely are real in their impact on myocardial infarct incidence. Cycle disturbances may be harbingers of predisposition and subsequent response to acute and chronic cardiac injury, and identifying the complex interactions of circadian rhythms and myocardial infarction may provide insights into possible preventative and therapeutic strategies for susceptible populations. PMID:25400588

  6. Contemporaryperspective on endogenous myocardial regeneration

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Considering the complex nature of the adult heart,it is no wonder that innate regenerative processes,while maintaining adequate cardiac function, fall shortin myocardial jeopardy. In spite of these enchaining limitations, cardiac rejuvenation occurs as well asrestricted regeneration. In this review, the backgroundas well as potential mechanisms of endogenousmyocardial regeneration are summarized. We presentand analyze the available evidence in three subsequentsteps. First, we examine the experimental researchdata that provide insights into the mechanisms andorigins of the replicating cardiac myocytes, includingcell populations referred to as cardiac progenitor cells(i.e. , c-kit+ cells). Second, we describe the role ofclinical settings such as acute or chronic myocardialischemia, as initiators of pathways of endogenousmyocardial regeneration. Third, the hitherto conductedclinical studies that examined different approachesof initiating endogenous myocardial regeneration infailing human hearts are analyzed. In conclusion, wepresent the evidence in support of the notion thatregaining cardiac function beyond cellular replacementof dysfunctional myocardium via initiation of innateregenerative pathways could create a new perspectiveand a paradigm change in heart failure therapeutics.Reinitiating cardiac morphogenesis by reintroducingdevelopmental pathways in the adult failing heart mightprovide a feasible way of tissue regeneration. Basedon our hypothesis "embryonic recall", we present firstsupporting evidence on regenerative impulses in themyocardium, as induced by developmental processes.

  7. [Trials with ACE-inhibitors in acute myocardial infarction].

    Science.gov (United States)

    Dalla Volta, S

    1994-12-01

    In acute myocardial infarction, the results of the trials with ACE-inhibitors have not been always good, in contrast with what has been observed in chronic heart failure. The comparison of these compounds with the placebo has demonstrated lack of reduction of mortality in the study CONSENSUS II, favorable results on the survival as first endpoint and on the secondary endpoints, as reinfarction, heart failure and stroke in the studies SOLVD, AIRE, GISSI 3, ISIS 4, and uncertain (interim report) results in the Chinese study. Nevertheless, the analysis of the recruitment of the patients with acute infarction and the way these patients have been treated seem to be the most important cause of the conflicting results. ACE-inhibitors have proved no efficacy in acute myocardial infarction without signs of left ventricular failure (CONSENSUS II), have worsened the clinical picture and the mortality in patients in shock or with severe heart failure in the acute phase. On the reverse, in presence of mild to moderate left ventricular dysfunction and failure, the use of ACE-inhibitors has been followed by reduction of mortality in the early (AIRE, GISSI 3, ISIS 4), medium term (GISSI 3) and long-term follow-up (up to 4 years in the AIRE study). In parallel with the reduction of the primary endpoint, also secondary endpoints have been favorably influenced by the different ACE-inhibitors. No differences have been observed among the different class of compounds. ACE-inhibitors seem, therefore, to have a clear indication in acute myocardial infarction with mild or moderate signs and symptoms of heart failure. PMID:7634258

  8. Affordances and synchronization in collective creative construction tasks

    DEFF Research Database (Denmark)

    Tylén, Kristian; Fusaroli, Riccardo

    to the affordances of the task at hand. We also show that during collective, but not individual tasks, within group synchronization grows over time. Finally, we discuss how these measures of synchronization relate to the participants’ engagement in the tasks at hand and to the end products (LEGO models......: the affordances of the task at hand and the gradual consolidation of collaborative practices. Six groups of participants were instructed to construct LEGO models of six abstract notions (“responsibility”, “knowledge”, “justice” etc.), both individually and in groups. We combine video analysis and heart rate...... measurements and employ recurrence analysis techniques to quantify the mutual adaptability of heart rates among the participants in the different tasks. We show that during individual tasks individual heart rates synchronize both within and between groups (but not with controls) plausibly due...

  9. Learning Objects and Grasp Affordances through Autonomous Exploration

    DEFF Research Database (Denmark)

    Kraft, Dirk; Detry, Renaud; Pugeault, Nicolas;

    2009-01-01

    We describe a system for autonomous learning of visual object representations and their grasp affordances on a robot-vision system. It segments objects by grasping and moving 3D scene features, and creates probabilistic visual representations for object detection, recognition and pose estimation......, which are then augmented by continuous characterizations of grasp affordances generated through biased, random exploration. Thus, based on a careful balance of generic prior knowledge encoded in (1) the embodiment of the system, (2) a vision system extracting structurally rich information from stereo...... image sequences as well as (3) a number of built-in behavioral modules on the one hand, and autonomous exploration on the other hand, the system is able to generate object and grasping knowledge through interaction with its environment....

  10. Affordable immersive projection system for 3d interaction

    OpenAIRE

    Andújar Gran, Carlos Antonio; Fairén González, Marta; Brunet Crosa, Pere

    2002-01-01

    This paper describes an affordable Virtual Reality system designed and developed by a group of researchers at the Polytechnic University of Catalunya (UPC). The system allows direct selection and manipulation of virtual 3D objects. The interaction is based on stereoscopic images projected over the user’s working space and on devices tracking the user’s natural movements. The system includes a screen being adjustable both in orientation and height, sensors tracking the head and hand movemen...

  11. Self-Supervised Online Learning of Basic Object Push Affordances

    OpenAIRE

    Barry Ridge; Aleš Leonardis; Aleš Ude; Miha Deniša; Danijel Skočaj

    2015-01-01

    Continuous learning of object affordances in a cognitive robot is a challenging problem, the solution to which arguably requires a developmental approach. In this paper, we describe scenarios where robotic systems interact with household objects by pushing them using robot arms while observing the scene with cameras, and which must incrementally learn, without external supervision, both the effect classes that emerge from these interactions as well as a discriminative model for predicting the...

  12. The Affordable Care Act and the Labor Market

    OpenAIRE

    Aaronson, Daniel; Lubotsky, Darren

    2014-01-01

    In 2010, Congress passed the Affordable Care Act (ACA), the largest expansion of health insurance since the advent of Medicaid and Medicare roughly a half century ago. Because the law is being phased in slowly and many provisions are still years away from being launched, the law’s impact on employment, wages, job mobility, retirement, self-employment, economic efficiency, and overall well-being remains contentious.

  13. Promoting Prevention Through the Affordable Care Act: Workplace Wellness

    OpenAIRE

    Anderko, Laura; Roffenbender, Jason S.; Goetzel, Ron Z.; Millard, Francois; Wildenhaus, Kevin; DeSantis, Charles; Novelli, William

    2012-01-01

    Public health in the United States can be improved by building workplace “cultures of health” that support healthy lifestyles. The Affordable Care Act (ACA), which includes the Prevention and Public Health Fund, will support a new focus on prevention and wellness, offering opportunities to strengthen the public’s health through workplace wellness initiatives. This article describes the opportunity the ACA provides to improve worker wellness.

  14. The Affordable Care Act and implications for young adult health

    OpenAIRE

    Monaghan, Maureen

    2013-01-01

    In the USA, young adults are most likely to be uninsured and least likely to report a usual source of medical care than any age group. The Patient Protection and Affordable Care Act (ACA) recognizes the critical need for expanded insurance coverage for this age group, and multiple provisions of the ACA address insurance coverage and health care utilization in young adults. This paper presents a brief overview of the challenges of maintaining health insurance coverage and accessing health care...

  15. Affordability in Health Care: Operationalizations and Applications in Different Contexts

    OpenAIRE

    Niëns, Laurens

    2014-01-01

    markdownabstract__Abstract__ Over the last decades, total health expenditures have increased significantly (Meltzer, 2001; Folland et al., 2004). Governments in low- and middle-income countries (LMICs) as well as in high-income countries face the difficult challenge of ensuring that necessary interventions are accessible for those who need them, while keeping care affordable. Since good quality health care and new medical interventions can be expensive, the process of balancing the goals of e...

  16. Can Low-Income Americans Afford a Healthy Diet?

    OpenAIRE

    Drewnowski, Adam; Eichelsdoerfer, Petra

    2010-01-01

    Many nutritional professionals believe that all Americans, regardless of income, have access to a nutritious diet of whole grains, lean meats, and fresh vegetables and fruit. In reality, food prices pose a significant barrier for many consumers who are trying to balance good nutrition with affordability. The Thrifty Food Plan (TFP), commonly cited as a model of a healthy low-cost diet, achieves cost goals by relaxing some nutrition constraints and by disregarding the usual eating habits of th...

  17. Monolithic QCL design approaches for improved reliability and affordability

    Science.gov (United States)

    Law, K. K.

    2013-12-01

    Many advances have been made recently in mid-wave infrared and long-wave infrared quantum cascade lasers (QCLs) technologies, and there is an increasing demand for these laser sources for ever expanding Naval, DoD and homeland security applications. We will discuss in this paper a portfolio of various Naval Air Warfare Weapons Division's current and future small business innovative research programs and efforts on significantly improving QCLs' performance, affordability, and reliability.

  18. Affordance-based individuation of junctions in Open Street Map

    Directory of Open Access Journals (Sweden)

    Simon Scheider

    2012-06-01

    Full Text Available We propose an algorithm that can be used to identify automatically the subset of street segments of a road network map that corresponds to a junction. The main idea is to use turn-compliant locomotion affordances, i.e., restricted patterns of supported movement, in order to specify junctions independently of their data representation, and in order to motivate tractable individuation and classification strategies. We argue that common approaches based solely on geometry or topology of the street segment graph are useful but insufficient proxies. They miss certain turn restrictions essential to junctions. From a computational viewpoint, the main challenge of affordance-based individuation of junctions lies in its complex recursive definition. In this paper, we show how Open Street Map data can be interpreted into locomotion affordances, and how the recursive junction definition can be translated into a deterministic algorithm. We evaluate this algorithm by applying it to small map excerpts in order to delineate the contained junctions.

  19. Approach to an Affordable and Productive Space Transportation System

    Science.gov (United States)

    McCleskey, Carey M.; Rhodes, Russel E.; Lepsch, Roger A.; Henderson, Edward M.; Robinson, John W.

    2012-01-01

    This paper describes an approach for creating space transportation architectures that are affordable, productive, and sustainable. The architectural scope includes both flight and ground system elements, and focuses on their compatibility to achieve a technical solution that is operationally productive, and also affordable throughout its life cycle. Previous papers by the authors and other members of the Space Propulsion Synergy Team (SPST) focused on space flight system engineering methods, along with operationally efficient propulsion system concepts and technologies. This paper follows up previous work by using a structured process to derive examples of conceptual architectures that integrate a number of advanced concepts and technologies. The examples are not intended to provide a near-term alternative architecture to displace current near-term design and development activity. Rather, the examples demonstrate an approach that promotes early investments in advanced system concept studies and trades (flight and ground), as well as in advanced technologies with the goal of enabling highly affordable, productive flight and ground space transportation systems.

  20. Determination of the Role of Oxygen in Suspected Acute Myocardial Infarction by Biomarkers

    Science.gov (United States)

    2016-01-25

    Acute Myocardial Infarction (AMI); Acute Coronary Syndrome (ACS); ST Elevation (STEMI) Myocardial Infarction; Ischemic Reperfusion Injury; Non-ST Elevation (NSTEMI) Myocardial Infarction; Angina, Unstable

  1. Early upregulation of myocardial CXCR4 expression is critical for dimethyloxalylglycine-induced cardiac improvement in acute myocardial infarction.

    Science.gov (United States)

    Mayorga, Mari; Kiedrowski, Matthew; Shamhart, Patricia; Forudi, Farhad; Weber, Kristal; Chilian, William M; Penn, Marc S; Dong, Feng

    2016-01-01

    The stromal cell-derived factor-1 (SDF-1):CXCR4 is important in myocardial repair. In this study we tested the hypothesis that early upregulation of cardiomyocyte CXCR4 (CM-CXCR4) at a time of high myocardial SDF-1 expression could be a strategy to engage the SDF-1:CXCR4 axis and improve cardiac repair. The effects of the hypoxia inducible factor (HIF) hydroxylase inhibitor dimethyloxalylglycine (DMOG) on CXCR4 expression was tested on H9c2 cells. In mice a myocardial infarction (MI) was produced in CM-CXCR4 null and wild-type controls. Mice were randomized to receive injection of DMOG (DMOG group) or saline (Saline group) into the border zone after MI. Protein and mRNA expression of CM-CXCR4 were quantified. Echocardiography was used to assess cardiac function. During hypoxia, DMOG treatment increased CXCR4 expression of H9c2 cells by 29 and 42% at 15 and 24 h, respectively. In vivo DMOG treatment increased CM-CXCR4 expression at 15 h post-MI in control mice but not in CM-CXCR4 null mice. DMOG resulted in increased ejection fraction in control mice but not in CM-CXCR4 null mice 21 days after MI. Consistent with greater cardiomyocyte survival with DMOG treatment, we observed a significant increase in cardiac myosin-positive area within the infarct zone after DMOG treatment in control mice, but no increase in CM-CXCR4 null mice. Inhibition of cardiomyocyte death in MI through the stabilization of HIF-1α requires downstream CM-CXCR4 expression. These data suggest that engagement of the SDF-1:CXCR4 axis through the early upregulation of CM-CXCR4 is a strategy for improving cardiac repair after MI.

  2. Importance of a history of hypertension for the prognosis after acute myocardial infarction--for the Bucindolol Evaluation in Acute myocardial infarction Trial (BEAT) study group

    DEFF Research Database (Denmark)

    Ali, Irma; Akman, Dilek; Bruun, Niels Eske;

    2004-01-01

    BACKGROUND: Arterial hypertension is a major risk factor for cardiovascular events. The prognosis for hypertensive patients after acute myocardial infarction (MI) is uncertain because of the sparse and somewhat contradictionary data. HYPOTHESIS: Our study aimed to investigate the importance of...... hypertension to prognosis after an MI in patients receiving contemporary medical therapy. METHODS: We performed a retrospective study using a large register from the Bucindolol Evaluation in Acute myocardial infarction Trial (BEAT). The register comprised 3,326 patients admitted between June 1998 and August.......9-1.2, p = 0.6). Adjustment for further covariates did not change the result. CONCLUSION: Our study showed that after an acute MI the survival rate of patients with and without a history of hypertension was identical when they received contemporary medical therapy....

  3. [Characteristics of therapy of acute myocardial infarction in diabetes].

    Science.gov (United States)

    Motz, W; Kerner, W

    2012-05-01

    Therapy of acute myocardial infarction (STEMI and NSTEMI) in diabetics does not principally differ from that of non-diabetic patients. Due to the higher mortality in diabetics reperfusion measures, such as direct percutaneous coronary intervention (PCI), should be rapidly performed. An intensive drug treatment with thrombocyte aggregation inhibitors, angiotensin-converting enzyme (ACE) inhibitors and beta-receptor blocking agents must be carried out according to the current guidelines. An important factor is the high risk of renal failure due to the contrast dye administered during PCI in the presence of pre-existing diabetic kidney damage which should be limited to 100 ml if possible. Direct PCI should be limited to the infarcted vessel. After stabilization a comprehensive strategy to cure coronary artery disease, whether with PCI or coronary artery bypass graft (CABG) should be finalized. If severe coronary 3-vessel disease is present, CABG should be favored in diabetic patients. After surviving an acute myocardial infarction differentiated metabolic monitoring is mandatory.

  4. Nanog expression in heart tissues induced by acute myocardial infarction.

    Science.gov (United States)

    Luo, Huanhuan; Li, Qiong; Pramanik, Jogen; Luo, Jiankai; Guo, Zhikun

    2014-10-01

    Nanog is a potential stem cell marker and is considered a regeneration factor during tissue repair. In the present study, we investigated expression patterns of nanog in the rat heart after acute myocardial infarction by semi-quantitative RT-PCR, immunohistochemistry and Western blot analyses. Our results show that nanog at both mRNA and protein levels is positively expressed in myocardial cells, fibroblasts and small round cells in different myocardial zones at different stages after myocardial infarction, showing a spatio-temporal and dynamic change. After myocardial infarction, the nanog expression in fibroblasts and small round cells in the infarcted zone (IZ) is much stronger than that in the margin zone (MZ) and remote infarcted zone (RIZ). From day 7 after myocardial infarction, the fibroblasts and small cells strongly expressed nanog protein in the IZ, and a few myocardial cells in the MZ and the RIZ and the numbers of nanog-positive fibroblasts and small cells reached the highest peak at 21 days after myocardial infarction, but in this period the number of nanog-positive myocardial cells decreased gradually. At 28 days after myocardial infarction, the numbers of all nanog-positive cells decreased into a low level. Therefore, our data suggest that all myocardial cells, fibroblasts and small round cells are involved in myocardial reconstruction after cardiac infarction. The nanog-positive myocardial cells may respond to early myocardial repair, and the nanog-positive fibroblasts and small round cells are the main source for myocardial reconstruction after cardiac infarction.

  5. Histochemical and immunohistochemical analyses of the myocardial scar fallowing acute myocardial infarction

    OpenAIRE

    Tatić Vujadin; Rafajlovski Sašo; Kanjuh Vladimir; Gajanin Radoslav; Suščević Dušan; Balint Bela; Obradović Slobodan

    2012-01-01

    Background/Aim. The heart has traditionally been considered as a static organ without capacity of regeneration after trauma. Currently, the more and more often asked question is whether the heart has any intrinsic capacities to regenerate myocytes after myocardial infarction. The aim of this study was to present the existence of the preserved muscle fibers in the myocardial scar following myocardial infarction as well as the presence of numerous cells of various size and form that diffe...

  6. Survivability Versus Time

    Science.gov (United States)

    Joyner, James J., Sr.

    2014-01-01

    Develop Survivability vs Time Model as a decision-evaluation tool to assess various emergency egress methods used at Launch Complex 39B (LC 39B) and in the Vehicle Assembly Building (VAB) on NASAs Kennedy Space Center. For each hazard scenario, develop probability distributions to address statistical uncertainty resulting in survivability plots over time and composite survivability plots encompassing multiple hazard scenarios.

  7. SPECT Myocardial Blood Flow Quantitation Concludes Equivocal Myocardial Perfusion SPECT Studies to Increase Diagnostic Benefits.

    Science.gov (United States)

    Chen, Lung-Ching; Lin, Chih-Yuan; Chen, Ing-Jou; Ku, Chi-Tai; Chen, Yen-Kung; Hsu, Bailing

    2016-01-01

    Recently, myocardial blood flow quantitation with dynamic SPECT/CT has been reported to enhance the detection of coronary artery disease in human. This advance has created important clinical applications to coronary artery disease diagnosis and management for areas where myocardial perfusion PET tracers are not available. We present 2 clinical cases that undergone a combined test of 1-day rest/dipyridamole-stress dynamic SPECT and ECG-gated myocardial perfusion SPECT scans using an integrated imaging protocol and demonstrate that flow parameters are capable to conclude equivocal myocardial perfusion SPECT studies, therefore increasing diagnostic benefits to add value in making clinical decisions.

  8. SPECT Myocardial Blood Flow Quantitation Concludes Equivocal Myocardial Perfusion SPECT Studies to Increase Diagnostic Benefits.

    Science.gov (United States)

    Chen, Lung-Ching; Lin, Chih-Yuan; Chen, Ing-Jou; Ku, Chi-Tai; Chen, Yen-Kung; Hsu, Bailing

    2016-01-01

    Recently, myocardial blood flow quantitation with dynamic SPECT/CT has been reported to enhance the detection of coronary artery disease in human. This advance has created important clinical applications to coronary artery disease diagnosis and management for areas where myocardial perfusion PET tracers are not available. We present 2 clinical cases that undergone a combined test of 1-day rest/dipyridamole-stress dynamic SPECT and ECG-gated myocardial perfusion SPECT scans using an integrated imaging protocol and demonstrate that flow parameters are capable to conclude equivocal myocardial perfusion SPECT studies, therefore increasing diagnostic benefits to add value in making clinical decisions. PMID:26053731

  9. Experimental myocardial ischemia. Pt. 2

    International Nuclear Information System (INIS)

    The comparative effects of meglumine sodium diatrizoate (MSD), sodium meglumine calcium metrizoate (SMCM), and metrizamide (M) were studied in an isolated canine heart preparation. The parameters observed were coronary blood flow (CBF), myocardial contractile force (MCF), positive and negative dF/dt, and perfusion pressure during normal and ischemic perfusion conditions. MSD had an initial negative inotropic effect but baseline MCF returned in 1 min during normal perfusion and 2 min under ischemic conditions. SMCM and M had only a positive inotropic effect under normal perfusion. However, during ischemia, the positive effect of SMCM was followed by a decrease in contractile force. M showed only a positive effect on force during ischemia. Our results indicate that calcium additive may increase the risk of coronary arteriography in patients with severe coronary artery disease. (orig.)

  10. [Stem cell perspectives in myocardial infarctions].

    Science.gov (United States)

    Aceves, José Luis; Archundia, Abel; Díaz, Guillermo; Páez, Araceli; Masso, Felipe; Alvarado, Martha; López, Manuel; Aceves, Rocío; Ixcamparij, Carlos; Puente, Adriana; Vilchis, Rafael; Montaño, Luis Felipe

    2005-01-01

    Myocardial infarction is the leading cause of congestive heart failure and death in industrializated countries. The cellular cardiomyoplasty has emerged as an alternative treatment in the regeneration of infarted myocardial tissue. In animals' models, different cellular lines such as cardiomyocites, skeletal myoblasts, embryonic stem cells and adult mesenchymal stem cells have been used, resulting in an improvement in ventricular function and decrease in amount of infarcted tissue. The first three cells lines have disvantages as they are allogenics and are difficult to obtain. The adult mesenchymal stem cells are autologous and can be obtained throught the aspiration of bone marrow or from peripherical circulation, after stimulating with cytokines (G-CSF). The implantation in humans with recent and old myocardial infarction have shown improvements similar to those shown in animal models. These findings encourage the continued investigation in the mechanism of cellular differentiation and implantation methods in infarcted myocardial tissue.

  11. Exosomes and cardiac repair after myocardial infarction.

    Science.gov (United States)

    Sahoo, Susmita; Losordo, Douglas W

    2014-01-17

    Myocardial infarction is a leading cause of death among all cardiovascular diseases. The analysis of molecular mechanisms by which the ischemic myocardium initiates repair and remodeling indicates that secreted soluble factors are key players in communication to local and distant tissues, such as bone marrow. Recently, actively secreted membrane vesicles, including exosomes, are being recognized as new candidates with important roles in intercellular and tissue-level communication. In this review, we critically examine the emerging role of exosomes in local and distant microcommunication mechanisms after myocardial infarction. A comprehensive understanding of the role of exosomes in cardiac repair after myocardial infarction could bridge a major gap in knowledge of the repair mechanism after myocardial injury.

  12. Myocardial hypoperfusion on conventional contrast computed tomography.

    Science.gov (United States)

    Ching, Shing; Chung, Tak Shun

    2015-10-01

    Non–electrocardiogram (ECG)–gated contrast computed tomography (CT) is commonly performed to exclude aortic dissection in chest pain patients. Besides evaluating the aorta for dissection flap, attention should be paid to the myocardium for areas of hypoenhancement that may suggest ischemia. Current models of multidetector CT enable assessment of myocardial perfusion with minimal motion artifact even without ECG gating. Transmural hypoenhancement with preserved wall thickness in a coronary distribution is highly specific for acute myocardial infarction. We report 2 cases of acute chest pain with initial nondiagnostic studies that underwent CT aortogram to exclude dissection. Instead, the CT showed myocardial hypoenhancement in left anterior descending artery territory. Myocardial hypoenhancement occurred before ST-segment elevation on ECG, suggesting that recognition of this important finding may lead to earlier revascularization decisions. PMID:26321167

  13. Crocin-Elicited Autophagy Rescues Myocardial Ischemia/Reperfusion Injury via Paradoxical Mechanisms.

    Science.gov (United States)

    Zeng, Chao; Li, Hu; Fan, Zhiwen; Zhong, Lei; Guo, Zhen; Guo, Yaping; Xi, Yusheng

    2016-01-01

    Crocin, the main effective component of saffron, exerts protective effects against ischemia/reperfusion injury during strokes. However, the effects of crocin in myocardial ischemia/reperfusion injury, and the mechanisms involved, remain unknown. Pretreated with crocin for 7 days, C57BL/6N mice were subjected to 30 min of myocardial ischemia followed by 12[Formula: see text]h of reperfusion (for cardiac function and infarct size, cell apoptosis and necrosis). Neonatal mouse cardiomyocytes were subjected to 2 h of hypoxia followed by 4 h of reoxygenation. NMCM's survival was assessed during hypoxia and reoxygenation in the presence or absence of the autophagy inhibitor 3-methyladenine or the inducer rapamycin. Western blotting was used to evaluate AMPK, Akt, and autophagy-related proteins. Autophagosome was observed using electron microscopy. In the in vivo experiment, crocin pretreatment significantly attenuated infarct size, myocardial apoptosis and necrosis, and improved left ventricular function following ischemia/reperfusion. In vitro data revealed that autophagy was induced during hypoxia, the levels of which were intensely elevated during reoxygenation. Crocin significantly promoted autophagy during ischemia, accompanied with the activation of AMPK. In contrast, crocin overtly inhibited autophagy during reperfusion, accompanied with Akt activation. Induction and inhibition of autophagy mitigated crocin induced protection against NMCMs injury during hypoxia and reoxygenation, respectively. Our data suggest that crocin demonstrated a myocardial protective effect via AMPK/mTOR and Akt/mTOR regulated autophagy against ischemia and reperfusion injury, respectively. PMID:27109157

  14. Beneficial effects of schisandrin B on the cardiac function in mice model of myocardial infarction.

    Directory of Open Access Journals (Sweden)

    Pengsheng Chen

    Full Text Available The fruit of Schisandra chinensis has been used in the traditional Chinese medicine for thousands of years. Accumulating evidence suggests that Schisandrin B (Sch B has cardioprotection effect on myocardial ischemia in vitro. However, it is unclear whether Sch B has beneficial effects on continuous myocardial ischemia in vivo. The aim of the present study was to investigate whether Sch B could improve cardiac function and attenuate myocardial remodeling after myocardial infarction (MI in mice. Mice model of MI was established by permanent ligation of the left anterior descending (LAD coronary artery. Then the MI mice were randomly treated with Sch B or vehicle alone. After treatment for 3 weeks, Sch B could increase survival rate, improve heart function and decrease infarct size compared with vehicle. Moreover, Sch B could down-regulate some inflammatory cytokines, activate eNOS pathway, inhibit cell apoptosis, and enhance cell proliferation. Further in vitro study on H9c2 cells showed similar effects of Sch B on prevention of hypoxia-induced inflammation and cell apoptosis. Taken together, our results demonstrate that Sch B can reduce inflammation, inhibit apoptosis, and improve cardiac function after ischemic injury. It represents a potential novel therapeutic approach for treatment of ischemic heart disease.

  15. Regional myocardial free fatty acid metabolism

    International Nuclear Information System (INIS)

    Experimental evidence to date has confirmed the potential value of radioactive labelled free fatty acid (FFA) and their analogs for the assessment of regional myocardial FFA metabolism despite a number of current limitations. It is emphasized that with these agents only one specific aspect of myocardial metabolism, that of FFA, can be tested and that with these compounds information on the overall metabolic state cannot always be obtained. (WU)

  16. Acute myocardial infarction following a hornet sting

    OpenAIRE

    Cvetković-Matić Danica; Ašanin Milika; Matić Dragan; Ivanović Branislava; Simić Dragan; Kalezić Nevena; Stojanov Vesna

    2009-01-01

    Background. The occurrence of an acute myocardial infarction following a hornet sting has been very rarely reported in the previous literature. Pathogenetic mechanisms include direct action of the venom components on the coronary endothelium and allergic reaction with mediators released from mast cells. The anaphylactic reaction and venom components can produce acute coronary artery thrombosis. Case report. We reported a 45-year-old man with acute myocardial infarction after a hornet sting in...

  17. Headache: A Symptom of Acute Myocardial Infarction

    OpenAIRE

    Yasmine Elgharably; Cesar Iliescu; Stefano Sdringola; Syed Wamique Yusuf

    2013-01-01

    ABSTRACT:We present a case of 55 year old man, with myocardial infarction and coronary thrombosis, whose initial presentation was with severe headache and review the literature.INTRODUCTION:Coronary ischemia typically presents with retrosternal pain that radiates to left arm (1). present atypically in various forms like indigestion (2), otalgia (3), facial pain (4) and syncope (5). Headache as the sole presentation of myocardial infarction (MI) is rare; however it has been reported previously...

  18. Improved exercise myocardial perfusion during lidoflazine therapy

    International Nuclear Information System (INIS)

    Lidoflazine is a synthetic drug with calcium-channel blocking effects. In a study of 6 patients with severe classic angina pectoris, single-blind administration of lidoflazine was associated with improved myocardial perfusion during exercise as determined by thallium-201 stress scintigraphy. These studies demonstrate that lidoflazine therapy is associated with relief of angina, an increased physical work capacity, and improved regional myocardial perfusion during exercise

  19. Long-term prognosis after acute myocardial infarction in patients with a history of arterial hypertension. TRACE study group

    DEFF Research Database (Denmark)

    Gustafsson, F; Køber, L; Torp-Pedersen, C;

    1998-01-01

    after acute myocardial infarction. METHODS: A retrospective analysis of survival data on 6676 patients with acute myocardial infarction screened for entry into the TRAndolapril Cardiac Evaluation (TRACE) study. Follow-up time was 4-6 years. RESULTS: One thousand five hundred and seven (23......AIMS: The objective of the study was to investigate the influence of a history of arterial hypertension on long-term prognosis after an acute myocardial infarction in a representative population, and secondly to assess the impact on prognosis of left ventricular systolic function in hypertensives......%) of the patients had a history of arterial hypertension. During the time of observation 763 (50.6%) hypertensives and 2253 (43.7%) normotensives died, corresponding to a risk ratio for death in hypertensives of 1.23 (1.13-1.33, P

  20. Myocardial Sleeve Tissues in Surgical Lung Specimens.

    Science.gov (United States)

    Yoshida, Akihiko; Kamata, Tsugumasa; Iwasa, Takeshi; Watanabe, Shun-ichi; Tsuta, Koji

    2015-10-01

    Left atrial myocardial extensions over the pulmonary veins (PVs), known as myocardial sleeves, are present in the physiological anatomy of most individuals. Although this structure has recently received clinical attention as a major origin of paroxysmal atrial fibrillation (AF), it has not been documented in surgical specimens. Here, we examine incidentally identified myocardial sleeve tissue in routinely processed lung resection specimens to determine its incidence and diagnostic implications. Among 694 lung resection specimens with evaluable PV margins, myocardial sleeve tissue was identified in 26 cases (3.7%). The tissue was located within the adventitia of the PVs, mostly in margin preparations, and existed outside the pericardium in the majority of cases. Carcinoma infiltration of the sleeves was evident in 6 cases. No heart injuries were observed, and no tumors invaded the heart. Preoperative electrocardiography showed sinus rhythm in all cases, whereas postoperative monitoring revealed sinus rhythm in all patients except one who showed AF and flutter. Myocardial sleeve tissue is an underrecognized incidental finding in lung resection specimens, and it is not indicative of heart injury. Cancer infiltration into this tissue indicates neither heart invasion nor, by itself, invasion into the pericardium. Although surgical transection of the myocardial sleeve did not evoke immediate arrhythmia in most cases, the overall influence of this procedure on the postsurgical risk of AF remains to be determined in further studies involving extensive rhythm assessment. PMID:26099012

  1. Computational modeling of acute myocardial infarction.

    Science.gov (United States)

    Sáez, P; Kuhl, E

    2016-01-01

    Myocardial infarction, commonly known as heart attack, is caused by reduced blood supply and damages the heart muscle because of a lack of oxygen. Myocardial infarction initiates a cascade of biochemical and mechanical events. In the early stages, cardiomyocytes death, wall thinning, collagen degradation, and ventricular dilation are the immediate consequences of myocardial infarction. In the later stages, collagenous scar formation in the infarcted zone and hypertrophy of the non-infarcted zone are auto-regulatory mechanisms to partly correct for these events. Here we propose a computational model for the short-term adaptation after myocardial infarction using the continuum theory of multiplicative growth. Our model captures the effects of cell death initiating wall thinning, and collagen degradation initiating ventricular dilation. Our simulations agree well with clinical observations in early myocardial infarction. They represent a first step toward simulating the progression of myocardial infarction with the ultimate goal to predict the propensity toward heart failure as a function of infarct intensity, location, and size. PMID:26583449

  2. Rethinking Space Design Standards Toward Quality Affordable Housing In Malaysia

    Directory of Open Access Journals (Sweden)

    Ishak Nor Haniza

    2016-01-01

    Full Text Available Provision of affordable housing is important to low- and middle-income population. A fit form of house will not only fulfil a basic human need for shelter, but it also contributes to physical and psychological well-being of the occupants. Excellent quality and affordable housing is an indication of a high quality of life. While writings exist on various aspects of the quality of affordable housing in Malaysia, discussion regarding space and design standards has scarcely been given any serious academic attention. Standards concerning residential development usually cover different aspects or stages of the development process. They can include planning standards, design standards, space standards and technical construction standards. The main concern of this paper is on space and design standards specifically. Space standard can be defined as a set of framework which dictates fixed internal space minimums. Meanwhile, design standard indicates design guidelines to ensure the functionality, comfortability and habitability of the house. This paper is concerned exclusively with indoor spaces of a house excluding external circulation spaces and service facilities (in case of strata housing. Its interest is in internal space as an aspect of housing quality. It can be concluded that one of the way forward will be to find the balance between providing adequate minimum spaces for resident satisfactions and having economic values for housing developers. This paper may be used as a valuable reference for authorities and policy makers to better address the best housing space design standards that would benefit not only the occupants, but also the local government and developers alike.

  3. A Bootstrap Approach to an Affordable Exploration Program

    Science.gov (United States)

    Oeftering, Richard C.

    2011-01-01

    This paper examines the potential to build an affordable sustainable exploration program by adopting an approach that requires investing in technologies that can be used to build a space infrastructure from very modest initial capabilities. Human exploration has had a history of flight programs that have high development and operational costs. Since Apollo, human exploration has had very constrained budgets and they are expected be constrained in the future. Due to their high operations costs it becomes necessary to consider retiring established space facilities in order to move on to the next exploration challenge. This practice may save cost in the near term but it does so by sacrificing part of the program s future architecture. Human exploration also has a history of sacrificing fully functional flight hardware to achieve mission objectives. An affordable exploration program cannot be built when it involves billions of dollars of discarded space flight hardware, instead, the program must emphasize preserving its high value space assets and building a suitable permanent infrastructure. Further this infrastructure must reduce operational and logistics cost. The paper examines the importance of achieving a high level of logistics independence by minimizing resource consumption, minimizing the dependency on external logistics, and maximizing the utility of resources available. The approach involves the development and deployment of a core suite of technologies that have minimum initial needs yet are able expand upon initial capability in an incremental bootstrap fashion. The bootstrap approach incrementally creates an infrastructure that grows and becomes self sustaining and eventually begins producing the energy, products and consumable propellants that support human exploration. The bootstrap technologies involve new methods of delivering and manipulating energy and materials. These technologies will exploit the space environment, minimize dependencies, and

  4. Affordable Housing Policy: Integration of Land Use Tools and the Role of State Growth Management

    OpenAIRE

    Morrow, Melissa Josephine

    2001-01-01

    Affordable housing is recognized as a problem in many localities throughout the United States. Local governments have the power to influence housing affordability through land use policies. Land use tools exist to address affordable housing.. However, these tools are primarily used to address other environmental, economic, and social issues. When implemented to serve other land use objectives, these tools can have a negative impact on affordable housing. This paper will describe the link ...

  5. The Reader's Devices: The affordances of ebook readers

    Directory of Open Access Journals (Sweden)

    Heather MacFadyen

    2011-04-01

    Full Text Available Print books and ebook devices now co-exist in a reading eco-system. The ways in which readers understand and describe their experience of reading on ebook devices is shaped by long-established cultural expectations about the abstract as well as the physical affordances of the print book. Ebook devices cannot help but challenge those expectations. A review of readers’ reactions to the emergence of ebook devices offers a glimpse into the complex cultural position of both the idea and the experience of reading.

  6. The affordances and use of green citizen engagement web tools

    DEFF Research Database (Denmark)

    Hoff, Jens Villiam; Scheele, Christian Elling

    2015-01-01

    The purpose of this paper is to analyse if and how three different green web applications create the basis for different levels of environmental citizen participation. This is relevant in both an e-governance context and an environmental policy context, as it is normally assumed that ICT...... that differences in affordance translates into differences in use. Theoretically, the paper departs from Contextual New Medium Theory. This theory focuses on technological practices, and demonstrates how these are created in interplay between technology, policy ideas and actor skills. Empirically, the paper...

  7. Housing Affordability in New Zealand: Evidence from Household Surveys

    OpenAIRE

    David Law; Lisa Meehan

    2013-01-01

    Housing affordability has been a topic of much interest in New Zealand over recent years with the median house price increasing by over 50% between 2004 and 2008. The aim of this paper is to inform debate by drawing out evidence from two surveys: the Household Economic Survey (HES); and the Survey of Family, Income and Employment (SoFIE). In particular, the paper examines how patterns of house prices, expenditures, and home ownership have changed over time and across groups. A model which may...

  8. On possibilities for action: The past, present and future of affordance research

    Directory of Open Access Journals (Sweden)

    Gert-Jan Pepping

    2012-12-01

    Full Text Available We give a historical overview of the development of almost 50 years of empirical research on the affordances in the past and in the present. Defined by James Jerome Gibson in the early development of the Ecological Approach to Perception and Action as the prime of perception and action, affordances have become a rich topic of investigation in the fields of human movement science and experimental psychology. The methodological origins of the empirical research performed on affordances can be traced back to the mid 1980’s and the works of Warren (1984, 1988 and Michaels (1988. Most of the research in Ecological Psychology performed since has focused on the actualization of discretely defined actions, the perception of action boundaries, the calculation of pi-numbers, and the measurement of response times. The research efforts have resulted in advancements in the understanding of the dynamic nature of affordances, affordances in a social context and the importance of calibration for perception of affordances. Although affordances are seen as an instrumental part of the control of action most studies investigating affordances do not pay attention to the control of the action. We conclude that affordances are still primarily treated as a utility to select behaviour, which creates a conceptual barrier that hinders deeper understanding of affordances. A focus on action-boundaries has largely prevented advancement in other aspects of affordances, most notably an integrative understanding of the role of affordances in the control of action.

  9. 75 FR 29877 - Affordable Housing Program Amendments: Federal Home Loan Bank Mortgage Refinancing Authority

    Science.gov (United States)

    2010-05-28

    ... 2590-AA04 Affordable Housing Program Amendments: Federal Home Loan Bank Mortgage Refinancing Authority... Federal Home Loan Banks (Banks) until July 30, 2010, to use Affordable Housing Program (AHP) homeownership..., 2798. B. The Banks' Affordable Housing Program Section 10(j) of the Federal Home Loan Bank Act...

  10. Endoscopic retrograde cholangiopancreatography causes reduced myocardial blood flow

    DEFF Research Database (Denmark)

    Christensen, M; Hendel, H W; Rasmussen, V;

    2002-01-01

    ). PATIENTS AND METHODS: 11 patients scheduled for ERCP were monitored with a Holter tape recorder and underwent myocardial perfusion scintigraphies, to evaluate myocardial perfusion at rest and during ERCP. RESULTS: Ten patients completed the study. Eight patients had no sign of myocardial ischemia...... with either of the two methods, while two patients developed signs of ischemia during ERCP with both the Holter tape recording and on myocardial scintigraphy (P = 0.02). CONCLUSIONS: Patients undergoing ERCP may develop true myocardial ischemia with reduced myocardial blood flow. Although this is a small...

  11. Spontaneous coronary dissection associated with myocardial bridge causing acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    GE Jun-bo; HUANG Zhe-yong; LIU Xue-bo; QIAN Ju-ying

    2008-01-01

    @@ Spontaneous coronary artery dissection (SCAD) is a rare cause of myocardial ischemia, myocardial infarction and sudden cardiac death.1-10 This disease mainly occurs in young women with oral contraceptive or during the peripartum period,without risk factors for coronary artery disease.

  12. Prognostic significance of transient myocardial ischaemia after first acute myocardial infarction: five year follow up study

    DEFF Research Database (Denmark)

    Mickley, H; Nielsen, J R; Berning, J;

    1995-01-01

    of a first myocardial infarction who can perform exercise tests before discharge. Patients at high risk of future myocardial infarction or death from cardiac causes are not identified. Ambulatory monitoring and exertional angina distinguish a small subset of patients who will develop severe angina pectoris......OBJECTIVE: To assess the five year prognostic significance of transient myocardial ischaemia on ambulatory monitoring after a first acute myocardial infarction, and to compare the diagnostic and long term prognostic value of ambulatory ST segment monitoring, maximal exercise testing...... infarction. MAIN OUTCOME MEASURES: Relation of ambulatory ST segment depression, exercise test variables, and left ventricular ejection fraction to subsequent objective (cardiac death or myocardial infarction) or subjective (need for coronary revascularisation) events. RESULTS: 23 of the 123 patients had...

  13. Evaluation of myocardial involvement in Duchenne's progressive muscular dystrophy with thallium-201 myocardial perfusion imaging

    International Nuclear Information System (INIS)

    Myocardial involvement in progressive muscular dystrophy of the Duchenne type was evaluated in 19 patients using thallium-201 myocardial perfusion imaging. A qualitative analysis was performed from five projection images by three experienced physicians. Distinct perfusion defects were shown in 13 patients, especially in the LV posterolateral or posterior wall (11 patients). There was no significant relationship between the presence of perfusion defects and the skeletal muscle involvements or thoracic deformities assessed by transmission computed tomography. Extensive perfusion defects were shown in 2 patients who died of congestive heart failure 1 to 2 years after the scintigraphic study. Progression of the myocardial scintigraphic abnormalities were considered to be minimal in 7 of 9 patients who underwent two serial scintigraphic studies over 2 to 3 years. It was concluded that thallium myocardial perfusion imaging is a useful clinical technique to assess myocardial involvement in Duchenne's progressive muscular dystrophy. (author)

  14. Anticipating Human Activities Using Object Affordances for Reactive Robotic Response.

    Science.gov (United States)

    Koppula, Hema S; Saxena, Ashutosh

    2016-01-01

    An important aspect of human perception is anticipation, which we use extensively in our day-to-day activities when interacting with other humans as well as with our surroundings. Anticipating which activities will a human do next (and how) can enable an assistive robot to plan ahead for reactive responses. Furthermore, anticipation can even improve the detection accuracy of past activities. The challenge, however, is two-fold: We need to capture the rich context for modeling the activities and object affordances, and we need to anticipate the distribution over a large space of future human activities. In this work, we represent each possible future using an anticipatory temporal conditional random field (ATCRF) that models the rich spatial-temporal relations through object affordances. We then consider each ATCRF as a particle and represent the distribution over the potential futures using a set of particles. In extensive evaluation on CAD-120 human activity RGB-D dataset, we first show that anticipation improves the state-of-the-art detection results. We then show that for new subjects (not seen in the training set), we obtain an activity anticipation accuracy (defined as whether one of top three predictions actually happened) of 84.1, 74.4 and 62.2 percent for an anticipation time of 1, 3 and 10 seconds respectively. Finally, we also show a robot using our algorithm for performing a few reactive responses.

  15. Interaction between affordance and handedness recognition: a chronometric study

    Directory of Open Access Journals (Sweden)

    A.P. Lameira

    2015-04-01

    Full Text Available The visualization of tools and manipulable objects activates motor-related areas in the cortex, facilitating possible actions toward them. This pattern of activity may underlie the phenomenon of object affordance. Some cortical motor neurons are also covertly activated during the recognition of body parts such as hands. One hypothesis is that different subpopulations of motor neurons in the frontal cortex are activated in each motor program; for example, canonical neurons in the premotor cortex are responsible for the affordance of visual objects, while mirror neurons support motor imagery triggered during handedness recognition. However, the question remains whether these subpopulations work independently. This hypothesis can be tested with a manual reaction time (MRT task with a priming paradigm to evaluate whether the view of a manipulable object interferes with the motor imagery of the subject's hand. The MRT provides a measure of the course of information processing in the brain and allows indirect evaluation of cognitive processes. Our results suggest that canonical and mirror neurons work together to create a motor plan involving hand movements to facilitate successful object manipulation.

  16. Affordance-controlled bifurcations of action patterns in martial arts.

    Science.gov (United States)

    Hristovski, Robert; Davids, Keith; Araújo, Duarte

    2006-10-01

    Effects of participant-target distance and perceived handstriking efficiency on emergent behavior in the martial art of boxing were investigated, revealing affordance-controlled nonlinear dynamical effects (i.e. bifurcations) within the participant--target system. Results established the existence of critical values of scaled distances for emergence of first time excitations and annihilations of a diverse range of boxing actions i.e. on the appearance and dissolution of jabs, hooks and uppercuts. Reasons for the action diversity were twofold: (a) topological discontinuous changes (bifurcations) in the number of possible handstrikes, i.e. motor solutions to the hitting task; (b) fine modification of probabilities of emergence of striking patterns. Exploitation of a 'strikeability' affordance available in scaled distance-to-target information by boxers led to a diversity of emergent actions through a cascade of bifurcations in the task perceptual-motor work space. Data suggested that perceived efficiency (E) of an action changed as a function of scaled distance (D) and was correlated with the probability of occurrence of action patterns (P), exhibiting the following dependence P = P(E(D)). The implication is that probability of occurrence (P) depends on efficiency (E), which in turn depends on scaled distance (D) to the target. Accordingly, scaled distance-dependent perceived efficiency seems a viable candidate for a contextual (control) parameter to describe the nonlinear dynamics of striking actions in boxing.

  17. Architecture & Design of Affordable and Highly Available Enterprise Cloud Service

    Directory of Open Access Journals (Sweden)

    Rabi Prasad Padhy

    2013-01-01

    Full Text Available Cloud computing is a way to increase capacity or add capabilities on the fly without investing in additional infrastructure, licensing additional software or training new personnel. Enterprises must embrace this bleeding edge real-time business model in order to compete in the current marketplace. Deployment of enterprise applications in public cloud can reduce investment on IT infrastructure both in terms of hardware and software, whenever new services are to be provisioned. Furthermore, cloud services are quite attractive to business because of its dynamic scalability, privacy, performance and ability to handle heterogeneous environments. Instead of spending a lot of time in figuring out server setup and working on routers, it is judicious to subscribe cloud based 24/7 support and affordable services. It’s an extremely important consideration to subscribe to at least two cloud vendors for smooth running of applications and ensure application availability by switching from one provider to another with minimal management effort. In this article we have proposed an architecture and design of a cost affordable online enterprise cloud application that subscribes to two public cloud vendors with respect to cost and availability parameters. We also present the reasons for the current trend of enterprises moving towards 24/7 online business cloud services.

  18. Deep Survival Analysis

    OpenAIRE

    Ranganath, Rajesh; Perotte, Adler; Elhadad, Noémie; Blei, David

    2016-01-01

    The electronic health record (EHR) provides an unprecedented opportunity to build actionable tools to support physicians at the point of care. In this paper, we investigate survival analysis in the context of EHR data. We introduce deep survival analysis, a hierarchical generative approach to survival analysis. It departs from previous approaches in two primary ways: (1) all observations, including covariates, are modeled jointly conditioned on a rich latent structure; and (2) the observation...

  19. Social Media, Privacy, and Self-Disclosure: The Turbulence Caused by Social Media’s Affordances

    Directory of Open Access Journals (Sweden)

    Sabine Trepte

    2015-04-01

    Full Text Available The struggle we currently perceive in terms of social media privacy may be the result of the incompatible natures of “warm” and “cold” affordances. Whereas social media’s warm affordances reflect long-standing privacy routines and expectations, cold affordances seem to challenge and sometimes violate them. Sharing under the realm of warm affordances means sharing according to the routines and habits we know. Sharing under the realm of cold affordances means understanding social media’s terms and conditions and how they reflect on our relationships and experiences - similar to assimilating to a new culture that seems opaque and constantly in flux.

  20. Glaucocalyxin A Ameliorates Myocardial Ischemia-Reperfusion Injury in Mice by Suppression of Microvascular Thrombosis

    Science.gov (United States)

    Liu, Xiaohui; Xu, Dongzhou; Wang, Yuxin; Chen, Ting; Wang, Qi; Zhang, Jian; You, Tao; Zhu, Li

    2016-01-01

    Background The aim of this study was to evaluate the cardio-protective roles of glaucocalyxin A (GLA) in myocardial ischemia-reperfusion injury and to explore the underlying mechanism. Material/Methods Myocardial ischemia-reperfusion in wild-type C57BL/6J mice was induced by transient ligation of the left anterior descending artery. GLA or vehicle (solvent) was administrated intraperitoneally to the mice before reperfusion started. After 24 h of myocardial reperfusion, ischemic size was revealed by Evans blue/TTC staining. Cardiac function was evaluated by echocardiography and microvascular thrombosis was assessed by immunofluorescence staining of affected heart tissue. We also measured the phosphorylation of AKT, ERK, P-GSK-3β, and cleaved caspase 3 in the myocardium. Results Compared to the solvent-treated control group, GLA administration significantly reduced infarct size (GLA 13.85±2.08% vs. Control 18.95±0.97%, p<0.05) and improved left ventricular ejection fraction (LVEF) (GLA 53.13±1.11% vs. Control 49.99±1.25%, p<0.05) and left ventricular fractional shortening (LVFS) (28.34±0.71% vs. Control 25.11±0.74%, p<0.05) in mice subjected to myocardial ischemia-reperfusion. GLA also attenuated microvascular thrombosis (P<0.05) and increased the phosphorylation of pro-survival kinase AKT (P<0.05) and GSK-3β (P<0.05) in the myocardium upon reperfusion injury. Conclusions Administration of GLA before reperfusion ameliorates myocardial ischemia-reperfusion injury in mice. The cardio-protective roles of GLA may be mediated through the attenuation of microvascular thrombosis. PMID:27716735

  1. Increased myocardial fibrosis and left ventricular dysfunction in Cushing's syndrome.

    NARCIS (Netherlands)

    Yiu, K.H.; Marsan, N.A.; Delgado, V.; Biermasz, N.R.; Holman, E.R.; Smit, J.W.A.; Feelders, R.A.; Bax, J.J.; Pereira, A.M.

    2012-01-01

    OBJECTIVE: Active Cushing's syndrome (CS) is associated with cardiomyopathy, characterized by myocardial structural, and ultrastructural abnormalities. The extent of myocardial fibrosis in patients with CS has not been previously evaluated. Therefore, the objective of this study was to assess myocar

  2. Association of blood transfusion with increased mortality in myocardial infarction

    DEFF Research Database (Denmark)

    Chatterjee, Saurav; Wetterslev, Jørn; Sharma, Abhishek;

    2013-01-01

    The benefit of blood transfusion in patients with myocardial infarction is controversial, and a possibility of harm exists.......The benefit of blood transfusion in patients with myocardial infarction is controversial, and a possibility of harm exists....

  3. Multinationals and plant survival

    DEFF Research Database (Denmark)

    Bandick, Roger

    2010-01-01

    The aim of this paper is twofold: first, to investigate how different ownership structures affect plant survival, and second, to analyze how the presence of foreign multinational enterprises (MNEs) affects domestic plants’ survival. Using a unique and detailed data set on the Swedish manufacturing...

  4. Survivability in warship design

    NARCIS (Netherlands)

    Keuning, P.J.; Smit, C.S.

    2002-01-01

    The initiative taken by the AVT panel to organise this symposium on combat survivability is much welcomed. From our perspective, the possibilities for the survivability experts within NATO to exchange their research efforts have always been rather limited. This symposium under sponsorship of the AVT

  5. A Fractional Survival Model

    OpenAIRE

    Lee, Cheng K.; Lee, Jenq-Daw

    2006-01-01

    A survival model is derived from the exponential function using the concept of fractional differentiation. The hazard function of the proposed model generates various shapes of curves including increasing, increasing-constant-increasing, increasing-decreasing-increasing, and so-called bathtub hazard curve. The model also contains a parameter that is the maximum of the survival time.

  6. Myocardial perfusion imaging with dual energy CT.

    Science.gov (United States)

    Jin, Kwang Nam; De Cecco, Carlo N; Caruso, Damiano; Tesche, Christian; Spandorfer, Adam; Varga-Szemes, Akos; Schoepf, U Joseph

    2016-10-01

    Dual-energy CT (DECT) enables simultaneous use of two different tube voltages, thus different x-ray absorption characteristics are acquired in the same anatomic location with two different X-ray spectra. The various DECT techniques allow material decomposition and mapping of the iodine distribution within the myocardium. Static dual-energy myocardial perfusion imaging (sCTMPI) using pharmacological stress agents demonstrate myocardial ischemia by single snapshot images of myocardial iodine distribution. sCTMPI gives incremental values to coronary artery stenosis detected on coronary CT angiography (CCTA) by showing consequent reversible or fixed myocardial perfusion defects. The comprehensive acquisition of CCTA and sCTMPI offers extensive morphological and functional evaluation of coronary artery disease. Recent studies have revealed that dual-energy sCTMPI shows promising diagnostic accuracy for the detection of hemodynamically significant coronary artery disease compared to single-photon emission computed tomography, invasive coronary angiography, and cardiac MRI. The aim of this review is to present currently available DECT techniques for static myocardial perfusion imaging and recent clinical applications and ongoing investigations.

  7. Effect of combined Antioxidants on Acute Myocardial infarction size

    OpenAIRE

    B.Farahani; K.Hadiyan; A.Mohseni

    2001-01-01

    SummaryBackground and purpose : The role of oxygen-derived free radicals in destruction of myocardial cells during acute ischemia or reperfusion has been proved. This phenomenon made the workers to study and find the inhibitory therapeutic methods in order to reduce the myocardial cell destruction during acute myocardial infarction. This study evaluates the role of combined antioxidants on acute myocardial infarction sige in patients referring to vali asr hospital of Arak.Materials and Method...

  8. Epigenetic Regulation of Myocardial Homeostasis, Self-Regeneration and Senescence.

    Science.gov (United States)

    Matteucci, Marco; Papini, Gaia; Ciofini, Enrica; Barile, Lucio; Lionetti, Vincenzo

    2015-01-01

    The adult myocardium has limited capacity to preserve, renew or rejuvenate itself. The local microenvironment may induce epigenetic changes affecting the survival, proliferation, function and senescence of cardiac cells at rest and following the exposure to different stressors. The cellular response to microenvironment is characterized by the release of ions, oxygen free radicals, auto/paracrine factors and RNAs that drive the magnitude of gene reprogramming through the interaction with specific promoters. The epigenetic alterations may act at transcriptional and post-transcriptional level and change cardiac physiological traits. The abnormal DNA methylation underlies the progressive decay of contractile function and the angiogenic ability; while, the histone acetylation promotes the survival, function and proliferation of cardiac cells in the presence of ischemic microenvironment. At least, the expression and secretion of microRNAs and long noncoding RNAs may regulate the threshold to stress tolerance of adult cardiac cells and induce the matrix turnover as well. Natural or synthetic active compounds effectively modulate the epigenetic state of cardiac cells. Plant foods contain many active compounds with epigenetic properties and might assume a clinical significance as natural cardiac regenerators or rejuvenators. Our review describes novel epigenetic mechanisms that underpin myocardial remodeling, repair/ regeneration or senescence in order to support the development of most effective and reproducible rescue therapy of adult heart. PMID:26122032

  9. Health Care Affordability: How to Make It a Reality.

    Science.gov (United States)

    Rotarius, Timothy; Liberman, Aaron

    2015-01-01

    Health care is a big business. US health care expenditures reached $2.9 trillion in 2013. Patient spending accounted for 28% of the total, which means patients spent approximately $810 billion in 2013 for insurance premiums, deductibles, copays, coinsurance, and noncovered health care services. How are patients expected to pay almost a trillion dollars in health care expenses? There is a need to find a health care financing methodology that will make health care affordable for all patients and families. An alternative method for funding health care is discussed that includes creating a government-funded annuity during the first decade of one's life. When this annuity matures later in life, many individuals will have amassed a large pot of money with which to pay for their (and their family's) health care treatment and products.

  10. Medical loss ratio regulation under the Affordable Care Act.

    Science.gov (United States)

    Harrington, Scott E

    2013-01-01

    The minimum medical loss ratio (MLR) regulations in the Affordable Care Act guarantee that a specific percentage of health insurance premiums is spent on medical care and specified activities to improve health care quality. This paper analyzes the regulations' potential unintended consequences and incentive effects, including: higher medical costs and premiums for some insurers; less innovation to align consumer, provider, and health plan incentives, less consumer choice and increased market concentration; and the risk that insurers will pay rebates if claim costs are lower than projected when premiums are established, despite the regulations' permitted "credibility adjustments." The paper discusses modifications and alternatives to the MLR regulations to help achieve their stated goals with less potential for adverse effects. PMID:23720876

  11. Strategic options towards an affordable high-performance infrared camera

    Science.gov (United States)

    Oduor, Patrick; Mizuno, Genki; Dutta, Achyut K.; Lewis, Jay; Dhar, Nibir K.

    2016-05-01

    The promise of infrared (IR) imaging attaining low-cost akin to CMOS sensors success has been hampered by the inability to achieve cost advantages that are necessary for crossover from military and industrial applications into the consumer and mass-scale commercial realm despite well documented advantages. Banpil Photonics is developing affordable IR cameras by adopting new strategies to speed-up the decline of the IR camera cost curve. We present a new short-wave IR (SWIR) camera; 640x512 pixel InGaAs uncooled system that is high sensitivity low noise ( 500 frames per second (FPS)) at full resolution, and low power consumption (security imaging adoption. Among the strategic options presented include new sensor manufacturing technologies that scale favorably towards automation, multi-focal plane array compatible readout electronics, and dense or ultra-small pixel pitch devices.

  12. Community-specific evaluation of tool affordances in wild chimpanzees.

    Science.gov (United States)

    Gruber, Thibaud; Muller, Martin N; Reynolds, Vernon; Wrangham, Richard; Zuberbühler, Klaus

    2011-01-01

    The notion of animal culture, defined as socially transmitted community-specific behaviour patterns, remains controversial, notably because the definition relies on surface behaviours without addressing underlying cognitive processes. In contrast, human cultures are the product of socially acquired ideas that shape how individuals interact with their environment. We conducted field experiments with two culturally distinct chimpanzee communities in Uganda, which revealed significant differences in how individuals considered the affording parts of an experimentally provided tool to extract honey from a standardised cavity. Firstly, individuals of the two communities found different functional parts of the tool salient, suggesting that they experienced a cultural bias in their cognition. Secondly, when the alternative function was made more salient, chimpanzees were unable to learn it, suggesting that prior cultural background can interfere with new learning. Culture appears to shape how chimpanzees see the world, suggesting that a cognitive component underlies the observed behavioural patterns. PMID:22355645

  13. Suggested Interactivity: Seeking Perceived Affordances for Information Visualization.

    Science.gov (United States)

    Boy, Jeremy; Eveillard, Louis; Detienne, Françoise; Fekete, Jean-Daniel

    2016-01-01

    In this article, we investigate methods for suggesting the interactivity of online visualizations embedded with text. We first assess the need for such methods by conducting three initial experiments on Amazon's Mechanical Turk. We then present a design space for Suggested Interactivity (i. e., visual cues used as perceived affordances-SI), based on a survey of 382 HTML5 and visualization websites. Finally, we assess the effectiveness of three SI cues we designed for suggesting the interactivity of bar charts embedded with text. Our results show that only one cue (SI3) was successful in inciting participants to interact with the visualizations, and we hypothesize this is because this particular cue provided feedforward. PMID:26390473

  14. Collaborative Affordances of Hybrid Patient Record Technologies in Medical Work

    DEFF Research Database (Denmark)

    Houben, Steven; Frost, Mads; Bardram, Jakob E

    2015-01-01

    The medical record is a central artifact used to organize, communicate and coordinate information related to patient care. Despite recent deployments of electronic health records (EHR), paper medical records are still widely used because of the affordances of paper. Although a number of approaches...... explored the integration of paper and digital technology, there are still a wide range of open issues in the design of technologies that integrate digital and paper-based medical records. This paper studies the use of one such novel technology, called the Hybrid Patient Record (HyPR), that is designed...... to digitally augment a paper medical record. We report on two studies: a field study in which we describe the benefits and challenges of using a combination of electronic and paper-based medical records in a large university hospital and a deployment study in which we analyze how 8 clinicians used the Hy...

  15. Design and construction of an optical compact and affordable tweezers

    International Nuclear Information System (INIS)

    The following paper presents a new design allowing a reduction on the amount of required optical elements for the construction of the optical tweezers, which results in a compact and affordable system. The latter is composed by a 40 mW Nd: YAG (532 nm) laser and commercially available optics and mounts. A virtual instrument, developed using Lab View 8.0, controls both a XYZ table and a web camera for visualizing. The quality of the laser beam at the end of optical system was characterized using the knife-edge method, resulting in a Gaussian shaped (TEM00) intensity profile. It is presented as well the necessary information to align and calibrate each optical element. (Author)

  16. Non-invasive imaging in detecting myocardial viability: Myocardial function versus perfusion

    Directory of Open Access Journals (Sweden)

    Iqbal A. Elfigih

    2014-12-01

    Full Text Available Coronary artery disease (CAD is the most prevalent and single most common cause of morbidity and mortality [1] with the resulting left ventricular (LV dysfunction an important complication. The distinction between viable and non-viable myocardium in patients with LV dysfunction is a clinically important issue among possible candidates for myocardial revascularization. Several available non-invasive techniques are used to detect and assess ischemia and myocardial viability. These techniques include echocardiography, radionuclide images, cardiac magnetic resonance imaging and recently myocardial computed tomography perfusion imaging. This review aims to distinguish between the available non-invasive imaging techniques in detecting signs of functional and perfusion viability and identify those which have the most clinical relevance in detecting myocardial viability in patients with CAD and chronic ischemic LV dysfunction. The most current available studies showed that both myocardial perfusion and function based on non-invasive imaging have high sensitivity with however wide range of specificity for detecting myocardial viability. Both perfusion and function imaging modalities provide complementary information about myocardial viability and no optimum single imaging technique exists that can provide very accurate diagnostic and prognostic viability assessment. The weight of the body of evidence suggested that non-invasive imaging can help in guiding therapeutic decision making in patients with LV dysfunction.

  17. Affordable Development and Qualification Strategy for Nuclear Thermal Propulsion

    Science.gov (United States)

    Gerrish, Harold P., Jr.; Doughty, Glen E.; Bhattacharyya, Samit K.

    2013-01-01

    A number of recent assessments have confirmed the results of several earlier studies that Nuclear Thermal Propulsion (NTP) is a leading technology for human exploration of Mars. It is generally acknowledged that NTP provides the best prospects for the transportation of humans to Mars in the 2030's. Its high Isp coupled with the high thrusts achievable, allow reasonable trip times, thereby alleviating concerns about space radiation and "claustrophobia" effects. NASA has embarked on the latest phase of the development of NTP systems, and is adopting an affordable approach in response to the pressure of the times. The affordable strategy is built on maximizing the use of the large NTP technology base developed in the 1950's and 60's. The fact that the NTP engines were actually demonstrated to work as planned, is a great risk reduction feature in its development. The strategy utilizes non-nuclear testing to the fullest extent possible, and uses focused nuclear tests for the essential qualification and certification tests. The perceived cost risk of conducting the ground tests is being addressed by considering novel testing approaches. This includes the use of boreholes to contain radioactive effluents, and use of fuel with very high retention capability for fission products. The use of prototype flight tests is being considered as final steps in the development prior to undertaking human flight missions. In addition to the technical issues, plans are being prepared to address the institutional and political issues that need to be considered in this major venture. While the development and deployment of NTP system is not expected to be cheap, the value of the system will be very high, and amortized over the many missions that it enables and enhances, the imputed costs will be very reasonable. Using the approach outlined, NASA and its partners, currently the DOE, and subsequently industry, have a good chance of creating a sustained development program leading to human

  18. Enabling Dedicated, Affordable Space Access Through Aggressive Technology Maturation

    Science.gov (United States)

    Jones, Jonathan; Kibbey, Tim; Lampton, Pat; Brown, Thomas

    2014-01-01

    A recent explosion in nano-sat, small-sat, and university class payloads has been driven by low cost electronics and sensors, wide component availability, as well as low cost, miniature computational capability and open source code. Increasing numbers of these very small spacecraft are being launched as secondary payloads, dramatically decreasing costs, and allowing greater access to operations and experimentation using actual space flight systems. While manifesting as a secondary payload provides inexpensive rides to orbit, these arrangements also have certain limitations. Small, secondary payloads are typically included with very limited payload accommodations, supported on a non interference basis (to the prime payload), and are delivered to orbital conditions driven by the primary launch customer. Integration of propulsion systems or other hazardous capabilities will further complicate secondary launch arrangements, and accommodation requirements. The National Aeronautics and Space Administration's Marshall Space Flight Center has begun work on the development of small, low cost launch system concepts that could provide dedicated, affordable launch alternatives to small, risk tolerant university type payloads and spacecraft. These efforts include development of small propulsion systems and highly optimized structural efficiency, utilizing modern advanced manufacturing techniques. This paper outlines the plans and accomplishments of these efforts and investigates opportunities for truly revolutionary reductions in launch and operations costs. Both evolution of existing sounding rocket systems to orbital delivery, and the development of clean sheet, optimized small launch systems are addressed. A launch vehicle at the scale and price point which allows developers to take reasonable risks with new propulsion and avionics hardware solutions does not exist today. Establishing this service provides a ride through the proverbial "valley of death" that lies between

  19. The effect of encapsulation of cardiac stem cells within matrix-enriched hydrogel capsules on cell survival, post-ischemic cell retention and cardiac function

    OpenAIRE

    Mayfield, Audrey E.; Tilokee, Everad L.; Latham, Nicholas; McNeill, Brian; Lam, Bu-Khanh; Ruel, Marc; Suuronen, Erik J; Courtman, David W.; Stewart, Duncan J.; Davis, Darryl R.

    2013-01-01

    Transplantation of ex vivo proliferated cardiac stem cells (CSCs) is an emerging therapy for ischemic cardiomyopathy but outcomes are limited by modest engraftment and poor long-term survival. As such, we explored the effect of single cell microencapsulation to increase CSC engraftment and survival after myocardial injection. Transcript and protein profiling of human atrial appendage sourced CSCs revealed strong expression the pro-survival integrin dimers αVβ3 and α5β1- thus rationalizing the...

  20. Assessment of myocardial viability using multidetector computed tomography in patients with reperfused acute myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Kim, T. [Department of Radiology, Ajou University School of Medicine, Suwon (Korea, Republic of); Choi, B.J. [Department of Cardiology, Ajou University School of Medicine, Suwon (Korea, Republic of); Kang, D.K., E-mail: kdklsm@ajou.ac.kr [Department of Radiology, Ajou University School of Medicine, Suwon (Korea, Republic of); Sun, J.S. [Department of Radiology, Ajou University School of Medicine, Suwon (Korea, Republic of)

    2012-08-15

    Aim: To assess the prognostic value of 64-section multidetector computed tomography (MDCT) to predict follow-up myocardial dysfunction and functional recovery after reperfusion therapy in patients with acute myocardial infarction (MI) as defined by echocardiography. Materials and methods: After reperfusion therapy for acute MI, 71 patients underwent two-phase contrast-enhanced MDCT and follow-up echocardiography. MDCT findings were compared with echocardiographic findings using kappa statistics. The areas under the receiver operating characteristic curves (AUCs) and the odds ratios (ORs) of early perfusion defects (EPD), delayed enhancement (DE), and residual perfusion defects (RPD) for predicting follow-up myocardial dysfunction and functional recovery were calculated on a segmental basis. Results: The presence of transmural EPD (EPD{sub TM}) or RPD showed good agreement (k = 0.611 and 0.658, respectively) with follow-up myocardial dysfunction, while subendocardial EPD (EPD{sub sub}) or subendocardial DE (DE{sub sub}) showed fair agreement with follow-up myocardial dysfunction (k = 0.235 and 0.234, respectively). The AUC of RPD (0.796) was superior (p < 0.001 and 0.031, respectively) to those of EPD{sub TM} (0.761) and DE{sub TM} (0.771). The presence of EPD{sub TM}, DE{sub TM}, and RPD were significant, independent positive predictors of follow-up myocardial dysfunction (OR = 6.4, 1.9, and 9.8, respectively). EPD{sub TM} was a significant, independent negative predictor of myocardial functional recovery (OR = 0.13). Conclusion: Abnormal myocardial attenuation on two-phase MDCT after reperfusion therapy may provide promising information regarding myocardial viability in patients with acute MI.

  1. Mechanisms and therapeutic modulation of myocardial infarct healing

    NARCIS (Netherlands)

    Timmers, L.

    2008-01-01

    This thesis aimed to increase the basic mechanistic understanding of myocardial infarct healing and to develop novel approaches to prevent heart failure following myocardial infarction (MI). Different approaches have been tested to reduce myocardial injury in the acute phase of MI, leading to reduce

  2. Association of stroke and myocardial infarction in children.

    Science.gov (United States)

    Nakashima, M; Takashima, S; Hashimoto, K; Shiraishi, M

    1982-02-01

    A 9-year-old boy with cerebrovascular accident (CVA) and old myocardial infarction with mural thrombi is reported. The cause of the myocardial infarction was congenital coronary artery fistula originating from the left coronary artery and emptying into the right atrium. Although a common cause of strokes in adults, myocardial infarction has infrequently been reported as the source of emboli in children.

  3. RAMIPRIL IN THERAPY OF PATIENTS AFTER MYOCARDIAL INFARCTION

    OpenAIRE

    I. V. Szirov; E. V. Malichenko

    2015-01-01

    Angiotensin converting enzyme inhibitors are the first line medicine for the treatment of the most of cardiovascular diseases. There is no class-effect for these drugs in myocardial infarction therapy. Moreover in myocardial infarction angiotensin converting enzyme inhibitors have significant intra-group differences. Ramipril is the one of the most studied drug of this group recommended for patients after acute myocardial infarction.

  4. Measurement of myocardial perfusion using magnetic resonance

    DEFF Research Database (Denmark)

    Fritz-Hansen, T.; Jensen, L.T.; Larsson, H.B.;

    2008-01-01

    Cardiac magnetic resonance imaging (MRI) has evolved rapidly. Recent developments have made non-invasive quantitative myocardial perfusion measurements possible. MRI is particularly attractive due to its high spatial resolution and because it does not involve ionising radiation. This paper review...... myocardial perfusion imaging with MR contrast agents: methods, validation and experiences from clinical studies. Unresolved issues still restrict the use of these techniques to research although clinical applications are within reach Udgivelsesdato: 2008/12/8......Cardiac magnetic resonance imaging (MRI) has evolved rapidly. Recent developments have made non-invasive quantitative myocardial perfusion measurements possible. MRI is particularly attractive due to its high spatial resolution and because it does not involve ionising radiation. This paper reviews...

  5. Hypoplasia of exocrine pancreas with myocardial necrosis

    Institute of Scientific and Technical Information of China (English)

    Xiang Sheng Zhang; Xin Xiu Xu; Yan Zhang; Sbu Hua Wu

    2000-01-01

    AIM To study the clinical and pathological features of hypoplasia of exocrine pancreas with myocardialnecrosis.METHODS One ease of hypoplasia of exocrine pancreas with myocardial necrosis was autopsied. Theclinical signs and pathological changes were analyzed.RESULTS A 15-month-old boy with hypoplasia of exocrine pancreas was reported. The main clinicalfeatures were steatorrhea and marked underdevelopment. He died of acute heart failure afterhospitalization. Autopsy showed that there were aplasia of exocrine portion and fatty metaplasia ofpancreas, the myocardium revealed focal necrosis and sear formation.CONCLUSION Atrophy of exocrine pancreas and myocardial necrosis exist at the same time, suggestingthat there may be some relationship between them. It was likely that the damaged pancreatic tissue releasedsome active materials that may harm the myocardium or decrease pancreatic juice that results in lack ofnutrient and myocardial necrosis.

  6. Quality indicators for acute myocardial infarction

    DEFF Research Database (Denmark)

    Schiele, Francois; Gale, Chris P; Bonnefoy, Eric;

    2016-01-01

    infarction (AMI), but no such indicators exist in Europe. In this context, the European Society of Cardiology (ESC) Acute Cardiovascular Care Association (ACCA) has reflected on the measurement of quality of care in the context of AMI (ST segment elevation myocardial infarction (STEMI) and non-ST segment...... be estimated solely on the basis of patients' clinical outcomes. Thus, measuring the process of care through quality indicators (QIs) has become a widely used practice in this context. Other professional societies have published QIs for the evaluation of quality of care in the context of acute myocardial...... elevation myocardial infarction (NSTEMI)) and created a set of QIs, with a view to developing programmes to improve quality of care for the management of AMI across Europe. We present here the list of QIs defined by the ACCA, with explanations of the methodology used, scientific justification and reasons...

  7. Acute myocardial infarction in a young patient

    International Nuclear Information System (INIS)

    Myocardial infarction (MI) is considered to be the disease of the fifth and sixth decade as seen in the West but an earlier age incidence is not infrequently encountered in the South Asian population. However, occurrence of MI in the teen-age still remains a rare happening. We are reporting a case of a teenager, who suffered a myocardial infarction with cardiogenic shock and pulmonary edema on two separate occasions with ECG and biochemical evidence of myocardial infarction. An exercise stress test done in between the two episodes was negative at a workload of 13.5 METs. A coronary angiogram done after the second event revealed normal coronary arteries and a preserved left ventricular systolic and segmental function. Except for low HDL (high density lipoprotein) and mildly raised homocysteine levels, the patient did not have other conventional or novel risk factors for coronary artery disease. (author)

  8. Ambulatory ST segment monitoring after myocardial infarction

    DEFF Research Database (Denmark)

    Mickley, H

    1994-01-01

    The prevalence of transient myocardial ischaemia after myocardial infarction seems to be lower than in other subgroups with coronary artery disease. In postinfarction patients, however, a greater proportion of ischaemic episodes are silent. At present there is substantial evidence that transient...... ischaemia provides prognostic information in different subsets of patients with previous myocardial infarction, but there is considerable disagreement about how this is expressed in terms of cardiac events. Small patient numbers, patient selection, and different timing of ambulatory monitoring are proposed...... be that it can be performed early after infarction at the time of maximum risk. Secondly, it can be performed in most patients after infarction, including those recognised as being at high risk who are unable to perform an exercise stress test....

  9. Enablements and Constraints: Inventorying Affordances Associated with Lingua Franca English

    Science.gov (United States)

    Henry, Alastair

    2016-01-01

    Transcultural flows of capital, culture and communication have created conditions for the widespread movement of people around the globe, leading to increasing diversity in countries of destination. In contexts of global migration lingua franca English is indispensable in initial and survival communication. For migrants to northern European…

  10. Nitroglycerine induced acute myocardial infarction in a patient with myocardial bridging

    DEFF Research Database (Denmark)

    Rujic, Dragana; Nielsen, Mette Lundgren; Veien, Karsten Tange;

    2014-01-01

    Muscle overlying an intramyocardial segment of a coronary artery is termed a myocardial bridge. The intramyocardial segment, the tunneled artery, is compressed during systole. The condition is generally benign but may occasionally cause myocardial ischemia, infarction, arrhythmia, or sudden cardiac...... death. We present a case regarding a 52-year-old man with exercise-induced angina who was diagnosed with a myocardial bridge overlying the left anterior descending artery. He was initially treated with beta-blockers and later received coronary bypass graft surgery....

  11. Association between coronary flow reserve, left ventricular systolic function, and myocardial viability in acute myocardial infarction

    DEFF Research Database (Denmark)

    Løgstrup, Brian Bridal; Høfsten, Dan E; Christophersen, Thomas B;

    2010-01-01

    AIMS: To investigate the relationships between coronary flow reserve (CFR), left ventricular (LV) systolic function, and myocardial viability in patients with acute myocardial infarction (AMI). METHODS AND RESULTS: In 149 patients with a first AMI, we estimated CFR non-invasively and assessed LV...... patients with CFR 2, P < 0.0001. CONCLUSION: Resting echocardiographic parameters were similar in patient groups. During LDDE, patients with reduced CFR had increased LV size and compromised longitudinal function of LV and were less likely to have evidence of myocardial viability....

  12. Myocardial performance index: prediction and monitoring of remodeling and functioning of the left ventricle after first myocardial infarction

    OpenAIRE

    Ćelić Vera; Dekleva Milica; Majstorović Anka; Radivojević Nenad; Kostić Nada; Čaparević Zorica

    2010-01-01

    Introduction. Dynamic changing of left ventricular geometry and contractile state after acute myocardial infarction is responsible for various aspects of left ventricular remodeling and dysfunction. A number of studies have shown that myocardial performance index allows prediction of acute myocardial infarction complications. The objective of our study was to determine the power of myocardial performance index to predict and assess the severity of left ventricular remodeling, systolic and dia...

  13. Prognostic risk stratification of myocardial ischaemia evaluated by gated myocardial perfusion SPECT in patients with chronic kidney disease

    Energy Technology Data Exchange (ETDEWEB)

    Hatta, Tsuguru [Ohmihachiman Community Medical Center, Division of Nephrology, Department of Medicine, Shiga (Japan); Nishimura, Shigeyuki [Saitama Medical School Hospital, Division of Cardiology, Saitama (Japan); Nishimura, Tsunehiko [Kyoto Prefectural University of Medicine, Department of Radiology, Graduate School of Medical Science, Kyoto (Japan)

    2009-11-15

    The aim of this study was to identify useful predictors of cardiac events in patients with chronic kidney disease (CKD). Among 4,031 patients identified from the Japanese Assessment of Cardiac Events and Survival Study (J-ACCESS) database with suspected or known ischaemic heart disease, we selected 820 with an estimated glomerular filtration rate (eGFR) of < 60 ml/min per 1.73 m{sup 2}. A total of 75 cardiac events developed among these 820 patients. The incidence of cardiac events was higher in the group with a lower eGFR. Multivariate Cox analysis indicated that age, diabetes mellitus, end-systolic volume, summed stress score (SSS) and eGFR were predictors of cardiac events. Event rates of patients with SSS {>=} 9 were significantly higher in groups with lower eGFR values (< 40 and 40-49 ml/min). The SSS value ({>=} 9) is a reliable predictor of cardiac events and myocardial single photon emission computed tomography has incremental value for predicting cardiac events and survival in CKD. (orig.)

  14. Predictive significance of residual ischemia proved by dobutamine stress: Echocardiography test in patients early after the first uncomplicated myocardial infarction

    Directory of Open Access Journals (Sweden)

    Karanović Nevena

    2004-01-01

    Full Text Available Background. To evaluate the long-term prognostic value of dobutamine stress-echocardiography (ECG test for new coronary events (new episodes of angina pectoris, cardiac-related deaths, and reinfarctions early after the first uncomplicated myocardial infarction. Methods. Dobutamine stress-echocardiography tests were performed in all of 104 patients 10-20 days after the first myocardial infarction. Patients were followed-up for 36 (29 ± 7 months. Kaplan-Meier cumulative survival curves were tested by Breslow test (Log Rank. Results. Two cardiac deaths (1.92%, nine nonfatal myocardial infarctions (8.65%, and three cases of recurrent angina pectoris (2.88% occurred during the prospective follow-up. Cumulative survival curves showed that in patients with negative findings of dobutamine stress-echocardiography test, survival time without significant events was 35.31 months, while in the group with positive findings of dobutamine stress-echocardiography test it was 30.91 months (log Rank 7.22; p<0.01. Prognostic value of dobutamine stress-echocardiography test was analyzed by Cox regression model and was 2.92, meaning that the risk of significant events was 2.92 times higher in the group of patients with positive findings of dobutamine stress-echocardiography test. Conclusion. Patients with negative findings of dobutamine stress-echocardiography test were with significantly higher possibility of surviving without significant events in comparison with the patients in whom the findings of dobutamine stress-echocardiography test were positive. In combination with clinical signs and ECG results, the results of dobutamine stress-echocardiography test improved prognostic value in the patients with the first uncomplicated myocardial infarction, and in that way influenced the strategy of their further treatment.

  15. Outcomes of after-hours versus regular working hours primary percutaneous coronary intervention for acute myocardial infarction

    OpenAIRE

    Graham, Michelle M; Ghali, William A.; Southern, Danielle A.; Traboulsi, Mouhieddin; Knudtson, Merril L.; ,

    2011-01-01

    Background Primary percutaneous coronary intervention (PCI) is a proven therapy for acute ST-segment elevation myocardial infarction. However, outcomes associated with primary PCI may differ depending on time of day. Methods and results Using the Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease, a clinical data-collection initiative capturing all cardiac catheterisation patients in Alberta, Canada, the authors described and compared crude and risk-adjusted survival...

  16. Remote ischemic preconditioning mitigates myocardial and neurological dysfunction via K(ATP) channel activation in a rat model of hemorrhagic shock.

    Science.gov (United States)

    Hu, Xianwen; Yang, Zhengfei; Yang, Min; Qian, Jie; Cahoon, Jena; Xu, Jiefeng; Sun, Shijie; Tang, Wanchun

    2014-09-01

    Severe hemorrhagic shock and resuscitation is a state of global body ischemia and reperfusion that causes myocardial and cerebral dysfunction. We investigated whether remote ischemic preconditioning (RIPC) would reduce myocardial and cerebral ischemia and reperfusion injuries after hemorrhagic shock as the result of the K(ATP) channel activation. Twenty-one male rats were randomized into three groups: RIPC, RIPC with K(ATP) channel blocker, and control. Remote ischemic preconditioning was induced by four cycles of 5 min of limb ischemia followed by reperfusion for 5 min. Hemorrhagic shock was induced by removing 50% of the estimated total blood volume during an interval of 1 h. Thirty minutes after the completion of bleeding, the animals were reinfused with shed blood during the ensuing 30 min. The animals were monitored for 2 h and observed for an additional 72 h. Myocardial function was measured by echocardiography, and sublingual microcirculation was measured by a sidestream dark-field imaging device at baseline, 1 h after bleeding, 30 min after the completion of bleeding, 30 min after reinfusion, and hourly intervals thereafter. The survival and neurological function were evaluated at 12, 24, 48, and 72 h after reinfusion. At 2 h after reinfusion, ejection fraction and myocardial performance index were significantly better in the RIPC group than in the control group (P shock and resuscitation, RIPC mitigated myocardial and neurological dysfunction with improved survival by activation of the K(ATP) channel.

  17. Myocardial bridges: morphological and functional aspects.

    OpenAIRE

    A.G. Ferreira; Trotter, S E; König, B; Décourt, L V; Fox, K; Olsen, E G

    1991-01-01

    OBJECTIVE--To assess the arrangement of myocardial bridges. DESIGN--A necropsy study of 90 consecutive hearts (56 male, 34 female). RESULTS--Myocardial bridges, either single or multiple, were seen in 50 (55.6%) of the 90 hearts. The left anterior descending artery was the most commonly affected artery. Thirty five of the 50 hearts which contained in total 41 muscle bridges were dissected further with a magnifying glass. Two different types of muscle bridges could be identified. Thirty one of...

  18. Does heavy physical exertion trigger myocardial infarction?

    DEFF Research Database (Denmark)

    Hallqvist, J; Möller, J; Ahlbom, A;

    2000-01-01

    To study possible triggering of first events of acute myocardial infarction by heavy physical exertion, the authors conducted a case-crossover analysis (1993-1994) within a population-based case-referent study in Stockholm County, Sweden (the Stockholm Heart Epidemiology Program). Interviews were...... carried out with 699 myocardial infarction patients after onset of the disease. These cases represented 47 percent of all cases in the study base, and 70 percent of all nonfatal cases. The relative risk from vigorous exertion was 6.1 (95% confidence interval: 4.2, 9.0). The rate difference was 1.5 per...

  19. Visualizing myocardial function using HARP MRI

    Energy Technology Data Exchange (ETDEWEB)

    Osman, N.F. [Center for Imaging Science, Department of Electrical and Computer Engineering, The Johns Hopkins University, Baltimore, MD 21218 (United States); Prince, J.L. [Center for Imaging Science, Department of Electrical and Computer Engineering, The Johns Hopkins University, Baltimore, MD 21218 (United States). E-mail: prince at jhu.edu

    2000-06-01

    Harmonic phase magnetic resonance imaging (HARP) is a new technique for measuring the motion of the left ventricle of the heart. HARP uses magnetic resonance tagging, Fourier filtering and special processing algorithms to calculate key indices of myocardial motion including Eulerian and Lagrangian strain. This paper presents several new methods for visualizing myocardial motion based on HARP. Quantities that are computed and visualized include motion grids, velocity fields, strain rates, pathlines, tracked Eulerian strain, and contraction angle. The computations are fast and fully automated and have the potential for clinical application. (author)

  20. Visualizing myocardial function using HARP MRI

    Science.gov (United States)

    Osman, Nael F.; Prince, Jerry L.

    2000-06-01

    Harmonic phase magnetic resonance imaging (HARP) is a new technique for measuring the motion of the left ventricle of the heart. HARP uses magnetic resonance tagging, Fourier filtering and special processing algorithms to calculate key indices of myocardial motion including Eulerian and Lagrangian strain. This paper presents several new methods for visualizing myocardial motion based on HARP. Quantities that are computed and visualized include motion grids, velocity fields, strain rates, pathlines, tracked Eulerian strain, and contraction angle. The computations are fast and fully automated and have the potential for clinical application.

  1. Acute myopericarditis masquerading as acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    Wen Tian; Zixin Zhang; Xiaojuan Bai; Dingyin Zeng; Guoxian Qi

    2008-01-01

    Patients with abrupt onset of chest pain, ischemic ECG abnormalities and elevated levels of cardiac markers could be given a diagnosis of acute myocardial infarction. However, some other diseases should be taken into consideration in this clinical setting when coronary arteries are proven to be normal. Here we report a case of acute myopericarditis with clinical presentation of myocardial infarction and normal coronary anatomy. The Herpes Simplex Virus Ⅱ was considered as the organism causing myopericarditis and the patient was recovered by the treatment with valacicloavir. A precise diagnosis is a prerequisite of successful treatment and favorable prognosis.

  2. Factors Affecting in-Hospital Mortality of Acute Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    M Salarifar

    2009-09-01

    Full Text Available "nBackground: Acute myocardial infarction (AMI is one of the most common causes of morbidity and mortality. Considering immense socioeconomic damages of growing AMI in developing countries we estimated prognostic value of major risk factors of AMI to predict probable In-hospital AMI mortality."nMethods: In a cohort survey from June 2004 to March 2006, 1798 patients hospitalized with proven AMI entered into two groups: Survived (patients discharged alive and Expired (patients expired during hospitalization due to AMI. We evaluated relationship of 17 risk factors including age, sex, smoking, opium usage, hypertension, diabetes mellitus (DM, dyslipidemia, Killip class, existence of Q wave, St segment elevation, bundle branch blocks (BBB, involved surface of heart, mean left ventricular ejection fraction (LVEF, mitral valve regurgitation (MR, and serum level of Troponin I and CKMB, with patients' survival and expiry by using chi square test, T test and multivariate logistic regression analysis. P value ≤ 0.05 was considered significant."nResults: There were 1629 (90.6% survived and 169 (9.4% expired patients. Factors significantly affected in-hospital mortality of AMI include: age (P< 0.001, femaleness (P< 0.001, smoking (P< 0.001, Killip class>II (P< 0.001, hy­per­tension (P= 0.036, DM (P< 0.001, bundle branch block (P< 0.001, Moderate to severe mitral regurgitation (P< 0.001, lower Mean LVEF (P< 0.001, and lower mean serum concentration of CKMB and Troponin I (P< 0.001. Mortality was significantly higher in anterolateral infarction."nConclusion: Mean age> 69.01 yr, femaleness, Killip class III & V, hypertension, DM, moderate to severe MR, anterolateral AMI, bundle branch block and higher serum concentration of CKMB & Troponin I are associated with higher In-hospital post-AMI mortality.

  3. Survival of falling robots

    Science.gov (United States)

    Cameron, Jonathan M.; Arkin, Ronald C.

    1992-01-01

    As mobile robots are used in more uncertain and dangerous environments, it will become important to design them so that they can survive falls. In this paper, we examine a number of mechanisms and strategies that animals use to withstand these potentially catastrophic events and extend them to the design of robots. A brief survey of several aspects of how common cats survive falls provides an understanding of the issues involved in preventing traumatic injury during a falling event. After outlining situations in which robots might fall, a number of factors affecting their survival are described. From this background, several robot design guidelines are derived. These include recommendations for the physical structure of the robot as well as requirements for the robot control architecture. A control architecture is proposed based on reactive control techniques and action-oriented perception that is geared to support this form of survival behavior.

  4. Surviving After Suicide

    Science.gov (United States)

    ... in grief are: Shock Denial Pain Guilt Anger Shame Despair Disbelief Hopelessness Stress Sadness Numbness Surviving After ... the loved one or to ask for help. Shame or embarrassment might prevent the surivior from reaching ...

  5. [Effect of wall thickness of left ventricle on 201Tl myocardial SPECT images: myocardial phantom study].

    Science.gov (United States)

    Koto, M; Namura, H; Kawase, O; Yamasaki, K; Kono, M

    1996-07-01

    201Tl myocardial SPECT is known for better sensitivity, specificity, and accuracy than planar images in detecting coronary artery disease and diagnosing myocardial viability. SPECT images are also superior to planar images in diagnostic sensitivity and anatomical orientation. However, as limitation of the spatial resolution of the machine, we often encounter poor SPECT plower image quality in patients with decreased wall thickness. To test the accuracy of SPECT images in patients with marked thinning of the left ventricular wall, as occurs in dilated cardiomyopathy, we performed a experimental study using myocardial phantom with 7 mm wall thickness. Tomographic image of the phantom images were rather heterogeneous, though no artificial defect was located. Dilated cardiomyopathy is thought to be characterized by patchy defects in the left ventricle. Careful attention should be given to elucidating myocardial perfusion in patients with a thin left ventricle wall, as there are technical limitations in addition to clinical features.

  6. Hypertabastic survival model

    OpenAIRE

    Williams David K; Bursac Zoran; Tabatabai Mohammad A; Singh Karan P

    2007-01-01

    Abstract A new two-parameter probability distribution called hypertabastic is introduced to model the survival or time-to-event data. A simulation study was carried out to evaluate the performance of the hypertabastic distribution in comparison with popular distributions. We then demonstrate the application of the hypertabastic survival model by applying it to data from two motivating studies. The first one demonstrates the proportional hazards version of the model by applying it to a data se...

  7. Affordance estimation for vision-based object replacement on a humanoid robot

    DEFF Research Database (Denmark)

    Mustafa, Wail; Wächter, Mirko; Szedmak, Sandor;

    2016-01-01

    In this paper, we address the problem of finding replacements of missing objects, involved in the execution of manipulation tasks. Our approach is based on estimating functional affordances for the unknown objects in order to propose replacements. We use a vision-based affordance estimation system...... large-scale datasets. The results indicate that the system is able to successfully predict the affordances of novel objects. We also implement our system on a humanoid robot and demonstrate the affordance estimation in a real scene....... utilizing object-wise global features and a multi-label learning method. This method also associates confidence values to the estimated affordances. We evaluate our approach on kitchen-related manipulation affordances. The evaluation also includes testing different scenarios for training the system using...

  8. Automated quantitative coronary computed tomography correlates of myocardial ischaemia on gated myocardial perfusion SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Graaf, Michiel A. de; Boogers, Mark J.; Veltman, Caroline E. [Leiden University Medical Center, Department of Cardiology, Leiden (Netherlands); The Interuniversity Cardiology Institute of The Netherlands, Utrecht (Netherlands); El-Naggar, Heba M.; Bax, Jeroen J.; Delgado, Victoria [Leiden University Medical Center, Department of Cardiology, Leiden (Netherlands); Broersen, Alexander; Kitslaar, Pieter H.; Dijkstra, Jouke [Leiden University Medical Center, Department of Radiology, Division of Image Processing, Leiden (Netherlands); Kroft, Lucia J. [Leiden University Medical Center, Department of Radiology, Leiden (Netherlands); Younis, Imad Al [Leiden University Medical Center, Department of Nuclear Medicine, Leiden (Netherlands); Reiber, Johan H. [Leiden University Medical Center, Department of Radiology, Division of Image Processing, Leiden (Netherlands); Medis medical imaging systems B.V., Leiden (Netherlands); Scholte, Arthur J. [Leiden University Medical Center, Department of Cardiology, Leiden (Netherlands)

    2013-08-15

    Automated software tools have permitted more comprehensive, robust and reproducible quantification of coronary stenosis, plaque burden and plaque location of coronary computed tomography angiography (CTA) data. The association between these quantitative CTA (QCT) parameters and the presence of myocardial ischaemia has not been explored. The aim of the present investigation was to evaluate the association between QCT parameters of coronary artery lesions and the presence of myocardial ischaemia on gated myocardial perfusion single-photon emission CT (SPECT). Included in the study were 40 patients (mean age 58.2 {+-} 10.9 years, 27 men) with known or suspected coronary artery disease (CAD) who had undergone multidetector row CTA and gated myocardial perfusion SPECT within 6 months. From the CTA datasets, vessel-based and lesion-based visual analyses were performed. Consecutively, lesion-based QCT was performed to assess plaque length, plaque burden, percentage lumen area stenosis and remodelling index. Subsequently, the presence of myocardial ischaemia was assessed using the summed difference score (SDS {>=}2) on gated myocardial perfusion SPECT. Myocardial ischaemia was seen in 25 patients (62.5 %) in 37 vascular territories. Quantitatively assessed significant stenosis and quantitatively assessed lesion length were independently associated with myocardial ischaemia (OR 7.72, 95 % CI 2.41-24.7, p < 0.001, and OR 1.07, 95 % CI 1.00-1.45, p = 0.032, respectively) after correcting for clinical variables and visually assessed significant stenosis. The addition of quantitatively assessed significant stenosis ({chi} {sup 2} = 20.7) and lesion length ({chi} {sup 2} = 26.0) to the clinical variables and the visual assessment ({chi} {sup 2} = 5.9) had incremental value in the association with myocardial ischaemia. Coronary lesion length and quantitatively assessed significant stenosis were independently associated with myocardial ischaemia. Both quantitative parameters have

  9. Improvement in long-term prognosis of elderly patients with acute myocardial infarction after the introduction of intravenous thrombolytic therapy

    DEFF Research Database (Denmark)

    Madsen, J K; Pedersen, F; Nielsen, H;

    1998-01-01

    Survival rate from a "thrombolytic" period of 351 patients above 66 years of age with acute myocardial infarction (AMI) was compared with that of 289 patients from a "prethrombolytic" period. The two groups were comparable regarding sex, age, previous AMI, cerebrovascular events, morbidity...... and mortality during admission. Survival rates after four years were 45.0% in the "thrombolytic" group and 38.4% in the "prethrombolytic" group (p = 0.047, log rank test). Using the Cox proportional hazard analysis, thrombolytic therapy was shown to be an independent prognostic predictor in "the thrombolytic...

  10. Influences of percutaneous coronary intervention on myocardial activity in myocardial infarction patients with different viable myocardium

    Institute of Scientific and Technical Information of China (English)

    李丽琪

    2013-01-01

    Objective To evaluate the effect of percutaneous coronary intervention (PCI) on left ventricular function in patients with different types of myocardial infarction and to explore the correlation factors for the left ventricular function.Methods A total of 43 patients diagnosed as acute myocardial infarction were enrolled in this study.The perfusion and delayed enhancement magnetic resonance imaging (DE-MRI) was applied to observe the fol-

  11. Physical Activitiea Associted with Angina Pectoris Before Myocardial Infarction and the Onset of Myocardial Infarction

    OpenAIRE

    Matsuda, Masako

    1984-01-01

    One hundred and ninety-seven patients with a history of myocardeal infarction were interviewed to evaluate the incidence of angina pectoris and the physical activity precipitating angina before myocardial infarction, and the mode of physical activity at the onset of myocardial infarction. Ninety-ewo patients had no angina before infarction, whereas 105 did, In 105 patients, 58 had a chronic stable angina without a change of pattern of angina before infarction, while 22 noticed worsening of th...

  12. Myocardial Ischemia: Lack of Coronary Blood Flow or Myocardial Oxygen Supply/Demand Imbalance?

    Science.gov (United States)

    Heusch, Gerd

    2016-07-01

    Regional myocardial blood flow and contractile function in ischemic myocardium are well matched, and there is no evidence for an oxygen supply/demand imbalance. Thus, myocardial ischemia is lack of coronary blood flow with electric, functional, metabolic, and structural consequences for the myocardium. All therapeutic interventions must aim to improve blood flow to ischemic myocardium as much and as quickly as possible. PMID:27390331

  13. Relation of impaired Thrombolysis In Myocardial Infarction myocardial perfusion grades to residual thrombus following the restoration of epicardial patency in ST-elevation myocardial infarction.

    Science.gov (United States)

    Kirtane, Ajay J; Weisbord, Aaron; Karmpaliotis, Dimitrios; Murphy, Sabina A; Giugliano, Robert P; Cannon, Christopher P; Antman, Elliott M; Ohman, E Magnus; Roe, Matthew T; Braunwald, Eugene; Gibson, C Michael

    2005-01-15

    Clinical and angiographic data were analyzed from 929 patients who had ST-elevation myocardial infarction and open epicardial arteries after fibrinolytic therapy. Residual angiographically evident thrombus was associated with more frequent Thrombolysis In Myocardial Infarction (TIMI) grade 2 flow (33.6% vs 26.8%, p = 0.03), higher corrected TIMI frame counts (34 vs 31 frames, p = 0.0003), and lower TIMI myocardial perfusion grades (43.0% vs 32.0% TIMI myocardial perfusion grades 0/1, p = 0.001) among all patients and among patients who had TIMI grade 3 flow (33.5% vs 26.0% TIMI myocardial perfusion grades 0/1, p = 0.043). In multivariate analyses, angiographically evident thrombus was associated with higher corrected TIMI frame counts and worsened myocardial perfusion independent of clinical and angiographic covariates, including TIMI grade 3 flow.

  14. Combination of epinephrine with esmolol attenuates post-resuscitation myocardial dysfunction in a porcine model of cardiac arrest.

    Directory of Open Access Journals (Sweden)

    Qian Zhang

    Full Text Available BACKGROUND: Recent experimental and clinical studies have indicated that the β-adrenergic effect of epinephrine significantly increases the severity of post resuscitation myocardial dysfunction. The aim of the study was to investigate whether the short-acting β₁-selective adrenergic blocking agent, esmolol, would attenuate post resuscitation myocardial dysfunction in a porcine model of cardiac arrest. METHODS AND RESULTS: After 8 min of untreated ventricular fibrillation and 2 min of basic life support, 24 pigs were randomized to three groups (n = 8 per group, which received central venous injection of either epinephrine combined with esmolol (EE group, epinephrine (EP group, or saline (SA group. Hemodynamic status and blood samples were obtained at 0, 30, 60, 120, 240 and 360 min after return of spontaneous circulation (ROSC. Surviving pigs were euthanatized at 24 h after ROSC, and the hearts were removed for analysis by electron microscopy, Western blotting, quantitative real-time polymerase chain reaction, and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL assay. Compared with the EP and SA groups, EE group had a better outcome in hemodynamic function, (improved dp/dt maxima and minima and cardiac output (P<0.05, and improved oxygen metabolism (oxygen delivery and oxygen consumption (P<0.05, which suggesting that EE can protect myocardial tissue from injury and improve post-resuscitation myocardial dysfunction. The protective effect of EE also correlated with reducing cardiomyocyte apoptosis, evidenced by reducing TUNEL-positive cells, increasing anti-apoptotic Bcl-2/Bax ratio and suppression of caspase-3 activity in myocardium. CONCLUSIONS: Esmolol, a short-acting β₁-selective adrenergic blocking agent, given during CPR has significant effects on attenuating post resuscitation myocardial dysfunction. The current study provides a potential pharmacologic target for post resuscitation myocardial dysfunction.

  15. Enalapril protects against myocardial ischemia/reperfusion injury in a swine model of cardiac arrest and resuscitation

    Science.gov (United States)

    Wang, Guoxing; Zhang, Qian; Yuan, Wei; Wu, Junyuan; Li, Chunsheng

    2016-01-01

    There is strong evidence to suggest that angiotensin-converting enzyme inhibitors (ACEIs) protect against local myocardial ischemia/reperfusion (I/R) injury. This study was designed to explore whether ACEIs exert cardioprotective effects in a swine model of cardiac arrest (CA) and resuscitation. Male pigs were randomly assigned to three groups: sham-operated group, saline treatment group and enalapril treatment group. Thirty minutes after drug infusion, the animals in the saline and enalapril groups were subjected to ventricular fibrillation (8 min) followed by cardiopulmonary resuscitation (up to 30 min). Cardiac function was monitored, and myocardial tissue and blood were collected for analysis. Enalapril pre-treatment did not improve cardiac function or the 6-h survival rate after CA and resuscitation; however, this intervention ameliorated myocardial ultrastructural damage, reduced the level of plasma cardiac troponin I and decreased myocardial apoptosis. Plasma angiotensin (Ang) II and Ang-(1–7) levels were enhanced in the model of CA and resuscitation. Enalapril reduced the plasma Ang II level at 4 and 6 h after the return of spontaneous circulation whereas enalapril did not affect the plasma Ang-(1–7) level. Enalapril pre-treatment decreased the myocardial mRNA and protein expression of angiotensin-converting enzyme (ACE). Enalapril treatment also reduced the myocardial ACE/ACE2 ratio, both at the mRNA and the protein level. Enalapril pre-treatment did not affect the upregulation of ACE2, Ang II type 1 receptor (AT1R) and MAS after CA and resuscitation. Taken together, these findings suggest that enalapril protects against ischemic injury through the attenuation of the ACE/Ang II/AT1R axis after CA and resuscitation in pigs. These results suggest the potential therapeutic value of ACEIs in patients with CA. PMID:27633002

  16. Thrombus aspiration in acute myocardial infarction.

    Science.gov (United States)

    Mahmoud, Karim D; Zijlstra, Felix

    2016-07-01

    The success of primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) is often hampered by incomplete microvascular myocardial reperfusion owing to distal embolization of thrombus resulting in microvascular obstruction. To address this problem, thrombus aspiration devices have been developed that can be used to evacuate coronary thrombus either manually or mechanically. Thrombus aspiration has the potential to reduce the local thrombus load, minimize the need for balloon predilatation, facilitate direct stenting, prevent distal embolization, and ultimately improve myocardial reperfusion. Furthermore, thrombus aspiration has enabled us to study coronary thrombus in vivo, and has facilitated recognition of distinct mechanisms of coronary thrombosis. Clinical trials focusing on manual thrombus aspiration in primary PCI have generally shown improved myocardial reperfusion. However, in two large trials powered for clinical end points, no reduction in 1-year mortality or other adverse clinical events was observed with the use of this strategy. Moreover, one of these trials showed a marginally increased risk of stroke. Consequently, current guidelines do not recommend routine use of thrombus aspiration. Future studies should focus on the identification of subgroups of patients with STEMI who might derive benefit from manual thrombus aspiration, and establish the effect of operator performance on the efficacy and safety of the procedure. PMID:26961064

  17. Mesenchymal Stem Cells : Promising for Myocardial Regeneration?

    NARCIS (Netherlands)

    Przybyt, Ewa; Harmsen, Martin C.

    2013-01-01

    The pandemic of cardiovascular disease is continuously expanding as the result of changing life styles and diets throughout the Old and New World. Immediate intervention therapy saves the lives of many patients after acute myocardial infarction (MI). However, for many this comes at the price of adve

  18. Pseudoxanthoma elasticum presenting with myocardial infarction.

    OpenAIRE

    Slade, A K; John, R.M.; Swanton, R H

    1990-01-01

    A 31 year old man presented with an anterior myocardial infarction. He had a history of recurrent gastrointestinal bleeding of obscure cause since childhood and peripheral vascular disease. A clinical diagnosis of the type 1 dominant form of pseudoxanthoma elasticum was supported by histological data from skin biopsy.

  19. Myocardial protection: what the anesthesiologist does.

    Science.gov (United States)

    Merin, R G

    1990-09-01

    The role of the anesthesiologist in myocardial protection is to optimize myocardial oxygen balance during the perioperative period. Nonpharmacological steps that can be taken to achieve this revolve around maintaining a satisfactory hemoglobin concentration and oxyhemoglobin saturation through maximizing ventilation. In addition, alkalosis and hypothermia should be prevented since they cause a left shift of the oxyhemoglobin dissociation curve, thus interfering with tissue oxygen delivery. Hypocarbia increases coronary vascular resistance. Blood volume must be adequate with an optimal hemoglobin concentration. Pharmacological measures should also be used, and it is important to continue through the perioperative period any previously administered cardioactive drugs. Furthermore, in the prebypass period, tachycardia may not be controlled by anesthetics; unless the tachycardia is paroxysmal, beta blockers are the drugs of choice. Depending on the cause, diastolic hypotension also needs to be treated either with volume, vasoconstrictors, or inotropes. Likewise, major hypertension can produce increased demand and, again depending on the cause, either anesthetics, vasodilators, beta blockers, or calcium blockers may be useful. Finally, myocardial ischemia without obvious cause probably should be treated with nitroglycerin or calcium blockers. During surgery, the effect of the anesthetic drugs on myocardial oxygen balance is important. PMID:2133851

  20. Management of myocardial damage in muscular dystrophy

    International Nuclear Information System (INIS)

    Heart failure (HF) is a fatal complication in many muscular dystrophy cases and has become the most common cause of death in Duchenne muscular dystrophy (DMD) since 2001. HF deaths in DMD occur in young patients and increase, along with respiratory failure, in older patients. Managing HF, therefore, is the most important component of DMD treatment. Management of HF is necessary in DMD patients of all ages because myocardial damage progresses regardless of age and disability. Electrocardiography, echocardiography, myocardial single-photon emission computed tomography (SPECT), and natriuretic peptides are used for the diagnosis of myocardial damage and chronic HF. Tissue Doppler echocardiography is in particularly useful for early detection of minute myocardial damage and dysfunction in DMD. The first-line drugs for chronic HF are angiotensin-converting enzyme inhibitors, and the prognosis of DMD patients has been improved using these drugs and beta-blockers. Diuretics are added in the presence of pulmonary congestion. Digoxin is most effective at a blood level of 0.5-0.8 ng/mL because of its pharmacokinetics in DMD. Surgical treatment may be necessary in cases of intractable HF. Cardiac resynchronization therapy (biventricular pacing), a treatment with an artificial pacemaker, is indicated for cases that meet specific criteria, including HF with ventricular dyssynchrony. Applications of partial left ventriculectomy (Batista procedure) and left ventricular assist devices in muscular dystrophy are likely in the near future. (author)

  1. Aeromedical transport after acute myocardial infarction

    DEFF Research Database (Denmark)

    Seidelin, Jakob B; Bruun, Niels Eske; Nielsen, Henrik

    2009-01-01

    BACKGROUND: No guidelines exist for the planning of aeromedical repatriation after acute myocardial infarction (AMI). In 2004, we employed a risk evaluation-based decision-making system for repatriation of patients after AMI. The objective was to evaluate the safety of transports during 2005...

  2. Primary coronary angioplasty in acute myocardial infarction.

    OpenAIRE

    Grech, E. D.; Ramsdale, D. R.

    1996-01-01

    It is well established that recanalisation of the infarct-related artery is of great benefit in the early hours after acute myocardial infarction. This can be achieved by the use of thrombolytic agents and/or by percutaneous transluminal coronary angioplasty (PTCA). This article reviews data on the role of primary PTCA and summarises current opinion on its use.

  3. THROMBOLYTIC THERAPY OF ACUTE MYOCARDIAL INFARCTION

    OpenAIRE

    D. P. Sementsov

    2015-01-01

    Importance of thrombolytic therapy for restoration of coronary blood flow in acute myocardial infarction is emphasized. Indications and contraindications, advantages and disadvantages for thrombolysis therapy are discussed. The ways of different thrombolytics implementation, efficacy criteria and possible side effects are also presented.

  4. TOWARD THE QUESTION OF ISCHEMIC MYOCARDIAL DYSFUNCTION

    Directory of Open Access Journals (Sweden)

    V. V. Kalyuzhin

    2014-01-01

    Full Text Available The authors of the review have analyzed papers published on the problem of ischemic myocardial dysfunction. They begin with a definition of the term “ischemia” (derived from two Greek words: ischō, meaning to hold back, and haima, meaning blood - a condition at which the arterial blood flow is insufficient to provide enough oxygen to prevent intracellular respiration from shifting from the aerobic to the anaerobic form. The poor rate of ATP generation from this process causes a decrease in cellular ATP, a concomitant rise in ADP, and ultimately, to depression inotropic (systolic and lusitropic (diastolic function of the affected segments of the myocardium. But with such simplicity of basic concepts, the consequences of ischemia so diverse. Influence of an ischemia on myocardial function so unequally at different patients, which is almost impossible to find two identical cases (as in the case of fingerprints. It depends on the infinite variety of lesions of coronary arteries, reperfusion (time and completeness of restoration of blood flow and reactions of a myocardium which, apparently, has considerable flexibility in its response. Ischemic myocardial dysfunction includes a number of discrete states, such as acute left ventricular failure in angina, acute myocardial infarction, ischemic cardiomyopathy, stunning, hibernation, pre- and postconditioning. There are widely differing underlying pathophysiologic states. The possibility exists that several of these states can coexist.

  5. Surgical myocardial revascularization without extracorporeal circulation

    Directory of Open Access Journals (Sweden)

    Salomón Soriano Ordinola Rojas

    2003-05-01

    Full Text Available OBJECTIVE: To assess the immediate postoperative period of patients undergoing myocardial revascularization without extracorporeal circulation with different types of grafts. METHODS: One hundred and twelve patients, 89 (79.5% of whom were males, were revascularized without extracorporeal circulation. Their ages ranged from 39 to 85 years. The criteria for indicating myocardial revascularization without extracorporeal circulation were as follows: revascularized coronary artery caliber > 1.5 mm, lack of intramyocardial trajectory on coronary angiography, noncalcified coronary arteries, and tolerance of the heart to the different rotation maneuvers. RESULTS: Myocardial revascularization without extracorporeal circulation was performed in 112 patients. Three were converted to extracorporeal circulation, which required a longer hospital stay but did not impact mortality. During the procedure, the following events were observed: atrial fibrillation in 10 patients, ventricular fibrillation in 4, total transient atrioventricular block in 2, ventricular extrasystoles in 58, use of a device to retrieve red blood cells in 53, blood transfusion in 8, and arterial hypotension in 89 patients. Coronary angiography was performed in 20 patients on the seventh postoperative day when the grafts were patent. CONCLUSION: Myocardial revascularization without extracorporeal circulation is a reproducible technique that is an alternative for treating ischemic heart disease.

  6. Myocardial ATP catabolism and its pharmacological prevention

    NARCIS (Netherlands)

    T. Huizer (Tom)

    1991-01-01

    textabstractThis thesis deals with high-energy phosphate metabolism during myocardial ischemia. describes the effects of some pharmacological interventions on the energy metabolism of ischemic myocardium. The chapters of this thesis are based on 11 published papers, added as appendices.

  7. Unrecognised myocardial infarction in patients with schizophrenia

    DEFF Research Database (Denmark)

    Nielsen, Jimmi; Juel, Jacob; Al Zuhairi, Karam Sadoon Majeed;

    2015-01-01

    OBJECTIVE: Schizophrenia is associated with a reduction of the lifespan by 20 years, with type II diabetes and cardiovascular disease contributing the most to the increased mortality. Unrecognised or silent myocardial infarction (MI) occurs in ~30% of the population, but the rates of unrecognised...

  8. Relation between job strain and myocardial infarction

    DEFF Research Database (Denmark)

    Netterstrøm, B; Nielsen, F E; Kristensen, T S;

    1999-01-01

    OBJECTIVES: To study the influence of different job related and socioeconomic factors for development of myocardial infarction (MI). METHOD: The study was a case-control study of 76 male wage earners who had been admitted to hospital with MI. As a control group 176 male wage earners not admitted...

  9. Cellular and genetic approaches to myocardial regeneration

    NARCIS (Netherlands)

    Tuyn, John van

    2008-01-01

    Injection of (stem) cells into the damaged heart has a positive effect on cardiac function. In this thesis two strategies for improving myocardial regeneration over classical cell therapy were investigated. The first is to induce cardiomyogenic differentiation by genetically engineering cells to ex

  10. THROMBOLYTIC THERAPY OF ACUTE MYOCARDIAL INFARCTION

    Directory of Open Access Journals (Sweden)

    D. P. Sementsov

    2015-12-01

    Full Text Available Importance of thrombolytic therapy for restoration of coronary blood flow in acute myocardial infarction is emphasized. Indications and contraindications, advantages and disadvantages for thrombolysis therapy are discussed. The ways of different thrombolytics implementation, efficacy criteria and possible side effects are also presented.

  11. Innovative Processing Methods for the Affordable Manufacture of Multifunctional High Temperature Coatings Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Research is proposed to investigate the feasibility of using advanced manufacturing techniques to enable the affordable application of multi-functional high...

  12. Understanding affordances: history and contemporary development of Gibson’s central concept

    Directory of Open Access Journals (Sweden)

    Dobromir G. Dotov

    2012-12-01

    Full Text Available Gibson developed the affordance concept to complement his theory of direct perception that stands in sharp contrast with the prevalent inferential theories of perception. A comparison of the two approaches shows that the distinction between them also has an ontological aspect. We trace the history and newer formalizations of the notion of affordance and discuss some competing opinions on its scope. Next, empirical work on the affordance concept is reviewed in brief and the relevance of dynamical systems theory to affordance research is demonstrated. Finally, the striking but often neglected convergence of the ideas of Gibson and those of certain Continental philosophers is discussed.

  13. One-year clinical outcomes in invasive treatment strategies for acute ST-elevation myocardial infarction complicated by cardiogenic shock in elderly patients

    OpenAIRE

    Yoo, Yeon Pyo; Kang, Ki-Woon; Yoon, Hyeon Soo; Myung, Jin Cheol; Choi, Yu Jeong; Kim, Won Ho; Park, Sang Hyun; Jung, Kyung Tae; Jeong, Myung Ho; ,

    2013-01-01

    Objective To investigate the clinical outcomes of an invasive strategy for elderly (aged ≥ 75 years) patients with acute ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock (CS). Methods Data on 366 of 409 elderly CS patients from a total of 6,132 acute STEMI cases enrolled in the Korea Acute Myocardial Infarction Registry between January 2008 and June 2011, were collected and analyzed. In-hospital deaths and the 1-month and 1-year survival rates free from majo...

  14. Effects of myocardial infarction on the distribution and transport of nutrients and oxygen in porcine myocardium.

    Science.gov (United States)

    Davis, Bryce H; Morimoto, Yoshihisa; Sample, Chris; Olbrich, Kevin; Leddy, Holly A; Guilak, Farshid; Taylor, Doris A

    2012-10-01

    One of the primary limitations of cell therapy for myocardial infarction is the low survival of transplanted cells, with a loss of up to 80% of cells within 3 days of delivery. The aims of this study were to investigate the distribution of nutrients and oxygen in infarcted myocardium and to quantify how macromolecular transport properties might affect cell survival. Transmural myocardial infarction was created by controlled cryoablation in pigs. At 30 days post-infarction, oxygen and metabolite levels were measured in the peripheral skeletal muscle, normal myocardium, the infarct border zone, and the infarct interior. The diffusion coefficients of fluorescein or FITC-labeled dextran (0.3-70 kD) were measured in these tissues using fluorescence recovery after photobleaching. The vascular density was measured via endogenous alkaline phosphatase staining. To examine the influence of these infarct conditions on cells therapeutically used in vivo, skeletal myoblast survival and differentiation were studied in vitro under the oxygen and glucose concentrations measured in the infarct tissue. Glucose and oxygen concentrations, along with vascular density were significantly reduced in infarct when compared to the uninjured myocardium and infarct border zone, although the degree of decrease differed. The diffusivity of molecules smaller than 40 kD was significantly higher in infarct center and border zone as compared to uninjured heart. Skeletal myoblast differentiation and survival were decreased stepwise from control to hypoxia, starvation, and ischemia conditions. Although oxygen, glucose, and vascular density were significantly reduced in infarcted myocardium, the rate of macromolecular diffusion was significantly increased, suggesting that diffusive transport may not be inhibited in infarct tissue, and thus the supply of nutrients to transplanted cells may be possible. in vitro studies mimicking infarct conditions suggest that increasing nutrients available to

  15. Delivery of affordable and equitable cancer care in India.

    Science.gov (United States)

    Pramesh, C S; Badwe, Rajendra A; Borthakur, Bibhuti B; Chandra, Madhu; Raj, Elluswami Hemanth; Kannan, T; Kalwar, Ashok; Kapoor, Sanjay; Malhotra, Hemant; Nayak, Sukdev; Rath, Goura K; Sagar, T G; Sebastian, Paul; Sarin, Rajiv; Shanta, V; Sharma, Suresh C; Shukla, Shilin; Vijayakumar, Manavalan; Vijaykumar, D K; Aggarwal, Ajay; Purushotham, Arnie; Sullivan, Richard

    2014-05-01

    The delivery of affordable and equitable cancer care is one of India's greatest public health challenges. Public expenditure on cancer in India remains below US$10 per person (compared with more than US$100 per person in high-income countries), and overall public expenditure on health care is still only slightly above 1% of gross domestic product. Out-of-pocket payments, which account for more than three-quarters of cancer expenditures in India, are one of the greatest threats to patients and families, and a cancer diagnosis is increasingly responsible for catastrophic expenditures that negatively affect not only the patient but also the welfare and education of several generations of their family. We explore the complex nature of cancer care systems across India, from state to government levels, and address the crucial issues of infrastructure, manpower shortages, and the pressing need to develop cross-state solutions to prevention and early detection of cancer, in addition to governance of the largely unregulated private sector and the cost of new technologies and drugs. We discuss the role of public insurance schemes, the need to develop new political mandates and authority to set priorities, the necessity to greatly improve the quality of care, and the drive to understand and deliver cost-effective cancer care programmes. PMID:24731888

  16. Affordable spectroscopy for 1m-class telescopes

    CERN Document Server

    Csák, B; Szabó, Gy M; Kiss, L L; Dózsa, Á; Sódor, Á; Jankovics, I

    2014-01-01

    Doppler observations of exoplanet systems have been a very expensive technique, mainly due to the high costs of high-resolution stable spectrographs. Recent advances in instrumentation enable affordable Doppler planet detections with surprisingly small optical telescopes. We investigate the possibility of measuring Doppler reflex motion of planet hosting stars with small-aperture telescopes that have traditionally been neglected for this kind of studies. After thoroughly testing the recently developed and commercially available Shelyak eShel echelle spectrograph, we demonstrated that it is routinely possible to achieve velocity precision at the $100 \\mathrm{m\\,s}^{-1}$ level, reaching down to $\\pm 50~\\mathrm{m\\,s}^{-1}$ for the best cases. We describe our off-the-shelf instrumentation, including a new 0.5m RC telescope at the Gothard Astrophysical Observatory of Lor\\'and E\\"otv\\"os University equipped with an intermediate resolution fiber-fed echelle spectrograph. We present some follow-up radial velocity mea...

  17. Experimental Enhanced Upper Stage (XEUS): An affordable large lander system

    Science.gov (United States)

    Scotkin, J.; Masten, D.; Powers, J.; O'Konek, N.; Kutter, B.; Stopnitzky, B.

    The Experimental Enhanced Upper Stage (XEUS) offers a path to reduce costs and development time to sustainable activity beyond LEO by equipping existing large cryogenic propulsion stages with MSS VTVL propulsion and GNC to create a large, multi-thrust axis lander. Conventional lander designs have been driven by the assumption that a single, highly reliable, and efficient propulsion system should conduct the entire descent, approach, and landing. Compromises in structural, propulsion, and operational efficiency result from this assumption. System reliability and safety also suffer. The result is often an iterative series of optimizations, making every subsystem mission-unique and expensive. The XEUS multi-thrust axis lander concept uniquely addresses the programmatic and technical challenges of large-mass planetary landing by taking advantage of proven technologies and decoupling the deorbit and descent propulsion system from the landing propulsion system. Precise control of distributed, multi-thrust axis landing propulsion units mounted on the horizontal axis of a Centaur stage will ultimately enable the affordable deployment of large planetary rovers, uncrewed base infrastructure and manned planetary expeditions. The XEUS lander has been designed to offer a significantly improved mass fraction and mass to surface capability over conventional lander designs, while reducing airlock/payload to surface distances and distributing plume effects by using multiple gimbaled landing thrusters. In utilizing a proven cryogenic propulsion stage, XEUS reduces development costs required for development of new cryogenic propulsion stages and fairings and builds upon the strong heritage of successful Centaur and MSS RLV flights.

  18. Developing affordable multi-touch technologies for use in physics

    Science.gov (United States)

    Potter, Mark; Ilie, Carolina; Schofield, Damian; Vampola, David

    2012-02-01

    Physics is one of many areas which has the ability to benefit from a number of different teaching styles and sophisticated instructional tools due to it having both theoretical and practical applications which can be explored. The purpose of this research is to develop affordable large scale multi-touch interfaces which can be used within and outside of the classroom as both an instruction technology and a computer supported collaborative learning tool. Not only can this technology be implemented at university levels, but also at the K-12 level of education. Pedagogical research indicates that kinesthetic learning is a fundamental, powerful, and ubiquitous learning style [1]. Through the use of these types of multi-touch tools and teaching methods which incorporate them, the classroom can be enriched to allow for better comprehension and retention of information. This is due in part to a wider range of learning styles, such as kinesthetic learning, which are being catered to within the classroom. [4pt] [1] Wieman, C.E, Perkins, K.K., Adams, W.K., ``Oersted Medal Lecture 2007: Interactive Simulations for teaching physics: What works, what doesn't and why,'' American Journal of Physics. 76 393-99.

  19. The NAO humanoid: a combination of performance and affordability

    CERN Document Server

    Gouaillier, David; Blazevic, Pierre; Kilner, Chris; Monceaux, Jerome; Lafourcade, Pascal; Marnier, Brice; Serre, Julien; Maisonnier, Bruno

    2008-01-01

    This article presents the design of the autonomous humanoid robot called NAO that is built by the French company Aldebaran-Robotics. With its height of 0.57 m and its weight about 4.5 kg, this innovative robot is lightweight and compact. It distinguishes itself from its existing Japanese, American, and other counterparts thanks to its pelvis kinematics design, its proprietary actuation system based on brush DC motors, its electronic, computer and distributed software architectures. This robot has been designed to be affordable without sacrificing quality and performance. It is an open and easy-to-handle platform where the user can change all the embedded system software or just add some applications to make the robot adopt specific behaviours. The robot's head and forearms are modular and can be changed to promote further evolution. The comprehensive and functional design is one of the reasons that helped select NAO to replace the AIBO quadrupeds in the 2008 RoboCup standard league.

  20. Rheumatic heart disease echocardiographic screening: approaching practical and affordable solutions.

    Science.gov (United States)

    Nascimento, Bruno R; Nunes, Maria Carmo P; Lopes, Eduardo L V; Rezende, Vitória M L R; Landay, Taylor; Ribeiro, Antonio L P; Sable, Craig; Beaton, Andrea Z

    2016-05-01

    Rheumatic heart disease (RHD) affects at least 32.9 million people worldwide and ranks as a leading cause of death and disability in low-income and middle-income countries (LMICs). Echocardiographic screening has been demonstrated to be a powerful tool for early RHD detection, and holds potential for global RHD control. However, national screening programmes have not emerged. Major barriers to implementation include the lack of human and financial resources in LMICs. Here, we focus on recent research advances that could make echocardiographic screening more practical and affordable, including handheld echocardiography devices, simplified screening protocols and task shifting of echocardiographic screening to non-experts. Additionally, we highlight some important remaining questions before echocardiographic screening can be widely recommended, including demonstration of cost-effectiveness, assessment of the impact of screening on children and communities, and determining the importance of latent RHD. While a single strategy for echocardiographic screening in all high-prevalence areas is unlikely, we believe recent advancements are bringing the public health community closer to developing sustainable programmes for echocardiographic screening. PMID:26891757

  1. Essential drugs in AIDS care: issues of availability and affordability.

    Science.gov (United States)

    Kaur, S R

    1996-01-01

    Several antiretroviral drugs against HIV/AIDS have been developed in recent years. These drugs, reverse transcriptase inhibitors and protease inhibitors, inhibit the reproduction of HIV, but do not eliminate the presence of HIV in the body. The cost of drugs to treat one person with HIV/AIDS easily runs into the thousands of US dollars per year. These new drugs are therefore routinely used in developed countries, but not among the masses in developing countries. Many of the drugs needed to treat the opportunistic infections present during advanced HIV infection and AIDS are also prohibitively expensive for both developing countries and most individuals in those countries. The imposition of World Bank and International Monetary Fund structural adjustment programs together with decreased household purchasing power during the 1990s has led to increased demand for public sector services amid reduced public expenditure. The private sector is increasingly taking over the drug supply in developing countries, driving the cost of drugs out of the range of affordability for the vast majority of the poor. One strategy to contain the cost of drugs is for governments to develop and implement an integrated national drug policy based upon the concept of essential drugs and their rational use. PMID:12292110

  2. [Prehospital thrombolytic therapy in acute myocardial infarction].

    Science.gov (United States)

    Carlsson, J; Schuster, H P; Tebbe, U

    1997-10-01

    The extent of myocardial damage occurring during acute myocardial infarction is time dependent, and there is abundant evidence from most clinical trials that mortality reduction is greatest in patients treated early with thrombolytic agents, although beneficial effects have been shown with treatment initiated up to 12 h after onset of symptoms. All studies on prehospital thrombolysis have conclusively shown the practicability and safety of patient selection and administration of the thrombolytic agent. The accuracy of diagnosis in the prehospital setting was comparable to trials of in-hospital thrombolysis, e.g., in the Myocardial Infarction Triage and Intervention Project (MITI) 98% of the patients enrolled had subsequent evidence of acute myocardial infarction. With regard to time savings, all randomized studies showed positive results. The smallest time gain was observed in the MITI trial: prehospital-treated patients received thrombolytic therapy an average of 33 min earlier than those treated in hospital. In the European Myocardial Infarction Project (EMIP) the difference in time between prehospital and hospital treatment was a median of 55 min. However, none of these trials was able to show a significant short-term mortality difference between the two groups. Only a meta analysis of five randomized studies with a combined median time gain of about 60 min showed a significant 17% reduction in short-term mortality for patients who received thrombolytic therapy in the prehospital phase. In the Grampian Region Early Anistreplase Trial (GREAT), a study performed in a more rural area than other studies, the time gain by prehospital initiation of thrombolysis was a median of 130 min. GREAT was the only study to date reporting a significant mortality benefit for prehospital-treated patients after 3 months and 1 year. In conclusion, prehospital thrombolysis is feasible and safe. Patients with acute myocardial infarction can be correctly identified and treated with

  3. Genistein promotes endothelial colony-forming cell (ECFC bioactivities and cardiac regeneration in myocardial infarction.

    Directory of Open Access Journals (Sweden)

    Sang Hun Lee

    Full Text Available Although stem cell-mediated treatment of ischemic diseases offers significant therapeutic promise, the limitation in the therapeutic efficacy of transplanted stem cells in vivo because of poor engraftment remains a challenge. Several strategies aimed at improving survival and engraftment of stem cells in the ischemic myocardium have been developed, such as cell transplantation in combination with growth factor delivery, genetic modification of stem cells, and/or cell therapy using scaffolds. To improve therapeutic efficacy, we investigated the effects of genistein on the engraftment of transplanted ECFCs in an acute myocardial ischemia model.We found that genistein treatment enhanced ECFCs' migration and proliferation, which was accompanied by increases in the expression of ILK, α-parvin, F-actin, and phospholylation of ERK 1/2 signaling. Transplantation of genistein-stimulates ECFCs (GS-ECFCs into myocardial ischemic sites in vivo induced cellular proliferation and secretion of angiogenic cytokines at the ischemic sites and thereby enhanced neovascularization and decreased myocardial fibrosis as well as improved cardiac function, as shown by echocardiography. Taken together, these data suggest that pretreatment of ECFCs with genistein prior to transplantation can improve the regenerative potential in ischemic tissues, providing a novel strategy in adult stem cell therapy for ischemic diseases.

  4. TNF-Like Weak Inducer of Apoptosis Aggravates Left Ventricular Dysfunction after Myocardial Infarction in Mice

    Directory of Open Access Journals (Sweden)

    Kai-Uwe Jarr

    2014-01-01

    Full Text Available Background. TNF-like weak inducer of apoptosis (TWEAK has recently been shown to be potentially involved in adverse cardiac remodeling. However, neither the exact role of TWEAK itself nor of its receptor Fn14 in this setting is known. Aim of the Study. To analyze the effects of sTWEAK on myocardial function and gene expression in response to experimental myocardial infarction in mice. Results. TWEAK directly suppressed the expression of PGC-1α and genes of oxidative phosphorylation (OXPHOS in cardiomyocytes. Systemic sTWEAK application after MI resulted in reduced left ventricular function and increased mortality without changes in interstitial fibrosis or infarct size. Molecular analysis revealed decreased phosphorylation of PI3K/Akt and ERK1/2 pathways associated with reduced expression of PGC-1α and PPARα. Likewise, expression of OXPHOS genes such as atp5O, cycs, cox5b, and ndufb5 was also reduced. Fn14 -/- mice showed significantly improved left ventricular function and PGC-1α levels after MI compared to their respective WT littermates (Fn14 +/+. Finally, inhibition of intrinsic TWEAK with anti-TWEAK antibodies resulted in improved left ventricular function and survival. Conclusions. TWEAK exerted maladaptive effects in mice after myocardial infarction most likely via direct effects on cardiomyocytes. Analysis of the potential mechanisms revealed that TWEAK reduced metabolic adaptations to increased cardiac workload by inhibition of PGC-1α.

  5. [Antithrombotic therapy after myocardial infarction: arguments for the use of acetylsalicylic acid and coumarin derivatives].

    Science.gov (United States)

    Waskowsky, W M; Brouwer, A; Verheugt, F W A

    2005-01-01

    Patients who survived myocardial infarction and who are being treated with the current optimal therapy (antithrombotics, statins and beta-blockers), have a 10-20% chance of death, re-infarction and stroke within in the first year. A possible explanation for this could be an increased activation and generation ofthrombin for at least 6 months following the cardiovascular event preceding preventative therapy. Acetylsalicylic acid and clopidogrel do not affect activation by thrombin of the platelet aggregation and the clotting cascade. The additional use of cumarin derivatives could therefore reduce the chance of recurring thrombotic events, and subsequently improve prognosis. Since the nineteen-nineties several randomised trials have been conducted to study the clinical relevance ofcumarin derivatives both with and without acetylsalicylic acid, in patients who had had a myocardial infarction. The conclusions of these studies were not unambiguous. If the international normalized ratio (INR) was kept > 2 for a long period, by means of frequent check-ups and effective dosage adjustment, the chance of death, recurrent myocardial infarction or stroke was 30-50% lower than when acetylsalicylic acid only was used. The risk of bleeding was raised by 2-4 times, but there were no life-threatening episodes of bleeding. In view of the recent development of anticoagulant agents, for which monitoring seems to be becoming unnecessary, identification of patients who would benefit most from a combined antithrombotic strategy is warranted. PMID:15688836

  6. Survival after blood transfusion

    DEFF Research Database (Denmark)

    Kamper-Jørgensen, Mads; Ahlgren, Martin; Rostgaard, Klaus;

    2008-01-01

    BACKGROUND: Long-term survival of transfusion recipients has rarely been studied. This study examines short- and long-term mortality among transfusion recipients and reports these as absolute rates and rates relative to the general population. STUDY DESIGN AND METHODS: Population-based cohort study...... of transfusion recipients in Denmark and Sweden followed for up to 20 years after their first blood transfusion. Main outcome measure was all-cause mortality. RESULTS: A total of 1,118,261 transfusion recipients were identified, of whom 62.0 percent were aged 65 years or older at the time of their first...... registered transfusion. Three months after the first transfusion, 84.3 percent of recipients were alive. One-, 5-, and 20-year posttransfusion survival was 73.7, 53.4, and 27.0 percent, respectively. Survival was slightly poorer in men than in women, decreased with increasing age, and was worst...

  7. Non-invasive technology that improves cardiac function after experimental myocardial infarction: Whole Body Periodic Acceleration (pGz.

    Directory of Open Access Journals (Sweden)

    Arkady Uryash

    Full Text Available Myocardial infarction (MI may produce significant inflammatory changes and adverse ventricular remodeling leading to heart failure and premature death. Pharmacologic, stem cell transplantation, and exercise have not halted the inexorable rise in the prevalence and great economic costs of heart failure despite extensive investigations of such treatments. New therapeutic modalities are needed. Whole Body Periodic Acceleration (pGz is a non-invasive technology that increases pulsatile shear stress to the endothelium thereby producing several beneficial cardiovascular effects as demonstrated in animal models, normal humans and patients with heart disease. pGz upregulates endothelial derived nitric oxide synthase (eNOS and its phosphorylation (p-eNOS to improve myocardial function in models of myocardial stunning and preconditioning. Here we test whether pGz applied chronically after focal myocardial infarction in rats improves functional outcomes from MI. Focal MI was produced by left coronary artery ligation. One day after ligation animals were randomized to receive daily treatments of pGz for four weeks (MI-pGz or serve as controls (MI-CONT, with an additional group as non-infarction controls (Sham. Echocardiograms and invasive pressure volume loop analysis were carried out. Infarct transmurality, myocardial fibrosis, and markers of inflammatory and anti-inflammatory cytokines were determined along with protein analysis of eNOS, p-eNOS and inducible nitric oxide synthase (iNOS.At four weeks, survival was 80% in MI-pGz vs 50% in MI-CONT (p< 0.01. Ejection fraction and fractional shortening and invasive pressure volume relation indices of afterload and contractility were significantly better in MI-pGz. The latter where associated with decreased infarct transmurality and decreased fibrosis along with increased eNOS, p-eNOS. Additionally, MI-pGz had significantly lower levels of iNOS, inflammatory cytokines (IL-6, TNF-α, and higher level of anti

  8. Affordable Development and Qualification Strategy for Nuclear Thermal Propulsion

    Science.gov (United States)

    Gerrish, Harold P., Jr.; Doughty, Glen E.; Bhattacharyya, Samit K.

    2013-01-01

    Nuclear Thermal Propulsion (NTP) is a concept which uses a nuclear reactor to heat a propellant to high temperatures without combustion and can achieve significantly greater specific impulse than chemical engines. NTP has been considered many times for human and cargo missions beyond low earth orbit. A lot of development and technical maturation of NTP components took place during the Rover/NERVA program of the 60's and early 70's. Other NTP programs and studies followed attempting to further mature the NTP concept and identify a champion customer willing to devote the funds and support the development schedule to a demonstration mission. Budgetary constraints require the use of an affordable development and qualification strategy that takes into account all the previous work performed on NTP to construct an existing database, and include lessons learned and past guidelines followed. Current guidelines and standards NASA uses for human rating chemical rocket engines is referenced. The long lead items for NTP development involve the fuel elements of the reactor and ground testing the engine system, subsystem, and components. Other considerations which greatly impact the development plans includes the National Space Policy, National Environmental Policy Act, Presidential Directive/National Security Council Memorandum #25 (Scientific or Technological Experiments with Possible Large-Scale Adverse Environmental Effects and Launch of Nuclear Systems into Space), and Safeguards and Security. Ground testing will utilize non-nuclear test capabilities to help down select components and subsystems before testing in a nuclear environment to save time and cost. Existing test facilities with minor modifications will be considered to the maximum extent practical. New facilities will be designed to meet minimum requirements. Engine and test facility requirements are based on the driving mission requirements with added factors of safety for better assurance and reliability

  9. Affordable Window Insulation with R-10/inch Rating

    Energy Technology Data Exchange (ETDEWEB)

    Jenifer Marchesi Redouane Begag; Je Kyun Lee; Danny Ou; Jong Ho Sonn; George Gould; Wendell Rhine

    2004-10-15

    During the performance of contract DE-FC26-00-NT40998, entitled ''Affordable Window Insulation with R-10/inch Value'', research was conducted at Aspen Aerogels, Inc. to develop new transparent aerogel materials suitable for window insulation applications. The project requirements were to develop a formulation or multiple formulations that have high transparency (85-90%) in the visible region, are hydrophobic (will not opacify with exposure to water vapor or liquid), and have at least 2% resiliency (interpreted as recoverable 2% strain and better than 5% strain to failure in compression). Results from an unrelated project showed that silica aerogels covalently bonded to organic polymers exhibit excellent mechanical properties. At the outset of this project, we believed that such a route is the best to improve mechanical properties. We have applied Design of Experiment (DOE) techniques to optimize formulations including both silica aerogels and organically modified silica aerogels (''Ormosils''). We used these DOE results to optimize formulations around the local/global optimization points. This report documents that we succeeded in developing a number of formulations that meet all of the stated criteria. We successfully developed formulations utilizing a two-step approach where the first step involves acid catalyzed hydrolysis and the second step involves base catalyzed condensation to make the gels. The gels were dried using supercritical CO{sub 2} and we were able to make 1 foot x 1 foot x 0.5 inch panels that met the criteria established.

  10. Teaching radio astronomy with Affordable Small Radio Telescope (ASRT)

    Science.gov (United States)

    Joshi, Bhal Chandra

    A simple, easy to build and portable radio telescope, called Affordable Small Radio Telescope (ASRT), has been developed by the Radio Physics Laboratory (RPL), a radio astronomy teaching unit associated with the National Centre for Radio Astrophysics (TIFR) and Inter-University Centre for Astronomy and Astrophysics (IUCAA), which are two premier astronomy institutes in India. ASRT consists of off-the-shelf available Direct to Home television dishes and is easy to assemble. Our design is scalable from simple very low cost telescope to more complex yet moderately costing instrument. ASRT provides a platform for demonstrating radio physics concepts through simple hands-on experiment as well as for carrying out solar monitoring by college/University students. The presentation will highlight the concept of ASRT and the different experiments that can be carried out using it. The solar monitoring observations will be discussed along-with details of methods for calibrating these measurements. The pedagogical usefulness of ASRT in introducing undergraduatephysics students to astrophysics, measurements and analysis methods used in radio astronomy will also be discussed. Use of ASRT in the last three years in the programs of RPL, namely the annual Radio Astronomy Winter School for College students (RAWSC) and Pulsar Observing for Students (POS) is also presented. This year a new program was initiated to form a virtual group of an ASRT community, which will not only share their measurements, but also think of improving the pedagogical usefulness of ASRT by innovative experiments. This initiative is presented with the best practices drawn from our experience in using ASRT as a tool for student training in space sciences. The talk will also point out future ideas in involving a larger body of students in simple radio astronomy experiments with the ASRT, which RPL is likely to nucleate as part of its mandate.

  11. Myocardial revascularization in the elderly patient: with or without cardiopulmonary bypass?

    Directory of Open Access Journals (Sweden)

    Iglézias José Carlos Rossini

    2003-01-01

    Full Text Available OBJECTIVE: To verify if there is advantage in myocardial revascularization the elderly without cardiopulmonary bypass (CPB in relation to the use of the same, being considered the viability of complete myocardial revascularization (MR and the hospital morbidity and mortality. METHOD: We prospectively studied a hundred consecutive, no randomized patients, with age > or = 70 years, submitted to the primary and isolated myocardial revascularization between January and December of 2000. The patients were divided in two groups, G1 - 50 patients operated with CPB and G2 - 50 patients operated without CPB. Univariate testing of variables was performed with chi-squared analysis in the SPSS 10.0 Program and a p value less than 0.005 was considered significant. RESULTS: There was no renal failure or myocardial infarction (MI in both groups; the incidence of respiratory failure was identical in the two groups (4%; two patient of G1 they had Strokes, and 12 presented low output syndrome, occurrences not registered in G2. The need of ventilatory support > 24 hs was not significant between groups. Medium time of hospital stay was 21.8 and 11.7 days respectively (NS and the survival after 30 days were similar in the two groups. The patients' of G1 eighty percent had more than two approached arteries, against only 48% of G2 (p < 0.0001. CONCLUSION: Because the largest number of grafts in the patients of G1, we can affirm that the use of CPB can provide a larger probability of complete RM.

  12. Understanding social engagement in autism: being different in perceiving and sharing affordances

    NARCIS (Netherlands)

    Hellendoorn, Annika

    2014-01-01

    In the current paper I will argue that the notion of affordances offers an alternative to theory of mind (ToM) approaches in studying social engagement in general and in explaining social engagement in autism spectrum disorder (ASD) specifically. Affordances are the possibilities for action offered

  13. Educational Affordances of a Ubiquitous Learning Environment in a Natural Science Course

    Science.gov (United States)

    Tan, Tan-Hsu; Lin, Min-Sheng; Chu, Yu-Ling; Liu, Tsung-Yu

    2012-01-01

    Educational affordances are worthy of being explored because the affordances of Information and Communication Technologies (ICT) provide the pedagogical effects for promoting cognitive acceleration, increasing the self-management of students, facilitating data collection, and presentation in science learning. This study aims to explore educational…

  14. The Role of Affordances in the Evolutionary Process Reconsidered A Niche Construction Perspective

    NARCIS (Netherlands)

    Withagen, Rob; van Wermeskerken, Margot

    2010-01-01

    Gibson asserted that affordances are the primary objects of perception. Although this assertion is especially attractive when considered in the context of evolutionary theory, the role that affordances play in the evolution of animals' perceptual and action systems is still unclear. Trying to combin

  15. California Community Colleges: Making Them Stronger and More Affordable. National Center Report #07-1

    Science.gov (United States)

    Zumeta, William; Frankle, Deborah

    2007-01-01

    This report highlights the affordability gaps faced by California's community colleges. Despite the lowest tuition in the country and tuition waivers for the lowest-income students, many California students struggle to afford the total cost of education, which includes housing, food, health care, and textbooks. And although California students are…

  16. An Exploratory Study of Emotional Affordance of a Massive Open Online Course

    Science.gov (United States)

    Cheng, Jeremy C. Y.

    2014-01-01

    This exploratory study examines emotional affordance of a massive open online course (MOOC). Postings in a discussion forum of a MOOC in computer science are analysed following a research design informed by virtual ethnography. Emotional affordance is investigated, focusing on non-achievement emotions which are not directly linked to achievement…

  17. Affordance of Braille Music as a Mediational Means: Significance and Limitations

    Science.gov (United States)

    Park, Hyu-Yong; Kim, Mi-Jung

    2014-01-01

    Affordance refers to the properties or designs of a thing that offer the function of the thing. This paper discusses the affordance of Braille music in terms of three notions: mediational means, mastery and appropriation, and focuses on answering the following three questions: (i) How do musicians with visual impairments (MVI) perceive Braille…

  18. Towards a Representational Model of Social Affordances from an Institutional Perspective

    NARCIS (Netherlands)

    G. Sileno; A. Boer; T. van Engers

    2014-01-01

    The paper investigates the connection of the concept of affordance with the concept of institution, fundamental in social sciences and in legal theory, with the purpose of delineating a working definition of social affordance. This hybrid concept enriches the representation tools to be used with age

  19. A Prototype using Territories and an Affordance Tree for Social Simulation Gameplay

    DEFF Research Database (Denmark)

    Geishauser, Tilman; Cheong, Yun-Gyung; Nelson, Mark

    2014-01-01

    so- cial simulation using smart objects. We extend the concept of smart objects to include a model of human behavior with regard to territoriality. To manage complexity in worlds with many such objects we employ a tree structure, which we call an Affordance Tree. The Affordance Tree allows...

  20. Affordance as a Key Aspect in the Creation of New learning Spaces

    DEFF Research Database (Denmark)

    Dau, Susanne

    2014-01-01

    This research aims to highlight how different places and spaces in undergraduate teacher education afford student learning and the development of certain types of knowledge related. The questions this article addresses are: a) What is the affordance of different learning spaces in an undergraduate...

  1. Affordances and Cognitive Walkthrough for Analyzing Human-Virtual Human Interaction

    NARCIS (Netherlands)

    Ruttkay, Z.M.; Akker, op den H.J.A.; Esposito, A.; Bourbakis, N.; Avouris, N.; Hatzilygeroudis, I.

    2008-01-01

    This study investigates how the psychological notion of affordance, known from human computer interface design, can be adopted for the analysis and design of communication of a user with a Virtual Human (VH), as a novel interface. We take as starting point the original notion of affordance, used to

  2. Affordances of ICT in science learning: implications for an integrated pedagogy

    Science.gov (United States)

    Webb, Mary E.

    2005-06-01

    This paper presents an analysis of how affordances of ICT-rich environments identified from a recent review of the research literature can support students in learning science in schools within a proposed framework for pedagogical practice in science education. Furthermore other pedagogical and curriculum innovations in science education (promoting cognitive change, formative assessment and lifelong learning) are examined to see how they may be supported and enhanced by affordances of ICT-rich environments. The affordances that I have identified support learning through four main effects: promoting cognitive acceleration; enabling a wider range of experience so that students can relate science to their own and other real-world experiences; increasing students' self-management; and facilitating data collection and presentation. ICT-rich environments already provide a range of affordances that have been shown to enable learning of science but integrating these affordances with other pedagogical innovations provides even greater potential for enhancement of students' learning.

  3. Affordable Exploration of Mars: Recommendations from a Community Workshop on Sustainable Initial Human Missions

    Science.gov (United States)

    Thronson, Harley; Carberry, Chris; Cassady, R. J.; Cooke, Doug; Hopkins, Joshua; Perino, Maria A.; Kirkpatrick, Jim; Raftery, Michael; Westenberg, Artemis; Zucker, Richard

    2013-01-01

    There is a growing consensus that within two decades initial human missions to Mars are affordable under plausible budget assumptions and with sustained international participation. In response to this idea, a distinguished group of experts from the Mars exploration stakeholder communities attended the "Affording Mars" workshop at George Washington University in December, 2013. Participants reviewed and discussed scenarios for affordable and sustainable human and robotic exploration of Mars, the role of the International Space Station over the coming decade as the essential early step toward humans to Mars, possible "bridge" missions in the 2020s, key capabilities required for affordable initial missions, international partnerships, and a usable definition of affordability and sustainability. We report here the findings, observations, and recommendations that were agreed to at that workshop.

  4. Altered myocardial substrate metabolism is associated with myocardial dysfunction in early diabetic cardiomyopathy in rats: studies using positron emission tomography

    Directory of Open Access Journals (Sweden)

    Lammertsma Adriaan A

    2009-07-01

    Full Text Available Abstract Background In vitro data suggest that changes in myocardial substrate metabolism may contribute to impaired myocardial function in diabetic cardiomyopathy (DCM. The purpose of the present study was to study in a rat model of early DCM, in vivo changes in myocardial substrate metabolism and their association with myocardial function. Methods Zucker diabetic fatty (ZDF and Zucker lean (ZL rats underwent echocardiography followed by [11C]palmitate positron emission tomography (PET under fasting, and [18F]-2-fluoro-2-deoxy-D-glucose PET under hyperinsulinaemic euglycaemic clamp conditions. Isolated cardiomyocytes were used to determine isometric force development. Results PET data showed a 66% decrease in insulin-mediated myocardial glucose utilisation and a 41% increase in fatty acid (FA oxidation in ZDF vs. ZL rats (both p glucose transporter-4 mRNA expression (p Conclusion Using PET and echocardiography, we found increases in myocardial FA oxidation with a concomitant decrease of insulin-mediated myocardial glucose utilisation in early DCM. In addition, the latter was associated with impaired myocardial function. These in vivo data expand previous in vitro findings showing that early alterations in myocardial substrate metabolism contribute to myocardial dysfunction.

  5. Fighting for their survival

    Institute of Scientific and Technical Information of China (English)

    Gracie; Guo

    2008-01-01

    The analysis of economic performance of China’s painting&dyeing industry during the first five months of 2008 Relying on the researches on enterprises,China Dyeing and Printing Association works out the industry performance in the first five months this year.According to the results,painting&dyeing firms are fighting for their survival in 2008 with yuan appreciation,

  6. Model checking for survivability!

    NARCIS (Netherlands)

    Cloth, Lucia; Haverkort, Boudewijn R.

    2005-01-01

    Business and social life have become increasingly dependent on large-scale communication and information systems. A partial or complete breakdown as a consequence of natural disasters or purposeful attacks might have severe impacts. Survivability refers to the ability of a system to recover from suc

  7. Survivability via Control Objectives

    Energy Technology Data Exchange (ETDEWEB)

    CAMPBELL,PHILIP L.

    2000-08-11

    Control objectives open an additional front in the survivability battle. A given set of control objectives is valuable if it represents good practices, it is complete (it covers all the necessary areas), and it is auditable. CobiT and BS 7799 are two examples of control objective sets.

  8. Use of resting myocardial scintigraphy during chest pain to exclude diagnosis of acute myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Barbirato, Gustavo Borges; Azevedo, Jader Cunha de; Felix, Renata Christian Martins; Correa, Patricia Lavatori; Volschan, Andre; Viegas, Monica; Pimenta, Lucia; Dohmann, Hans Fernando Rocha; Mesquita, Evandro Tinoco; Mesquita, Claudio Tinoco [Centro de Estudos do Hospital Pro-Cardiaco (Procep), Rio de Janeiro, RJ (Brazil)

    2009-04-15

    Background: Images of myocardial perfusion taken during an episode of chest pain have been used for patients in the emergency department. Objective: To evaluate the operating characteristics of {sup 99m}Tc-Tetrofosmin scintigraphy during an episode of chest pain to exclude the diagnosis of cute myocardial infarction. Methods: One hundred and eight patients admitted with chest pain, or up to four hours after the end of symptoms and non diagnostic electrocardiogram, underwent resting scintigraphy and measurement of troponin I concentrations. Patients with a history of myocardial infarction (MI) were not excluded (24 patients). Troponin I concentrations were determined at admission and 6 hours later. Nuclear physicians performed a blind analysis of the images, and myocardial infarction was confirmed whenever troponin I level increase was three times that of the control. Results: Resting perfusion image was abnormal in all 6 patients with MI. Only 1 patient had a normal image and increased troponin levels. Fifty-five patients had positive images without MI, and 46 patients had normal images and troponin levels. The prevalence of the disease was 6.5%. The sensitivity and specificity of the resting images during an episode of chest pain to diagnose MI was 85.7% and 45.5%, respectively. The negative predictive value was 97.7%. Conclusion: Patients undergoing chest pain protocol with SPECT showed an excellent negative predictive value to exclude diagnosis of myocardial infarction. These results suggest that resting perfusion image is an important tool at the chest pain unit. (author)

  9. Evaluation of myocardial damage in Duchenne's muscular dystrophy with thallium-201 myocardial SPECT

    International Nuclear Information System (INIS)

    Myocardial damage and cardiopulmonary functions in patients with Duchenne's muscular dystrophy (DMD) were assessed using thallium-201 myocardial single-photon emission computed tomography (SPECT) and technetium-99m multigated radionuclide angiography. Twenty-five patients with DMD were divided into 4 groups according to percent of perfusion defect (%PD) calculated by the bull's-eye method and age. PD was detected in 24 (96.0%) of 25 patients with DMD, and it spread from the left ventricular lateral wall to the anterior wall and/or interventricular septum. PD was detected even in a 6-year-old DMD boy. Patients in Group I (%PD≥10% and age<15 years old) were shown to have a higher risk of left-sided heart failure without respiratory failure. Patients in Group II (%PD≥10 and age≥15) showed decreased pulmonary function and worsened arterial blood gas values as compared with Group IV (%PD<10 and age≥15). There was no significant difference in cardiac function among the 4 groups. It is postulated that myocardial damage in Group II patients is dependent primarily on a deficiency of dystrophin and on chronic respiratory failure, and that some of them are at risk of cardiopulmonary failure. It is concluded that myocardial SPECT is useful for the early diagnosis of myocardial damage and evaluation of cardiopulmonary function in DMD patients. (author)

  10. Detection of myocardial perfusion defect with 320-row volume CT myocardial perfusion imaging

    International Nuclear Information System (INIS)

    Objective: To evaluate the feasibility of 320-row volume CT myocardial perfusion imaging (CT-MPI) in detecting myocardial perfusion defect. Methods: Fourteen patients with positive single-positron emission computed tomography myocardial perfusion imaging (SPECT-MPI) findings underwent both rest and adenosine stress 320-row volume CT-MPI. Rest and stress CT perfusion images were analyzed by employing dedicated software in 320-row CT workstation. Both SPECT-MPI and CT-MPI were evaluated for fixed and reversible perfusion defects using a 16-segment model (apex was excluded). The sensitivity, specificity of 320-row volume CT-MPI in detecting myocardial perfusion defect were evaluated by taking SPECT-MPI as a reference standard. Results: Both rest and stress 320-row volume CT-MPI were successfully performed in all patients. Thirty nine segments with fixed or reversible perfusion defects in all patients were depicted by SPECT-MPI, while 34 perfusion defects in 12 patients were identified by CT-MPI. The sensitivity, specificity of 320-row volume CT-MPI for detection of perfusion defects were 87.2%(34/39), 91.4% (169/185), respectively. Conclusion: 320-row volume CT-MPI has high sensitivity and specificity for detection of myocardial perfusion defects. (authors)

  11. Effect of hydroxy safflower yellow A on myocardial apoptosis after acute myocardial infarction in rats.

    Science.gov (United States)

    Zhou, M X; Fu, J H; Zhang, Q; Wang, J Q

    2015-04-10

    This study aimed to investigate the effect of hydroxy safflower yellow A (HSYA) on myocardial apoptosis after acute myocardial infarction (AMI) in rats. We randomly divided 170 male Wistar rats into 6 groups (N = 23): normal control, sham, control, SY (90 mg/kg), HSYA high-dose (HSYA-H, 40 mg/kg), and HSYA low-dose groups (HSYA-L, 20 mg/kg). Myocardial ischemic injury was induced by ligating the anterior descending coronary artery, and the degree of myocardial ischemia was evaluated using electrocardiography and nitroblue tetrazolium staining. Bax and Bcl-2 expressions in the ischemic myocardium were determined using immunohistochemical analysis. Peroxisome proliferator-activated receptor-γ (PPAR-γ) expression in the myocardium of rats with AMI was determined using reverse transcription-polymerase chain reaction. Compared to rats in the control group, those in the HYSA-H, HSYA-L, and SY groups showed a decrease in the elevated ST segments and an increase in the infarct size. The rats in the drug-treated groups showed a significantly lower percentage of Bax-positive cells and a significantly higher percentage of Bcl-2-positive cells than those in the control group (P myocardial ischemia in rats, possibly by increasing the level of Bcl-2/Bax, and PPAR-γ may be not a necessary link in this process.

  12. Evaluation of myocardial abnormalities in collagen diseases by thallium-201 myocardial scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Yamano, Shigeru; Kagoshima, Tadashi; Sugihara, Kiyotaka (Nara Medical Univ., Kashihara (Japan)) (and others)

    1993-12-01

    This study was performed to evaluate myocardial abnormalities in patients with collagen diseases by exercise and rest thallium-201 myocardial scintigrams. A total of 65 patients without ischemic ECG changes, consisting of 18 with systemic lupus erythematosus (SLE), 18 with polymyositis (PM), 8 with progressive systemic sclerosis (PSS), and 21 with Sjoegren's syndrome (SjS), was enrolled in this study. Reversible exercise-induced defects scintigraphically suggesting myocardial ischemia were noted in 8 cases of SLE, 4 cases of PM, 4 cases of PSS, and 3 cases of SjS. Nineteen patients had exercise-induced defects and underwent cardiac catheterization, 8 of whom had normal coronary angiograms. Fixed hypoperfusion areas were observed in one case of SLE, 6 cases of PM and 3 cases of SjS. Rest thallium-201 myocardial scintigram disclosed hypoperfusion areas which were not induced by exercise in 2 cases of SLE, 3 cases of PM, one case of PSS and 5 cases of SjS. Echocardiogram showed no significant differences in ejection fraction and % fractional shortening between the disease groups and healthy control group. These findings suggest that patients with collagen diseases have abnormalities of coronary circulation at the level of the intramural vasculature before cardiac function impairment, myocardial fibrosis and functional abnormalities at the cell membrane. (author).

  13. Understanding the adoption dynamics of medical innovations: affordances of the da Vinci robot in the Netherlands.

    Science.gov (United States)

    Abrishami, Payam; Boer, Albert; Horstman, Klasien

    2014-09-01

    This study explored the rather rapid adoption of a new surgical device - the da Vinci robot - in the Netherlands despite the high costs and its controversial clinical benefits. We used the concept 'affordances' as a conceptual-analytic tool to refer to the perceived promises, symbolic meanings, and utility values of an innovation constructed in the wider social context of use. This concept helps us empirically understand robot adoption. Data from 28 in-depth interviews with diverse purposively-sampled stakeholders, and from medical literature, policy documents, Health Technology Assessment reports, congress websites and patients' weblogs/forums between April 2009 and February 2014 were systematically analysed from the perspective of affordances. We distinguished five interrelated affordances of the robot that accounted for shaping and fulfilling its rapid adoption: 'characteristics-related' affordances such as smart nomenclature and novelty, symbolising high-tech clinical excellence; 'research-related' affordances offering medical-technical scientific excellence; 'entrepreneurship-related' affordances for performing better-than-the-competition; 'policy-related' affordances indicating the robot's liberalised provision and its reduced financial risks; and 'communication-related' affordances of the robot in shaping patients' choices and the public's expectations by resonating promising discourses while pushing uncertainties into the background. These affordances make the take-up and use of the da Vinci robot sound perfectly rational and inevitable. This Dutch case study demonstrates the fruitfulness of the affordances approach to empirically capturing the contextual dynamics of technology adoption in health care: exploring in-depth actors' interaction with the technology while considering the interpretative spaces created in situations of use. This approach can best elicit real-life value of innovations, values as defined through the eyes of (potential) users. PMID

  14. Encapsulating the delivery of affordable housing: An overview of Malaysian practice

    Directory of Open Access Journals (Sweden)

    Jamaluddin Nor Baizura

    2016-01-01

    Full Text Available Urban population increases much faster than other geographical areas and this brings huge challenges to Malaysian government especially those responsible for the provision of housing. Moreover, the rise of living cost and pressure towards the current economic situation had inevitably led to huge demands for affordable housing. Thus, affordability and inaccessibility of people in owning a house has become one of the major issues in Malaysia. These issues are not only faced by the low-income group but mostly experienced by urban dwellers including the middle-income group whom are not eligible to apply for low-cost housing delivered by the government, yet cannot afford to buy a house. Hence, the Malaysian government had therefore established the Perumahan Rakyat 1 Malaysia (PR1MA as the catalyst in providing adequate, quality and affordable houses. Furthermore, the Syarikat Perumahan Negara Berhad (SPNB and the state governments also play their big role in providing affordable house at the state level. In trying to ensure smooth delivery of affordable housing, a systematic approach is required. This paper intends to examine the delivery of affordable housing in Malaysia. The objective was to assess the parties involved, and the various stages of the process. The methodology adopted for this study includes in-depth interviews with affordable housing agencies. Investigation showed that the major problem relates to a mismatch in the delivery of affordable housing. Moreover, the political and economic aspects, as well as the organization situation had also influenced the inefficiency of affordable housing delivery system. Additionally, the significant of this paper is expected to formulate an improved strategy and guidance in delivery system, thus ensuring that the method of practice is applicable throughout the country.

  15. Myocardial ischemia in hypertrophic cardiomyopathy; Isquemia miocardica na cardiomiopatia hipertrofica

    Energy Technology Data Exchange (ETDEWEB)

    Lima Filho, Moyses de Oliveira; Figueiredo, Geraldo L.; Simoes, Marcus V.; Pyntia, Antonio O.; Marin Neto, Jose Antonio [Sao Paulo Univ., Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Div. de Cardiologia

    2000-08-01

    Myocardial ischemia in hypertrophic cardiomyopathy is multifactorial and explains the occurrence of angina, in about 50% of patients. The pathophysiology of myocardial ischemia may be explained by the increase of the ventricular mass and relative paucity of the coronary microcirculation; the elevated ventricular filling pressures and myocardial stiffness causing a compression of the coronary microvessels; the impaired coronary vasodilator flow reserve caused by anatomic and functional abnormalities; and the systolic compression of epicardial vessel (myocardial bridges). Myocardial ischemia must be investigated by perfusion scintigraphic methods since its presence influences the prognosis and has relevant clinical implications for management of patients. Patients with hypertrophic cardiomyopathy and documented myocardial ischemia usually need to undergo invasive coronary angiography to exclude the presence of concomitant atherosclerotic coronary disease. (author)

  16. Strategies for recruitment of stem cells to treat myocardial infarction.

    Science.gov (United States)

    Shafiq, Muhammad; Lee, Sang-Hoon; Jung, Youngmee; Kim, Soo Hyun

    2015-01-01

    Heart failure is one of the most prominent causes of morbidity and mortality worldwide. According to the World Health Organization, coronary artery disease and myocardial infarction (MI) are responsible for 29% of deaths worldwide. MI results in obstruction of the blood supply to the heart and scar formation, and causes substantial death of cardiomyocytes in the infarct zone followed by an inflammatory response. Current treatment methodologies of MI and heart failure include organ transplantation, coronary artery bypass grafting, ventricular remodeling, cardiomyoplasty, and cellular therapy. Each of these methodologies has associated risks and benefits. Cellular cardiomyoplasty is a viable option to decrease the fibrosis of infarct scars, adverse post-ischemic remodeling, and improve heart function. However, the low rate of cell survival, shortage of cell sources and donors, tumorigenesis, and ethical issues hamper full exploitation of cell therapy for MI treatment. Consequently, the mobilization and recruitment of endogenous stem/progenitor cells from bone marrow, peripheral circulation, and cardiac tissues has immense potential through harnessing the host's own reparative capacities that result from interplay among cytokines, chemokines, and adhesion molecules. Therapeutic treatments to enhance the mobilization and homing of stem cells are under development. In this review, we present state-of-the-art approaches that are being pursued for stem cell mobilization and recruitment to regenerate infarcted myocardium. Potential therapeutic interventions and delivery strategies are discussed in detail. PMID:25594408

  17. Strategies for recruitment of stem cells to treat myocardial infarction.

    Science.gov (United States)

    Shafiq, Muhammad; Lee, Sang-Hoon; Jung, Youngmee; Kim, Soo Hyun

    2015-01-01

    Heart failure is one of the most prominent causes of morbidity and mortality worldwide. According to the World Health Organization, coronary artery disease and myocardial infarction (MI) are responsible for 29% of deaths worldwide. MI results in obstruction of the blood supply to the heart and scar formation, and causes substantial death of cardiomyocytes in the infarct zone followed by an inflammatory response. Current treatment methodologies of MI and heart failure include organ transplantation, coronary artery bypass grafting, ventricular remodeling, cardiomyoplasty, and cellular therapy. Each of these methodologies has associated risks and benefits. Cellular cardiomyoplasty is a viable option to decrease the fibrosis of infarct scars, adverse post-ischemic remodeling, and improve heart function. However, the low rate of cell survival, shortage of cell sources and donors, tumorigenesis, and ethical issues hamper full exploitation of cell therapy for MI treatment. Consequently, the mobilization and recruitment of endogenous stem/progenitor cells from bone marrow, peripheral circulation, and cardiac tissues has immense potential through harnessing the host's own reparative capacities that result from interplay among cytokines, chemokines, and adhesion molecules. Therapeutic treatments to enhance the mobilization and homing of stem cells are under development. In this review, we present state-of-the-art approaches that are being pursued for stem cell mobilization and recruitment to regenerate infarcted myocardium. Potential therapeutic interventions and delivery strategies are discussed in detail.

  18. Toll-Like Receptors and Myocardial Inflammation

    Directory of Open Access Journals (Sweden)

    Yan Feng

    2011-01-01

    Full Text Available Toll-like receptors (TLRs are a member of the innate immune system. TLRs detect invading pathogens through the pathogen-associated molecular patterns (PAMPs recognition and play an essential role in the host defense. TLRs can also sense a large number of endogenous molecules with the damage-associated molecular patterns (DAMPs that are produced under various injurious conditions. Animal studies of the last decade have demonstrated that TLR signaling contributes to the pathogenesis of the critical cardiac conditions, where myocardial inflammation plays a prominent role, such as ischemic myocardial injury, myocarditis, and septic cardiomyopathy. This paper reviews the animal data on (1 TLRs, TLR ligands, and the signal transduction system and (2 the important role of TLR signaling in these critical cardiac conditions.

  19. Armour Protection and Affordable Protection for Futuristic Combat Vehicles

    Directory of Open Access Journals (Sweden)

    V. Madhu

    2011-07-01

    Full Text Available Protection creates a shift in the internal paradigm of the soldier and leads to multiplied psychological stamina for moving fearlessly in the battlefield which generates a major force-multiplier effect. Hence, the mechanized forces are still likely to be one of the dominant forces on the futuristic battlefield and would be the primary target of enemy forces capable of engaging from tank guns up to 4-5 km in a direct fire mode and up to 8-10 km in an indirect fire modes. Increased protection is possible only using advanced armour technology. Throughout the history of warfare, materials technologies have had a significant impact on land-combat force capabilities. Armour materials have progressed through improvements in metallic systems and development of advanced, lightweight (low areal density composite materials. The advancements in ceramic systems have further improved the performance. Similarly, the advances in development of explosive reactive armour has generated efficient armour system against all contemporary high explosive antitank (HEAT ammunition and missile threats for armoured vehicles. Yet, to achieve armour performance exceeding that of the current light combat vehicles and main battle tanks for new vehicular systems, weighing significantly less than the present combat vehicles, advances in new armour materials, systems, and survivability technologies are required. This paper describes various approaches and advancements in the metallic, ceramic, and composite armour materials and new dynamic armour systems that are essential to improve the survivability of armoured vehicles in the futurisitic multi-spectral battlefied scenarios.Defence Science Journal, 2011, 61(4, pp.394-402, DOI:http://dx.doi.org/10.14429/dsj.61.365

  20. Nonrigid registration of myocardial perfusion MRI

    DEFF Research Database (Denmark)

    Ólafsdóttir, Hildur

    2005-01-01

    This paper describes a fully automatic registration of 10 multi-slice myocardial perfusion magnetic resonance image sequences. The registration of these sequences is crucial for the clinical interpretation, which currently is subjected to manual labour. The approach used in this study is a nonrigid...... registration algorithm based on free-form deformations due to Rueckert et al. Inspection of difference images from the wash-out part of the perfusion sequences indicates that a good registration accuracy is obtained....

  1. Secondary Prevention in Acute Myocardial Infarction

    OpenAIRE

    IRMAK, Yrd.Doç.Dr. Zöhre; FESCİ, Doç.Dr. Hatice

    2005-01-01

    Recent studies on patients who had an acute myocardial infarction have shown that risk factors are decreased, atherosclerosis regressed, and re-infarction and mortality rates are reduced as a result of drug therapy in combination with the changes in the lifestyle. This treatment called as secondary prevention, requires a behavioral change in the lifestyle that includes stopping smoking, making healthy food choices, and increasing physical activity. Risk factors related with lifestyle, wh...

  2. Myocardial Inflammation—Are We There Yet?

    OpenAIRE

    Greulich, Simon; Ferreira, Vanessa M; Dall’Armellina, Erica; Mahrholdt, Heiko

    2015-01-01

    Several exogenous or endogenous factors can lead to inflammatory heart disease. Beside infectious myocarditis, other systemic inflammatory disorders such as sarcoidosis, systemic lupus erythematosus (SLE), systemic sclerosis (SSc), Churg-Strauss syndrome, and rheumatoid arthritis can affect the myocardium. Myocardial inflammation may have a major impact on the outcome of these patients, resulting in sudden cardiac death, severe arrhythmias, or end-stage heart failure. The current gold standar...

  3. Acute Myocardial Infarction, 1992-2001.

    OpenAIRE

    Robert Schmitz

    2005-01-01

    Heart disease is the leading cause of hospitalization and death in the United States among persons age 65 and older. Acute myocardial infarction (AMI), more commonly known as heart attack, accounted for more than 321,000 hospitalizations among Medicare beneficiaries in 2001. This report presents trends in AMI hospitalization, readmission, and mortality rates from 1992 through 2001 among Medicare fee-for-service beneficiaries across various demographic groups.

  4. Myocardial infarction induced by spontaneous pneumothorax

    OpenAIRE

    Clarke, Viktoriya; McWilliams, Eric

    2010-01-01

    Chest pain is a very common condition. Patients may have a benign condition or present with a potentially lethal condition such as acute myocardial infarction, aortic dissection or tension pneumothorax. It is important to remember that patients may present with more than one serious pathology and that other serious conditions may potentially precipitate an acute coronary syndrome in a susceptible individual. We report the case of an elderly man with a background of chronic obstructive pulmona...

  5. Fatigue in Older Adults Post Myocardial Infarction

    OpenAIRE

    Patricia Barton Crane; Jimmy eEfird; Willie Mae Abel

    2016-01-01

    Objective. The purpose of this study was to comprehensively examine putative factors that may independently contribute to fatigue and subsequent persistence of fatigue in elderly adults 6-8 months post myocardial infarction (MI). Studies suggest cardiac function, comorbidities, daytime sleepiness, depression, anemia, interleukins, and social support are correlates of fatigue; however, no studies have systematically examined these factors 6 months post MI in an aging population. Methods. Study...

  6. Myocardial contractile function and intradialytic hypotension.

    Science.gov (United States)

    Owen, Paul J; Priestman, William S; Sigrist, Mhairi K; Lambie, Stewart H; John, Stephen G; Chesterton, Lindsay J; McIntyre, Christopher W

    2009-07-01

    Dialysis-induced hypotension remains a significant problem in hemodialysis (HD) patients. Numerous factors result in dysregulation of blood pressure control and impaired myocardial reserve in response to HD-induced cardiovascular stress. Episodic intradialytic hypotension may be involved in the pathogenesis of evolving myocardial injury. We performed an initial pilot investigation of cardiovascular functional response to pharmacological cardiovascular stress in hypotension-resistant (HR) and hypotension-prone (HP) HD patients. We studied 10 matched chronic HD patients (5 HP, 5 HR). Dobutamine-atropine stress (DAS) was performed on a nondialysis short interval day, with noninvasive pulse-wave analysis using the Finometer to continuously measure hemodynamic variables. Baroreflex sensitivity was assessed at rest and during DAS. Baseline hemodynamic variables were not significantly different. The groups had differing hemodynamic responses to DAS. The Mean arterial pressure was unchanged in the HR group but decreased in HP patients (-13.6 +/- 3.5 mmHg; P<0.001). This was associated with failure to significantly increase cardiac output in the HP group (cf. increase in cardiac output in the HR group of +33.4 +/- 6%; P<0.05), and a reduced response in total peripheral resistance (HP -10.3 +/- 6.8%, HR -22.7 +/- 2.9%, P=NS). Baroreflex sensitivity was not significantly different between groups at baseline or within groups with increasing levels of DAS; however, the mean baroreflex sensitivity was higher in HR cf. HP subjects throughout pharmacological stress (P<0.05). Hypotension-prone patients appear to have an impaired cardiovascular response to DAS. The most significant abnormality is an impaired myocardial contractile reserve. Early identification of these patients would allow utilization of therapeutic strategies to improve intradialytic tolerability, potentially abrogating aggravation of myocardial injury.

  7. Myocardial perfusion studies in coronary diseases

    International Nuclear Information System (INIS)

    For detecting in precocious form a coronary disease is necessary to apply a diagnostic techniques. The main considerations to be indicated in the present work are: physiological considerations, myocardial perfusion studies with radiotracers such as Talio 201, 99mTc, MIBI, 99mTc-Teboroxima, 99mTc-Fosfinas, instrumentation for obtain good images,proceedings protocols, studies interpretation, standards, SPECT, anomalies standards, coronary diseases

  8. Molecular Imaging of Healing After Myocardial Infarction

    OpenAIRE

    Naresh, Nivedita K; Ben-Mordechai, Tamar; Leor, Jonathan; Epstein, Frederick H

    2011-01-01

    The progression from acute myocardial infarction (MI) to heart failure continues to be a major cause of morbidity and mortality. Potential new therapies for improved infarct healing such as stem cells, gene therapy, and tissue engineering are being investigated. Noninvasive imaging plays a central role in the evaluation of MI and infarct healing, both clinically and in preclinical research. Traditionally, imaging has been used to assess cardiac structure, function, perfusion, and viability. H...

  9. Animal models of primary myocardial diseases.

    OpenAIRE

    Liu, S. K.; Tilley, L. P.

    1980-01-01

    Feline and canine cardiomyopathies (primary myocardial diseases) were reviewed and divided into three groups based on the clinical, hemodynamic, angiocardiographic, and pathologic findings: (1) feline and canine hypertrophic cardiomyopathy, (2) feline and canine congestive (dilated) cardiomyopathy, and (3) feline restrictive cardiomyopathy. All three groups consisted predominantly of mature adult male cats and dogs. Cardiomyopathy in the hamster and turkey was also reviewed. The most common p...

  10. Severe myocardial injury and extracorporeal membrane oxygenation following perinatal asphyxia

    OpenAIRE

    P Benson Ham; Pinkal Patel; Linda J. Wise; Christian Walters; Stansfield, Brian K.

    2015-01-01

    Perinatal asphyxia is a common cause of morbidity and mortality in the newborn and is associated with myocardial injury in a significant proportion of cases. Biomarkers, echocardiography, and rhythm disturbances are sensitive indicators of myocardial ischemia and may predict mortality. We present a case of severe myocardial dysfunction immediately after delivery managed with extracorporeal membrane oxygenation (ECMO) and discuss the role of cardiac biomarkers, echocardiography, electrocardiog...

  11. Double heart rupture after acute myocardial infarction: A case report

    OpenAIRE

    Ivanov Igor; Lovrenski Aleksandra; Dejanović Jadranka; Petrović Milovan; Jung Robert; Raffay Violetta

    2014-01-01

    Introduction. Double heart rupture is a rare complication of acute myocardial infarction with high mortality. Case report. We presented a 67-year-old female patient with symptoms and signs of myocardial infarction, diagnosed with echocardiography, rupture of the septum, the presence of a thrombus and a small pericardial effusion. Soon after admission the patient died. Autopsy revealed tamponade and double myocardial rupture, free wall rupture and ventricula...

  12. Sensitive Troponin Assay and the Classification of Myocardial Infarction

    OpenAIRE

    Shah, Anoop SV; McAllister, David A; Mills, Rosamund; Lee, Kuan Ken; Churchhouse, Antonia Md; Fleming, Kathryn M.; Layden, Elizabeth; Anand, Atul; Fersia, Omar; Joshi, Nikhil V; Walker, Simon; Jaffe, Allan S.; Fox, Keith Aa; Newby, David E; Mills, Nicholas L.

    2015-01-01

    Background Lowering the diagnostic threshold for troponin is controversial because it may disproportionately increase the diagnosis of myocardial infarction in patients without acute coronary syndrome. We assessed the impact of lowering the diagnostic threshold of troponin on the incidence, management, and outcome of patients with type 2 myocardial infarction or myocardial injury. Methods Consecutive patients with elevated plasma troponin I concentrations (≥50 ng/L; n = 2929) were classified ...

  13. Gallium-67 uptake in silent myocardial infarction: a case report

    International Nuclear Information System (INIS)

    Scintigrams obtained 24 and 48 hours after the injection of 67Ga in a patient undergoing evaluation for fever of unknown origin revealed positive myocardial uptake. The subsequent clinical course, electrocardiograms, radionuclear studies, and postmortem examination confirmed a silent myocardial infarction in the region of 67Ga localization. No other clinical reports were found of an acute myocardial infarction diagnosed by scintigraphy with 67Ga

  14. The value of exercise tests after acute myocardial infarction

    DEFF Research Database (Denmark)

    Nielsen, F E; Nielsen, S L; Knudsen, F;

    1992-01-01

    The aim of the present study was to relate the clinical course in patients after a first acute myocardial infarction with the response to exercise-tests performed one month after discharge. 90 consecutive patients who suffered an acute myocardial infarction for the first time were followed-up after...... (W) were predictive with respect to mortality, heart failure, and angina pectoris requiring drug treatment. Exercise tests following acute myocardial infarction could not predict the chances of returning to work....

  15. Anti-Cardiolipin Antibody in Acute Myocardial Infarction

    OpenAIRE

    Abdolreza S. Jahromi; Mohammad Shojaie; Samira Dana; Abdoulhossain Madani

    2010-01-01

    Problem statement: Myocardial infarction is the combined result of environmental and personal factors. Data concerning the relation between anti-Phospholipid (aPL) antibodies and myocardial infarction in subjects without evidence of overt autoimmune disease are conflicting. Anticardiolipin antibody is detected in various diseases like rheumatoid arthritis, systemic lupus erythematosus and anti-phospholipid antibody syndrome. The study of Anticardiolipin antibody in Acute Myocardial Infarction...

  16. Severe myocardial injury and extracorporeal membrane oxygenation following perinatal asphyxia

    Directory of Open Access Journals (Sweden)

    P. Benson Ham

    2015-05-01

    Full Text Available Perinatal asphyxia is a common cause of morbidity and mortality in the newborn and is associated with myocardial injury in a significant proportion of cases. Biomarkers, echocardiography, and rhythm disturbances are sensitive indicators of myocardial ischemia and may predict mortality. We present a case of severe myocardial dysfunction immediately after delivery managed with extracorporeal membrane oxygenation (ECMO and discuss the role of cardiac biomarkers, echocardiography, electrocardiography, and ECMO in the asphyxiated newborn.

  17. PARP inhibition and postinfarction myocardial remodeling.

    Science.gov (United States)

    Halmosi, Robert; Deres, Laszlo; Gal, Roland; Eros, Krisztian; Sumegi, Balazs; Toth, Kalman

    2016-08-01

    Coronary artery disease accounts for the greatest proportion of cardiovascular diseases therefore it is the major cause of death worldwide. Its therapeutic importance is indicated by still high mortality of myocardial infarction, which is one of the most severe forms of CVDs. Moreover, the risk of developing heart failure is very high among survivors. Heart failure is accompanied by high morbidity and mortality rate, therefore this topic is in the focus of researchers' interest. After a myocardial infarct, at first ventricular hypertrophy develops as a compensatory mechanism to decrease wall stress but finally leads to left ventricular dilation. This phenomenon is termed as myocardial remodeling. The main characteristics of underlying mechanisms involve cardiomyocyte growth, vessel changes and increased collagen production, in all of which several mechanical stress induced neurohumoral agents, oxidative stress and signal transduction pathways are involved. The long term activation of these processes ultimately leads to left ventricular dilation and heart failure with decreased systolic function. Oxidative stress causes DNA breaks producing the activation of nuclear poly(ADP-ribose) polymerase-1 (PARP-1) enzyme that leads to energy depletion and unfavorable modulation of different kinase cascades (Akt-1/GSK-3β, MAPKs, various PKC isoforms) and thus it promotes the development of heart failure. Therefore inhibition of PARP enzyme could offer a promising new therapeutical approach to prevent the onset of heart failure among postinfarction patients. The purpose of this review is to give a comprehensive summary about the most significant experimental results and mechanisms in postinfarction remodeling. PMID:27392900

  18. Myocardial infarction: management of the subacute period.

    Science.gov (United States)

    Mercado, Michael G; Smith, Dustin K; McConnon, Michael L

    2013-11-01

    Optimal management of myocardial infarction in the subacute period focuses on improving the discharge planning process, implementing therapies early to prevent recurrent myocardial infarction, and avoiding hospital readmission. Evidence-based guidelines for the care of patients with acute coronary syndrome are not followed up to 25% of the time. Antiplatelet therapy, renin-angiotensin-aldosterone system inhibitors, beta blockers, and statins constitute the foundation of medical therapy. Early noninvasive stress testing is an important risk assessment tool, especially in patients who do not undergo revascularization. Discharge preparation should include a review of medications, referral for exercise-based cardiac rehabilitation, activity recommendations, education about lifestyle modification and recognition of cardiac symptoms, and a clear follow-up plan. Because nonadherence to medications is common in patients after a myocardial infarction and is associated with increased mortality risk, modifiable factors associated with medication self-discontinuation should be addressed before discharge. Structured discharge processes should be used to enhance communication and facilitate the transition from the hospital to the family physician's care.

  19. Quantitative myocardial blood flow with Rubidium-82 PET

    DEFF Research Database (Denmark)

    Hagemann, Christoffer E; Ghotbi, Adam A; Kjær, Andreas;

    2015-01-01

    Positron emission tomography (PET) allows assessment of myocardial blood flow in absolute terms (ml/min/g). Quantification of myocardial blood flow (MBF) and myocardial flow reserve (MFR) extend the scope of conventional semi-quantitative myocardial perfusion imaging (MPI): e.g. in 1) identificat......Positron emission tomography (PET) allows assessment of myocardial blood flow in absolute terms (ml/min/g). Quantification of myocardial blood flow (MBF) and myocardial flow reserve (MFR) extend the scope of conventional semi-quantitative myocardial perfusion imaging (MPI): e.g. in 1...... pretest probability of CAD can support the clinical decision-making in treatment of CAD patients as a complementary tool to the invasive coronary angiography (CAG). Recently, several studies have proven Rubidium-82 ((82)Rb) PET's long-term prognostic value by a significant association between compromised...... global MFR and major adverse cardiovascular events (MACE), and together with new diagnostic possibilities from measuring the longitudinal myocardial perfusion gradient, cardiac (82)Rb PET faces a promising clinical future. This article reviews current evidence on quantitative (82)Rb PET's ability...

  20. The prognostic importance of creatinine clearance after acute myocardial infarction

    DEFF Research Database (Denmark)

    Sørensen, C R; Brendorp, B; Rask-Madsen, C;

    2002-01-01

    AIMS: The purpose of this study was to assess renal dysfunction as an independent predictor of mortality after acute myocardial infarction. METHODS: The study population was 6252 patients with a myocardial infarction admitted alive from 1990 to 1992. The mortality status was obtained after at least.......9-1.3) respectively. CONCLUSION: Renal dysfunction is an important risk factor after acute myocardial infarction. When the risk is adjusted for available competing risk factors only severely reduced renal function is associated with an important and independent risk of mortality after acute myocardial infarction...

  1. Myocardial Perfusion Spect Imaging in Dextrocardia: A Case Report

    Directory of Open Access Journals (Sweden)

    Semra Özdemir

    2013-08-01

    Full Text Available The myocardial perfusion scintigraphy acquisition and analysis present some technical differences in the rare dextrocardia cases. Here we report a case of a 38 year-old woman with dextrocardia who had been applied myocardial perfusion scintigraphy. Presented case showed that the thoracic and abdominal organs had a mirror image with situs inversus totalis type dextrocardia. The incidence of coronary heart disease and life span of people with situs inversus totalis are the same as the normal population. So we may apply myocardial perfusion scintigraphy to this patient group. The current case is presented in order to remind the special applications of myocardial perfusion SPECT imaging in patients with dextrocardia.

  2. Inferior ST-Elevation Myocardial Infarction Associated with Takotsubo Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Oliver Koeth

    2010-01-01

    Full Text Available Takotsubo cardiomyopathy (TCM is usually characterized by transient left ventricular apical ballooning. Due to the clinical symptoms which include chest pain, electrocardiographic changes, and elevated myocardial markers, Takotsubo cardiomyopathy is frequently mimicking ST-elevation myocardial infarction in the absence of a significant coronary artery disease. Otherwise an acute occlusion of the left anterior descending coronary artery can produce a typical Takotsubo contraction pattern. ST-elevation myocardial infarction (STEMI is frequently associated with emotional stress, but to date no cases of STEMI triggering TCM have been reported. We describe a case of a female patient with inferior ST-elevation myocardial infarction complicated by TCM.

  3. Usefulness of local delivery of thrombolytics before thrombectomy in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention (the delivery of thrombolytics before thrombectomy in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention [DISSOLUTION] randomized trial).

    Science.gov (United States)

    Greco, Cesare; Pelliccia, Francesco; Tanzilli, Gaetano; Tinti, Maria Denitza; Salenzi, Paola; Cicerchia, Cristina; Schiariti, Michele; Franzoni, Ferdinando; Speziale, Giuseppe; Gallo, Pietro; Gaudio, Carlo

    2013-09-01

    Thrombus aspiration during percutaneous coronary intervention can result in improved rates of normal epicardial flow and myocardial perfusion, but several unmet needs remain. The purpose of the Delivery of thrombolytIcs before thrombectomy in patientS with ST-segment elevatiOn myocardiaL infarction Undergoing primary percuTaneous coronary interventION (DISSOLUTION) trial was to evaluate the hypothesis that local delivery of thrombolytics can enhance the efficacy of thrombus aspiration in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. A total of 102 patients with ST-segment elevation myocardial infarction and angiographic evidence of massive thrombosis in the culprit artery were randomly assigned to receive a local, intrathrombus bolus of 200,000 U of urokinase (n = 51) or saline solution (n = 51) by way of an infusion microcatheter, followed by manual aspiration thrombectomy. The end points included the final Thrombolysis In Myocardial Infarction flow grade and frame count, myocardial blush grade, 60-minute ST-segment resolution >70%, and major adverse cardiac and cerebrovascular events, defined as the death, reinfarction, stroke, or clinically driven target vessel revascularization at 6 months. The use of intrathrombus urokinase was associated with a significantly higher incidence of Thrombolysis In Myocardial Infarction flow grade 3 (90% vs 66%, p = 0.008) and lower postpercutaneous coronary intervention Thrombolysis In Myocardial Infarction frame count (19 ± 15 vs 25 ± 17, p = 0.033). The postprocedural myocardial perfusion was significantly increased with the use of urokinase (myocardial blush grade 2 or 3, 68% vs 45%, p = 0.028), with more patients showing ST-segment resolution >70% (82% vs 55%, p = 0.006). At 6 months of follow-up, the patients treated with intrathrombus urokinase showed a better major adverse cardiac event-free survival (6% vs 21%; log-rank p = 0.044). In conclusion, local

  4. Depressive symptoms are associated with mental stress-induced myocardial ischemia after acute myocardial infarction.

    Directory of Open Access Journals (Sweden)

    Jingkai Wei

    Full Text Available Depression is an adverse prognostic factor after an acute myocardial infarction (MI, and an increased propensity toward emotionally-driven myocardial ischemia may play a role. We aimed to examine the association between depressive symptoms and mental stress-induced myocardial ischemia in young survivors of an MI.We studied 98 patients (49 women and 49 men age 38-60 years who were hospitalized for acute MI in the previous 6 months. Patients underwent myocardial perfusion imaging at rest, after mental stress (speech task, and after exercise or pharmacological stress. A summed difference score (SDS, obtained with observer-independent software, was used to quantify myocardial ischemia under both stress conditions. The Beck Depression Inventory-II (BDI-II was used to measure depressive symptoms, which were analyzed as overall score, and as separate somatic and cognitive depressive symptom scores.There was a significant positive association between depressive symptoms and SDS with mental stress, denoting more ischemia. After adjustment for demographic and lifestyle factors, disease severity and medications, each incremental depressive symptom was associated with 0.14 points higher SDS. When somatic and cognitive depressive symptoms were examined separately, both somatic [β = 0.17, 95% CI: (0.04, 0.30, p = 0.01] and cognitive symptoms [β = 0.31, 95% CI: (0.07, 0.56, p = 0.01] were significantly associated with mental stress-induced ischemia. Depressive symptoms were not associated with ischemia induced by exercise or pharmacological stress.Among young post-MI patients, higher levels of both cognitive and somatic depressive symptoms are associated with a higher propensity to develop myocardial ischemia with mental stress, but not with physical (exercise or pharmacological stress.

  5. Americans' Experiences with ACA Marketplace Coverage: Affordability and Provider Network Satisfaction: Findings from the Commonwealth Fund Affordable Care Act Tracking Survey, February--April 2016.

    Science.gov (United States)

    Gunja, Munira Z; Collins, Sara R; Doty, Michelle M; Beutel, Sophie

    2016-07-01

    For people with low and moderate incomes, the Affordable Care Act's tax credits have made premium costs roughly comparable to those paid by people with job-based health insurance. For those with higher incomes, the tax credits phase out, meaning that adults in marketplace plans on average have higher premium costs than those in employer plans. The law's cost-sharing reductions are reducing deductibles. Lower-income adults in marketplace plans were less likely than higher-income adults to report having deductibles of $1,000 or more. Majorities of new marketplace enrollees and those who have changed plans since they initially obtained marketplace coverage are satisfied with the doctors participating in their plans. Overall, the majority of marketplace enrollees expressed confidence in their ability to afford care if they were to become seriously ill. This issue brief explores these and other findings from the Commonwealth Fund Affordable Care Act Tracking Survey, February--April 2016. PMID:27400465

  6. Short-Term Hyperglycemic Dysregulation in Patients With Type 1 Diabetes Does Not Change Myocardial Triglyceride Content or Myocardial Function

    OpenAIRE

    Hammer, Sebastiaan; Jonker, Jacqueline T; Lamb, Hildo J.; Rutger W van der Meer; Zondag, Wendy; Sepers, Jan M.; de Roos, Albert; Johannes W A Smit; Romijn, Johannes A.

    2008-01-01

    OBJECTIVE—To evaluate the effects of hyperglycemia due to partial insulin deprivation on myocardial triglyceride (TG) content and myocardial function in patients with type 1 diabetes. RESEARCH DESIGN AND METHODS—Myocardial and hepatic TG content and left ventricular (LV) function were measured by magnetic resonance (MR) spectroscopy and MR imaging during optimal glucoregulation and after 24 h of partial insulin deprivation (n = 10). RESULTS—Mean insulin infusion rate was 45 ± 5 units at basel...

  7. Survival of the cheapest

    Directory of Open Access Journals (Sweden)

    Julian F.V Vincent

    2002-12-01

    The natural world, of which we are a significant part, has many examples of survival with minimum use of energy. These examples range from the production and use of materials to the organization of entire populations. But not all organisms exist in a half-lit, miserly half-life. Their (that is to say, our driving purpose in life is to reproduce, and no organism (that is, me or you would be here unless our parents had a strong urge to reproduce, something which we, mostly, inherit. So any way that we can have the largest number of surviving offspring will be favored. In doing this we are in competition with nearly all the other organisms in the vicinity. The ones with which we are overtly friendly are our immediate genetic (or to a lesser extent, social relatives, and much has been made of the concept that it is our genes, rather than ourselves, that crave dominance.

  8. Survival of extreme opinions

    Science.gov (United States)

    Hsu, Jiann-wien; Huang, Ding-wei

    2009-12-01

    We study the survival of extreme opinions in various processes of consensus formation. All the opinions are treated equally and subjected to the same rules of changing. We investigate three typical models to reach a consensus in each case: (A) personal influence, (B) influence from surroundings, and (C) influence to surroundings. Starting with uniformly distributed random opinions, our calculated results show that the extreme opinions can survive in both models (A) and (B), but not in model (C). We obtain a conclusion that both personal influence and passive adaptation to the environment are not sufficient enough to eradicate all the extreme opinions. Only the active persuasion to change the surroundings eliminates the extreme opinions completely.

  9. Doubly robust survival trees.

    Science.gov (United States)

    Steingrimsson, Jon Arni; Diao, Liqun; Molinaro, Annette M; Strawderman, Robert L

    2016-09-10

    Estimating a patient's mortality risk is important in making treatment decisions. Survival trees are a useful tool and employ recursive partitioning to separate patients into different risk groups. Existing 'loss based' recursive partitioning procedures that would be used in the absence of censoring have previously been extended to the setting of right censored outcomes using inverse probability censoring weighted estimators of loss functions. In this paper, we propose new 'doubly robust' extensions of these loss estimators motivated by semiparametric efficiency theory for missing data that better utilize available data. Simulations and a data analysis demonstrate strong performance of the doubly robust survival trees compared with previously used methods. Copyright © 2016 John Wiley & Sons, Ltd. PMID:27037609

  10. Histochemical and immunohistochemical analyses of the myocardial scar fallowing acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Tatić Vujadin

    2012-01-01

    Full Text Available Background/Aim. The heart has traditionally been considered as a static organ without capacity of regeneration after trauma. Currently, the more and more often asked question is whether the heart has any intrinsic capacities to regenerate myocytes after myocardial infarction. The aim of this study was to present the existence of the preserved muscle fibers in the myocardial scar following myocardial infarction as well as the presence of numerous cells of various size and form that differently reacted to the used immunohistochemical antibodies. Methods. Histological, histochemical and immunohistochemical analyses of myocardial sections taken from 177 patients who had died of acute myocardial infarction and had the myocardial scar following myocardial infarction, were carried out. More sections taken both from the site of acute infarction and scar were examined by the following methods: hematoxylin-eosin (HE, periodic acid schiff (PAS, PAS-diastasis, Masson trichrom, Malory, van Gieson, vimentin, desmin, myosin, myoglobin, alpha actin, smoth muscle actin (SMA, p53, leukocyte common antigen (LCA, proliferating cell nuclear antigen (PCNA, Ki-67, actin HHF35, CD34, CD31, CD45, CD45Ro, CD8, CD20. Results. In all sections taken from the scar region, larger or smaller islets of the preserved muscle fibers with the signs of hypertrophy were found. In the scar, a large number of cells of various size and form: spindle, oval, elongated with abundant cytoplasm, small with one nucleus and cells with scanty cytoplasm, were found. The present cells differently reacted to histochemical and immunohistochemical methods. Large oval cells showed negative reaction to lymphocytic and leukocytic markers, and positive to alpha actin, actin HHF35, Ki-67, myosin, myoglobin and desmin. Elongated cells were also positive to those markers. Small mononuclear cells showed positive reaction to lymphocytic markers. Endothelial and smooth muscle cells in the blood vessel walls

  11. Microbial interference with hatch and survival of European eel larvae

    DEFF Research Database (Denmark)

    Sørensen, Sune Riis; Lauesen; Tomkiewicz, Jonna;

    Recent research has significantly improved our knowledge and capabilities in the field of in vitro production of yolk sac larvae from European eel (Anguilla anguilla). Female broodstock European eels are matured by weekly administration of pituitary extract and male eels with hCG (human chorionic...... gonadotropin), which afford gametes for in vitro fertilization studies. The maturing process may lead to mass hatchings of up to ½ million larvae of which some survive the entire yolk sac phase. However, the rearing of larvae suffers from high larval mortalities, and water quality might be a crucial factor...... for larval survival in rearing systems. By applying antibiotic treatment as a research tool, it was possible to determine the extent of microbial interference in the production of high numbers of good quality larvae. By controlling microbiota during egg and larval incubation, the egg hatching success...

  12. Dissociating between object affordances and spatial compatibility effects using early response components

    Directory of Open Access Journals (Sweden)

    Meytal eWilf

    2013-09-01

    Full Text Available Perception and action are tightly linked: objects may be perceived not only in terms of visual features, but also in terms of possibilities for action. Previous studies showed that when a centrally located object has a salient graspable feature (e.g., a handle, it facilitates motor responses corresponding with the feature's position. However, such so-called affordance effects have been criticized as resulting from spatial compatibility effects, due to the visual asymmetry created by the graspable feature, irrespective of any affordances. In order to dissociate between affordance and spatial compatibility effects, we asked participants to perform a simple reaction-time task to typically graspable and non-graspable objects with similar visual features (e.g., lollipop and stop sign. Responses were measured using either electromyography (EMG on proximal arm muscles during reaching-like movements, or with finger key-presses. In both EMG and button press measurements, participants responded faster when the object was either presented in the same location as the responding hand, or was affordable, resulting in significant and independent spatial compatibility and affordance effects, but no interaction. Furthermore, while the spatial compatibility effect was present from the earliest stages of movement preparation and throughout the different stages of movement execution, the affordance effect was restricted to the early stages of movement execution. Finally, we tested a small group of unilateral arm amputees using EMG, and found residual spatial compatibility but no affordance, suggesting that spatial compatibility effects do not necessarily rely on individuals’ available affordances. Our results show dissociation between affordance and spatial compatibility effects, and suggest that rather than evoking the specific motor action most suitable for interaction with the viewed object, graspable objects prompt the motor system in a general, body

  13. Carbonaceous Survivability on Impact

    Science.gov (United States)

    Bunch, T. E.; Becker, Luann; Morrison, David (Technical Monitor)

    1994-01-01

    In order to gain knowledge about the potential contributions of comets and cosmic dust to the origin of life on Earth, we need to explore the survivability of their potential organic compounds on impact and the formation of secondary products that may have arisen from the chaotic events sustained by the carriers as they fell to Earth. We have performed a series of hypervelocity impact experiments using carbon-bearing impactors (diamond, graphite, kerogens, PAH crystals, and Murchison and Nogoya meteorites) into Al plate targets at velocities - 6 km/s. Estimated peak shock pressures probably did not exceed 120 GPa and peak shock temperatures were probably less than 4000 K for times of nano- to microsecs. Nominal crater dia. are less than one mm. The most significant results of these experiments are the preservation of the higher mass PAHs (e. g., pyrene relative to napthalene) and the formation of additional alkylated PAHs. We have also examined the residues of polystyrene projectiles impacted by a microparticle accelerator into targets at velocities up to 15 km/s. This talk will discuss the results of these experiments and their implications with respect to the survival of carbonaceous deliverables to early Earth. The prospects of survivability of organic molecules on "intact" capture of cosmic dust in space via soft: and hard cosmic dust collectors will also be discussed.

  14. Modified Mediterranean diet and survival after myocardial infarction : the EPIC-Elderly study

    NARCIS (Netherlands)

    Trichopoulou, A.; Bamia, C.; Norat, T.; Overvad, K.; Tjonneland, A.; Halkjaer, J.; Clavel-Chapelon, F.; Vercambre, M. -N.; Boutron-Ruault, M. -C.; Linseisen, J.; Rohrmann, S.; Boeing, H.; Weikert, C.; Benetou, V.; Psaltopoulou, T.; Orfanos, P.; Boffetta, P.; Masala, G.; Pala, V.; Panico, S.; Tumino, R.; Sacerdote, C.; Bueno-de-Mesquita, H. B.; Ocke, M. C.; Peeters, P. H.; Van der Schouw, Y. T.; Gonzalez, C.; Sanchez, M. J.; Schmidt, E.B.; Chirlaque, M. D.; Moreno, C.; Larranaga, N.; Van Guelpen, B.; Jansson, J. -H.; Bingham, S.; Khaw, K. -T.; Spencer, E. A.; Key, T.; Riboli, E.; Trichopoulos, D.

    2007-01-01

    Mediterranean diet is associated with lower incidence of coronary heart disease, and two randomised trials indicated that it improves prognosis of coronary patients. These trials, however, relied on a total of 100 deaths and evaluated designer diets in the clinical context. We have evaluated the ass

  15. FCJ-178 Network Affordances: The unpredictable parameters of a Hong Kong SPEED SHOW

    Directory of Open Access Journals (Sweden)

    Audrey Samson

    2015-06-01

    Full Text Available This paper examines the notion of network affordance within the context of network art. We expand on the notion of affordances, (Gibson, 1977; Gaver, 1996 to include ecological and computational parameters of unpredictability. We illustrate the notion of unpredictability by considering four specific works that were included in a network art exhibition, SPEED SHOW [2.0] Hong Kong (2013. The paper discusses how the artworks are contingent upon the parametric relations (Parisi, 2013 of the network. We introduce network affordance as a dynamic framework that could articulate the experience of tension arising from the (visible symbolic representation of computational processes and its hidden occurrences.

  16. Coverage, access, and affordability under health reform: learning from the Massachusetts model.

    Science.gov (United States)

    Long, Sharon K; Stockley, Karen; Nordahl, Kate Willrich

    While the impacts of the Affordable Care Act will vary across the states given their different circumstances, Massachusetts' 2006 reform initiative, the template for national reform, provides a preview of the potential gains in insurance coverage, access to and use of care, and health care affordability for the rest of the nation. Under reform, uninsurance in Massachusetts dropped by more than 50%, due, in part, to an increase in employer-sponsored coverage. Gains in health care access and affordability were widespread, including a 28% decline in unmet need for doctor care and a 38% decline in high out-of-pocket costs.

  17. Affordable Care Organizations and Bundled Pricing: A New Philosophy of Care.

    Science.gov (United States)

    Barinaga, Gonzalo; Chambers, Monique C; El-Othmani, Mouhanad M; Siegrist, Richard B; Saleh, Khaled J

    2016-10-01

    Under the Patient Protection and Affordable Care Act (ACA), the Centers for Medicare and Medicaid Services' Innovation was chartered to develop new models of health care delivery. The changes meant a drastic need to restructure the health care system. To minimize costs and optimize quality, new laws encourage continuity in health care delivery within an integrated system. Affordable care organizations provided a model of high-quality care while reducing costs. Bundled payments can have a substantial effect on the national expenditures. This article examines new developments in bundle payments, affordable care organizations, and gainsharing agreements as they pertain to arthroplasty. PMID:27637657

  18. Survival analysis models and applications

    CERN Document Server

    Liu, Xian

    2012-01-01

    Survival analysis concerns sequential occurrences of events governed by probabilistic laws.  Recent decades have witnessed many applications of survival analysis in various disciplines. This book introduces both classic survival models and theories along with newly developed techniques. Readers will learn how to perform analysis of survival data by following numerous empirical illustrations in SAS. Survival Analysis: Models and Applications: Presents basic techniques before leading onto some of the most advanced topics in survival analysis.Assumes only a minimal knowledge of SAS whilst enablin

  19. A global need for affordable neonatal jaundice technologies.

    Science.gov (United States)

    Slusher, Tina M; Zipursky, Alvin; Bhutani, Vinod K

    2011-06-01

    Globally, health care providers worldwide recognize that severe neonatal jaundice is a "silent" cause of significant neonatal morbidity and mortality. Untreated neonatal jaundice can lead to death in the neonatal period and to kernicterus, a major cause of neurologic disability (choreo-athetoid cerebral palsy, deafness, language difficulty) in children who survive this largely preventable neonatal tragedy. Appropriate technologies are urgently needed. These include tools to promote and enhance visual assessment of the degree of jaundice, such as simpler transcutaneous bilirubin measurements and readily available serum bilirubin measurements that could be incorporated into routine treatment and follow-up. Widespread screening for glucose-6-phoshate dehydrogenase deficiency is needed because this is often a major cause of neonatal jaundice and kernicterus worldwide. Recognition and treatment of Rh hemolytic disease, another known preventable cause of kernicterus, is critical. In addition, effective phototherapy is crucial if we are to make kernicterus a "never-event." Finally it is essential that we conduct appropriate population-based studies to accurately elucidate the magnitude of the problem. However, knowledge alone is not sufficient. If we are to implement these and other programs and technologies to relegate severe neonatal jaundice and its sequelae to the history books, screening and interventions must be low cost and technologically appropriate for low and middle income nations. PMID:21641493

  20. How much domestic quick response manufacturing can a business afford?

    Science.gov (United States)

    Warburton, Roger D. H.; Warner, Steven B.

    2000-10-01

    Employment in the U.S. apparel industry has declined dramatically since the 1960s. Will it fall inexorably to zero, or is there some base level that can endure? If so, what strategic characteristics are required to survive? There is considerable interest in Quick Response Manufacturing (QRM), not only as a reason to support domestic manufacturing, but also as part of the larger goal of reducing supply chain costs. However, since Domestic Manufacturing is more expensive, why should anyone bother considering it? This paper presents an analytical model of a team approach that includes both domestic and offshore manufacturing. Despite the additional costs associated with U.S. manufacturing, our model predicts that including a domestic contractor is legitimate and cost effective. However, the alliance must be genuinely cooperative. A partnership has to be established early in the retailer's planning cycle, and the manufacturer should participate in the planning. Also, sharing data and making timely decisions imposes a strategic business approach, and the model allows us to describe the characteristic roles and capabilities required. Using this model for guidance, we anticipate that retailers will have the stock to satisfy more customers with fewer markdowns, while manufacturers will see increased margins and lower inventories.

  1. How many people have had a myocardial infarction? Prevalence estimated using historical hospital data

    Directory of Open Access Journals (Sweden)

    Tanuseputro Peter

    2007-07-01

    Full Text Available Abstract Background Health administrative data are increasingly used to examine disease occurrence. However, health administrative data are typically available for a limited number of years – posing challenges for estimating disease prevalence and incidence. The objective of this study is to estimate the prevalence of people previously hospitalized with an acute myocardial infarction (AMI using 17 years of hospital data and to create a registry of people with myocardial infarction. Methods Myocardial infarction prevalence in Ontario 2004 was estimated using four methods: 1 observed hospital admissions from 1988 to 2004; 2 observed (1988 to 2004 and extrapolated unobserved events (prior to 1988 using a "back tracing" method using Poisson models; 3 DisMod incidence-prevalence-mortality model; 4 self-reported heart disease from the population-based Canadian Community Health Survey (CCHS in 2000/2001. Individual respondents of the CCHS were individually linked to hospital discharge records to examine the agreement between self-report and hospital AMI admission. Results 170,061 Ontario residents who were alive on March 31, 2004, and over age 20 years survived an AMI hospital admission between 1988 to 2004 (cumulative incidence 1.8%. This estimate increased to 2.03% (95% CI 2.01 to 2.05 after adding extrapolated cases that likely occurred before 1988. The estimated prevalence appeared stable with 5 to 10 years of historic hospital data. All 17 years of data were needed to create a reasonably complete registry (90% of estimated prevalent cases. The estimated prevalence using both DisMod and self-reported "heart attack" was higher (2.5% and 2.7% respectively. There was poor agreement between self-reported "heart attack" and the likelihood of having an observed AMI admission (sensitivity = 63.5%, positive predictive value = 54.3%. Conclusion Estimating myocardial infarction prevalence using a limited number of years of hospital data is feasible, and

  2. Applied survival analysis using R

    CERN Document Server

    Moore, Dirk F

    2016-01-01

    Applied Survival Analysis Using R covers the main principles of survival analysis, gives examples of how it is applied, and teaches how to put those principles to use to analyze data using R as a vehicle. Survival data, where the primary outcome is time to a specific event, arise in many areas of biomedical research, including clinical trials, epidemiological studies, and studies of animals. Many survival methods are extensions of techniques used in linear regression and categorical data, while other aspects of this field are unique to survival data. This text employs numerous actual examples to illustrate survival curve estimation, comparison of survivals of different groups, proper accounting for censoring and truncation, model variable selection, and residual analysis. Because explaining survival analysis requires more advanced mathematics than many other statistical topics, this book is organized with basic concepts and most frequently used procedures covered in earlier chapters, with more advanced topics...

  3. Assessment of myocardial fatty acid metabolism in patients with angina pectoris and diabetes mellitus using 123I-BMIPP myocardial scintigraphy

    International Nuclear Information System (INIS)

    We studied the effect of myocardial ischemia and diabetes mellitus (DM) on the myocardial fatty acid metabolism using 123I-BMIPP myocardial scintigraphy. We performed 123I-BMIPP myocardial scintigraphy in 50 patients with myocardial ischemia and without DM (AP), in 30 patients with myocardial ischemia and DM (AP+DM), 12 patients with DM and without myocardial ischemia (DM), and in 10 normal subjects (N). Myocardial uptake rate of 123I-BMIPP was obtained using the time activity curve. Myocardial washout rate of 123I-BMIPP was calculated using the polar images of early and delayed SPECT images. Myocardial uptake rate of 123I-BMIPP (%) were AP: 4.9±0.6, AP+DM: 5.5±0.5, DM 5.7±0.5 and N: 5.0±0.4. 123I-BMIPP myocardial uptake rate was increased in AP+DM and DM. 123I-BMIPP myocardial washout rate (%) were AP: 30.2±4.3, AP+DM: 24.5±3.9, DM: 16.1±2.8 and N: 19.4±3.2. 123I-BMIPP myocardial washout rate was increased in AP and AP+DM. 123I-BMIPP myocardial washout rate was increased particularly in patients with multi-vessels disease. 123I-BMIPP myocardial washout rate was decreased in DM. The present study suggested that diabetes mellitus increased myocardial fatty acid uptake and decreased myocardial fatty acid washout, and that myocardial ischemia increased myocardial fatty acid washout. (author)

  4. Assessment of myocardial fatty acid metabolism in patients with angina pectoris and diabetes mellitus using {sup 123}I-BMIPP myocardial scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Kazuki; Tanabe, Takuji; Yuba, Tatsuya; Doue, Tomoki; Adachi, Yoshihiko; Katoh, Shuuji [Asahi Univ., Gifu (Japan). Murakami Memorial Hospital; Sugihara, Hiroki; Azuma, Akihiro; Nakagawa, Masao

    2001-11-01

    We studied the effect of myocardial ischemia and diabetes mellitus (DM) on the myocardial fatty acid metabolism using {sup 123}I-BMIPP myocardial scintigraphy. We performed {sup 123}I-BMIPP myocardial scintigraphy in 50 patients with myocardial ischemia and without DM (AP), in 30 patients with myocardial ischemia and DM (AP+DM), 12 patients with DM and without myocardial ischemia (DM), and in 10 normal subjects (N). Myocardial uptake rate of {sup 123}I-BMIPP was obtained using the time activity curve. Myocardial washout rate of {sup 123}I-BMIPP was calculated using the polar images of early and delayed SPECT images. Myocardial uptake rate of {sup 123}I-BMIPP (%) were AP: 4.9{+-}0.6, AP+DM: 5.5{+-}0.5, DM 5.7{+-}0.5 and N: 5.0{+-}0.4. {sup 123}I-BMIPP myocardial uptake rate was increased in AP+DM and DM. {sup 123}I-BMIPP myocardial washout rate (%) were AP: 30.2{+-}4.3, AP+DM: 24.5{+-}3.9, DM: 16.1{+-}2.8 and N: 19.4{+-}3.2. {sup 123}I-BMIPP myocardial washout rate was increased in AP and AP+DM. {sup 123}I-BMIPP myocardial washout rate was increased particularly in patients with multi-vessels disease. {sup 123}I-BMIPP myocardial washout rate was decreased in DM. The present study suggested that diabetes mellitus increased myocardial fatty acid uptake and decreased myocardial fatty acid washout, and that myocardial ischemia increased myocardial fatty acid washout. (author)

  5. Pharmacological prevention of reperfusion injury in acute myocardial infarction. A potential role for adenosine as a therapeutic agent.

    Science.gov (United States)

    Quintana, Miguel; Kahan, Thomas; Hjemdahl, Paul

    2004-01-01

    last years, three relatively large placebo-controlled clinical trials have been conducted: Acute Myocardial Infarction Study of Adenosine Trial (AMISTAD) I and II and Attenuation by Adenosine of Cardiac Complications (ATTACC). In the AMISTAD trials, the final infarct size was reduced and the LV systolic function was improved by adenosine treatment, mainly in patients with anterior MI localization. However, morbidity and mortality were not affected. In the ATTACC study, the LV systolic function was not affected by adenosine, however, trends towards improved survival were observed in patients with anterior MI localization. The possibility of obtaining a Thrombolysis in Myocardial Infarction (TIMI) grade 3 flow in the infarct-related artery in up to 95% of patients with acute MI (increasing the occurrence of reperfusion injury) has turned back the interest towards the protection of myocardial cells from the impending ischemic and reperfusion injury in which adenosine alone or together with other cardio-protective agents may exert important clinical effects. PMID:15134468

  6. Prognostic value of myocardial sympathetic activity in patients with asymptomatic myocardial infarction

    International Nuclear Information System (INIS)

    To clarify the significance of myocardial sympathetic activity in patients with asymptomatic myocardial infarction (MI), we performed 123I-metaiodobenzyl-guanidine (MIBG) and 201Tl imaging at rest. We calculated the ratio of cardiac uptake of the isotope to the total injected dose (%Uptake), percent washout of MIBG over 3 hours and the Uptake Ratio (UR, %Uptake of MIBG divided by %Uptake of 201Tl). We compared these indices with clinical findings, exercise stress-rest myocardial perfusion imaging with 99Tc-methoxy-2-isobutyl isonitrile, coronary angiography, echocardiography and neurohumoral findings. During the follow-up period of 19.9±10.3 months in 32 patients, events (heart failure or cardiac death) developed in 10 (31%). In univariate analysis, diabetes mellitus, atrial fibrillation, left ventricular end-diastolic dimension (LVDd) greater than 54 mm, and the %Uptake of MIBG and UR differed significantly between event and event-free groups. Cox proportional hazard model showed that the UR was a predictor of events (p=0.0007). In patients with UR less than 0.58, the relative risk of events was 19.1 times greater than in patients with an UR greater than 0.58. UR was closely correlated to LVDd (r=-0.578, p=0.01) suggesting that myocardial sympathetic activity is related to LV remodeling after MI. MIBG imaging provides important information regarding the prognosis and the pathophysiologic process of asymptomatic MI. (author)

  7. Prognostic value of myocardial sympathetic activity in patients with asymptomatic myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Narita, Michihiro; Kurihara, Tadashi; Sindoh, Takashi; Sawada, Yoshihiro [Sumitomo Hospital, Osaka (Japan)

    1999-04-01

    To clarify the significance of myocardial sympathetic activity in patients with asymptomatic myocardial infarction (MI), we performed {sup 123}I-metaiodobenzyl-guanidine (MIBG) and {sup 201}Tl imaging at rest. We calculated the ratio of cardiac uptake of the isotope to the total injected dose (%Uptake), percent washout of MIBG over 3 hours and the Uptake Ratio (UR, %Uptake of MIBG divided by %Uptake of {sup 201}Tl). We compared these indices with clinical findings, exercise stress-rest myocardial perfusion imaging with {sup 99}Tc-methoxy-2-isobutyl isonitrile, coronary angiography, echocardiography and neurohumoral findings. During the follow-up period of 19.9{+-}10.3 months in 32 patients, events (heart failure or cardiac death) developed in 10 (31%). In univariate analysis, diabetes mellitus, atrial fibrillation, left ventricular end-diastolic dimension (LVDd) greater than 54 mm, and the %Uptake of MIBG and UR differed significantly between event and event-free groups. Cox proportional hazard model showed that the UR was a predictor of events (p=0.0007). In patients with UR less than 0.58, the relative risk of events was 19.1 times greater than in patients with an UR greater than 0.58. UR was closely correlated to LVDd (r=-0.578, p=0.01) suggesting that myocardial sympathetic activity is related to LV remodeling after MI. MIBG imaging provides important information regarding the prognosis and the pathophysiologic process of asymptomatic MI. (author)

  8. Evaluation of myocardial involvement in Duchenne progressive muscular dystrophy with thallium-201 myocardial perfusion imaging

    International Nuclear Information System (INIS)

    Myocardial involvement in progressive muscular dystrophy of the Duchenne type was evaluated in 19 patients using thallium-201 myocardial perfusion imaging. The qualitative analysis was performed in anterior, 3 left anterior oblique and left lateral projection images by three experienced physicians. Distinct perfusion defects were shown in 13 patients, especially in LV posterolateral or posterior walls (11 patients). There was no significant relationship between the presence of perfusion defects and the skeletal muscle changes or thoracic deformities assessed by transmission computed tomography. Slightly increased thallium-201 activity in RV free wall and lungs was shown in nine and one patient, respectively. The extensive perfusion defects were shown in 2 patients who died of congestive heart failure 1 to 2 years after the scintigraphic study. The myocardial scintigraphic changes were considered to be minimal in 7 of 9 patients who underwent two serial scintigraphic studies in 2 to 3 years. It was concluded that the thallium myocardial perfusion imaging was a useful clinical technique to evaluate the cardiomyopathy in Duchenne progressive muscular dystrophy. (author)

  9. Protective effects of betaglucin on myocardial tissue during myocardial infarction in rats and dogs

    Institute of Scientific and Technical Information of China (English)

    Jiao QIAN; Ai-jun LIU; Wei ZHANG; Zhi-peng WEN; Lili LIN; Jing-hang WANG; Ding-feng SU; Jian-guo LIU

    2009-01-01

    Aim: To test the protective effects of betaglucin, a novel beta-glucan, on models of myocardial infarction (MI) in rats and dogs.Methods: The left anterior descending (LAD) coronary artery occlusion model was used to induce an MI in rats and dogs. Three doses of betaglucin (10, 30 and 100 mg/kg), propranolol (positive control, 1 mg/kg) and vehicle alone (5% glucose solution) were adminis-tered before LAD occlusion, and characteristics of the resulting MI were subsequently assessed. In anesthetized dogs, blood pressure,heart rate, ventricular function, coronary artery blood flow and myocardial oxygen consumption were determined before and after the drug administration.Results: The MI mass in both rats and dogs was significantly reduced by betaglucin (30 and 100 mg/kg, P0.05). High-dose betaglucin (100 mg/kg) increased myocar-dial oxygen consumption, but not to a statistically significant level (P>0.05). The hemodynamic indexes were significantly changed by propranolol.Conclusion: Betaglucin has protective effects on myocardial tissue during MI in rats and dogs and has no influence on hemodynamic parameters at a therapeutic dose. The increase in coronary artery blood flow induced by betaglucin might be beneficial in the treat-ment of patients with MI.

  10. A detailed family history of myocardial infarction and risk of myocardial infarction

    DEFF Research Database (Denmark)

    Ranthe, Mattis Flyvholm; Petersen, Jonathan Aavang; Bundgård, Henning;

    2015-01-01

    BACKGROUND: Family history of myocardial infarction (MI) is an independent risk factor for MI. Several genetic variants are associated with increased risk of MI and family history of MI in a first-degree relative doubles MI risk. However, although family history of MI is not a simple dichotomous...

  11. Evaluation of myocardial involvement in Duchenne progressive muscular dystrophy with thallium-201 myocardial perfusion imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kawai, Naoki; Yamamoto, Shuhei; Okada, Mitsuhiro (Nagoya Univ. (Japan). Faculty of Medicine)

    1983-12-01

    Myocardial involvement in progressive muscular dystrophy of the Duchenne type was evaluated in 19 patients using thallium-201 myocardial perfusion imaging. The qualitative analysis was performed in anterior, 3 left anterior oblique and left lateral projection images by three experienced physicians. Distinct perfusion defects were shown in 13 patients, especially in LV posterolateral or posterior walls (11 patients). There was no significant relationship between the presence of perfusion defects and the skeletal muscle changes or thoracic deformities assessed by transmission computed tomography. Slightly increased thallium-201 activity in RV free wall and lungs was shown in nine and one patient, respectively. The extensive perfusion defects were shown in 2 patients who died of congestive heart failure 1 to 2 years after the scintigraphic study. The myocardial scintigraphic changes were considered to be minimal in 7 of 9 patients who underwent two serial scintigraphic studies in 2 to 3 years. It was concluded that the thallium myocardial perfusion imaging was a useful clinical technique to evaluate the cardiomyopathy in Duchenne progressive muscular dystrophy.

  12. 77 FR 4564 - Request for Information Regarding the Reinsurance Program Under the Affordable Care Act

    Science.gov (United States)

    2012-01-30

    ..., 2011 (76 FR 41930). The Affordable Care Act instructs each State to establish or contract with an... hotlines, helpdesk)? 21. Are your support systems compliant or have the capability of being Section...

  13. 77 FR 19750 - Office of Domestic Finance; Small Business, Community Development and Affordable Housing Policy...

    Science.gov (United States)

    2012-04-02

    ... Office of Domestic Finance; Small Business, Community Development and Affordable Housing Policy; Small... of consideration. ADDRESSES: Direct all written comments to Office of Domestic Finance, Small... be directed to the Office of Domestic Finance, Small Business Lending Fund; Daniel Rourke;...

  14. 77 FR 42831 - Office of Domestic Finance; Small Business, Community Development and Affordable Housing Policy...

    Science.gov (United States)

    2012-07-20

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF TREASURY Office of Domestic Finance; Small Business, Community Development and Affordable Housing Policy; Small... INFORMATION CONTACT: Requests for additional information should be directed to the Office of Domestic...

  15. Are Housing Markets Decoupled? A Case Study of Residential Real Estate Affordability in Austria

    Directory of Open Access Journals (Sweden)

    Florian PHILIPP

    2015-09-01

    Full Text Available Real estate arguably forms the most important asset to most households and the basis for their wealth. Around this context a model has been set up testing the relative affordability of real estate for the median household in Austria and the consequences of lower borrowing costs between 2004 and 2013 by vintage year. In this paper the hypothesis that the significant decline in base interest rates is not sufficient to offset the relative affordability loss caused by declining net household incomes and the simultaneous increase of real estate prices. To test this hypothesis a model has been set up comparing two different Housing Affordability Indices – one including and one excluding financing effects, having been compared via a multi factor model. Based on this calculation the author finds decreased base interest rates to offset relative affordability losses by only approximately 50%, verifying the hypothesis. The paper therefore argues for a potential decoupling of the residential housing market in Austria.

  16. What can be done with an egg? Creativity, material objects and the theory of affordances

    DEFF Research Database (Denmark)

    Glaveanu, Vlad Petre

    2012-01-01

    This article offers a reflection on the role of material objects in the creative process and explores the potential links between creativity and the theory of affordances (Gibson, ), conceptualized from a sociocultural perspective. From this standpoint, creativity can be defined as a process...... of perceiving, exploiting, and “generating” novel affordances during socially and materially situated activities. Illustrations are offered for each of the above from a research project investigating traditional Easter egg decoration activities in rural Romania. This brief case study exemplifies the discovery...... of existing action potentials, the generation of objects with novel affordances, and the transgression of conventional procedures, all resulting in creative forms of expression. In the end, some conclusions are drawn regarding the ways in which an affordance theory of creativity can enrich our understanding...

  17. Myocardial wall motion imaging with cardiac magnetic resonance imaging

    NARCIS (Netherlands)

    Lubbers, Dani�l; Kuijpers, D.; Oudkerk, M.

    2006-01-01

    Wall motion imaging with cardiac magnetic resonance imaging (CMR) provides important functional information about global and regional myocardial function. This review will give an overview of the current state of myocardial wall motion imaging, especially focusing on the clinical role of dobutamine

  18. Nonfasting glucose, ischemic heart disease, and myocardial infarction

    DEFF Research Database (Denmark)

    Benn, Marianne; Tybjaerg-Hansen, Anne; McCarthy, Mark I;

    2012-01-01

    The purpose of this study was to test whether elevated nonfasting glucose levels associate with and cause ischemic heart disease (IHD) and myocardial infarction (MI).......The purpose of this study was to test whether elevated nonfasting glucose levels associate with and cause ischemic heart disease (IHD) and myocardial infarction (MI)....

  19. Myocardial Ischemia Assessment in Chronic Kidney Disease: Challenges and Pitfalls

    OpenAIRE

    Susie Fei Cen Parnham; Gleadle, Jonathan M.; De Pasquale, Carmine G; Selvanayagam, Joseph B

    2014-01-01

    Coronary artery disease is the leading cause of mortality and morbidity in the chronic kidney disease population and often presents with atypical symptoms. Current diagnostic investigations of myocardial ischemia in chronic kidney disease lack sensitivity and specificity or may have adverse effects. We present a case vignette and explore the challenges of diagnostic myocardial stress investigation in patients with chronic kidney disease.

  20. Left ventricular assessment in myocardial infarction - The VALIANT registry

    NARCIS (Netherlands)

    Hernandez, AF; Velazquez, EJ; Solomon, SD; Kilaru, R; Diaz, R; O'Connor, CM; Ertl, G; Maggioni, AP; Rouleau, JL; van Gilst, W; Pfeffer, MA; Califf, RM

    2005-01-01

    Background: How often echocardiography and cardiac catheterization are used to evaluate left ventricular (LV) function in patients with myocardial infarction (MI) and how they are associated with quality of care is unknown. Methods: Patients with MI in the Valsartan in Acute Myocardial Infarction (V