Multigated radionuclide study of the total artificial heart

Energy Technology Data Exchange (ETDEWEB)

Datz, F L; Christian, P E; Taylor, A Jr; Hastings, W L; De Vries, W C

1987-07-01

A permanent total artificial heart, the Jarvik-7, was implanted into a 61-year-old male with a severe cardiomyopathy. Gated radionuclide studies were performed in the patient both prior to surgery and following implantation. Preoperative gated radionuclide cardiac studies revealed marked left ventricular enlargement, severe hypokinesis and a left ventricular ejection fraction of 10%. The right ventricle was moderately enlarged with a 27% ejection fraction. Following implantation of the Jarvik-7 artificial heart, gated cardiac studies were performed with a computer gated by a signal from the heart controller. The left ventricular ejection fraction was 69% and the right ventricular ejection fraction was 62%. This compared to a theoretical ejection fraction of 74% for each ventricle based on chamber anatomy. There was excellent ventricular emptying. Phase analysis showed uniform diaphragm motion. The use of gated cardiac studies in humans may prove helpful in evaluating mechanical problems with the artificial heart, such as manlfunction of the diaphragm, before they become clinically apparent.

Combined heart-kidney transplantation after total artificial heart insertion.

Science.gov (United States)

Ruzza, A; Czer, L S C; Ihnken, K A; Sasevich, M; Trento, A; Ramzy, D; Esmailian, F; Moriguchi, J; Kobashigawa, J; Arabia, F

2015-01-01

We present the first single-center report of 2 consecutive cases of combined heart and kidney transplantation after insertion of a total artificial heart (TAH). Both patients had advanced heart failure and developed dialysis-dependent renal failure after implantation of the TAH. The 2 patients underwent successful heart and kidney transplantation, with restoration of normal heart and kidney function. On the basis of this limited experience, we consider TAH a safe and feasible option for bridging carefully selected patients with heart and kidney failure to combined heart and kidney transplantation. Recent FDA approval of the Freedom driver may allow outpatient management at substantial cost savings. The TAH, by virtue of its capability of providing pulsatile flow at 6 to 10 L/min, may be the mechanical circulatory support device most likely to recover patients with marginal renal function and advanced heart failure. Copyright © 2015 Elsevier Inc. All rights reserved.

[Review of wireless energy transmission system for total artificial heart].

Science.gov (United States)

Zhang, Chi; Yang, Ming

2009-11-01

This paper sums up the fundamental structure of wireless energy transmission system for total artificial heart, and compares the key parameters and performance of some representative systems. After that, it is discussed that the future development trend of wireless energy transmission system for total artificial heart.

COMPUTER MODELING IN THE DEVELOPMENT OF ARTIFICIAL VENTRICLES OF HEART

Directory of Open Access Journals (Sweden)

L. V. Belyaev

2011-01-01

Full Text Available In article modern researches of processes of development of artificial ventricles of heart are described. Advanta- ges of application computer (CAD/CAE technologies are shown by development of artificial ventricles of heart. The systems developed with application of the given technologies are submitted. 

Percutaneous dilatational tracheostomy following total artificial heart implantation.

Science.gov (United States)

Spiliopoulos, Sotirios; Dimitriou, Alexandros Merkourios; Serrano, Maria Rosario; Guersoy, Dilek; Autschbach, Ruediger; Goetzenich, Andreas; Koerfer, Reiner; Tenderich, Gero

2015-07-01

Coagulation disorders and an immune-altered state are common among total artificial heart patients. In this context, we sought to evaluate the safety of percutaneous dilatational tracheostomy in cases of prolonged need for mechanical ventilatory support. We retrospectively analysed the charts of 11 total artificial heart patients who received percutaneous dilatational tracheostomy. We focused on early and late complications. We observed no major complications and no procedure-related deaths. Early minor complications included venous oozing (45.4%) and one case of local infection. Late complications, including subglottic stenosis, stomal infection or infections of the lower respiratory tract, were not observed. In conclusion, percutaneous dilatational tracheostomy in total artificial heart patients is safe. Considering the well-known benefits of early tracheotomy over prolonged translaryngeal intubation, we advocate early timing of therapy in cases of prolonged mechanical ventilation. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Nuclear-powered artificial heart system

International Nuclear Information System (INIS)

Pouchot, W.D.; Lehrfeld, D.

1976-01-01

As reported to the 9th IECEC, a bench model version of a nuclear-powered artificial heart system to be used as a replacement for the natural heart was constructed and tested as part of a broader U.S. ERDA program. A report is given of the system design and integration, bench testing, and field support equipment of an implantable and advanced version of the bench model incorporating some of the component developments reported to the 10th IECEC. The basic elements of the system are a 32-watt Pu-238 heat source, a Stirling engine thermal converter, a coupling mechanism, and a mechanical blood pump drive actuating, alternatively, two artificial ventricles of polymeric material. As tested on the bench using a mock circulation, the system provides approximately 9 liters/minute at 120/80 mm Hg aortic pressure. At 190/145 mm Hg aortic pressure, the maximum flow decreases to about 7 liters/minute

Successful heart transplant after 1374 days living with a total artificial heart.

Science.gov (United States)

Gerosa, Gino; Gallo, Michele; Bottio, Tomaso; Tarzia, Vincenzo

2016-04-01

The CardioWest Total Artificial Heart (CW-TAH) has been approved as a temporary device for bridge to cardiac transplantation and is under investigation for destination therapy by US Food and Drug Administration (FDA). We herein report the longest worldwide survival out of hospital (1374 days) of a patient supported with Cardio West Total Artificial Heart (CW-TAH). This experience is intended as a proof of concept of using CW-TAH as the destination therapy in patients with biventricular failure. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Initial in vitro testing of a paediatric continuous-flow total artificial heart.

Science.gov (United States)

Fukamachi, Kiyotaka; Karimov, Jamshid H; Horvath, David J; Sunagawa, Gengo; Byram, Nicole A; Kuban, Barry D; Moazami, Nader

2018-06-01

Mechanical circulatory support has become standard therapy for adult patients with end-stage heart failure; however, in paediatric patients with congenital heart disease, the options for chronic mechanical circulatory support are limited to paracorporeal devices or off-label use of devices intended for implantation in adults. Congenital heart disease and cardiomyopathy often involve both the left and right ventricles; in such cases, heart transplantation, a biventricular assist device or a total artificial heart is needed to adequately sustain both pulmonary and systemic circulations. We aimed to evaluate the in vitro performance of the initial prototype of our paediatric continuous-flow total artificial heart. The paediatric continuous-flow total artificial heart pump was downsized from the adult continuous-flow total artificial heart configuration by a scale factor of 0.70 (1/3 of total volume) to enable implantation in infants. System performance of this prototype was evaluated using the continuous-flow total artificial heart mock loop set to mimic paediatric circulation. We generated maps of pump performance and atrial pressure differences over a wide range of systemic vascular resistance/pulmonary vascular resistance and pump speeds. Performance data indicated left pump flow range of 0.4-4.7 l/min at 100 mmHg delta pressure. The left/right atrial pressure difference was maintained within ±5 mmHg with systemic vascular resistance/pulmonary vascular resistance ratios between 1.4 and 35, with/without pump speed modulation, verifying expected passive self-regulation of atrial pressure balance. The paediatric continuous-flow total artificial heart prototype met design requirements for self-regulation and performance; in vivo pump performance studies are ongoing.

Total artificial heart implantation in a young Marfan syndrome patient.

Science.gov (United States)

Rao, Prashant; Keenan, Jack B; Rajab, Taufiek K; Kim, Samuel; Smith, Richard; Amabile, Orazio; Khalpey, Zain

2018-03-01

Cardiovascular complications represent the leading cause of morbidity and mortality in patients with Marfan syndrome. Here, we describe a unique case where a total artificial heart was implanted in a young Marfan syndrome woman. A 22-year-old postpartum African American female with Marfan syndrome developed multiple severe valve dysfunction and biventricular failure that was refractory to medical management. She previously had a Bentall procedure for Type A aortic dissection and repair of a Type B dissection. We implanted a total artificial heart with a good outcome. Total artificial heart is a durable option for severe biventricular failure and multiple valvular dysfunction as a bridge to transplant in a young patient with Marfan syndrome.

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

Science.gov (United States)

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

2015-01-01

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

Total Artificial Heart Implantation After Undifferentiated High-Grade Sarcoma Excision.

Science.gov (United States)

Kremer, Jamila; Farag, Mina; Arif, Rawa; Brcic, Andreas; Sabashnikov, Anton; Schmack, Bastian; Popov, Aron-Frederik; Karck, Matthias; Dohmen, Pascal M; Ruhparwar, Arjang; Weymann, Alexander

2016-11-02

BACKGROUND Total artificial heart (TAH) implantation in patients with aggressive tumor infiltration of the heart can be challenging. CASE REPORT We report on a patient with a rare primary undifferentiated high-grade spindle cell sarcoma of the mitral valve and in the left atrium, first diagnosed in 2014. The referring center did a first resection in 2014. In the course of 17 months, computer tomography (CT) scan again showed massive invasion of the mitral valve and left atrium. Partial resection and mitral valve replacement was not an option. We did a subtotal heart excision with total artificial heart implantation. In this report we discuss complications, risk factors, and perioperative management of this patient. CONCLUSIONS Patients with aggressive tumors of the heart can be considered for TAH implantation.

Perioperative Care of the Patient With the Total Artificial Heart.

Science.gov (United States)

Yaung, Jill; Arabia, Francisco A; Nurok, Michael

2017-05-01

Advanced heart failure continues to be a leading cause of morbidity and mortality despite improvements in pharmacologic therapy. High demand for cardiac transplantation and shortage of donor organs have led to an increase in the utilization of mechanical circulatory support devices. The total artificial heart is an effective biventricular assist device that may be used as a bridge to transplant and that is being studied for destination therapy. This review discusses the history, indications, and perioperative management of the total artificial heart with emphasis on the postoperative concerns.

Human technology after cardiac epigenesis. Artificial heart versus cardiac transplantation.

Science.gov (United States)

Losman, J G

1977-09-24

Cardiovascular disease is the chief cause of death in technologically advanced countries and accounts for more than 50% of all deaths in the USA. For a patient with end-stage cardiac failure the only treatment presently available is organ replacement, either by transplantation or by the use of a mechanical heart. Transplantation has demonstrated its value: survival of more than 8 years and restoration of a normal quality of life to patients who were in end-stage cardiac decompensation. However, the prospect of routine clinical application of an artificial heart remains distant. The development of a totally implantable artificial heart still presents a series of challenging engineering problems with regard to strict constraints of size, weight, blood-material compatibility, adaptability of output to demand, efficiency and reliability of the power supply, and safety if nuclear fuel is used. The totally artificial heart is presently not an alternative to the cardiac allograft, but could provide short-term support for patients awaiting cardiac transplantation.

Mechanism of artificial heart

CERN Document Server

Yamane, Takashi

2016-01-01

This book first describes medical devices in relation to regenerative medicine before turning to a more specific topic: artificial heart technologies. Not only the pump mechanisms but also the bearing, motor mechanisms, and materials are described, including expert information. Design methods are described to enhance hemocompatibility: main concerns are reduction of blood cell damage and protein break, as well as prevention of blood clotting. Regulatory science from R&D to clinical trials is also discussed to verify the safety and efficacy of the devices.

Summary of the clinical use of the Symbion total artificial heart: a registry report.

Science.gov (United States)

Johnson, K E; Prieto, M; Joyce, L D; Pritzker, M; Emery, R W

1992-01-01

Several models of total artificial hearts have been used for transient or permanent circulatory support in patients with decompensation. The most successful and widely used device, however, has been the Symbion total artificial heart. From Dec. 12, 1982, to Jan. 1, 1991, 180 Symbion total artificial hearts were implanted in 176 patients in 28 centers. Five patients received a Symbion total artificial heart as a permanent circulatory support device, whereas 171 patients received the device as a bridge to heart transplantation. Of the 175 bridge devices (171 patients) 141 were Symbion J7-70 hearts and 34 were Symbion J7-100 hearts. Four patients received two total artificial hearts, the second one after the failure of a transplanted heart because of either rejection (two patients) or donor heart failure (2 patients). Most of the recipients were males (152). The age was 42 +/- 12 years (mean +/- SD) with a weight of 74 +/- 14 kg. The most common indications for implantation included deterioration while awaiting heart transplant (36%) and acute cardiogenic shock (32%). The cause of heart disease was primarily ischemic (52%) and idiopathic (35%) cardiomyopathy. Duration of implantation ranged from 0 to 603 days (mean 25 +/- 64 days). One hundred three (60%) patients had the device less than 2 weeks, 37 (22%) between 2 to 4 weeks and 31 (18%) more than 4 weeks. Complications during implantation included infection (37%), thromboembolic events (stroke 7%, transient ischemic attack 4%), kidney failure requiring dialysis (20%), bleeding requiring intervention (26%), and device malfunction (4%). Of the 171 patients, 118 (69%) underwent orthotopic heart transplantation. Actuarial survival for all patients with implants was 62% for 30 days and 42% for 1 year, and for patients with transplants was 72% for 30 days and 57% for 1 year. The main causes of death were sepsis (33%), multiorgan failure (21%), and posttransplant rejection (10%). The results indicate a relative success of

Moderate hypothermia technique for chronic implantation of a total artificial heart in calves.

Science.gov (United States)

Karimov, Jamshid H; Grady, Patrick; Sinkewich, Martin; Sunagawa, Gengo; Dessoffy, Raymond; Byram, Nicole; Moazami, Nader; Fukamachi, Kiyotaka

2017-06-01

The benefit of whole-body hypothermia in preventing ischemic injury during cardiac surgical operations is well documented. However, application of hypothermia during in vivo total artificial heart implantation has not become widespread because of limited understanding of the proper techniques and restrictions implied by constitutional and physiological characteristics specific to each animal model. Similarly, the literature on hypothermic set-up in total artificial heart implantation has also been limited. Herein we present our experience using hypothermia in bovine models implanted with the Cleveland Clinic continuous-flow total artificial heart.

The Total Artificial Heart in End-Stage Congenital Heart Disease.

Science.gov (United States)

Villa, Chet R; Morales, David L S

2017-01-01

The development of durable ventricular assist devices (VADs) has improved mortality rates and quality of life in patients with end stage heart failure. While the use of VADs has increased dramatically in recent years, there is limited experience with VAD implantation in patients with complex congenital heart disease (CHD), despite the fact that the number of patients with end stage CHD has grown due to improvements in surgical and medical care. VAD use has been limited in patients with CHD and end stage heart failure due to anatomic (systemic right ventricle, single ventricle, surgically altered anatomy, valve dysfunction, etc.) and physiologic constraints (diastolic dysfunction). The total artificial heart (TAH), which has right and left sided pumps that can be arranged in a variety of orientations, can accommodate the anatomic variation present in CHD patients. This review provides an overview of the potential use of the TAH in patients with CHD.

Liver failure in total artificial heart therapy.

Science.gov (United States)

Dimitriou, Alexandros Merkourios; Dapunt, Otto; Knez, Igor; Wasler, Andrae; Oberwalder, Peter; Koerfer, Reiner; Tenderich, Gero; Spiliopoulos, Sotirios

2016-07-01

Congestive hepatopathy (CH) and acute liver failure (ALF) are common among biventricular heart failure patients. We sought to evaluate the impact of total artificial heart (TAH) therapy on hepatic function and associated clinical outcomes. A total of 31 patients received a Syncardia Total Artificial Heart. Preoperatively 17 patients exhibited normal liver function or mild hepatic derangements that were clinically insignificant and did not qualify as acute or chronic liver failure, 5 patients exhibited ALF and 9 various hepatic derangements owing to CH. Liver associated mortality and postoperative course of liver values were prospectively documented and retrospectively analyzed. Liver associated mortality in normal liver function, ALF and CH cases was 0%, 20% (P=0.03) and 44.4% (P=0.0008) respectively. 1/17 (5.8%) patients with a normal liver function developed an ALF, 4/5 (80%) patients with an ALF experienced a markedly improvement of hepatic function and 6/9 (66.6%) patients with CH a significant deterioration. TAH therapy results in recovery of hepatic function in ALF cases. Patients with CH prior to surgery form a high risk group with increased liver associated mortality.

Total Artificial Heart Implantation Blood Pressure Management as Resolving Treatment for Massive Hemolysis following Total Artificial Heart Implantation.

Science.gov (United States)

Ghodsizad, Ali; Koerner, Michael M; El-Banayosy, A; Zeriouh, Mohamed; Ruhparwar, Arjang; Loebe, Matthias

2016-10-21

The SynCardia Total Artificial Heart (TAH) has been used for patients with biventricular failure, who cannot be managed with implantation of a left ventricular (LV) assist device. Following TAH implantation, our patient developed severe hemolysis, which could only be managed successfully by aggressive blood pressure control [Ohashi 2003; Nakata 1998].

Inspection of an artificial heart by the neutron radiography technique

International Nuclear Information System (INIS)

Pugliesi, R.; Geraldo, L.P.; Andrade, M.L.G.; Menezes, M.O.; Pereira, M.A.S.; Maizato, M.J.S.

1999-01-01

The neutron radiography technique was employed to inspect an artificial heart prototype which is being developed to provide blood circulation for patients expecting heart transplant surgery. The radiographs have been obtained by the direct method with a gadolinium converter screen along with the double coated Kodak-AA emulsion film. The artificial heart consists of a flexible plastic membrane located inside a welded metallic cavity, which is employed for blood pumping purposes. The main objective of the present inspection was to identify possible damages in this plastic membrane, produced during the welding process of the metallic cavity. The obtained radiographs were digitized as well as analysed in a PC and the improved images clearly identify several damages in the plastic membrane, suggesting changes in the welding process

Inspection of an artificial heart by the neutron radiography technique

CERN Document Server

Pugliesi, R; Andrade, M L G; Menezes, M O; Pereira, M A S; Maizato, M J S

1999-01-01

The neutron radiography technique was employed to inspect an artificial heart prototype which is being developed to provide blood circulation for patients expecting heart transplant surgery. The radiographs have been obtained by the direct method with a gadolinium converter screen along with the double coated Kodak-AA emulsion film. The artificial heart consists of a flexible plastic membrane located inside a welded metallic cavity, which is employed for blood pumping purposes. The main objective of the present inspection was to identify possible damages in this plastic membrane, produced during the welding process of the metallic cavity. The obtained radiographs were digitized as well as analysed in a PC and the improved images clearly identify several damages in the plastic membrane, suggesting changes in the welding process.

Demikhov's "Mechanical Heart": The Circumstances Surrounding Creation of the World's First Implantable Total Artificial Heart in 1937.

Science.gov (United States)

Glyantsev, Sergey P; Tchantchaleishvili, Vakhtang; Bockeria, Leo A

2016-01-01

The world's first implantable total artificial heart was designed by Vladimir Demikhov as a fourth year biology student in Voronezh, Soviet Union, in 1937. As a prototype of his device, Demikhov must have used an apparatus for extracorporeal blood circulation invented by Sergei Bryukhonenko of Moscow. The device was the size of a dog's native heart and consisted of two diaphragm pumps brought into motion by an electric motor. A dog with an implanted device lived for 2.5 hours. In addition to having the prototype, the preconditions for Demikhov's artificial heart creation were his manual dexterity, expertise in animal physiology, and his mechanistic worldview.

Hybrid Continuous-Flow Total Artificial Heart.

Science.gov (United States)

Fox, Carson; Chopski, Steven; Murad, Nohra; Allaire, Paul; Mentzer, Robert; Rossano, Joseph; Arabia, Francisco; Throckmorton, Amy

2018-05-01

Clinical studies using total artificial hearts (TAHs) have demonstrated that pediatric and adult patients derive quality-of-life benefits from this form of therapy. Two clinically-approved TAHs and other pumps under development, however, have design challenges and limitations, including thromboembolic events, neurologic impairment, infection risk due to large size and percutaneous drivelines, and lack of ambulation, to name a few. To address these limitations, we are developing a hybrid-design, continuous-flow, implantable or extracorporeal, magnetically-levitated TAH for pediatric and adult patients with heart failure. This TAH has only two moving parts: an axial impeller for the pulmonary circulation and a centrifugal impeller for the systemic circulation. This device will utilize the latest generation of magnetic bearing technology. Initial geometries were established using pump design equations, and computational modeling provided insight into pump performance. The designs were the basis for prototype manufacturing and hydraulic testing. The study results demonstrate that the TAH is capable of delivering target blood flow rates of 1-6.5 L/min with pressure rises of 1-92 mm Hg for the pulmonary circulation and 24-150 mm Hg for the systemic circulation at 1500-10 000 rpm. This initial design of the TAH was successful and serves as the foundation to continue its development as a novel, more compact, nonthrombogenic, and effective therapeutic alternative for infants, children, adolescents, and adults with heart failure. © 2018 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Establishing the framework to support bioartificial heart fabrication using fibrin-based three-dimensional artificial heart muscle.

Science.gov (United States)

Hogan, Matthew; Mohamed, Mohamed; Tao, Ze-Wei; Gutierrez, Laura; Birla, Ravi

2015-02-01

Only 3000 heart transplants are performed in the USA every year, leaving some 30 000-70 000 Americans without proper care. Current treatment modalities for heart failure have saved many lives yet still do not correct the underlying problems of congestive heart failure. Tissue engineering represents a potential field of study wherein a combination of cells, scaffolds, and/or bioreactors can be utilized to create constructs to mimic, replace, and/or repair defective tissue. The focus of this study was to generate a bioartificial heart (BAH) model using artificial heart muscle (AHM), composed of fibrin gel and neonatal rat cardiac myocytes, and a decellularized scaffold, formed by subjecting an adult rat heart to a series of decellularization solutions. By suturing the AHM around the outside of the decellularized heart and culturing while suspended in media, we were able to retain functional cardiac cells on the scaffold as evinced by visible contractility. Observed contractility rate was correlated with biopotential measurements to confirm essential functionality of cardiac constructs. Cross-sections of the BAH show successful decellularization of the scaffold and contiguous cell-rich AHM around the perimeter of the heart. Copyright © 2014 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Hemodynamic deterioration during extracorporeal membrane oxygenation weaning in a patient with a total artificial heart.

Science.gov (United States)

Hosseinian, Leila; Levin, Matthew A; Fischer, Gregory W; Anyanwu, Anelechi C; Torregrossa, Gianluca; Evans, Adam S

2015-01-01

The Total Artificial Heart (Syncardia, Tucson, AZ) is approved for use as a bridge-to-transplant or destination therapy in patients who have irreversible end-stage biventricular heart failure. We present a unique case, in which the inferior vena cava compression by a total artificial heart was initially masked for days by the concurrent placement of an extracorporeal membrane oxygenation cannula. This is the case of a 33-year-old man admitted to our institution with recurrent episodes of ventricular tachycardia requiring emergent total artificial heart and venovenous extracorporeal membrane oxygenation placement. This interesting scenario highlights the importance for critical care physicians to have an understanding of exact anatomical localization of a total artificial heart, extracorporeal membrane oxygenation, and their potential interactions. In total artificial heart patients with hemodynamic compromise or reduced device filling, consideration should always be given to venous inflow compression, particularly in those with smaller body surface area. Transesophageal echocardiogram is a readily available diagnostic tool that must be considered standard of care, not only in the operating room but also in the ICU, when dealing with this complex subpopulation of cardiac patients.

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

Science.gov (United States)

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

2018-04-01

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

Anatomy studies for an artificial heart. Final summary report

International Nuclear Information System (INIS)

Kiraly, R.J.; Nose, Y.

1977-12-01

In the interval from February of 1972 through December of 1977, studies were conducted relating to the anatomical feasibility of implanting a total artificial heart system. These studies included both the calf as an experimental animal as well as the ultimate human recipient of the artificial heart system. Studies with the calf included definition of the thoracic anatomy relative to the size, shape, and vascular connections for implanting the blood pump. To test the animal's tolerance to an implanted engine system, mockups of the thermal converter were implanted chronically in various locations within the calf. No problems developed in retroperitoneal or intraperitoneal implants ranging from 8 to 15 months. A study to determine accelerations experienced by an abdominally implanted thermal converter was performed in calves. Under the most severe conditions, accelerations of a maximum of 34 Gs were experienced. The largest effort was devoted to defining the human anatomy relative to implanting an artificial heart in the thorax. From a number of data sources, including cadavers as well as living patients, a quantitative, statistical analysis of the size and shape of the male thorax was obtained. Finally, an in vivo study of a functional intrathoracic compliance bag in a calf demonstrated the feasibility of this method

Artificial muscle for end-stage heart failure.

Science.gov (United States)

Tozzi, Piergiorgio; Michalis, Alexandre; Hayoz, Daniel; Locca, Didier; von Segesser, Ludwig K

2012-01-01

We describe a device made of artificial muscle for the treatment of end-stage heart failure as an alternative to current heart assist devices. The key component is a matrix of nitinol wires and aramidic fibers called Biometal muscle (BM). When heated electrically, it produces a motorless, smooth, and lifelike motion. The BM is connected to a carbon fiber scaffold, tightening the heart and providing simultaneous assistance to the left and right ventricles. A pacemaker-like microprocessor drives the contraction of the BM. We tested the device in a dedicated bench model of diseased heart. It generated a systolic pressure of 75 mm Hg and ejected a maximum of 330 ml/min, with an ejection fraction of 12%. The device required a power supply of 6 V, 250 mA. This could be the beginning of an era in which BMs integrate or replace the mechanical function of natural muscles.

[History, present and future of biomaterials used for artificial heart valves].

Science.gov (United States)

Kostrzewa, Benita; Rybak, Zbigniew

2013-01-01

Artificial heart valves can be classified into mechanical and biological. We have three types of mechanical heart valves: caged ball, tilting disc and bileaflet. Mechanical heart valves are made from various materials. They may be produced from metals, ceramics and polymers, e.g.: stainless steel, titanium, silicone, pyrolytic carbon. Biological valves are made from synthetic components (e.g.: PTFE, Dacron) and materials of biological origin (e.g.: cow pericardium, pig heart valve). We have also identified transcatheter aortic valve implantation (TAVI). TAVI may be produced from metals, ceramics and polymers (e.g.: stainless steel, titanium, Dacron) and biological material (e.g.: pig heart valve). This paper describes advantages and disadvantages of different types of artificial heart valves. The lifespan of mechanical valves is 20-30 years and they can be used for patients of any age. Mechanical valves have also disadvantages--anticoagulants are required to prevent thrombosis. Biological valves are made from natural materials, so they do not require prolonged anticoagulation. Their lifetime is 10-15 years, so they are offered to patients over 40 years. Another problem is the occurrence of calcification.

Domestic and foreign trends in the prevalence of heart failure and the necessity of next-generation artificial hearts: a survey by the Working Group on Establishment of Assessment Guidelines for Next-Generation Artificial Heart Systems.

Science.gov (United States)

Tatsumi, Eisuke; Nakatani, Takeshi; Imachi, Kou; Umezu, Mitsuo; Kyo, Shun-Ei; Sase, Kazuhiro; Takatani, Setsuo; Matsuda, Hikaru

2007-01-01

A series of guidelines for development and assessment of next-generation medical devices has been drafted under an interagency collaborative project by the Ministry of Health, Labor and Welfare and the Ministry of Economy, Trade and Industry. The working group for assessment guidelines of next-generation artificial hearts reviewed the trend in the prevalence of heart failure and examined the potential usefulness of such devices in Japan and in other countries as a fundamental part of the process of establishing appropriate guidelines. At present, more than 23 million people suffer from heart failure in developed countries, including Japan. Although Japan currently has the lowest mortality from heart failure among those countries, the number of patients is gradually increasing as our lifestyle becomes more Westernized; the associated medical expenses are rapidly growing. The number of heart transplantations, however, is limited due to the overwhelming shortage of donor hearts, not only in Japan but worldwide. Meanwhile, clinical studies and surveys have revealed that the major causes of death in patients undergoing long-term use of ventricular assist devices (VADs) were infection, thrombosis, and mechanical failure, all of which are typical of VADs. It is therefore of urgent and universal necessity to develop next-generation artificial hearts that have excellent durability to provide at least 2 years of event-free operation with a superior quality of life and that can be used for destination therapy to save patients with irreversible heart failure. It is also very important to ensure that an environment that facilitates the development, testing, and approval evaluation processes of next-generation artificial hearts be established as soon as possible.

Artificial heart thermal converter component research and development

International Nuclear Information System (INIS)

Goldowsky, M.; Lehrfeld, D.

1977-01-01

Under U.S. ERDA contract, a radioisotope powered artificial heart system to be used as a replacement for the diseased natural heart is under development by the Westinghouse Advanced Energy Systems Division and Philips Laboratories. A portion of the program activity is in research and development of components for the Stirling cycle thermal converter. Developments in current areas of thermal converter R and D investigation are discussed, including the control system, lubrication system, magnetic shaft coupling, rotary seals, and materials joining

ERDA artificial heart program workshop. Final report, September 1, 1975--August 31, 1976

International Nuclear Information System (INIS)

Kantrowitz, A.; Altieri, F.; Beall, A.

1976-08-01

The major conclusions of the ERDA Artificial Heart Program Workshop are that the concept of a biologically compatible mechanical device which can totally replace the heart is sound, that such a device is needed as an alternative to cardiac transplantation and that its development is a realistic goal. The major recommendation of the committee is that an ERDA program with primary orientation toward development of a total heart replacement should continue, with assured funding about 50 percent higher than at present, for a minimum of 3 additional years at which time another major review should take place. To achieve better management of the program it is recommended that the present contract effort be reorganized under one prime contractor with responsibility for development and demonstration of the ERDA artificial heart system. The formation of a joint artificial heart advisory committee to improve coordination between ERDA and NHLI is also recommended. The committee suggests future policies and directions which it believes will lead to more effective use of funds available for specific aspects of the program. These include the nuclear heart source, engine, blood pump, biomaterials and overall system reliability. Possible future goals for the program are also proposed

Machines versus medication for biventricular heart failure: focus on the total artificial heart.

Science.gov (United States)

Arabia, Francisco A; Moriguchi, Jaime D

2014-09-01

The medical/surgical management of advanced heart failure has evolved rapidly over the last few decades. With better understanding of heart failure pathophysiology, new pharmacological agents have been introduced that have resulted in improvements in survival. For those patients that fail to improve, mechanical circulatory support with left ventricular assist devices and total artificial hearts (TAHs) have served as a beneficial bridge to transplantation. The TAH has continued to play a significant role as a bridge to transplantation in patients with biventricular failure and more selected indications that could not be completely helped with left ventricular assist devices. Improved survival with the TAH has resulted in more patients benefiting from this technology. Improvements will eventually lead to a totally implantable device that will permanently replace the failing human heart.

Total artificial heart implantation for biventricular failure due to eosinophilic myocarditis.

Science.gov (United States)

Kawabori, Masashi; Kurihara, Chitaru; Miller, Yair; Heck, Kent A; Bogaev, Roberta C; Civitello, Andrew B; Cohn, William E; Frazier, O H; Morgan, Jeffrey A

2017-09-01

Idiopathic hypereosinophilic syndrome is a condition of unknown etiology characterized by proliferation of eosinophils and their infiltration into tissues. Although cardiac involvement is rare, eosinophilic myocarditis can lead to life-threating fulminant congestive heart failure. Treatment of patients with eosinophilic myocarditis is challenging as heart failure can be caused by biventricular dysfunction. To our knowledge, this is the first case reported in the literature describing a patient with acute severe biventricular heart failure caused by eosinophilic myocarditis with mural left ventricular apical thrombus who was successfully treated with implantation of a total artificial heart as a bridge to heart transplant.

Renal Function Recovery with Total Artificial Heart Support.

Science.gov (United States)

Quader, Mohammed A; Goodreau, Adam M; Shah, Keyur B; Katlaps, Gundars; Cooke, Richard; Smallfield, Melissa C; Tchoukina, Inna F; Wolfe, Luke G; Kasirajan, Vigneshwar

2016-01-01

Heart failure patients requiring total artificial heart (TAH) support often have concomitant renal insufficiency (RI). We sought to quantify renal function recovery in patients supported with TAH at our institution. Renal function data at 30, 90, and 180 days after TAH implantation were analyzed for patients with RI, defined as hemodialysis supported or an estimated glomerular filtration rate (eGFR) less than 60 ml/min/1.73 m. Between January 2008 and December 2013, 20 of the 46 (43.5%) TAH recipients (age 51 ± 9 years, 85% men) had RI, mean preoperative eGFR of 48 ± 7 ml/min/1.73 m. Renal function recovery was noted at each follow-up interval: increment in eGFR (ml/min/1.73 m) at 30, 90, and 180 days was 21 ± 35 (p = 0.1), 16.5 ± 18 (p = 0.05), and 10 ± 9 (p = 0.1), respectively. Six patients (30%) required preoperative dialysis. Of these, four recovered renal function, one remained on dialysis, and one died. Six patients (30%) required new-onset dialysis. Of these, three recovered renal function and three died. Overall, 75% (15 of 20) of patients' renal function improved with TAH support. Total artificial heart support improved renal function in 75% of patients with pre-existing significant RI, including those who required preoperative dialysis.

Reliability studies for the nuclear-powered artificial heart program

International Nuclear Information System (INIS)

Horita, M.; Zeigler, R.K.

1976-04-01

By assuming that the failures of an artificial heart system with a mean life of 10 y can be modeled by a particular probability distribution, both the probability of a failure in the system within t years and the reliability required of each subsystem and component were investigated

Novel technique for airless connection of artificial heart to vascular conduits.

Science.gov (United States)

Karimov, Jamshid H; Gao, Shengqiang; Dessoffy, Raymond; Sunagawa, Gengo; Sinkewich, Martin; Grady, Patrick; Sale, Shiva; Moazami, Nader; Fukamachi, Kiyotaka

2017-12-01

Successful implantation of a total artificial heart relies on multiple standardized procedures, primarily the resection of the native heart, and exacting preparation of the atrial and vascular conduits for pump implant and activation. Achieving secure pump connections to inflow/outflow conduits is critical to a successful outcome. During the connection process, however, air may be introduced into the circulation, traveling to the brain and multiple organs. Such air emboli block blood flow to these areas and are detrimental to long-term survival. A correctly managed pump-to-conduit connection prevents air from collecting in the pump and conduits. To further optimize pump-connection techniques, we have developed a novel connecting sleeve that enables airless connection of the Cleveland Clinic continuous-flow total artificial heart (CFTAH) to the conduits. In this brief report, we describe the connecting sleeve design and our initial results from two acute in vivo implantations using a scaled-down version of the CFTAH.

A Physical Heart Failure Simulation System Utilizing the Total Artificial Heart and Modified Donovan Mock Circulation.

Science.gov (United States)

Crosby, Jessica R; DeCook, Katrina J; Tran, Phat L; Betterton, Edward; Smith, Richard G; Larson, Douglas F; Khalpey, Zain I; Burkhoff, Daniel; Slepian, Marvin J

2017-07-01

With the growth and diversity of mechanical circulatory support (MCS) systems entering clinical use, a need exists for a robust mock circulation system capable of reliably emulating and reproducing physiologic as well as pathophysiologic states for use in MCS training and inter-device comparison. We report on the development of such a platform utilizing the SynCardia Total Artificial Heart and a modified Donovan Mock Circulation System, capable of being driven at normal and reduced output. With this platform, clinically relevant heart failure hemodynamics could be reliably reproduced as evidenced by elevated left atrial pressure (+112%), reduced aortic flow (-12.6%), blunted Starling-like behavior, and increased afterload sensitivity when compared with normal function. Similarly, pressure-volume relationships demonstrated enhanced sensitivity to afterload and decreased Starling-like behavior in the heart failure model. Lastly, the platform was configured to allow the easy addition of a left ventricular assist device (HeartMate II at 9600 RPM), which upon insertion resulted in improvement of hemodynamics. The present configuration has the potential to serve as a viable system for training and research, aimed at fostering safe and effective MCS device use. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Functionality of albumin-derived perfluorocarbon-based artificial oxygen carriers in the Langendorff-heart †.

Science.gov (United States)

Wrobeln, Anna; Schlüter, Klaus D; Linders, Jürgen; Zähres, Manfred; Mayer, Christian; Kirsch, Michael; Ferenz, Katja B

2017-06-01

The aim of this study was to prove whether albumin-derived perfluorocarbon-based nanoparticles (capsules) can operate as a novel artificial oxygen carrier in a rat Langendorff-heart perfusion model. Hearts perfused with capsules showed increased left ventricular pressure and rate pressure product compared to hearts perfused with pure Krebs-Henseleit (KH)-buffer. The capsules prevented the myocardium from functional fail when in their absence a noxious ischemia was observed. Capsules did not change rheological properties of KH-buffer and could repeatedly reload with oxygen. This albumin-derived perfluorocarbon-based artificial oxygen carrier preserved the function of rat hearts due to the transport of oxygen in a satisfactory manner. Because of these positive results, the functionality of the applied capsules should be verified in living animals.

Physical principles of artificial stimulation of the heart : Stimulation of the canine heart in situ

NARCIS (Netherlands)

Schneider, H.

1. 1. In artificial heart stimulation, the essential quantity is the density of current, , in the intramyocardial wall. Dosage of the pulse amplitude in volts can have serious consequences for the patient. Curve indications in volts on pacemakers and in publications and records must, therefore, be

An original valveless artificial heart providing pulsatile flow tested in mock circulatory loops.

Science.gov (United States)

Tozzi, Piergiorgio; Maertens, Audrey; Emery, Jonathan; Joseph, Samuel; Kirsch, Matthias; Avellan, François

2017-11-24

We present the test bench results of a valveless total artificial heart that is potentially compatible with the pediatric population. The RollingHeart is a valveless volumetric pump generating pulsatile flow. It consists of a single spherical cavity divided into 4 chambers by 2 rotating disks. The combined rotations of both disks produce changes in the volumes of the 4 cavities (suction and ejection). The blood enters/exits the spherical cavity through 4 openings that are symmetrical to the fixed rotation axis of the first disk.Mock circulatory system: The device pumps a 37% glycerin solution through 2 parallel circuits, simulating the pulmonary and systemic circulations. Flow rates are acquired with a magnetic inductive flowmeter, while pressure sensors collect pressure in the left and right outflow and inflow tracts.In vitro test protocol: The pump is run at speeds ranging from 20 to 180 ejections per minute. The waveform of the pressure generated at the inflow and outflow of the 4 chambers and the flow rate in the systemic circulation are measured. At an ejection rate of 178 min-1, the RollingHeart pumps 5.3 L/min for a systemic maximal pressure gradient of 174 mmHg and a pulmonary maximal pressure gradient of 75 mmHg. The power input was 14 W, corresponding to an efficiency of 21%. The RollingHeart represents a new approach in the domain of total artificial heart. This preliminary study endorses the feasibility of a single valveless device acting as a total artificial heart.

Pulmonary Hypertension After Heart Transplantation in Patients Bridged with the Total Artificial Heart.

Science.gov (United States)

Shah, Rachit; Patel, Dhavalkumar B; Mankad, Anit K; Rennyson, Stephen L; Tang, Daniel G; Quader, Mohammed A; Smallfield, Melissa C; Kasirajan, Vigneshwar; Shah, Keyur B

2016-01-01

Pulmonary hypertension (PH) among heart transplant recipients is associated with an increased risk of mortality. Pulmonary hemodynamics improves after left ventricular assist device (LVAD) implantation; however, the impact of PH before total artificial heart (TAH) implantation on posttransplant hemodynamics and survival is unknown. This is a single center retrospective study aimed to evaluate the impact of TAH implantation on posttransplant hemodynamics and mortality in two groups stratified according to severity of PH: high (≥3 Woods units [WU]) and low (heart catheterization performed at baseline (before TAH) and posttransplant at 1 and 12 months. Patients in the high PVR group (n = 12) experienced improvement in PVR (baseline = 4.31 ± 0.7; 1-month = 1.69 ± 0.7, p heart transplantation (HT), but remained elevated. There was no significant difference in survival between the two groups at 12 months follow-up. Patients with high PVR who are bridged to transplant with TAH had improvement in PVR at 12 months after transplant, and the degree of PVR did not impact posttransplant survival.

Total Artificial Heart Implantation after Excision of Right Ventricular Angiosarcoma.

Science.gov (United States)

Bruckner, Brian A; Abu Saleh, Walid K; Al Jabbari, Odeaa; Copeland, Jack G; Estep, Jerry D; Loebe, Matthias; Reardon, Michael J

2016-06-01

Primary cardiac sarcomas, although rare, are aggressive and lethal, requiring thorough surgical resection and adjuvant chemotherapy for the best possible outcome. We report the case of a 32-year-old woman who underwent total artificial heart implantation for right-sided heart failure caused by right ventricular angiosarcoma. For the first several weeks in intensive care, the patient recovered uneventfully. However, a postoperative liver biopsy indicated hepatocellular injury consistent with preoperative chemotherapy. She developed continuing liver failure, from which she died despite good cardiac function.

On the feasibility of detecting flaws in artificial heart valves

NARCIS (Netherlands)

Lepelaars, E.S.A.M.; Ooijen, van W.D.R.; Tijhuis, A.G.

2000-01-01

Investigates the feasibility of detecting defects in certain artificial heart valves by determining the electromagnetic behavior of some simple models with the aid of thin-wire integral equations. The idea is to use the stationary current that occurs at late times after the excitation of a closed

Past and Present of Total Artificial Heart Therapy: A Success Story

Science.gov (United States)

Samak, Mostafa; Fatullayev, Javid; Sabashnikov, Anton; Zeriouh, Mohamed; Rahmanian, Parwis B.; Choi, Yeong-Hoon; Wippermann, Jens; Wahlers, Thorsten; Schmack, Bastian; Ruhparwar, Arjang; Dohmen, Pascal M.; Karck, Matthias; Popov, Aron-Frederik; Simon, André R.; Weymann, Alexander

2015-01-01

The totally artificial heart (TAH) is among the most prominent medical innovations of the 21st century, especially due to the increasing population with end-stage heart failure. The progressive course of the disease, its resistance to conventional therapy, and the scarcity of hearts available for transplantation were the prime impetus for developing a TAH, especially when other options of mechanical circulatory assist devices are exhausted. In this review, we narrate the history of TAH, give an overview of its technology, and address the pros and cons of the currently available TAH models in light of published clinical experience. PMID:26343363

Past and Present of Total Artificial Heart Therapy: A Success Story.

Science.gov (United States)

Samak, Mostafa; Fatullayev, Javid; Sabashnikov, Anton; Zeriouh, Mohamed; Rahmanian, Parwis B; Choi, Yeong-Hoon; Wippermann, Jens; Wahlers, Thorsten; Schmack, Bastian; Ruhparwar, Arjang; Dohmen, Pascal M; Karck, Matthias; Popov, Aron-Frederik; Simon, André R; Weymann, Alexander

2015-09-07

The totally artificial heart (TAH) is among the most prominent medical innovations of the 21st century, especially due to the increasing population with end-stage heart failure. The progressive course of the disease, its resistance to conventional therapy, and the scarcity of hearts available for transplantation were the prime impetus for developing a TAH, especially when other options of mechanical circulatory assist devices are exhausted. In this review, we narrate the history of TAH, give an overview of its technology, and address the pros and cons of the currently available TAH models in light of published clinical experience.

A Soft Total Artificial Heart-First Concept Evaluation on a Hybrid Mock Circulation.

Science.gov (United States)

Cohrs, Nicholas H; Petrou, Anastasios; Loepfe, Michael; Yliruka, Maria; Schumacher, Christoph M; Kohll, A Xavier; Starck, Christoph T; Schmid Daners, Marianne; Meboldt, Mirko; Falk, Volkmar; Stark, Wendelin J

2017-10-01

The technology of 3D-printing has allowed the production of entirely soft pumps with complex chamber geometries. We used this technique to develop a completely soft pneumatically driven total artificial heart from silicone elastomers and evaluated its performance on a hybrid mock circulation. The goal of this study is to present an innovative concept of a soft total artificial heart (sTAH). Using the form of a human heart, we designed a sTAH, which consists of only two ventricles and produced it using a 3D-printing, lost-wax casting technique. The diastolic properties of the sTAH were defined and the performance of the sTAH was evaluated on a hybrid mock circulation under various physiological conditions. The sTAH achieved a blood flow of 2.2 L/min against a systemic vascular resistance of 1.11 mm Hg s/mL (afterload), when operated at 80 bpm. At the same time, the mean pulmonary venous pressure (preload) was fixed at 10 mm Hg. Furthermore, an aortic pulse pressure of 35 mm Hg was measured, with a mean aortic pressure of 48 mm Hg. The sTAH generated physiologically shaped signals of blood flow and pressures by mimicking the movement of a real heart. The preliminary results of this study show a promising potential of the soft pumps in heart replacements. Further work, focused on increasing blood flow and in turn aortic pressure is required. © 2017 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Total Artificial Heart Implantation as a Bridge to Heart Transplantation in an Active Duty Service Member With Amyloid Cardiomyopathy.

Science.gov (United States)

Scully, Michael S; Wessman, Dylan E; McKee, James M; Francisco, Gregory M; Nayak, Keshav R; Kobashigawa, Jon A

2017-03-01

Cardiac involvement by light-chain (AL) amyloid occurs in up to 50% of patients with primary AL amyloidosis. The prognosis of amyloid heart disease is poor with 1-year survival rates of 35 to 40%. Historically, heart transplantation was considered controversial for patients with AL amyloid cardiomyopathy (CM) given the systemic nature of the disease and poor survival. We present a case report of an active duty service member diagnosed with advanced cardiac amyloid who underwent total artificial heart transplant as a bridge to heart transplant and eventual autologous stem cell transplant. A 47-year-old active duty male initially evaluated for atypical chest pain was found to have severe concentric left ventricular hypertrophy on echocardiogram but normal voltage on electrocardiogram. Cardiac magnetic resonance imaging, laboratory studies, and bone marrow biopsy established the diagnosis of cardiac amyloidosis. At the time of diagnosis, the patient's prognosis was very poor with a median survival of 5 months on the basis of the Mayo Clinic revised prognostic staging system for amyloidosis. The patient developed rapidly progressive left ventricular dysfunction and heart failure leading to cardiac arrest. The patient received a total artificial heart as a bridge to orthotopic heart and kidney transplantation and eventual stem cell transplant. He continues to be in remission and has a fair functional capacity without restriction in activities of daily living or moderate exercise. Amyloid CM is a rare and devastating disease. The natural course of the disease has made heart transplant in these patients controversial. Modern advancements in chemotherapies and advanced heart failure treatments have improved outcomes for select patients with AL amyloid CM undergoing heart transplantation. There is ongoing research seeking improvement in treatment options and outcomes for patients with this deadly disease. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

First North American 50 cc Total Artificial Heart Experience: Conversion from a 70 cc Total Artificial Heart.

Science.gov (United States)

Khalpey, Zain; Kazui, Toshinobu; Ferng, Alice S; Connell, Alana; Tran, Phat L; Meyer, Mark; Rawashdeh, Badi; Smith, Richard G; Sweitzer, Nancy K; Friedman, Mark; Lick, Scott; Slepian, Marvin J; Copeland, Jack G

2016-01-01

The 70 cc total artificial heart (TAH) has been utilized as bridge to transplant (BTT) for biventricular failure. However, the utilization of 70 cc TAH has been limited to large patients for the low output from the pulmonary as well as systemic vein compression after chest closure. Therefore, the 50 cc TAH was developed by SynCardia (Tucson, AZ) to accommodate smaller chest cavity. We report the first TAH exchange from a 70 to 50 cc due to a fit difficulty. The patient failed to be closed with a 70 cc TAH, although the patient met the conventional 70 cc TAH fit criteria. We successfully closed the chest with a 50 cc TAH.

Anatomy of the bovine ascending aorta and brachiocephalic artery found unfavorable for total artificial heart implant.

Science.gov (United States)

Karimov, Jamshid H; Sunagawa, Gengo; Such, Kimberly A; Sale, Shiva; Golding, Leonard A R; Moazami, Nader; Fukamachi, Kiyotaka

2015-12-01

The biocompatibility assessment of the Cleveland Clinic continuous-flow total artificial heart is an important part of the device developmental program. Surgical and postoperative management are key factors in achieving optimal outcomes. However, the presence of vascular anatomical abnormalities in experimental animal models is often unpredictable and may worsen the expected outcomes. We report a technical impediment encountered during total artificial heart implantation complicated by unfavorable bovine anatomy of the ascending aorta and brachiocephalic arterial trunk.

Total Artificial Heart as Bridge to Heart Transplantation in Chagas Cardiomyopathy: Case Report.

Science.gov (United States)

Ruzza, A; Czer, L S C; De Robertis, M; Luthringer, D; Moriguchi, J; Kobashigawa, J; Trento, A; Arabia, F

2016-01-01

Chagas disease (CD) is becoming an increasingly recognized cause of dilated cardiomyopathy outside of Latin America, where it is endemic, due to population shifts and migration. Heart transplantation (HTx) is a therapeutic option for end-stage cardiomyopathy due to CD, but may be considered a relative contraindication due to potential reactivation of the causative organism with immunosuppression therapy. The total artificial heart (TAH) can provide mechanical circulatory support in decompensated patients with severe biventricular dysfunction until the time of HTx, while avoiding immunosuppressive therapy and removing the organ most affected by the causative organism. We report herein a patient with CD and severe biventricular dysfunction, who had mechanical circulatory support with a TAH for more than 6 months, followed by successful orthotopic HTx and treatment with benznidazole for 3 months. The patient had no evidence of recurrent disease in the transplanted heart based on endomyocardial biopsy up to 1 year post-transplantation, and remains alive more than 30 months after insertion of a TAH and 24 months after HTx. Copyright © 2016 Elsevier Inc. All rights reserved.

Automatic Emboli Detection System for the Artificial Heart

Science.gov (United States)

Steifer, T.; Lewandowski, M.; Karwat, P.; Gawlikowski, M.

In spite of the progress in material engineering and ventricular assist devices construction, thromboembolism remains the most crucial problem in mechanical heart supporting systems. Therefore, the ability to monitor the patient's blood for clot formation should be considered an important factor in development of heart supporting systems. The well-known methods for automatic embolus detection are based on the monitoring of the ultrasound Doppler signal. A working system utilizing ultrasound Doppler is being developed for the purpose of flow estimation and emboli detection in the clinical artificial heart ReligaHeart EXT. Thesystem will be based on the existing dual channel multi-gate Doppler device with RF digital processing. A specially developed clamp-on cannula probe, equipped with 2 - 4 MHz piezoceramic transducers, enables easy system setup. We present the issuesrelated to the development of automatic emboli detection via Doppler measurements. We consider several algorithms for the flow estimation and emboli detection. We discuss their efficiency and confront them with the requirements of our experimental setup. Theoretical considerations are then met with preliminary experimental findings from a) flow studies with blood mimicking fluid and b) in-vitro flow studies with animal blood. Finally, we discuss some more methodological issues - we consider several possible approaches to the problem of verification of the accuracy of the detection system.

Chest radiographic findings and complications of the temporary implantation of the Jarvik-7 artificial heart while patients await orthotopic heart transplantation

International Nuclear Information System (INIS)

Sadler, L.; Fuhrman, C.; Hardesty, R.; Griffith, B.

1987-01-01

At the University of Pittsburgh, the authors have had 15 patients in whom Jarvik-7 hearts were implanted as a temporary measure while the patients awaited suitable donors for cardiac transplantation. The paper presents a brief description of the Jarvik-7 artificial heart, factors affecting patient selection, and the radiographic appearance of a normally functioning Jarvik-7 heart, and reviews the chest radiographic complications seen in this patient group, along with eventual patient outcome

Dose-to-the-population exposure estimates for use of plutonium-238-powered artificial hearts

Energy Technology Data Exchange (ETDEWEB)

McKee, R.W.; Clark, L.L.; Cole, B.M.

1976-09-01

Estimates of dose to the population from /sup 238/Pu-powered artificial hearts were developed using a calculational model called REPRIEVE. This model develops the projected user population by incorporating assumptions regarding future heart disease death rates, the fraction dying who would be eligible candidates for artificial hearts, population projections, beginning implant rates, death rates after implant due to natural causes, and deaths caused by device failure. The user population was characterized by age, sex, household description, employment status and occupation. Census data on household descriptions and special surveys in selected cities provided the information necessary to describe persons exposed during both household and public activities. These surveys further defined distance and time of contact factors for these persons. Calculations using a dosemetry computer code defined the relationships between distance and dose. The validity of these calculations has been substantiated by experimental measurements.

Dose-to-the-population exposure estimates for use of plutonium-238-powered artificial hearts

International Nuclear Information System (INIS)

McKee, R.W.; Clark, L.L.; Cole, B.M.

1976-09-01

Estimates of dose to the population from 238 Pu-powered artificial hearts were developed using a calculational model called REPRIEVE. This model develops the projected user population by incorporating assumptions regarding future heart disease death rates, the fraction dying who would be eligible candidates for artificial hearts, population projections, beginning implant rates, death rates after implant due to natural causes, and deaths caused by device failure. The user population was characterized by age, sex, household description, employment status and occupation. Census data on household descriptions and special surveys in selected cities provided the information necessary to describe persons exposed during both household and public activities. These surveys further defined distance and time of contact factors for these persons. Calculations using a dosemetry computer code defined the relationships between distance and dose. The validity of these calculations has been substantiated by experimental measurements

The OregonHeart Total Artificial Heart: Design and Performance on a Mock Circulatory Loop.

Science.gov (United States)

Glynn, Jeremy; Song, Howard; Hull, Bryan; Withers, Stanley; Gelow, Jill; Mudd, James; Starr, Albert; Wampler, Richard

2017-10-01

Widespread use of heart transplantation is limited by the scarcity of donor organs. Total artificial heart (TAH) development has been pursued to address this shortage, especially to treat patients who require biventricular support. We have developed a novel TAH that utilizes a continuously spinning rotor that shuttles between two positions to provide pulsatile, alternating blood flow to the systemic and pulmonary circulations without artificial valves. Flow rates and pressures generated by the TAH are controlled by adjusting rotor speed, cycle frequency, and the proportion of each cycle spent pumping to either circulation. To validate the design, a TAH prototype was placed in a mock circulatory loop that simulates vascular resistance, pressure, and compliance in normal and pathophysiologic conditions. At a systemic blood pressure of 120/80 mm Hg, nominal TAH output was 7.4 L/min with instantaneous flows reaching 17 L/min. Pulmonary artery, and left and right atrial pressures were all maintained within normal ranges. To simulate implant into a patient with severe pulmonary hypertension, the pulmonary vascular resistance of the mock loop was increased to 7.5 Wood units. By increasing pump speed to the pulmonary circulation, cardiac output could be maintained at 7.4 L/min as mean pulmonary artery pressure increased to 56 mm Hg while systemic blood pressures remained normal. This in vitro testing of a novel, shuttling TAH demonstrated that cardiac output could be maintained across a range of pathophysiologic conditions including pulmonary hypertension. These experiments serve as a proof-of-concept for the design, which has proceeded to in vivo testing. © 2017 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Simulation of a pulsatile total artificial heart: Development of a partitioned Fluid Structure Interaction model

Science.gov (United States)

Sonntag, Simon J.; Kaufmann, Tim A. S.; Büsen, Martin R.; Laumen, Marco; Linde, Torsten; Schmitz-Rode, Thomas; Steinseifer, Ulrich

2013-04-01

Heart disease is one of the leading causes of death in the world. Due to a shortage in donor organs artificial hearts can be a bridge to transplantation or even serve as a destination therapy for patients with terminal heart insufficiency. A pusher plate driven pulsatile membrane pump, the Total Artificial Heart (TAH) ReinHeart, is currently under development at the Institute of Applied Medical Engineering of RWTH Aachen University.This paper presents the methodology of a fully coupled three-dimensional time-dependent Fluid Structure Interaction (FSI) simulation of the TAH using a commercial partitioned block-Gauss-Seidel coupling package. Partitioned coupling of the incompressible fluid with the slender flexible membrane as well as a high fluid/structure density ratio of about unity led inherently to a deterioration of the stability (‘artificial added mass instability’). The objective was to conduct a stable simulation with high accuracy of the pumping process. In order to achieve stability, a combined resistance and pressure outlet boundary condition as well as the interface artificial compressibility method was applied. An analysis of the contact algorithm and turbulence condition is presented. Independence tests are performed for the structural and the fluid mesh, the time step size and the number of pulse cycles. Because of the large deformation of the fluid domain, a variable mesh stiffness depending on certain mesh properties was specified for the fluid elements. Adaptive remeshing was avoided. Different approaches for the mesh stiffness function are compared with respect to convergence, preservation of mesh topology and mesh quality. The resulting mesh aspect ratios, mesh expansion factors and mesh orthogonalities are evaluated in detail. The membrane motion and flow distribution of the coupled simulations are compared with a top-view recording and stereo Particle Image Velocimetry (PIV) measurements, respectively, of the actual pump.

Artificial heart for humanoid robot using coiled SMA actuators

Science.gov (United States)

Potnuru, Akshay; Tadesse, Yonas

2015-03-01

Previously, we have presented the design and characterization of artificial heart using cylindrical shape memory alloy (SMA) actuators for humanoids [1]. The robotic heart was primarily designed to pump a blood-like fluid to parts of the robot such as the face to simulate blushing or anger by the use of elastomeric substrates for the transport of fluids. It can also be used for other applications. In this paper, we present an improved design by using high strain coiled SMAs and a novel pumping mechanism that uses sequential actuation to create peristalsis-like motions, and hence pump the fluid. Various placements of actuators will be investigated with respect to the silicone elastomeric body. This new approach provides a better performance in terms of the fluid volume pumped.

Radiological symptoms of the disfunction of artificial heart valves

Energy Technology Data Exchange (ETDEWEB)

Erdelyi, M Jr [Orszagos Roentgen es Sugarfizikai Intezet, Budapest (Hungary)

1981-01-31

The possible causes of the disfunction of artificial valves are detailed. Routine X-ray examinations of the chest only rarely reveal direct signs of disfunction, but the haemodynamic alterations (dilated heart chambers, or veins) must be considered as important indirect signs. The characteristics and possibly the cause of the valve insufficience can be analyzed on the basis of kino- and spot radiograms. The symptoms observed by these methods are reported in detail.

[Percutaneous catheter-based implantation of artificial pulmonary valves in patients with congenital heart defects].

Science.gov (United States)

Wyller, Vegard Bruun; Aaberge, Lars; Thaulow, Erik; Døhlen, Gaute

2011-07-01

Percutaneous catheter-based implantation of artificial heart valves is a new technique that may supplement surgery and which may be used more in the future. We here report our first experience with implantation of artificial pulmonary valves in children with congenital heart defects. Eligible patients were those with symptoms of heart failure combined with stenosis and/or insufficiency in an established artificial right ventricular outflow tract. The valve was inserted through a catheter from a vein in the groin or neck. Symptoms, echocardiography, invasive measurements and angiography were assessed for evaluation of treatment effect. Our treatment results are reported for the period April 2007-September 2009. Ten patients (seven men and three women, median age 17 years) were assessed. The procedure reduced pressure in the right ventricle (p = 0.008) and resolved the pulmonary insufficiency in all patients. The median time in hospital was two days. No patients had complications that were directly associated with the implantation procedure. One patient developed a pseudoaneurysm in the femoral artery, another had a short-lasting fever two days after the procedure and one patient experienced a stent fracture that required surgery 9 months after the implantation. After 6 months all patients had a reduced pressure gradient in the right ventricular outflow tract (p = 0.008), the pulmonary insufficiency had improved (p = 0.006) and they all reported improval of symptoms. These results persisted for at least 24 months for the four patients who were monitored until then. Percutaneous catheter-based implantation of artificial pulmonary valves improves hemodynamics in the right ventricle of selected patients with congenital heart defects. A randomized controlled study should be undertaken to provide a stronger evidence-base for usefulness of this procedure.

Design of a portable artificial heart drive system based on efficiency analysis.

Science.gov (United States)

Kitamura, T

1986-11-01

This paper discusses a computer simulation of a pneumatic portable piston-type artificial heart drive system with a linear d-c-motor. The purpose of the design is to obtain an artificial heart drive system with high efficiency and small dimensions to enhance portability. The design employs two factors contributing the total efficiency of the drive system. First, the dimensions of the pneumatic actuator were optimized under a cost function of the total efficiency. Second, the motor performance was studied in terms of efficiency. More than 50 percent of the input energy of the actuator with practical loads is consumed in the armature circuit in all linear d-c-motors with brushes. An optimal design is: the piston cross-sectional area of 10.5 cm2 cylinder longitudinal length of 10 cm. The total efficiency could be up to 25 percent by improving the gasket to reduce the frictional force.

Thrombotic Depositions on Right Impeller of Double-Ended Centrifugal Total Artificial Heart In Vivo.

Science.gov (United States)

Karimov, Jamshid H; Horvath, David J; Okano, Shinji; Goodin, Mark; Sunagawa, Gengo; Byram, Nicole; Moazami, Nader; Golding, Leonard A R; Fukamachi, Kiyotaka

2017-05-01

The development of total artificial heart devices is a complex undertaking that includes chronic biocompatibility assessment of the device. It is considered particularly important to assess whether device design and features can be compatible long term in a biological environment. As part of the development program for the Cleveland Clinic continuous-flow total artificial heart (CFTAH), we evaluated the device for signs of thrombosis and biological material deposition in four animals that had achieved the intended 14-, 30-, or 90-day durations in each respective experiment. Explanted CFTAHs were analyzed for possible clot buildup at "susceptible" areas inside the pump, particularly the right pump impeller. Depositions of various consistency and shapes were observed. We here report our findings, along with macroscopic and microscopic analysis post explant, and provide computational fluid dynamics data with its potential implications for thrombus formation. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Successful heart transplantation in patients with total artificial heart infections.

Science.gov (United States)

Taimur, Sarah; Sullivan, Timothy; Rana, Mennakshi; Patel, Gopi; Roldan, Julie; Ashley, Kimberly; Pinney, Sean; Anyanwu, Anelechi; Huprikar, Shirish

2018-02-01

Data are limited on clinical outcomes in patients awaiting heart transplant (HT) with total artificial heart (TAH) infections. We retrospectively reviewed all TAH recipients at our center. TAH infection was classified as definite if a microorganism was isolated in cultures from the exit site or deep tissues around the TAH; as probable in patients without surgical or microbiologic evidence of infection but no other explanation for persistent or recurrent bloodstream infection (BSI); or possible in patients with clinical suspicion and radiographic findings suggestive of TAH infection, but without surgical intervention or microbiologic evidence. From 2012 to 2015, a total of 13 patients received a TAH, with a median age at implantation of 52 years (range: 28-60). TAH infection occurred in nine patients (seven definite, one probable, one possible) a median of 41 days after implant (range: 17-475). The majority of TAH infections were caused by Staphylococcus species. Seven of nine patients underwent HT (four had pre-HT mediastinal washout, and five had positive HT operative cultures). Three patients had an active BSI caused by the same pathogen causing TAH infection at the time of HT, with one developing a post-HT BSI with the same bacteria. No patient developed post-HT surgical site infection caused by the TAH infection pathogen. No deaths among HT recipients were attributed to infection. TAH infection is frequently associated with BSI and mediastinitis and Staphylococcus was the most common pathogen. A multimodal approach of appropriate pre- and post-HT antimicrobial therapy, surgical drainage, and heart transplantation with radical mediastinal debridement was successful in curing infection. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A first step beyond traditional boundaries: destination therapy with the SynCardia total artificial heart.

Science.gov (United States)

Spiliopoulos, Sotirios; Koerfer, Reiner; Tenderich, Gero

2014-06-01

The SynCardia total artificial heart is currently used as a bridge to transplantation therapy in cases of irreversible, acute or chronic, biventricular heart failure. We describe the implementation of this technology in the context of destination therapy in a patient with an end-stage heart failure on grounds of primary amyloidosis. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Materials testing and requirements for the ERDA nuclear-powered artificial heart. Technical progress report, July 15, 1974--May 1, 1975

International Nuclear Information System (INIS)

Andrade, J.D.; Coleman, D.L.; Leigh, A.; Hufferd, W.L.

1975-01-01

Progress on the materials research and development effort for the ERDA-sponsored nuclear-powered artificial heart program is presented. Progress made during the first three years on hydrogel grafting and biological studies is summarized. Progress during the fourth year on studies of implanted artificial hearts, development of albumin surfaces, and in vitro mechanical studies is presented. (U.S.)

Application of Artificial Neural Networks in the Heart Electrical Axis Position Conclusion Modeling

Science.gov (United States)

Bakanovskaya, L. N.

2016-08-01

The article touches upon building of a heart electrical axis position conclusion model using an artificial neural network. The input signals of the neural network are the values of deflections Q, R and S; and the output signal is the value of the heart electrical axis position. Training of the network is carried out by the error propagation method. The test results allow concluding that the created neural network makes a conclusion with a high degree of accuracy.

Reconstructed image of human heart for total artificial heart implantation, based on MR image and cast silicone model of heart

International Nuclear Information System (INIS)

Komoda, Takashi; Maeta, Hajime; Uyama, Chikao.

1991-01-01

Based on transverse (TRN) and LV long axis (LAX) MR images of two cadaver hearts, three-dimensional (3-D) computer models of the connecting interface between remaining heart and total artificial heart, i.e., mitral and tricuspid valvular annuli (MVA and TVA), ascending aorta (Ao) and pulmonary artery (PA), were reconstructed to compare the shape and the size of MVA and those of TVA, the distance between the center of MVA and TVA (D G ), the angle between the plane of MVA and that of TVA (R T ), and the angles of Ao and PA, respectively, to the plane of MVA (R A , R P ), with those obtained in cast silicone models. It was found that based on LAX rather than TRN MR image, MVA and TVA might be more precisely reconstructed. The data obtained in 3-D images of MVA, TVA, Ao and PA based on silicone models of 32 hearts were as follows: D G (cm): 4.17±0.43, R T (degrees): 22.1±11.3, R A (degrees): 54.9±15.3, R P (degrees): 30.8±17.1. (author)

Future Prospects for the Total Artificial Heart.

Science.gov (United States)

Sunagawa, Gengo; Horvath, David J; Karimov, Jamshid H; Moazami, Nader; Fukamachi, Kiyotaka

2016-01-01

A total artificial heart (TAH) is the sole remaining option for patients with biventricular failure who cannot be rescued by left ventricular assist devices (LVADs) alone. However, the pulsatile TAH in clinical use today has limitations: large pump size, unknown durability, required complex anticoagulation regimen, and association with significant postsurgical complications. That pump is noisy; its large pneumatic driving lines traverse the body, with bulky external components for its drivers. Continuous-flow pumps, which caused a paradigm shift in the LVAD field, have already contributed to the rapidly evolving development of TAHs. Novel continuous-flow TAHs are only in preclinical testing or developmental stages. We here review the current state of TAHs, with recommended requirements for the TAH of the future.

Prototype Development of an Implantable Compliance Chamber for a Total Artificial Heart.

Science.gov (United States)

Schmitz, Stephanie; Unthan, Kristin; Sedlaczek, Marc; Wald, Felix; Finocchiaro, Thomas; Spiliopoulos, Sotirios; Koerfer, Reiner; Steinseifer, Ulrich

2017-02-01

At our institute a total artificial heart is being developed. It is directly actuated by a linear drive in between two ventricles, which comprise membranes to separate the drive and blood flow. A compliance chamber (CC) is needed to reduce pressure peaks in the ventricles and to increase the pump capacity. Therefore, the movement of the membrane is supported by applying a negative pressure to the air volume inside the drive unit. This study presents the development of the implantable CC which is connected to the drive unit of the total artificial hearts (TAH). The anatomical fit of the CC is optimized by analyzing CT data and adapting the outer shape to ensure a proper fit. The pressure peaks are reduced by the additional volume and the flexible membrane of the CC. The validation measurements of change in pressure peaks and flow are performed using the complete TAH system connected to a custom mock circulation loop. Using the CC, the pressure peaks could be damped below 5 mm Hg in the operational range. The flow output was increased by up to 14.8% on the systemic side and 18.2% on the pulmonary side. The described implantable device can be used for upcoming chronic animal trials. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Worldwide Experience with the Syncardia Total Artificial Heart in the Pediatric Population.

Science.gov (United States)

Morales, David L S; Lorts, Angela; Rizwan, Raheel; Zafar, Farhan; Arabia, Francisco A; Villa, Chet R

Individual centers have documented the use of the Syncardia Total Artificial Heart (TAH) in adolescents with heart failure; however, the number of patients at any given center is small. Herein, we describe the worldwide experience for all patients ≤21 years old supported with the TAH between May 2005 and May 2015 (n = 43). The number of patients experiencing a positive outcome at 60, 90, and 120 days were 30 (70%), 27 (63%), and 25 (58%), respectively. Successful bridge to transplantation varied by diagnosis, but outcomes reported are similar to adults supported with the TAH or biventricular assist devices.

A monitoring device for pressurised-air-driven diaphragm-based artificial heart assist devices

NARCIS (Netherlands)

Hoeben, F.P.; Hoeben, F.P.; de Mul, F.F.M.; Stokkink, J.S.D.; Stokkink, H.S.D.; Koelink, M.H.; Koelink, M.H.; Greve, Jan

1992-01-01

A non-invasive device has been developed to monitor the diaphragm position and the blood flow in artificial heart assist devices equipped with a pressurised-air-driven diaphragm. Light scattering from the diaphragm is used as a mechanism for measuring. Information about the position of several

First clinical use of a bioprosthetic total artificial heart: report of two cases.

Science.gov (United States)

Carpentier, Alain; Latrémouille, Christian; Cholley, Bernard; Smadja, David M; Roussel, Jean-Christian; Boissier, Elodie; Trochu, Jean-Noël; Gueffet, Jean-Pierre; Treillot, Michèle; Bizouarn, Philippe; Méléard, Denis; Boughenou, Marie-Fazia; Ponzio, Olivier; Grimmé, Marc; Capel, Antoine; Jansen, Piet; Hagège, Albert; Desnos, Michel; Fabiani, Jean-Noël; Duveau, Daniel

2015-10-17

The development of artificial hearts in patients with end-stage heart disease have been confronted with the major issues of thromboembolism or haemorrhage. Since valvular bioprostheses are associated with a low incidence of these complications, we decided to use bioprosthetic materials in the construction of a novel artificial heart (C-TAH). We report here the device characteristics and its first clinical applications in two patients with end-stage dilated cardiomyopathy. The aim of the study was to evaluate safety and feasibility of the CARMAT TAH for patients at imminent risk of death from biventricular heart failure and not eligible for transplant. The C-TAH is an implantable electro-hydraulically actuated pulsatile biventricular pump. All components, batteries excepted, are embodied in a single device positioned in the pericardial sac after excision of the native ventricles. We selected patients admitted to hospital who were at imminent risk of death, having irreversible biventricular failure, and not eligible for heart transplantation, from three cardiac surgery centres in France. The C-TAH was implanted in two male patients. Patient 1, aged 76 years, had the C-TAH implantation on Dec 18, 2013; patient 2, aged 68 years, had the implantation on Aug 5, 2014. The cardiopulmonary bypass times for C-TAH implantation were 170 min for patient 1 and 157 min for patient 2. Both patients were extubated within the first 12 postoperative hours and had a rapid recovery of their respiratory and circulatory functions as well as a normal mental status. Patient 1 presented with a tamponade on day 23 requiring re-intervention. Postoperative bleeding disorders prompted anticoagulant discontinuation. The C-TAH functioned well with a cardiac output of 4·8-5·8 L/min. On day 74, the patient died due to a device failure. Autopsy did not detect any relevant thrombus formation within the bioprosthesis nor the different organs, despite a 50-day anticoagulant-free period. Patient 2

Total artificial heart in the pediatric patient with biventricular heart failure.

Science.gov (United States)

Park, S S; Sanders, D B; Smith, B P; Ryan, J; Plasencia, J; Osborn, M B; Wellnitz, C M; Southard, R N; Pierce, C N; Arabia, F A; Lane, J; Frakes, D; Velez, D A; Pophal, S G; Nigro, J J

2014-01-01

Mechanical circulatory support emerged for the pediatric population in the late 1980s as a bridge to cardiac transplantation. The Total Artificial Heart (TAH-t) (SynCardia Systems Inc., Tuscon, AZ) has been approved for compassionate use by the Food and Drug Administration for patients with end-stage biventricular heart failure as a bridge to heart transplantation since 1985 and has had FDA approval since 2004. However, of the 1,061 patients placed on the TAH-t, only 21 (2%) were under the age 18. SynCardia Systems, Inc. recommends a minimum patient body surface area (BSA) of 1.7 m(2), thus, limiting pediatric application of this device. This unique case report shares this pediatric institution's first experience with the TAH-t. A 14-year-old male was admitted with dilated cardiomyopathy and severe biventricular heart failure. The patient rapidly decompensated, requiring extracorporeal life support. An echocardiogram revealed severe biventricular dysfunction and diffuse clot formation in the left ventricle and outflow tract. The decision was made to transition to biventricular assist device. The biventricular failure and clot formation helped guide the team to the TAH-t, in spite of a BSA (1.5 m(2)) below the recommendation of 1.7 m(2). A computed tomography (CT) scan of the thorax, in conjunction with a novel three-dimensional (3D) modeling system and team, assisted in determining appropriate fit. Chest CT and 3D modeling following implantation were utilized to determine all major vascular structures were unobstructed and the bronchi were open. The virtual 3D model confirmed appropriate device fit with no evidence of compression to the left pulmonary veins. The postoperative course was complicated by a left lung opacification. The left lung anomalies proved to be atelectasis and improved with aggressive recruitment maneuvers. The patient was supported for 11 days prior to transplantation. Chest CT and 3D modeling were crucial in assessing whether the device would

The 50/50 cc Total Artificial Heart Trial: Extending the Benefits of the Total Artificial Heart to Underserved Populations.

Science.gov (United States)

Wells, Dennis; Villa, Chet R; Simón Morales, David Luís

2017-01-01

While use of the total artificial heart (TAH) is growing, the use of the device is not uniform across the gender and age spectrum because the vast majority of implants are in adult males. SynCardia has recently developed a smaller 50 cc TAH that was designed to accommodate patients with a body surface area as low as 1.2 m 2 (potentially even lower using virtual implantation). Herein, we describe the early use of the 50 cc TAH (10 implants in the US and 18 outside the US). Twenty-eight devices have been implanted worldwide. Nineteen (68%) patients were female, 4 (14%) were 21 years of age or younger, and 2 (7%) had a diagnosis of congenital heart disease (1 Fontan). The smallest patient, by body surface area, was 1.35 m 2 . Six patients (21%) have been placed on the Freedom Driver, all of whom have survived. Fourteen patients (50%) have had a positive outcome to date. The development of the 50 cc TAH has expanded the population of patients who may benefit from TAH support and thus may help improve outcomes for patients who have had limited biventricular support options to date. Copyright © 2017 Elsevier Inc. All rights reserved.

AbioCor totally implantable artificial heart. How will it impact hospitals?

Science.gov (United States)

2002-09-01

Although heart transplantation remains the most effective treatment for severe heart failure, there are far fewer donor hearts available than there are patients who could benefit from them. One approach to addressing this shortfall is the total artificial heart, or TAH. To date, however, no TAH design has been able to achieve one of the ultimate goals of heart replacement: to allow a patient to live a reasonably normal life without being connected to external machinery. A new design, the AbioCor TAH developed by Abiomed Inc., may make this goal achievable. Thanks to a power system that transfers energy through the skin without the aid of wires, the AbioCor--currently undergoing clinical trials in the United States--allows the patient to be completely mobile. The lack of transcutaneous wires also eliminates the primary source of the infections that have plagued TAH patients in the past. Though it is not without drawbacks, the AbioCor could represent a crucial advance in TAH technology. In this Technology Overview, we describe the operation of the AbioCor and discuss its likely impact on hospitals if it is approved for marketing in the United States. We also discuss a related cardiac-support technology: ventricular assist devices (VADs), which may also be used for permanent cardiac support someday.

An example of the use of the DELPHI method: future prospects of artificial heart techniques in France

International Nuclear Information System (INIS)

Derian, Jean-Claude; Morize, Francoise; Vernejoul, Pierre de; Vial, Renee

1971-01-01

The artificial heart is still only a research project surrounded by numerous uncertainties which make it very difficult to estimate, at the moment, the possibilities for future development of this technique in France. A systematic analysis of the hazards which characterize this project has been undertaken in the following report: restricting these uncertainties has required a taking into account of opinions of specialists concerned with type of research or its upshot. We have achieved this by adapting an investigation technique which is still unusual in France, the DELPHI method. This adaptation has allowed the confrontation and statistical aggregation of the opinions given by a body of a hundred experts who were consulted through a program of sequential interrogations which studied in particular, the probable date of the research issue, the clinical cases which require the use of an artificial heart, as well as the probable future needs. After having taken into account the economic constraints, we can deduce from these results the probable amount of plutonium 238 needed in the hypothesis where isotopic generator would be retained for the energetics feeding of the artificial heart [fr

Total Artificial Heart Bridge to Transplantation for a Patient With Occult Intracardiac Malignancy: Case Report.

Science.gov (United States)

Reich, H; Czer, L; Bannykh, S; De Robertis, M; Wolin, E; Amersi, F; Moriguchi, J; Kobashigawa, J; Arabia, F

2015-09-01

Malignancy is the leading cause of long-term morbidity and mortality after heart and other solid organ transplantation; therefore, great emphasis is placed on pre- and post-transplantation cancer screening. Even with meticulous screening during evaluation for heart transplant candidacy, an occult cancer may not be apparent. Here, we share the case of a 51-year-old man with refractory heart failure who underwent total artificial heart implantation as a bridge to transplantation with the surprise finding of an isolated deposit of metastatic carcinoid tumor nested within a left ventricular papillary muscle in his explanted heart. The primary ileal carcinoid tumor was identified and resected completely. After remaining cancer-free for 14 months, he was listed for heart transplantation and was transplanted 2 months later. He is currently 3.5 months out from heart transplantation and doing well, without evidence of recurring malignancy. Copyright © 2015 Elsevier Inc. All rights reserved.

Surface Modifications of Polymeric Materials for Application in Artificial Heart and Circulatory Assist Devices

NARCIS (Netherlands)

Feijen, J.; Engbers, G.H.M.; Terlingen, J.G.A.; van Delden, C.J.; Poot, A.A.; Vaudaux, P.; Akutsu, Tetsuzo; Koyanagi, Hitoshi

1996-01-01

Several methods have been developed to modify the surfaces of materials used in artificial hearts and circulatory assist devices to suppress the host response, especially with respect to the occurrence of clotting, cellular damage, and infections. In this review, special attention is paid to

Validation of measurements of Fourier phase and amplitude analysis of technetium99 gated cardiac scans using artificial hearts

International Nuclear Information System (INIS)

Yiannikas, J.; Takatani, S.; MacIntyre, W.J.; Underwood, D.A.; Cook, S.A.; Go, R.T.; Napoli, C.; Nose, Y.

1982-01-01

The use of artificial hearts, developed for total heart replacement programs, allows assessment of the accuracy of measuring the first Fourier component phase and amplitude when applied to gated cardiac technetium 99 scans. In the extreme example of asynchrony of ventricular contraction in coronary artery disease that of ventricular aneurysms, the first Fourier component measurements of amplitude were highly correlated to volume increases suggesting that the calculated amplitude accurately reflects volume changes. The calculated asynchrony using Fourier analysis of the gated technetium 99 studies of two artificial hearts was highly accurate when compared to the predetermined calculation of phase angle difference and hence degree of asynchrony. The studies suggest that measurement of phase and amplitude using the first Fourier component of time-activity waves of gated cardiac technetium 99 studies accurately measure degree of asynchrony and volume changes respectively

Stirling engine with hydraulic power output for powering artificial hearts

International Nuclear Information System (INIS)

Johnston, R.P.; Noble, J.E.; Emigh, S.G.; White, M.A.; Griffith, W.R.; Perrone, R.E.

1975-01-01

The DWDL heart power source combines the high efficiency of Stirling engines with the reliability, efficiency, and flexibility of hydraulic power transfer and control to ensure long system life and physiological effectiveness. Extended life testing has already been achieved with an engine module; animal in-vivo tests with an assist heart have consistently demonstrated required performance by biological synchronization and effective ventricle relief. The present System 5 can reliably meet near-term thousand-hour animal in-vivo test goals as far as the durability and efficacy of the power source are concerned. Carefully planned development of System 6 has produced major reductions in size and required input power. Research engine tests have provided the basis for achieving performance goals and the approach for further improvement is well established. The near term goal is 33 W heat input with 16 W input projected for normal physical activity. The goal of reduction of engine module volume to 0.9 liter has been achieved. Demonstrated reliability of 292 d for the engine and 35 d for the full system, as well as effectiveness of the artificial heart power source in short-term in-vivo tests indicate that life-limiting problems are now blood pump reliability and the machine-animal interface

Reasons for readmission in heart failure : Perspectives of patients, caregivers, cardiologists, and heart failure nurses

NARCIS (Netherlands)

Annema, Coby; Luttik, Marie-Louise; Jaarsma, Tiny

2009-01-01

OBJECTIVE: Despite efforts to improve outcomes in heart failure (HF), readmission rates remain relatively high. Reasons for readmission from different perspectives (patient, caregiver, health care providers) may help to optimize the future management of patients with HF. The aims of this study are

Rapid Speed Modulation of a Rotary Total Artificial Heart Impeller.

Science.gov (United States)

Kleinheyer, Matthias; Timms, Daniel L; Tansley, Geoffrey D; Nestler, Frank; Greatrex, Nicholas A; Frazier, O Howard; Cohn, William E

2016-09-01

Unlike the earlier reciprocating volume displacement-type pumps, rotary blood pumps (RBPs) typically operate at a constant rotational speed and produce continuous outflow. When RBP technology is used in constructing a total artificial heart (TAH), the pressure waveform that the TAH produces is flat, without the rise and fall associated with a normal arterial pulse. Several studies have suggested that pulseless circulation may impair microcirculatory perfusion and the autoregulatory response and may contribute to adverse events such as gastrointestinal bleeding, arteriovenous malformations, and pump thrombosis. It may therefore be beneficial to attempt to reproduce pulsatile output, similar to that generated by the native heart, by rapidly modulating the speed of an RBP impeller. The choice of an appropriate speed profile and control strategy to generate physiologic waveforms while minimizing power consumption and blood trauma becomes a challenge. In this study, pump operation modes with six different speed profiles using the BiVACOR TAH were evaluated in vitro. These modes were compared with respect to: hemodynamic pulsatility, which was quantified as surplus hemodynamic energy (SHE); maximum rate of change of pressure (dP/dt); pulse power index; and motor power consumption as a function of pulse pressure. The results showed that the evaluated variables underwent different trends in response to changes in the speed profile shape. The findings indicated a possible trade-off between SHE levels and flow rate pulsatility related to the relative systolic duration in the speed profile. Furthermore, none of the evaluated measures was sufficient to fully characterize hemodynamic pulsatility. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Post-explant visualization of thrombi in outflow grafts and their junction to a continuous-flow total artificial heart using a high-definition miniaturized camera.

Science.gov (United States)

Karimov, Jamshid H; Horvath, David; Sunagawa, Gengo; Byram, Nicole; Moazami, Nader; Golding, Leonard A R; Fukamachi, Kiyotaka

2015-12-01

Post-explant evaluation of the continuous-flow total artificial heart in preclinical studies can be extremely challenging because of the device's unique architecture. Determining the exact location of tissue regeneration, neointima formation, and thrombus is particularly important. In this report, we describe our first successful experience with visualizing the Cleveland Clinic continuous-flow total artificial heart using a custom-made high-definition miniature camera.

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

Science.gov (United States)

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

2018-01-01

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

The evolving role of the total artificial heart in the management of end-stage congenital heart disease and adolescents.

Science.gov (United States)

Ryan, Thomas D; Jefferies, John L; Zafar, Farhan; Lorts, Angela; Morales, David L S

2015-01-01

Advances in medical therapies have yielded improvement in morbidity and a decrease in mortality for patients with congenital heart disease, both surgically palliated and uncorrected. An unintended consequence is a cohort of adolescent and adult patients with heart failure who require alternative therapies. One intriguing option is placement of a total artificial heart (TAH) either as a bridge to transplant or as a destination therapy. Of the 1091 Jarvik-7 type TAH (Symbion, CardioWest and SynCardia) placed between 1985 and 2012, only 24 have been performed in patients with congenital heart disease, and a total of 51 were placed in patients younger than 21. At our institution, the SynCardia TAH was implanted in a 19-year-old patient with cardiac allograft failure because of chronic rejection and related multisystem organ failure including need for hemodialysis. Over the next year, she was nutritionally and physically rehabilitated, as were her end organs, allowing her to come off dialysis, achieve normal renal function and eventually be successfully transplanted. Given the continued growth of adolescent and adult congenital heart disease populations with end-stage heart failure, the TAH may offer therapeutic options where previously there were few. In addition, smaller devices such as the SynCardia 50/50 will open the door for applications in smaller children. The Freedom Driver offers the chance for patients to leave the hospital with a TAH, as does the AbioCor, which is a fully implantable TAH option. In this report, we review the history of the TAH and potential applications in adolescent patients and congenital heart disease.

[Hydrodynamics of disk artificial heart valves with different design characteristics].

Science.gov (United States)

Dobrova, N B; Zaretskiĭ, Iu V

1989-01-01

Bench tests for 38 models of artificial heart valves (AHV) with different design parameters allowed us to decide in favour of the valves with reduced eccentricity (compared to the serial AHV of the EMAHV type) according to its resistance in the constant flow. Out of the compatibility checks of the design parameters tested it was concluded that the disk did not make the complete calculated angle when rotated. The dependence of AHV resistance on the disk rotation angle showed that there is no necessity to increase that angle more than 70 degrees for the mitral valve and more than 75 degrees for the aortic AHV.

Prologue: ventricular assist devices and total artificial hearts. A historical perspective.

Science.gov (United States)

Frazier, O H

2003-02-01

In the 1960s, when LVADs and TAHs were introduced into clinical use, researchers estimated that, with this technology, the problem of heart failure could be solved within 20 years. Unfortunately, the evolution of these devices has taken much longer than anticipated. Nevertheless, significant advances have been achieved in both cardiac assistance and replacement, and today's cardiac surgeons have a wide range of devices from which to choose (Table 4). This progress has largely been due to the support of the NHLBI, especially the Devices and Technology Division headed by John Watson, and of the devoted commitment of the investigators. Because of the long-term commitment required for both basic and clinical research, commercial medical technology companies are unable to assume this burden. Advances in mechanical circulatory support and replacement have benefited numerous patients worldwide who would otherwise have died of heart failure, and devices now exist for use as bridges to recovery, bridges to transplant, and destination therapy. The current challenge is to refine what we have and to apply these technologies to broader patient populations with maximal safety and at a reasonable cost.

Perioperative Prophylaxis for Total Artificial Heart Transplantation.

Science.gov (United States)

Chambers, H E; Pelish, P; Qiu, F; Florescu, D F

2017-11-01

Practice variation regarding perioperative antimicrobial prophylaxis in total artificial heart transplantations (TAH-t) across institutions is unknown. The aim of our survey was to assess the current practices for prevention of infection in TAH-t recipients among different programs. An electronic survey was sent to programs that implant Syncardia TAH (Syncardia Systems, Tuscon, Ariz, USA). Proportions were analyzed for categorical variables; means and SDs were analyzed for continuous variables. The majority of centers (80.8%) had a formal surgical infection prophylaxis protocol. For non-penicillin-allergic patients, five (20.1%) institutions reported using a 4-drug regimen, seven (29.2%) used a 3-drug regimen, five (20.1%) used a 2-drug regimen, and seven (29.2%) used a cephalosporin alone. Similar data was seen in the penicillin-allergic patients. Infections were reported to occur postoperatively in 52.2% centers. During the first month after TAH-t, bacteremia represented 27.3%, driveline infections 27.2%, pulmonary infections 9%, and mediastinal infections 18.2%. The most common organisms seen within the first month were Candida spp., Escherichia coli, and Pseudomonas aeruginosa (21.4%). In 65% of centers, the mean rate of death post-TAH-t due to infection was 14.5% (SD, 22.3%). The mean rate of patients surviving until orthotopic heart transplantation was 58.6% (SD, 27.7%). Preventing infections post-TAH-t is key to decreasing morbidity and mortality. All institutions administered perioperative prophylaxis for TAH-t with significant variation among the centers. The majority of the centers have a formal perioperative prophylactic protocol. Copyright © 2017. Published by Elsevier Inc.

Chest radiographic findings and complications of the temporary implantation of the Jarvik-7 artificial heart while awaiting orthotopic heart transplantation: Experience with five cases

International Nuclear Information System (INIS)

Sadler, L.R.; Fuhrman, C.R.; Hardesty, R.A.; Griffith, B.P.

1986-01-01

The Jarvik-7 artificial heart was originally introduced as a therapeutic alternative to cardiac transplantation in patients with endstage refractory cardiac disease. Its use has been expanded to those patients awaiting cardiac transplantation in whom death is impending and for whom a suitable donor match is unavailable. At Presbyterian-University Hospital of Pittsburgh five patients have had Jarvik-7 hearts implanted as a temporary measure while awaiting compatible donors for cardiac transplantation. The authors believe this is the largest patient group to undergo this procedure at a single institution. They present a brief description of the Jarvik-7 heart, the clinical factors affecting patient selection, and the radiographic appearance of a normally functioning Jarvik-7 heart, and review the chest radiographic complications seen in the patient group, along with eventual patient outcome

Making Artificial Heart Components – Selected Aspects Of Casting Technology

Directory of Open Access Journals (Sweden)

Sobczak J.J.

2015-09-01

Full Text Available This study shown possibilities of Rapid Prototyping techniques (RP and metal casting simulation software (MCSS, including non inertial reference systems. RP and MCSS have been used in order to design and produce essential elements for artificial heart. Additionally it has been shown possibilities of Fused Deposition Modeling (FDM technique and DodJet technology using prototyped elements of rotodynamic pump. MAGMASOFT® software allowed to verify the cast kit heart valves model. Optical scanner Atos III enabled size verification of experimental elements supplied by rapid prototyping together with metal casting elements. Due to the selection of ceramic materials and assessment of molten metal – ceramic reactivity at high temperatures together with pattern materials selection model it was possible to design, manufacture a ceramic mould for titanium based alloys. The casting structure modification has been carried out by means of high isostatic pressure technique (HIP. The quality assessment of the casting materials has been performed using X-ray fluorescence (XRF, ARL 4460 Optical Emission Spectrometer, metallographic techniques and X-ray computed tomography.

[Artificial organs].

Science.gov (United States)

Raguin, Thibaut; Dupret-Bories, Agnès; Debry, Christian

2017-01-01

Research has been fighting against organ failure and shortage of donations by supplying artificial organs for many years. With the raise of new technologies, tissue engineering and regenerative medicine, many organs can benefit of an artificial equivalent: thanks to retinal implants some blind people can visualize stimuli, an artificial heart can be proposed in case of cardiac failure while awaiting for a heart transplant, artificial larynx enables laryngectomy patients to an almost normal life, while the diabetic can get a glycemic self-regulation controlled by smartphones with an artificial device. Dialysis devices become portable, as well as the oxygenation systems for terminal respiratory failure. Bright prospects are being explored or might emerge in a near future. However, the retrospective assessment of putative side effects is not yet sufficient. Finally, the cost of these new devices is significant even if the advent of three dimensional printers may reduce it. © 2017 médecine/sciences – Inserm.

Exploiting Artificial Intelligence To Enhance Training: A Short- and Medium-Term Perspective.

Science.gov (United States)

Cumming, Geoff

This paper is an introductory discussion of industrial training, artificial intelligence (AI), and AI applications in training, prepared in the context of the United Kingdom Training Commission (TC) program. Following an outline of the activities and aims of the program, individual sections describe perspectives on: (1) training needs, including…

Artificial heart system thermal converter and blood pump component research and development

International Nuclear Information System (INIS)

Pouchot, W.D.; Bifano, N.J.; Hanson, J.P.

1975-01-01

A bench model version of a nuclear-powered artificial heart system to be used as a replacement for the natural heart was constructed and tested as a part of a broader U. S. ERDA program. The objective of the broader program has been to develop a prototype of a fully implantable nuclear-powered total artificial heart system powered by the thermal energy of plutonium-238 and having minimum weight and volume and a minimum life of ten years. As a forward step in this broader program, component research and development has been carried out directed towards a fully implantable and advanced version of the bench model (IVBM). Some of the results of the component research and development effort on a Stirling engine, blood pump drive mechanisms, and coupling mechanisms are presented. The Stirling-mechanical system under development is shown. There are three major subassemblies: the thermal converter, the coupling mechanism, and the blood pump drive mechanism. The thermal converter uses a Stirling cycle to convert the heat of the plutonium-238 fueled heat source to a rotary shaft power output. The coupling mechanism changes the orientation of the output shaft by 90 degrees and transmits the pumping power by wire-wound core flexible shafting to the pumping mechanism. The coupling mechanism also provides routing of the coolant lines which carry the cycle waste heat from the thermal converter to the blood pump. The change in orientation of the thermal converter output shaft is for convenience in implanting in a calf. This orientation of thermal converter to blood pump seemed to give the best overall system fit in a calf based on fit trials with wooden models in a calf cadaver

Total Artificial Heart and Chronic Haemodialysis: A Possible Bridge to Transplantation?

Science.gov (United States)

Demiselle, Julien; Besson, Virginie; Sayegh, Johnny; Subra, Jean-François; Augusto, Jean-François

2016-01-01

Total artificial heart (TAH) device is sometimes necessary to treat end stage heart failure (HF). After surgery, renal impairment can occur with the need of renal replacement therapy. We report the case of a 51-year-old man who was treated with conventional hemodialysis (HD) while on support with TAH. The patient underwent HD while on TAH support during 14 months. He benefited from conventional HD, 6 sessions per week. HD sessions were well tolerated, and patient's condition and quality of life improved significantly. The main difficulty was to maintain red blood cell level because of chronic hemolysis due to TAH, which required repetitive blood transfusions, resulting in a high rate of human leukocyte antigen sensitization. Unfortunately, the patient died of mesenteric ischemia due to anticoagulation under dosing. We conclude that HD treatment is possible despite TAH and should be considered in patients with both end stage renal and HF. © 2016 S. Karger AG, Basel.

Artificial heart system thermal insulation component development

International Nuclear Information System (INIS)

Svedberg, R.C.; Buckman, R.W. Jr.

1975-01-01

A concentric cup vacuum multifoil insulation system has been selected by virtue of its size, weight, and thermal performance to insulate the hot radioisotope portion of the thermal converter of an artificial implantable heart system. A factor of 2 improvement in thermal performance, based on the heat loss per number of foil layers (minimum system weight and volume) has been realized over conventional spiral wrapped multifoil vacuum insulation. This improvement is the result of the concentric cup construction to maintain a uniform interfoil spacing and the elimination of corner heat losses. Based on external insulation system dimensions (surface area in contact with host body), heat losses of 0.019 W/ cm 2 at 1140 0 K (1600 0 F) and 0.006 W/cm 2 at 920 0 K (1200 0 F) have been achieved. Factors which influence thermal performance of the nickel foil concentric cup insulation system include the number of cups, configuration and method of application of zirconia (ZrO 2 ) spacer material, system pressure, emittance of the cups, and operating temperature

Deairing Techniques for Double-Ended Centrifugal Total Artificial Heart Implantation.

Science.gov (United States)

Karimov, Jamshid H; Horvath, David J; Byram, Nicole; Sunagawa, Gengo; Grady, Patrick; Sinkewich, Martin; Moazami, Nader; Sale, Shiva; Golding, Leonard A R; Fukamachi, Kiyotaka

2017-06-01

The unique device architecture of the Cleveland Clinic continuous-flow total artificial heart (CFTAH) requires dedicated and specific air-removal techniques during device implantation in vivo. These procedures comprise special surgical techniques and intraoperative manipulations, as well as engineering design changes and optimizations to the device itself. The current study evaluated the optimal air-removal techniques during the Cleveland Clinic double-ended centrifugal CFTAH in vivo implants (n = 17). Techniques and pump design iterations consisted of developing a priming method for the device and the use of built-in deairing ports in the early cases (n = 5). In the remaining cases (n = 12), deairing ports were not used. Dedicated air-removal ports were not considered an essential design requirement, and such ports may represent an additional risk for pump thrombosis. Careful passive deairing was found to be an effective measure with a centrifugal pump of this design. In this report, the techniques and design changes that were made during this CFTAH development program to enable effective residual air removal and prevention of air embolism during in vivo device implantation are explained. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Investigation of the Durability of a Diaphragm for a Total Artificial Heart.

Science.gov (United States)

Gräf, Felix; Rossbroich, Ralf; Finocchiaro, Thomas; Steinseifer, Ulrich

2016-10-01

One of the most critical components regarding the durability of the ReinHeart total artificial heart (TAH) is its biocompatible diaphragm, which separates the drive unit from the ventricles. Hence, a durability tester was designed to investigate its required 5-year lifetime. The aim of this study was to prove the validity of accelerated testing of the polyurethane diaphragm. The durability tester allows simultaneous testing of 12 diaphragms and mimics physiological conditions. To accelerate the time of testing, it operates with an increased speed at a frequency of 8 Hz. To prove the correctness of this acceleration, a servo-hydraulic testing machine was used to study the effect of different frequencies and their corresponding loads. Thereby the viscoelastic behavior of the polyurethane was investigated. Additionally, high-speed video measurements were performed. The force against frequency and the high-speed video measurements showed constant behavior. In the range of 1-10 Hz, the maximum resulting forces varied by 3%, and the diaphragm movement was identical. Frequencies below 10 Hz allow a valid statement of the diaphragm's mechanical durability. Viscoelasticity of the polyurethane in the considered frequency-range is negligible. The accelerated durability test is applicable to polyurethane diaphragms, and the results are applicable to TAH use. The reliability of the diaphragm for a lifetime of 5 years was found to be 80% with a confidence of 62%. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Elective Inactivation of Total Artificial Heart Technology in Non-Futile Situations: Inpatients, Outpatients and Research Participants

Science.gov (United States)

Bramstedt, Katrina A.

2004-01-01

Total artificial heart technology as a potential clinical therapy raises the issue of elective device inactivation in both futile and non-futile situations. This article explores elective device inactivation in non-futile situations. In reply to such requests for inactivation, the medical team should reflect on the individual's decision-making…

Heart rate and leukocytes after air and ground transportation in artificially ventilated neonates: a prospective observational study.

Science.gov (United States)

Grosek, Stefan; Mlakar, Gorazd; Vidmar, Ivan; Ihan, Alojz; Primozic, Janez

2009-01-01

To evaluate the effect of interhospital air and ground transportation of artificially ventilated neonates on heart rate and peripheral blood leukocyte counts. Prospective, observational study. Level III multidisciplinary Neonatal and Pediatric Intensive Care Unit. Fifty-eight near-term artificially ventilated transported neonates between May 2006 and April 2007. Day-helicopter, day- and night-ground transportation. Heart rate at retrieval, on admission to the ICU and 1 h later, and peripheral blood leukocyte counts on admission and 1 d later were compared. Fifteen neonates were transported by helicopter during the daytime (D-HEL), 20 by daytime ground and 23 by nighttime ground transportation (D-GROUND, N-GROUND). No differences in delivery mode, birth weight, gestational age, gender, primary diagnoses for transportation, response time and duration of transportation were found between the groups. Similarly, no differences in pH, pCO(2), blood pressure and skin temperature at retrieval and on admission to the ICU were found between the three groups. The mean heart rate at retrieval did not differ significantly, while on arrival in the ICU and 1 h later the D-GROUND group of patients showed a significantly higher mean heart rate compared to the D-HEL and N-GROUND groups. Moreover, leukocyte counts on arrival in the ICU showed significantly higher leukocyte counts in the D-GROUND group of patients compared to the D-HEL group of patients. These results demonstrate that there is an association between daytime ground transportation and higher heart rate and peripheral blood leukocytes.

Incorporating an Exercise Detection, Grading, and Hormone Dosing Algorithm Into the Artificial Pancreas Using Accelerometry and Heart Rate

OpenAIRE

Jacobs, Peter G.; Resalat, Navid; El Youssef, Joseph; Reddy, Ravi; Branigan, Deborah; Preiser, Nicholas; Condon, John; Castle, Jessica

2015-01-01

In this article, we present several important contributions necessary for enabling an artificial endocrine pancreas (AP) system to better respond to exercise events. First, we show how exercise can be automatically detected using body-worn accelerometer and heart rate sensors. During a 22 hour overnight inpatient study, 13 subjects with type 1 diabetes wearing a Zephyr accelerometer and heart rate monitor underwent 45 minutes of mild aerobic treadmill exercise while controlling their glucose ...

Research on micro-structure and hemo-compatibility of the artificial heart valve surface

International Nuclear Information System (INIS)

Ye Xia; Shao Yunliang; Zhou Ming; Li Jian; Cai Lan

2009-01-01

In order to seek the method to improve the hemo-compatibility of artificial mechanical heart valve, the surface of rabbit's heart valve was observed using the scanning electron microscopy (SEM). The results showed that the dual-scale structure which consists of cobblestones-like structure of 8 μm in underside diameter and 3 μm in height, and the fine cilia of about 150 nm in diameter, was helpful to the hemo-compatibility of the heart valve. Therefore, the polydimethylsiloxane (PDMS) surface with hierarchical micro-structure was fabricated using femtosecond laser fabrication technique and soft lithography. At the same time, the tests of apparent contact angle and platelet adhesion on both smooth and textured PDMS surfaces were carried out to study their wettability and hemo-compatibility. The results demonstrated that the surface with textured structure displayed more excellent wettabililty and anti-coagulation property than that of smooth surface. The apparent contact angle of textured surface enhanced from 113.1 deg. to 163.6 deg. and the amount of adsorbed platelet on such surface was fewer, no distortion and no activation were found.

Self-efficacy in the context of heart transplantation - a new perspective.

Science.gov (United States)

Almgren, Matilda; Lennerling, Annette; Lundmark, Martina; Forsberg, Anna

2017-10-01

An in-depth exploration of self-efficacy among heart transplant recipients by means of Bandura's self-efficacy theory. An essential component of chronic illness management is self-management, which refers to activities carried out by people to create order, structure and control in their lives. Self-efficacy is an important aspect of self-management, which seems to have become the main paradigm for long-term management after solid organ transplantation. A directed content analysis using Bandura's self-efficacy theory. Open-ended, in-depth interviews were conducted with 14 heart transplant recipients at their 12-month follow-up after heart transplantation. This study generated the hypothesis that from the patients' perspective, self-efficacy after heart transplantation concerns balancing expectations to find the optimum level of self-efficacy. Performance accomplishment was found to have the greatest impact on self-efficacy, while its absence was the main source of disappointments. It was also revealed that the gap between performance accomplishment and efficacy expectations can be understood as uncertainty. It is essential to assess both expectations and disappointments from the patient perspective in order to promote an optimum level of self-efficacy among heart transplant recipients. This includes supporting the heart recipient to adopt mental and physical adjustment strategies to balance her/his expectations as a means of minimising disappointments. The understanding that uncertainty can undermine self-efficacy is crucial. The merging of the uncertainty in illness and self-efficacy theories provides an excellent framework for the provision of self-management support. In addition, focusing on a partnership between the transplant professionals and the recipient is essential because it minimises the use of a behavioural approach. © 2016 John Wiley & Sons Ltd.

Noninvasive Measurement of EKG Properties of 3D Artificial Heart Muscle

Directory of Open Access Journals (Sweden)

Betsy H. Salazar

2017-06-01

Full Text Available Developing and testing a custom fabricated 16-electrode noninvasive direct contact system was necessary to assess the electrical properties of bioengineered heart muscle and to further evaluate the efficacy of cardiac constructs. By culturing neonatal rat primary cardiac cells on a fibrin gel, we constructed 3D artificial heart muscle (3D-AHM, as described in previous studies, which were used in validating this novel system. Electrical and mechanical functional assessment of the tissues was performed, which yielded contractile forces of the tissues, electrical field potential characteristics, and tissue conduction velocities (CV (20–170 cm/s. Immunohistological evaluation revealed the formation of cardiac tissue structures and cardiomyocyte proliferation. EKG data analysis also yielded time delays between signals in the range of 0–38 ms with electrical maps showing some evidence of synchronous contraction within the fabricated tissues. This study demonstrates the effectiveness and practicality of our novel EKG measuring system to acquire distinct electrical metrics of 3D-AHM, which will aid in increasing the viability and applicability of cardiac tissue constructs.

Development of a nuclear-powered artificial heart

International Nuclear Information System (INIS)

Mott, W.E.; Cole, D.W. Jr.

1972-01-01

Of the few known methods of furnishing power for a completely implantable artificial heart one of the most promising involves the conversion of the thermal energy from the decay of man-made radioisotopes. Serious consideration of radioisotopic, or nuclear, heat sources for implantable power supplies began in early 1964. Since then there have been some notable accomplishments on the road to a nuclear-powered system but a large number of important and difficult problems remain to be clarified. The overall objective of the Atomic Energy Commission's current program is to examine critically these problems and to provide information so that the reasonableness and practicability of the nuclear approach can be assessed at an early date. Research and development projects are underway on radioisotope heat source fuel and containment materials, on a highly reliable, long-life thermal energy conversion system and its requisite high performance thermal insulation package, on the coupling of the converter output power to the diaphragm of a suitable blood pump in such a manner that the system is fully responsive to the needs of the body, and on the radiobiological implications of large-scale heat source implantation. (auth)

Heart murmur detection based on wavelet transformation and a synergy between artificial neural network and modified neighbor annealing methods.

Science.gov (United States)

Eslamizadeh, Gholamhossein; Barati, Ramin

2017-05-01

Early recognition of heart disease plays a vital role in saving lives. Heart murmurs are one of the common heart problems. In this study, Artificial Neural Network (ANN) is trained with Modified Neighbor Annealing (MNA) to classify heart cycles into normal and murmur classes. Heart cycles are separated from heart sounds using wavelet transformer. The network inputs are features extracted from individual heart cycles, and two classification outputs. Classification accuracy of the proposed model is compared with five multilayer perceptron trained with Levenberg-Marquardt, Extreme-learning-machine, back-propagation, simulated-annealing, and neighbor-annealing algorithms. It is also compared with a Self-Organizing Map (SOM) ANN. The proposed model is trained and tested using real heart sounds available in the Pascal database to show the applicability of the proposed scheme. Also, a device to record real heart sounds has been developed and used for comparison purposes too. Based on the results of this study, MNA can be used to produce considerable results as a heart cycle classifier. Copyright © 2017 Elsevier B.V. All rights reserved.

Perspective on the Ongoing Replacement of Artificial and Animal-Based Dyes with Alternative Natural Pigments in Foods and Beverages.

Science.gov (United States)

Schweiggert, Ralf M

2018-03-28

This perspective highlights current trends, advances, and challenges related to the replacement of artificial dyes and the insect-based carmine with alternative natural pigments. Briefly reviewing the history of food coloration, key publications and public events leading to diverse concerns about artificial dyes and carmine will be summarized. An overview about promising alternatives in the market and those under development is provided, including a separate section on coloring foodstuffs. The perspective aims at supporting readers to keep abreast with the enormous efforts undertaken by the food and beverage industry to replace certain food dyes.

[Artificial muscle and its prospect in application for direct cardiac compression assist].

Science.gov (United States)

Dong, Jing; Yang, Ming; Zheng, Zhejun; Yan, Guozheng

2008-12-01

Artificial heart is an effective device in solving insufficient native heart supply for heart transplant, and the research and application of novel actuators play an important role in the development of artificial heart. In this paper, artificial muscle is introduced as the actuators of direct cardiac compression assist, and some of its parameters are compared with those of native heart muscle. The open problems are also discussed.

Interagency registry for mechanically assisted circulatory support report on the total artificial heart.

Science.gov (United States)

Arabía, Francisco A; Cantor, Ryan S; Koehl, Devin A; Kasirajan, Vigneshwar; Gregoric, Igor; Moriguchi, Jaime D; Esmailian, Fardad; Ramzy, Danny; Chung, Joshua S; Czer, Lawrence S; Kobashigawa, Jon A; Smith, Richard G; Kirklin, James K

2018-04-26

We sought to better understand the patient population who receive a temporary total artificial heart (TAH) as bridge to transplant or as bridge to decision by evaluating data from the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) database. We examined data related to survival, adverse events, and competing outcomes from patients who received TAHs between June 2006 and April 2017 and used hazard function analysis to explore risk factors for mortality. Data from 450 patients (87% men; mean age, 50 years) were available in the INTERMACS database. The 2 most common diagnoses were dilated cardiomyopathy (50%) and ischemic cardiomyopathy (20%). Risk factors for right heart failure were present in 82% of patients. Most patients were INTERMACS Profile 1 (43%) or 2 (37%) at implantation. There were 266 patients who eventually underwent transplantation, and 162 died. Overall 3-, 6-, and 12-month actuarial survival rates were 73%, 62%, and 53%, respectively. Risk factors for death included older age (p = 0.001), need for pre-implantation dialysis (p = 0.006), higher creatinine (p = 0.008) and lower albumin (p Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Cyclic stress-strain behavior of polymeric nonwoven structures for the use as artificial leaflet material for transcatheter heart valve prostheses

Directory of Open Access Journals (Sweden)

Arbeiter Daniela

2017-09-01

Full Text Available Xenogenic leaflet material, bovine and porcine pericardium, is widely used for the fabrication of surgically implanted and transcatheter heart valve prostheses. As a biological material, long term durability of pericardium is limited due to calcification, degeneration and homogeneity. Therefore, polymeric materials represent a promising approach for a next generation of artificial heart valve leaflets with improved durability. Within the current study we analyzed the mechanical performance of polymeric structures based on elastomeric materials. Polymeric cast films were prepared and nonwovens were manufactured in an electrospinning process. Analysis of cyclic stress-strain behavior was performed, using a universal testing machine. The uniaxial cyclic tensile experiments of the elastomeric samples yielded a non-linear elastic response due to viscoelastic behavior with hysteresis. Equilibrium of stress-strain curves was found after a specific number of cycles, for cast films and nonwovens, respectively. In conclusion, preconditioning was found obligatory for the evaluation of the mechanical performance of polymeric materials for the use as artificial leaflet material for heart valve prostheses.

Examination of mitral regurgitation with a goat heart model for the development of intelligent artificial papillary muscle.

Science.gov (United States)

Shiraishi, Y; Yambe, T; Yoshizawa, M; Hashimoto, H; Yamada, A; Miura, H; Hashem, M; Kitano, T; Shiga, T; Homma, D

2012-01-01

Annuloplasty for functional mitral or tricuspid regurgitation has been made for surgical restoration of valvular diseases. However, these major techniques may sometimes be ineffective because of chamber dilation and valve tethering. We have been developing a sophisticated intelligent artificial papillary muscle (PM) by using an anisotropic shape memory alloy fiber for an alternative surgical reconstruction of the continuity of the mitral structural apparatus and the left ventricular myocardium. This study exhibited the mitral regurgitation with regard to the reduction in the PM tension quantitatively with an originally developed ventricular simulator using isolated goat hearts for the sophisticated artificial PM. Aortic and mitral valves with left ventricular free wall portions of isolated goat hearts (n=9) were secured on the elastic plastic membrane and statically pressurized, which led to valvular leaflet-papillary muscle positional change and central mitral regurgitation. PMs were connected to the load cell, and the relationship between the tension of regurgitation and PM tension were measured. Then we connected the left ventricular specimen model to our hydraulic ventricular simulator and achieved hemodynamic simulation with the controlled tension of PMs.

"Artificial humans": Psychology and neuroscience perspectives on embodiment and nonverbal communication.

Science.gov (United States)

Vogeley, Kai; Bente, Gary

2010-01-01

"Artificial humans", so-called "Embodied Conversational Agents" and humanoid robots, are assumed to facilitate human-technology interaction referring to the unique human capacities of interpersonal communication and social information processing. While early research and development in artificial intelligence (AI) focused on processing and production of natural language, the "new AI" has also taken into account the emotional and relational aspects of communication with an emphasis both on understanding and production of nonverbal behavior. This shift in attention in computer science and engineering is reflected in recent developments in psychology and social cognitive neuroscience. This article addresses key challenges which emerge from the goal to equip machines with socio-emotional intelligence and to enable them to interpret subtle nonverbal cues and to respond to social affordances with naturally appearing behavior from both perspectives. In particular, we propose that the creation of credible artificial humans not only defines the ultimate test for our understanding of human communication and social cognition but also provides a unique research tool to improve our knowledge about the underlying psychological processes and neural mechanisms. Copyright © 2010. Published by Elsevier Ltd.

Histopathology Image Analysis in Two Long-Term Animal Experiments with Helical Flow Total Artificial Heart.

Science.gov (United States)

Wotke, Jiri; Homolka, Pavel; Vasku, Jaromír; Dobsak, Petr; Palanova, Petra; Mrkvicova, Veronika; Konecny, Petr; Soska, Vladimir; Pohanka, Michal; Novakova, Marie; Yurimoto, Terumi; Saito, Itsuro; Inoue, Yusuke; Isoyama, Takashi; Abe, Yusuke

2016-12-01

Histopathological analysis can provide important information in long-term experiments with total artificial heart (TAH). Recently, a new type of blood pump, the helical flow total artificial heart (HF-TAH) was developed. This study aimed to investigate the changes in selected vital organs in animal experiments with implanted HF-TAH. Samples from lung, liver, and kidneys from two female goats (No. 1301 and No. 1304) with implanted HF-TAH were analyzed. Tissue samples were fixed in 10% formaldehyde and 4 µm thick transverse sections were stained with hematoxylin-eosin (HE). Additional staining was done for detection of connective tissue (Masson-Goldner stain) and for detection of iron (hemosiderin) deposits (Perls stain). Sections were scanned at 100× and 500× magnification with a light microscope. Experiment no. 1301 survived 100 days (cause of termination was heavy damage of the right pump); experimental goat no.1304 survived 68 days and was sacrificed due to severe right hydrodynamic bearing malfunction. Histopathological analysis of liver samples proved signs of chronic venostasis with limited focal necrotic zones. Dilated tubules, proteinaceous material in tubular lumen, and hemosiderin deposits were detected in kidney samples. Contamination of the organs by embolized micro-particles was suspected at the autopsy after discovery of visible damage (scratches) of the pump impeller surface (made from titanium alloy) in both experiments. Sporadic deposits of foreign micro-particles (presumably titanium) were observed in most of the analyzed parenchymal organs. However, the described deposits were not in direct connection with inflammatory reactions in the analyzed tissues. Histopathological analysis showed the presence of minimal contamination of the lung, kidney, and liver tissue samples by foreign material (titanium very likely). The analysis showed only limited pathological changes, especially in liver and kidneys, which might be attributed to the influence of

Design and analysis of a field modulated magnetic screw for artificial heart

Science.gov (United States)

Ling, Zhijian; Ji, Jinghua; Wang, Fangqun; Bian, Fangfang

2017-05-01

This paper proposes a new electromechanical energy conversion system, called Field Modulated Magnetic Screw (FMMS) as a high force density linear actuator for artificial heart. This device is based on the concept of magnetic screw and linear magnetic gear. The proposed FMMS consists of three parts with the outer and inner carrying the radially magnetized helically permanent-magnet (PM), and the intermediate having a set of helically ferromagnetic pole pieces, which modulate the magnetic fields produced by the PMs. The configuration of the newly designed FMMS is presented and its electromagnetic performances are analyzed by using the finite-element analysis, verifying the advantages of the proposed structure.

Assessment of the interface of beating heart with total artificial heart using magnetic resonance imaging

International Nuclear Information System (INIS)

Komoda, Tsuyoshi; Maeta, Hajime; Uyama, Chikao; Sanou, Kazuo.

1992-01-01

We have studied three-dimensionally (3-D) reconstructed images of atrioventricular (AV) annuli based on four-chamber magnetic resonance (MR) images for total artificial heart (TAH) implantation. To assess the interrelationship among the AV annuli and the thorax, we applied the frame of reference of the vertebral canal to these images. The Z-axis was along the vertebral canal, the Y-axis in the anteroposterior direction. The angle alpha was defined as the angle between the X-axis and the intersection between the plane of the annulus and the X-Y plane. The angle beta was defined as the angle between the Z-axis and the intersection between the plane of annulus and X-Z plane. The angle gamma was defined as the angle between the plane of the annulus and the anterior thoracic wall. We determined each angle for the mitral annulus (MVA) and tricuspid annulus (TVA) in four normal subjects to be as follows: alpha-MVA, 20.5-39.5 degrees; alpha-TVA, 26.1-43.5 degrees; beta-MVA, 4.7-49.4 degrees; beta-TVA, 4.4-40.9 degrees; and gamma-TVA, 35.2-44.1 degrees. It is suggested that reconstruction of the thoracic wall and AV annuli using the frame of reference of the diaphragmatic surface of the heart would facilitate evaluation of the spacial requirements for TAH implantation. Research to define this new frame of reference is in progress. (author)

Early in vivo experience with the pediatric continuous-flow total artificial heart.

Science.gov (United States)

Karimov, Jamshid H; Horvath, David J; Byram, Nicole; Sunagawa, Gengo; Kuban, Barry D; Gao, Shengqiang; Dessoffy, Raymond; Fukamachi, Kiyotaka

2018-03-30

Heart transplantation in infants and children is an accepted therapy for end-stage heart failure, but donor organ availability is low and always uncertain. Mechanical circulatory support is another standard option, but there is a lack of intracorporeal devices due to size and functional range. The purpose of this study was to evaluate the in vivo performance of our initial prototype of a pediatric continuous-flow total artificial heart (P-CFTAH), comprising a dual pump with one motor and one rotating assembly, supported by a hydrodynamic bearing. In acute studies, the P-CFTAH was implanted in 4 lambs (average weight: 28.7 ± 2.3 kg) via a median sternotomy under cardiopulmonary bypass. Pulmonary and systemic pump performance parameters were recorded. The experiments showed good anatomical fit and easy implantation, with an average aortic cross-clamp time of 98 ± 18 minutes. Baseline hemodynamics were stable in all 4 animals (pump speed: 3.4 ± 0.2 krpm; pump flow: 2.1 ± 0.9 liters/min; power: 3.0 ± 0.8 W; arterial pressure: 68 ± 10 mm Hg; left and right atrial pressures: 6 ± 1 mm Hg, for both). Any differences between left and right atrial pressures were maintained within the intended limit of ±5 mm Hg over a wide range of ratios of systemic-to-pulmonary vascular resistance (0.7 to 12), with and without pump-speed modulation. Pump-speed modulation was successfully performed to create arterial pulsation. This initial P-CFTAH prototype met the proposed requirements for self-regulation, performance, and pulse modulation. Copyright © 2018 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Materials testing and requirement for the ERDA nuclear-powered artificial heart. Technical progress report, July 15, 1975--May 30, 1976

International Nuclear Information System (INIS)

Andrade, J.D.; Hufferd, W.L.; Lyman, D.J.

1976-01-01

The two materials currently being used for the artificial heart fabrication are BIOMER and AVCOTHANE. BIOMER is a polyether urethane polymer. AVCOTHANE is a proprietary polyurethane/polydimethylsiloxane polymer blend. Research progress on the chemical degradation, mechanical strength, and blood compatibility is reported

Human Fitting Studies of Cleveland Clinic Continuous-Flow Total Artificial Heart

Science.gov (United States)

Karimov, Jamshid H.; Steffen, Robert J.; Byram, Nicole; Sunagawa, Gengo; Horvath, David; Cruz, Vincent; Golding, Leonard A.R.; Fukamachi, Kiyotaka; Moazami, Nader

2015-01-01

Implantation of mechanical circulatory support devices is challenging, especially in patients with a small chest cavity. We evaluated how well the Cleveland Clinic continuous-flow total artificial heart (CFTAH) fit the anatomy of patients about to receive a heart transplant. A mock pump model of the CFTAH was rapid-prototyped using biocompatible materials. The model was brought to the operative table, and the direction, length, and angulation of the inflow/outflow ports and outflow conduits were evaluated after the recipient's ventricles had been resected. Thoracic cavity measurements were based on preoperative computed tomographic data. The CFTAH fit well in all five patients (height, 170 ± 9 cm; weight, 75 ± 24 kg). Body surface area was 1.9 ± 0.3 m2 (range, 1.6-2.1 m2). The required inflow and outflow port orientation of both the left and right housings appeared consistent with the current version of the CFTAH implanted in calves. The left outflow conduit remained straight, but the right outflow direction necessitated a 73 ± 22 degree angulation to prevent potential kinking when crossing over the connected left outflow. These data support the fact that our design achieves the proper anatomical relationship of the CFTAH to a patient's native vessels. PMID:25806613

Estimation of Filling and Afterload Conditions by Pump Intrinsic Parameters in a Pulsatile Total Artificial Heart.

Science.gov (United States)

Cuenca-Navalon, Elena; Laumen, Marco; Finocchiaro, Thomas; Steinseifer, Ulrich

2016-07-01

A physiological control algorithm is being developed to ensure an optimal physiological interaction between the ReinHeart total artificial heart (TAH) and the circulatory system. A key factor for that is the long-term, accurate determination of the hemodynamic state of the cardiovascular system. This study presents a method to determine estimation models for predicting hemodynamic parameters (pump chamber filling and afterload) from both left and right cardiovascular circulations. The estimation models are based on linear regression models that correlate filling and afterload values with pump intrinsic parameters derived from measured values of motor current and piston position. Predictions for filling lie in average within 5% from actual values, predictions for systemic afterload (AoPmean , AoPsys ) and mean pulmonary afterload (PAPmean ) lie in average within 9% from actual values. Predictions for systolic pulmonary afterload (PAPsys ) present an average deviation of 14%. The estimation models show satisfactory prediction and confidence intervals and are thus suitable to estimate hemodynamic parameters. This method and derived estimation models are a valuable alternative to implanted sensors and are an essential step for the development of a physiological control algorithm for a fully implantable TAH. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Veno-venous extracorporeal membrane oxygenation using an innovative dual-lumen cannula following implantation of a total artificial heart.

Science.gov (United States)

Youdle, Jemma; Penn, Sarah; Maunz, Olaf; Simon, Andre

2017-01-01

We report our first clinical use of the new Protek Duo TM cannula for peripheral veno-venous extra-corporeal life support (ECLS). A 53-year-old male patient underwent implantation of a total artificial heart (TAH) for biventricular failure. However, due to the development of post-operative respiratory dysfunction, the patient required ECLS for six days.

Getting a New Heart

Science.gov (United States)

... may be able to replace it with an artificial (man-made) valve. Cardiac size reduction . During this procedure, your doctor removes a piece of the heart muscle from an enlarged heart. This makes your heart ...

Implantation technique of the 50-cm3 SynCardia Total Artificial Heart: does size make a difference?

Science.gov (United States)

Spiliopoulos, Sotirios; Guersoy, Dilek; Dimitriou, Alexandros Merkourios; Koerfer, Reiner; Tenderich, Gero

2015-01-01

Despite downsizing, implantation technique of the 50-cm(3) SynCardia Total Artificial Heart and settings of the Companion driver remain unchanged. Owing to the absence of de-airing nipples, de-airing procedure is even more crucial and has to be performed carefully. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

[Flowmetric assessment of coronary bypass grafts in the conditions of artificial circulation and on the beating heart].

Science.gov (United States)

Bazylev, V V; Nemchenko, E V; Karnakhin, V A; Pavlov, A A; Mikulyak, A I

2016-01-01

Advantages and shortcomings of aortocoronary bypass grafting on the beating heart and in the conditions of artificial circulation (AC) have long been discussed. The data on patency of bypass grafts in the remote period are indicative of comparable results of operations with and without AC or advantages of using AC. In order to determine benefits of each method it is necessary to reveal intraoperative predictors of bypass grafts occlusion in the remote period. We analyzed the results of ultrasound flowmetry of the blood flow through the left internal thoracic artery during bypass grafting of the anterior descending artery with the use of AC and on the beating heart. A retrospective study included a total of 352 patients subdivided into 2 groups: Group One was composed of 120 patients undergoing surgery in the conditions of AC and Group Two comprised 232 patients subjected to similar operations on the beating heart. Blood flow was measured with the help of flowmeter VeryQ MediStim® after termination of AC and inactivation of heparin by protamine, with systolic pressure of 100-110 mm Hg. There were no statistically significant differences between the groups by the diameter and degree of stenosis of the anterior descending artery, diameter of the left internal thoracic artery. The mean volumetric blood flow velocity (Qmean) along the shunts in Group One was higher (p=0.01). No statistically significant differences by the pulsatility index (PI) between the groups were revealed (p=0.2). A conclusion was drawn that coronary bypass grafting of the anterior descending artery by the left internal thoracic artery in the conditions of artificial circulation made it possible to achieve higher volumetric velocity of blood flow through the conduit as compared with operations on the beating heart, with similar resistance index. The immediate results of the operations with the use of the both techniques did not differ.

Numerical model of total artificial heart hemodynamics and the effect of its size on stress accumulation.

Science.gov (United States)

Marom, Gil; Chiu, Wei-Che; Slepian, Marvin J; Bluestein, Danny

2014-01-01

The total artificial heart (TAH) is a bi-ventricular mechanical circulatory support device that replaces the heart in patients with end-stage congestive heart failure. The device acts as blood pump via pneumatic activation of diaphragms altering the volume of the ventricular chambers. Flow in and out of the ventricles is controlled by mechanical heart valves. The aim of this study is to evaluate the flow regime in the TAH and to estimate the thrombogenic potential during systole. Toward that goal, three numerical models of TAHs of differing sizes, that include the deforming diaphragm and the blood flow from the left chamber to the aorta, are introduced. A multiphase model with injection of platelet particles is employed to calculate their trajectories. The shear stress accumulation in the three models are calculated along the platelets trajectories and their probability density functions, which represent the `thrombogenic footprint' of the device are compared. The calculated flow regime successfully captures the mitral regurgitation and the flows that open and close the aortic valve during systole. Physiological velocity magnitudes are found in all three models, with higher velocities and increased stress accumulation predicted for smaller devices.

Electrical Stimulation of Artificial Heart Muscle: a look into the electrophysiological and genetic implications

Science.gov (United States)

Mohamed, Mohamed A; Islas, Jose F; Schwartz, Robert J; Birla, Ravi K

2016-01-01

Development of tissue-engineered hearts for treatment of myocardial infarction or biological pacemakers has been hindered by the production of mostly arrhythmic or in-synergistic constructs. Electrical stimulation (ES) of these constructs has been shown to produce tissues with greater twitch force and better adrenergic response. In order to further our understanding of the mechanisms underlying the effect of ES, we fabricated a bioreactor capable of delivering continuous or intermittent waveforms of various types to multiple constructs simultaneously. In this study, we examined the effect of an intermittent biphasic square wave on our artificial heart muscle (AHM) composed of neonatal rat cardiac cells and fibrin gel. Twitch forces, spontaneous contraction rates, biopotentials, gene expression profiles, and histological observations were examined for the ES protocol over a 12 day culture period. We demonstrate improved consistency between samples for twitch force and contraction rate, and higher normalized twitch force amplitudes for electrically stimulated AHM. Improvements in electrophysiology within the AHM was noted by higher conduction velocities and lower latency in electrical response for electrically stimulated AHM. Genes expressing key electrophysiological and structural markers peaked at days 6 and 8 of culture, only a few days after the initiation of ES. These results may be used for optimization strategies to establish protocols for producing AHM capable of replacing damaged heart tissue in either a contractile or electrophysiological capacity. Optimized AHM can lead to alternative treatments to heart failure and alleviate the limited donor supply crisis. PMID:28459744

Electrical Stimulation of Artificial Heart Muscle: A Look Into the Electrophysiologic and Genetic Implications.

Science.gov (United States)

Mohamed, Mohamed A; Islas, Jose F; Schwartz, Robert J; Birla, Ravi K

Development of tissue-engineered hearts for treatment of myocardial infarction or biologic pacemakers has been hindered by the production of mostly arrhythmic or in-synergistic constructs. Electrical stimulation (ES) of these constructs has been shown to produce tissues with greater twitch force and better adrenergic response. To further our understanding of the mechanisms underlying the effect of ES, we fabricated a bioreactor capable of delivering continuous or intermittent waveforms of various types to multiple constructs simultaneously. In this study, we examined the effect of an intermittent biphasic square wave on our artificial heart muscle (AHM) composed of neonatal rat cardiac cells and fibrin gel. Twitch forces, spontaneous contraction rates, biopotentials, gene expression profiles, and histologic observations were examined for the ES protocol over a 12 day culture period. We demonstrate improved consistency between samples for twitch force and contraction rate, and higher normalized twitch force amplitudes for electrically stimulated AHMs. Improvements in electrophysiology within the AHM were noted by higher conduction velocities and lower latency in electrical response for electrically stimulated AHMs. Genes expressing key electrophysiologic and structural markers peaked at days 6 and 8 of culture, only a few days after the initiation of ES. These results may be used for optimization strategies to establish protocols for producing AHMs capable of replacing damaged heart tissue in either a contractile or electrophysiologic capacity. Optimized AHMs can lead to alternative treatments to heart failure and alleviate the limited donor supply crisis.

Control system for an artificial heart

Science.gov (United States)

Gebben, V. D.; Webb, J. A., Jr.

1970-01-01

Inexpensive industrial pneumatic components are combined to produce control system to drive sac-type heart-assistance blood pump with controlled pulsatile pressure that makes pump rate of flow sensitive to venous /atrial/ pressure, while stroke is centered about set operating point and pump is synchronized with natural heart.

Impact of INTERMACS Profile on Clinical Outcomes for Patients Supported With the Total Artificial Heart.

Science.gov (United States)

Shah, Keyur B; Thanavaro, Kristin L; Tang, Daniel G; Quader, Mohammed A; Mankad, Anit K; Tchoukina, Inna; Thacker, Leroy R; Smallfield, Melissa C; Katlaps, Gundars; Hess, Michael L; Cooke, Richard H; Kasirajan, Vigneshwar

2016-11-01

Insufficient data delineate outcomes for Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profile 1 patients with the total artificial heart (TAH). We studied 66 consecutive patients implanted with the TAH at our institution from 2006 through 2012 and compared outcome by INTERMACS profile. INTERMACS profiles were adjudicated retrospectively by a reviewer blinded to clinical outcomes. Survival after TAH implantation at 6 and 12 months was 76% and 71%, respectively. INTERMACS profile 1 patients had decreased 6-month survival on the device compared with those in profiles 2-4 (74% vs 95%, log rank: P = .015). For the 50 patients surviving to heart transplantation, the 1-year posttransplant survival was 82%. There was no difference in 1-year survival when comparing patients in the INTERMACS 1 profile with less severe profiles (79% vs 84%; log rank test P = .7; hazard ratio [confidence interval] 1.3 [0.3-4.8]). Patients implanted with the TAH as INTERMACS profile 1 had reduced survival to transplantation compared with less sick profiles. INTERMACS profile at the time of TAH implantation did not affect 1-year survival after heart transplantation. Copyright © 2016 Elsevier Inc. All rights reserved.

The Syncardia™ total artificial heart: in vivo, in vitro, and computational modeling studies

Science.gov (United States)

Slepian, Marvin J.; Alemu, Yared; Soares, João Silva; Smith, Richard G.; Einav, Shmuel; Bluestein, Danny

2014-01-01

The SynCardia™ total artificial heart (TAH) is the only FDA-approved TAH in the world. The SynCardia™ TAH is a pneumatically driven, pulsatile system capable of flows of >9 L/min. The TAH is indicated for use as a bridge to transplantation (BTT) in patients at imminent risk of death from non-reversible bi-ventricular failure. In the Pivotal US approval trial the TAH achieved a BTT rate of >79%. Recently a multi-center, post-market approval study similarly demonstrated a comparable BTT rate. A major milestone was recently achieved for the TAH, with over 1100 TAHs having been implanted to date, with the bulk of implantation occurring at an ever increasing rate in the past few years. The TAH is most commonly utilized to save the lives of patients dying from end-stage bi-ventricular heart failure associated with ischemic or non-ischemic dilated cardiomyopathy. Beyond progressive chronic heart failure, the TAH has demonstrated great efficacy in supporting patients with acute irreversible heart failure associated with massive acute myocardial infarction. In recent years several diverse clinical scenarios have also proven to be well served by the TAH including severe heart failure associated with advanced congenital heart disease. failed or burned-out transplants, infiltrative and restrictive cardiomyopathies and failed ventricular assist devices. Looking to the future a major unmet need remains in providing total heart support for children and small adults. As such, the present TAH design must be scaled to fit the smaller patient, while providing equivalent, if not superior flow characteristics, shear profiles and overall device thrombogenicity. To aid in the development of a new “pediatric,” TAH an engineering methodology known as “Device Thrombogenicity Emulation (DTE)”, that we have recently developed and described, is being employed. Recently, to further our engineering understanding of the TAH, as steps towards next generation designs we have: (1

Heart pacemaker

Science.gov (United States)

Cardiac pacemaker implantation; Artificial pacemaker; Permanent pacemaker; Internal pacemaker; Cardiac resynchronization therapy; CRT; Biventricular pacemaker; Arrhythmia - pacemaker; Abnormal heart ...

Experimental method to reveal the effect of rotor magnet size and air gap on artificial heart driving motor torque and efficiency.

Science.gov (United States)

Qian, K X; Yuan, H Y; Ru, W M; Zeng, P

2002-01-01

To investigate experimentally the effect of rotor magnet design on artificial heart driving motor performance, seven rotors with different magnet lengths or thicknesses, as well as different peripheral angles, were manufactured and tested in the same motor stator with different rotating speeds. The input power (voltage and current) and output torque were measured and the motor efficiency was computed. The results demonstrated that the reduction of rotor magnet size and the enlargement of the air gap between the rotor magnets and the stator coil core have no significant effect on motor efficiency, but will reduce the torque value on which the motor achieves the highest efficiency; it could be remedied however by increasing the rotating speed, because the torque at the high efficiency point will increase along with the rotating speed. These results may provide a basis for developing small rotor magnets, large air gap and high efficiency motors for driving an artificial heart pump.

Artificial Intelligence in Astronomy

Science.gov (United States)

Devinney, E. J.; Prša, A.; Guinan, E. F.; Degeorge, M.

2010-12-01

From the perspective (and bias) as Eclipsing Binary researchers, we give a brief overview of the development of Artificial Intelligence (AI) applications, describe major application areas of AI in astronomy, and illustrate the power of an AI approach in an application developed under the EBAI (Eclipsing Binaries via Artificial Intelligence) project, which employs Artificial Neural Network technology for estimating light curve solution parameters of eclipsing binary systems.

Heart failure analysis dashboard for patient's remote monitoring combining multiple artificial intelligence technologies.

Science.gov (United States)

Guidi, G; Pettenati, M C; Miniati, R; Iadanza, E

2012-01-01

In this paper we describe an Heart Failure analysis Dashboard that, combined with a handy device for the automatic acquisition of a set of patient's clinical parameters, allows to support telemonitoring functions. The Dashboard's intelligent core is a Computer Decision Support System designed to assist the clinical decision of non-specialist caring personnel, and it is based on three functional parts: Diagnosis, Prognosis, and Follow-up management. Four Artificial Intelligence-based techniques are compared for providing diagnosis function: a Neural Network, a Support Vector Machine, a Classification Tree and a Fuzzy Expert System whose rules are produced by a Genetic Algorithm. State of the art algorithms are used to support a score-based prognosis function. The patient's Follow-up is used to refine the diagnosis.

Report on the results of the FY 1999 R and D of the medical welfare equipment technology and the development of an implantable total artificial heart system using a non-pulsatile pump. R and D of an implantable total artificial heart system using a non-pulsatile pump (R and D of the functional/cure artificial heart); Iryo fukushi kiki gijutsu no kenkyu kaihatsu tainai umekomigata jinko shinzo system 1999 nendo seika hokokusho. 5. Renzokuryu pump wo mochiita tainai umekomigata jinko shinzo system no kenkyu kaihatsu (kinoteki chiryoteki jinko shinzo no kenkyu kaihatsu)

Energy Technology Data Exchange (ETDEWEB)

NONE

2000-07-01

The R and D of element technology were made on non-pulsatile pump, drive/controller, energy supply storage system, structural coating materials, etc., and the prescribed target was achieved. In the R and D of a total system, a blood-removing conduit with movability was designed to avoid the functional inlet obstruction, and the animal experiment was carried out. In the short-term chronic animal experiment on the implantation of a single bypass model using this artificial conduit and in the animal experiment for implantation of functional/cure artificial heart, it was confirmed that the operation was conducted easily, the flow rate of the blood of the artificial heart is extremely stable, and the blood-removing conduit functions favorably. In the R and D on Tele-TAH with the aim of future home medical treatment, it became possible to acquire via monitor the pump drive information and blood circulation state information on the animals tested in the breeding farm. The remote medical simulation was made. (NEDO)

Median Sternotomy or Right Thoracotomy Techniques for Total Artificial Heart Implantation in Calves.

Science.gov (United States)

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

2016-10-01

The choice of optimal operative access technique for mechanical circulatory support device implantation ensures successful postoperative outcomes. In this study, we retrospectively evaluated the median sternotomy and lateral thoracotomy incisions for placement of the Cleveland Clinic continuous-flow total artificial heart (CFTAH) in a bovine model. The CFTAH was implanted in 17 calves (Jersey calves; weight range, 77.0-93.9 kg) through a median sternotomy (n = 9) or right thoracotomy (n = 8) for elective chronic implantation periods of 14, 30, or 90 days. Similar preoperative preparation, surgical techniques, and postoperative care were employed. Implantation of the CFTAH was successfully performed in all cases. Both methods provided excellent surgical field visualization. After device connection, however, the median sternotomy approach provided better visualization of the anastomoses and surgical lines for hemostasis confirmation and repair due to easier device displacement, which is severely limited following right thoracotomy. All four animals sacrificed after completion of the planned durations (up to 90 days) were operated through full median sternotomy. Our data demonstrate that both approaches provide excellent initial field visualization. Full median sternotomy provides larger viewing angles at the anastomotic suture line after device connection to inflow and outflow ports. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Materials testing and requirement for the ERDA nuclear-powered artificial heart. Technical progress report, July 15, 1975--May 30, 1976. [BIOMER and AVCOTHANE

Energy Technology Data Exchange (ETDEWEB)

Andrade, J. D.; Hufferd, W. L.; Lyman, D. J.

1976-01-01

The two materials currently being used for the artificial heart fabrication are BIOMER and AVCOTHANE. BIOMER is a polyether urethane polymer. AVCOTHANE is a proprietary polyurethane/polydimethylsiloxane polymer blend. Research progress on the chemical degradation, mechanical strength, and blood compatibility is reported. (TFD)

Fiscal 2000 achievement report on the research and development of medical and welfare apparatus/technology. Totally implantable artificial heart for clinical use; 2000 nendo iryo fukushi kiki gijutsu kenkyu kaihatsu seika hokokusho. Rinsho oyo ni muketa tainai umekomigata jinko shinzo system

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-05-01

In the development of control technologies for a pulsatile pump, studies proceeded with a view to using a mixed venous blood oxygen saturation sensor, an ultrasonic sensor, and an absolute pressure sensor. Efforts were started to downsize the hydraulic actuator and to enhance its efficiency. In the development of a non-pulsatile artificial heart, the GyroP1710 series of artificial heart systems of Japanese make was developed, which employed a curved inlet known to be highly compatible from the anatomical point of view. In the development of a total system, a pulsatile auxiliary artificial heart was given a chronic animal test which continued approximately three weeks, when it yielded a flow of approximately 4 liters/minute showing that it would be practical as an auxiliary heart. As for the non-pulsatile artificial heart, a cardiopulmonary bypass test was conducted, when the blood circulation behavior was normal and organ functions were sustained. The free hemoglobin level was 9.3mg/dl achieving the target value, and the test animal lived as long as 50 days. (NEDO)

Attitude of the Saudi community towards heart donation, transplantation, and artificial hearts.

Science.gov (United States)

AlHabeeb, Waleed; AlAyoubi, Fakhr; Tash, Adel; AlAhmari, Leenah; AlHabib, Khalid F

2017-07-01

To understand the attitudes of the Saudi population towards heart donation and transplantation. Methods: A survey using a questionnaire addressing attitudes towards organ transplantation and donation was conducted across 18 cities in Saudi Arabia between September 2015 and March 2016.  Results: A total of 1250 respondents participated in the survey. Of these, approximately 91% agree with the concept of organ transplantation but approximately 17% do not agree with the concept of heart transplantation; 42.4% of whom reject heart transplants for religious reasons. Only 43.6% of respondents expressed a willingness to donate their heart and approximately 58% would consent to the donation of a relative's organ after death. A total of 59.7% of respondents believe that organ donation is regulated and 31.8% fear that the doctors will not try hard enough to save their lives if they consent to organ donation. Approximately 77% believe the heart is removed while the donor is alive; although, the same proportion of respondents thought they knew what brain death meant. Conclusion: In general, the Saudi population seem to accept the concept of transplantation and are willing to donate, but still hold some reservations towards heart donation.

Extracorporeal total artificial heart as bailout surgery.

Science.gov (United States)

Perrodin, Stéphanie F; Muller, Olivier; Gronchi, Fabrizio; Liaudet, Lucas; Hullin, Roger; Kirsch, Matthias

2017-03-01

We report the use of a total extracorporeal heart for uncontrolled bleeding following a proximal left anterior descending artery perforation, using two centrifugal ventricular assist devices after heart explantation. The literature describing similar techniques and patient outcomes for this "bailout" technique are reviewed. © 2017 Wiley Periodicals, Inc.

An example of the use of the DELPHI method: future prospects of artificial heart techniques in France; Un exemple d'utilisation de la methode DELPHI: perspectives de developpement en France des techniques de coeur artificiel

Energy Technology Data Exchange (ETDEWEB)

Derian, Jean-Claude [Commissariat a l' energie atomique et aux energies alternatives - CEA, Centre d' Etudes Nucleaires de Fontenay-aux-Roses, Departement des Programmes, Section des Etudes Economiques Generales (France); Morize, Francoise [Commissariat a l' energie atomique et aux energies alternatives - CEA, Centre d' Etudes Nucleaires de Saclay, Institut National des Sciences et Techniques Nucleaires (France); Vernejoul, Pierre de [Faculte de Medecine Necker - Enfants Malades (France); Service Hospitalier Frederic Joliot (France); Vial, Renee [Direction de Protection et Surete Radiologiques (France)

1971-07-01

The artificial heart is still only a research project surrounded by numerous uncertainties which make it very difficult to estimate, at the moment, the possibilities for future development of this technique in France. A systematic analysis of the hazards which characterize this project has been undertaken in the following report: restricting these uncertainties has required a taking into account of opinions of specialists concerned with type of research or its upshot. We have achieved this by adapting an investigation technique which is still unusual in France, the DELPHI method. This adaptation has allowed the confrontation and statistical aggregation of the opinions given by a body of a hundred experts who were consulted through a program of sequential interrogations which studied in particular, the probable date of the research issue, the clinical cases which require the use of an artificial heart, as well as the probable future needs. After having taken into account the economic constraints, we can deduce from these results the probable amount of plutonium 238 needed in the hypothesis where isotopic generator would be retained for the energetics feeding of the artificial heart [French] Le coeur artificiel n'est encore actuellement qu'un projet de recherche auquel sont attachees de nombreuses incertitudes qui rendent difficile l'appreciation des possibilites de developpement futures de cette technique en France. Une analyse systematique des aleas qui caracterisent ce projet est entreprise dans l'etude ci-apres: circonscrire ces aleas necessite la prise en compte d'opinions emanant des specialistes concernes par cette recherche ou par son issue: c'est ce qui a ete realise en adaptant une methodologie non classique en France, la methode DELPHI. Cette adaptation a permis la confrontation et l'agregation statistique des opinions fournies par un college d'une centaine d'experts consultes par un programme d'interrogations sequentielles, envisageant en particulier les

Perspectives of Puerto Rican Adults about Heart Health and a Potential Community Program.

Science.gov (United States)

Todorova, Irina L G; Tejada, Shirley; Castaneda-Sceppa, Carmen

Puerto Ricans are the second largest Hispanic group in the U.S. and older adults have significant health disparities. Educational programs that address heart disease risk for this population have rarely been developed and implemented. To address this gap, the Heart Healthy Initiative for Puerto Rican adults is being developed. To develop it as a participatory program, the community members were asked about their perspectives. Five focus groups with 28 participants, aged 45-60, were conducted, transcribed and analyzed using Thematic Analysis. In-depth analysis of meanings of health promoting behaviors, in the context of cultural beliefs and values was carried out. The following themes were identified: Health as balance and integration; Health as connection of self, connection with others; Cultural meanings of lifestyle choices; Stresses and struggles. Participants suggested that the program should have significant variety and a holistic perspective, be sensitive to different needs and motivations, stimulate mutual understanding and shared cultural meanings. The program needs to support lifestyle changes which maximally preserve traditions and to introduce multi-level changes. The identified cultural meanings of diet, physical activity and relationships were taken into account to develop the educational curriculum.

Hemodynamics of a functional centrifugal-flow total artificial heart with functional atrial contraction in goats.

Science.gov (United States)

Shiga, Takuya; Shiraishi, Yasuyuki; Sano, Kyosuke; Taira, Yasunori; Tsuboko, Yusuke; Yamada, Akihiro; Miura, Hidekazu; Katahira, Shintaro; Akiyama, Masatoshi; Saiki, Yoshikatsu; Yambe, Tomoyuki

2016-03-01

Implantation of a total artificial heart (TAH) is one of the therapeutic options for the treatment of patients with end-stage biventricular heart failure. There is no report on the hemodynamics of the functional centrifugal-flow TAH with functional atrial contraction (fCFTAH). We evaluated the effects of pulsatile flow by atrial contraction in acute animal models. The goats received fCFTAH that we created from two centrifugal-flow ventricular assist devices. Some hemodynamic parameters maintained acceptable levels: heart rate 115.5 ± 26.3 bpm, aortic pressure 83.5 ± 10.1 mmHg, left atrial pressure 18.0 ± 5.9 mmHg, pulmonary pressure 28.5 ± 9.7 mmHg, right atrial pressure 13.6 ± 5.2 mmHg, pump flow 4.0 ± 1.1 L/min (left) 3.9 ± 1.1 L/min (right), and cardiac index 2.13 ± 0.14 L/min/m(2). fCFTAH with atrial contraction was able to maintain the TAH circulation by forming a pulsatile flow in acute animal experiments. Taking the left and right flow rate balance using the low internal pressure loss of the VAD pumps may be easier than by other pumps having considerable internal pressure loss. We showed that the remnant atrial contraction effected the flow rate change of the centrifugal pump, and the atrial contraction waves reflected the heart rate. These results indicate that remnant atria had the possibility to preserve autonomic function in fCFTAH. We may control fCFTAH by reflecting the autonomic function, which is estimated with the flow rate change of the centrifugal pump.

Artificial heart development program. Volume I. System development. Phase III summary report, July 1, 1973--September 30, 1977

International Nuclear Information System (INIS)

1977-01-01

Efforts and results in the development of the power system portions of a calf implantable model of nuclear-powered artificial heart are discussed. The primary objective in developing the implantable model was to solve the packaging problems for total system implantation. The power system's portion is physically that portion of the implantable model between the 238 Pu heat sources and the blood pump ventricles. The 238 Pu heat sources and blood pump ventricles were provided as Government Furnished Equipment as developed and fabricated by other contractors

Cardiopulmonary exercise testing responses to different external portable drivers in a patient with a CardioWest Total Artificial Heart.

Science.gov (United States)

Tarzia, Vincenzo; Braccioni, Fausto; Bortolussi, Giacomo; Buratto, Edward; Gallo, Michele; Bottio, Tomaso; Vianello, Andrea; Gerosa, Gino

2016-06-01

Management of patients treated with CardioWest Total Artificial Heart (CW-TAH) as a bridge to heart transplantation (HTx) is complicated by difficulties in determining the optimal timing of transplantation. We present a case of a 53-year-old man supported as an outpatient with a CW-TAH, whose condition deteriorated following exchange of the portable driver. The patient was followed-up with serial cardiopulmonary exercise testing (CPET) which demonstrated a fall of peak VO2 to below 12 ml/kg/min following driver substitution, and the patient was subsequently treated with urgent orthotopic HTx. This case highlights the potential utility of CPET as a means for monitoring and indicating timing of HTx in patients with CW-TAH, as well as the potential for clinical deterioration following portable driver substitution.

Artificial UV sources in perspective

International Nuclear Information System (INIS)

Coppell, R.

1993-01-01

With rare exceptions, the sun is by far the most important source of exposure to ultraviolet radiation. This is the conclusion of a brief examination into use of artificial sources in New Zealand. (author). 1 tab

Development of a microcontroller-based automatic control system for the electrohydraulic total artificial heart.

Science.gov (United States)

Kim, H C; Khanwilkar, P S; Bearnson, G B; Olsen, D B

1997-01-01

An automatic physiological control system for the actively filled, alternately pumped ventricles of the volumetrically coupled, electrohydraulic total artificial heart (EHTAH) was developed for long-term use. The automatic control system must ensure that the device: 1) maintains a physiological response of cardiac output, 2) compensates for an nonphysiological condition, and 3) is stable, reliable, and operates at a high power efficiency. The developed automatic control system met these requirements both in vitro, in week-long continuous mock circulation tests, and in vivo, in acute open-chested animals (calves). Satisfactory results were also obtained in a series of chronic animal experiments, including 21 days of continuous operation of the fully automatic control mode, and 138 days of operation in a manual mode, in a 159-day calf implant.

Artificial heart development program. Volume I. System development. Phase III summary report, July 1, 1973--September 30, 1977

Energy Technology Data Exchange (ETDEWEB)

1977-01-01

Efforts and results in the development of the power system portions of a calf implantable model of nuclear-powered artificial heart are discussed. The primary objective in developing the implantable model was to solve the packaging problems for total system implantation. The power system's portion is physically that portion of the implantable model between the /sup 238/Pu heat sources and the blood pump ventricles. The /sup 238/Pu heat sources and blood pump ventricles were provided as Government Furnished Equipment as developed and fabricated by other contractors.

Heart Rate Variability: New Perspectives on Physiological Mechanisms, Assessment of Self-regulatory Capacity, and Health risk.

Science.gov (United States)

McCraty, Rollin; Shaffer, Fred

2015-01-01

Heart rate variability, the change in the time intervals between adjacent heartbeats, is an emergent property of interdependent regulatory systems that operates on different time scales to adapt to environmental and psychological challenges. This article briefly reviews neural regulation of the heart and offers some new perspectives on mechanisms underlying the very low frequency rhythm of heart rate variability. Interpretation of heart rate variability rhythms in the context of health risk and physiological and psychological self-regulatory capacity assessment is discussed. The cardiovascular regulatory centers in the spinal cord and medulla integrate inputs from higher brain centers with afferent cardiovascular system inputs to adjust heart rate and blood pressure via sympathetic and parasympathetic efferent pathways. We also discuss the intrinsic cardiac nervous system and the heart-brain connection pathways, through which afferent information can influence activity in the subcortical, frontocortical, and motor cortex areas. In addition, the use of real-time HRV feedback to increase self-regulatory capacity is reviewed. We conclude that the heart's rhythms are characterized by both complexity and stability over longer time scales that reflect both physiological and psychological functional status of these internal self-regulatory systems.

Experience with the SynCardia total artificial heart in a Canadian centre.

Science.gov (United States)

Nguyen, Anthony; Pellerin, Michel; Perrault, Louis P; White, Michel; Ducharme, Anique; Racine, Normand; Carrier, Michel

2017-12-01

The SynCardia total artificial heart (TAH) provides complete circulatory support by replacing both native ventricles. Accepted indications include bridge to transplantation and destination therapy. We review our experience with TAH implantation during a period when axial flow pump became available. We retrospectively analyzed the demographics, clinical characteristics and survival of all patients receiving the TAH. From September 2004 to November 2016, 13 patients (12 men, mean age 45 ± 13 yr) received the TAH for refractory cardiogenic shock secondary to idiopathic (56%) or ischemic (17%) cardiomyopathy and to other various causes (33%). Before implantation, mean ejection fraction was 14% ± 4%, 7 (54%) patients had previous cardiac surgery, 4 (31%) were on mechanical ventilation, and 3 (23%) patients were on dialysis. The mean duration of TAH support was 46 ± 40 days. Three (23%) patients died while on support after a mean of 15 days. Actuarial survival on support was 77% ± 12% at 30 days after implantation. Complications on support included stroke ( n = 1, 8%), acute respiratory distress syndrome requiring prolonged intubation ( n = 5, 38%) and acute renal failure requiring temporary dialysis ( n = 5, 38%). Ten (77%) patients survived to be transplanted after a mean of 52 ± 42 days of support. Actuarial survival rates after transplant were 67% ± 16% at 1 month and 56% ± 17% at 1 year after transplantation. The TAH provides an alternative with low incidence of neurologic events in extremely fragile and complex patients waiting for heart transplantation. Complex and unusual anatomic conditions explained the current use of TAH.

The patient perspective: Quality of life in advanced heart failure with frequent hospitalisations.

Science.gov (United States)

Nieminen, Markku S; Dickstein, Kenneth; Fonseca, Cândida; Serrano, Jose Magaña; Parissis, John; Fedele, Francesco; Wikström, Gerhard; Agostoni, Piergiuseppe; Atar, Shaul; Baholli, Loant; Brito, Dulce; Colet, Josep Comín; Édes, István; Gómez Mesa, Juan E; Gorjup, Vojka; Garza, Eduardo Herrera; González Juanatey, José R; Karanovic, Nenad; Karavidas, Apostolos; Katsytadze, Igor; Kivikko, Matti; Matskeplishvili, Simon; Merkely, Béla; Morandi, Fabrizio; Novoa, Angel; Oliva, Fabrizio; Ostadal, Petr; Pereira-Barretto, Antonio; Pollesello, Piero; Rudiger, Alain; Schwinger, Robert H G; Wieser, Manfred; Yavelov, Igor; Zymliński, Robert

2015-07-15

End of life is an unfortunate but inevitable phase of the heart failure patients' journey. It is often preceded by a stage in the progression of heart failure defined as advanced heart failure, and characterised by poor quality of life and frequent hospitalisations. In clinical practice, the efficacy of treatments for advanced heart failure is often assessed by parameters such as clinical status, haemodynamics, neurohormonal status, and echo/MRI indices. From the patients' perspective, however, quality-of-life-related parameters, such as functional capacity, exercise performance, psychological status, and frequency of re-hospitalisations, are more significant. The effects of therapies and interventions on these parameters are, however, underrepresented in clinical trials targeted to assess advanced heart failure treatment efficacy, and data are overall scarce. This is possibly due to a non-universal definition of the quality-of-life-related endpoints, and to the difficult standardisation of the data collection. These uncertainties also lead to difficulties in handling trade-off decisions between quality of life and survival by patients, families and healthcare providers. A panel of 34 experts in the field of cardiology and intensive cardiac care from 21 countries around the world convened for reviewing the existing data on quality-of-life in patients with advanced heart failure, discussing and reaching a consensus on the validity and significance of quality-of-life assessment methods. Gaps in routine care and research, which should be addressed, were identified. Finally, published data on the effects of current i.v. vasoactive therapies such as inotropes, inodilators, and vasodilators on quality-of-life in advanced heart failure patients were analysed. Copyright © 2015. Published by Elsevier Ireland Ltd.

A novel dynamic cardiac simulator utilizing pneumatic artificial muscle.

Science.gov (United States)

Liu, Hao; Yan, Jie; Zhou, Yuanyuan; Li, Hongyi; Li, Changji

2013-01-01

With the development of methods and skills of minimally invasive surgeries, equipments for doctors' training and practicing are in high demands. Especially for the cardiovascular surgeries, operators are requested to be familiar with the surgical environment of a beating heart. In this paper, we present a new dynamic cardiac simulator utilizing pneumatic artificial muscle to realize heartbeat. It's an artificial left ventricular of which the inner chamber is made of thermoplastic elastomers (TPE) with an anatomical structure of the real human heart. It is covered by another layer of material forming the artificial muscle which actuates the systole and diastole uniformly and omnidirectionally as the cardiac muscle does. Preliminary experiments were conducted to evaluate the performance of the simulator. The results indicated that the pressure at the terminal of the aorta could be controlled within the range of normal human systolic pressure, which quantitatively validated the new actuating mode of the heart-beating is effective.

Electromagnetic Compatibility of Transcutaneous Energy Transmission Systemfor Totally Implantable Artificial Heart

Science.gov (United States)

Shiba, Kenji; Koshiji, Kohji

Transcutaneous Energy Transmission (TET) is one way of providing the energy needed to power a totally implantable artificial heart (TIAH). In the present study, an externally coupled TET system was implanted in a prototype human phantom to evaluate emission and immunity. In the emission evaluation, measurements were conducted based on CISPR Pub.11 and VDE 0871 standards, while immunity tests were based on the standards of the IEC 61000-4 series. The magnetic field of the radiated emission was measured using a loop antenna. At 0.1[MHz], we found the greatest magnetic field of 47.8 [dBμA/m], somewhat less than CISPR’s upper limit of 54 [dBμA/m]. For the conducted emission, by installing a noise filter and ferrite beads in the input section of the DC-power supply, conducted emission could be kept within the allowable limits of CISPR Pub.11 and VDE 0871. Finally, the immunity tests against radiated and conducted emission, electrostatic discharge and voltage fluctuation proved that the prototype could withstand the maximum level of disturbance. These results confirmed that the TET system implanted in a human phantom could, through modification, meet the emission and immunity standards.

Prospects for using implanted systems of assisted circulation and artificial heart with a radioisotope power source (biomedical, thermal, and radiation aspects)

Energy Technology Data Exchange (ETDEWEB)

Kiselev, I M; Dubrovskii, G P; Mosidze, T G; Bazhanov, A I.U.

1983-02-01

The capacity of dogs to diffuse heat (up to 50 W) from an artificial heart and to tolerate prolonged intracorporeal ionizing radiation from a radioisotope power source (/sup 238/Pu) was investigated, using electrical models of vascular blood heat exchangers that permit reproduction of elimination and heat transmission in autonomous systems. It was shown that up to 50 W can be discharged at temperatures of the wall-blood interface that do not exceed 43 degrees C. Clotting indexes, concentration of total protein, hemolysis, and serum enzyme activity during 1-1.5 months of heating remained within physiologically normal limits. A specific power load of up to 1.5 W/kg at ambient temperatures of 18-20 degrees C revealed no evidence of changes in heat production. By measuring the distribution of power of the dose absorbed around a 45-W plutonium source it was possible to estimate dose loads on critical organs and to assess overall risk of death from malignant tumors induced by radiation over a 10-year period: 6-12% for males and 8-14% for females. It is not very probable that use of the artificial heart with a radioisotope power source will be limited by thermal and radiational effects.

Artificial heart development program. Volume I. System development. Phase III summary report

Energy Technology Data Exchange (ETDEWEB)

1977-01-01

The report documents efforts and results in the development of the power system portions of a calf implantable model of nuclear-powered artificial heart. The primary objective in developing the implantable model was to solve the packaging problems for total system implantation. The power systems portion is physically that portion of the implantable model between the Pu-238 heat sources and the blood pump ventricles. The work performed had two parallel themes. The first of these was the development of an integrated implantable model for bench and animal experiments plus design effort on a more advanced model. The second was research and development on components of the system done in conjunction with the development of the implantable model and to provide technology for incorporation into advanced models plus support to implantations, at the University of Utah, of the systems blood pumping elements when driven by electric motor. The efforts and results of implantable model development are covered, mainly, in the text of the report. The research and development efforts and results are reported, primarily, in the appendices (Vol. 2).

Artificial heart development program. Volume I. System development. Phase III summary report

International Nuclear Information System (INIS)

1977-01-01

The report documents efforts and results in the development of the power system portions of a calf implantable model of nuclear-powered artificial heart. The primary objective in developing the implantable model was to solve the packaging problems for total system implantation. The power systems portion is physically that portion of the implantable model between the Pu-238 heat sources and the blood pump ventricles. The work performed had two parallel themes. The first of these was the development of an integrated implantable model for bench and animal experiments plus design effort on a more advanced model. The second was research and development on components of the system done in conjunction with the development of the implantable model and to provide technology for incorporation into advanced models plus support to implantations, at the University of Utah, of the systems blood pumping elements when driven by electric motor. The efforts and results of implantable model development are covered, mainly, in the text of the report. The research and development efforts and results are reported, primarily, in the appendices

Radiochemicals used to scan the heart

International Nuclear Information System (INIS)

Anon.

1975-01-01

Techniques for heart scanning using 201 Tl and /sup 99m/Tc pyrophosphate are discussed. Thallium-201, produced artificially in a cyclotron, concentrates in normal heart muscle but not in abnormal tissue. Technetium-99m is deposited in mitochondria of heart cells that are irreversibly damaged. The combined use of 201 Tl and /sup 99m/Tc makes it possible to identify regions of recent heart damage as well as older heart damage. Advantages of using 129 Cs for heart scanning are also discussed

Multi-Targeted Antithrombotic Therapy for Total Artificial Heart Device Patients.

Science.gov (United States)

Ramirez, Angeleah; Riley, Jeffrey B; Joyce, Lyle D

2016-03-01

To prevent thrombotic or bleeding events in patients receiving a total artificial heart (TAH), agents have been used to avoid adverse events. The purpose of this article is to outline the adoption and results of a multi-targeted antithrombotic clinical procedure guideline (CPG) for TAH patients. Based on literature review of TAH anticoagulation and multiple case series, a CPG was designed to prescribe the use of multiple pharmacological agents. Total blood loss, Thromboelastograph(®) (TEG), and platelet light-transmission aggregometry (LTA) measurements were conducted on 13 TAH patients during the first 2 weeks of support in our institution. Target values and actual medians for postimplant days 1, 3, 7, and 14 were calculated for kaolinheparinase TEG, kaolin TEG, LTA, and estimated blood loss. Protocol guidelines were followed and anticoagulation management reduced bleeding and prevented thrombus formation as well as thromboembolic events in TAH patients postimplantation. The patients in this study were susceptible to a variety of possible complications such as mechanical device issues, thrombotic events, infection, and bleeding. Among them all it was clear that patients were at most risk for bleeding, particularly on postoperative days 1 through 3. However, bleeding was reduced into postoperative days 3 and 7, indicating that acceptable hemostasis was achieved with the anticoagulation protocol. The multidisciplinary, multi-targeted anticoagulation clinical procedure guideline was successful to maintain adequate antithrombotic therapy for TAH patients.

Burst Activity and Heart Rhythm Modulation in the Sympathetic Outflow to the Heart

National Research Council Canada - National Science Library

Baselli, G

2001-01-01

In 13 decerebrate, artificially ventilated cats preganglionic sympathetic outflow to the heart was recorded with ECG and ventilation signal, A novel algorithm was implemented that extracts weighted...

Artificial organs and transplantation.

Science.gov (United States)

Splendiani, G; Cipriani, S; Vega, A; Casciani, C U

2003-05-01

Nowadays artificial devices are not able to totally and undefinitely replace the loss of function of all vital organs and artificial organs can be used only to bridge the time to transplantation, which must be considered the first choice in the therapeutical approach for many chronic diseases. Since general population aging process is leading to an increase of organ demand, the gap between performed and requested transplantation is hard to fill. Xenotransplantation is nowadays only an experimental alternative solution and we have to do our best using available artificial organs to increase and improve the survival of patients waiting for transplantation. In this meeting we particularly dealt about organ function replacing therapy, especially regarding the kidney, heart, liver, pancreas and ear.

The Japanese artificial organs scene: current status.

Science.gov (United States)

Mitamura, Yoshinori; Murabayashi, Shun

2005-08-01

Artificial organs and regenerative medicine are the subjects of very active research and development (R&D) in Japan and various artificial organs are widely used in patients. Results of the R&D are presented at the annual conference of the Japanese Society for Artificial Organs (JSAO). Progress in the fields of artificial organs and regenerative medicine are reviewed annually in the Japanese Journal of Artificial Organs. The official English-language journal of JSAO, Journal of Artificial Organs, also publishes many original articles by Japanese researchers. Although the annual conference and the publications of JSAO provide the world with update information on artificial organs and regenerative medicine in Japan, the information is not always understood appropriately in the rest of the world, mainly due to language problems. This article therefore introduces the current status of artificial organs and regenerative medicine in Japan. Artificial hearts and metabolic support systems are reviewed here and other interesting areas such as regenerative medicine can be found elsewhere.

Driver electronics design and control for a total artificial heart linear motor.

Science.gov (United States)

Unthan, Kristin; Cuenca-Navalon, Elena; Pelletier, Benedikt; Finocchiaro, Thomas; Steinseifer, Ulrich

2018-01-27

For any implantable device size and efficiency are critical properties. Thus, a linear motor for a Total Artificial Heart was optimized with focus on driver electronics and control strategies. Hardware requirements were defined from power supply and motor setup. Four full bridges were chosen for the power electronics. Shunt resistors were set up for current measurement. Unipolar and bipolar switching for power electronics control were compared regarding current ripple and power losses. Here, unipolar switching showed smaller current ripple and required less power to create the necessary motor forces. Based on calculations for minimal power losses Lorentz force was distributed to the actor's four coils. The distribution was determined as ratio of effective magnetic flux through each coil, which was captured by a force test rig. Static and dynamic measurements under physiological conditions analyzed interaction of control and hardware and all efficiencies were over 89%. In conclusion, the designed electronics, optimized control strategy and applied current distribution create the required motor force and perform optimal under physiological conditions. The developed driver electronics and control offer optimized size and efficiency for any implantable or portable device with multiple independent motor coils. Graphical Abstract ᅟ.

An innovative, sensorless, pulsatile, continuous-flow total artificial heart: device design and initial in vitro study.

Science.gov (United States)

Fukamachi, Kiyotaka; Horvath, David J; Massiello, Alex L; Fumoto, Hideyuki; Horai, Tetsuya; Rao, Santosh; Golding, Leonard A R

2010-01-01

We are developing a very small, innovative, continuous-flow total artificial heart (CFTAH) that passively self-balances left and right pump flows and atrial pressures without sensors. This report details the CFTAH design concept and our initial in vitro data. System performance of the CFTAH was evaluated using a mock circulatory loop to determine the range of systemic and pulmonary vascular resistance (SVR and PVR) levels over which the design goal of a maximum absolute atrial pressure difference of 10 mm Hg is achieved for a steady-state flow condition. Pump speed was then modulated at 2,600 +/- 900 rpm to induce flow and arterial pressure pulsation to evaluate the effects of speed pulsations on the system performance. An automatic control mode was also evaluated. Using only passive self-regulation, pump flows were balanced and absolute atrial pressure differences were maintained at mode adjusted pump speed to achieve targeted pump flows based on sensorless calculations of SVR and CFTAH flow. The initial in vitro testing of the CFTAH with a single, valveless, continuous-flow pump demonstrated its passive self-regulation of flows and atrial pressures and a new automatic control mode. Copyright (c) 2010 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Experimental study of physical properties of artificial materials for the development of the tissue-engineered valvular heart apparatus in comparison with biological analogs

Science.gov (United States)

Chiryatyeva, Aleksandra; Trebushat, Dmitry; Prokhorokhin, Aleksei; Khakhalkin, Vladimir; Andreev, Mark; Novokhreschenov, Aleksei; Kretov, Evgeny

2017-12-01

Cardiovascular diseases are the leading cause of death worldwide. Valvular heart disease often requires valve repair or replacement. Today, surgery uses xenograft—porcine or bovine pericardium. However, bioprosthetic valves do not ensure sufficient durability. We investigated 0.6% glutaraldehyde-treated porcine pericardium to define its properties. Using a tensile test stand, we studied characteristics of the polymeric material—expanded polytetrafluoroethylene (ePTFE)—and compared it to xenopericardium. The artificial material provides a better durability; it has higher elastic modulus and ultimate tensile strength. However, ePTFE samples demonstrated direction anisotropy due to extrusion features. It requires the enhancement of quality of the ePTFE sheet or investigation of other polymeric materials to find the adequate replacement for bioprosthetic heart valves.

ARTIFICIAL INTELLIGENCE IN DETERMINATION OF MARKETING CUSTOMER STRATEGY

OpenAIRE

Markić, Brano; Bijakšić, Sanja; Šantić, Marko

2015-01-01

Artificial intelligence is a computer-based analytical process that tends to create computational systems which we would incline to be called intelligent. Expert systems are the most important part of the artificial intelligence from economic perspective. Expert systems attempt to mimic the human thought process including reasoning and optimization. “Knowledge” is represented by a set of “if-then” rules in a form of knowledge base. The results of artificial intelligence system implementation ...

ARTIFICIAL INTELLIGENCE IN DETERMINATION OF MARKETING CUSTOMER STRATEGY

OpenAIRE

Markić, Brano; Bijakšić, Sanja; Šantić, Marko

2016-01-01

Artificial intelligence is a computer-based analytical process that tends to create computational systems which we would incline to be called intelligent. Expert systems are the most important part of the artificial intelligence from economic perspective. Expert systems attempt to mimic the human thought process including reasoning and optimization. “Knowledge” is represented by a set of “if-then” rules in a form of knowledge base. The results of artificial intelligence system implementation ...

Hydro-mechanical foundation for blood swirling vortex flows formation in the cardio-vascular system and the problem of artificial heart creation

Directory of Open Access Journals (Sweden)

Sergey G. Chefranov

2013-11-01

Full Text Available Leonardo da Vinci perhaps was the first who paid attention to the energetic efficiency of existence of vortices emerging near sines of Valsalva and defining normal functioning (opening of aortal valve. However up to now a fundamental problem of defining of mechanisms of mysterious energetic efficiency of functioning of cardio-vascular system (CVS of blood feeding of the organism is still remaining significantly not solved and this is, for example, one of the main restriction for the creation of artificial heart and corresponding valve systems. In the present paper, results witnessing possible important role of the very hydro-mechanical mechanism in the realization of the noted energetic efficiency of CVS due to formation in the CVS of spiral structural organization of the arterial blood flow observed by methods of MRT and color Doppler-measuring in the left ventricular of the heart and in aorta.

Animal studies with the Carmat bioprosthetic total artificial heart.

Science.gov (United States)

Latrémouille, Christian; Duveau, Daniel; Cholley, Bernard; Zilberstein, Luca; Belbis, Guillaume; Boughenou, Marie-Fazia; Meleard, Denis; Bruneval, Patrick; Adam, Clovis; Neuschwander, Arthur; Perles, Jean-Christophe; Jansen, Piet; Carpentier, Alain

2015-05-01

The Carmat bioprosthetic total artificial heart (TAH) contains bioprosthetic blood-contacting surfaces, and is designed for orthotopic cardiac replacement. In preparation for clinical studies, we evaluated the TAH performance and its effects on end-organ function in an animal model. Twelve female Charolais calves, 2-3 months of age and weighing 102-122 kg, were implanted with the TAH through a mid-sternotomy to ensure an adequate anatomic fit. The intended support duration was 4-10 days. Haematological values, creatinine, bilirubin and lactate levels were measured and mean arterial and central venous pressure, central venous oxygen saturation and TAH parameters were monitored. The calves were placed in a cage immediately postoperatively, and extubated on postoperative day 1 in most cases. Average support duration was 3 days, with 4 of 12 calves supported for 4, 4, 8 and 10 days. The initial procedures were used to refine surgical techniques and postoperative care. Pump output ranged from 7.3 to 10 l/min. Haemodynamic parameters and blood analysis were within acceptable ranges. No device failures occurred. No anticoagulation was used in the postoperative phase. The calves were euthanized in case of discomfort compromising the animal well-being, such as respiratory dysfunction, severe blood loss and cerebral dysfunction. Device explant analysis showed no thrombus formation inside the blood cavities. Histological examination of kidneys showed isolated micro-infarction in 2/12 animals; brain histology revealed no thromboembolic depositions. The Carmat bioprosthetic TAH implanted in calves up to 10 days provided adequate blood flow to organs and tissues. Low levels of haemolysis and no visible evidence of thromboembolic depositions in major organs and device cavities, without the use of anticoagulation, may indicate early-phase haemocompatibility of the TAH. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio

Collective intelligence of the artificial life community on its own successes, failures, and future.

Science.gov (United States)

Rasmussen, Steen; Raven, Michael J; Keating, Gordon N; Bedau, Mark A

2003-01-01

We describe a novel Internet-based method for building consensus and clarifying conflicts in large stakeholder groups facing complex issues, and we use the method to survey and map the scientific and organizational perspectives of the artificial life community during the Seventh International Conference on Artificial Life (summer 2000). The issues addressed in this survey included artificial life's main successes, main failures, main open scientific questions, and main strategies for the future, as well as the benefits and pitfalls of creating a professional society for artificial life. By illuminating the artificial life community's collective perspective on these issues, this survey illustrates the value of such methods of harnessing the collective intelligence of large stakeholder groups.

Heart Rate Variability - A Historical Perspective

Directory of Open Access Journals (Sweden)

George E Billman

2011-11-01

Full Text Available Heart rate variability (HRV, the beat-to-beat variation in either heart rate or the duration of the R-R interval – the heart period, has become a popular clinical and investigational tool. The temporal fluctuations in heart rate exhibit a marked synchrony with respiration (increasing during inspiration and decreasing during expiration – the so called respiratory sinus arrhythmia, RSA and are widely believed to reflect changes in cardiac autonomic regulation. Although the exact contributions of the parasympathetic and the sympathetic divisions of the autonomic nervous system to this variability are controversial and remain the subject of active investigation and debate, a number of time and frequency domain techniques have been developed to provide insight into cardiac autonomic regulation in both health and disease. It is the purpose of this essay to provide an historical overview of the evolution in the concept of heart rate variability. Briefly, pulse rate was first measured by ancient Greek physicians and scientists. However, it was not until the invention of the Physician’s Pulse Watch (a watch with a second hand that could be stopped in 1707 that changes in pulse rate could be accurately assessed. The Rev. Stephen Hales (1733 was the first to note that pulse varied with respiration and in 1847 Carl Ludwig was the first to record RSA. With the measurement of the ECG (1895 and advent of digital signal processing techniques in the 1960’s, investigation of HRV and its relationship to health and disease has exploded. This essay will conclude with a brief description of time domain, frequency domain, and non-linear dynamic analysis techniques (and their limitations that are commonly used to measure heart rate variability.

Artificial intelligence in nanotechnology.

Science.gov (United States)

Sacha, G M; Varona, P

2013-11-15

During the last decade there has been increasing use of artificial intelligence tools in nanotechnology research. In this paper we review some of these efforts in the context of interpreting scanning probe microscopy, the study of biological nanosystems, the classification of material properties at the nanoscale, theoretical approaches and simulations in nanoscience, and generally in the design of nanodevices. Current trends and future perspectives in the development of nanocomputing hardware that can boost artificial-intelligence-based applications are also discussed. Convergence between artificial intelligence and nanotechnology can shape the path for many technological developments in the field of information sciences that will rely on new computer architectures and data representations, hybrid technologies that use biological entities and nanotechnological devices, bioengineering, neuroscience and a large variety of related disciplines.

Artificial intelligence in nanotechnology

Science.gov (United States)

Sacha, G. M.; Varona, P.

2013-11-01

During the last decade there has been increasing use of artificial intelligence tools in nanotechnology research. In this paper we review some of these efforts in the context of interpreting scanning probe microscopy, the study of biological nanosystems, the classification of material properties at the nanoscale, theoretical approaches and simulations in nanoscience, and generally in the design of nanodevices. Current trends and future perspectives in the development of nanocomputing hardware that can boost artificial-intelligence-based applications are also discussed. Convergence between artificial intelligence and nanotechnology can shape the path for many technological developments in the field of information sciences that will rely on new computer architectures and data representations, hybrid technologies that use biological entities and nanotechnological devices, bioengineering, neuroscience and a large variety of related disciplines.

Artificial intelligence in nanotechnology

International Nuclear Information System (INIS)

Sacha, G M; Varona, P

2013-01-01

During the last decade there has been increasing use of artificial intelligence tools in nanotechnology research. In this paper we review some of these efforts in the context of interpreting scanning probe microscopy, the study of biological nanosystems, the classification of material properties at the nanoscale, theoretical approaches and simulations in nanoscience, and generally in the design of nanodevices. Current trends and future perspectives in the development of nanocomputing hardware that can boost artificial-intelligence-based applications are also discussed. Convergence between artificial intelligence and nanotechnology can shape the path for many technological developments in the field of information sciences that will rely on new computer architectures and data representations, hybrid technologies that use biological entities and nanotechnological devices, bioengineering, neuroscience and a large variety of related disciplines. (topical review)

Heart regeneration.

Science.gov (United States)

Breckwoldt, Kaja; Weinberger, Florian; Eschenhagen, Thomas

2016-07-01

Regenerating an injured heart holds great promise for millions of patients suffering from heart diseases. Since the human heart has very limited regenerative capacity, this is a challenging task. Numerous strategies aiming to improve heart function have been developed. In this review we focus on approaches intending to replace damaged heart muscle by new cardiomyocytes. Different strategies for the production of cardiomyocytes from human embryonic stem cells or human induced pluripotent stem cells, by direct reprogramming and induction of cardiomyocyte proliferation are discussed regarding their therapeutic potential and respective advantages and disadvantages. Furthermore, different methods for the transplantation of pluripotent stem cell-derived cardiomyocytes are described and their clinical perspectives are discussed. This article is part of a Special Issue entitled: Cardiomyocyte Biology: Integration of Developmental and Environmental Cues in the Heart edited by Marcus Schaub and Hughes Abriel. Copyright © 2015 Elsevier B.V. All rights reserved.

Exploring partners' perspectives on participation in heart failure home care: a mixed-method design.

Science.gov (United States)

Näsström, Lena; Luttik, Marie Louise; Idvall, Ewa; Strömberg, Anna

2017-05-01

To describe the partners' perspectives on participation in the care for patients with heart failure receiving home care. Partners are often involved in care of patients with heart failure and have an important role in improving patients' well-being and self-care. Partners have described both negative and positive experiences of involvement, but knowledge of how partners of patients with heart failure view participation in care when the patient receives home care is lacking. A convergent parallel mixed-method design was used, including data from interviews and questionnaires. A purposeful sample of 15 partners was used. Data collection lasted between February 2010 - December 2011. Interviews were analysed with content analysis and data from questionnaires (participation, caregiving, health-related quality of life, depressive symptoms) were analysed statistically. Finally, results were merged, interpreted and labelled as comparable and convergent or as being inconsistent. Partners were satisfied with most aspects of participation, information and contact. Qualitative findings revealed four different aspects of participation: adapting to the caring needs and illness trajectory, coping with caregiving demands, interacting with healthcare providers and need for knowledge to comprehend the health situation. Results showed confirmatory results that were convergent and expanded knowledge that gave a broader understanding of partner participation in this context. The results revealed different levels of partner participation. Heart failure home care included good opportunities for both participation and contact during home visits, necessary to meet partners' ongoing need for information to comprehend the situation. © 2016 John Wiley & Sons Ltd.

Initial Experience with IV Ketamine Infusion for Treatment of Post Sternotomy Pain in a Patient with a Total Artificial Heart.

Science.gov (United States)

Maher, Dermot P; Loyferman, Rusty; Yumul, Roya; Louy, Charles

2015-01-01

The implantation of total artificial hearts (TAH) via midline sternotomy for the treatment of severe biventricular cardiac dysfunction is associated with complex postoperative pain management. Ketamaine increases blood pressure by raising sympathetic outflow and cardiac output; however, ketamine is a direct vasodilator on isolated arterial tissues. In the setting of a TAH with a mechanically fixed cardiac output, a ketamine infusion for postoperative pain control has the potential to decrease blood pressure due to direct arterial vasodilation. We present the initial experience with a ketamine infusion in a patient with a TAH with minimal observed decreases in blood pressure and significantly improved postoperative pain.

Comparative analysis of von Willebrand factor profiles after implantation of left ventricular assist device and total artificial heart.

Science.gov (United States)

Reich, H J; Morgan, J; Arabia, F; Czer, L; Moriguchi, J; Ramzy, D; Esmailian, F; Lam, L; Dunhill, J; Volod, O

2017-08-01

Essentials Bleeding is a major source of morbidity during mechanical circulatory support. von Willebrand factor (VWF) multimer loss may contribute to bleeding. Different patterns of VWF multimer loss were seen with the two device types. This is the first report of total artificial heart associated VWF multimer loss. Background Bleeding remains a challenge during mechanical circulatory support and underlying mechanisms are incompletely understood. Functional von Willebrand factor (VWF) impairment because of loss of high-molecular-weight multimers (MWMs) produces acquired von Willebrand disease (VWD) after left ventricular assist device (LVAD). Little is known about VWF multimers with total artificial hearts (TAHs). Here, VWF profiles with LVADs and TAHs are compared using a VWD panel. Methods VWD evaluations for patients with LVAD or TAH (2013-14) were retrospectively analyzed and included: VWF activity (ristocetin cofactor, VWF:RCo), VWF antigen (VWF:Ag), ratio of VWF:RCo to VWF:Ag, and quantitative VWF multimeric analysis. Results Twelve patients with LVADs and 12 with TAHs underwent VWD evaluation. All had either normal (47.8%) or elevated (52.2%) VWF:RCo, normal (26.1%) or elevated (73.9%) VWF:Ag and 50.0% were disproportional (ratio ≤ 0.7). Multimeric analysis showed abnormal patterns in all patients with LVADs: seven with high MWM loss; five with highest MWM loss. With TAH, 10/12 patients had abnormal patterns: all with highest MWM loss. High MWM loss correlated with presence of LVAD and highest MWM loss with TAH. Increased low MWMs were detected in 22/24. Conclusion Using VWF multimeric analysis, abnormalities after LVAD or TAH were detected that would be missed with measurements of VWF level alone: loss of high MWM predominantly in LVAD, loss of highest MWM in TAH, and elevated levels of low MWM in both. This is the first study to describe TAH-associated highest MWM loss, which may contribute to bleeding. © 2017 International Society on Thrombosis and

Antithrombotic Therapy in Atrial Fibrillation Associated with Valvular Heart Disease: Executive Summary of a Joint Consensus Document from the European Heart Rhythm Association (EHRA) and European Society of Cardiology Working Group on Thrombosis, Endorsed by the ESC Working Group on Valvular Heart Disease, Cardiac Arrhythmia Society of Southern Africa (CASSA), Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), South African Heart (SA Heart) Association and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE).

Science.gov (United States)

Lip, Gregory Y H; Collet, Jean Philippe; de Caterina, Raffaele; Fauchier, Laurent; Lane, Deirdre A; Larsen, Torben B; Marin, Francisco; Morais, Joao; Narasimhan, Calambur; Olshansky, Brian; Pierard, Luc; Potpara, Tatjana; Sarrafzadegan, Nizal; Sliwa, Karen; Varela, Gonzalo; Vilahur, Gemma; Weiss, Thomas; Boriani, Giuseppe; Rocca, Bianca

2017-12-01

Management strategies for patients with atrial fibrillation (AF) in association with valvular heart disease (VHD) have been less informed by randomized trials, which have largely focused on ‘non-valvular AF’ patients. Thromboembolic risk also varies according to valve lesion and may also be associated with CHA2DS2-VASc score risk factor components, rather than only the valve disease being causal. Given the need to provide expert recommendations for professionals participating in the care of patients presenting with AF and associated VHD, a task force was convened by the European Heart Rhythm Association (EHRA) and European Society of Cardiology (ESC) Working Group (WG) on Thrombosis, with representation from the ESC WG on Valvular Heart Disease, Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), South African Heart (SA Heart) Association and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE) with the remit to comprehensively review the published evidence, and to produce a consensus document on the management of patients with AF and associated VHD, with up-to-date consensus statements for clinical practice for different forms of VHD, based on the principles of evidence-based medicine. This is an executive summary of a consensus document which proposes that the term ‘valvular AF’ is outdated and given that any definition ultimately relates to the evaluated practical use of oral anticoagulation (OAC) type, we propose a functional EHRA (Evaluated Heartvalves, Rheumatic or Artificial) categorization in relation to the type of OAC use in patients with AF, as follows: (1) EHRA (Evaluated Heartvalves, Rheumatic or Artificial) type 1 VHD, which refers to AF patients with ‘VHD needing therapy with a vitamin K antagonist (VKA)’ and (2) EHRA (Evaluated Heartvalves, Rheumatic or Artificial) type 2 VHD, which refers to AF patients with ‘VHD needing therapy with a VKA or a non-VKA oral anticoagulant also taking

Right ventricular strain in heart failure: Clinical perspective.

Science.gov (United States)

Tadic, Marijana; Pieske-Kraigher, Elisabeth; Cuspidi, Cesare; Morris, Daniel A; Burkhardt, Franziska; Baudisch, Ana; Haßfeld, Sabine; Tschöpe, Carsten; Pieske, Burket

2017-10-01

The number of studies demonstrating the importance of right ventricular remodelling in a wide range of cardiovascular diseases has increased in the past two decades. Speckle-tracking imaging provides new variables that give comprehensive information about right ventricular function and mechanics. In this review, we summarize current knowledge of right ventricular mechanics in heart failure with reduced ejection fraction and preserved ejection fraction. We searched PubMed, MEDLINE, Ovid and Embase databases for studies published from January 2000 to December 2016 in the English language using the following keywords: "right ventricle"; "strain"; "speckle tracking"; "heart failure with reduced ejection fraction"; and "heart failure with preserved ejection fraction". Investigations showed that right ventricular dysfunction is associated with higher cardiovascular and overall mortality in patients with heart failure, irrespective of ejection fraction. The number of studies investigating right ventricular strain in patients with heart failure with reduced ejection fraction is constantly increasing, whereas data on right ventricular mechanics in patients with heart failure with preserved ejection fraction are limited. Given the high feasibility, accuracy and clinical implications of right ventricular strain in the population with heart failure, it is of great importance to try to include the evaluation of right ventricular strain as a regular part of each echocardiographic examination in patients with heart failure. However, further investigations are necessary to establish right ventricular strain as a standard variable for decision-making. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Artificial heart development program. Volume II. System support. Phase III summary report, July 1, 1973--September 30, 1977

International Nuclear Information System (INIS)

1977-01-01

Volume 2 covers major activities of the Artificial Heart Development program that supported the design, fabrication, and test of the system demonstration units. Section A.1.0 provides a listing beyond that of the body of the report on the components needed for an implantation. It also presents glove box sterilization calibration results and results of an extensive mock circulation calibration. Section A.2.0 provides detailed procedures for assembly, preparing for use, and the use of the system and major components. Section A.3.0 covers the component research and development activities undertaken to improve components of the existing system units and to prepare for a future prototype system. Section A.4.0 provides a listing of the top assembly drawings of the major systems variations fabricated and tested

Artificial heart development program. Volume II. System support. Phase III summary report, July 1, 1973--September 30, 1977

Energy Technology Data Exchange (ETDEWEB)

1977-01-01

Volume 2 covers major activities of the Artificial Heart Development program that supported the design, fabrication, and test of the system demonstration units. Section A.1.0 provides a listing beyond that of the body of the report on the components needed for an implantation. It also presents glove box sterilization calibration results and results of an extensive mock circulation calibration. Section A.2.0 provides detailed procedures for assembly, preparing for use, and the use of the system and major components. Section A.3.0 covers the component research and development activities undertaken to improve components of the existing system units and to prepare for a future prototype system. Section A.4.0 provides a listing of the top assembly drawings of the major systems variations fabricated and tested.

Artificial muscle: the human chimera is the future.

Science.gov (United States)

Tozzi, P

2011-12-14

Severe heart failure and cerebral stroke are broadly associated with the impairment of muscular function that conventional treatments struggle to restore. New technologies enable the construction of "smart" materials that could be of great help in treating diseases where the main problem is muscle weakness. These materials "behave" similarly to biological systems, because the material directly converts energy, for example electrical energy into movement. The extension and contraction occur silently like in natural muscles. The real challenge is to transfer this amazing technology into devices that restore or replace the mechanical function of failing muscle. Cardiac assist devices based on artificial muscle technology could envelope a weak heart and temporarily improve its systolic function, or, if placed on top of the atrium, restore the atrial kick in chronic atrial fibrillation. Artificial sphincters could be used to treat urinary incontinence after prostatectomy or faecal incontinence associated with stomas. Artificial muscles can restore the ability of patients with facial paralysis due to stroke or nerve injury to blink. Smart materials could be used to construct an artificial oesophagus including peristaltic movement and lower oesophageal sphincter function to replace the diseased oesophagus thereby avoiding the need for laparotomy to mobilise stomach or intestine. In conclusion, in the near future, smart devices will integrate with the human body to fill functional gaps due to organ failure, and so create a human chimera.

Knowledge representation an approach to artificial intelligence

CERN Document Server

Bench-Capon, TJM

1990-01-01

Although many texts exist offering an introduction to artificial intelligence (AI), this book is unique in that it places an emphasis on knowledge representation (KR) concepts. It includes small-scale implementations in PROLOG to illustrate the major KR paradigms and their developments.****back cover copy:**Knowledge representation is at the heart of the artificial intelligence enterprise: anyone writing a program which seeks to work by encoding and manipulating knowledge needs to pay attention to the scheme whereby he will represent the knowledge, and to be aware of the consequences of the ch

Machine learning an artificial intelligence approach

CERN Document Server

Banerjee, R; Bradshaw, Gary; Carbonell, Jaime Guillermo; Mitchell, Tom Michael; Michalski, Ryszard Spencer

1983-01-01

Machine Learning: An Artificial Intelligence Approach contains tutorial overviews and research papers representative of trends in the area of machine learning as viewed from an artificial intelligence perspective. The book is organized into six parts. Part I provides an overview of machine learning and explains why machines should learn. Part II covers important issues affecting the design of learning programs-particularly programs that learn from examples. It also describes inductive learning systems. Part III deals with learning by analogy, by experimentation, and from experience. Parts IV a

Biocompatibility of Hydrogen-Diluted Amorphous Silicon Carbide Thin Films for Artificial Heart Valve Coating

Science.gov (United States)

Rizal, Umesh; Swain, Bhabani S.; Rameshbabu, N.; Swain, Bibhu P.

2018-01-01

Amorphous silicon carbide (a-SiC:H) thin films were synthesized using trichloromethylsilane by a hot wire chemical vapor deposition process. The deposited films were characterized by Fourier transform infrared spectroscopy (FTIR), Raman spectroscopy, x-ray diffraction and x-ray photoelectron spectroscopy to confirm its chemical bonding, structural network and composition of the a-SiC:H films. The optical microscopy images reveal that hydrogen dilution increased the surface roughness and pore density of a-SiC:H thin film. The Raman spectroscopy and FTIR spectra reveal chemical network consisting of Si-Si, C-C and Si-C bonds, respectively. The XRD spectroscopy and Raman spectroscopy indicate a-SiC:H still has short-range order. In addition, in vitro cytotoxicity test ensures the behavior of cell-semiconductor hybrid to monitor the proper coordination. The live-dead assays and MTT assay reveal an increase in green nucleus cell, and cell viability is greater than 88%, respectively, showing non-toxic nature of prepared a-SiC:H film. Moreover, the result indicated by direct contact assay, and cell prefers to adhere and proliferate on a-SiC:H thin films having a positive effect as artificial heart valve coating material.

The challenge of home discharge with a total artificial heart: the La Pitie Salpetriere experience.

Science.gov (United States)

Demondion, Pierre; Fournel, Ludovic; Niculescu, Michaela; Pavie, Alain; Leprince, Pascal

2013-11-01

The total artificial heart (TAH) helps to counteract the current decrease in heart donors and is likely to bridge patients to transplant under favourable conditions. Today's mobile consoles facilitate home discharge. The aim of this study was to report on the La Pitie Hospital experience with CardioWest TAH recipients, and more particularly, on generally successful outpatient' management. A retrospective analysis was performed on clinical and biological data from patients implanted with a TAH between December 2006 and July 2010 in a single institution. Morbi-mortality during hospital stay, number and causes of rehospitalizations, quality of life during home discharge, bridge to transplant results and survival have all been analysed. Twenty-seven patients were implanted with the CardioWest. Fifteen patients (55.5%) died during support. Prior to home discharge, the most frequent cause of death was multi-organ failure (46.6%). Twelve patients were discharged home from hospital within a median of 88 days [range 35-152, interquartile range 57] postimplantation. Mean rehospitalization rate was 1.2 by patient, on account of device infection (n = 7), technical problems with the console (n = 3) and other causes (n = 4). Between discharge and transplant, patients spent 87% of their support time out of hospital. All patients who returned home with the TAH were subsequently transplanted, and 1 died in post-transplant. Despite the morbidity and mortality occurring during the postimplantation period, home discharge with a TAH is possible. Portables drivers allow for a safe return home. Aside from some remaining weak points such as infectious complications or noise, CardioWest TAH allows for successful rehabilitation of graft candidates, and assures highly satisfactory transplant results.

A positive perspective of knowledge, attitude, and practices for health-promoting behaviors of adolescents with congenital heart disease.

Science.gov (United States)

Huang, Hui-Ru; Chen, Chi-Wen; Chen, Chin-Mi; Yang, Hsiao-Ling; Su, Wen-Jen; Wang, Jou-Kou; Tsai, Pei-Kwei

2018-03-01

Health-promoting behaviors could serve as a major strategy to optimize long-term outcomes for adolescents with congenital heart disease. The associations assessed from a positive perspective of knowledge, attitudes, and practice model would potentially cultivate health-promoting behaviors during adolescence. The purpose of this study was to examine the relationships between disease knowledge, resilience, family functioning, and health-promoting behaviors in adolescents with congenital heart disease. A total of 320 adolescents with congenital heart disease who were aged 12-18 years were recruited from pediatric cardiology outpatient departments, and participated in a cross-sectional survey. The participants completed the Leuven Knowledge Questionnaire for Congenital Heart Disease; Haase Adolescent Resilience in Illness Scale; Family Adaptability, Partnership, Growth, Affection, and Resolve; and Adolescent Health Promotion scales. The collected data were analyzed using descriptive statistics and three multiple regression models. Greater knowledge of prevention of complications and higher resilience had a more powerful effect in enhancing health-promoting behaviors. Having symptoms and moderate or severe family dysfunction were significantly more negatively predictive of health-promoting behaviors than not having symptoms and positive family function. The third model explained 40% of the variance in engaging in health-promoting behaviors among adolescents with congenital heart disease. The findings of this study provide new insights into the role of disease knowledge, resilience, and family functioning in the health-promoting behavior of adolescents with congenital heart disease. Continued efforts are required to plan family care programs that promote the acquisition of sufficient disease knowledge and the development of resilience for adolescents with congenital heart disease.

Clinicohemodynamic and roentgenologic correlations in patients with artificial pacemakers

International Nuclear Information System (INIS)

Tatarchenko, I.P.; Iskenderov, B.G.; Koledinov, V.I.; Zhivotovskaya, G.G.

1987-01-01

The clinical pattern, central hemodynamics and roentgenologic data are studied in 34 patients with artificial cardiac pacemaker (ACP) to solve the problem on adequate medicamental therapy of heart failure (HF). Heart sizes and the state of a pulmonary image are estimated roentgenologically. Two types of cardiac-vessel system reactions on physical load: adequate and nonadequate - are detected. Implantation of ACP in patients with the nonadequate reaction does not lead to total liquidation of HF

Clinicohemodynamic and roentgenologic correlations in patients with artificial pacemakers

Energy Technology Data Exchange (ETDEWEB)

Tatarchenko, I P; Iskenderov, B G; Koledinov, V I; Zhivotovskaya, G G

1987-05-01

The clinical pattern, central hemodynamics and roentgenologic data are studied in 34 patients with artificial cardiac pacemaker (ACP) to solve the problem on adequate medicamental therapy of heart failure (HF). Heart sizes and the state of a pulmonary image are estimated roentgenologically. Two types of cardiac-vessel system reactions on physical load: adequate and nonadequate - are detected. Implantation of ACP in patients with the nonadequate reaction does not lead to total liquidation of HF.

Comparison of total artificial heart and biventricular assist device support as bridge-to-transplantation.

Science.gov (United States)

Cheng, Allen; Trivedi, Jaimin R; Van Berkel, Victor H; Massey, H Todd; Slaughter, Mark S

2016-10-01

The use of left ventricular assist devices (LVAD) has increased significantly in the last decade. However, right heart dysfunction remains a problem despite the improved outcomes with continuous-flow LVADs. Surgical options for bridge to transplantation (BTT) in patients with biventricular failure are total artificial heart (TAH) or biventricular support (BiVAD). This study examines the differences in pre- and post-transplantation outcomes and survival in patients with TAH or BiVAD support as BTT. The United Network of Organ Sharing database was retrospectively queried from January 2005 to December 2014 to identify adult patients undergoing heart transplantation (n = 17,022). Patients supported with either TAH (n = 212) or BiVAD (n = 366) at the time of transplantation were evaluated. Pre- and post-transplantation Kaplan-Meier survival curves were examined. Cox regression model was used to study the hazard ratios of the association between TAH versus BiVAD support and post-transplant survival. The median age of the study groups was 49.8 ± 12.9 (TAH) and 47.2 ± 13.9 (BiVAD) years (range 18-74 years). There were more men, 87% versus 74%, in the TAH group (p < 0.0001) with greater body mass index, 27.3 ± 5.2 versus 25.6 ± 4.7 (p < 0.0001), compared to those with BiVADs. Creatinine was higher, 1.7 + 1.2 versus 1.3 + 0.8 mg/dL (p < 0.0001), in the TAH group before transplant. The 30-day, one-, and three-year post-transplantation survival was 88%, 78%, and 67%, respectively, for patients with TAH support versus 93%, 83%, and 73% (p = 0.06) for patients with BiVAD support. Cox regression model shows pre-transplant creatinine (HR = 1.21, p = 0.008) is associated with a lower post-transplant survival. TAH is not associated with a worse post-transplant survival (p = 0.1). There was no difference in wait-list survival in patients supported with TAH or BiVAD (p = 0.8). Although there has been a recent

Artificial Lipid Membranes: Past, Present, and Future.

Science.gov (United States)

Siontorou, Christina G; Nikoleli, Georgia-Paraskevi; Nikolelis, Dimitrios P; Karapetis, Stefanos K

2017-07-26

The multifaceted role of biological membranes prompted early the development of artificial lipid-based models with a primary view of reconstituting the natural functions in vitro so as to study and exploit chemoreception for sensor engineering. Over the years, a fair amount of knowledge on the artificial lipid membranes, as both, suspended or supported lipid films and liposomes, has been disseminated and has helped to diversify and expand initial scopes. Artificial lipid membranes can be constructed by several methods, stabilized by various means, functionalized in a variety of ways, experimented upon intensively, and broadly utilized in sensor development, drug testing, drug discovery or as molecular tools and research probes for elucidating the mechanics and the mechanisms of biological membranes. This paper reviews the state-of-the-art, discusses the diversity of applications, and presents future perspectives. The newly-introduced field of artificial cells further broadens the applicability of artificial membranes in studying the evolution of life.

Biological effects of implanted nuclear energy sources for artificial heart devices. Progress report, September 1, 1975--August 31, 1976

International Nuclear Information System (INIS)

Kallfelz, F.A.; Wentworth, R.A.; Cady, K.B.

1976-01-01

A total of sixty dogs were implanted with radioisotope-powered artificial heart systems producing radiation fluxes similar to that of plutonium-238, but having no associated heat, at levels of from one to seventy times the radiation flux expected from a 30-watt plutonium-238 source. Results from studies lasting up to 6 years after implantation indicate that these animals, and by inference human beings, may be able to tolerate the radiation flux from 30-watt 238 Pu power sources. Results of heat dissipation studies in calves indicate that it may be possible to induce a vascularized connective tissue capsule sufficient to dissipate 30 watts of additional heat from a surface area of approximately 500 cm sq., allowing a heat flux of 0.06 watts per cm sq

New concepts and new design of permanent maglev rotary artificial heart blood pumps.

Science.gov (United States)

Qian, K X; Zeng, P; Ru, W M; Yuan, H Y

2006-05-01

According to tradition, permanent maglev cannot achieve stable equilibrium. The authors have developed, to the contrary, two stable permanent maglev impeller blood pumps. The first pump is an axially driven uni-ventricular assist pump, in which the rotor with impeller is radially supported by two passive magnetic bearings, but has one point contact with the stator axially at standstill. As the pump raises its rotating speed, the increasing hydrodynamic force of fluid acting on the impeller will make the rotor taking off from contacting point and disaffiliate from the stator. Then the rotor becomes fully suspended. The second pump is a radially driven bi-ventricular assist pump, i.e., an impeller total artificial heart. Its rotor with two impellers on both ends is supported by two passive magnetic bearings, which counteract the attractive force between rotor magnets and stator coil iron core. The rotor is affiliated to the stator radially at standstill and becomes levitated during rotation. Therefore, the rotor keeps concentric with stator during rotation but eccentric at standstill, as is confirmed by rotor position detection with Honeywell sensors. It concludes that the permanent maglev needs action of a non-magnetic force to achieve stability but a rotating magnetic levitator with high speed and large inertia can maintain its stability merely with passive magnetic bearings.

Heart rate variability - a historical perspective.

Science.gov (United States)

Billman, George E

2011-01-01

Heart rate variability (HRV), the beat-to-beat variation in either heart rate or the duration of the R-R interval - the heart period, has become a popular clinical and investigational tool. The temporal fluctuations in heart rate exhibit a marked synchrony with respiration (increasing during inspiration and decreasing during expiration - the so called respiratory sinus arrhythmia, RSA) and are widely believed to reflect changes in cardiac autonomic regulation. Although the exact contributions of the parasympathetic and the sympathetic divisions of the autonomic nervous system to this variability are controversial and remain the subject of active investigation and debate, a number of time and frequency domain techniques have been developed to provide insight into cardiac autonomic regulation in both health and disease. It is the purpose of this essay to provide an historical overview of the evolution in the concept of HRV. Briefly, pulse rate was first measured by ancient Greek physicians and scientists. However, it was not until the invention of the "Physician's Pulse Watch" (a watch with a second hand that could be stopped) in 1707 that changes in pulse rate could be accurately assessed. The Rev. Stephen Hales (1733) was the first to note that pulse varied with respiration and in 1847 Carl Ludwig was the first to record RSA. With the measurement of the ECG (1895) and advent of digital signal processing techniques in the 1960s, investigation of HRV and its relationship to health and disease has exploded. This essay will conclude with a brief description of time domain, frequency domain, and non-linear dynamic analysis techniques (and their limitations) that are commonly used to measure HRV.

Analysis of Mental Processes Represented in Models of Artificial Consciousness

Directory of Open Access Journals (Sweden)

Luana Folchini da Costa

2013-12-01

Full Text Available The Artificial Consciousness concept has been used in the engineering area as being an evolution of the Artificial Intelligence. However, consciousness is a complex subject and often used without formalism. As a main contribution, in this work one proposes an analysis of four recent models of artificial consciousness published in the engineering area. The mental processes represented by these models are highlighted and correlations with the theoretical perspective of cognitive psychology are made. Finally, considerations about consciousness in such models are discussed.

The man who feels two hearts: the different pathways of interoception.

Science.gov (United States)

Couto, Blas; Salles, Alejo; Sedeño, Lucas; Peradejordi, Margarita; Barttfeld, Pablo; Canales-Johnson, Andrés; Dos Santos, Yamil Vidal; Huepe, David; Bekinschtein, Tristán; Sigman, Mariano; Favaloro, Roberto; Manes, Facundo; Ibanez, Agustin

2014-09-01

Recent advances in neuroscience have provided new insights into the understanding of heart-brain interaction and communication. Cardiac information to the brain relies on two pathways, terminating in the insular cortex (IC) and anterior cingulate cortex (ACC), along with the somatosensory cortex (S1-S2). Interoception relying on these neuroanatomical pathways has been shown to modulate social cognition. We report the case study of C.S., a patient with an 'external heart' (an extracorporeal left-univentricular cardiac assist device, LVAD). The patient was assessed with neural/behavioral measures of cardiac interoception complemented by neuropsychological and social cognition measures. The patient's performance on the interoception task (heartbeat detection) seemed to be guided by signals from the artificial LVAD, which provides a somatosensory beat rather than by his endogenous heart. Cortical activity (HEP, heartbeat-evoked potential) was found decreased in comparison with normal volunteers, particularly during interoceptive states. The patient accurately performed several cognitive tasks, except for interoception-related social cognition domains (empathy, theory of mind and decision making). This evidence suggests an imbalance in the patient's cardiac interoceptive pathways that enhances sensation driven by the artificial pump over that from the cardiac vagal-IC/ACC pathway. A patient with two hearts, one endogenous and one artificial, presents a unique opportunity to explore models of interoception and heart-brain interaction. © The Author (2013). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

Wireless patient monitoring system for a moving-actuator type artificial heart.

Science.gov (United States)

Nam, K W; Chung, J; Choi, S W; Sun, K; Min, B G

2006-10-01

In this study, we developed a wireless monitoring system for outpatients equipped with a moving-actuator type pulsatile bi-ventricular assist device, AnyHeart. The developed monitoring system consists of two parts; a Bluetooth-based short-distance self-monitoring system that can monitor and control the operating status of a VAD using a Bluetooth-embedded personal digital assistant or a personal computer within a distance of 10 meters, and a cellular network-based remote monitoring system that can continuously monitor and control the operating status of AnyHeart at any location. Results of in vitro experiments demonstrate the developed system's ability to monitor the operational status of an implanted AnyHeart.

Antithrombotic artificial organs

Energy Technology Data Exchange (ETDEWEB)

Takamatsu, T; Fukada, E; Saegusa, M; Hasegawa, T

1971-07-12

A new antithrombotic material useful for making artificial organs (artificial blood vessel, artificial heart, etc.) can be prepared by graft-polymerizing an acrylic ester (methyl methacrylate, methyl acrylate, ethyl acrylate, etc.) with a synthetic fiber (teflon, etc.). The graft-polymerization can be carried out by means of gamma radiation with cobalt 60 (dose rate 2.6x10/sup 3/ r/min., total dose 8x10/sup 4/ to 3.5x10/sup 5/ r). A graft ratio of 5 to 80% is attainable. In one example, a tubular sample made of teflon fiber having an inner diameter of 5 to 10 mm was immersed into methyl methacrylate in an ampoule in the absence of air and exposed to cobalt 60 gamma ray at the dose rate of 3.18x10/sup 3/ rad/min. After extraction with acetone, the sample was dried. The total dose was 3.5x10/sup 5/ rad and the graft ratio was ca. 25%. The sample was transplanted to vena cava of dog. No formation of thrombus was observed by autopsy (4 months after the transplantation). In control (teflon tube not graft-polymerized) thrombus was observed by autopsy 7 days after the transplantation.

Generating pulsatility by pump speed modulation with continuous-flow total artificial heart in awake calves.

Science.gov (United States)

Fukamachi, Kiyotaka; Karimov, Jamshid H; Sunagawa, Gengo; Horvath, David J; Byram, Nicole; Kuban, Barry D; Dessoffy, Raymond; Sale, Shiva; Golding, Leonard A R; Moazami, Nader

2017-12-01

The purpose of this study was to evaluate the effects of sinusoidal pump speed modulation of the Cleveland Clinic continuous-flow total artificial heart (CFTAH) on hemodynamics and pump flow in an awake chronic calf model. The sinusoidal pump speed modulations, performed on the day of elective sacrifice, were set at ±15 and ± 25% of mean pump speed at 80 bpm in four awake calves with a CFTAH. The systemic and pulmonary arterial pulse pressures increased to 12.0 and 12.3 mmHg (±15% modulation) and to 15.9 and 15.7 mmHg (±25% modulation), respectively. The pulsatility index and surplus hemodynamic energy significantly increased, respectively, to 1.05 and 1346 ergs/cm at ±15% speed modulation and to 1.51 and 3381 ergs/cm at ±25% speed modulation. This study showed that it is feasible to generate pressure pulsatility with pump speed modulation; the platform is suitable for evaluating the physiologic impact of pulsatility and allows determination of the best speed modulations in terms of magnitude, frequency, and profiles.

Willem J Kolff (1911-2009): physician, inventor and pioneer: father of artificial organs.

Science.gov (United States)

Morrissey, Megan

2012-08-01

Medical pioneer Willem Johan Kolff was an inspirational father, son, physician and inventor. He founded the development of the first kidney dialysis machine, pioneered advances in the heart and lung machine, laid down the foundations for the first mainland blood bank in Europe and successfully implanted the first artificial heart into humans.

Guide to prosthetic cardiac valves

International Nuclear Information System (INIS)

Morse, D.; Steiner, R.M.; Fernandez, J.

1985-01-01

This book contains 10 chapters. Some of the chapter titles are: The development of artificial heart valves: Introduction and historical perspective; The radiology of prosthetic heart valves; The evaluation of patients for prosthetic valve implantation; Pathology of cardiac valve replacement; and Bioengineering of mechanical and biological heart valve substitutes

Artificial Gravity with Ergometric Exercise Training Improves Cardiovascular Function in Ambulatory Men

Science.gov (United States)

Sun, Xi-Qing; Zhu, Chao; Shang, Shu; Yao, Yong-Jie

2008-06-01

The necessity of preventing physiological deconditioning in astronauts exposed to long-term space flights is well known. Artificial gravity training via short-arm centrifugation as a countermeasure to microgravity has been considered for many years. However, an optimal duration, level and rate of exposure to artificial gravity have not yet been determined. The purpose of the present study was to investigate the cardiovascular effects of three weeks of intermittent artificial gravity with ergometric exercise training on normal ambulatory men. During 3 weeks experiment, eight healthy male subjects received alternate +1 to +2 Gz (at the foot) short-arm centrifuge training with 30 W ergometric exercise for 30 min per day. Cardiac function, heart rate variability, heart rate and blood pressure were measured before and after training. Stroke volume and total peripheral resistance increased significantly after 3 weeks training, compared with the pre-training baseline. Left ventricular ejection time (LVET) and ejection fraction increased significantly after 3 weeks training, while heart rate, the ratio of pre-ejection period to LVET, and the ratio of low frequency to high frequency power decreased significantly after 3 weeks training. These results suggest that three weeks short-arm centrifuge training with ergometric exercise could improve human cardiac systolic and pumping functions, and increase cardiac vagal modulation.

Psychological Perspectives on the Development of Coronary Heart Disease

Science.gov (United States)

Matthews, Karen A.

2005-01-01

Psychological science has new opportunities to have major input into the understanding of the development of coronary heart disease. This article provides an overview of advances in understanding the etiology of heart disease, recently applied technologies for measuring early stages of heart disease, and an accumulating base of evidence on the…

Artificial heart development program. Volume II. System support. Phase III summary report. Period covered: July 1, 1973--September 30, 1977

International Nuclear Information System (INIS)

1977-01-01

Appendix A covers major activities of the Artificial Heart Development program that supported the design, fabrication, and test of the system demonstration units. Section A.1.0 provides a listing beyond that of the body of the report on the components needed for an implantation. It also presents glove box sterilization calibration results and results of an extensive mock circulation calibration. Section A.2.0 provides detail procedures for assembly, preparing for use, and the use of the system and major components. Section A.3.0 covers the component research and development activities undertaken to improve components of the existing system units and to prepare for a future prototype system. Section A.4.0 provides a listing of the top assembly drawings of the major systems variations fabricated and tested

Artificial heart development program. Volume II. System support. Phase III summary report. Period covered: July 1, 1973--September 30, 1977

Energy Technology Data Exchange (ETDEWEB)

1977-01-01

Appendix A covers major activities of the Artificial Heart Development program that supported the design, fabrication, and test of the system demonstration units. Section A.1.0 provides a listing beyond that of the body of the report on the components needed for an implantation. It also presents glove box sterilization calibration results and results of an extensive mock circulation calibration. Section A.2.0 provides detail procedures for assembly, preparing for use, and the use of the system and major components. Section A.3.0 covers the component research and development activities undertaken to improve components of the existing system units and to prepare for a future prototype system. Section A.4.0 provides a listing of the top assembly drawings of the major systems variations fabricated and tested.

Biomaterials for artificial organs

CERN Document Server

Lysaght, Michael J

2010-01-01

The worldwide demand for organ transplants far exceeds available donor organs. Consequently some patients die whilst waiting for a transplant. Synthetic alternatives are therefore imperative to improve the quality of, and in some cases, save people's lives. Advances in biomaterials have generated a range of materials and devices for use either outside the body or through implantation to replace or assist functions which may have been lost through disease or injury. Biomaterials for artificial organs reviews the latest developments in biomaterials and investigates how they can be used to improve the quality and efficiency of artificial organs. Part one discusses commodity biomaterials including membranes for oxygenators and plasmafilters, titanium and cobalt chromium alloys for hips and knees, polymeric joint-bearing surfaces for total joint replacements, biomaterials for pacemakers, defibrillators and neurostimulators and mechanical and bioprosthetic heart valves. Part two goes on to investigate advanced and ...

Artificial Intelligence, Counseling, and Cognitive Psychology.

Science.gov (United States)

Brack, Greg; And Others

With the exception of a few key writers, counselors largely ignore the benefits that Artificial Intelligence (AI) and Cognitive Psychology (CP) can bring to counseling. It is demonstrated that AI and CP can be integrated into the counseling literature. How AI and CP can offer new perspectives on information processing, cognition, and helping is…

Dynamic cardiomyoplasty using artificial muscle.

Science.gov (United States)

Suzuki, Yasuyuki; Daitoku, Kazuyuki; Minakawa, Masahito; Fukui, Kozo; Fukuda, Ikuo

2008-01-01

Dynamic cardiomyoplasty using latissimus dorsi muscle was previously used to compensate for congestive heart failure. Now, however, this method is not acceptable because the long-term result was not as expected owing to fatigue of the skeletal muscle. BioMetal fiber developed by Toki Corporation is one of the artificial muscles activated by electric current. The behavior of this fiber is similar to that of organic muscle. We made an artificial muscle like the latissimus dorsi using BioMetal fiber and tested whether we could use this new muscle as a cardiac supporting device. Testing one Biometal fiber showed the following performance: practical use maximal generative force was 30 g, exercise variation was 50%, and the standard driving current was 220 mA. We created a 4 x 12-cm tabular artificial muscle using 8 BioMetal fibers as a cardiac support device. We also made a simulation circuit composed of a 6 x 8-cm soft bag with unidirectional valves, reservoir, and connecting tube. The simulation circuit was filled with water and the soft bag was wrapped with the artificial muscle device. After powering the device electrically at 9 V with a current of 220 mA for each fiber, we measured the inside pressure and observed the movement of the artificial device. The artificial muscle contracted in 0.5 s for peak time and squeezed the soft bag. The peak pressure inside the soft bag was measured as 10 mmHg. Although further work will be needed to enhance the speed of deformability and movement simulating contraction, we conclude that artificial muscle may be potentially useful as a cardiac assistance device that can be developed for dynamic cardiomyoplasty.

Artificial organs versus regenerative medicine: is it true?

Science.gov (United States)

Nosé, Yukihiko; Okubo, Hisashi

2003-09-01

Individuals engaged in the fields of artificial kidney and artificial heart have often mistakenly stated that "the era of artificial organs is over; regenerative medicine is the future." Contrarily, we do not believe artificial organs and regenerative medicine are different medical technologies. As a matter of fact, artificial organs developed during the last 50 years have been used as a bridge to regeneration. The only difference between regenerative medicine and artificial organs is that artificial organs for the bridge to regeneration promote tissue regeneration in situ, instead of outside the body (for example, vascular prostheses, neuroprostheses, bladder substitutes, skin prostheses, bone prostheses, cartilage prostheses, ligament prostheses, etc.). All of these artificial organs are successful because tissue regeneration over a man-made prosthesis is established inside the patient's body (artificial organs to support regeneration). Another usage of the group of artificial organs for the bridge to regeneration is to sustain the functions of the patient's diseased organs during the regeneration process of the body's healthy tissues and/or organs. This particular group includes artificial kidney, hepatic assist, respiratory assist, and circulatory assist. Proof of regeneration of these healthy tissues and/or organs is demonstrated in the short-term recovery of end-stage organ failure patients (artificial organs for bridge to regeneration). A third group of artificial organs for the bridge to regeneration accelerates the regenerating process of the patient's healthy tissues and organs. This group includes neurostimulators, artificial blood (red cells) blood oxygenators, and plasmapheresis devices, including hemodiafiltrators. So-called "therapeutic artificial organs" fall into this category (artificial organs to accelerate regeneration). Thus, almost all of today's artificial organs are useful in the bridge to regeneration of healthy natural tissues and organs

Artificial Atoms: from Quantum Physics to Applications

International Nuclear Information System (INIS)

2014-01-01

The primary objective of this workshop is to survey the most recent advances of technologies enabling single atom- and artificial atom-based devices. These include the assembly of artificial molecular structures with magnetic dipole and optical interactions between engineered atoms embedded in solid-state lattices. The ability to control single atoms in diamond or similar solids under ambient operating conditions opens new perspectives for technologies based on nanoelectronics and nanophotonics. The scope of the workshop is extended towards the physics of strong coupling between atoms and radiation field modes. Beyond the traditional atom-cavity systems, artificial dipoles coupled to microwave radiation in circuit quantum electrodynamics is considered. All these technologies mutually influence each other in developing novel devices for sensing at the quantum level and for quantum information processing.

Artificial hearts-recent progress: republication of the article published in the Japanese Journal of Artificial Organs.

Science.gov (United States)

Nishida, Masahiro

2017-09-01

This review was created based on a translation of the Japanese review written in the Japanese Journal of Artificial Organs in 2015 (Vol.44, No. 3, pp.130-135), with some modifications regarding several references published in 2015 or later.

Fluid mechanics of heart valves.

Science.gov (United States)

Yoganathan, Ajit P; He, Zhaoming; Casey Jones, S

2004-01-01

Valvular heart disease is a life-threatening disease that afflicts millions of people worldwide and leads to approximately 250,000 valve repairs and/or replacements each year. Malfunction of a native valve impairs its efficient fluid mechanic/hemodynamic performance. Artificial heart valves have been used since 1960 to replace diseased native valves and have saved millions of lives. Unfortunately, despite four decades of use, these devices are less than ideal and lead to many complications. Many of these complications/problems are directly related to the fluid mechanics associated with the various mechanical and bioprosthetic valve designs. This review focuses on the state-of-the-art experimental and computational fluid mechanics of native and prosthetic heart valves in current clinical use. The fluid dynamic performance characteristics of caged-ball, tilting-disc, bileaflet mechanical valves and porcine and pericardial stented and nonstented bioprostheic valves are reviewed. Other issues related to heart valve performance, such as biomaterials, solid mechanics, tissue mechanics, and durability, are not addressed in this review.

Artificial intelligence in medicine: the challenges ahead.

Science.gov (United States)

Coiera, E W

1996-01-01

The modern study of artificial intelligence in medicine (AIM) is 25 years old. Throughout this period, the field has attracted many of the best computer scientists, and their work represents a remarkable achievement. However, AIM has not been successful-if success is judged as making an impact on the practice of medicine. Much recent work in AIM has been focused inward, addressing problems that are at the crossroads of the parent disciplines of medicine and artificial intelligence. Now, AIM must move forward with the insights that it has gained and focus on finding solutions for problems at the heart of medical practice. The growing emphasis within medicine on evidence-based practice should provide the right environment for that change.

Mathematical Model Analysis of Heart-Arterial Interaction in Hypertension

Science.gov (United States)

2001-10-25

conscious dogs with dilated cardiomyopathy ,” ! " # , vol. 260, pp. H1903-H1911, 1991. [7] P. Segers, N...with data measured in the isolated canine [14] or cat [15] heart, pumping into an artificial load or in the intact sheep [16] and human [7]. Left...instantaneous pressure-volume ratio of the canine left ventricle and effects of epinephrine and heart rate on the ratio,” , vol. 32, pp. 314

Getting home with artifical heart – what is the everyday life experience of people with mechanical circulatory Support. A qualitative study

Science.gov (United States)

Braunsdorf, Sandy

2017-07-01

Background: The growing number of mechanical circulatory support systems implanted with successful results in terms of quality of life and physical resilience means that more and more people are being discharged from hospital to live at home with an artificial heart. This puts high requirements on affected persons’ disease and therapy management – a subject which has attracted very little qualitative research to date. Aim: This study therefore sought to shed light on how people with mechanical circulatory support experience their everyday lives. The aim was to document the subjective associations of those affected from an insider perspective. Methods: Following the interpretative phenomenological paradigm, narrative interviews were conducted with two female and eight male participants. For qualitative analysis, a multi-step process guided by the methodology of hermeneutic philosophy was used. Results: The qualitative data analysis revealed five main topic areas. These describe patients’ state of health after implantation and the various adjustments, constraints and pressures necessitated by their illness and therapeutic requirements. On this basis, coping and management strategies are identified. Other significant aspects of patients’ everyday lives are social interaction and environment and health care with an artificial heart. Conclusions: The findings add to our knowledge of the day-to-day lives of people with mechanical circulatory support systems, giving us a better understanding of their specific situation.

Stirling/hydraulic artificial heart power source

International Nuclear Information System (INIS)

Johnston, R.P.; Bennett, A.; Emigh, S.G.; Griffith, W.R.; Noble, J.E.; Perrone, R.E.; White, M.A.; Martini, W.R.; Alexander, J.E.

1977-01-01

The REL power source combines the high efficiency of Stirling engines with the reliability, efficiency, and flexibility of hydraulic power transfer and control to ensure long system life and physiological effectiveness. Extended life testing has been achieved with an engine (2.6 years) and hydraulic actuator/controller (1.6 years). Peak power source efficiency is 15.5 percent on 5 to 10 watts delivered to the blood pump push plate with 33 watts steady thermal input. Planned incorporation of power source output control is expected to reduce daily average thermal input to 18 watts. Animal in-vivo tests with an assist heart have consistently demonstrated required performance by biological synchronization and effective ventricle relief. Volume and weight are 0.93 liter and 2.4 kg (excluding blood pump) with an additional 0.4 liter of low temperature foam insulation required to preclude tissue thermal damage. Carefully planned development of System 7 is expected to produce major reductions in size

Home Discharge and Out-of-Hospital Follow-Up of Total Artificial Heart Patients Supported by a Portable Driver System

Science.gov (United States)

2014-01-01

To enhance ambulation and facilitate hospital discharge of total artificial heart (TAH)–supported patients, we adapted a mobile ventricular assistance device (VAD) driver (Excor) for TAH use and report on the performance of Excor-driven TAH patients discharged home. Ten patients stabilized on a TAH, driven by the CSS (“Circulatory Support System”), were progressively switched over to the Excor in hospital over 14 days as a pilot, with daily hemodynamics and laboratory parameters measured. Twenty-two stable TAH patients were subsequently placed on the Excor, trained, and discharged home. Clinical and hemodynamic parameters were followed. All pilot study patients were clinically stable on the Excor, with no decrease in TAH output noted (6.3 + 0.3 L/min [day 1] vs. 5.8 + 0.2 L/min [day 14], p = 0.174), with a trend suggesting improvement of both hepatic and renal function. Twenty-two TAH patients were subsequently successfully discharged home on the portable driver and were supported out of hospital for up to 598 days (range, 2–598; mean = 179 ± 140 days), remaining ambulatory, New York Heart Association (NYHA) class I or II, and free of readmission for 88.5% of the time of support. TAH patients may be effectively and safely supported by a mobile drive system. As such, the utility of the TAH may be extended to support patients beyond the hospital, at home, with overall ambulatory freedom. PMID:24577369

Electrocardiogram Pattern Recognition and Analysis Based on Artificial Neural Networks and Support Vector Machines: A Review

Directory of Open Access Journals (Sweden)

Mario Sansone

2013-01-01

Full Text Available Computer systems for Electrocardiogram (ECG analysis support the clinician in tedious tasks (e.g., Holter ECG monitored in Intensive Care Units or in prompt detection of dangerous events (e.g., ventricular fibrillation. Together with clinical applications (arrhythmia detection and heart rate variability analysis, ECG is currently being investigated in biometrics (human identification, an emerging area receiving increasing attention. Methodologies for clinical applications can have both differences and similarities with respect to biometrics. This paper reviews methods of ECG processing from a pattern recognition perspective. In particular, we focus on features commonly used for heartbeat classification. Considering the vast literature in the field and the limited space of this review, we dedicated a detailed discussion only to a few classifiers (Artificial Neural Networks and Support Vector Machines because of their popularity; however, other techniques such as Hidden Markov Models and Kalman Filtering will be also mentioned.

Three-dimentional simulation of flow-induced platelet activation in artificial heart valves

Science.gov (United States)

Hedayat, Mohammadali; Asgharzadeh, Hafez; Borazjani, Iman

2015-11-01

Since the advent of heart valve, several valve types such as mechanical and bio-prosthetic valves have been designed. Mechanical Heart Valves (MHV) are durable but suffer from thromboembolic complications that caused by shear-induced platelet activation near the valve region. Bio-prosthetic Heart Valves (BHV) are known for better hemodynamics. However, they usually have a short average life time. Realistic simulations of heart valves in combination with platelet activation models can lead to a better understanding of the potential risk of thrombus formation in such devices. In this study, an Eulerian approach is developed to calculate the platelet activation in three-dimensional simulations of flow through MHV and BHV using a parallel overset-curvilinear immersed boundary technique. A curvilinear body-fitted grid is used for the flow simulation through the anatomic aorta, while the sharp-interface immersed boundary method is used for simulation of the Left Ventricle (LV) with prescribed motion. In addition, dynamics of valves were calculated numerically using under-relaxed strong-coupling algorithm. Finally, the platelet activation results for BMV and MHV are compared with each other.

Translation of First North American 50 and 70 cc Total Artificial Heart Virtual and Clinical Implantations: Utility of 3D Computed Tomography to Test Fit Devices.

Science.gov (United States)

Ferng, Alice S; Oliva, Isabel; Jokerst, Clinton; Avery, Ryan; Connell, Alana M; Tran, Phat L; Smith, Richard G; Khalpey, Zain

2017-08-01

Since the creation of SynCardia's 50 cc Total Artificial Hearts (TAHs), patients with irreversible biventricular failure now have two sizing options. Herein, a case series of three patients who have undergone successful 50 and 70 cc TAH implantation with complete closure of the chest cavity utilizing preoperative "virtual implantation" of different sized devices for surgical planning are presented. Computed tomography (CT) images were used for preoperative planning prior to TAH implantation. Three-dimensional (3D) reconstructions of preoperative chest CT images were generated and both 50 and 70 cc TAHs were virtually implanted into patients' thoracic cavities. During the simulation, the TAHs were projected over the native hearts in a similar position to the actual implantation, and the relationship between the devices and the atria, ventricles, chest wall, and diaphragm were assessed. The 3D reconstructed images and virtual modeling were used to simulate and determine for each patient if the 50 or 70 cc TAH would have a higher likelihood of successful implantation without complications. Subsequently, all three patients received clinical implants of the properly sized TAH based on virtual modeling, and their chest cavities were fully closed. This virtual implantation increases our confidence that the selected TAH will better fit within the thoracic cavity allowing for improved surgical outcome. Clinical implantation of the TAHs showed that our virtual modeling was an effective method for determining the correct fit and sizing of 50 and 70 cc TAHs. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Analysis, design, and control of a transcutaneous power regulator for artificial hearts.

Science.gov (United States)

Qianhong Chen; Siu Chung Wong; Tse, C K; Xinbo Ruan

2009-02-01

Based on a generic transcutaneous transformer model, a remote power supply using a resonant topology for use in artificial hearts is analyzed and designed for easy controllability and high efficiency. The primary and secondary windings of the transcutaneous transformer are positioned outside and inside the human body, respectively. In such a transformer, the alignment and gap may change with external positioning. As a result, the coupling coefficient of the transcutaneous transformer is also varying, and so are the two large leakage inductances and the mutual inductance. Resonant-tank circuits with varying resonant-frequency are formed from the transformer inductors and external capacitors. For a given range of coupling coefficients, an operating frequency corresponding to a particular coupling coefficient can be found, for which the voltage transfer function is insensitive to load. Prior works have used frequency modulation to regulate the output voltage under varying load and transformer coupling. The use of frequency modulation may require a wide control frequency range which may extend well above the load insensitive frequency. In this paper, study of the input-to-output voltage transfer function is carried out, and a control method is proposed to lock the switching frequency at just above the load insensitive frequency for optimized efficiency at heavy loads. Specifically, operation at above resonant of the resonant circuits is maintained under varying coupling-coefficient. Using a digital-phase-lock-loop (PLL), zero-voltage switching is achieved in a full-bridge converter which is also programmed to provide output voltage regulation via pulsewidth modulation (PWM). A prototype transcutaneous power regulator is built and found to to perform excellently with high efficiency and tight regulation under variations of the alignment or gap of the transcutaneous transformer, load and input voltage.

Mass print media depictions of cancer and heart disease: community versus individualistic perspectives?

Science.gov (United States)

Clarke, Juanne; van Amerom, Gudrun

2008-01-01

This paper is based on a critical discourse content analysis of 40 stories from the 20 highest circulating English-language mass magazines available in Canada and published in Canada or the USA in 2001. It examines the presence or absence of the social determinants perspective in the portrayal of the two most significant causes of morbidity and mortality in these countries: cancer and heart disease. The media analysis documents an absence of reflection of the social determinants viewpoint on these, the most important causes of disease and death. Thus, magazine stories ignore the role of such considerations as income, education level, ethnicity, visible minority or, Aboriginal status, early life experiences, employment and working conditions, food accessibility and quality, housing, social services, social exclusion, or unemployment and employment security in explaining health. Instead, the magazine articles underscore an individualistic approach to disease that assumes that health care is accessible and available to all, and that these diseases are preventable and treatable through individual lifestyle choices in combination with the measures prescribed through conventional medicine. Although cancer and heart disease are framed by a medical discourse, articles tended to emphasise the independence, freedom and power of the individual within the medical care system. The research documents a continuation of the dominance of conventional medicine buttressed by individualism in media stories. Theoretical and methodological issues are discussed. Some of the practical consequences for policy-makers and professionals are noted.

Parental overprotection and heart-focused anxiety in adults with congenital heart disease.

Science.gov (United States)

Ong, Lephuong; Nolan, Robert P; Irvine, Jane; Kovacs, Adrienne H

2011-09-01

The care of adult patients with congenital heart disease (CHD) is challenging from a mental health perspective, as these patients continue to face a variety of biopsychosocial issues that may impact emotional functioning. Despite these issues, there are limited data on the psychosocial functioning of adults with CHD, and there are no data on the impact of parental overprotection on heart-focused anxiety in this patient population. The aim of this study was to examine the relationships between patient recollections of parental overprotection and current heart-focused anxiety in adults with CHD. A cross-sectional sample of 190 adult patients with CHD (51% male; mean age = 32.28, SD = 11.86 years) completed validated measures of perceived parental overprotection (Parental Bonding Instrument) and heart-focused anxiety (Cardiac Anxiety Questionnaire). The results indicated that perceived parental overprotection (β = 0.19, p = 0.02) and heart defect complexity (β = 0.17, p = 0.03) were significantly related to heart-focused anxiety. Contrary to hypotheses, perceived parental overprotection did not vary as a function of heart defect complexity (F (2, 169) = 0.02, p = 0.98). Perceived parental overprotection and heart defect complexity are associated with heart-focused anxiety in adults with congenital heart disease. These results can inform the development of clinical interventions aimed at improving the psychosocial adjustment of this patient population.

Heart rate informed artificial pancreas system enhances glycemic control during exercise in adolescents with T1D.

Science.gov (United States)

DeBoer, Mark D; Cherñavvsky, Daniel R; Topchyan, Katarina; Kovatchev, Boris P; Francis, Gary L; Breton, Marc D

2017-11-01

To evaluate the safety and performance of using a heart rate (HR) monitor to inform an artificial pancreas (AP) system during exercise among adolescents with type 1 diabetes (T1D). In a randomized, cross-over trial, adolescents with T1D age 13 - 18 years were enrolled to receive on separate days either the unmodified UVa AP (stdAP) or an AP system connected to a portable HR monitor (AP-HR) that triggered an exercise algorithm for blood glucose (BG) control. During admissions participants underwent a structured exercise regimen. Hypoglycemic events and CGM tracings were compared between the two admissions, during exercise and for the full 24-hour period. Eighteen participants completed the trial. While number of hypoglycemic events during exercise and rest was not different between visits (0.39 AP-HR vs 0.50 stdAP), time below 70 mg dL -1 was lower on AP-HR compared to stdAP, 0.5±2.1% vs 7.4±12.5% (P = 0.028). Time with BG within 70-180 mg dL -1 was higher for the AP-HR admission vs stdAP during the exercise portion and overall (96% vs 87%, and 77% vs 74%), but these did not reach statistical significance (P = 0.075 and P = 0.366). Heart rate signals can safely and efficaciously be integrated in a wireless AP system to inform of physical activity. While exercise contributes to hypoglycemia among adolescents, even when using an AP system, informing the system of exercise via a HR monitor improved time <70 mg dL -1 . Nonetheless, it did not significantly reduce the total number of hypoglycemic events, which were low in both groups. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Kant, Xunzi and the Artificiality of Manners

Directory of Open Access Journals (Sweden)

Anja BERNINGER

2017-01-01

Full Text Available Both Chinese and Western philosophers have argued for the ethical importance of manners. Their approaches are sometimes criticized on the grounds that manners are artificial. I compare Xunzi’s and Kant’s responses to this claim, and discuss the relevance of both positions for the development of a theory of manners. I show that there is no single artificiality claim, but rather four different claims: the claim that polite behavior lacks spontaneity, the claim that it is insincere, the claim that it goes against human nature, and the claim that it is arbitrary. While Kant is mainly concerned with the insincerity claim, Xunzi focusses on the claim that manners are arbitrary rules. Because of their different understandings of the function of manners both authors only provide a partial answer to the artificiality claim. To arrive at a full account of manners both perspectives must be combined.

Cardiac imaging in valvular heart disease

Science.gov (United States)

Choo, W S; Steeds, R P

2011-01-01

The aim of this article is to provide a perspective on the relative importance and contribution of different imaging modalities in patients with valvular heart disease. Valvular heart disease is increasing in prevalence across Europe, at a time when the clinical ability of physicians to diagnose and assess severity is declining. Increasing reliance is placed on echocardiography, which is the mainstay of cardiac imaging in valvular heart disease. This article outlines the techniques used in this context and their limitations, identifying areas in which dynamic imaging with cardiovascular magnetic resonance and multislice CT are expanding. PMID:22723532

Surface Modification using Plasma treatments and Adhesion Peptide for Durable Tissue-Engineered Heart Valves

International Nuclear Information System (INIS)

Jung, Young mee; Kim, Soo Hyun

2010-01-01

Artificial heart valves are used in valvular heart diseases, but these valves have disadvantages that they cannot grow, repair and remodel. In current study, the strategies to development of in vitro cultured functional tissue by tissue engineering is available to heart valve disease. In the point of using viable autolougous cells, tissue engineered heart valves have some advantage to include that they can repair, remodel, and grow. Because heart valve is placed under the strong shear stress condition by pumping of heart, the durability of tissue-engineered heart valves is now questionable. The purpose of the study is to evaluate of the durability of tissue engineered heart valve with surface modified scaffolds under hemodynamic conditions

Uncertainty in artificial intelligence

CERN Document Server

Kanal, LN

1986-01-01

How to deal with uncertainty is a subject of much controversy in Artificial Intelligence. This volume brings together a wide range of perspectives on uncertainty, many of the contributors being the principal proponents in the controversy.Some of the notable issues which emerge from these papers revolve around an interval-based calculus of uncertainty, the Dempster-Shafer Theory, and probability as the best numeric model for uncertainty. There remain strong dissenting opinions not only about probability but even about the utility of any numeric method in this context.

New twist on artificial muscles.

Science.gov (United States)

Haines, Carter S; Li, Na; Spinks, Geoffrey M; Aliev, Ali E; Di, Jiangtao; Baughman, Ray H

2016-10-18

Lightweight artificial muscle fibers that can match the large tensile stroke of natural muscles have been elusive. In particular, low stroke, limited cycle life, and inefficient energy conversion have combined with high cost and hysteretic performance to restrict practical use. In recent years, a new class of artificial muscles, based on highly twisted fibers, has emerged that can deliver more than 2,000 J/kg of specific work during muscle contraction, compared with just 40 J/kg for natural muscle. Thermally actuated muscles made from ordinary polymer fibers can deliver long-life, hysteresis-free tensile strokes of more than 30% and torsional actuation capable of spinning a paddle at speeds of more than 100,000 rpm. In this perspective, we explore the mechanisms and potential applications of present twisted fiber muscles and the future opportunities and challenges for developing twisted muscles having improved cycle rates, efficiencies, and functionality. We also demonstrate artificial muscle sewing threads and textiles and coiled structures that exhibit nearly unlimited actuation strokes. In addition to robotics and prosthetics, future applications include smart textiles that change breathability in response to temperature and moisture and window shutters that automatically open and close to conserve energy.

Can Artificial Intelligences Suffer from Mental Illness? A Philosophical Matter to Consider.

Science.gov (United States)

Ashrafian, Hutan

2017-04-01

The potential for artificial intelligences and robotics in achieving the capacity of consciousness, sentience and rationality offers the prospect that these agents have minds. If so, then there may be a potential for these minds to become dysfunctional, or for artificial intelligences and robots to suffer from mental illness. The existence of artificially intelligent psychopathology can be interpreted through the philosophical perspectives of mental illness. This offers new insights into what it means to have either robot or human mental disorders, but may also offer a platform on which to examine the mechanisms of biological or artificially intelligent psychiatric disease. The possibility of mental illnesses occurring in artificially intelligent individuals necessitates the consideration that at some level, they may have achieved a mental capability of consciousness, sentience and rationality such that they can subsequently become dysfunctional. The deeper philosophical understanding of these conditions in mankind and artificial intelligences might therefore offer reciprocal insights into mental health and mechanisms that may lead to the prevention of mental dysfunction.

Biological effects of implanted nuclear energy sources for artificial heart devices. Progress report, September 1, 1974--August 31, 1975

International Nuclear Information System (INIS)

Kallfelz, F.A.; Wentworth, R.A.; Cady, K.B.

1975-01-01

Results are reported from a study of the biological effects of radiation from mock plutonium power sources in dogs and a study of the feasibility of a tissue heat sink for waste heat from such sources in calves. It is also designed to evaluate effects of heat and radiation from plutonium sources in calves. The work is part of a program to evaluate the use of plutonium as a power source for an artificial heart device. A total of 60 dogs have been implanted with mock plutonium sources (producing a similar radiation flux as plutonium but having no associated heat) at levels of from 1 to 70 times the expected radiation flux from a 30 watt plutonium source. Results up to 4.5 years after implantation indicate that mammals may be able to tolerate the radiation flux from such sources. Results in calves indicate that 30 watts of additional endogenous heat can be dissipated to a connective tissue covered heat exchanger with a surface area of 494 cm 2 providing a heat flux of 0.06 watts/cm 2 . (U.S.)

Synthetic and Bio-Artificial Tactile Sensing: A Review

Directory of Open Access Journals (Sweden)

Maria Chiara Carrozza

2013-01-01

Full Text Available This paper reviews the state of the art of artificial tactile sensing, with a particular focus on bio-hybrid and fully-biological approaches. To this aim, the study of physiology of the human sense of touch and of the coding mechanisms of tactile information is a significant starting point, which is briefly explored in this review. Then, the progress towards the development of an artificial sense of touch are investigated. Artificial tactile sensing is analysed with respect to the possible approaches to fabricate the outer interface layer: synthetic skin versus bio-artificial skin. With particular respect to the synthetic skin approach, a brief overview is provided on various technologies and transduction principles that can be integrated beneath the skin layer. Then, the main focus moves to approaches characterized by the use of bio-artificial skin as an outer layer of the artificial sensory system. Within this design solution for the skin, bio-hybrid and fully-biological tactile sensing systems are thoroughly presented: while significant results have been reported for the development of tissue engineered skins, the development of mechanotransduction units and their integration is a recent trend that is still lagging behind, therefore requiring research efforts and investments. In the last part of the paper, application domains and perspectives of the reviewed tactile sensing technologies are discussed.

Application of Adaptive Starling-Like Controller to Total Artificial Heart Using Dual Rotary Blood Pumps.

Science.gov (United States)

Ng, Boon C; Smith, Peter A; Nestler, Frank; Timms, Daniel; Cohn, William E; Lim, Einly

2017-03-01

The successful clinical applicability of rotary left ventricular assist devices (LVADs) has led to research interest in devising a total artificial heart (TAH) using two rotary blood pumps (RBPs). The major challenge when using two separately controlled LVADs for TAH support is the difficulty in maintaining the balance between pulmonary and systemic blood flows. In this study, a starling-like controller (SLC) hybridized with an adaptive mechanism was developed for a dual rotary LVAD TAH. The incorporation of the adaptive mechanism was intended not only to minimize the risk of pulmonary congestion and atrial suction but also to match cardiac demand. A comparative assessment was performed between the proposed adaptive starling-like controller (A-SLC) and a conventional SLC as well as a constant speed controller. The performance of all controllers was evaluated by subjecting them to three simulated scenarios [rest, exercise, head up tilt (HUT)] using a mock circulation loop. The overall results showed that A-SLC was superior in matching pump flow to cardiac demand without causing hemodynamic instabilities. In contrast, improper flow regulation by the SLC resulted in pulmonary congestion during exercise. From resting supine to HUT, overpumping of the RBPs at fixed speed (FS) caused atrial suction, whereas implementation of SLC resulted in insufficient flow. The comparative study signified the potential of the proposed A-SLC for future TAH implementation particularly among outpatients, who are susceptible to variety of clinical scenarios.

Artificial Organs 2017: A Year in Review.

Science.gov (United States)

Malchesky, Paul S

2018-03-01

In this Editor's Review, articles published in 2017 are organized by category and summarized. We provide a brief reflection of the research and progress in artificial organs intended to advance and better human life while providing insight for continued application of these technologies and methods. Artificial Organs continues in the original mission of its founders "to foster communications in the field of artificial organs on an international level." Artificial Organs continues to publish developments and clinical applications of artificial organ technologies in this broad and expanding field of organ Replacement, Recovery, and Regeneration from all over the world. Peer-reviewed Special Issues this year included contributions from the 12th International Conference on Pediatric Mechanical Circulatory Support Systems and Pediatric Cardiopulmonary Perfusion edited by Dr. Akif Undar, Artificial Oxygen Carriers edited by Drs. Akira Kawaguchi and Jan Simoni, the 24th Congress of the International Society for Mechanical Circulatory Support edited by Dr. Toru Masuzawa, Challenges in the Field of Biomedical Devices: A Multidisciplinary Perspective edited by Dr. Vincenzo Piemonte and colleagues and Functional Electrical Stimulation edited by Dr. Winfried Mayr and colleagues. We take this time also to express our gratitude to our authors for offering their work to this journal. We offer our very special thanks to our reviewers who give so generously of time and expertise to review, critique, and especially provide meaningful suggestions to the author's work whether eventually accepted or rejected. Without these excellent and dedicated reviewers the quality expected from such a journal could not be possible. We also express our special thanks to our Publisher, John Wiley & Sons for their expert attention and support in the production and marketing of Artificial Organs. We look forward to reporting further advances in the coming years. © 2018 International Center for

Robotics and artificial intelligence: Jewish ethical perspectives.

Science.gov (United States)

Rappaport, Z H

2006-01-01

In 16th Century Prague, Rabbi Loew created a Golem, a humanoid made of clay, to protect his community. When the Golem became too dangerous to his surroundings, he was dismantled. This Jewish theme illustrates some of the guiding principles in its approach to the moral dilemmas inherent in future technologies, such as artificial intelligence and robotics. Man is viewed as having received the power to improve upon creation and develop technologies to achieve them, with the proviso that appropriate safeguards are taken. Ethically, not-harming is viewed as taking precedence over promoting good. Jewish ethical thinking approaches these novel technological possibilities with a cautious optimism that mankind will derive their benefits without coming to harm.

A healthy heart is not a metronome: an integrative review of the heart's anatomy and heart rate variability.

Science.gov (United States)

Shaffer, Fred; McCraty, Rollin; Zerr, Christopher L

2014-01-01

Heart rate variability (HRV), the change in the time intervals between adjacent heartbeats, is an emergent property of interdependent regulatory systems that operate on different time scales to adapt to challenges and achieve optimal performance. This article briefly reviews neural regulation of the heart, and its basic anatomy, the cardiac cycle, and the sinoatrial and atrioventricular pacemakers. The cardiovascular regulation center in the medulla integrates sensory information and input from higher brain centers, and afferent cardiovascular system inputs to adjust heart rate and blood pressure via sympathetic and parasympathetic efferent pathways. This article reviews sympathetic and parasympathetic influences on the heart, and examines the interpretation of HRV and the association between reduced HRV, risk of disease and mortality, and the loss of regulatory capacity. This article also discusses the intrinsic cardiac nervous system and the heart-brain connection, through which afferent information can influence activity in the subcortical and frontocortical areas, and motor cortex. It also considers new perspectives on the putative underlying physiological mechanisms and properties of the ultra-low-frequency (ULF), very-low-frequency (VLF), low-frequency (LF), and high-frequency (HF) bands. Additionally, it reviews the most common time and frequency domain measurements as well as standardized data collection protocols. In its final section, this article integrates Porges' polyvagal theory, Thayer and colleagues' neurovisceral integration model, Lehrer et al.'s resonance frequency model, and the Institute of HeartMath's coherence model. The authors conclude that a coherent heart is not a metronome because its rhythms are characterized by both complexity and stability over longer time scales. Future research should expand understanding of how the heart and its intrinsic nervous system influence the brain.

Thermally induced magnetic relaxation in square artificial spin ice

Science.gov (United States)

Andersson, M. S.; Pappas, S. D.; Stopfel, H.; Östman, E.; Stein, A.; Nordblad, P.; Mathieu, R.; Hjörvarsson, B.; Kapaklis, V.

2016-11-01

The properties of natural and artificial assemblies of interacting elements, ranging from Quarks to Galaxies, are at the heart of Physics. The collective response and dynamics of such assemblies are dictated by the intrinsic dynamical properties of the building blocks, the nature of their interactions and topological constraints. Here we report on the relaxation dynamics of the magnetization of artificial assemblies of mesoscopic spins. In our model nano-magnetic system - square artificial spin ice - we are able to control the geometrical arrangement and interaction strength between the magnetically interacting building blocks by means of nano-lithography. Using time resolved magnetometry we show that the relaxation process can be described using the Kohlrausch law and that the extracted temperature dependent relaxation times of the assemblies follow the Vogel-Fulcher law. The results provide insight into the relaxation dynamics of mesoscopic nano-magnetic model systems, with adjustable energy and time scales, and demonstrates that these can serve as an ideal playground for the studies of collective dynamics and relaxations.

Stable ischemic heart disease in women: current perspectives

Directory of Open Access Journals (Sweden)

Samad F

2017-09-01

Full Text Available Fatima Samad,1 Anushree Agarwal,2 Zainab Samad3 1Aurora Cardiovascular Services, Aurora Sinai/Aurora St Luke’s Medical Centers, University of Wisconsin School of Medicine and Public Health, Milwaukee, WI, 2Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, CA, 3Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, NC, USA Abstract: Cardiovascular disease is the leading cause of death in women accounting for 1 in every 4 female deaths. Pathophysiology of ischemic heart disease in women includes epicardial coronary artery, endothelial dysfunction, coronary vasospasm, plaque erosion and spontaneous coronary artery dissection. Angina is the most common presentation of stable ischemic heart disease (SIHD in women. Risk factors for SIHD include traditional risks such as older age, obesity (body mass index [BMI] >25 kg/m2, smoking, hypertension, dyslipidemia, cerebrovascular and peripheral vascular disease, sedentary lifestyle, family history of premature coronary artery disease, metabolic syndrome and diabetes mellitus, and nontraditional risk factors, such as gestational diabetes, insulin resistance/polycystic ovarian disease, pregnancy-induced hypertension, pre-eclampsia, eclampsia, menopause, mental stress and autoimmune diseases. Diagnostic testing can be used effectively to risk stratify women. Guidelines-directed medical therapy including aspirin, statins, beta-blocker therapy, calcium channel blockers and ranolazine should be instituted for symptom and ischemia management. Despite robust evidence regarding the adverse outcomes seen in women with ischemic heart disease, knowledge gaps exist in several areas. Future research needs to be directed toward a greater understanding of the role of nontraditional risk factors for SIHD in women, gaining deeper insights into the sex differences in therapeutic effects and formulating a sex-specific algorithm for the

3D Bioprinting of Artificial Tissues: Construction of Biomimetic Microstructures.

Science.gov (United States)

Luo, Yongxiang; Lin, Xin; Huang, Peng

2018-04-24

It is promising that artificial tissues/organs for clinical application can be produced via 3D bioprinting of living cells and biomaterials. The construction of microstructures biomimicking native tissues is crucially important to create artificial tissues with biological functions. For instance, the fabrication of vessel-like networks to supply cells with initial nutrient and oxygen, and the arrangement of multiple types of cells for creating lamellar/complex tissues through 3D bioprinting are widely reported. The current advances in 3D bioprinting of artificial tissues from the view of construction of biomimetic microstructures, especially the fabrication of lamellar, vascular, and complex structures are summarized. In the end, the conclusion and perspective of 3D bioprinting for clinical applications are elaborated. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Artificial intelligence and robot responsibilities: innovating beyond rights.

Science.gov (United States)

Ashrafian, Hutan

2015-04-01

The enduring innovations in artificial intelligence and robotics offer the promised capacity of computer consciousness, sentience and rationality. The development of these advanced technologies have been considered to merit rights, however these can only be ascribed in the context of commensurate responsibilities and duties. This represents the discernable next-step for evolution in this field. Addressing these needs requires attention to the philosophical perspectives of moral responsibility for artificial intelligence and robotics. A contrast to the moral status of animals may be considered. At a practical level, the attainment of responsibilities by artificial intelligence and robots can benefit from the established responsibilities and duties of human society, as their subsistence exists within this domain. These responsibilities can be further interpreted and crystalized through legal principles, many of which have been conserved from ancient Roman law. The ultimate and unified goal of stipulating these responsibilities resides through the advancement of mankind and the enduring preservation of the core tenets of humanity.

Application of artificial intelligence methods for prediction of steel mechanical properties

Directory of Open Access Journals (Sweden)

Z. Jančíková

2008-10-01

Full Text Available The target of the contribution is to outline possibilities of applying artificial neural networks for the prediction of mechanical steel properties after heat treatment and to judge their perspective use in this field. The achieved models enable the prediction of final mechanical material properties on the basis of decisive parameters influencing these properties. By applying artificial intelligence methods in combination with mathematic-physical analysis methods it will be possible to create facilities for designing a system of the continuous rationalization of existing and also newly developing industrial technologies.

Simulation of blood flow through an artificial heart

Science.gov (United States)

Kiris, Cetin; Chang, I-Dee; Rogers, Stuart E.; Kwak, Dochan

1991-01-01

A numerical simulation of the incompressible viscous flow through a prosthetic tilting disk heart valve is presented in order to demonstrate the current capability to model unsteady flows with moving boundaries. Both steady state and unsteady flow calculations are done by solving the incompressible Navier-Stokes equations in 3-D generalized curvilinear coordinates. In order to handle the moving boundary problems, the chimera grid embedding scheme which decomposes a complex computational domain into several simple subdomains is used. An algebraic turbulence model for internal flows is incorporated to reach the physiological values of Reynolds number. Good agreement is obtained between the numerical results and experimental measurements. It is found that the tilting disk valve causes large regions of separated flow, and regions of high shear.

A Study on the Bandwidth Characteristics of Pleated Pneumatic Artificial Muscles

Directory of Open Access Journals (Sweden)

Rino Versluys

2009-01-01

Full Text Available Pleated pneumatic artificial muscles have interesting properties that can be of considerable significance in robotics and automation. With a view to the potential use of pleated pneumatic artificial muscles as actuators for a fatigue test bench (high forces and small displacements, the bandwidth characteristics of a muscle-valve system were investigated. Bandwidth is commonly used for linear systems, as the Bode plot is independent of the amplitude of the input signal. However, due to the non-linear behaviour of pleated pneumatic artificial muscles, the system's gain becomes dependent on the amplitude of the input sine wave. As a result, only one Bode plot is insufficient to clearly describe or identify a non-linear system. In this study, the bandwidth of a muscle-valve system was assessed from two perspectives: a varying amplitude and a varying offset of the input sine wave. A brief introduction to pneumatic artificial muscles is given. The concept of pleated pneumatic artificial muscles is explained. Furthermore, the different test methods and experimental results are presented.

A PHILOSOPHICAL APPROACH TO ARTIFICIAL INTELLIGENCE AND ISLAMIC VALUES

Directory of Open Access Journals (Sweden)

Ali Akbar Ziaee

2012-02-01

Full Text Available Artificial Intelligence has the potential to empower humans through enhanced learning and performance. But if this potential is to be realized and accepted, the ethical aspects as well as the technical must be addressed. Many engineers claim that AI will be smarter than human brains, including scientific creativity, general wisdom and social skills, so we must consider it an important factor for making decisions in our social life and especially in our Islamic societies. The most important challenges will be the quality of representing the Islamic values like piety, obedience, Halal and Haram, and etc in the form of semantics. In this paper, I want to emphasize on the role of Divine Islamic values in the application of AI and discuss it according to philosophy of AI and Islamic perspective.Keywords- Value, expert, Community Development, Artificial Intelligence, Superintelligence, Friendly Artificial Intelligence

Development of data communication system with ultra high frequency radio wave for implantable artificial hearts.

Science.gov (United States)

Tsujimura, Shinichi; Yamagishi, Hiroto; Sankai, Yoshiyuki

2009-01-01

In order to minimize infection risks of patients with artificial hearts, wireless data transmission methods with electromagnetic induction or light have been developed. However, these methods tend to become difficult to transmit data if the external data transmission unit moves from its proper position. To resolve this serious problem, the purpose of this study is to develop a prototype wireless data communication system with ultra high frequency radio wave and confirm its performance. Due to its high-speed communication rate, low power consumption, high tolerance to electromagnetic disturbances, and secure wireless communication, we adopted Bluetooth radio wave technology for our system. The system consists of an internal data transmission unit and an external data transmission unit (53 by 64 by 16 mm, each), and each has a Bluetooth module (radio field intensity: 4 dBm, receiver sensitivity: -80 dBm). The internal unit also has a micro controller with an 8-channel 10-bit A/D converter, and the external unit also has a RS-232C converter. We experimented with the internal unit implanted into pig meat, and carried out data transmission tests to evaluate the performance of this system in tissue thickness of up to 3 mm. As a result, data transfer speeds of about 20 kbps were achieved within the communication distance of 10 m. In conclusion, we confirmed that the system can wirelessly transmit the data from the inside of the body to the outside, and it promises to resolve unstable data transmission due to accidental movements of an external data transmission unit.

Stable ischemic heart disease in women: current perspectives.

Science.gov (United States)

Samad, Fatima; Agarwal, Anushree; Samad, Zainab

2017-01-01

Cardiovascular disease is the leading cause of death in women accounting for 1 in every 4 female deaths. Pathophysiology of ischemic heart disease in women includes epicardial coronary artery, endothelial dysfunction, coronary vasospasm, plaque erosion and spontaneous coronary artery dissection. Angina is the most common presentation of stable ischemic heart disease (SIHD) in women. Risk factors for SIHD include traditional risks such as older age, obesity (body mass index [BMI] >25 kg/m 2 ), smoking, hypertension, dyslipidemia, cerebrovascular and peripheral vascular disease, sedentary lifestyle, family history of premature coronary artery disease, metabolic syndrome and diabetes mellitus, and nontraditional risk factors, such as gestational diabetes, insulin resistance/polycystic ovarian disease, pregnancy-induced hypertension, pre-eclampsia, eclampsia, menopause, mental stress and autoimmune diseases. Diagnostic testing can be used effectively to risk stratify women. Guidelines-directed medical therapy including aspirin, statins, beta-blocker therapy, calcium channel blockers and ranolazine should be instituted for symptom and ischemia management. Despite robust evidence regarding the adverse outcomes seen in women with ischemic heart disease, knowledge gaps exist in several areas. Future research needs to be directed toward a greater understanding of the role of nontraditional risk factors for SIHD in women, gaining deeper insights into the sex differences in therapeutic effects and formulating a sex-specific algorithm for the management of SIHD in women.

An Evolutionary Perspective of the Relationship Between Corporate Strategy and Performance, Through the Use of Artificial Neural Networks and Genetic AlgorithmsHttp://Dx.Doi.Org/10.5585/Riae.V9i3.1689

Directory of Open Access Journals (Sweden)

Alexandre Teixeira Dias

2011-01-01

Full Text Available This study aims to contribute to the understanding of the relationship between Corporate Strategy and Performance, from the perspective of the Evolutionary Theory. As methods of data processing, obtained in secondary databases, we used artificial neural networks and genetic algorithms. The results of processing neural networks and genetic algorithms demonstrate the importance of corporate strategies in determining performance. The evolutionary perspective emphasizes the importance of investing in operations as a factor influencing the adequacy of the organization, in order to achieve an improved performance, in addition to establishing relationships with other organizations, through members of the board.

Prediction of the external work of the native heart from the dynamic H-Q curves of the rotary blood pumps during left heart bypass.

Science.gov (United States)

Yokoyama, Yoshimasa; Kawaguchi, Osamu; Kitao, Takashi; Kimura, Taro; Steinseifer, Ulrich; Takatani, Setsuo

2010-09-01

The ventricular performance is dependent on the drainage effect of rotary blood pumps (RBPs) and the performance of RBPs is affected by the ventricular pulsation. In this study, the interaction between the ventricle and RBPs was examined using the pressure-volume (P-V) diagram of the ventricle and dynamic head pressure-bypass flow (H-Q) curves (H, head pressure: arterial pressure minus ventricular pressure vs. Q, bypass flow) of the RBPs. We first investigated the relationships in a mock loop with a passive fill ventricle, followed by validation in ex vivo animal experiments. An apical drainage cannula with a micro-pressure sensor was especially fabricated to obtain ventricular pressure, while three pairs of ultrasonic crystals placed on the heart wall were used to derive ventricular volume. The mock loop-configured ventricular apical-descending aorta bypass revealed that the external work of the ventricle expressed by the area inside the P-V diagrams (EW(Heart) ) correlated strongly with the area inside dynamic H-Q curves (EW(VAD)), with the coefficients of correlation being R² = 0.869 ∼ 0.961. The results in the mock loop were verified in the ex vivo studies using three Shiba goats (10-25 kg in body weight), showing the correlation coefficients of R² = 0.802 ∼ 0.817. The linear regression analysis indicated that the increase in the bypass flow reduced pulsatility in the ventricle expressed in EW(Heart) as well as in EW(VAD) . Experimental results, both mock loop and animal studies, showed that the interaction between cardiac external work and H-Q performance of RBPs can be expressed by the relationships "EW(Heart) versus EW(VAD) ." The pulsatile nature of the native heart can be expressed in the area underneath the H-Q curves of RBPs EW(VAD) during left heart bypass indicating the status of the level of assistance by RBPs and the native heart function. © 2010, Copyright the Authors. Artificial Organs © 2010, International Center for Artificial Organs and

Fuzzy Expert System for Heart Attack Diagnosis

Science.gov (United States)

Hassan, Norlida; Arbaiy, Nureize; Shah, Noor Aziyan Ahmad; Afizah Afif@Afip, Zehan

2017-08-01

Heart attack is one of the serious illnesses and reported as the main killer disease. Early prevention is significant to reduce the risk of having the disease. The prevention efforts can be strengthen through awareness and education about risk factor and healthy lifestyle. Therefore the knowledge dissemination is needed to play role in order to distribute and educate public in health care management and disease prevention. Since the knowledge dissemination in medical is important, there is a need to develop a knowledge based system that can emulate human intelligence to assist decision making process. Thereby, this study utilized hybrid artificial intelligence (AI) techniques to develop a Fuzzy Expert System for Diagnosing Heart Attack Disease (HAD). This system integrates fuzzy logic with expert system, which helps the medical practitioner and people to predict the risk and as well as diagnosing heart attack based on given symptom. The development of HAD is expected not only providing expert knowledge but potentially become one of learning resources to help citizens to develop awareness about heart-healthy lifestyle.

Biomedical engineering support. Annual progress report, August 15, 1974--August 14, 1975. [/sup 238/PuO/sub 2/-powered mechanical heart

Energy Technology Data Exchange (ETDEWEB)

Kolff, W.J.; Smith, L.M.; Sandquist, G.M.

1975-01-01

The major responsibility of the Institute for Biomedical Engineering at the University of Utah under the ERDA Artificial Heart Program has been to provide in vitro and in vivo experimental data and evaluation of the anatomical fitting, accommodation, performance and adequacy of the artificial heart system and its components as they are developed in the ERDA Program and provided to the Institute for study. The Institute also has the responsibility of designing, constructing and testing the blood handling components of the Blood Pump and insuring reliability, durability and satisfactory performance of these system components. During the reporting period, nine total heart replacement experiments were performed in calves using the ERDA Blood Pump powered by an electric motor implanted in the abdomen. Results of the experiments are given. Ultimately the mechanical heart will be powered by a radioisotope heat source. (TFD)

Favorable Effects of the Detergent and Enzyme Extraction Method for Preparing Decellularized Bovine Pericardium Scaffold for Tissue Engineered Heart Valves

NARCIS (Netherlands)

Yang, Min; Chen, Chang-Zhi; Wang, Xue-Ning; Zhu, Ya-Bin; Gu, Y. John

2009-01-01

Bovine pericardium has been extensively applied as the biomaterial for artificial heart valves and may potentially be used as a scaffold for tissue-engineered heart valves after decellularization. Although various methods of decellularization are currently available, it is unknown which method is

Physiological and Psychological Effects on High School Students of Viewing Real and Artificial Pansies

Directory of Open Access Journals (Sweden)

Miho Igarashi

2015-02-01

Full Text Available The relaxation effects of gardening have attracted attention; however, very few studies have researched its physiological effects on humans. This study aimed to clarify the physiological and psychological effects on high school students of viewing real and artificial pansies. Forty high school students (male: 19, female: 21 at Chiba Prefectural Kashiwanoha Senior High School, Japan, participated in this experiment. The subjects were presented with a visual stimulation of fresh yellow pansies (Viola x wittrockiana “Nature Clear Lemon” in a planter for 3 min. Artificial yellow pansies in a planter were used as the control. Heart rate variability was used as a physiological measurement and the modified semantic differential method was used for subjective evaluation. Compared with artificial pansies, visual stimulation with real flowers resulted in a significant decrease in the ratio of low- to high-frequency heart rate variability component, which reflects sympathetic nerve activity. In contrast, high frequency, which reflects parasympathetic nerve activity, showed no significant difference. With regard to the psychological indices, viewing real flowers resulted in “comfortable”, “relaxed”, and “natural” feelings. The findings indicate that visual stimulation with real pansies induced physiological and psychological relaxation effects in high school students.

Polymeric materials as artificial muscles: an overview.

Science.gov (United States)

Ariano, Paolo; Accardo, Daisy; Lombardi, Mariangela; Bocchini, Sergio; Draghi, Lorenza; De Nardo, Luigi; Fino, Paolo

2015-03-18

The accurate selection of materials and the fine tuning of their properties represent a fundamental aspect in the realization of new active systems able to produce actuating forces, such as artificial muscles. In this regard, exciting opportunities for the design of new advanced systems are offered by materials belonging to the emerging class of functional polymers: exploiting their actuation response, specific devices can be realized. Along this direction, materials showing either shape-memory effect (SME) or shape-change effect (SCE) have been the subject of extensive studies aimed at designing of actuators as artificial muscles. Here, we concisely review active polymers in terms of properties and main applications in artificial muscle design. The main aspects related to material properties in both shape-memory polymers (SMPs) and electroactive polymers (EAPs) are reviewed, based on recent scientific literature. SME in thermally activated SMPs is presented by preliminarily providing a definition that encompasses the new theories regarding their fundamental properties. EAPs are briefly presented, describing the working mechanisms and highlighting the main properties and drawbacks, in view of their application as actuators. For both classes of materials, some key examples of effective application in artificial muscles are offered. The potential in polymer architecture design for the fabrication of actively moving systems is described to give a perspective on the main achievements and new research activities.

Mechanical ventilation and the total artificial heart: optimal ventilator trigger to avoid post-operative autocycling - a case series and literature review

Directory of Open Access Journals (Sweden)

Arabia Francisco A

2010-05-01

Full Text Available Abstract Many patients with end-stage cardiomyopathy are now being implanted with Total Artificial Hearts (TAHs. We have observed individual cases of post-operative mechanical ventilator autocycling with a flow trigger, and subsequent loss of autocycling after switching to a pressure trigger. These observations prompted us to do a retrospective review of all TAH devices placed at our institution between August 2007 and May 2009. We found that in the immediate post-operative period following TAH placement, autocycling was present in 50% (5/10 of cases. There was immediate cessation of autocycling in all patients after being changed from a flow trigger of 2 L/minute to a pressure trigger of 2 cm H2O. The autocycling group was found to have significantly higher CVP values than the non-autocycling group (P = 0.012. Our data suggest that mechanical ventilator autocycling may be resolved or prevented by the use of a pressure trigger rather than a flow trigger setting in patients with TAHs who require mechanical ventilation.

Artificial urinary conduit construction using tissue engineering methods.

Science.gov (United States)

Kloskowski, Tomasz; Pokrywczyńska, Marta; Drewa, Tomasz

2015-01-01

Incontinent urinary diversion using an ileal conduit is the most popular method used by urologists after bladder cystectomy resulting from muscle invasive bladder cancer. The use of gastrointestinal tissue is related to a series of complications with the necessity of surgical procedure extension which increases the time of surgery. Regenerative medicine together with tissue engineering techniques gives hope for artificial urinary conduit construction de novo without affecting the ileum. In this review we analyzed history of urinary diversion together with current attempts in urinary conduit construction using tissue engineering methods. Based on literature and our own experience we presented future perspectives related to the artificial urinary conduit construction. A small number of papers in the field of tissue engineered urinary conduit construction indicates that this topic requires more attention. Three main factors can be distinguished to resolve this topic: proper scaffold construction along with proper regeneration of both the urothelium and smooth muscle layers. Artificial urinary conduit has a great chance to become the first commercially available product in urology constructed by regenerative medicine methods.

From the seat of heat and intelligence to regular heart activity as automatic movement: progress in cardiology up to 1900 from a Dutch perspective.

Science.gov (United States)

van Tellingen, C

2009-04-01

The development in cardiovascular anatomy and physiology is described from a Dutch perspective. The newly formed Republic in the 17th century, with its pragmatism and business-like character, became an ideal breeding ground for Descartes' new philosophy. His separation of body and soul provided a mechanistic model of body structure and formed a firm basis for anatomical and physiological research to become catalysts for a tempestuous growth and progress in medicine. (Neth Heart J 2009;17:130-5.).

Artificial Consciousness or Artificial Intelligence

OpenAIRE

Spanache Florin

2017-01-01

Artificial intelligence is a tool designed by people for the gratification of their own creative ego, so we can not confuse conscience with intelligence and not even intelligence in its human representation with conscience. They are all different concepts and they have different uses. Philosophically, there are differences between autonomous people and automatic artificial intelligence. This is the difference between intelligence and artificial intelligence, autonomous versus a...

Artificial immune system applications in computer security

CERN Document Server

Tan, Ying

2016-01-01

This book provides state-of-the-art information on the use, design, and development of the Artificial Immune System (AIS) and AIS-based solutions to computer security issues. Artificial Immune System: Applications in Computer Security focuses on the technologies and applications of AIS in malware detection proposed in recent years by the Computational Intelligence Laboratory of Peking University (CIL@PKU). It offers a theoretical perspective as well as practical solutions for readers interested in AIS, machine learning, pattern recognition and computer security. The book begins by introducing the basic concepts, typical algorithms, important features, and some applications of AIS. The second chapter introduces malware and its detection methods, especially for immune-based malware detection approaches. Successive chapters present a variety of advanced detection approaches for malware, including Virus Detection System, K-Nearest Neighbour (KNN), RBF networ s, and Support Vector Machines (SVM), Danger theory, ...

Theory of heart biomechanics, biophysics, and nonlinear dynamics of cardiac function

CERN Document Server

Hunter, Peter; McCulloch, Andrew

1991-01-01

In recent years there has been a growth in interest in studying the heart from the perspective of the physical sciences: mechanics, fluid flow, electromechanics. This volume is the result of a workshop held in July 1989 at the Institute for Nonlinear Sciences at the University of California at San Diego that brought together scientists and clinicians with graduate students and postdoctoral fellows who shared an interest in the heart. The chapters were prepared by the invited speakers as didactic reviews of their subjects but also include the structure, mechanical properties, and function of the heart and the myocardium, electrical activity of the heart and myocardium, and mathematical models of heart function.

Flow Rate Through Pigtail Catheter Used for Left Heart Decompression in an Artificial Model of Extracorporeal Membrane Oxygenation Circuit.

Science.gov (United States)

Kim, Won Ho; Hong, Tae Hee; Byun, Joung Hun; Kim, Jong Woo; Kim, Sung Hwan; Moon, Sung Ho; Park, Hyun Oh; Choi, Jun Young; Yang, Jun Ho; Jang, In Seok; Lee, Chung Eun; Yun, Jeong Hee

In refractory cardiogenic shock, veno-arterial extracorporeal membrane oxygenation (ECMO) can be initiated. Although left heart decompression can be accomplished by insertion of a left atrial (LA) or left ventricular (LV) cannula using a percutaneous pigtail catheter, the venting flow rate according to catheter size and ECMO flow rate is unknown. We developed an artificial ECMO circuit. One liter saline bag with its pressure set to 20 mm Hg was connected to ECMO to mimic LV failure. A pigtail catheter was inserted into the 1 L saline bag to simulate LV unloading. For each pigtail catheter size (5-8 Fr) and ECMO flow rate (2.0-4.0 L/min), the moving distance of an air bubble that was injected through a three-way stopcock was measured in the arterial pressure line between the pigtail catheter and ECMO inflow limb. The flow rate was then calculated. We obtained the following equation to estimate the pigtail catheter flow rate.Pigtail vent catheter flow rate (ml/min) = 8×ECMOflow rate(L /min)+9×pigtail catheter size(Fr)- 57This equation would aid in designing of a further study to determine optimal venting flow rate. To achieve optimal venting flow, our equation would enable selection of an adequate catheter size.

Effective heart disease prevention: lessons from a qualitative study of user perspectives in Bangladeshi, Indian and Pakistani communities.

Science.gov (United States)

Netto, G; McCloughan, L; Bhatnagar, A

2007-03-01

Coronary heart disease (CHD) has a high mortality, incidence and prevalence among Indian, Pakistani and Bangladeshi communities in the UK, indicating the need for effective heart disease prevention initiatives for these communities. This paper considers how service user perspectives can be used to develop effective, culturally focused CHD prevention interventions for these target groups by addressing identified barriers, including deeply held cultural beliefs. A qualitative research study, using a longitudinal action research approach. This was a community-based study in Edinburgh. Six focus group discussions--two for each community--were organized with participants from these communities at the beginning of the project. A further six focus group discussions for the same communities were organized six months later. Over the period examined, participants reported varying changes in levels of knowledge relating to the nature, causes and symptoms of CHD. Some participants reported taking slight to significant steps to reduce or prevent heart disease, while others did not. The project was viewed as helpful in increasing knowledge about CHD and preventive measures and encouraging healthier lifestyles. However, persistent barriers to change were also identified, requiring changes to the project that involved not only matching intervention materials and messages to observable, superficial characteristics of the target population, but more fundamental changes that address the cultural, social, historical, environmental and psychological forces that influence health behaviour. CHD prevention initiatives need to identify and respond to deep-rooted influences on health-behaviour in 'at-risk' groups, in addition to superficial characteristics of the target populations. It is important for specific prevention initiatives to be linked into wider CHD frameworks to ensure transferability of learning and integration within wider service provision.

Development of the hearts of lizards and snakes and perspectives to cardiac evolution

NARCIS (Netherlands)

Jensen, Bjarke; van den Berg, Gert; van den Doel, Rick; Oostra, Roelof-Jan; Wang, Tobias; Moorman, Antoon F. M.

2013-01-01

Birds and mammals both developed high performance hearts from a heart that must have been reptile-like and the hearts of extant reptiles have an unmatched variability in design. Yet, studies on cardiac development in reptiles are largely old and further studies are much needed as reptiles are

Artificial heartbeat: design and fabrication of a biologically inspired pump

International Nuclear Information System (INIS)

Walters, Peter; Stephenson, Robert; Lewis, Amy; Stinchcombe, Andrew; Ieropoulos, Ioannis

2013-01-01

We present a biologically inspired actuator exhibiting a novel pumping action. The design of the ‘artificial heartbeat’ actuator is inspired by physical principles derived from the structure and function of the human heart. The actuator employs NiTi artificial muscles and is powered by electrical energy generated by microbial fuel cells (MFCs). We describe the design and fabrication of the actuator and report the results of tests conducted to characterize its performance. This is the first artificial muscle-driven pump to be powered by MFCs fed on human urine. Results are presented in terms of the peak pumping pressure generated by the actuator, as well as for the volume of fluid transferred, when the actuator was powered by energy stored in a capacitor bank, which was charged by 24 MFCs fed on urine. The results demonstrate the potential for the artificial heartbeat actuator to be employed as a fluid circulation pump in future generations of MFC-powered robots (‘EcoBots’) that extract energy from organic waste. We also envisage that the actuator could in the future form part of a bio-robotic artwork or ‘bio-automaton’ that could help increase public awareness of research in robotics, bio-energy and biologically inspired design. (paper)

Architecture and biological applications of artificial neural networks: a tuberculosis perspective.

Science.gov (United States)

Darsey, Jerry A; Griffin, William O; Joginipelli, Sravanthi; Melapu, Venkata Kiran

2015-01-01

Advancement of science and technology has prompted researchers to develop new intelligent systems that can solve a variety of problems such as pattern recognition, prediction, and optimization. The ability of the human brain to learn in a fashion that tolerates noise and error has attracted many researchers and provided the starting point for the development of artificial neural networks: the intelligent systems. Intelligent systems can acclimatize to the environment or data and can maximize the chances of success or improve the efficiency of a search. Due to massive parallelism with large numbers of interconnected processers and their ability to learn from the data, neural networks can solve a variety of challenging computational problems. Neural networks have the ability to derive meaning from complicated and imprecise data; they are used in detecting patterns, and trends that are too complex for humans, or other computer systems. Solutions to the toughest problems will not be found through one narrow specialization; therefore we need to combine interdisciplinary approaches to discover the solutions to a variety of problems. Many researchers in different disciplines such as medicine, bioinformatics, molecular biology, and pharmacology have successfully applied artificial neural networks. This chapter helps the reader in understanding the basics of artificial neural networks, their applications, and methodology; it also outlines the network learning process and architecture. We present a brief outline of the application of neural networks to medical diagnosis, drug discovery, gene identification, and protein structure prediction. We conclude with a summary of the results from our study on tuberculosis data using neural networks, in diagnosing active tuberculosis, and predicting chronic vs. infiltrative forms of tuberculosis.

Echocardiographic evaluation of simple versus complex congenital heart disease in a tertiary care Paediatrics Hospital

OpenAIRE

Uttam Kumar Sarkar; Anish Chatterjee; Suprit Basu; Atanu Pan; Sumit Periwal

2017-01-01

Background & Objectives:Congenital heart diseases are treatable either by catheter based intervention or open heart surgery according to their quality. In our study we aim to analyze congenital heart disease echocardiographically into simple versus complex heart disease at a tertiary care centre with a public health planning and policy making perspective.Materials & Methods:This hospital based study was done on 1010 patients, both from in-patient and out-patient, who were clinically s...

Nuclear magnetic resonance zeugmatographic imaging of the heart: application to the study of ventricular septal defect

International Nuclear Information System (INIS)

Heneghan, M.A.; Biancaniello, T.M.; Heidel, E.; Peterson, S.B.; Marsh, M.J.; Lauterbur, P.C.

1982-01-01

The present work was undertaken to determine the applicability of nuclear magnetic resonance (NMR) imaging to the study of congenital heart disease. Three-dimensional proton density images of preserved lamb hearts with and without an artificially created ventricular septal defect were reconstructed and displayed in multiple planes. Sections obtained in the sagittal plane through the ventricular septum clearly showed the size, shape, and location of the defect. Results of these experiments suggest that NMR zeugmatography will become a valuable addition to existing imaging techniques for the study of congenital heart disease

Bridge to transplantation using paracorporeal biventricular assist devices or the syncardia temporary total artificial heart: is there a difference?

Science.gov (United States)

Nguyen, A; Pozzi, M; Mastroianni, C; Léger, P; Loisance, D; Pavie, A; Leprince, P; Kirsch, M

2015-06-01

Biventricular support can be achieved using paracorporeal ventricular assist devices (p-BiVAD) or the Syncardia temporary total artificial heart (t-TAH). The purpose of the present study was to compare survival and morbidity between these devices. Data from 2 French neighboring hospitals were reviewed. Between 1996 and 2009, 148 patients (67 p-BiVADs and 81 t-TAH) underwent primary, planned biventricular support. There were 128 (86%) males aged 44±13 years. Preoperatively, p-BiVAD recipients had significantly lower systolic and diastolic blood pressures, more severe hepatic cytolysis and higher white blood cell counts than t-TAH recipients. In contrast, t-TAH patients had significantly higher rates of pre-implant ECLS and hemofiltration. Mean support duration was 79±100 days for the p-BiVAD group and 71±92 for t-TAH group (P=0.6). Forty two (63%) p-BiVAD recipients were bridged to transplantation (39, 58%) or recovery (3, 5%), whereas 51 (63%) patients underwent transplantation in the t-TAH group. Death on support was similar between groups (p-BiVAD, 26 (39%); t-TAH, 30 (37%); P=0.87). Survival while on device was not significantly different between patient groups and multivariate analysis showed that only preimplant diastolic blood pressure and alanine amino-transferase levels were significant predictors of death. Post-transplant survival in the p-BiVAD group was 76±7%, 70±8%, and 58±9% at 1, 3, and 5 years after transplantation, respectively, and was similar to that of the t-TAH group (77±6%, 72±6%, and 70±7%, P=0.60). Survival while on support and up to 5 years after heart transplantation was not significantly different in patients supported by p-BiVADs or t-TAH. Multivariate analysis revealed that survival while on transplantation was not affected by the type of device implanted.

Heart Palpitation From Traditional and Modern Medicine Perspectives

Science.gov (United States)

Ershadifar, Tabassom; Minaiee, Bagher; Gharooni, Manouchehr; Isfahani, Mohammad Mahdi; Nikbakht Nasrabadi, Alireza; Nazem, Esmaiel; Gousheguir, Ashraf Aldin; Kazemi Saleh, Davod

2014-01-01

Background: Palpitation is a sign of a disease and is very common in general population. For this purpose we decided to explain it in this study. Objectives: The purpose of this study was to describe the palpitation in both modern and traditional medicine aspect. It may help us to diagnose and cure better because the traditional medicine view is holistic and different from modern medicine. Materials and Methods: We addressed some descriptions to the articles of traditional medicine subjects which have published recently. Palpitation in modern medicine was extracted from medical books such as Braunwald, Harrison and Guyton physiology and some related articles obtained from authentic journals in PubMed and Ovid and Google scholar between1990 to 2013. Results: According to modern medicine, there are many causes for palpitation and in some cases it is cured symptomatically. In traditional medicine view, palpitation has been explained completely and many causes have been described. Its aspect is holistic and it cures causatively. The traditional medicine scientists evaluated the body based on Humors and temperament. Temperament can be changed to dis-temperament in diseases. Humors are divided in 4 items: sanguine, humid or phlegm, melancholy and bile. Palpitation is a disease, it is heart vibration and is caused by an abnormal substance in the heart itself or its membrane or other adjacent organs that would result in the heart suffering. Conclusions: Our data of this article suggests that causes of palpitation in the aspect of traditional medicine are completely different from modern medicine. It can help us to approach and treat this symptom better and with lower side effects than chemical drugs. According to this article we are able to detect a new approach in palpitation. PMID:24719741

Totally implantable total artificial heart and ventricular assist device with multipurpose miniature electromechanical energy system.

Science.gov (United States)

Takatani, S; Orime, Y; Tasai, K; Ohara, Y; Naito, K; Mizuguchi, K; Makinouchi, K; Damm, G; Glueck, J; Ling, J

1994-01-01

A multipurpose miniature electromechanical energy system has been developed to yield a compact, efficient, durable, and biocompatible total artificial heart (TAH) and ventricular assist device (VAD). Associated controller-driver electronics were recently miniaturized and converted into hybrid circuits. The hybrid controller consists of a microprocessor and controller, motor driver, Hall sensor, and commutation circuit hybrids. The sizing study demonstrated that all these components can be incorporated in the pumping unit of the TAH and VAD, particularly in the centerpiece of the TAH and the motor housing of the VAD. Both TAH and VAD pumping units will start when their power line is connected to either the internal power pack or the external battery unit. As a redundant driving and diagnostic port, an emergency port was newly added and will be placed in subcutaneous location. In case of system failure, the skin will be cut down, and an external motor drive or a pneumatic driver will be connected to this port to run the TAH. This will minimize the circulatory arrest time. Overall efficiency of the TAH without the transcutaneous energy transmission system was 14-18% to deliver pump outputs of 4-9 L/min against the right and left afterload pressures of 25 and 100 mm Hg. The internal power requirement ranged from 6 to 13 W. The rechargeable batteries such as NiCd or NiMH with 1 AH capacity can run the TAH for 30-45 min. The external power requirement, when TETS efficiency of 75% was assumed, ranged from 8 to 18 W. The accelerated endurance test in the 42 degrees C saline bath demonstrated stable performance over 4 months. Long-term endurance and chronic animal studies will continue toward a system with 5 years durability by the year 2000.

Natural - synthetic - artificial!

DEFF Research Database (Denmark)

Nielsen, Peter E

2010-01-01

The terms "natural," "synthetic" and "artificial" are discussed in relation to synthetic and artificial chromosomes and genomes, synthetic and artificial cells and artificial life.......The terms "natural," "synthetic" and "artificial" are discussed in relation to synthetic and artificial chromosomes and genomes, synthetic and artificial cells and artificial life....

Can artificial parthenogenesis sidestep ethical pitfalls in human therapeutic cloning? An historical perspective

Science.gov (United States)

Fangerau, H

2005-01-01

The aim of regenerative medicine is to reconstruct tissue that has been lost or pathologically altered. Therapeutic cloning seems to offer a method of achieving this aim; however, the ethical debate surrounding human therapeutic cloning is highly controversial. Artificial parthenogenesis—obtaining embryos from unfertilised eggs—seems to offer a way to sidestep these ethical pitfalls. Jacques Loeb (1859–1924), the founding father of artificial parthogenesis, faced negative public opinion when he published his research in 1899. His research, the public's response to his findings, and his ethical foundations serve as an historical argument both for the communication of science and compromise in biological research. PMID:16319240

Artificial Intelligence, Evolutionary Computing and Metaheuristics In the Footsteps of Alan Turing

CERN Document Server

2013-01-01

Alan Turing pioneered many research areas such as artificial intelligence, computability, heuristics and pattern formation.  Nowadays at the information age, it is hard to imagine how the world would be without computers and the Internet. Without Turing's work, especially the core concept of Turing Machine at the heart of every computer, mobile phone and microchip today, so many things on which we are so dependent would be impossible. 2012 is the Alan Turing year -- a centenary celebration of the life and work of Alan Turing. To celebrate Turing's legacy and follow the footsteps of this brilliant mind, we take this golden opportunity to review the latest developments in areas of artificial intelligence, evolutionary computation and metaheuristics, and all these areas can be traced back to Turing's pioneer work. Topics include Turing test, Turing machine, artificial intelligence, cryptography, software testing, image processing, neural networks, nature-inspired algorithms such as bat algorithm and cuckoo sear...

Application, difficulties and perspectives of artificial recharge of groundwater in Spain; Aplicacion, dificultades y perspectivas de la recarga artificial de acuiferos en Espana

Energy Technology Data Exchange (ETDEWEB)

Perez-Paricio, A.

2001-07-01

Artificial recharge of groundwater is an extremely useful techniques for the management of water resources. This is why artificial recharge is viewed as an essential component of water supply systems in some countries. Because spreading scientific-technical knowledge is a key to combat misconceptions, this paper describes the results obtained in an European project, where the author participated as representative of the Technical University of Catalonia. the variety of topics addressed by this project and the status of artificial recharge in other regions contrast notoriously with the current situation in Spain, as explained in the paper. Nowadays, there are symptoms of improvement, but it is still necessary a conceptual change. This requires more imaginative plants that take advantage of treated waste-water and storm water, as well as their integration with alternative measures, such as desalination, reuse, optimization of water distribution and irrigation networks and the management of water demand. (Author) 25 refs.

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

Science.gov (United States)

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

2015-01-01

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

Fear and distress disorders as predictors of heart disease : A temporal perspective

NARCIS (Netherlands)

Roest, A M; de Jonge, P; Lim, C W W; Stein, D J; Al-Hamzawi, A; Alonso, J; Benjet, C; Bruffaerts, R; Bunting, B; Caldas-de-Almeida, J M; Ciutan, M; de Girolamo, G; Hu, C; Levinson, D; Nakamura, Y; Navarro-Mateu, F; Piazza, M; Posada-Villa, J; Torres, Y; Wojtyniak, B; Kessler, R C; Scott, K M

OBJECTIVE: Few studies have been able to contrast associations of anxiety and depression with heart disease. These disorders can be grouped in fear and distress disorders. Aim of this study was to study the association between fear and distress disorders with subsequent heart disease, taking into

Patient with a total artificial heart maintained on outpatient dialysis while listed for combined organ transplant, a single center experience.

Science.gov (United States)

Hanna, Ramy M; Hasnain, Huma; Kamgar, Mohammad; Hanna, Mina; Minasian, Raffi; Wilson, James

2017-10-01

Advanced mechanical circulatory support is increasingly being used with more sophisticated devices that can deliver pulsatile rather than continuous flow. These devices are more portable as well, allowing patients to await cardiac transplantation in an outpatient setting. It is known that patients with renal failure are at increased risk for developing worsening acute kidney injury during implantation of a ventricular assist device (VAD) or more advanced modalities like a total artificial heart (TAH). Dealing with patients who have an implanted TAH who develop renal failure has been a challenge with the majority of such patients having to await a combined cardiac and renal transplant prior to transition to outpatient care. Protocols do exist for VAD implanted patients to be transitioned to outpatient dialysis care, but there are no reported cases of TAH patients with end stage renal disease (ESRD) being successfully transitioned to outpatient dialysis care. In this report, we identify a patient with a TAH and ESRD transitioned successfully to outpatient hemodialysis and maintained for more than 2 years, though he did not survive to transplant. It is hoped that this report will raise awareness of this possibility, and assist in the development of protocols for similar patients to be successfully transitioned to outpatient dialysis care. © 2017 International Society for Hemodialysis.

Development of a Simple Structured Artificial Muscle Using SMA Wire

International Nuclear Information System (INIS)

Ibuki, Ryuta; Maruyama, Shigenao; Komiya, Atsuki

2006-01-01

Artificial heart muscle using SMA wire is developed to assist weaken heartbeat. Simple structure design was adopted for large output force, large displacement and rapid cyclic motion of the actuator. The actuator was designed and fabricated from the viewpoint of heat transfer. Moving performance of the actuator was experimentally measured under 10N of loading condition. Under the maximum efficiency condition, the actuator shows cyclic motion with 1mm of displacement and time period of about 2 seconds in one cycle

Development of the hearts of lizards and snakes and perspectives to cardiac evolution.

Directory of Open Access Journals (Sweden)

Bjarke Jensen

Full Text Available Birds and mammals both developed high performance hearts from a heart that must have been reptile-like and the hearts of extant reptiles have an unmatched variability in design. Yet, studies on cardiac development in reptiles are largely old and further studies are much needed as reptiles are starting to become used in molecular studies. We studied the growth of cardiac compartments and changes in morphology principally in the model organism corn snake (Pantherophis guttatus, but also in the genotyped anole (Anolis carolinenis and A. sagrei and the Philippine sailfin lizard (Hydrosaurus pustulatus. Structures and chambers of the formed heart were traced back in development and annotated in interactive 3D pdfs. In the corn snake, we found that the ventricle and atria grow exponentially, whereas the myocardial volumes of the atrioventricular canal and the muscular outflow tract are stable. Ventricular development occurs, as in other amniotes, by an early growth at the outer curvature and later, and in parallel, by incorporation of the muscular outflow tract. With the exception of the late completion of the atrial septum, the adult design of the squamate heart is essentially reached halfway through development. This design strongly resembles the developing hearts of human, mouse and chicken around the time of initial ventricular septation. Subsequent to this stage, and in contrast to the squamates, hearts of endothermic vertebrates completely septate their ventricles, develop an insulating atrioventricular plane, shift and expand their atrioventricular canal toward the right and incorporate the systemic and pulmonary venous myocardium into the atria.

Advancements in artificial heart valve disks using nano-sized thin films deposited by CVD and sol-gel techniques

International Nuclear Information System (INIS)

Kousar, Y.; Ali, N.; Neto, V.F.; Mei, S.; Gracio, J.

2003-01-01

Pyrolytic carbon (PyC) is widely used in manufacturing commercial artificial heart valve disks (HVD). Although, PyC is commonly used in HVD, it is not the best material for this application since its blood compatibility is not ideal for prolonged clinical use. As a result thrombosis often occurs and the patients are required to take anti- coagulation drugs on a regular basis in order to minimise the formation of thrombosis. However, the anti-coagulation therapy gives rise to some detrimental side effects in patients. Therefore, it is extremely urgent that newer and more technically advanced materials with better surface and bulk properties are developed. In this paper, we report the mechanical properties of PyC-HVD, namely, strength, wear resistance and coefficient of friction. The strength of the material was assessed using Brinell indentation tests. Furthermore, wear resistance and the coefficient of friction values were obtained from the pin-on-disk testing. The micro-structural properties of PyC were characterized using XRD, Raman spectroscopy and SEM analysis. Also, in this paper we report the preparation of free standing nanocrystalline diamond films (FSND) using the time-modulated chemical vapor deposition (TMCVD) process. Furthermore, the sol-gel technique was used to uniformly coat PyC-HVD with dense, nanocrystalline-titanium oxide (nc-TiO/sub 2/) coatings. The as-grown nc-TiO/sub 2/ coatings were characterized for microstructure using SEM and XRD analysis. (author)

Artificial gait in complete spinal cord injured subjects: how to assess clinical performance

Directory of Open Access Journals (Sweden)

Karla Rocha Pithon

2015-02-01

Full Text Available Objective Adapt the 6 minutes walking test (6MWT to artificial gait in complete spinal cord injured (SCI patients aided by neuromuscular electrical stimulation. Method Nine male individuals with paraplegia (AIS A participated in this study. Lesion levels varied between T4 and T12 and time post injured from 4 to 13 years. Patients performed 6MWT 1 and 6MWT 2. They used neuromuscular electrical stimulation, and were aided by a walker. The differences between two 6MWT were assessed by using a paired t test. Multiple r-squared was also calculated. Results The 6MWT 1 and 6MWT 2 were not statistically different for heart rate, distance, mean speed and blood pressure. Multiple r-squared (r2 = 0.96 explained 96% of the variation in the distance walked. Conclusion The use of 6MWT in artificial gait towards assessing exercise walking capacity is reproducible and easy to apply. It can be used to assess SCI artificial gait clinical performance.

Cardiac rehabilitation patient's perspectives on the recovery following heart valve surgery: a narrative analysis

DEFF Research Database (Denmark)

Hansen, Tina Birgitte; Zwisler, Ann Dorthe Olsen; Kikkenborg Berg, Selina

2016-01-01

collected data over 18 months (April 2013-October 2014). We recruited nine patients undergoing heart valve surgery from a randomized trial, CopenHeartVR and conducted 27 individual narrative interviews at 2-3 weeks, 3-4 months and 8-9 months after surgery. FINDINGS: Following heart valve surgery...

67Ga imaging in the patients with infective endocarditis after surgery for congenital heart disease

International Nuclear Information System (INIS)

Kohata, Tohru; Ono, Yasuo; Kamiya, Tetsuro; Nishimura, Tsunehiko; Takamiya, Makoto; Yagihara, Toshikatsu

1991-01-01

67 Ga imaging was performed in sixteen patients (age: 8 m.-18 y.) who had persistent fever and positive acute phase reactants after surgery for congenital heart disease. Abnormal uptake of 67 Ga over the heart and the lungs was evaluated with a computer. Abnormal uptake of 67 Ga was observed in seven patients. Of them, three showed it in the area of peripheral pulmonary artery and the other four showed it in the area of artificial vessels for pulmonary artery reconstruction. In six patients with positive blood cultures, five showed abnormal uptake of 67 Ga and in ten patients with negative blood cultures, two showed it. Vegetation was detected with 2D-echocardiography in four patients and all of them showed abnormal uptake of 67 Ga, while in 12 patients without vegetation three showed it. In conclusion, 67 Ga imaging was useful to detect the foci of infective endocarditis or pulmonary embolism caused by the vegetation in infective endocarditis in the patients after surgery for congenital heart disease, especially in the peripheral pulmonary arteries and artificial vessels which could not be detected with 2D-echo. (author)

Artificial intelligence

CERN Document Server

Hunt, Earl B

1975-01-01

Artificial Intelligence provides information pertinent to the fundamental aspects of artificial intelligence. This book presents the basic mathematical and computational approaches to problems in the artificial intelligence field.Organized into four parts encompassing 16 chapters, this book begins with an overview of the various fields of artificial intelligence. This text then attempts to connect artificial intelligence problems to some of the notions of computability and abstract computing devices. Other chapters consider the general notion of computability, with focus on the interaction bet

Bioengineering of Artificial Antigen Presenting Cells and Lymphoid Organs.

Science.gov (United States)

Wang, Chao; Sun, Wujin; Ye, Yanqi; Bomba, Hunter N; Gu, Zhen

2017-01-01

The immune system protects the body against a wide range of infectious diseases and cancer by leveraging the efficiency of immune cells and lymphoid organs. Over the past decade, immune cell/organ therapies based on the manipulation, infusion, and implantation of autologous or allogeneic immune cells/organs into patients have been widely tested and have made great progress in clinical applications. Despite these advances, therapy with natural immune cells or lymphoid organs is relatively expensive and time-consuming. Alternatively, biomimetic materials and strategies have been applied to develop artificial immune cells and lymphoid organs, which have attracted considerable attentions. In this review, we survey the latest studies on engineering biomimetic materials for immunotherapy, focusing on the perspectives of bioengineering artificial antigen presenting cells and lymphoid organs. The opportunities and challenges of this field are also discussed.

Study of shape memory alloy fibers for the development of artificial myocardium.

Science.gov (United States)

Hassoulas, Ioannis A; Ladopoulos, Vlassios S; Kalogerakos, Paris-Dimitrios K

2010-01-01

Circulatory support devices are employed to treat heart failure. Such a device could be made from shape memory alloy (SMA) fibers. These Ni-Ti fibers contract when electric current flows through them, thus resembling artificial muscles. An artificial myocardium device made from SMA fibers can directly compress the epicardial surface of a failing heart, thus contributing to the pumping action. Unlike modern mechanical circulatory support devices, there is no blood-contacting surface to provoke thromboembolism, hemorrhage, inflammatory response or hemolysis. The experimental setup permitted a detailed study of a sample SMA fiber with great accuracy while the ambient temperature was controlled to resemble that of the human body. The current profile through the fiber was controlled (current shaping, CS) by a microcontroller and a portable computer. Parameters such as strain, contraction and relaxation velocities and the effect of ambient temperature were measured. The contraction and relaxation velocities were measured after applying various effective currents. It was found that the contraction velocity could be manipulated to reach that of the healthy myocardium through CS. On the other hand, the relaxation velocity was independent of the contraction velocity. A cardiac assist device can be made from SMA fibers. More studies need to be conducted in this direction.

Artificial Consciousness or Artificial Intelligence

Directory of Open Access Journals (Sweden)

Spanache Florin

2017-05-01

Full Text Available Artificial intelligence is a tool designed by people for the gratification of their own creative ego, so we can not confuse conscience with intelligence and not even intelligence in its human representation with conscience. They are all different concepts and they have different uses. Philosophically, there are differences between autonomous people and automatic artificial intelligence. This is the difference between intelligence and artificial intelligence, autonomous versus automatic. But conscience is above these differences because it is neither conditioned by the self-preservation of autonomy, because a conscience is something that you use to help your neighbor, nor automatic, because one’s conscience is tested by situations which are not similar or subject to routine. So, artificial intelligence is only in science-fiction literature similar to an autonomous conscience-endowed being. In real life, religion with its notions of redemption, sin, expiation, confession and communion will not have any meaning for a machine which cannot make a mistake on its own.

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

Science.gov (United States)

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

2015-09-01

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

Perspectives for the information approach application to natural and artificial ecosystems investigation

Science.gov (United States)

Lankin, Yuliy

As a methodological matter, all modern conceptions of life development can be subdivided into the substrate (S), the energetic (E) and the informational (I). The S-conception is based on biochemical, genetic and morphological ideas. The E-conception deals with an idea of development of complicated open systems (COS) which are characterized by energy getting constantly from the outside, by improvement of substance cycles and as speeding-up and increasing of "power" of them as well, and by increasing of energy intensity transformation by the each structure of COS. The I-conception has been developing so far in the main within the frameworks of the traditional both cybernetic ideas and information theory that are convenient for many technical applications but are deficient for investigation of ecoand bio-systems. Situation was changed when the conception of adaptive systems (CAS) based on the ideas of ecology, biology and neurocybernetic (neuroinforamtic) had offered. As a consequence of this, the I-conception based on the CAS well accords with the S- and the E-conceptions and allows to hope to their combine into one the S + E + I conception that will include all virtues of the S-, the E-, and the I-conceptions and eliminate of their limitations. Thanks to relative easiness of hierarchic adaptive nonlinear models making using of the CAS, it is possible overcome effectively both of the problems as the "dimensionality problem" and the "loss of stability" as well for complicated models of ecosystems (CME). Optimization of energy and substance consumption process and adaptation of the CME to changes of current conditions are well realized in ranges given by goal function. A use adaptive networks (including neural nets) in frames of the CAS allows to realize any continuous function in control loops and at information processing. The considered features of the S + E + I proposed approach based on the CAS make it perspective for construction as biosphere models and

sup 67 Ga imaging in the patients with infective endocarditis after surgery for congenital heart disease

Energy Technology Data Exchange (ETDEWEB)

Kohata, Tohru; Ono, Yasuo; Kamiya, Tetsuro; Nishimura, Tsunehiko; Takamiya, Makoto; Yagihara, Toshikatsu [National Cardiovascular Center, Suita, Osaka (Japan)

1991-11-01

{sup 67}Ga imaging was performed in sixteen patients (age: 8 m.-18 y.) who had persistent fever and positive acute phase reactants after surgery for congenital heart disease. Abnormal uptake of {sup 67}Ga over the heart and the lungs was evaluated with a computer. Abnormal uptake of {sup 67}Ga was observed in seven patients. Of them, three showed it in the area of peripheral pulmonary artery and the other four showed it in the area of artificial vessels for pulmonary artery reconstruction. In six patients with positive blood cultures, five showed abnormal uptake of {sup 67}Ga and in ten patients with negative blood cultures, two showed it. Vegetation was detected with 2D-echocardiography in four patients and all of them showed abnormal uptake of {sup 67}Ga, while in 12 patients without vegetation three showed it. In conclusion, {sup 67}Ga imaging was useful to detect the foci of infective endocarditis or pulmonary embolism caused by the vegetation in infective endocarditis in the patients after surgery for congenital heart disease, especially in the peripheral pulmonary arteries and artificial vessels which could not be detected with 2D-echo. (author).

How to improve our understanding of group decision making with the help of artificial intelligence

NARCIS (Netherlands)

Liebrand, Wim B.G.

Within science we primarily obtain knowledge of a specific field by reading the published results of theoretical and empirical studies. It is argued that this approach may lead to a biased and incomplete perspective of a research area. It is proposed to also use methods from Artificial Intelligence

The influx of amino acids into the heart of the rat

International Nuclear Information System (INIS)

Banos, G.; Moorhouse, S.R.; Pratt, O.E.; Wilson, P.A.; Daniel, P.M.

1978-01-01

The influx of nineteen amino acids into the heart of the living rat was studied by a method specially devised for experiments under controlled conditions in vivo. When, in separate experiments, the concentration of each amino acid in turn was artificially raised in the circulation, the influx of that amino acid into the heart increased. The data indicate that at least ten of these amino acids enter the heart in vivo by means of saturable carrier-mediated transport systems. The transport rates conform, at least approximately, to Michaelis kinetics and the transport systems are clearly, in the case of many amino acids, active, i.e. energy-dependent. The amino acids which were studied had rates of influx into the heart which differed from each other over a range of more than 10 to 1, even when allowances were made for the differences in their concentration in the circulating blood. These differences in influx were not related to such factors as the molecular size of the individual amino acids. The amino acids which have a high influx into the heart are mainly those which are needed either to re-synthesize contractile protein or as oxidizable substrates. (author)

Surface engineering of artificial heart valve disks using nanostructured thin films deposited by chemical vapour deposition and sol-gel methods.

Science.gov (United States)

Jackson, M J; Robinson, G M; Ali, N; Kousar, Y; Mei, S; Gracio, J; Taylor, H; Ahmed, W

2006-01-01

Pyrolytic carbon (PyC) is widely used in manufacturing commercial artificial heart valve disks (HVD). Although PyC is commonly used in HVD, it is not the best material for this application since its blood compatibility is not ideal for prolonged clinical use. As a result thrombosis often occurs and the patients are required to take anti-coagulation drugs on a regular basis in order to minimize the formation of thrombosis. However, anti-coagulation therapy gives rise to some detrimental side effects in patients. Therefore, it is extremely urgent that newer and more technically advanced materials with better surface and bulk properties are developed. In this paper, we report the mechanical properties of PyC-HVD, i.e. strength, wear resistance and coefficient of friction. The strength of the material was assessed using Brinell indentation tests. Furthermore, wear resistance and coefficient of friction values were obtained from pin-on-disk testing. The micro-structural properties of PyC were characterized using XRD, Raman spectroscopy and SEM analysis. Also in this paper we report the preparation of freestanding nanocrystalline diamond films (FSND) using the time-modulated chemical vapour deposition (TMCVD) process. Furthermore, the sol-gel technique was used to uniformly coat PyC-HVD with dense, nanocrystalline-titanium oxide (nc-TiO2) coatings. The as-grown nc-TiO2 coatings were characterized for microstructure using SEM and XRD analysis.

Tracing artificial trans fat in popular foods in Europe

DEFF Research Database (Denmark)

Stender, Steen; Astrup, Arne; Dyerberg, Jørn

2014-01-01

OBJECTIVE: To minimise the intake of industrial artificial trans fat (I-TF), nearly all European countries rely on food producers to voluntarily reduce the I-TF content in food. The objective of this study was to investigate the effect of this strategy on I-TF content in prepackaged biscuits...... countries in Europe still consume I-TF in amounts that increase their risk of coronary heart disease. Under current European Union (EU) legislation, the sale of products containing I-TF is legal but conflicts with the WHO recommendation to minimise the intake of I-TF. An EU-legislative limit on I-TF content...

Autonomic innervation of the heart. Role of molecular imaging

Energy Technology Data Exchange (ETDEWEB)

Slart, Riemer H.J.A; Elsinga, Philip H. [Univ. Medical Center Groningen (Netherlands). Nuclear Medicine and Molecular Imaging; Tio, Rene A. [Univ. Medical Center Groningen (Netherlands). Thorax Center Cardiology; Schwaiger, Markus (ed.) [Technische Univ. Muenchen Klinikum Rechts der Isar (Germany). Nuklearmedizinische Klinik

2015-03-01

Reviews in detail the value of SPECT-CT and PET-CT in the imaging of cardiac innervation. Details the role of imaging in a range of conditions and diseases. Includes important background on pathophysiology, tracers, radiopharmaceutical production, and kinetic modeling software. This book explains in detail the potential value of the hybrid modalities, SPECT-CT and PET-CT, in the imaging of cardiac innervation in a wide range of conditions and diseases, including ischemic heart disease, diabetes mellitus, heart failure, amyloidosis, heart transplantation, and ventricular arrhythmias. Imaging of the brain-heart axis in neurodegenerative disease and stress and of cardiotoxicity is also discussed. The roles of the various available tracers are fully considered, and individual chapters address radiopharmaceutical development under GMP, imaging physics, and kinetic modeling software. Highly relevant background information is included on the autonomic nervous system of the heart and its pathophysiology, and in addition future perspectives are discussed. Awareness of the importance of autonomic innervation of the heart for the optimal management of cardiac patients is growing, and there is an evident need for objective measurement techniques or imaging modalities. In this context, Autonomic Innervation of the Heart will be of wide interest to clinicians, researchers, and industry.

Autonomic innervation of the heart. Role of molecular imaging

International Nuclear Information System (INIS)

Slart, Riemer H.J.A; Elsinga, Philip H.; Tio, Rene A.; Schwaiger, Markus

2015-01-01

Reviews in detail the value of SPECT-CT and PET-CT in the imaging of cardiac innervation. Details the role of imaging in a range of conditions and diseases. Includes important background on pathophysiology, tracers, radiopharmaceutical production, and kinetic modeling software. This book explains in detail the potential value of the hybrid modalities, SPECT-CT and PET-CT, in the imaging of cardiac innervation in a wide range of conditions and diseases, including ischemic heart disease, diabetes mellitus, heart failure, amyloidosis, heart transplantation, and ventricular arrhythmias. Imaging of the brain-heart axis in neurodegenerative disease and stress and of cardiotoxicity is also discussed. The roles of the various available tracers are fully considered, and individual chapters address radiopharmaceutical development under GMP, imaging physics, and kinetic modeling software. Highly relevant background information is included on the autonomic nervous system of the heart and its pathophysiology, and in addition future perspectives are discussed. Awareness of the importance of autonomic innervation of the heart for the optimal management of cardiac patients is growing, and there is an evident need for objective measurement techniques or imaging modalities. In this context, Autonomic Innervation of the Heart will be of wide interest to clinicians, researchers, and industry.

Application of artificial neural network for medical image recognition and diagnostic decision making

International Nuclear Information System (INIS)

Asada, N.; Eiho, S.; Doi, K.; MacMahon, H.; Montner, S.M.; Giger, M.L.

1989-01-01

An artificial neural network has been applied for pattern recognition and used as a tool in an expert system. The purpose of this study is to examine the potential usefulness of the neural network approach in medical applications for image recognition and decision making. The authors designed multilayer feedforward neural networks with a back-propagation algorithm for our study. Using first-pass radionuclide ventriculograms, we attempted to identify the right and left ventricles of the heart and the lungs by training the neural network from patterns of time-activity curves. In a preliminary study, the neural network enabled identification of the lungs and heart chambers once the network was trained sufficiently by means of repeated entries of data from the same case

Pre-mRNA mis-splicing of sarcomeric genes in heart failure.

Science.gov (United States)

Zhu, Chaoqun; Chen, Zhilong; Guo, Wei

2017-08-01

Pre-mRNA splicing is an important biological process that allows production of multiple proteins from a single gene in the genome, and mainly contributes to protein diversity in eukaryotic organisms. Alternative splicing is commonly governed by RNA binding proteins to meet the ever-changing demands of the cell. However, the mis-splicing may lead to human diseases. In the heart of human, mis-regulation of alternative splicing has been associated with heart failure. In this short review, we focus on alternative splicing of sarcomeric genes and review mis-splicing related heart failure with relatively well studied Sarcomeric genes and splicing mechanisms with identified regulatory factors. The perspective of alternative splicing based therapeutic strategies in heart failure has also been discussed. Copyright © 2016 Elsevier B.V. All rights reserved.

Perspectives of Puerto Rican Adults about Heart Health and a Potential Community Program

Science.gov (United States)

Todorova, Irina L. G.; Tejada, Shirley; Castaneda-Sceppa, Carmen

2014-01-01

Background: Puerto Ricans are the second largest Hispanic group in the United States, and older adults have significant health disparities. Educational programs that address heart disease risk for this population have rarely been developed and implemented. Purpose: To address this gap, the Heart Healthy Initiative for Puerto Rican adults is being…

Exploring the perspectives and preferences for HTA across German healthcare stakeholders using a multi-criteria assessment of a pulmonary heart sensor as a case study.

Science.gov (United States)

Wahlster, Philip; Goetghebeur, Mireille; Schaller, Sandra; Kriza, Christine; Kolominsky-Rabas, Peter

2015-04-28

Health technology assessment and healthcare decision-making are based on multiple criteria and evidence, and heterogeneous opinions of participating stakeholders. Multi-criteria decision analysis (MCDA) offers a potential framework to systematize this process and take different perspectives into account. The objectives of this study were to explore perspectives and preferences across German stakeholders when appraising healthcare interventions, using multi-criteria assessment of a heart pulmonary sensor as a case study. An online survey of 100 German healthcare stakeholders was conducted using a comprehensive MCDA framework (EVIDEM V2.2). Participants were asked to provide i) relative weights for each criterion of the framework; ii) performance scores for a health pulmonary sensor, based on available data synthesized for each criterion; and iii) qualitative feedback on the consideration of contextual criteria. Normalized weights and scores were combined using a linear model to calculate a value estimate across different stakeholders. Differences across types of stakeholders were explored. The survey was completed by 54 participants. The most important criteria were efficacy, patient reported outcomes, disease severity, safety, and quality of evidence (relative weight >0.075 each). Compared to all participants, policymakers gave more weight to budget impact and quality of evidence. The quantitative appraisal of a pulmonary heart sensor revealed differences in scoring performance of this intervention at the criteria level between stakeholder groups. The highest value estimate of the sensor reached 0.68 (on a scale of 0 to 1, 1 representing maximum value) for industry representatives and the lowest value of 0.40 was reported for policymakers, compared to 0.48 for all participants. Participants indicated that most qualitative criteria should be considered and their impact on the quantitative appraisal was captured transparently. The study identified important

Tissue engineering and cell-based therapy toward integrated strategy with artificial organs.

Science.gov (United States)

Gojo, Satoshi; Toyoda, Masashi; Umezawa, Akihiro

2011-09-01

Research in order that artificial organs can supplement or completely replace the functions of impaired or damaged tissues and internal organs has been underway for many years. The recent clinical development of implantable left ventricular assist devices has revolutionized the treatment of patients with heart failure. The emerging field of regenerative medicine, which uses human cells and tissues to regenerate internal organs, is now advancing from basic and clinical research to clinical application. In this review, we focus on the novel biomaterials, i.e., fusion protein, and approaches such as three-dimensional and whole-organ tissue engineering. We also compare induced pluripotent stem cells, directly reprogrammed cardiomyocytes, and somatic stem cells for cell source of future cell-based therapy. Integrated strategy of artificial organ and tissue engineering/regenerative medicine should give rise to a new era of medical treatment to organ failure.

Scientific approaches and techniques for negotiation : a game theoretic and artificial intelligence perspective

NARCIS (Netherlands)

E.H. Gerding (Enrico); D.D.B. van Bragt; J.A. La Poutré (Han)

2000-01-01

textabstractDue to the rapid growth of electronic environments (such as the Internet) much research is currently being performed on autonomous trading mechanisms. This report contains an overview of the current literature on negotiations in the fields of game theory and artificial intelligence (AI).

Biological effects of implanted nuclear energy sources for artificial heart devices. Progress report, September 1, 1975--August 31, 1976. [Heat dissipation from /sup 238/Pu power sources implanted in dogs

Energy Technology Data Exchange (ETDEWEB)

Kallfelz, F.A.; Wentworth, R.A.; Cady, K.B.

1976-01-01

A total of sixty dogs were implanted with radioisotope-powered artificial heart systems producing radiation fluxes similar to that of plutonium-238, but having no associated heat, at levels of from one to seventy times the radiation flux expected from a 30-watt plutonium-238 source. Results from studies lasting up to 6 years after implantation indicate that these animals, and by inference human beings, may be able to tolerate the radiation flux from 30-watt /sup 238/Pu power sources. Results of heat dissipation studies in calves indicate that it may be possible to induce a vascularized connective tissue capsule sufficient to dissipate 30 watts of additional heat from a surface area of approximately 500 cm sq., allowing a heat flux of 0.06 watts per cm sq.

[Cognitive emotion regulation of patients qualified for implantation of heart rhythm control device].

Science.gov (United States)

Ziętalewicz, Urszula; Jędrzejczyk, Jan; Mojkowski, Włodzimierz; Mojkowski, Dariusz

2016-11-25

The aim of the artificial heart stimulation is not only saving lives, but also improvement of the quality of life of patients with cardiac arrhythmias. One of the key dimensions of quality of life is psychological functioning. Until now, little research assess this dimension in patients before the implantation of the heart rhythm control device. The aim of the study was to assess the severity of depression and anxiety and the frequency of the used cognitive emotion regulation strategies and to examine the relationship between them. The study group consisted of 60 people qualified for pacemaker implantation (42 PM patients and 18 ICD): 15 women and 45 men ranging in age from 43 to 85. To assess cognitive emotion regulation strategies Cognitive Emotion Regulation Questionnaire was used, and to assess the severity of depression and anxiety - Mood Assessment Questionnaire. Patients with PM more often than patients with ICD use the strategy of Positive Reappraisal (U = 231.50, p = 0.045). There were no statistically significant differences in the frequency of use of other strategies and severity of depression and anxiety. In PM patients there are negative correlations between the severity of depression and anxiety and the use of Acceptance ( τ = -0.380), a Positive Reappraisal ( τ = -0.278), Positive Refocusing ( τ = -0.366) and between the level of anxiety and Putting into Perspective ( τ = -0.402). In ICD patients there was a positive relationship between anxiety and Cathastrophizing ( τ = 0.324). The severity of depression and anxiety, and emotion regulation strategies in patients qualified for PM implantation in comparison with patients qualified for ICD implantation are similar. Both groups of patients show a good adaptation of the psychological.

Artificial skin and patient simulator comprising the artificial skin

NARCIS (Netherlands)

2011-01-01

The invention relates to an artificial skin (10, 12, 14), and relates to a patient simulator (100) comprising the artificial skin. The artificial skin is a layered structure comprising a translucent cover layer (20) configured for imitating human or animal skin, and comprising a light emitting layer

Immunohistochemical Distribution of Serum Proteins in Living Mouse Heart with In Vivo Cryotechnique

International Nuclear Information System (INIS)

Shi, Liye; Terada, Nobuo; Saitoh, Yurika; Saitoh, Sei; Ohno, Shinichi

2011-01-01

In vivo cryotechnique (IVCT), which immediately cryofixes target organs in situ, was used to clarify the morphological features of beating heart tissue of living mice. IVCT was performed for diastolic heart tissue under the condition of monitoring with electrocardiogram (ECG). Other mouse hearts were prepared with conventional perfusion-fixation (PF-DH) or immersion-fixation followed by dehydration (IM-DH), and quick-freezing of resected heart tissues (FQF). Immunolocalizations of albumin, immunoglobulin G1 (IgG1), intravenously injected bovine serum albumin (BSA), and connexin 43 were examined after different intervals of BSA injection. In the case of IVCT, the exact stop time of beating mouse hearts was recorded by ECG, and open blood vessels with flowing erythrocytes were observed with less artificial tissue shrinkage than with conventional preparation methods. Both albumin and BSA were well preserved in intercalated discs and t-tubules of cardiomyocytes in addition to blood vessels and interstitial matrices. IgG1 was immunolocalized in interstitial matrices of heart tissues in addition to their blood vessels. At 4 hr after BSA injection, it was immunolocalized in the intercalated discs of cardiomyocytes and lost later at 8 hr. IVCT should prove to be more useful for the morphofunctional examination of dynamically changing heart tissue than conventional preparation methods

Artificial Intelligence.

Science.gov (United States)

Information Technology Quarterly, 1985

1985-01-01

This issue of "Information Technology Quarterly" is devoted to the theme of "Artificial Intelligence." It contains two major articles: (1) Artificial Intelligence and Law" (D. Peter O'Neill and George D. Wood); (2) "Artificial Intelligence: A Long and Winding Road" (John J. Simon, Jr.). In addition, it contains two sidebars: (1) "Calculating and…

Artificial organs: recent progress in artificial hearing and vision.

Science.gov (United States)

Ifukube, Tohru

2009-01-01

Artificial sensory organs are a prosthetic means of sending visual or auditory information to the brain by electrical stimulation of the optic or auditory nerves to assist visually impaired or hearing-impaired people. However, clinical application of artificial sensory organs, except for cochlear implants, is still a trial-and-error process. This is because how and where the information transmitted to the brain is processed is still unknown, and also because changes in brain function (plasticity) remain unknown, even though brain plasticity plays an important role in meaningful interpretation of new sensory stimuli. This article discusses some basic unresolved issues and potential solutions in the development of artificial sensory organs such as cochlear implants, brainstem implants, artificial vision, and artificial retinas.

A review on robotic fish enabled by ionic polymer-metal composite artificial muscles.

Science.gov (United States)

Chen, Zheng

2017-01-01

A novel actuating material, which is lightweight, soft, and capable of generating large flapping motion under electrical stimuli, is highly desirable to build energy-efficient and maneuverable bio-inspired underwater robots. Ionic polymer-metal composites are important category of electroactive polymers, since they can generate large bending motions under low actuation voltages. IPMCs are ideal artificial muscles for small-scale and bio-inspired robots. This paper takes a system perspective to review the recent work on IPMC-enabled underwater robots, from modeling, fabrication, and bio-inspired design perspectives. First, a physics-based and control-oriented model of IPMC actuator will be reviewed. Second, a bio-inspired robotic fish propelled by IPMC caudal fin will be presented and a steady-state speed model of the fish will be demonstrated. Third, a novel fabrication process for 3D actuating membrane will be introduced and a bio-inspired robotic manta ray propelled by two IPMC pectoral fins will be demonstrated. Fourth, a 2D maneuverable robotic fish propelled by multiple IPMC fin will be presented. Last, advantages and challenges of using IPMC artificial muscles in bio-inspired robots will be concluded.

Incident solar radiation and coronary heart disease mortality rates in Europe

International Nuclear Information System (INIS)

Wong, Alfred

2008-01-01

The reported low mortality rate from coronary heart disease in Portugal, Spain, Italy, Greece, and France, to a lesser extent, has been attributed in numerous nutritional studies to the consumption of a Mediterranean-type diet. There are still many unresolved issues about the direct causal effect of the Mediterranean dietary regime on low incidence of coronary heart disease. An analysis of coronary heart disease mortality rates in Europe from a latitudinal gradient perspective has shown to have a close correlation to incident solar radiation. It is surmised that the resulting increased in situ biosynthesis of Vitamin D 3 could be the critical missing confounder in the analysis of the beneficial health outcome of the Mediterranean diet

Cardiac autonomic testing and treating heart disease. 'A clinical perspective'

Directory of Open Access Journals (Sweden)

Nicholas L. DePace

2014-12-01

Full Text Available Background Coronary heart disease (CHD is a major health concern, affecting nearly half the middle-age population and responsible for nearly one-third of all deaths. Clinicians have several major responsibilities beyond diagnosing CHD, such as risk stratification of patients for major adverse cardiac events (MACE and treating risks, as well as the patient. This second of a two-part review series discusses treating risk factors, including autonomic dysfunction, and expected outcomes. Methods Therapies for treating cardiac mortality risks including cardiovascular autonomic neuropathy (CAN, are discussed. Results While risk factors effectively target high-risk patients, a large number of individuals who will develop complications from heart disease are not identified by current scoring systems. Many patients with heart conditions, who appear to be well-managed by traditional therapies, experience MACE. Parasympathetic and Sympathetic (P&S function testing provides more information and has the potential to further aid doctors in individualizing and titrating therapy to minimize risk. Advanced autonomic dysfunction (AAD and its more severe form cardiovascular autonomic neuropathy have been strongly associated with an elevated risk of cardiac mortality and are diagnosable through autonomic testing. This additional information includes patient-specific physiologic measures, such as sympathovagal balance (SB. Studies have shown that establishing and maintaining proper SB minimizes morbidity and mortality risk. Conclusions P&S testing promotes primary prevention, treating subclinical disease states, as well as secondary prevention, thereby improving patient outcomes through (1 maintaining wellness, (2 preventing symptoms and disorder and (3 treating subclinical manifestations (autonomic dysfunction, as well as (4 disease and symptoms (autonomic neuropathy.

A Comparative Investigation on Citation Counts and Altmetrics between Papers Authored by Universities and Companies in the Research Field of Artificial Intelligence

OpenAIRE

Luo, Feiheng; Zheng, Han; Erdt, Mojisola Helen; Raamkumar, Aravind Sesagiri; Theng, Yin-Leng

2018-01-01

Artificial Intelligence is currently a popular research field. With the development of deep learning techniques, researchers in this area have achieved impressive results in a variety of tasks. In this initial study, we explored scientific papers in Artificial Intelligence, making comparisons between papers authored by the top universities and companies from the dual perspectives of bibliometrics and altmetrics. We selected publication venues according to the venue rankings provided by Google...

Artificial muscle: facts and fiction.

Science.gov (United States)

Schaub, Marcus C

2011-12-19

Mechanical devices are sought to support insufficient or paralysed striated muscles including the failing heart. Nickel-titanium alloys (nitinol) present the following two properties: (i) super-elasticity, and (ii) the potential to assume different crystal structures depending on temperature and/or stress. Starting from the martensite state nitinol is able to resume the austenite form (state of low potential energy and high entropy) even against an external resistance. This one-way shape change is deployed in self-expanding vascular stents. Heating induces the force generating transformation from martensite to the austenite state while cooling induces relaxation back to the martensite state. This two-way shape change oscillating between the two states may be used in cyclically contracting support devices of silicon-coated nitinol wires. Such a contractile device sutured to the right atrium has been tested in vitro in a bench model and in vivo in sheep. The contraction properties of natural muscles, specifically of the myocardium, and the tight correlation with ATP production by oxidative phosphorylation in the mitochondria is briefly outlined. Force development by the nitinol device cannot be smoothly regulated as in natural muscle. Its mechanical impact is forced onto the natural muscle regardless of the actual condition with regard to metabolism and Ca2+-homeostasis. The development of artificial muscle on the basis of nitinol wires is still in its infancy. The nitinol artificial muscle will have to prove its viability in the various clinical settings.

Artificial skin in perspective: concepts and applications.

Science.gov (United States)

Brohem, Carla A; Cardeal, Laura B da Silva; Tiago, Manoela; Soengas, María S; Barros, Silvia B de Moraes; Maria-Engler, Silvya S

2011-02-01

Skin, the largest organ of the human body, is organized into an elaborate layered structure consisting mainly of the outermost epidermis and the underlying dermis. A subcutaneous adipose-storing hypodermis layer and various appendages such as hair follicles, sweat glands, sebaceous glands, nerves, lymphatics, and blood vessels are also present in the skin. These multiple components of the skin ensure survival by carrying out critical functions such as protection, thermoregulation, excretion, absorption, metabolic functions, sensation, evaporation management, and aesthetics. The study of how these biological functions are performed is critical to our understanding of basic skin biology such as regulation of pigmentation and wound repair. Impairment of any of these functions may lead to pathogenic alterations, including skin cancers. Therefore, the development of genetically controlled and well characterized skin models can have important implications, not only for scientists and physicians, but also for manufacturers, consumers, governing regulatory boards and animal welfare organizations. As cells making up human skin tissue grow within an organized three-dimensional (3D) matrix surrounded by neighboring cells, standard monolayer (2D) cell cultures do not recapitulate the physiological architecture of the skin. Several types of human skin recombinants, also called artificial skin, that provide this critical 3D structure have now been reconstructed in vitro. This review contemplates the use of these organotypic skin models in different applications, including substitutes to animal testing. © 2010 John Wiley & Sons A/S.

Immunostaining of dissected zebrafish embryonic heart.

Science.gov (United States)

Yang, Jingchun; Xu, Xiaolei

2012-01-10

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

Artificial intelligence in radiology.

Science.gov (United States)

Hosny, Ahmed; Parmar, Chintan; Quackenbush, John; Schwartz, Lawrence H; Aerts, Hugo J W L

2018-05-17

Artificial intelligence (AI) algorithms, particularly deep learning, have demonstrated remarkable progress in image-recognition tasks. Methods ranging from convolutional neural networks to variational autoencoders have found myriad applications in the medical image analysis field, propelling it forward at a rapid pace. Historically, in radiology practice, trained physicians visually assessed medical images for the detection, characterization and monitoring of diseases. AI methods excel at automatically recognizing complex patterns in imaging data and providing quantitative, rather than qualitative, assessments of radiographic characteristics. In this Opinion article, we establish a general understanding of AI methods, particularly those pertaining to image-based tasks. We explore how these methods could impact multiple facets of radiology, with a general focus on applications in oncology, and demonstrate ways in which these methods are advancing the field. Finally, we discuss the challenges facing clinical implementation and provide our perspective on how the domain could be advanced.

Nebivolol in chronic heart failure : current evidence and future perspectives

NARCIS (Netherlands)

Lipsic, Erik; van Veldhuisen, Dirk J.

Areas covered in the review: We describe the role of the sympathetic nervous system, beta-blockers and specifically nebivolol in chronic heart failure. What the reader will gain: Nebivolol is a third-generation beta-blocker, with high beta(1)/beta(2) selectivity. Moreover, it has important

Effects of Orthostatism and Hemodialysis on Mean Heart Period and Fractal Heart Rate Properties of Chronic Renal Failure Patients.

Science.gov (United States)

Echeverría, Juan C; Infante, Oscar; Pérez-Grovas, Héctor; González, Hortensia; José, Marco V; Lerma, Claudia

2017-11-01

The aim of this work was to evaluate the short-term fractal index (α 1 ) of heart rate variability (HRV) in chronic renal failure (CRF) patients by identifying the effects of orthostatism and hemodialysis (HD), and by evaluating the correlation between α 1 and the mean RR interval from sinus beats (meanNN). HRV time series were derived from ECG data of 19 CRF patients and 20 age-matched healthy subjects obtained at supine and orthostatic positions (lasting 5 min each). Data from CRF patients were collected before and after HD. α 1 was calculated from each time series and compared by analysis of variance. Pearson's correlations between meanNN and α 1 were calculated using the data from both positions by considering three groups: healthy subjects, CRF before HD and CRF after HD. At supine position, α 1 of CRF patients after HD (1.17 ± 0.30) was larger (P renal disease condition in itself. In conclusion, as in healthy subjects, α 1 of CRF patients correlates with meanNN after HD (indicating a more irregular-like HRV behavior at slower heart rates). This suggests that CRF patients with stable blood pressure preserve a regulatory adaptability despite a shifted setting point of the heart period (i.e., higher heart rate) in comparison with healthy subjects. © 2017 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Mechanical circulatory assist device development at the Texas Heart Institute: a personal perspective.

Science.gov (United States)

Frazier, O H

2014-01-01

In December 2013, we performed our 1000th ventricular assist device implantation at the Texas Heart Institute. In my professional career, I have been fortunate to see the development of numerous mechanical circulatory support devices for the treatment of patients with advanced heart failure. In fact, most of the cardiac pumps in wide use today were developed in the Texas Heart Institute research laboratories in cooperation with the National Heart, Lung and Blood Institute or device innovators and manufacturers and implanted clinically at our partner St. Luke's Episcopal Hospital. My early involvement in this field was guided by my mentors, Dr Michael E. DeBakey and, especially, Dr Denton A. Cooley. Also, many of the advances are directly attributable to my ongoing clinical experience. What I learned daily in my surgical practice allowed me to bring insights to the development of this technology that a laboratory researcher alone might not have had. Young academic surgeons interested in this field might be well served to be active not only in laboratory research but also in clinical practice. Copyright © 2014 Elsevier Inc. All rights reserved.

Mind-wandering and alterations to default mode network connectivity when listening to naturalistic versus artificial sounds.

Science.gov (United States)

Gould van Praag, Cassandra D; Garfinkel, Sarah N; Sparasci, Oliver; Mees, Alex; Philippides, Andrew O; Ware, Mark; Ottaviani, Cristina; Critchley, Hugo D

2017-03-27

Naturalistic environments have been demonstrated to promote relaxation and wellbeing. We assess opposing theoretical accounts for these effects through investigation of autonomic arousal and alterations of activation and functional connectivity within the default mode network (DMN) of the brain while participants listened to sounds from artificial and natural environments. We found no evidence for increased DMN activity in the naturalistic compared to artificial or control condition, however, seed based functional connectivity showed a shift from anterior to posterior midline functional coupling in the naturalistic condition. These changes were accompanied by an increase in peak high frequency heart rate variability, indicating an increase in parasympathetic activity in the naturalistic condition in line with the Stress Recovery Theory of nature exposure. Changes in heart rate and the peak high frequency were correlated with baseline functional connectivity within the DMN and baseline parasympathetic tone respectively, highlighting the importance of individual neural and autonomic differences in the response to nature exposure. Our findings may help explain reported health benefits of exposure to natural environments, through identification of alterations to autonomic activity and functional coupling within the DMN when listening to naturalistic sounds.

The surface microstructure of cusps and leaflets in rabbit and mouse heart valves

Directory of Open Access Journals (Sweden)

Xia Ye

2014-05-01

Full Text Available In this investigation, scanning electron microscopy was used to characterize the microstructure on the surfaces of animal heart valve cusps/leaflets. The results showed that though these surfaces appear smooth to the naked eye, they are actually comprised of a double hierarchical structure consisting of a cobblestone-like microstructure and nano-cilia along with mastoids with a directional arrangement. Such nanostructures could play a very important role in the hemocompatibility characteristics of heart valves. On this basis, the model of the microstructure was constructed and theoretical analysis was used to obtain optimal geometric parameters for the rough surface of artificial valve cusps/leaflets. This model may help improve reconstructive techniques and it may be beneficial in the design and fabrication of valve substitutes or partial substitutes. Namely, the model may help ameliorate heart valve replacement surgery.

Sterilization of the artificial blood circulation apparatus with ozone

Energy Technology Data Exchange (ETDEWEB)

Pisarevskii, A A; Korukhov, N I.U.; Brazhnikov, E M; Konstantinova, M L; Razumovskii, S D

1982-01-01

Presented in this paper is the sterilization method of the assisted circulation unit. The method has been approved by stand testing and then applied for sterilizing the unit Ae, yeK-5 m when experimental implanting artificial heart. According to the method, ozone in concentration of 5 x 10(-3) moles/1 and with flow rate of 0,5 1/min is passed through an internal circuit of the unit during I h and 15 min. Control wash-out samples from lines have demonstrated complete sterility of the internal circuit. The method makes the sterilization process of such units much easier and may be recommended for clinical application.

The Carmat Bioprosthetic Total Artificial Heart Is Associated With Early Hemostatic Recovery and no Acquired von Willebrand Syndrome in Calves.

Science.gov (United States)

Smadja, David M; Susen, Sophie; Rauch, Antoine; Cholley, Bernard; Latrémouille, Christian; Duveau, Daniel; Zilberstein, Luca; Méléard, Denis; Boughenou, Marie-Fazia; Belle, Eric Van; Gaussem, Pascale; Capel, Antoine; Jansen, Piet; Carpentier, Alain

2017-10-01

To determine hemostasis perturbations, including von Willebrand factor (VWF) multimers, after implantation of a new bioprosthetic and pulsatile total artificial heart (TAH). Preclinical study SETTING: Single-center biosurgical research laboratory. Female Charolais calves, 2-to-6 months old, weighing 102-to-122 kg. Surgical implantation of TAH through a mid-sternotomy approach. Four of 12 calves had a support duration of several days (4, 4, 8, and 10 days), allowing for the exploration of early steps of hemostasis parameters, including prothrombin time; coagulation factor levels (II, V, VII+X, and fibrinogen); and platelet count. Multimeric analysis of VWF was performed to detect a potential loss of high-molecular weight (HMW) multimers, as previously described for continuous flow rotary blood pumps. Despite the absence of anticoagulant treatment administered in the postoperative phase, no signs of coagulation activation were detected. Indeed, after an immediate postsurgery decrease of prothrombin time, platelet count, and coagulation factor levels, most parameters returned to baseline values. HMW multimers of VWF remained stable either after initiation or during days of support. Coagulation parameters and platelet count recovery in the postoperative phase of the Carmat TAH (Camat SA, Velizy Villacoublay Cedex, France) implantation in calves, in the absence of anticoagulant treatment and associated with the absence of decrease in HMW multimers of VWF, is in line with early hemocompatibility that is currently being validated in human clinical studies. Copyright © 2017 Elsevier Inc. All rights reserved.

Simulation of Blood flow in Different Configurations Design of Bi-leaflet Mechanical Heart Valve

Science.gov (United States)

Hafizah Mokhtar, N.; Abas, Aizat

2018-05-01

In this work, two different designs of artificial heart valve were devised and then compared by considering the thrombosis, wear and valve orifice to anatomical orifice ratio of each mechanical heart valve. These different design configurations of bi-leaflet mechanical heart valves model are created through the use of Computer-aided design (CAD) modelling and simulated using Computational fluid dynamic (CFD) software. Design 1 is based on existing conventional bi-leaflet valve and design 2 based on modified bi-leaflet respectively. The flow pattern, velocity, vorticity and stress analysis have been done to justify the best design. Based on results, both of the designs show a Doppler velocity index of less than the allowable standard of 2.2 which is safe to be used as replacement of the human heart valve. However, design 2 shows that it has a lower possibility of cavitation issue which will lead to lower thrombosis and provide good central flow area of blood as compared to design 1.

[The relationship between depression, anxiety and heart disease - a psychosomatic challenge].

Science.gov (United States)

Kapfhammer, Hans-Peter

2011-12-01

Depressive and cardiological disorders present a major comorbidity. Their manifold interrelations may be best analysed within a biopsychosocial model of disease. A systematic research was done on empirical studies published during the last 15 years and dealing with epidemiological, etiopathogenetic and therapeutic dimensions of the comorbidity of depression, anxiety and heart disease. From an epidemiological perspective recurrent depressions are associated with a significantly increased risk of coronary heart disease. Depressive disorders play a major role in triggering critical cardiac events, e.g. myocardial infarction. The prevalence rates of depressive disorders in various cardiological conditions are significantly higher than the frequencies that can be expected in healthy general population. Depression shows a negative impact on the somatic morbidity and mortality during the further course of illness. Anxiety and posttraumatic stress disorders seem to be interrelated with cardiological conditions in quite a similar way, probably contributing even more negatively to critical and lethal cardiological events than depression. From an etiopathogenetic perspective some clusters of depressive symptoms seem to be linked to cardiotoxicity more closely than other, vital exhaustion, anhedonia, and hopelessness probably mediating a special risk. In any case, postmyocardial infarct depression that proves treatment-resistent indicates a negative prognosis of the prevailing cardiological condition. On a level of psychological and psychosocial constructs type-A personality, anger/hostility, type-D personality, and alexithymia have been explored regarding its proper pathogenetic role. Psychological and psychopathological variables have to be set into a context of psychosocial stressors on the one hand, and have to be simultaneously analysed with various underlying psycho- and neurobiological variables on the other. Above all, HPA- and sympathicomedullary dysfunctions, reduced

Intelligent postoperative morbidity prediction of heart disease using artificial intelligence techniques.

Science.gov (United States)

Hsieh, Nan-Chen; Hung, Lun-Ping; Shih, Chun-Che; Keh, Huan-Chao; Chan, Chien-Hui

2012-06-01

Endovascular aneurysm repair (EVAR) is an advanced minimally invasive surgical technology that is helpful for reducing patients' recovery time, postoperative morbidity and mortality. This study proposes an ensemble model to predict postoperative morbidity after EVAR. The ensemble model was developed using a training set of consecutive patients who underwent EVAR between 2000 and 2009. All data required for prediction modeling, including patient demographics, preoperative, co-morbidities, and complication as outcome variables, was collected prospectively and entered into a clinical database. A discretization approach was used to categorize numerical values into informative feature space. Then, the Bayesian network (BN), artificial neural network (ANN), and support vector machine (SVM) were adopted as base models, and stacking combined multiple models. The research outcomes consisted of an ensemble model to predict postoperative morbidity after EVAR, the occurrence of postoperative complications prospectively recorded, and the causal effect knowledge by BNs with Markov blanket concept.

A healthy heart is not a metronome: An integrative review of the heart’s anatomy and heart rate variability

Directory of Open Access Journals (Sweden)

Fredric Bruce Shaffer

2014-09-01

Full Text Available Heart rate variability (HRV, the change in the time intervals between adjacent heartbeats, is an emergent property of interdependent regulatory systems that operate on different time scales to adapt to challenges and achieve optimal performance. This article briefly reviews neural regulation of the heart, and its basic anatomy, the cardiac cycle, and the sinoatrial and atrioventricular pacemakers. The cardiovascular regulation center in the medulla integrates sensory information and input from higher brain centers, and afferent cardiovascular system inputs to adjust heart rate and blood pressure via sympathetic and parasympathetic efferent pathways. This article reviews sympathetic and parasympathetic influences on the heart, and examines the interpretation of HRV and the association between reduced HRV, risk of disease and mortality, and the loss of regulatory capacity. This article also discusses the intrinsic cardiac nervous system and the heart-brain connection, through which afferent information can influence activity in the subcortical and frontocortical areas, and motor cortex. It also considers new perspectives on the putative underlying physiological mechanisms and properties of the ultra-low-frequency (ULF, very-low-frequency (VLF, low-frequency (LF, and high-frequency (HF bands. Additionally, it reviews the most common time and frequency domain measurements as well as standardized data collection protocols. In its final section, this article integrates Porges’ polyvagal theory, Thayer and colleagues’ neurovisceral integration model, Lehrer, Vaschillo, and Vaschillo’s resonance frequency model, and the Institute of HeartMath’s coherence model. The authors conclude that a coherent heart is not a metronome because its rhythms are characterized by both complexity and stability over longer time scales. Future research should expand understanding of how the heart and its intrinsic nervous system influence the brain.

Evaluation of sympathetic nerve system activity with MIBG. Comparison with heart rate variability

International Nuclear Information System (INIS)

Kurata, Chinori; Wakabayashi, Yasushi; Shouda, Sakae; Mikami, Tadashi; Tawarahara, Kei; Sugiyama, Tsuyoshi; Nakano, Tomoyasu; Suzuki, Toshihiko.

1997-01-01

Authors attempted to elucidate the relations of plasma concentration of norepinephrine (pNE) and findings of heart rate variability and MIBG myocardial scintigraphy and evaluated cardiac autonomic nervous activity in chronic renal failure. Subjects were 211 patients with various heart diseases (coronary artery lesion, cardiomyopathy, hypertension, diabetes mellitus, renal failure and so on), 60 patients with artificial kidney due to chronic renal failure, 13 of whom were found to have coronary arterial disease by Tl myocardial scintigraphy, and 14 normal volunteers. ECG was recorded with the portable recorder for heart rate variability. Together with collection of blood for pNE measurement, myocardial scintigraphy was done at 15 and 150 min after intravenous administration of 111 MBq of MIBG for acquisition of early and delayed, respectively, images of the frontal breast. Accumulation at and elimination during the time points of MIBG were computed in cps unit. Variability of heart rate was found to have the correlation positive with MIBG delayed accumulation and negative with the elimination, and pNE, negative with heart rate variability and the delayed accumulation and positive with the elimination. Thus cardiac autonomic nervous abnormality was suggested to occur before uremic cardiomyopathy. (K.H.)

Potential consequences of clinical application of artificial gametes: a systematic review of stakeholder views.

Science.gov (United States)

Hendriks, Saskia; Dondorp, Wybo; de Wert, Guido; Hamer, Geert; Repping, Sjoerd; Dancet, Eline A F

2015-01-01

recommendations could be categorized under the following eight objectives to be safeguarded during clinical application of artificial gametes: (i) timing the implementation of new treatments correctly, (ii) meeting 'plausible demands of patients', (iii) improving and safeguarding public health, (iv) promoting the progress of medical science in the interest of future patients, (v) providing treatments that are morally acceptable for the general public, (vi) controlling medical practice, (vii) offering treatments that allow acquisition of informed consent and (viii) funding treatments fairly. Professionals specialized in biomedical science, science journalists and professionals specialized in ethics all addressed these eight objectives on artificial gametes, whereas professionals specialized in law or political science addressed seven objectives. Although one study reported on the perspective of parents of under-aged patients on three objectives, the perspectives of patients themselves were not reported by the reviewed literature. Of course, clinical introduction of artificial gametes should only be considered on the basis of reassuring outcomes of appropriate preclinical effectiveness and safety studies. In addition, potential users' views on the desirability and acceptability of artificial gametes should be studied before clinical introduction. A societal debate including all stakeholders is needed to determine the relative importance of all arguments in favor of and against the introduction of artificial gametes into clinical practice. More broadly, establishing pre-implementation processes for new medical techniques is relevant for all fields of medicine. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Biomimetic artificial sphincter muscles: status and challenges

Science.gov (United States)

Leung, Vanessa; Fattorini, Elisa; Karapetkova, Maria; Osmani, Bekim; Töpper, Tino; Weiss, Florian; Müller, Bert

2016-04-01

Fecal incontinence is the involuntary loss of bowel content and affects more than 12% of the adult population, including 45% of retirement home residents. Severe fecal incontinence is often treated by implanting an artificial sphincter. Currently available implants, however, have long-term reoperation rates of 95% and definitive explantation rates of 40%. These statistics show that the implants fail to reproduce the capabilities of the natural sphincter and that the development of an adaptive, biologically inspired implant is required. Dielectric elastomer actuators (DEA) are being developed as artificial muscles for a biomimetic sphincter, due to their suitable response time, reaction forces, and energy consumption. However, at present the operation voltage of DEAs is too high for artificial muscles implanted in the human body. To reduce the operating voltage to tens of volts, we are using microfabrication to reduce the thickness of the elastomer layer to the nanometer level. Two microfabrication methods are being investigated: molecular beam deposition and electrospray deposition. This communication covers the current status and a perspective on the way forward, including the long-term prospects of constructing a smart sphincter from low-voltage sensors and actuators based on nanometer-thin dielectric elastomer films. As DEA can also provide sensory feedback, a biomimetic sphincter can be designed in accordance with the geometrical and mechanical parameters of its natural counterpart. The availability of such technology will enable fast pressure adaption comparable to the natural feedback mechanism, so that tissue atrophy and erosion can be avoided while maintaining continence du ring daily activities.

ERVING: A Program to Teach Sociological Reasoning from the Dramaturgical Perspective.

Science.gov (United States)

Brent, Edward E., Jr.; And Others

1989-01-01

Describes the computer program labeled ERVING which teaches students to reason sociologically using E. Goffman's classic dramaturgical perspective. Suggests that artificial intelligence programs offer a means for developing instructional models for the social sciences which are not amenable to a quantitative approach. (KO)

Management of single-ventricle patients with Berlin Heart EXCOR Ventricular Assist Device: single-center experience.

Science.gov (United States)

Mackling, Tracey; Shah, Tejas; Dimas, Vivian; Guleserian, Kristine; Sharma, Mahesh; Forbess, Joseph; Ardura, Monica; Gross-Toalson, Jami; Lee, Ying; Journeycake, Janna; Barnes, Aliessa

2012-06-01

intubation, significant anasarca, and bleeding from the endotracheal tube. The family elected to withdraw support. Although both patients died prior to heart transplantation, a consistent specialized multidisciplinary team approach to the medical care of our VAD patients, consisting of cardiothoracic surgeons, heart transplant team, hematologists, pharmacists, infectious disease physicians, psychiatrists, specialty trained bedside nursing, and nurse practitioners, allowed us to manage these patients long term while awaiting heart transplantation. © 2012, Copyright the Authors. Artificial Organs © 2012, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

The economic aspects of artificial snow production in the perspective of climate change

Science.gov (United States)

Gonseth, C.

2012-04-01

Snowmaking is now used by ski resorts worldwide as a measure to cope with both natural snow reduction and variability. This extensive recourse casts doubt on its sustainability mainly because of the large amount of natural resources being used (energy, water). In the middle to long run, this problem is expected to increase with future climate change triggering the production of more snow. The research field that focuses on the economic aspects of artificial snow production is still in its infancy but potentially covers a wide array of issues. Among these issues, benefits and costs of snowmaking are important ones. On the one hand, benefits arise as snowmaking extends or preserves the operating period of ski areas. Several empirical studies speculate or show that snowmaking considerably reduces the sensitivity of tourism consumption to variations in snow conditions. These benefits have long been neglected in studies analyzing the consequences of climate change for the winter tourism sector. While failing to introduce these benefits, many studies have generated overly high costs of climate change. On the other hand, investments and operating costs of artificial snow production depend upon several factors, such as technology and local conditions. Consequently, costs vary considerably from one location to another and over time, yet indicative values can be found in the literature. In addition, artificial snow production generates external costs, i.e. costs that are not born by those producing it. Typical of these external costs are environmental ones that are related to CO2 emissions or biodiversity losses. To our knowledge, very little has been done so far to integrate these costs in economic studies. To the extent that vertical integration is absent, it may happen as well that snow production generates important external benefits for different stakeholders at a given ski resort. From an economic point of view, both types of externalities could lead to investment

INDICATIONS FOR IMPLANTATION OF A PERMANENT DRIVER’S TRANSPLANTED HEART RHYTHM AND CHOICE OF A TREATMENT ELEKTROKARDIOSTIMULYATION

Directory of Open Access Journals (Sweden)

S. J. Shemakin

2009-01-01

Full Text Available This report presents retrospective analysis of using artificial pacemaker in 16 heart transplanted patients because of developmented bradiarithmic disfunctions in the early and later posttransplanted periods. DDDR or SSIR regimens are recommended for persistened disfuncion of sinus node. DDDR regimen is recommened to prevent atrio-ventricular conduction. 

Parental perspectives on suffering and quality of life at end-of-life in children with advanced heart disease: an exploratory study*.

Science.gov (United States)

Blume, Elizabeth D; Balkin, Emily Morell; Aiyagari, Ranjit; Ziniel, Sonja; Beke, Dorothy M; Thiagarajan, Ravi; Taylor, Laura; Kulik, Thomas; Pituch, Kenneth; Wolfe, Joanne

2014-05-01

To describe parent perspectives regarding the end-of-life experience of children with advanced heart disease. Cross-sectional multicenter survey study of bereaved parents. Two tertiary care pediatric hospitals. Parents of children younger than 21 years with primary cardiac diagnoses who died in the hospital 9 months to 4 years before the survey date. Parents were excluded if they were non-English speakers or had previously denied permission to contact. The Survey for Caring for Children with Advanced Heart Disease was developed, piloted, and then sent to parents of all children who died at two sites. Fifty bereaved parents responded (39% response rate) a mean of 2.7 years after their child's death. Median age at death was 6 months (3.6 d to 20.4 yr). At end-of-life, 86% of children were intubated and 46% were receiving mechanical circulatory support. Seventy-eight percent died during withdrawal of life-sustaining interventions and 16% during resuscitative efforts. Parents realized that their child had no realistic chance of survival a median of 2 days prior to death (0-30 d). According to parents, 47% of children suffered "a great deal," "a lot," or "somewhat" during the end-of-life period. The symptoms parents perceived to be causing the most suffering were breathing and feeding difficulties in children under 2 years and fatigue and sleeping difficulties in older children. Seventy-one percent of parents described the quality of life of their child during the last month of life as "poor" or "fair." Most parents (84%) described the quality of care delivered as "very good" or "excellent." According to their parents, many children with advanced heart disease experience suffering in the end-of-life care period. For most, realization that their child has no realistic chance of survival does not occur until late, some not until death is imminent. Once this realization occurs, however, parents perceive peacefulness, a "good death," and excellent quality of care

Appropriate control time constant in relation to characteristics of the baroreflex vascular system in 1/R control of the total artificial heart.

Science.gov (United States)

Mizuta, Sora; Saito, Itsuro; Isoyama, Takashi; Hara, Shintaro; Yurimoto, Terumi; Li, Xinyang; Murakami, Haruka; Ono, Toshiya; Mabuchi, Kunihiko; Abe, Yusuke

2017-09-01

1/R control is a physiological control method of the total artificial heart (TAH) with which long-term survival was obtained with animal experiments. However, 1/R control occasionally diverged in the undulation pump TAH (UPTAH) animal experiment. To improve the control stability of the 1/R control, appropriate control time constant in relation to characteristics of the baroreflex vascular system was investigated with frequency analysis and numerical simulation. In the frequency analysis, data of five goats in which the UPTAH was implanted were analyzed with first Fourier transform technique to examine the vasomotion frequency. The numerical simulation was carried out repeatedly changing baroreflex parameters and control time constant using the elements-expanded Windkessel model. Results of the frequency analysis showed that the 1/R control tended to diverge when very low frequency band that was an indication of the vasomotion frequency was relative high. In numerical simulation, divergence of the 1/R control could be reproduced and the boundary curves between the divergence and convergence of the 1/R control varied depending on the control time constant. These results suggested that the 1/R control tended to be unstable when the TAH recipient had high reflex speed in the baroreflex vascular system. Therefore, the control time constant should be adjusted appropriately with the individual vasomotion frequency.

Valvular Heart Disease in Heart Failure

Directory of Open Access Journals (Sweden)

Giuseppe MC Rosano

2017-01-01

Full Text Available Structural valvular heart disease may be the cause of heart failure or may worsen the clinical status of patients with heart failure. Heart failure may also develop in patients treated with valve surgery. Patients with heart failure with valvular heart disease are at increased risk of events including sudden cardiac death. Before considering intervention (surgical or percutaneous all patients should receive appropriate medical and device therapy taking into account that vasodilators must be used with caution in patients with severe aortic stenosis. Numerous percutaneous and/or hybrid procedures have been introduced in the past few years and they are changing the management of valvular heart disease. In patients with heart failure and valvular heart disease, either primary or functional, the whole process of decision-making should be staged through a comprehensive evaluation of the risk– benefit ratio of different treatment strategies and should be made by a multidisciplinary ‘heart team’ with a particular expertise in valvular heart disease. The heart team should include heart failure cardiologists, cardiac surgeons/structural valve interventionists, imaging specialists, anaesthetists, geriatricians and intensive care specialists. This article will review recent developments and distill practical guidance in the management of this important heart failure co-morbidity.

Artificial reefs as a conservation tool: biodiversity assessment and perspectives in SE Brazil

Directory of Open Access Journals (Sweden)

Marcelo Soeth

2015-11-01

Full Text Available Artificial reefs (ARs has been suggested as a possible tool for reef fish restoration and biodiversity rehabilitation. In Brazil, and since 1996, ARs has been implemented in the continental shelf between latitudes of 25.6-25.8 S. Underwater visual censuses (UVC of fishes were conducted from 2010 to 2015 at both artificial (AR and natural rocky (NR reefs to assess similarity at local sites. NR were natural formations with an average depth of 10 meters, and UVC were performed between 6 to 8 meters. Protected AR (PAR were installed between the years 1996 to 2001 at depths ranging from 15 to 18 meters. It consist of a total of 1788 hollow blocks (2.4-3.6 m2 divided into eleven groups. Non protected AR (NPAR have been implemented between the years 2010 and 2012 at depths between 9 to 12 meters. It consist of a total of 2832 rectangular hollow blocks (1.2 m2 distributed in 10 parallel groups near the coastal line. Since 2013, NR and PAR were classified as marine protected areas (MPAs. A total of 69 fish species, distributed in 38 families and 10 orders were recorded during the UVC. PERMANOVA analysis showed a decreasing similarity between the NPAR and PAR (20.3%, NR and PAR (15.9%, and NR and NPAR (10.5%. The density of fish showed a strong correlation with the ARs, probably due to a higher perimeter-to-area ratio. Species richness and Shannon diversity index were correlated with NR, such as taxonomic distinctness was correlated to NPAR. Pielou's evenness index and taxonomic diversity were negatively correlated with PAR. Five threatened species (following IUCN, Epinephelus itajara, Epinephelus marginatus, Hyporthodus niveatus, Lutjanus cyanopterus and Lutjanus analis were recorded, which were noticeably more abundant in PAR, namely the former. The hereby data suggested the importance of the implementation of artificial reefs for conservation purposes, namely within MPAs.

The heart of Africa: succeeding against the odds.

Science.gov (United States)

Sliwa, Karen

2016-12-17

South Africa and other areas of sub-Saharan Africa have in the past 20 years undergone rapid demographical changes, largely due to urbanisation and changes in lifestyle. This rapid change has led to a marked increase in specific cardiac conditions, such as hypertensive heart disease and coronary artery disease (with the highest prevalence in the middle-aged population), in conjunction with a range of other heart diseases, which are historically common in Africa-eg, rheumatic heart disease, cardiomyopathies, and unoperated congenital heart disease. The short supply of well-equipped screening facilities, late diagnosis, and inadequate care at primary, secondary, and tertiary levels have led to a large burden of patients with poorly treated heart failure. Excellent progress has been made in the understanding of the epidemiology, sociodemographical factors, effect of urbanisation, and pathophysiology of cardiac conditions, such as peripartum cardiomyopathy, rheumatic heart disease, and tuberculous pericarditis, which are common in sub-Saharan Africa. This progress has been achieved largely through several studies, such as the Heart of Soweto, THESUS, REMEDY, BA-HEF, Abeokuta-HF, and the PAPUCO studies. Studies on the suitable therapeutic management of several heart conditions have also been done or are underway. In this Lecture, I provide a personal perspective on the evolving burden of cardiac disease, as witnessed since my appointment at Chris Hani Baragwanath Hospital, in Soweto, South Africa, in 1992, which was also the year that the referendum to end apartheid in South Africa was held. Subsequently, a network of cardiologists was formed under the umbrella of the Heart of Africa Studies and the Pan African Cardiac Society. Furthermore, I summarise the major gaps in the health-care system dealing with the colliding epidemic of communicable and non-communicable heart diseases, including cardiac diseases common in peripartum women. I also touch on the fantastic

Echocardiographic evaluation of simple versus complex congenital heart disease in a tertiary care Paediatrics Hospital

Directory of Open Access Journals (Sweden)

Uttam Kumar Sarkar

2017-10-01

Full Text Available Background & Objectives:Congenital heart diseases are treatable either by catheter based intervention or open heart surgery according to their quality. In our study we aim to analyze congenital heart disease echocardiographically into simple versus complex heart disease at a tertiary care centre with a public health planning and policy making perspective.Materials & Methods:This hospital based study was done on 1010 patients, both from in-patient and out-patient, who were clinically suspected to have heart disease from January 2015 to September 2016 at Dr.B.C.Roy P.G.I.P.S. Kolkata and echocardiographically categorized.Results:A VSD was the commonest acyanotic heart disease (17. 08%.Tetralogy of Fallot (TOF was commonest complex cyanotic heart disease (10.64%, VSD +ASD was the commonest combined lesion (8.12%. Simple heart lesions (63.1% were commoner than complex (36.9% congenital heart diseases.Conclusion:Health policy makers should give due care to manage Congenital Heart Disease either catheter based or surgically keeping in mind about 63.1% of the lesions are simple cardiac lesions and 36.9% lesions are complex cardiac lesion where complex surgery is required. 

Future Perspectives for Management of Stage A Heart Failure.

Science.gov (United States)

Tanaka, Hidekazu

2018-05-07

Patients with Stage A heart failure (HF) show no HF symptoms but have related comorbid diseases with a high risk of progressing to HF. Screening for comorbid diseases warrants closer attention because of the growing interest in addressing Stage A HF as the best means of preventing eventual progression to overt HF such as Stages C and D. The identification of individuals of Stage A HF is potentially useful for the implementation of HF-prevention strategies; however, not all Stage A HF patients develop left ventricular (LV) structural heart disease or symptomatic HF, which lead to advanced HF stages. Therefore, Stage A HF requires management with the long-term goal of avoiding HF development; likewise, Stage B HF patients are ideal targets for HF prevention. Although the early detection of subclinical LV dysfunction is, thus, essential for delaying the progression to HF, the assessment of subclinical LV dysfunction can be challenging. Global longitudinal strain (GLS) as assessed by speckle-tracking echocardiography has recently been reported to be a sensitive marker of early subtle LV myocardial abnormalities, helpful for the prediction of the outcomes for various cardiac diseases, and superior to conventional echocardiographic indices. GLS reflects LV longitudinal myocardial systolic function, and can be assessed usually by means of two-dimensional speckle-tracking. This article reviews the importance of the assessment of subclinical LV dysfunction in Stage A HF patients by means of GLS, and its current potential to prevent progression to later stage HF.

Heart Health - Brave Heart

Science.gov (United States)

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

Artificial intelligence

CERN Document Server

Ennals, J R

1987-01-01

Artificial Intelligence: State of the Art Report is a two-part report consisting of the invited papers and the analysis. The editor first gives an introduction to the invited papers before presenting each paper and the analysis, and then concludes with the list of references related to the study. The invited papers explore the various aspects of artificial intelligence. The analysis part assesses the major advances in artificial intelligence and provides a balanced analysis of the state of the art in this field. The Bibliography compiles the most important published material on the subject of

Beyond AI: Multi-Intelligence (MI) Combining Natural and Artificial Intelligences in Hybrid Beings and Systems

OpenAIRE

Stephen Fox

2017-01-01

Framing strongly influences actions among technology proponents and end-users. Underlying much debate about artificial intelligence (AI) are several fundamental shortcomings in its framing. First, discussion of AI is atheoretical, and therefore has limited potential for addressing the complexity of causation. Second, intelligence is considered from an anthropocentric perspective that sees human intelligence, and intelligence developed by humans, as superior to all other intelligences. Thus, t...

An artificial vector model for generating abnormal electrocardiographic rhythms

International Nuclear Information System (INIS)

Clifford, Gari D; Nemati, Shamim; Sameni, Reza

2010-01-01

We present generalizations of our previously published artificial models for generating multi-channel ECG to provide simulations of abnormal cardiac rhythms. Using a three-dimensional vectorcardiogram (VCG) formulation, we generate the normal cardiac dipole for a patient using a sum of Gaussian kernels, fitted to real VCG recordings. Abnormal beats are specified either as perturbations to the normal dipole or as new dipole trajectories. Switching between normal and abnormal beat types is achieved using a first-order Markov chain. Probability transitions can be learned from real data or modeled by coupling to heart rate and sympathovagal balance. Natural morphology changes from beat-to-beat are incorporated by varying the angular frequency of the dipole as a function of the inter-beat (RR) interval. The RR interval time series is generated using our previously described model whereby time- and frequency-domain heart rate (HR) and heart rate variability characteristics can be specified. QT-HR hysteresis is simulated by coupling the Gaussian kernels associated with the T-wave in the model with a nonlinear factor related to the local HR (determined from the last n RR intervals). Morphology changes due to respiration are simulated by introducing a rotation matrix couple to the respiratory frequency. We demonstrate an example of the use of this model by simulating HR-dependent T-wave alternans (TWA) with and without phase-switching due to ectopy. Application of our model also reveals previously unreported effects of common TWA estimation methods

Assessment of urban green space structures and their quality from a multidimensional perspective.

Science.gov (United States)

Daniels, Benjamin; Zaunbrecher, Barbara S; Paas, Bastian; Ottermanns, Richard; Ziefle, Martina; Roß-Nickoll, Martina

2018-02-15

Facing the growing amount of people living in cities and, at the same time, the need for a compact and sustainable urban development to mitigate urban sprawl, it becomes increasingly important that green spaces in compact cities are designed to meet the various needs within an urban environment. Urban green spaces have a multitude of functions: Maintaining ecological processes and resulting services, e.g. providing habitat for animals and plants, providing a beneficial city microclimate as well as recreational space for citizens. Regarding these requirements, currently existing assessment procedures for green spaces have some major shortcomings, which are discussed in this paper. It is argued why a more detailed spatial level as well as a distinction between natural and artificial varieties of structural elements is justified and needed and how the assessment of urban green spaces benefits from the multidimensional perspective that is applied. By analyzing a selection of structural elements from an ecological, microclimatic and social perspective, indicator values are derived and a new, holistic metrics 1 is proposed. The results of the integrated analysis led to two major findings: first, that for some elements, the evaluation differs to a great extent between the different perspectives (disciplines) and second, that natural and artificial varieties are, in most cases, evaluated considerably different from each other. The differences between the perspectives call for an integrative planning policy which acknowledges the varying contribution of a structural element to different purposes (ecological, microclimatic, social) as well as a discussion about the prioritization of those purposes. The differences in the evaluation of natural vs. artificial elements verify the assumption that indicators which consider only generic elements fail to account for those refinements and are thus less suitable for planning and assessment purposes. Implications, challenges and

The future of the artificial kidney: moving towards wearable and miniaturized devices.

Science.gov (United States)

Ronco, C; Davenport, A; Gura, V

2011-01-01

New directions in dialysis research include cheaper treatments, home based therapies and simpler methods of blood purification. These objectives may be probably obtained with innovations in the field of artificial kidney through the utilization of new disciplines such as miniaturization, microfluidics, nanotechnology. This research may lead to a new era of dialysis in which the new challenges are transportability, wearability and why not the possibility to develop implantable devices. Although we are not there yet, a new series of papers have recently been published disclosing interesting and promising results on the application of wearable ultrafiltration systems (WUF) and wearable artificial kidneys (WAK). Some of them use extracorporeal blood cleansing as a method of blood purification while others use peritoneal dialysis as a treatment modality (ViWAK and AWAK.) A special mention deserves the wearable/portable ultrafiltration system for the therapy of overhydration and congestive heart failure (WAKMAN). This system will allow dehospitalization and treatment of patients with less comorbidity and improved tolerance. On the way to the wearable artificial kidney, new discoveries have been made such as a complete system for hemofiltration in newborns (CARPEDIEM). The neonate in fact is the typical patient who may benefit from miniaturization of the dialysis circuit. This review analyzes the rationale for such endeavour and the challenges to overcome in order to make possible a true ambulatory dialysis treatment. Some initial results with these new devices are presented. We would like to stimulate a collaborative effort to make a quantum leap in technology making the wearable artificial kidney a reality rather than a dream. 

Improving Decision Making for Advanced Heart Failure Patients and Caregivers.

Science.gov (United States)

McIlvennan, Colleen K

2017-04-01

In this month's Magnet® Perspectives column, Colleen K. McIlvennan, DNP, ANP, lead nurse practitioner, Advanced Heart Failure and Transplantation at the University of Colorado, discusses her groundbreaking research encompassing patients' and caregivers' emotional, rational, and fundamental beliefs when considering a left ventricular assist device (LVAD). Results have led to the development of 2 innovative decision aids that are currently in use by LVAD programs across the United States and Canada. Dr McIlvennan's efforts led to a $2 million grant from the Patient-Centered Outcomes Research Institute, as well as national recognition from the American Heart Association and the Heart Failure Society of America. Last year, she received the 2016 National Magnet Nurse of the Year® Award in the Empirical Outcomes category. In addition to sharing her findings, Dr McIlvennan examines the value of performing research in a Magnet-recognized organization.

Entertainment Capture through Heart Rate Activity in Physical Interactive Playgrounds

DEFF Research Database (Denmark)

Yannakakis, Georgios; Hallam, John; Lund, Henrik Hautop

2008-01-01

children’s physiological signals, an estimator of the degree to which games provided by the playground engage the players. For this purpose children’s heart rate (HR) signals, and their expressed preferences of how much “fun” particular game variants are, are obtained from experiments using games...... that predict reported entertainment preferences given HR features. These models are expressed as artificial neural networks and are demonstrated and evaluated on two Playware games and two control tasks requiring physical activity. The best network is able to correctly match expressed preferences in 64...

Influence of artificial carbon nanotubes on expression of Rb gene and viability of lymphocytes

International Nuclear Information System (INIS)

Zhornik, E.V.

2010-01-01

Nanotechnologies that received the development last decades are the most perspective field of modern engineering and medicine. Alongside with the strong advantages nanoparticles can render negative influence on living cells and organisms. In connection with increasing use of nanotechnologies there is the necessity of studying the potential toxicity related to influence of nanoparticles. The changes in expression of Rb gene of human lymphocytes after short-term action of multiwalled carbon nanotubes at 100 mg/ml concentration was investigated to assess the potential risks of using the artificial nanotubes, and also the vitality of blood lymphocytes after their incubation with artificial nanotubes. The increase in the expression of Rb gene in time-dependent manner and the influence of nanoparticles on survival rate of lymphocytes in comparison with control samples were shown. (authors)

Learning modalities in artificial intelligence systems: a framework and review

Energy Technology Data Exchange (ETDEWEB)

Araya, A A

1982-01-01

Intelligent systems should possess two fundamental capabilities: problem solving and learning. Problem solving capabilities allow an intelligent system to cope with problems in a given domain. Learning capabilities make possible for an intelligent system to improve the solution to the problems within its current reach or to cope with new problems. This paper examines research in artificial intelligence from the perspective of learning with the purpose of: 1) developing and understanding of the problem of learning from the AI point of view, and II) characterizing the current state of the art on learning in AI. 35 references.

123I-meta-iodo-benzyl-guanidine myocardial scintigraphy and congestive heart failure: current data and perspective

International Nuclear Information System (INIS)

Agostini, D.; Darlas, Y.; Quennelle, F.; Bouvard, G.; Scanu, P.; Grollier, G.; Potier, J.C.; Babatasi, G.; Belin, A.

1997-01-01

Congestive heart failure is often associated with an impairment of the sympathetic nervous system, i.e., global hyperactivity and regional impairment of the adrenergic system. Cardiac 123 I-MIBG scintigraphy is a radionuclide technique which can explore the presynaptic adrenergic function. Myocardial MIBG fixation is decreased in congestive heart failure, reflecting a reduction of norepinephrine uptake by the myocardial presynaptic nerve endings. The impairment of presynaptic function occurs early in the disease and is actually involved in the pathogenesis of cardiac failure. Cardiac MIBG scintigraphy is a useful tool to explore the myocardial adrenergic stores in patients with congestive heart failure. It could be proposed in patients with severe ventricular dysfunction in order to assist physicians in setting-up the timing of heart transplantation. (authors)

Three-Dimensional Effects of Artificial Mixing in a Shallow Drinking-Water Reservoir

Science.gov (United States)

Chen, Shengyang; Little, John C.; Carey, Cayelan C.; McClure, Ryan P.; Lofton, Mary E.; Lei, Chengwang

2018-01-01

Studies that examine the effects of artificial mixing for water-quality mitigation in lakes and reservoirs often view a water column with a one-dimensional (1-D) perspective (e.g., homogenized epilimnetic and hypolimnetic layers). Artificial mixing in natural water bodies, however, is inherently three dimensional (3-D). Using a 3-D approach experimentally and numerically, the present study visualizes thermal structure and analyzes constituent transport under the influence of artificial mixing in a shallow drinking-water reservoir. The purpose is to improve the understanding of artificial mixing, which may help to better design and operate mixing systems. In this reservoir, a side-stream supersaturation (SSS) hypolimnetic oxygenation system and an epilimnetic bubble-plume mixing (EM) system were concurrently deployed in the deep region. The present study found that, while the mixing induced by the SSS system does not have a distinct 3-D effect on the thermal structure, epilimnetic mixing by the EM system causes 3-D heterogeneity. In the experiments, epilimnetic mixing deepened the lower metalimnetic boundary near the diffuser by about 1 m, with 55% reduction of the deepening rate at 120 m upstream of the diffuser. In a tracer study using a 3-D hydrodynamic model, the operational flow rate of the EM system is found to be an important short-term driver of constituent transport in the reservoir, whereas the duration of the EM system operation is the dominant long-term driver. The results suggest that artificial mixing substantially alters both 3-D thermal structure and constituent transport, and thus needs to be taken into account for reservoir management.

Artificial Leaf Based on Artificial Photosynthesis for Solar Fuel Production

Science.gov (United States)

2017-06-30

collect light energy and separate charge for developing new types of nanobiodevices to construct ”artificial leaf” from solar to fuel. or Concept of...AFRL-AFOSR-JP-TR-2017-0054 Artificial Leaf Based on Artificial Photosynthesis for Solar Fuel Production Mamoru Nango NAGOYA INSTITUTE OF TECHNOLOGY...display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ORGANIZATION. 1. REPORT DATE (DD-MM-YYYY)      30-06-2017 2

Preferences of heart failure patients in daily clinical practice : quality of life or longevity?

NARCIS (Netherlands)

Kraai, Imke H; Vermeulen, Karin M; Luttik, Marie Louise A; Hoekstra, Tialda; Jaarsma, Tiny; Hillege, Hans L

2013-01-01

AIMS: Knowledge of patient preferences is vital for delivering optimal healthcare. This study uses utility measurement to assess the preferences of heart failure (HF) patients regarding quality of life or longevity. The utility approach represents the perspective of a patient; facilitates the

Preferences of heart failure patients in daily clinical practice : quality of life or longevity?

NARCIS (Netherlands)

Kraai, Imke H.; Vermeulen, Karin M.; Luttik, Marie Louise A.; Hoekstra, Tialda; Jaarsma, Trijntje; Hillege, Hans L.

2013-01-01

Knowledge of patient preferences is vital for delivering optimal healthcare. This study uses utility measurement to assess the preferences of heart failure (HF) patients regarding quality of life or longevity. The utility approach represents the perspective of a patient; facilitates the combination

Next generation in vitro systems for biofilm studies - a cystic fibrosis patient airway perspective

DEFF Research Database (Denmark)

Weiss Nielsen, Martin

proven essential aspects on biofilm formations, however generates highly artificial biofilms that lack several CF airway scenarios. The driving force and the heart of this project has its origin in the study of the role played by P. aeruginosa in the CF airways. One of the aims of this thesis...

Mercury Exposure and Heart Diseases

Science.gov (United States)

Genchi, Giuseppe; Sinicropi, Maria Stefania; Carocci, Alessia; Lauria, Graziantonio; Catalano, Alessia

2017-01-01

Environmental contamination has exposed humans to various metal agents, including mercury. It has been determined that mercury is not only harmful to the health of vulnerable populations such as pregnant women and children, but is also toxic to ordinary adults in various ways. For many years, mercury was used in a wide variety of human activities. Nowadays, the exposure to this metal from both natural and artificial sources is significantly increasing. Recent studies suggest that chronic exposure, even to low concentration levels of mercury, can cause cardiovascular, reproductive, and developmental toxicity, neurotoxicity, nephrotoxicity, immunotoxicity, and carcinogenicity. Possible biological effects of mercury, including the relationship between mercury toxicity and diseases of the cardiovascular system, such as hypertension, coronary heart disease, and myocardial infarction, are being studied. As heart rhythm and function are under autonomic nervous system control, it has been hypothesized that the neurotoxic effects of mercury might also impact cardiac autonomic function. Mercury exposure could have a long-lasting effect on cardiac parasympathetic activity and some evidence has shown that mercury exposure might affect heart rate variability, particularly early exposures in children. The mechanism by which mercury produces toxic effects on the cardiovascular system is not fully elucidated, but this mechanism is believed to involve an increase in oxidative stress. The exposure to mercury increases the production of free radicals, potentially because of the role of mercury in the Fenton reaction and a reduction in the activity of antioxidant enzymes, such as glutathione peroxidase. In this review we report an overview on the toxicity of mercury and focus our attention on the toxic effects on the cardiovascular system. PMID:28085104

Mercury Exposure and Heart Diseases.

Science.gov (United States)

Genchi, Giuseppe; Sinicropi, Maria Stefania; Carocci, Alessia; Lauria, Graziantonio; Catalano, Alessia

2017-01-12

Environmental contamination has exposed humans to various metal agents, including mercury. It has been determined that mercury is not only harmful to the health of vulnerable populations such as pregnant women and children, but is also toxic to ordinary adults in various ways. For many years, mercury was used in a wide variety of human activities. Nowadays, the exposure to this metal from both natural and artificial sources is significantly increasing. Recent studies suggest that chronic exposure, even to low concentration levels of mercury, can cause cardiovascular, reproductive, and developmental toxicity, neurotoxicity, nephrotoxicity, immunotoxicity, and carcinogenicity. Possible biological effects of mercury, including the relationship between mercury toxicity and diseases of the cardiovascular system, such as hypertension, coronary heart disease, and myocardial infarction, are being studied. As heart rhythm and function are under autonomic nervous system control, it has been hypothesized that the neurotoxic effects of mercury might also impact cardiac autonomic function. Mercury exposure could have a long-lasting effect on cardiac parasympathetic activity and some evidence has shown that mercury exposure might affect heart rate variability, particularly early exposures in children. The mechanism by which mercury produces toxic effects on the cardiovascular system is not fully elucidated, but this mechanism is believed to involve an increase in oxidative stress. The exposure to mercury increases the production of free radicals, potentially because of the role of mercury in the Fenton reaction and a reduction in the activity of antioxidant enzymes, such as glutathione peroxidase. In this review we report an overview on the toxicity of mercury and focus our attention on the toxic effects on the cardiovascular system.

Mercury Exposure and Heart Diseases

Directory of Open Access Journals (Sweden)

Giuseppe Genchi

2017-01-01

Full Text Available Environmental contamination has exposed humans to various metal agents, including mercury. It has been determined that mercury is not only harmful to the health of vulnerable populations such as pregnant women and children, but is also toxic to ordinary adults in various ways. For many years, mercury was used in a wide variety of human activities. Nowadays, the exposure to this metal from both natural and artificial sources is significantly increasing. Recent studies suggest that chronic exposure, even to low concentration levels of mercury, can cause cardiovascular, reproductive, and developmental toxicity, neurotoxicity, nephrotoxicity, immunotoxicity, and carcinogenicity. Possible biological effects of mercury, including the relationship between mercury toxicity and diseases of the cardiovascular system, such as hypertension, coronary heart disease, and myocardial infarction, are being studied. As heart rhythm and function are under autonomic nervous system control, it has been hypothesized that the neurotoxic effects of mercury might also impact cardiac autonomic function. Mercury exposure could have a long-lasting effect on cardiac parasympathetic activity and some evidence has shown that mercury exposure might affect heart rate variability, particularly early exposures in children. The mechanism by which mercury produces toxic effects on the cardiovascular system is not fully elucidated, but this mechanism is believed to involve an increase in oxidative stress. The exposure to mercury increases the production of free radicals, potentially because of the role of mercury in the Fenton reaction and a reduction in the activity of antioxidant enzymes, such as glutathione peroxidase. In this review we report an overview on the toxicity of mercury and focus our attention on the toxic effects on the cardiovascular system.

[PULMONARY COMPLICATIONS IN CHILDREN, OPERATED ON FOR INBORN HEART FAILURES IN THE ARTIFICIAL BLOOD CIRCULATION ENVIRONMENT].

Science.gov (United States)

Moshkivska, L V; Nastenko, E A; Golovenko, O S; Lazoryshynets, V V

2015-11-01

The risk factors of pulmonary complications occurrence were analyzed in children, operated on for inborn heart failures in atrificial blood circulation environment. Pulmonary complications rate and the risk factors of their occurrence were analyzed.

Generative Artificial Intelligence : Philosophy and Theory of Artificial Intelligence

NARCIS (Netherlands)

van der Zant, Tijn; Kouw, Matthijs; Schomaker, Lambertus; Mueller, Vincent C.

2013-01-01

The closed systems of contemporary Artificial Intelligence do not seem to lead to intelligent machines in the near future. What is needed are open-ended systems with non-linear properties in order to create interesting properties for the scaffolding of an artificial mind. Using post-structuralistic

Autonomous development and learning in artificial intelligence and robotics: Scaling up deep learning to human-like learning.

Science.gov (United States)

Oudeyer, Pierre-Yves

2017-01-01

Autonomous lifelong development and learning are fundamental capabilities of humans, differentiating them from current deep learning systems. However, other branches of artificial intelligence have designed crucial ingredients towards autonomous learning: curiosity and intrinsic motivation, social learning and natural interaction with peers, and embodiment. These mechanisms guide exploration and autonomous choice of goals, and integrating them with deep learning opens stimulating perspectives.

Artificial life and Piaget.

Science.gov (United States)

Mueller, Ulrich; Grobman, K H.

2003-04-01

Artificial life provides important theoretical and methodological tools for the investigation of Piaget's developmental theory. This new method uses artificial neural networks to simulate living phenomena in a computer. A recent study by Parisi and Schlesinger suggests that artificial life might reinvigorate the Piagetian framework. We contrast artificial life with traditional cognitivist approaches, discuss the role of innateness in development, and examine the relation between physiological and psychological explanations of intelligent behaviour.

"Open your heart first of all": perspectives of holistic providers in Costa Rica about communication in the provision of health care.

Science.gov (United States)

Geist-Martin, Patricia; Bell, Keely K

2009-10-01

Research documents how the care the holistic providers offer represents the quality communication that patients often do not receive from their biomedical providers. However, research investigating the perspectives of holistic providers concerning the role they see themselves playing in the provision of health is limited. This research explores the perceptions of holistic providers in Costa Rica about their communication with their patients. The results reveal two practices of communication-authenticating and integrating as central to providers' communication with patients in the provision of holistic health care. Providers describe their communication as an exploration of an anatomy of pain/suffering, including investigating the location, timing, length, intensity, and overall rhythm of the patient's condition and sense making that leads them to seek the care of a holistic provider. Most holistic providers see their role as being careful or full of care and suggest that they have an obligation to open their heart first of all.

Wastewater treatment by artificial wetlands in the Museum of Popular Culture of the National University

Directory of Open Access Journals (Sweden)

Carolina Alfaro

2013-06-01

Full Text Available The fulfillment of the Millennium Development Goals in terms of sustainable access to sanitation requires increasing the development of research programs that promote simple and low cost technological options, appropriate to the social, economic, and environmental conditions of each population. These processes must be accompanied by actions of environmental and sanitation education, which allow appropriation of these systems by the communities. In this sense, there are two projects in the National University converging on this subject. The Museum of Popular Culture together with the Public Service Company of Heredia develop an environmental education project that promotes the protection of water, from an historical perspective of its management, which has an artificial wetland as the main teaching unit. On the other hand, the Waste Management Laboratory at the School of Chemistry evaluates the performance of this artificial wetland as part of a research project that promotes this type of alternative sanitation. This paper presents results of the monitoring of this artificial wetland, showing average removal percentages of 93% BOD5,20 , 95% COD, 73% P-PO4, and 95% for SS.

Magnetic resonance imaging in patients with heart valve prostheses

International Nuclear Information System (INIS)

Bachmann, R.; Juengehuelsing, M.; Schicha, H.; Deutsch, H.J.; Sechtem, U.; Hilger, H.H.

1991-01-01

Artifical valve prostheses are often regarded as a contraindication for magnetic resonance imaging (MRI), although preliminary in vitro studies suggested, that patients with these metallic implants might safely undergo MR examination. This study reports on the experience with a group of 89 patients with 100 heart valve prostheses who were examined by spin-echo MR and gradient-echo MR. MR examination was performed in all patients without complications. The spin-echo sequence showed advantages in the depiction of anatomical structures like paravalvular abcesses. Anatomical structures adjacent to the artificial valve were clearly visivle and the metal components of the valves showes no or only small artifacts. Artifacts were accentuated when using gradient-echo sequences. Gradient-echo sequences provided valuable information regarding the presence of valvular insufficiency. Physiological valvular regurgitation was easy to differentiate from pathological paravalvular or transvalvular regurgitation. These results demonstrate that patients with artificial valve prostheses can be imaged by MR without risk and that prosthesis-induced artifacts do no interfere with image interpretation. (orig.) [de

Description, evaluation and clinical decision making according to various fetal heart rate patterns. Inter-observer and regional variability

DEFF Research Database (Denmark)

Lidegaard, O; Bøttcher, L M; Weber, Tom

1992-01-01

departments, especially between departments far apart. It is concluded that we still need a scientific clarification of which specific heart rate changes are the best predictors of fetal stress. Artificial intelligence programs for interpreting fetal cardiotocograms and ECG signals constitute one promising......At 10 Danish obstetrical departments, 116 residents (42 senior and 74 junior) participated in a study to assess inter-observer and regional variability in the description and evaluation of and clinical decision regarding 11 fetal heart rate patterns. The 11 traces included normal as well...... as pathological patterns, and normal as well as clinically asphyxiated babies. Five antepartum and six intrapartum patterns were included. A total of 1,276 descriptions and evaluations were obtained. The degree of agreement in description of fetal heart rate changes was high regarding the baseline...

Artificial sweeteners

DEFF Research Database (Denmark)

Raben, Anne Birgitte; Richelsen, Bjørn

2012-01-01

Artificial sweeteners can be a helpful tool to reduce energy intake and body weight and thereby risk for diabetes and cardiovascular diseases (CVD). Considering the prevailing diabesity (obesity and diabetes) epidemic, this can, therefore, be an important alternative to natural, calorie-containin......Artificial sweeteners can be a helpful tool to reduce energy intake and body weight and thereby risk for diabetes and cardiovascular diseases (CVD). Considering the prevailing diabesity (obesity and diabetes) epidemic, this can, therefore, be an important alternative to natural, calorie......-containing sweeteners. The purpose of this review is to summarize the current evidence on the effect of artificial sweeteners on body weight, appetite, and risk markers for diabetes and CVD in humans....

Artificial cognition architectures

CERN Document Server

Crowder, James A; Friess, Shelli A

2013-01-01

The goal of this book is to establish the foundation, principles, theory, and concepts that are the backbone of real, autonomous Artificial Intelligence. Presented here are some basic human intelligence concepts framed for Artificial Intelligence systems. These include concepts like Metacognition and Metamemory, along with architectural constructs for Artificial Intelligence versions of human brain functions like the prefrontal cortex. Also presented are possible hardware and software architectures that lend themselves to learning, reasoning, and self-evolution

Industrial accident compensation insurance benefits on cerebrovascular and heart disease in Korea.

Science.gov (United States)

Kim, Hyeong Su; Choi, Jae Wook; Chang, Soung Hoon; Lee, Kun Sei

2003-01-01

The purpose of this study is to present the importance of work-related cerebrovascular and heart disease from the viewpoint of expenses. Using the insurance benefit paid for the 4,300 cases, this study estimated the burden of insurance benefits spent on work-related cerebrovascular and heart disease. The number of cases with work-related cerebrovascular and heart disease per 100,000 insured workers were 3.36 in 1995; they were increased to 13.16 in 2000. By the days of occurrence, the estimated number of cases were 1,336 in 2001 (95% CI: 1,211-1,460 cases) and 1,769 in 2005 (CI: 1,610-1,931 cases). The estimated average insurance benefits paid per person with work-related cerebrovascular and heart disease was 75-19 million won for medical care benefit and 56 million won for other benefits except medical care. By considering the increase in insurance payment and average pay, the predicted insurance benefits for work-related cerebrovascular and heart disease was 107.9 billion won for the 2001 cohort and 192.4 billion won for the 2005 cohort. From an economic perspective, the results will be used as important evidence for the prevention and management of work-related cerebrovascular and heart disease. PMID:12923322

Artificial intelligence and Internet of Things in a “smart home” context

DEFF Research Database (Denmark)

Lynggaard, Per

We are currently witnessing an evolution from building and home automation to smart homes, driven by progressing maturity of the Internet of Things and the use of artificial intelligence. However, significant technological challenges such as immature home intelligence, huge network and central...... of the distributed system is comparable to state-of-the-art centralized smart home architectures. In a larger perspective, the proposed framework supports and facilitates the coming era of Internet of Things. The distributed approach and elements of the framework can be applied in many related areas, such as ambient...

A Study on Narrative Perspectives in The Heart is a Lonely Hunter%论《心是孤独的猎手》中的叙事视角

Institute of Scientific and Technical Information of China (English)

陈博

2012-01-01

The theme of loneliness in McCullers＂ works has always been the focus of which the connotations of feminism, poetic traits as well as cultural background of criticism have been circles, out explored to the fullest extent over the past few years. McCullers＂ genius is not only embodied in her keen and deep insight; but also in her unique and exquisite narrative skill. This thesis attempts to elaborate on the narrative strategies of McCullers＂ The Heart is a Lonely Hunter, of which the narrative perspective is of variety. That is mainly embodied in the applications of third person external perspective, zero perspective and internal perspective. These three kinds of perspective are switched back and forth tactfully, reflecting the unique creative concept of the author.%麦卡勒斯作品的孤独主题一直占据评论界的中心，其引申出的女性主义、诗性特征以及文化背景义涵都得到了充分的拓展。麦卡勒斯的天才不仅体现在其敏锐深刻的洞察力上，也体现在其独特精致的叙事技巧上。麦卡勒斯作品《心是孤独的猎手》的叙事视角具有多变性特征，主要表现在第三人称外视角的应用，零视角的应用，以及内视角的应用等方面。三种视角巧妙地来回切换，体现了作者独具匠心的创作理念。

Antithrombotic therapy in atrial fibrillation associated with valvular heart disease: a joint consensus document from the European Heart Rhythm Association (EHRA) and European Society of Cardiology Working Group on Thrombosis, endorsed by the ESC Working Group on Valvular Heart Disease, Cardiac Arrhythmia Society of Southern Africa (CASSA), Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), South African Heart (SA Heart) Association and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE).

Science.gov (United States)

Lip, Gregory Y H; Collet, Jean Philippe; Caterina, Raffaele de; Fauchier, Laurent; Lane, Deirdre A; Larsen, Torben B; Marin, Francisco; Morais, Joao; Narasimhan, Calambur; Olshansky, Brian; Pierard, Luc; Potpara, Tatjana; Sarrafzadegan, Nizal; Sliwa, Karen; Varela, Gonzalo; Vilahur, Gemma; Weiss, Thomas; Boriani, Giuseppe; Rocca, Bianca

2017-11-01

Atrial fibrillation (AF) is a major worldwide public health problem, and AF in association with valvular heart disease (VHD) is also common. However, management strategies for this group of patients have been less informed by randomized trials, which have largely focused on 'non-valvular AF' patients. Thrombo-embolic risk also varies according to valve lesion and may also be associated with CHA2DS2VASc score risk factor components, rather than only the valve disease being causal. Given marked heterogeneity in the definition of valvular and non-valvular AF and variable management strategies, including non-vitamin K antagonist oral anticoagulants (NOACs) in patients with VHD other than prosthetic heart valves or haemodynamically significant mitral valve disease, there is a need to provide expert recommendations for professionals participating in the care of patients presenting with AF and associated VHD. To address this topic, a Task Force was convened by the European Heart Rhythm Association (EHRA) and European Society of Cardiology (ESC) Working Group on Thrombosis, with representation from the ESC Working Group on Valvular Heart Disease, Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), South African Heart (SA Heart) Association and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE) with the remit to comprehensively review the published evidence, and to publish a joint consensus document on the management of patients with AF and associated VHD, with up-to-date consensus recommendations for clinical practice for different forms of VHD. This consensus document proposes that the term 'valvular AF' is outdated and given that any definition ultimately relates to the evaluated practical use of oral anticoagulation (OAC) type, we propose a functional Evaluated Heartvalves, Rheumatic or Artificial (EHRA) categorization in relation to the type of OAC use in patients with AF, as follows: (i) EHRA Type 1 VHD, which refers

A computer simulation model of the cost-effectiveness of routine Staphylococcus aureus screening and decolonization among lung and heart-lung transplant recipients.

Science.gov (United States)

Clancy, C J; Bartsch, S M; Nguyen, M H; Stuckey, D R; Shields, R K; Lee, B Y

2014-06-01

Our objective was to model the cost-effectiveness and economic value of routine peri-operative Staphylococcus aureus screening and decolonization of lung and heart-lung transplant recipients from hospital and third-party payer perspectives. We used clinical data from 596 lung and heart-lung transplant recipients to develop a model in TreeAge Pro 2009 (Williamsport, MA, USA). Sensitivity analyses varied S. aureus colonization rate (5-15 %), probability of infection if colonized (10-30 %), and decolonization efficacy (25-90 %). Data were collected from the Cardiothoracic Transplant Program at the University of Pittsburgh Medical Center. Consecutive lung and heart-lung transplant recipients from January 2006 to December 2010 were enrolled retrospectively. Baseline rates of S. aureus colonization, infection and decolonization efficacy were 9.6 %, 36.7 %, and 31.9 %, respectively. Screening and decolonization was economically dominant for all scenarios tested, providing more cost savings and health benefits than no screening. Savings per case averted (2012 $US) ranged from $73,567 to $133,157 (hospital perspective) and $10,748 to $16,723 (third party payer perspective), varying with the probability of colonization, infection, and decolonization efficacy. Using our clinical data, screening and decolonization led to cost savings per case averted of $240,602 (hospital perspective) and averted 6.7 S. aureus infections (4.3 MRSA and 2.4 MSSA); 89 patients needed to be screened to prevent one S. aureus infection. Our data support routine S. aureus screening and decolonization of lung and heart-lung transplant patients. The economic value of screening and decolonization was greater than in previous models of other surgical populations.

Gender Differences in Sexual Attraction and Moral Judgment: Research With Artificial Face Models.

Science.gov (United States)

González-Álvarez, Julio; Cervera-Crespo, Teresa

2018-01-01

Sexual attraction in humans is influenced by cultural or moral factors, and some gender differences can emerge in this complex interaction. A previous study found that men dissociate sexual attraction from moral judgment more than women do. Two experiments consisting of giving attractiveness ratings to photos of real opposite-sex individuals showed that men, compared to women, were significantly less influenced by the moral valence of a description about the person shown in each photo. There is evidence of some processing differences between real and artificial computer-generated faces. The present study tests the robustness of González-Álvarez's findings and extends the research to an experimental design using artificial face models as stimuli. A sample of 88 young adults (61 females and 27 males, average age 19.32, SD = 2.38) rated the attractiveness of 80 3D artificial face models generated with the FaceGen Modeller 3.5 software. Each face model was paired with a "good" and a "bad" (from a moral point of view) sentence depicting a quality or activity of the person represented in the model (e.g., she/he is an altruistic nurse in Africa vs. she/he is a prominent drug dealer). Results were in line with the previous findings and showed that, with artificial faces as well, sexual attraction is less influenced by morality in men than in women. This gender difference is consistent with an evolutionary perspective on human sexuality.

Artificial Disc Replacement

Science.gov (United States)

... Spondylolisthesis BLOG FIND A SPECIALIST Treatments Artificial Disc Replacement (ADR) Patient Education Committee Jamie Baisden The disc ... Disc An artificial disc (also called a disc replacement, disc prosthesis or spine arthroplasty device) is a ...

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

Science.gov (United States)

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

2007-08-01

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

Design of a heart rate controller for treadmill exercise using a recurrent fuzzy neural network.

Science.gov (United States)

Lu, Chun-Hao; Wang, Wei-Cheng; Tai, Cheng-Chi; Chen, Tien-Chi

2016-05-01

In this study, we developed a computer controlled treadmill system using a recurrent fuzzy neural network heart rate controller (RFNNHRC). Treadmill speeds and inclines were controlled by corresponding control servo motors. The RFNNHRC was used to generate the control signals to automatically control treadmill speed and incline to minimize the user heart rate deviations from a preset profile. The RFNNHRC combines a fuzzy reasoning capability to accommodate uncertain information and an artificial recurrent neural network learning process that corrects for treadmill system nonlinearities and uncertainties. Treadmill speeds and inclines are controlled by the RFNNHRC to achieve minimal heart rate deviation from a pre-set profile using adjustable parameters and an on-line learning algorithm that provides robust performance against parameter variations. The on-line learning algorithm of RFNNHRC was developed and implemented using a dsPIC 30F4011 DSP. Application of the proposed control scheme to heart rate responses of runners resulted in smaller fluctuations than those produced by using proportional integra control, and treadmill speeds and inclines were smoother. The present experiments demonstrate improved heart rate tracking performance with the proposed control scheme. The RFNNHRC scheme with adjustable parameters and an on-line learning algorithm was applied to a computer controlled treadmill system with heart rate control during treadmill exercise. Novel RFNNHRC structure and controller stability analyses were introduced. The RFNNHRC were tuned using a Lyapunov function to ensure system stability. The superior heart rate control with the proposed RFNNHRC scheme was demonstrated with various pre-set heart rates. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Artificial life and life artificialization in Tron

Directory of Open Access Journals (Sweden)

Carolina Dantas Figueiredo

2012-12-01

Full Text Available Cinema constantly shows the struggle between the men and artificial intelligences. Fiction, and more specifically fiction films, lends itself to explore possibilities asking “what if?”. “What if”, in this case, is related to the eventual rebellion of artificial intelligences, theme explored in the movies Tron (1982 and Tron Legacy (2010 trat portray the conflict between programs and users. The present paper examines these films, observing particularly the possibility programs empowering. Finally, is briefly mentioned the concept of cyborg as a possibility of response to human concerns.

Experimental study on the effect of an artificial cardiac valve on the left ventricular flow

Science.gov (United States)

Wang, JiangSheng; Gao, Qi; Wei, RunJie; Wang, JinJun

2017-09-01

The use of artificial valves to replace diseased human heart valves is currently the main solution to address the malfunctioning of these valves. However, the effect of artificial valves on the ventricular flow still needs to be understood in flow physics. The left ventricular flow downstream of a St. Jude Medical (SJM) bileaflet mechanical heart valve (BMHV), which is a widely implanted mechanical bileaflet valve, is investigated with time-resolved particle image velocimetry in the current work. A tilting-disk valve is installed on the aortic orifice to guarantee unidirectional flow. Several post-processing tools are applied to provide combined analyses of the physics involved in the ventricular flow. The triple jet pattern that is closely related to the characteristics of the bileaflet valve is discussed in detail from both Eulerian and Lagrangian views. The effects of large-scale vortices on the transportation of blood are revealed by the combined analysis of the tracking of Lagrangian coherent structures, the Eulerian monitoring of the shear stresses, and virtual dye visualization. It is found that the utilization of the SJM BMHV complicates the ventricular flow and could reduce the efficiency of blood transportation. In addition, the kinematics of the bileaflets is presented to explore the effects of flow structures on their motion. These combined analyses could elucidate the properties of SJM BMHV. Furthermore, they could provide new insights into the understanding of other complex blood flows.

The effect of rigor mortis on the passage of erythrocytes and fluid through the myocardium of isolated dog hearts.

Science.gov (United States)

Nevalainen, T J; Gavin, J B; Seelye, R N; Whitehouse, S; Donnell, M

1978-07-01

The effect of normal and artificially induced rigor mortis on the vascular passage of erythrocytes and fluid through isolated dog hearts was studied. Increased rigidity of 6-mm thick transmural sections through the centre of the posterior papillary muscle was used as an indication of rigor. The perfusibility of the myocardium was tested by injecting 10 ml of 1% sodium fluorescein in Hanks solution into the circumflex branch of the left coronary artery. In prerigor hearts (20 minute incubation) fluorescein perfused the myocardium evenly whether or not it was preceded by an injection of 10 ml of heparinized dog blood. Rigor mortis developed in all hearts after 90 minutes incubation or within 20 minutes of perfusing the heart with 50 ml of 5 mM iodoacetate in Hanks solution. Fluorescein injected into hearts in rigor did not enter the posterior papillary muscle and adjacent subendocardium whether or not it was preceded by heparinized blood. Thus the vascular occlusion caused by rigor in the dog heart appears to be so effective that it prevents flow into the subendocardium of small soluble ions such as fluorescein.

A new "twist" on right heart failure with left ventricular assist systems.

Science.gov (United States)

Houston, Brian A; Shah, Keyur B; Mehra, Mandeep R; Tedford, Ryan J

2017-07-01

Despite significant efforts to predict and prevent right heart failure, it remains a leading cause of morbidity and mortality after implantation of left ventricular assist systems (LVAS). In this Perspective, we review the underappreciated anatomic and physiologic principles that govern the relationship between left and right heart function and contribute to this phenomenon. This includes the importance of considering the right ventricle (RV) and pulmonary arterial circuit as a coupled system; the contribution of the left ventricle (LV) to RV contractile function and the potential negative impact of acutely unloading the LV; the influence of the pericardium and ventricular twist on septal function; the role of RV deformation in reduced mechanical efficiency after device placement; and the potential of ongoing stressors of an elevated right-sided preload. We believe an appreciation of these complex issues is required to fully understand the expression of the unique phenotypes of right heart failure after LVAS implantation and for developing better prognostic and therapeutic strategies. Copyright © 2017 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Bleeding with the artificial heart: Gastrointestinal hemorrhage in CF-LVAD patients.

Science.gov (United States)

Gurvits, Grigoriy E; Fradkov, Elena

2017-06-14

Continuous-flow left ventricular assist devices (CF-LVADs) have significantly improved outcomes for patients with end-stage heart failure when used as a bridge to cardiac transplantation or, more recently, as destination therapy. However, its implantations carries a risk of complications including infection, device malfunction, arrhythmias, right ventricular failure, thromboembolic disease, postoperative and nonsurgical bleeding. A significant number of left ventricular assist devices (LVAD) recipients may experience recurrent gastrointestinal hemorrhage, mainly due to combination of antiplatelet and vitamin K antagonist therapy, activation of fibrinolytic pathway, acquired von Willebrand factor deficiency, and tendency to develop small intestinal angiodysplasias due to increased rotary speed of the pump. Gastrointestinal bleeding in LVAD patients remains a source of increased morbidity including the need for blood transfusions, extended hospital stays, multiple readmissions, and overall mortality. Management of gastrointestinal bleeding in LVAD patients involves multidisciplinary approach in stabilizing the patients, addressing risk factors and performing structured endoluminal evaluation with focus on upper gastrointestinal tract including jejunum to find and eradicate culprit lesion. Medical and procedural intervention is largely successful and universal bleeding cessation occurs in transplanted patients.

Heart transplantation in adults with congenital heart disease.

Science.gov (United States)

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

2017-05-01

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

The costs of heart failure in Poland from the public payer's perspective. Polish programme assessing diagnostic procedures, treatment and costs in patients with heart failure in randomly selected outpatient clinics and hospitals at different levels of care: POLKARD.

Science.gov (United States)

Czech, Marcin; Opolski, Grzegorz; Zdrojewski, Tomasz; Dubiel, Jacek S; Wizner, Barbara; Bolisęga, Dorota; Fedyk-Łukasik, Małgorzata; Grodzicki, Tomasz

2013-01-01

Heart failure (HF) is a chronic disease of great clinical and economic significance for both the healthcare system and patients themselves. To determine the consumption of medical resources for treatment and care of HF patients and to estimate the related costs. The study involved 400 primary care practices and 396 specialist outpatient clinics, as well as 259 hospitals at all reference levels. The sample was representative and supplemented with patient interview data. Based on the consumption of particular resources and the unit costs of services in 2011, costs of care for HF patients in Poland were estimated. Separate analyses were conducted depending on the stage of the disease (according to NYHA classification I-IV). The public payer's perspective and a one year time horizon were adopted. Direct annual costs of an HF patient's treatment in Poland may range between PLN 3,373.23 and 7,739.49 (2011), the main cost item being hospitalisation. The total costs for the healthcare system could be as high as PLN 1,703 million, which is 3.16% of the National Health Fund's budget (Ex. rate from 05.03.2012: 1 EUR = 4.14 PLN). The costs of treating heart failure in Poland are high; proper allocation of resources to diagnostic procedures and treatment may contribute to rationalisation of the relevant expenditure.

Artificial Neural Network approach to develop unique Classification and Raga identification tools for Pattern Recognition in Carnatic Music

Science.gov (United States)

Srimani, P. K.; Parimala, Y. G.

2011-12-01

A unique approach has been developed to study patterns in ragas of Carnatic Classical music based on artificial neural networks. Ragas in Carnatic music which have found their roots in the Vedic period, have grown on a Scientific foundation over thousands of years. However owing to its vastness and complexities it has always been a challenge for scientists and musicologists to give an all encompassing perspective both qualitatively and quantitatively. Cognition, comprehension and perception of ragas in Indian classical music have always been the subject of intensive research, highly intriguing and many facets of these are hitherto not unravelled. This paper is an attempt to view the melakartha ragas with a cognitive perspective using artificial neural network based approach which has given raise to very interesting results. The 72 ragas of the melakartha system were defined through the combination of frequencies occurring in each of them. The data sets were trained using several neural networks. 100% accurate pattern recognition and classification was obtained using linear regression, TLRN, MLP and RBF networks. Performance of the different network topologies, by varying various network parameters, were compared. Linear regression was found to be the best performing network.

Women's Heart Disease: Heart Attack Symptoms

Science.gov (United States)

... of this page please turn JavaScript on. Feature: Women's Heart Disease Heart Attack Symptoms Past Issues / Winter ... most common heart attack symptom in men and women is chest pain or discomfort. However, women also ...

Using Artificial Intelligence to Reduce the Risk of Nonadherence in Patients on Anticoagulation Therapy.

Science.gov (United States)

Labovitz, Daniel L; Shafner, Laura; Reyes Gil, Morayma; Virmani, Deepti; Hanina, Adam

2017-05-01

This study evaluated the use of an artificial intelligence platform on mobile devices in measuring and increasing medication adherence in stroke patients on anticoagulation therapy. The introduction of direct oral anticoagulants, while reducing the need for monitoring, have also placed pressure on patients to self-manage. Suboptimal adherence goes undetected as routine laboratory tests are not reliable indicators of adherence, placing patients at increased risk of stroke and bleeding. A randomized, parallel-group, 12-week study was conducted in adults (n=28) with recently diagnosed ischemic stroke receiving any anticoagulation. Patients were randomized to daily monitoring by the artificial intelligence platform (intervention) or to no daily monitoring (control). The artificial intelligence application visually identified the patient, the medication, and the confirmed ingestion. Adherence was measured by pill counts and plasma sampling in both groups. For all patients (n=28), mean (SD) age was 57 years (13.2 years) and 53.6% were women. Mean (SD) cumulative adherence based on the artificial intelligence platform was 90.5% (7.5%). Plasma drug concentration levels indicated that adherence was 100% (15 of 15) and 50% (6 of 12) in the intervention and control groups, respectively. Patients, some with little experience using a smartphone, successfully used the technology and demonstrated a 50% improvement in adherence based on plasma drug concentration levels. For patients receiving direct oral anticoagulants, absolute improvement increased to 67%. Real-time monitoring has the potential to increase adherence and change behavior, particularly in patients on direct oral anticoagulant therapy. URL: http://www.clinicaltrials.gov. Unique identifier: NCT02599259. © 2017 American Heart Association, Inc.

Nanoelectronics: The perspective in microelectronics

International Nuclear Information System (INIS)

Mutihac, R.; Mutihac, R.C.; Cicuttin, A.; Colavita, A.A.

2001-10-01

The present survey briefly presents the-state-of-the-art in microelectronics, invokes physical considerations in estimating the intrinsic limits of present microelectronic devices, and highlights the future trends in the perspectives of the incoming nanoscale technologies. In order to design artificial systems with molecular precision, molecular brand new engineering methods must be developed, that is, to hold, position, and assemble nanoscale parts in compliance with the laws of physics. In the framework of the nanoscale technologies, the thermodynamically reversible single electron switching systems are considered as ultimate evolutionary end point of electronic logic devices built up at molecular level. (author)

Lung and Heart Sounds Analysis: State-of-the-Art and Future Trends.

Science.gov (United States)

Padilla-Ortiz, Ana L; Ibarra, David

2018-01-01

Lung sounds, which include all sounds that are produced during the mechanism of respiration, may be classified into normal breath sounds and adventitious sounds. Normal breath sounds occur when no respiratory problems exist, whereas adventitious lung sounds (wheeze, rhonchi, crackle, etc.) are usually associated with certain pulmonary pathologies. Heart and lung sounds that are heard using a stethoscope are the result of mechanical interactions that indicate operation of cardiac and respiratory systems, respectively. In this article, we review the research conducted during the last six years on lung and heart sounds, instrumentation and data sources (sensors and databases), technological advances, and perspectives in processing and data analysis. Our review suggests that chronic obstructive pulmonary disease (COPD) and asthma are the most common respiratory diseases reported on in the literature; related diseases that are less analyzed include chronic bronchitis, idiopathic pulmonary fibrosis, congestive heart failure, and parenchymal pathology. Some new findings regarding the methodologies associated with advances in the electronic stethoscope have been presented for the auscultatory heart sound signaling process, including analysis and clarification of resulting sounds to create a diagnosis based on a quantifiable medical assessment. The availability of automatic interpretation of high precision of heart and lung sounds opens interesting possibilities for cardiovascular diagnosis as well as potential for intelligent diagnosis of heart and lung diseases.

Progress in artificial vision through suprachoroidal retinal implants

Science.gov (United States)

Bareket, Lilach; Barriga-Rivera, Alejandro; Zapf, Marc Patrick; Lovell, Nigel H.; Suaning, Gregg J.

2017-08-01

Retinal implants have proven their ability to restore visual sensation to people with degenerative retinopathy, characterized by photoreceptor cell death and the retina’s inability to sense light. Retinal bionics operate by electrically stimulating the surviving neurons in the retina, thus triggering the transfer of visual sensory information to the brain. Suprachoroidal implants were first investigated in Australia in the 1950s. In this approach, the neuromodulation hardware is positioned between the sclera and the choroid, thus providing significant surgical and safety benefits for patients, with the potential to maintain residual vision combined with the artificial input from the device. Here we review the latest advances and state of the art devices for suprachoroidal prostheses, highlight future technologies and discuss challenges and perspectives towards improved rehabilitation of vision.

Family caregivers' experiences of caring for patients with heart failure: a descriptive, exploratory qualitative study.

Science.gov (United States)

Etemadifar, Shahram; Bahrami, Masoud; Shahriari, Mohsen; Farsani, Alireza Khosravi

2015-06-01

Living with heart failure is a complex situation for family caregivers. Many studies addressing the challenges faced by heart failure family caregivers have already been conducted in Western societal settings. Sociocultural factors and perspectives influence the family caring experience and roles. The ethnic/culturally based differences in family caring behavior make this a subject worth further exploration and clarification. This study explores the experiences of family caregivers in Iran of caring for patients with heart failure. A descriptive, exploratory, and qualitative approach was applied to gain authentic insight into the experiences of participants. Purposive sampling was used to recruit 21 family caregivers from three educational hospitals in Isfahan, Iran. Data were collected using semistructured interviews and field notes. Interviews and field notes were transcribed verbatim and concurrently analyzed. Three major themes emerged from the analysis of the transcripts: caregiver uncertainty, lack of familial and organizational support, and Allah-centered caring. Participants believed that they did not have the basic knowledge related to their disease and drugs. In addition, they received little guidance from the healthcare team. Lack of support and insurance as well as financial issues were major problems faced by the caregivers. They accepted the providence of Allah and noted that Allah always helps them accomplish their caregiving responsibilities. The care performed by the caregivers of patients with heart failure exceeds their individual capabilities. Nurses, other healthcare providers, and health policy makers may use the findings of this study to develop more effective programs to address these challenges and to provide more effective support.Sociocultural factors and perspectives were the primary factors affecting the caregiving experiences of participants in this study. Improved understanding of these factors and perspectives will help healthcare

[Preparation of nano-nacre artificial bone].

Science.gov (United States)

Chen, Jian-ting; Tang, Yong-zhi; Zhang, Jian-gang; Wang, Jian-jun; Xiao, Ying

2008-12-01

To assess the improvements in the properties of nano-nacre artificial bone prepared on the basis of nacre/polylactide acid composite artificial bone and its potential for clinical use. The compound of nano-scale nacre powder and poly-D, L-lactide acid (PDLLA) was used to prepare the cylindrical hollow artificial bone, whose properties including raw material powder scale, pore size, porosity and biomechanical characteristics were compared with another artificial bone made of micron-scale nacre powder and PDLLA. Scanning electron microscope showed that the average particle size of the nano-nacre powder was 50.4-/+12.4 nm, and the average pore size of the artificial bone prepared using nano-nacre powder was 215.7-/+77.5 microm, as compared with the particle size of the micron-scale nacre powder of 5.0-/+3.0 microm and the pore size of the resultant artificial bone of 205.1-/+72.0 microm. The porosities of nano-nacre artificial bone and the micron-nacre artificial bone were (65.4-/+2.9)% and (53.4-/+2.2)%, respectively, and the two artificial bones had comparable compressive strength and Young's modulus, but the flexural strength of the nano-nacre artificial bone was lower than that of the micro-nacre artificial bone. The nano-nacre artificial bone allows better biodegradability and possesses appropriate pore size, porosity and biomechanical properties for use as a promising material in bone tissue engineering.

Heart murmurs

Science.gov (United States)

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

Implementing telemonitoring in heart failure care : Barriers from the perspectives of patients, healthcare professionals and healthcare organizations

NARCIS (Netherlands)

Boyne, J.J.; Vrijhoef, H.J.M.

2013-01-01

The increasing prevalence of chronic diseases, such as heart failure, presents a substantial challenge to healthcare systems. Telemonitoring is believed to be a useful instrument in the delivery of heart failure care. However, a widespread use of telemonitoring is currently failing for various

Prospective Heart Tracking for Whole-heart Magnetic Resonance Angiography

Science.gov (United States)

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

2015-01-01

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

Artificial Intelligence Study (AIS).

Science.gov (United States)

1987-02-01

ARTIFICIAL INTELLIGNECE HARDWARE ....... 2-50 AI Architecture ................................... 2-49 AI Hardware ....................................... 2...ftf1 829 ARTIFICIAL INTELLIGENCE STUDY (RIS)(U) MAY CONCEPTS 1/3 A~NLYSIS AGENCY BETHESA RD R B NOJESKI FED 6? CM-RP-97-1 NCASIFIED /01/6 M |K 1.0...p/ - - ., e -- CAA- RP- 87-1 SAOFŔ)11 I ARTIFICIAL INTELLIGENCE STUDY (AIS) tNo DTICFEBRUARY 1987 LECT 00 I PREPARED BY RESEARCH AND ANALYSIS

Fiat or bona fide boundary--a matter of granular perspective.

Directory of Open Access Journals (Sweden)

Lars Vogt

Full Text Available Distinguishing bona fide (i.e. natural and fiat (i.e. artificial physical boundaries plays a key role for distinguishing natural from artificial material entities and is thus relevant to any scientific formal foundational top-level ontology, as for instance the Basic Formal Ontology (BFO. In BFO, the distinction is essential for demarcating two foundational categories of material entity: object and fiat object part. The commonly used basis for demarcating bona fide from fiat boundary refers to two criteria: (i intrinsic qualities of the boundary bearers (i.e. spatial/physical discontinuity, qualitative heterogeneity and (ii mind-independent existence of the boundary. The resulting distinction of bona fide and fiat boundaries is considered to be categorial and exhaustive.By Referring to various examples from biology, we demonstrate that the hitherto used distinction of boundaries is not categorial: (i spatial/physical discontinuity is a matter of scale and the differentiation of bona fide and fiat boundaries is thus granularity-dependent, and (ii this differentiation is not absolute, but comes in degrees. By reducing the demarcation criteria to mind-independence and by also considering dispositions and historical relations of the bearers of boundaries, instead of only considering their spatio-structural properties, we demonstrate with various examples that spatio-structurally fiat boundaries can nevertheless be mind-independent and in this sense bona fide.We argue that the ontological status of a given boundary is perspective-dependent and that the strictly spatio-structural demarcation criteria follow a static perspective that is ignorant of causality and the dynamics of reality. Based on a distinction of several ontologically independent perspectives, we suggest different types of boundaries and corresponding material entities, including boundaries based on function (locomotion, physiology, ecology, development, reproduction and common history

Heart failure with preserved ejection fraction: mechanisms, clinical features, and therapies.

Science.gov (United States)

Sharma, Kavita; Kass, David A

2014-06-20

The clinical syndrome comprising heart failure (HF) symptoms but with a left ventricular ejection fraction (EF) that is not diminished, eg, HF with preserved EF, is increasingly the predominant form of HF in the developed world, and soon to reach epidemic proportions. It remains among the most challenging of clinical syndromes for the practicing clinician and scientist alike, with a multitude of proposed mechanisms involving the heart and other organs and complex interplay with common comorbidities. Importantly, its morbidity and mortality are on par with HF with reduced EF, and as the list of failed treatments continues to grow, HF with preserved EF clearly represents a major unmet medical need. The field is greatly in need of a more unified approach to its definition and view of the syndrome that engages integrative and reserve pathophysiology beyond that related to the heart alone. We need to reflect on prior treatment failures and the message this is providing, and redirect our approaches likely with a paradigm shift in how the disease is viewed. Success will require interactions between clinicians, translational researchers, and basic physiologists. Here, we review recent translational and clinical research into HF with preserved EF and give perspectives on its evolving demographics and epidemiology, the role of multiorgan deficiencies, potential mechanisms that involve the heart and other organs, clinical trials, and future directions. © 2014 American Heart Association, Inc.

Coronary heart disease patients transitioning to a normal life: perspectives and stages identified through a grounded theory approach.

Science.gov (United States)

Najafi Ghezeljeh, Tahereh; Yadavar Nikravesh, Mansoureh; Emami, Azita

2014-02-01

To explore how Iranian patients with coronary heart disease experience their lives. Coronary heart disease is a leading cause of death in Iran and worldwide. Understanding qualitatively how patients experience the acute and postacute stages of this chronic condition is essential knowledge for minimising the negative consequences of coronary heart disease. Qualitative study using grounded theory for the data analysis. Data for this study were collected through individual qualitative interviews with 24 patients with coronary heart disease, conducted between January 2009 and January 2011. Patients with angina pectoris were selected for participation through purposive sampling, and sample size was determined by data saturation. Data analysis began with initial coding and continued with focused coding. Categories were determined, and the core category was subsequently developed and finalised. The main categories of the transition from acute phase to a modified or 'new normal' life were: (1) Loss of normal life. Experiencing emotions and consequences of illness; (2) Coming to terms. Using coping strategies; (3) Recreating normal life. Healthcare providers must correctly recognise the stages of transition patients navigate while coping with coronary heart disease to support and educate them appropriately throughout these stages. Patients with coronary heart disease lose their normal lives and must work towards recreating a revised life using coping strategies that enable them to come to terms with their situations. By understanding Iranian patients' experiences, healthcare providers and especially nurses can use the information to support and educate patients with coronary heart disease on how to more effectively deal with their illness and its consequences. © 2013 John Wiley & Sons Ltd.

Quo Vadis, Artificial Intelligence?

OpenAIRE

Berrar, Daniel; Sato, Naoyuki; Schuster, Alfons

2010-01-01

Since its conception in the mid 1950s, artificial intelligence with its great ambition to understand and emulate intelligence in natural and artificial environments alike is now a truly multidisciplinary field that reaches out and is inspired by a great diversity of other fields. Rapid advances in research and technology in various fields have created environments into which artificial intelligence could embed itself naturally and comfortably. Neuroscience with its desire to understand nervou...

Inteligencia artificial en vehiculo

OpenAIRE

Amador Díaz, Pedro

2012-01-01

Desarrollo de un robot seguidor de líneas, en el que se implementan diversas soluciones de las áreas de sistemas embebidos e inteligencia artificial. Desenvolupament d'un robot seguidor de línies, en el qual s'implementen diverses solucions de les àrees de sistemes encastats i intel·ligència artificial. Follower robot development of lines, in which various solutions are implemented in the areas of artificial intelligence embedded systems.

Heart Failure

Science.gov (United States)

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

Criminal Aspects of Artificial Abortion

OpenAIRE

Hartmanová, Leona

2016-01-01

Criminal Aspects of Artificial Abortion This diploma thesis deals with the issue of artificial abortion, especially its criminal aspects. Legal aspects are not the most important aspects of artificial abortion. Social, ethical or ideological aspects are of the same importance but this diploma thesis cannot analyse all of them. The main issue with artificial abortion is whether it is possible to force a pregnant woman to carry a child and give birth to a child when she cannot or does not want ...

Heart MRI

Science.gov (United States)

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

The heart of McDonaldization: the perspective of the other.

OpenAIRE

Brimm, Morissa

2010-01-01

This dissertation aims to investigate the effect of organisational culture change on job satisfaction and work motivation from the perspective of the employees. McDonald’s Restaurants have been chosen due to having embraced organisational change in the last five years. One particular branch has been chosen – Castle Marina McDonald’s, Nottingham – for analysis. Triangulation was used to collect the data needed for my research; methods used were both qualitative and quantitative to provide rich...

Heart Health - Heart Disease: Symptoms, Diagnosis, Treatment

Science.gov (United States)

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

Heart Health: The Heart Truth Campaign 2009

Science.gov (United States)

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

Women's Heart Disease: Heart Disease Risk Factors

Science.gov (United States)

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

Artificial Hydration and Nutrition

Science.gov (United States)

... Crisis Situations Pets and Animals myhealthfinder Food and Nutrition Healthy Food Choices Weight Loss and Diet Plans ... Your Health Resources Healthcare Management Artificial Hydration and Nutrition Artificial Hydration and Nutrition Share Print Patients who ...

Artificial Evolution for the Detection of Group Identities in Complex Artificial Societies

DEFF Research Database (Denmark)

Grappiolo, Corrado; Togelius, Julian; Yannakakis, Georgios N.

2013-01-01

This paper aims at detecting the presence of group structures in complex artificial societies by solely observing and analysing the interactions occurring among the artificial agents. Our approach combines: (1) an unsupervised method for clustering interactions into two possible classes, namely in...

Artificial intelligence

International Nuclear Information System (INIS)

Perret-Galix, D.

1992-01-01

A vivid example of the growing need for frontier physics experiments to make use of frontier technology is in the field of artificial intelligence and related themes. This was reflected in the second international workshop on 'Software Engineering, Artificial Intelligence and Expert Systems in High Energy and Nuclear Physics' which took place from 13-18 January at France Telecom's Agelonde site at La Londe des Maures, Provence. It was the second in a series, the first having been held at Lyon in 1990

Elderly women's experiences of support when living with congestive heart failure.

Science.gov (United States)

Sundin, Karin; Bruce, Elisabeth; Barremo, Ann-Sofi

2010-03-04

Heart failure is a chronic syndrome that has physiological, psychological and social effects. The aim of the study was to illuminate the meanings of support as experienced by elderly women with chronic heart failure. Narrative interviews were conducted with five elderly women with chronic heart failure. A phenomenological hermeneutic method of interpretation was used. The meanings of support were experienced by the women out of two perspectives, that is, when support is present and when there is a lack of support. The findings were revealed in two themes: "Feeling confident means support" and "Feeling abandoned". The women do not wish to be a burden. They want to be independent as much as possible to defend their dignity. An important support to the women is that they are understood and confirmed in their illness. Supportive relations are most valuable, that is, a relationship that supports the women's independence. If there is no supportive relationship, they feel like a burden to others and they feel lonely; this loneliness creates suffering and counteracts wellbeing and health.

Exercise in children with common congenital heart lesions: balancing benefits with risks.

Science.gov (United States)

Halliday, Melanie; Selvadurai, Hiran; Sherwood, Megan; Fitzgerald, Dominic A

2013-10-01

Children with corrected common congenital heart lesions are often withheld from regular exercise by their parents. While there are some modest risks with exercise, they should be seen in perspective, and the life-long benefits of regular exercise on general health, mood and well-being should be emphasised. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

#%Applications of artificial intelligence in intelligent manufacturing: a review

Institute of Scientific and Technical Information of China (English)

#

2017-01-01

#%Based on research into the applications of artificial intelligence (AI) technology in the manufacturing industry in recent years, we analyze the rapid development of core technologies in the new era of 'Internet plus AI', which is triggering a great change in the models, means, and ecosystems of the manufacturing industry, as well as in the development of AI. We then propose new models, means, and forms of intelligent manufacturing, intelligent manufacturing system architecture, and intelligent man-ufacturing technology system, based on the integration of AI technology with information communications, manufacturing, and related product technology. Moreover, from the perspectives of intelligent manufacturing application technology, industry, and application demonstration, the current development in intelligent manufacturing is discussed. Finally, suggestions for the appli-cation of AI in intelligent manufacturing in China are presented.

Deep into the Brain: Artificial Intelligence in Stroke Imaging.

Science.gov (United States)

Lee, Eun-Jae; Kim, Yong-Hwan; Kim, Namkug; Kang, Dong-Wha

2017-09-01

Artificial intelligence (AI), a computer system aiming to mimic human intelligence, is gaining increasing interest and is being incorporated into many fields, including medicine. Stroke medicine is one such area of application of AI, for improving the accuracy of diagnosis and the quality of patient care. For stroke management, adequate analysis of stroke imaging is crucial. Recently, AI techniques have been applied to decipher the data from stroke imaging and have demonstrated some promising results. In the very near future, such AI techniques may play a pivotal role in determining the therapeutic methods and predicting the prognosis for stroke patients in an individualized manner. In this review, we offer a glimpse at the use of AI in stroke imaging, specifically focusing on its technical principles, clinical application, and future perspectives.

Clinical observation on the treatment of acute liver failure by combined non-biological artificial liver.

Science.gov (United States)

Li, Maoqin; Sun, Jingxi; Li, Jiaqiong; Shi, Zaixiang; Xu, Jiyuan; Lu, Bo; Cheng, Shuli; Xu, Yanjun; Wang, Xiaomeng; Zhang, Xianjiang

2016-12-01

The clinical efficacy and safety of different combinations of non-bio artificial liver in the treatment of acute liver failure was examined. A total of 61 cases were selected under blood purification treatment from the patients with severe acute liver failure admitted to the severe disease department of the hospital from December, 2010 to December, 2015. Three types of artificial liver combinations were observed, i.e., plasma exchange plus hemoperfusion plus continuous venovenous hemodiafiltration (PE+HP+CVVHDF), PE+CVVHDF and HP+CVVHDF. The heart rate (HR), mean arterial pressure (MAP), respiratory index (PaO 2 /FiO 2 ), liver and kidney function indicator, as well as platelet and coagulation function were compared. A comparison before and after the treatment using the three methods, showed improvement in the HRs, MAPs, PaO 2 /FiO 2 , total bilirubins (TBIL) and alanine aminotransferases (ALT) (Prate of 62.3% (38/61), and a viral survival rate of 35.0% (7/20); with the non-viral survival rate being 75.6% (31/41). In conclusion, following the treatment of three types of artificial livers, the function was improved to varying degrees, with the PE+HP+CVVHDF and the PE+CVVHDF method being better. By contrast, after the treatment of non-viral liver failure, the survival rate was significantly higher than the patients with viral liver failure.

Characterizing potential heart agents with an isolated perfused heart system

International Nuclear Information System (INIS)

Pendleton, D.B.; Sands, H.; Gallagher, B.M.; Camin, L.L.

1984-01-01

The authors have used an isolated perfused heart system for characterizing potential myocardial perfusion radiopharamaceuticals. Rabbit or guinea pig (GP) hearts are removed and perfused through the aorta with a blood-free buffer. Heart rate and ventricular pressure are monitored as indices of viability. Tc-99m-MAA is 96-100% retained in these hearts, and Tc-99m human serum albumin shows less than 5% extraction. Tl-201 is 30-40% extracted. It is known that in-vivo, Tc-99m(dmpe)/sub 2/Cl/sub 2//sup +/ is taken up by rabbit heart but not by GP or human heart. Analogous results are obtained with the isolated perfused heart model, where the complex is extracted well by the isolated rabbit heart (24%) but not by the GP heart (<5%). Values are unchanged if human, rabbit or GP blood is mixed and co-injected with the complex. Tc-99m)dmpe)/sub 3//sup +/ is also taken up by rabbit but not by GP hearts in-vivo. However, isolated perfused hearts of both species extract this complex well (45-52%). Heart uptake is diminished to <7% if the complex is pre-equilibrated with human blood. GP blood produces a moderate inhibition (in GP hearts only) and rabbit blood has no effect. This suggests that a human or GP blood factor may have a significant effect on heart uptake of this complex. Tc-99m(CN-t-butyl)/sub 6//sup +/ is taken up well by both rabbit and GP hearts in-vivo, and is extracted 100% by both isolated perfused hearts. Heart retention remains high (73-75%) in the presence of human blood

'From the moment of conception...': the Vatican instruction on artificial procreation techniques.

Science.gov (United States)

Coughlan, Michael J

1988-10-01

An analysis is presented of Instruction on Respect for Human Life in Its Origins and on the Dignity of Procreation, the official response of the Catholic Church to moral questions raised by the new reproductive technologies which sets down ethical guidelines for the treatment to be accorded human embryos and for procreative techniques from artificial insemination to surrogate motherhood. The document is viewed in the perspective of earlier Church pronouncements, such as The Declaration on Procured Abortion , and its definition of a person as an individual animated by a rational soul is explored in detail for its implications for discussions on the personhood of the human embryo.

Morphological characteristic of surgically removed cardiac myxomas: 25-YEAR EXPERIENCE IN V.I. SHUMAKOV FEDERAL RESEARCH CENTER OF TRANSPLANTOLOGY AND ARTIFICIAL ORGANS

Directory of Open Access Journals (Sweden)

I. M. Iljinsky

2017-01-01

Full Text Available Analysis of intracardiac space-occupying lesions, surgically removed at V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs over 25 years (in the period from 1992 until 2016 was carried out. During that period 134 patients underwent surgery. Preoperative clinical diagnosis before surgery was heart myxoma. From 134 patients, only in 115 (85.8% patients the removed intracardiac lesions were myxomas: left atrium – 103 (89.7% patients, right atrium – 10 (8.7%, right ventricle – 2 (1.8% and mitral valve – 1 (0.8% patient. 9 patients had thrombi in the heart, 10 patients had not myxomas, but other benign and malignant heart tumors. This article presents macroscopic, histolological and ultrastructural characteristic of cardiac myxomas. Recurrence of the left atrium myxoma occurred in 2 patients. They were re-operated in four and six years after the first removal of myxoma. 2 patients died during hospital period. One patient with atherosclerosis of the coronary arteries as a concurrent disease died of embolization of the stent coronary artery with myxoma particles with the development of acute heart failure. Death of the 2nd patient was not directly related to the surgery, and was due to the acute heart failure as well in connection with the presence of concurrent disease, coronary heart disease.

Heart Diseases

Science.gov (United States)

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

Heart Transplantation

Science.gov (United States)

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

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

Science.gov (United States)

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

2014-03-01

This article presents the most relevant developments in 2013 in 3 key areas of cardiology: congenital heart disease, clinical cardiology, and heart failure and transplant. Within the area of congenital heart disease, we reviewed contributions related to sudden death in adult congenital heart disease, the importance of specific echocardiographic parameters in assessing the systemic right ventricle, problems in patients with repaired tetralogy of Fallot and indication for pulmonary valve replacement, and confirmation of the role of specific factors in the selection of candidates for Fontan surgery. The most recent publications in clinical cardiology include a study by a European working group on correct diagnostic work-up in cardiomyopathies, studies on the cost-effectiveness of percutaneous aortic valve implantation, a consensus document on the management of type B aortic dissection, and guidelines on aortic valve and ascending aortic disease. The most noteworthy developments in heart failure and transplantation include new American guidelines on heart failure, therapeutic advances in acute heart failure (serelaxin), the management of comorbidities such as iron deficiency, risk assessment using new biomarkers, and advances in ventricular assist devices. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

Pediatric heart surgery

Science.gov (United States)

Heart surgery - pediatric; Heart surgery for children; Acquired heart disease; Heart valve surgery - children ... There are many kinds of heart defects. Some are minor, and others are more serious. Defects can occur inside the heart or in the large blood vessels ...

Off-pump transapical implantation of artificial neo-chordae to correct mitral regurgitation: the TACT Trial (Transapical Artificial Chordae Tendinae) proof of concept.

Science.gov (United States)

Seeburger, Joerg; Rinaldi, Mauro; Nielsen, Sten Lyager; Salizzoni, Stefano; Lange, Ruediger; Schoenburg, Markus; Alfieri, Ottavio; Borger, Michael Andrew; Mohr, Friedrich Wilhelm; Aidietis, Audrius

2014-03-11

The goal of this study was to evaluate the safety and performance of the NeoChord DS1000 system (NeoChord, Inc., Minneapolis, Minnesota). There is an increasing interest in transcatheter mitral valve (MV) treatment. The NeoChord DS 1000 system enables off-pump beating heart transapical MV repair with implantation of artificial neo-chordae. Patients with severe mitral regurgitation (MR) due to isolated posterior prolapse were included in this TACT (Transapical Artificial Chordae Tendinae) trial. All patients were scheduled for off-pump transapical implantation of neo-chordae. Thirty patients at 7 centers were enrolled. Major adverse events included 1 death due to post-cardiotomy syndrome and concomitant sepsis and 1 minor stroke with the patient fully recovered at the 30-day follow-up visit. Additional patients experienced procedural major adverse events related to a reoperation or conversion to standard of care. Acute procedural success (placement of at least 1 neo-chord and reduction of MR from 3+ or 4+ to ≤2+) was achieved in 26 patients (86.7%). In 4 patients neo-chordae were not placed for technical and/or patient-specific reasons. These patients underwent intraoperative (3 patients) or post-operative (1 patient) standard MV repair. At 30 days, 17 patients maintained an MR grade ≤2+. Four patients who developed recurrent MR were successfully treated with open MV repair during 30-day follow-up. Results improved with experience: durable reduction in MR to ≤2+ at 30 days was achieved in 5 (33.3%) of the first 15 patients and 12 (85.7%) of the last 14 patients. Off-pump transapical implantation of artificial chordae to correct MR is technically safe and feasible; however, it yields further potential for improvement of efficacy and durability. (Safety and Performance Study of the NeoChord Device [TACT]; NCT01777815). Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Soft computing in artificial intelligence

CERN Document Server

Matson, Eric

2014-01-01

This book explores the concept of artificial intelligence based on knowledge-based algorithms. Given the current hardware and software technologies and artificial intelligence theories, we can think of how efficient to provide a solution, how best to implement a model and how successful to achieve it. This edition provides readers with the most recent progress and novel solutions in artificial intelligence. This book aims at presenting the research results and solutions of applications in relevance with artificial intelligence technologies. We propose to researchers and practitioners some methods to advance the intelligent systems and apply artificial intelligence to specific or general purpose. This book consists of 13 contributions that feature fuzzy (r, s)-minimal pre- and β-open sets, handling big coocurrence matrices, Xie-Beni-type fuzzy cluster validation, fuzzy c-regression models, combination of genetic algorithm and ant colony optimization, building expert system, fuzzy logic and neural network, ind...

Artificial Intelligence

CERN Document Server

Warwick, Kevin

2011-01-01

if AI is outside your field, or you know something of the subject and would like to know more then Artificial Intelligence: The Basics is a brilliant primer.' - Nick Smith, Engineering and Technology Magazine November 2011 Artificial Intelligence: The Basics is a concise and cutting-edge introduction to the fast moving world of AI. The author Kevin Warwick, a pioneer in the field, examines issues of what it means to be man or machine and looks at advances in robotics which have blurred the boundaries. Topics covered include: how intelligence can be defined whether machines can 'think' sensory

Healthy Body, Happy Heart: Improve Your Heart Health

Science.gov (United States)

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

Charlas sobre inteligencia artificial

OpenAIRE

Álvarez Sánchez, José Ramón; Ferrández Vicente, José Manuel; Paz López, Félix de la

2014-01-01

Serie: Informática en Radio 3 La Inteligencia Artificial es una de las ciencias que causa mayor impacto en la sociedad, mucho más si tenemos en cuenta que cambiará el futuro de la humanidad. En España existen actualmente un nutrido grupo de equipos de investigación relacionados con las tecnologías de computación natural-artificial que aúnan sus esfuerzos a través de la RTNAC la Red Temática en Tecnologías de Computación Natural-Artificial . La UNED participa en todas sus actividades desde ...

Artificial Intelligence Project

Science.gov (United States)

1990-01-01

Symposium on Aritificial Intelligence and Software Engineering Working Notes, March 1989. Blumenthal, Brad, "An Architecture for Automating...Artificial Intelligence Project Final Technical Report ARO Contract: DAAG29-84-K-OGO Artificial Intelligence LaboratO"ry The University of Texas at...Austin N>.. ~ ~ JA 1/I 1991 n~~~ Austin, Texas 78712 ________k A,.tificial Intelligence Project i Final Technical Report ARO Contract: DAAG29-84-K-0060

Participation in Heart-Healthy Behaviors: A Secondary Analysis of the American Heart Association Go Red Heart Match Data.

Science.gov (United States)

Arslanian-Engoren, Cynthia; Eastwood, Jo-Ann; De Jong, Marla J; Berra, Kathy

2015-01-01

The American Heart Association created Go Red Heart Match, a free and secure online program that enables women to connect with each other to fight heart disease either personally or as a caregiver for someone with heart disease. Through these connections, participants have an opportunity to develop a personal, private, and supportive relationship with other women; share common experiences; and motivate and encourage each other to follow a heart-healthy lifestyle. The aims of this study were to describe the demographic characteristics of the Go Red Heart Match responders and to determine whether participation in the program prompted participants to engage in heart-healthy behaviors. A secondary analysis of data collected as part of a needs assessment survey from the American Heart Association Go Red Heart Match was conducted. A total of 117 (35%) of the 334 invited women completed the survey. Most responders were female, married, and college educated. A total of 105 (90%) responders were diagnosed with a type of heart disease or stroke and 77 (73%) responders had undergone treatment. As a result of participating in the program, 75% of the responders reported the following improvements in heart-healthy behaviors: eating a more heart-healthy diet (54%), exercising more frequently (53%), losing weight (47%), and quitting smoking (10%). Responders who had a diagnosis of heart attack (n = 48) were more likely (P = .003) to quit smoking than were those with other diagnoses (n = 69). Notably, 48% of responders reported encouraging someone else in their life to speak to their doctor about their risk for heart disease. Most women who participated in Heart Match reported engaging in new heart-healthy behaviors. The findings support expanding the existing program in a more diverse population as a potentially important way to reach women and encourage cardiovascular disease risk reduction for those with heart disease and stroke.

Rearing the southern green stink bug using an artificial dry diet and an artificial plant Criação do percevejo-verde usando dieta artificial seca e planta artificial

Directory of Open Access Journals (Sweden)

ANTÔNIO RICARDO PANIZZI

2000-09-01

Full Text Available Laboratory and greenhouse studies were conducted with an artificial dry diet to rear nymphs, and with an artificial plant as substrate for egg laying by the southern green stink bug, Nezara viridula (L.. The artificial diet was composed of: soybean protein (15 g; potato starch (7.5 g; dextrose (7.5 g; sucrose (2.5 g; cellulose (12.5 g; vitamin mixture (niacinamide 1 g, calcium pantothenate 1 g, thiamine 0.25 g, riboflavin 0.5 g, pyridoxine 0.25 g, folic acid 0.25 g, biotin 0.02 mL, vitamin B12 1 g - added to 1,000 mL of distilled water (5.0 mL; soybean oil (20 mL; wheat germ (17.9 g; and water (30 mL. Nymphs showed normal feeding behavior when fed on the artificial diet. Nymphal development time was longer than or similar to that of nymphs fed on soybean pods. Total nymphal mortality was low (ca. 30%, both for nymphs reared on the artificial diet, and for nymphs fed on soybean pods. At adult emergence, fresh body weights were significantly (PForam conduzidos estudos em laboratório e em casa de vegetação, com uma dieta artificial seca para a criação de ninfas e com um modelo de planta artificial como substrato para a colocação de ovos por adultos do percevejo-verde, Nezara viridula (L.. Os componentes da dieta artificial foram: proteína de soja (15 g; fécula de batata (7,5 g; dextrose (7,5 g; sacarose (2,5 g; celulose (12,5 g; mistura vitamínica (niacinamida 1 g, pantotenato de cálcio 1 g, tiamina 0,25 g, riboflavina 0,5 g, piridoxina 0,25 g, ácido fólico 0,25 g, biotina 0,02 mL, vitamina B12 1 g, adicionada em 1.000 mL de água destilada (5,0 mL; óleo de soja (20 mL; germe de trigo (17,9 g; e água (30 mL. As ninfas alimentaram-se normalmente da dieta, embora o tempo de desenvolvimento tenha sido em um caso, maior, e em outro, semelhante, ao das ninfas que se alimentaram de vagens da soja. A mortalidade total das ninfas foi baixa (ca. 30%, tanto na dieta como na vagem de soja. Na emergência, os adultos apresentaram peso fresco

Beyond AI: Artificial Dreams Conference

CERN Document Server

Zackova, Eva; Kelemen, Jozef; Beyond Artificial Intelligence : The Disappearing Human-Machine Divide

2015-01-01

This book is an edited collection of chapters based on the papers presented at the conference “Beyond AI: Artificial Dreams” held in Pilsen in November 2012. The aim of the conference was to question deep-rooted ideas of artificial intelligence and cast critical reflection on methods standing at its foundations.  Artificial Dreams epitomize our controversial quest for non-biological intelligence, and therefore the contributors of this book tried to fully exploit such a controversy in their respective chapters, which resulted in an interdisciplinary dialogue between experts from engineering, natural sciences and humanities.   While pursuing the Artificial Dreams, it has become clear that it is still more and more difficult to draw a clear divide between human and machine. And therefore this book tries to portrait such an image of what lies beyond artificial intelligence: we can see the disappearing human-machine divide, a very important phenomenon of nowadays technological society, the phenomenon which i...

The effects of exposure to environmental factors on Heart Rate Variability: An ecological perspective

International Nuclear Information System (INIS)

Schnell, Izhak; Potchter, Oded; Epstein, Yoram; Yaakov, Yaron; Hermesh, Hagai; Brenner, Shmuel; Tirosh, Emanuel

2013-01-01

The impact of human exposure to environmental factors on Heart Rate Variability (HRV) was examined in the urban space of Tel-Aviv-Jaffa. Four environmental factors were investigated: thermal and social loads; CO concentrations and noise. Levels of HRV are explained mainly by subjective social stresses, noise and CO. The most interesting result is the fact that while subjective social stress and noise increase HRV, low levels of CO are reducing HRV to some extent moderating the impact of subjective social stress and noise. Beyond the poisoning effect of CO and the fact that extremely low levels of HRV associated with high dozes of CO increase risk for life, low levels of CO may have a narcotic effect, as it is measured by HRV. The effects of thermal loads on HRV are negligible probably due to the use of behavioral means in order to neutralize heat and cold effects. -- Highlights: ► The impact of human exposure to environmental factors on Heart Rate Variability (HRV) was examined. ► Previous studies measured human exposure to pollution by fixed monitoring stations. ► This study measured actual personal exposure by mini sensors. ► High level of subjective social load and noise increase HRV. ► Low levels of CO may have a narcotic effect, as it is measured by HRV. -- The research focuses on the effects of environmental factors; noise, subjective social stress, thermal load and CO on Heart Rate Variability

Enlarged Heart

Science.gov (United States)

... rheumatic fever, a heart defect, infections (infectious endocarditis), connective tissue disorders, certain medications or radiation treatments for cancer, your heart may enlarge. Disease of the heart ...

Artificial Photosynthesis: Beyond Mimicking Nature

International Nuclear Information System (INIS)

Dau, Holger; Fujita, Etsuko; Sun, Licheng

2017-01-01

In this Editorial, Guest Editors Holger Dau, Etsuko Fujita, and Licheng Sun introduce the Special Issue of ChemSusChem on “Artificial Photosynthesis for Sustainable Fuels”. Here, they discuss the need for non-fossil based fuels, introduce both biological and artificial photosynthesis, and outline various important concepts in artificial photosynthesis, including molecular and solid-state catalysts for water oxidation and hydrogen evolution, catalytic CO 2 reduction, and photoelectrochemical systems.

Physical activity in patients with stable coronary heart disease: an international perspective

OpenAIRE

Stewart, Ralph; Held, Claes; Brown, Rebekkah; Vedin, Ola; Hagstrom, Emil; Lonn, Eva; Armstrong, Paul; Granger, Christopher B.; Hochman, Judith; Davies, Richard; Soffer, Joseph; Wallentin, Lars; White, Harvey

2013-01-01

Aims Despite the known benefits of regular exercise, the reasons why many coronary heart disease (CHD) patients engage in little physical activity are not well understood. This study identifies factors associated with low activity levels in individuals with chronic CHD participating in the STABILITY study, a global clinical outcomes trial evaluating the lipoprotein phospholipaseA2 inhibitor darapladib. Methods and results Prior to randomization, 15 486 (97.8%) participants from 39 countries c...

Parallel artificial liquid membrane extraction

DEFF Research Database (Denmark)

Gjelstad, Astrid; Rasmussen, Knut Einar; Parmer, Marthe Petrine

2013-01-01

This paper reports development of a new approach towards analytical liquid-liquid-liquid membrane extraction termed parallel artificial liquid membrane extraction. A donor plate and acceptor plate create a sandwich, in which each sample (human plasma) and acceptor solution is separated by an arti......This paper reports development of a new approach towards analytical liquid-liquid-liquid membrane extraction termed parallel artificial liquid membrane extraction. A donor plate and acceptor plate create a sandwich, in which each sample (human plasma) and acceptor solution is separated...... by an artificial liquid membrane. Parallel artificial liquid membrane extraction is a modification of hollow-fiber liquid-phase microextraction, where the hollow fibers are replaced by flat membranes in a 96-well plate format....

Women's Heart Disease: Join the Heart Truth Community

Science.gov (United States)

... this page please turn JavaScript on. Feature: Women's Heart Disease Join The Heart Truth Community Past Issues / Winter 2014 Table of Contents National Symbol The centerpiece of The Heart Truth ® is The Red Dress ® which was introduced ...

Keeping the heart in balance: the functional interactions of myoglobin with nitrogen oxides

DEFF Research Database (Denmark)

Flögel, Ulrich; Fago, Angela; Rassaf, Tienush

2010-01-01

in the heart. By a dynamic cycle, in which a decrease in tissue O2 tension drives the conversion of Mb from being a NO scavenger under normoxia to a NO producer during hypoxia, mitochondrial respiration is reversibly adapted to the intracellular O2 tension. Therefore, Mb may act as an important O2 sensor...... through which NO can regulate muscle energetics and function. As Mb is widespread throughout the fauna, the diverse oxygen-dependent interactions between Mb and nitrogen oxides may not only be of relevance for mammals but also for other vertebrates as evidenced by comparable phenotypes of ‘artificial...

Biomedical Engineering support. Semiannual progress report

International Nuclear Information System (INIS)

Kolff, W.J.; Smith, L.M.; Sandquist, G.M.

1976-01-01

The basic goal of the ERDA Artificial Heart Program is to develop and construct an artificial heart, powered by a 238 Pu heat source, which can be successfully employed as an emplantable total artificial heart system for animal experiments. Future studies will be directed at developing and evaluating a satisfactory system for total heart replacement in humans. A total of 32 ERDA artificial hearts have been implanted since the initiation of the program. During the reporting period ten total heart replacement experiments were performed in calves using the ERDA blood pump powered by an electric motor implanted in the abdomen. Results of the experiments are given

Heart Health: Learn the Truth About Your Heart

Science.gov (United States)

... Bar Home Current Issue Past Issues Cover Story Heart Health Learn the Truth About Your Heart Past Issues / Winter 2009 Table of Contents For ... turn Javascript on. Photo: iStock February is American Heart Month. Now is the time to make sure ...

Artificial Intelligence in Space Platforms.

Science.gov (United States)

1984-12-01

computer algorithms, there still appears to be a need for Artificial Inteligence techniques in the navigation area. The reason is that navigaion, in...RD-RI32 679 ARTIFICIAL INTELLIGENCE IN SPACE PLRTFORNSMU AIR FORCE 1/𔃼 INST OF TECH WRIGHT-PRTTERSON AFB OH SCHOOL OF ENGINEERING M A WRIGHT DEC 94...i4 Preface The purpose of this study was to analyze the feasibility of implementing Artificial Intelligence techniques to increase autonomy for

Trimaran Resistance Artificial Neural Network

Science.gov (United States)

2011-01-01

11th International Conference on Fast Sea Transportation FAST 2011, Honolulu, Hawaii, USA, September 2011 Trimaran Resistance Artificial Neural Network Richard...Trimaran Resistance Artificial Neural Network 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e... Artificial Neural Network and is restricted to the center and side-hull configurations tested. The value in the parametric model is that it is able to

Artificial Intelligence and Moral intelligence

OpenAIRE

Laura Pana

2008-01-01

We discuss the thesis that the implementation of a moral code in the behaviour of artificial intelligent systems needs a specific form of human and artificial intelligence, not just an abstract intelligence. We present intelligence as a system with an internal structure and the structural levels of the moral system, as well as certain characteristics of artificial intelligent agents which can/must be treated as 1- individual entities (with a complex, specialized, autonomous or selfdetermined,...

Artificial Intelligence and Economic Theories

OpenAIRE

Marwala, Tshilidzi; Hurwitz, Evan

2017-01-01

The advent of artificial intelligence has changed many disciplines such as engineering, social science and economics. Artificial intelligence is a computational technique which is inspired by natural intelligence such as the swarming of birds, the working of the brain and the pathfinding of the ants. These techniques have impact on economic theories. This book studies the impact of artificial intelligence on economic theories, a subject that has not been extensively studied. The theories that...