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Sample records for cardiac pacing artificial

  1. Recent developments in cardiac pacing.

    Science.gov (United States)

    Rodak, D J

    1995-10-01

    Indications for cardiac pacing continue to expand. Pacing to improve functional capacity, which is now common, relies on careful patient selection and technical improvements, such as complex software algorithms and diagnostic capabilities.

  2. Pneumothorax in cardiac pacing

    DEFF Research Database (Denmark)

    Kirkfeldt, Rikke Esberg; Johansen, Jens Brock; Nohr, Ellen Aagaard;

    2012-01-01

    AIM: To identify risk factors for pneumothorax treated with a chest tube after cardiac pacing device implantation in a population-based cohort.METHODS AND RESULTS: A nationwide cohort study was performed based on data on 28 860 patients from the Danish Pacemaker Register, which included all Danish...... patients who received their first pacemaker (PM) or cardiac resynchronization device from 1997 to 2008. Multiple logistic regression was used to estimate adjusted odds ratios (aOR) with 95% confidence intervals for the association between risk factors and pneumothorax treated with a chest tube. The median...... age was 77 years (25th and 75th percentile: 69-84) and 55% were male (n = 15 785). A total of 190 patients (0.66%) were treated for pneumothorax, which was more often in women [aOR 1.9 (1.4-2.6)], and in patients with age >80 years [aOR 1.4 (1.0-1.9)], a prior history of chronic obstructive pulmonary...

  3. Historical highlights in cardiac pacing.

    Science.gov (United States)

    Geddes, L A

    1990-01-01

    The benchmarks in cardiac pacing are identified, beginning with F. Steiner (1871), who rhythmically stimulated the chloroform-arrested hearts of 3 horses, 1 donkey, 10 dogs, 14 cats, and 8 rabbits. The chloroform-arrested heart in human subjects was paced by T. Greene in the following year (1872) in the UK. In 1882, H. Ziemssen in Germany applied cardiac pacing to a 42-year old woman who had a large defect in the anterior left chest wall subsequent to resection of an enchondroma. Intentional cardiac pacing did not occur until 1932, when A.A. Hyman in the US demonstrated that cardiac pacing could be clinically practical. Hyman made a batteryless pacemaker for delivery in induction shock stimuli (60-120/min) to the atria. His pacemaker was powered by a hand-wound, spring-driven generator which provided 6 min of pacemaking without rewinding. Closed-chest ventricular pacing was introduced in the US in 1952 by P.M. Zoll et al. Zoll (1956) also introduced closed-chest ventricular defibrillation. W.L. Weirich et al. (1958) demonstrated that direct-heart stimulation in closed-chest patients could be achieved with slender wire electrodes. S. Furman and J.B. Schwedel (1959) developed a monopolar catheter electrode for ventricular pacing in man. In the same year, W. Greatbatch and W.M. Chardack developed the implantable pacemaker. PMID:18238328

  4. Thallium cardiac stressing by esophageal pacing

    Energy Technology Data Exchange (ETDEWEB)

    Allen, M.L.; Vacek, J.L.; Preston, D.F.; Robinson, R.G.; Feldkamp, M.J. (Univ. of Kansas Medical Center, Kansas City (USA))

    1989-09-01

    Forty-three patients were examined with the transesophageal pacing method of cardiac stressing and thallium imaging. Transesophageal cardiac pacing, using a pill electrode or a permanent pacemaker lead, is a safe alternative for patients who are physically unable to exercise. Prior studies suggest that transvenous right atrial pacing with thallium injection is equivalent to physical exercise thallium studies in the detection of coronary artery disease. The esophageal pacing bipolar electrode similarly increases heart rate without the necessity of transvenous pacing or fluoroscopy and without the adverse side effects often seen when using pharmacologic stressing agents (i.e., dipyridamole). The results compare well with cardiac catheterization, echocardiographic, and electrocardiographic results. Cardiac paced stress testing requires no sedation, is performed on an out-patient basis, and causes little if any discomfort for the patient.

  5. Cardiac pacing in pediatrics: Is still the right ventricle the optimal pacing site?

    Directory of Open Access Journals (Sweden)

    Michel Cabrera Ortega

    2015-10-01

    Full Text Available Permanent cardiac pacing is frequently indicated in pediatric patients due to atrioventricular block. Traditionally, the right ventricle has been the pacing site because it is readily accessible, and provides lead stability and optimal chronic pacing thresholds. However, it is associated with a dyssynchrony pattern of ventricular activation, that may cause remodeling and impairment of left ventricular function. In pediatric patients, paced from an early age and with a long life expectancy, the preservation of cardiac function is a premise. Therefore, the prevention of dyssynchrony, using possible alternative sites, is not just a priority, is a challenge. The aim of the article is to show the effects of chronic right ventricular pacing as well as the evidence of benefits provided by alternatives pacing sites in pediatric population and their clinical and practical implications.

  6. Determination of myocardial energetic output for cardiac rhythm pacing

    OpenAIRE

    Heřman, Dalibor; Převorovská, Světlana; Maršík, František

    2007-01-01

    This research is aimed to the determination of the changes in the cardiac energetic output for three different modes of cardiac rhythm pacing. The clinical investigation of thirteen patients with the permanent dual-chamber pacemaker implantation was carried out. The patients were taken to echocardiography examination conducted by way of three pacing modes (AAI, VVI and DDD). The myocardial energetic parameters—the stroke work index (SWI) and the myocardial oxygen consumption (MVO2) are not di...

  7. Optogenetics for in vivo cardiac pacing and resynchronization therapies.

    Science.gov (United States)

    Nussinovitch, Udi; Gepstein, Lior

    2015-07-01

    Abnormalities in the specialized cardiac conduction system may result in slow heart rate or mechanical dyssynchrony. Here we apply optogenetics, widely used to modulate neuronal excitability, for cardiac pacing and resynchronization. We used adeno-associated virus (AAV) 9 to express the Channelrhodopsin-2 (ChR2) transgene at one or more ventricular sites in rats. This allowed optogenetic pacing of the hearts at different beating frequencies with blue-light illumination both in vivo and in isolated perfused hearts. Optical mapping confirmed that the source of the new pacemaker activity was the site of ChR2 transgene delivery. Notably, diffuse illumination of hearts where the ChR2 transgene was delivered to several ventricular sites resulted in electrical synchronization and significant shortening of ventricular activation times. These findings highlight the unique potential of optogenetics for cardiac pacing and resynchronization therapies.

  8. Feasibility of Leadless Cardiac Pacing Using Injectable Magnetic Microparticles.

    Science.gov (United States)

    Rotenberg, Menahem Y; Gabay, Hovav; Etzion, Yoram; Cohen, Smadar

    2016-01-01

    A noninvasive, effective approach for immediate and painless heart pacing would have invaluable implications in several clinical scenarios. Here we present a novel strategy that utilizes the well-known mechano-electric feedback of the heart to evoke cardiac pacing, while relying on magnetic microparticles as leadless mechanical stimulators. We demonstrate that after localizing intravenously-injected magnetic microparticles in the right ventricular cavity using an external electromagnet, the application of magnetic pulses generates mechanical stimulation that provokes ventricular overdrive pacing in the rat heart. This temporary pacing consistently managed to revert drug-induced bradycardia, but could only last up to several seconds in the rat model, most likely due to escape of the particles between the applied pulses using our current experimental setting. In a pig model with open chest, MEF-based pacing was induced by banging magnetic particles and has lasted for a longer time. Due to overheating of the electromagnet, we intentionally terminated the experiments after 2 min. Our results demonstrate for the first time the feasibility of external leadless temporary pacing, using injectable magnetic microparticles that are manipulated by an external electromagnet. This new approach can have important utilities in clinical settings in which immediate and painless control of cardiac rhythm is required. PMID:27091192

  9. Impact of pacing modality and biventricular pacing on cardiac output and coronary conduit flow in the post-cardiotomy patient.

    LENUS (Irish Health Repository)

    Healy, David G

    2012-02-03

    We have previously demonstrated the role of univentricular pacing modalities in influencing coronary conduit flow in the immediate post-operative period in the cardiac surgery patient. We wanted to determine the mechanism of this improved coronary conduit and, in addition, to explore the possible benefits with biventricular pacing. Sixteen patients undergoing first time elective coronary artery bypass grafting who required pacing following surgery were recruited. Comparison of cardiac output and coronary conduit flow was performed between VVI and DDD pacing with a single right ventricular lead and biventricular pacing lead placement. Cardiac output was measured using arterial pulse waveform analysis while conduit flow was measured using ultrasonic transit time methodology. Cardiac output was greatest with DDD pacing using right ventricular lead placement only [DDD-univentricular 5.42 l (0.7), DDD-biventricular 5.33 l (0.8), VVI-univentricular 4.71 l (0.8), VVI-biventricular 4.68 l (0.6)]. DDD-univentricular pacing was significantly better than VVI-univentricular (P=0.023) and VVI-biventricular pacing (P=0.001) but there was no significant advantage to DDD-biventricular pacing (P=0.45). In relation to coronary conduit flow, DDD pacing again had the highest flow [DDD-univentricular 55 ml\\/min (24), DDD-biventricular 52 ml\\/min (25), VVI-univentricular 47 ml\\/min (23), VVI-biventricular 50 ml\\/min (26)]. DDD-univentricular pacing was significantly better than VVI-univentricular (P=0.006) pacing but not significantly different to VVI-biventricular pacing (P=0.109) or DDD-biventricular pacing (P=0.171). Pacing with a DDD modality offers the optimal coronary conduit flow by maximising cardiac output. Biventricular lead placement offered no significant benefit to coronary conduit flow or cardiac output.

  10. Determination of myocardial energetic output for cardiac rhythm pacing.

    Science.gov (United States)

    Herman, Dalibor; Prevorovská, Svetlana; Marsík, Frantisek

    2007-12-01

    This research is aimed to the determination of the changes in the cardiac energetic output for three different modes of cardiac rhythm pacing. The clinical investigation of thirteen patients with the permanent dual-chamber pacemaker implantation was carried out. The patients were taken to echocardiography examination conducted by way of three pacing modes (AAI, VVI and DDD). The myocardial energetic parameters-the stroke work index (SWI) and the myocardial oxygen consumption (MVO2) are not directly measurable, however, their values can be determined using the numerical model of the human cardiovascular system. The 24-segment hemodynamical model (pulsating type) of the human cardiovascular system was used for the numerical simulation of the changes of myocardial workload for cardiac rhythm pacing. The model was fitted by well-measurable parameters for each patient. The calculated parameters were compared using the two-tailed Student's test. The differences of SWI and MVO2 between the modes AAI and VVI and the modes DDD and VVI are statistically significant (P0.05). PMID:18080208

  11. Cardiac pacing in left bundle branch/ bifascicular block patients

    Directory of Open Access Journals (Sweden)

    Maddali Madan

    2010-01-01

    Full Text Available The primary concern in patients with bifascicular block is the increased risk of progression to complete heart block. Further, an additional first-degree A-V block in patients with bifascicular block or LBBB might increase the risk of block progression. Anesthesia, monitoring and surgical techniques can induce conduction defects and bradyarrhythmias in patients with pre-existing bundle branch block. In the setting of an acute MI, several different types of conduction disturbance may become manifest and complete heart block occurs usually in patients with acute myocardial infarction more commonly if there is pre-existing or new bundle branch block. The question that arises is whether it is necessary to insert a temporary pacing catheter in patients with bifascicular block undergoing anesthesia. It is important that an anesthesiologist should be aware of the indications for temporary cardiac pacing as well as the current recommendations for permanent pacing in patients with chronic bifascicular and trifascicular block. This article also highlights the recent guidelines for temporary transvenous pacing in the setting of acute MI and the different pacing modalities that are available for an anesthesiologist.

  12. MRI with cardiac pacing devices – Safety in clinical practice

    International Nuclear Information System (INIS)

    Objectives: The aim of this study was to introduce a single centre “real life” experience of performing MRI examinations in clinical practice on patients with cardiac pacemaker systems. Additionally, we aimed to evaluate the safety of using a dedicated safety protocol for these patients. Materials and methods: We used a 1.5 T MRI scanner to conduct 68 MRI scans of different body regions in patients with pacing systems. Of the cardiac devices, 32% were MR-conditional, whereas the remaining 68% were MR-unsafe. We recorded the functional parameters of the devices prior, immediately after, and approximately one month after the MRI scanning, and compared the device parameters to the baseline values. Results: All MRI examinations were completed safely, and each device could be interrogated normally following the MRI. We observed no changes in the programmed parameters of the devices. For most of the participants, the distributions of the immediate and one-month changes in the device parameters were within 20% of the baseline values, although some changes approached clinically important thresholds. Furthermore, we observed no differences in the variable changes between MR-conditional and MR-unsafe pacing systems, or between scans of the thorax area and other scanned areas. Conclusion: MRI in patients with MR-conditional pacing systems and selected MR-unsafe systems could be performed safely under strict conditions in this study

  13. Two unsung heroes of closed-chest cardiac pacing: Green and McWilliam.

    Science.gov (United States)

    Geddes, L A

    1994-07-01

    In the latter half of the last century, cardiorespiratory arrest was not uncommon due to the anesthetic used (chloroform). Animal studies showed that the heart could be paced. One physician (Green) resuscitated 5 of 7 cardiac arrest patients with single stimuli applied to body surface electrodes. Another (McWilliam) issued a proposal for adoption of closed-chest pacing and provided information on the procedure. The following historical footnote describes these pioneering events in the history of cardiac pacing. PMID:7937239

  14. Electrical Pacing of Cardiac Tissue Including Potassium Inward Rectification.

    Science.gov (United States)

    Galappaththige, Suran; Roth, Bradley J

    2015-01-01

    In this study cardiac tissue is stimulated electrically through a small unipolar electrode. Numerical simulations predict that around an electrode are adjacent regions of depolarization and hyperpolarization. Experiments have shown that during pacing of resting cardiac tissue the hyperpolarization is often inhibited. Our goal is to determine if the inward rectifying potassium current (IK1) causes the inhibition of hyperpolarization. Numerical simulations were carried out using the bidomain model with potassium dynamics specified to be inward rectifying. In the simulations, adjacent regions of depolarization and hyperpolarization were observed surrounding the electrode. For cathodal currents the virtual anode produces a hyperpolarization that decreases over time. For long duration pulses the current-voltage curve is non-linear, with very small hyperpolarization compared to depolarization. For short pulses, the hyperpolarization is more prominent. Without the inward potassium rectification, the current voltage curve is linear and the hyperpolarization is evident for both long and short pulses. In conclusion, the inward rectification of the potassium current explains the inhibition of hyperpolarization for long duration stimulus pulses, but not for short duration pulses.

  15. Electrical Pacing of Cardiac Tissue Including Potassium Inward Rectification.

    Directory of Open Access Journals (Sweden)

    Suran Galappaththige

    Full Text Available In this study cardiac tissue is stimulated electrically through a small unipolar electrode. Numerical simulations predict that around an electrode are adjacent regions of depolarization and hyperpolarization. Experiments have shown that during pacing of resting cardiac tissue the hyperpolarization is often inhibited. Our goal is to determine if the inward rectifying potassium current (IK1 causes the inhibition of hyperpolarization. Numerical simulations were carried out using the bidomain model with potassium dynamics specified to be inward rectifying. In the simulations, adjacent regions of depolarization and hyperpolarization were observed surrounding the electrode. For cathodal currents the virtual anode produces a hyperpolarization that decreases over time. For long duration pulses the current-voltage curve is non-linear, with very small hyperpolarization compared to depolarization. For short pulses, the hyperpolarization is more prominent. Without the inward potassium rectification, the current voltage curve is linear and the hyperpolarization is evident for both long and short pulses. In conclusion, the inward rectification of the potassium current explains the inhibition of hyperpolarization for long duration stimulus pulses, but not for short duration pulses.

  16. Temporary pacing

    Directory of Open Access Journals (Sweden)

    L.J. Workman

    1983-09-01

    Full Text Available Artificial cardiac pacing, the use of electrical stimuli to cause contraction of heart muscle, is a sophisticated therapeutic and diagnostic tool. Its rapid technologic improvement since first developed in the late 1930’s by Hyman, has made it possible not only to avoid certain cases of death due to heart block, but also to extend and improve the quality of life. Pacemaker therapy is generally used to treat heart rate or rhythm disturbances, being either tachy- or bradyarrhythmias that produce a detrimental drop in cardiac output. Of the many different types of pacemakers and electrodes currently available, ventricular demand pacing is the most commonly used.

  17. Biventricular stimulation to prevent cardiac desynchronization: rationale, design, and endpoints of the 'Biventricular Pacing for Atrioventricular Block to Prevent Cardiac Desynchronization (BioPace)' study.

    Science.gov (United States)

    Funck, Reinhard C; Blanc, Jean-Jacques; Mueller, Hans-Helge; Schade-Brittinger, Carmen; Bailleul, Christophe; Maisch, Bernhard

    2006-08-01

    Despite the deleterious effects of cardiac dyssynchrony and the positive effects of cardiac resynchronization therapy, patients with high-degree atrioventricular block continue to receive desynchronizing right ventricular (RV) pacing systems. Although it is unclear whether the negative effects of RV pacing and left bundle branch block (LBBB) are comparable, and whether they depend on the presence and the degree of structural heart disease, one may hypothesize that RV pacing may have similar effects to LBBB. In the BioPace trial, the long-term effects of RV pacing vs. biventricular pacing will be prospectively compared in 1200 pacemaker patients with high likelihood of mostly paced ventricular events, regardless of whether in sinus rhythm or in atrial fibrillation (AF). After echocardiographic examination of left ventricular (LV) function, patients will be randomly assigned to the implantation of an RV vs. a biventricular pacing system and followed for up to 5 years. Primary study endpoints are survival, quality of life (QoL), and the distance covered in a 6-min hall walk (6-MHW) at 24 months after implantation. Secondary endpoints are QoL and the 6-MHW result at 12 months after implantation, hospitalization rate, LV dimensions, LV ejection fraction, and the development of chronic AF and other adverse events. PMID:16864616

  18. TEE-guided left ventricular epicardial pacing lead placement for cardiac resynchronization therapy

    Directory of Open Access Journals (Sweden)

    Rajesh Chand Arya

    2012-01-01

    Full Text Available Biventricular pacing has demonstrated improvement in cardiac functions in treating congestive cardiac failure patients. Recent trials have proven the clinical and functional benefits of cardiac resynchronization therapy in severe heart failure and intraventricular cardiac delays, mainly left bundle branch block. Biventricular pacing improves the exercise tolerance, quality of life, systolic heart function, reduces hospitalization and slows progression of the disease. A 54-year-old lady, a known case of dilated cardiomyopathy, was on biventricular pacing since 2 years. She presented in emergency with sudden deterioration of dyspnea to NYHA class III/IV. When investigated, the coronary sinus lead was found displaced; thus, left ventricle (LV was not getting paced. After multiple failures to reposition the coronary sinus lead, it was decided to surgically place the epicardial lead for LV pacing under general anesthesia. Lateral thoracotomy was done and LV pacing lead was placed at different sites with simultaneous monitoring of cardiac output (CO and stroke volume (SV by transesophageal echocardiography (TEE. Baseline CO and SV were 1.9 l/min and 19.48 ml respectively and increased at different sites of pacing at LV, the best CO and SV were 4.2 l/min and 42.39 ml respectively on lateral surface. Intraoperative TEE can calculate beat to beat stroke volume and thus CO and helps to choose optimal site for placement of epicardial pacing lead.

  19. Effects of right atrial and ventricular DDD pacing on cardiac function and ventricular contraction synchrony

    Institute of Scientific and Technical Information of China (English)

    支力大; 华伟; 张澍; 史蓉芳; 王方正; 陈新

    2004-01-01

    Background Right ventricular apical pacing has been reported to reduce cardiac performance. But there are few reports on the effects of dual chamber (DDD) pacing on cardiac function compared to sinus rhythm. In this study, we evaluated the effects of right atrial and ventricular DDD pacing on cardiac function and ventricular contraction synchrony using equilibrium radionuclide angiography.Methods Ten patients implanted with a right atrial and ventricular DDD pacemaker underwent equilibrium radionuclide angiography. The scintigraphic data were obtained during sinus rhythm and pacing rhythm. Cardiac function parameters were obtained semimanually. Phase analysis was used to study the ventricular activation sequence and ventricular synchrony.Results The left ventricular 1/3 ejection fraction decreased significantly during pacing compared with that during sinus rhythm[(23.4 ±6.1)% vs(27.7 ±4.5)%, P =0.01]. Regional ejection fraction also decreased during pacing, although the difference was not statistically significant. Phase analysis showed that the right ventricle was activated earlier than the left ventricle during pacing, and that the phase shift was significantly greater during pacing than that during sinus rhythm[64.13°±16.80° vs 52.88°± 9.26°, P =0.007]. The activation of both ventricles occurred simultaneously during sinus rhythm, with the activation sequence from proximal septum or base of left ventricle to apex. The earliest activation during pacing occurred at the right ventricular apex, and subsequently spread to the base and left ventricle.Conclusion Right atrial and ventricular DDD pacing impairs left ventricular systolic function and ventricular synchrony.

  20. Observation of blood B-type natriuretic peptide level changes in different periods and different cardiac pacing modes

    Institute of Scientific and Technical Information of China (English)

    WANG Ru-xing; LI Xiao-rong; JIANG Wen-ping; LIU Zhi-hua; YANG Xiang-jun; XIAO Chun-hui; SHAO Li-zheng; ZHU Jian-qiu

    2005-01-01

    @@ In recent years, the indications of cardiac pacing have extended continuously with the rapid development of pacing technique. Pacemaker treatment has not only limited in arrhythmias of bradycardia and the number of pacemaker treatment has increased year by year.

  1. Acute impact of pacing at different cardiac sites on left ventricular rotation and twist in dogs.

    Directory of Open Access Journals (Sweden)

    Zhi-Wen Zhou

    Full Text Available We evaluated the acute impact of different cardiac pacing sites on two-dimensional speckle-tracking echocardiography (STE derived left ventricular (LV rotation and twist in healthy dogs.Twelve dogs were used in this study. The steerable pacing electrodes were positioned into right heart through the superior or inferior vena cava, into LV through aorta across the aortic valve. The steerable pacing electrodes were positioned individually in the right atrium (RA, right ventricular apex (RVA, RV outflow tract (RVOT, His bundle (HB, LV apex (LVA and LV high septum (LVS, individual pacing mode was applied at 10 minutes interval for at least 5 minutes from each position under fluoroscopy and ultrasound guidance and at stabilized hemodynamic conditions. LV short-axis images at the apical and basal levels were obtained during sinus rhythm and pacing. Offline STE analysis was performed. Rotation, twist, time to peak rotation (TPR, time to peak twist (TPT, and apical-basal rotation delay (rotational synchronization index, RSI values were compared at various conditions. LV pressure was monitored simultaneously.Anesthetic death occurred in 1 dog, and another dog was excluded because of bad imaging quality. Data from 10 dogs were analyzed. RVA, RVOT, HB, LVA, LVS, RARV (RA+RVA pacing resulted in significantly reduced apical and basal rotation and twist, significantly prolonged apical TPR, TPT and RSI compared to pre-pacing and RA pacing (all P<0.05. The apical and basal rotation and twist values were significantly higher during HB pacing than during pacing at ventricular sites (all P<0.05, except basal rotation at RVA pacing. The apical TPR during HB pacing was significantly shorter than during RVOT and RVA pacing (both P<0.05. The LV end systolic pressure (LVESP was significantly lower during ventricular pacing than during pre-pacing and RA pacing.Our results show that RA and HB pacing results in less acute reduction on LV twist, rotation and LVESP compared

  2. Coronary grafts flow and cardiac pacing modalities: how to improve perioperative myocardial perfusion.

    LENUS (Irish Health Repository)

    D'Ancona, Giuseppe

    2012-02-03

    OBJECTIVE: Aim of this study was to investigate modifications of coronary grafts flow during different pacing modalities after CABG. MATERIALS AND METHODS: Two separate prospective studies were conducted in patients undergoing CABG and requiring intraoperative epicardial pacing. In a first study (22 patients) coronary grafts flows were measured during dual chamber pacing (DDD) and during ventricular pacing (VVI). In a second study (10 patients) flows were measured during DDD pacing at different atrio-ventricular (A-V) delay periods. A-V delay was adjusted in 25 ms increments from 25 to 250 ms and flow measurements were performed for each A-V delay increment. A transit time flowmeter was used for the measurements. RESULTS: An average of 3.4 grafts\\/patient were performed. In the first study, average coronary graft flow was 47.4+\\/-20.8 ml\\/min during DDD pacing and 41.8+\\/-18.2 ml\\/min during VVI pacing (P = 0.0004). Furthermore average systolic pressure was 94.3+\\/-10.1 mmHg during DDD pacing and 89.6+\\/-12.2 mmHg during VVV pacing (P = 0.0007). No significant differences in diastolic pressure were recorded during the two different pacing modalities. In the second study, maximal flows were achieved during DDD pacing with an A-V delay of 175 ms (54+\\/-9.6 ml\\/min) and minimal flows were detected at 25 ms A-V delay (38.1+\\/-4.7 ml\\/min) (P=ns). No significant differences in systolic or diastolic blood pressure were noticed during the different A-V delays. CONCLUSION: Grafts flowmetry provides an extra tool to direct supportive measures such as cardiac pacing after CABG. DDD mode with A-V delay around 175 ms. should be preferred to allow for maximal myocardial perfusion via the grafts.

  3. Dual-Chamber Pacing for Cardiac Arrhythmias: Controversies in Cloning the Conduction System

    OpenAIRE

    Parsonnet, Victor; Bernstein, Alan D.; Norman, John C.

    1984-01-01

    From the outset, the art and science of cardiac pacing has been beset with a variety of problems. With the passage of time and concentrated effort in the interrelated sciences, many have been solved. We no longer are concerned with premature battery failure or leaking pulse-generator capsules, but now focus on an entirely new set of issues that beg for resolution. Foremost among these is the true role of dual-chamber pacing in the treatment of slow and fast cardiac arrhythmias of a multitude ...

  4. Temporary epicardial cardiac resynchronisation versus conventional right ventricular pacing after cardiac surgery: study protocol for a randomised control trial

    Directory of Open Access Journals (Sweden)

    Russell Stuart J

    2012-02-01

    Full Text Available Abstract Background Heart failure patients with stable angina, acute coronary syndromes and valvular heart disease may benefit from revascularisation and/or valve surgery. However, the mortality rate is increased- 5-30%. Biventricular pacing using temporary epicardial wires after surgery is a potential mechanism to improve cardiac function and clinical endpoints. Method/design A multi-centred, prospective, randomised, single-blinded, intervention-control trial of temporary biventricular pacing versus standard pacing. Patients with ischaemic cardiomyopathy, valvular heart disease or both, an ejection fraction ≤ 35% and a conventional indication for cardiac surgery will be recruited from 2 cardiac centres. Baseline investigations will include: an electrocardiogram to confirm sinus rhythm and measure QRS duration; echocardiogram to evaluate left ventricular function and markers of mechanical dyssynchrony; dobutamine echocardiogram for viability and blood tests for renal function and biomarkers of myocardial injury- troponin T and brain naturetic peptide. Blood tests will be repeated at 18, 48 and 72 hours. The principal exclusions will be subjects with permanent atrial arrhythmias, permanent pacemakers, infective endocarditis or end-stage renal disease. After surgery, temporary pacing wires will be attached to the postero-lateral wall of the left ventricle, the right atrium and right ventricle and connected to a triple chamber temporary pacemaker. Subjects will be randomised to receive either temporary biventricular pacing or standard pacing (atrial inhibited pacing or atrial-synchronous right ventricular pacing for 48 hours. The primary endpoint will be the duration of level 3 care. In brief, this is the requirement for invasive ventilation, multi-organ support or more than one inotrope/vasoconstrictor. Haemodynamic studies will be performed at baseline, 6, 18 and 24 hours after surgery using a pulmonary arterial catheter. Measurements will be

  5. Effects of Long-term Right Ventricular Apical Pacing on Left Ventricular Remodeling and Cardiac Function

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    Objective: To investigate the impacts of long-term right ventricular apical pacing on the ventricular remodeling and cardiac functions of patients with high-grade and third-degree atrioventricular blockage with normal heart structures and cardiac functions. In addition, we provide many evidences for choosing an optimal electrode implantation site.Methods: Study participants included patients who were admitted for pacemaker replacements and revisited for examinations of implanted pacemakers at outpatient. Pa...

  6. Cardiac pacing device therapy for atrial dysrhythmias: how does it work?

    Science.gov (United States)

    Irwin, Marleen E

    2004-01-01

    Atrial fibrillation (AF) is the most common dysrhythmia in North America. Paroxysmal or persistent AF affects an estimated 2.8 million individuals, causes significant morbidity, and is associated with 1 billion dollars in healthcare costs each year in the United States. An aging population, the prevalence of hypertension, and the emergence of heart failure as the final common pathway of heart disease finds us in an age where the incidence of AF is ever increasing and the management challenges are indeed an expanding clinical problem. Although guidelines for selection of the appropriate pacing mode have been published, device therapy for the control of AF and paroxysmal AF is an emerging clinical management strategy. In 2001 The American College of Cardiology (ACC)/American Heart Association (AHA) published a document to revise the 1998 guidelines for device therapy, and even now these guidelines require elucidation and inclusion for the use of cardiac pacing device therapy for the control of atrial dysrhythmia. Choosing a complex system, in particular for the patient with persistent and symptomatic atrial dysrhythmia, is a most intricate challenge for the healthcare professional and the healthcare system. Rate dependent effects on refractoriness, reduction of ectopy, remodeling of the substrate, and prevention of pauses have been described as the potential mechanisms responsible for the rhythmic control effect attributed to atrial pacing. However, while permanent cardiac pacing is required for patients with symptomatic bradycardia with atrioventricular block and AF, the concept of pacing for the primary prevention of AF is novel. Pacing algorithms, single site, biatrial, and dual-site atrial pacing and site-specific pacing have all been studied as substrate modulators to prevent recurrent atrial dysrhythmia.A dilemma exists surrounding the primary approach for the control of symptomatic AF with rapid ventricular response. The question remains: should it be to

  7. Optimal Cardiac Resynchronization Therapy Pacing Rate in Non-Ischemic Heart Failure Patients

    DEFF Research Database (Denmark)

    Ghotbi, Adam Ali; Sander, Mikael; Køber, Lars;

    2015-01-01

    patients with non-ischemic heart failure (NYHA class II-III) were enrolled in a randomized, double-blind, crossover trial, in which the basal pacing rate was set at DDD-60 and DDD-80 for 3 months (DDD-R for 2 patients). At baseline, 3 months and 6 months, we assessed sympathetic nerve activity...... by microneurography (MSNA), peak oxygen consumption (pVO2), N-terminal pro-brain natriuretic peptide (p-NT-proBNP), echocardiography and QoL. RESULTS: DDD-80 pacing for 3 months increased the mean heart rate from 77.3 to 86.1 (p = 0.001) and reduced sympathetic activity compared to DDD-60 (51±14 bursts/100 cardiac...... cycles vs. 64±14 bursts/100 cardiac cycles, pDDD-60 to 16.7±6 mL/min/kg during DDD-80, and p-NT-proBNP remained unchanged. The QoL score indicated that DDD-60 was better tolerated. CONCLUSION: In CRT patients with non...

  8. In vivo mechanical study of helical cardiac pacing electrode interacting with canine myocardium

    Institute of Scientific and Technical Information of China (English)

    Xiangming Zhang; Nianke Ma; Hualin Fan; Guodong Niu; Wei Yang

    2007-01-01

    Cardiac pacing is a medical device to help human to overcome arrhythmia and to recover the regular beats of heart. A helical configuration of electrode tip is a new type of cardiac pacing lead distal tip. The helical electrode attaches itself to the desired site of heart by screwing its helical tip into the myocardium. In vivo experiments on anesthetized dogs were carried out to measure the acute interactions between helical electrode and myocardium during screw-in and pull-out processes. These data would be helpful for electrode tip design and electrode/myocardium adherence safety evaluation. They also provide reliability data for clinical site choice of human heart to implant and to fix the pacing lead.A special design of the helical tip using strain gauges is instrumented for the measurement of the screw-in and pull-out forces. We obtained the data of screw-in torques and pull-out forces for five different types of helical electrodes at nine designed sites on ten canine hearts. The results indicate that the screw-in torques increased steplike while the torque-time curves presente saw-tooth fashion. The maximum torque has a range of 0.3-1.9N mm. Obvious differences are observed for different types of helical tips and for different test sites.Large pull-out forces are frequently obtained at epicardium of left ventricle and right ventricle lateral wall, and the forces obtained at right ventricle apex and outflow tract of right ventricle are normally small. The differences in pull-out forces are dictated by the geometrical configuration of helix and regional structures of heart muscle.

  9. Exogenous midkine administration prevents cardiac remodeling in pacing-induced congestive heart failure of rabbits.

    Science.gov (United States)

    Harada, Masahide; Hojo, Mayumi; Kamiya, Kaichiro; Kadomatsu, Kenji; Murohara, Toyoaki; Kodama, Itsuo; Horiba, Mitsuru

    2016-01-01

    Midkine (MK), a heparin-binding growth factor, has been shown to prevent cardiac remodeling after ischemic injury through its anti-apoptotic effect. Cell apoptosis is central to the pathophysiology of cardiac remodeling in congestive heart failure (CHF) of ischemic as well as non-ischemic origin. We hypothesized that MK exerts the anti-apoptotic cardioprotective effect in CHF of non-ischemic etiology. MK protein or vehicle (normal saline) was subcutaneously administered in tachycardia-induced CHF rabbits (right ventricular pacing, 350 beats/min, 4 weeks). The vehicle-treated rabbits (n = 19, control) demonstrated severe CHF and high mortality rate, whereas MK (n = 16) demonstrated a well-compensated state and a lower mortality rate. In echocardiography, left ventricular (LV) end-diastolic dimension decreased in MK versus control, whereas LV systolic function increased. In histological analysis (picrosirius red staining), MK decreased collagen deposition area compared with control. TUNEL staining showed that MK prevented cell apoptosis and minimized myocyte loss in the CHF rabbit ventricle, associated with activation of PI3-K/Akt signaling, producing a parallel decrease of Bax/Bcl-2 ratio. MK prevented progression of cardiac remodeling in the CHF rabbit, likely by activation of anti-apoptotic signaling. Exogenous MK application might be a novel therapeutic strategy for CHF due to non-ischemic origin.

  10. The Australian history of cardiac pacing: memories from a bygone era.

    Science.gov (United States)

    Mond, Harry G; Wickham, Geoffrey G; Sloman, J Graeme

    2012-06-01

    Although Dr Albert Hyman in New York is believed to have built the first cardiac pacemaker in 1932, he acknowledges Dr Mark Lidwell in Sydney, Australia as having not only built a pacemaker, but also successfully used it to resuscitate a newborn infant in or before 1929. Fully implantable pacemakers, however, were not possible until 1958, following the development of the silicon transistor. Within three years of that first implant, a pulse generator attached to epicardial leads was implanted at the Royal Melbourne Hospital. About the same time, an engineer in Sydney with intermittent complete heart block who had received epicardial leads and an external pulse generator proposed a simple sensing circuit, leading to the design of the first demand pacing system. By the mid 1960s, physicians were inserting transvenous leads in the right ventricle attached to pulse generators implanted in the anterior abdominal wall. In 1963, an Australian pacemaker company, Telectronics, was founded in Sydney. This innovative company-designed many of the features of transvenous leads and pulse generators we take for granted today. Australia also played a leading role in the design or early evaluation of the lithium power source, lead fixation, steroid elution, automatic anti-tachycardia pacing algorithms and the minute ventilation rate adaptive sensor. This manuscript describes the challenges and frustrations of those pioneers: physicians, surgeons and biomedical engineers. PMID:22033147

  11. BK channels regulate sinoatrial node firing rate and cardiac pacing in vivo.

    Science.gov (United States)

    Lai, Michael H; Wu, Yuejin; Gao, Zhan; Anderson, Mark E; Dalziel, Julie E; Meredith, Andrea L

    2014-11-01

    Large-conductance Ca(2+)- and voltage-activated K(+) (BK) channels play prominent roles in shaping muscle and neuronal excitability. In the cardiovascular system, BK channels promote vascular relaxation and protect against ischemic injury. Recently, inhibition of BK channels has been shown to lower heart rate in intact rodents and isolated hearts, suggesting a novel role in heart function. However, the underlying mechanism is unclear. In the present study, we recorded ECGs from mice injected with paxilline (PAX), a membrane-permeable BK channel antagonist, and examined changes in cardiac conduction. ECGs revealed a 19 ± 4% PAX-induced reduction in heart rate in wild-type but not BK channel knockout (Kcnma1(-/-)) mice. The heart rate decrease was associated with slowed cardiac pacing due to elongation of the sinus interval. Action potential firing recorded from isolated sinoatrial node cells (SANCs) was reduced by 55 ± 15% and 28 ± 9% by application of PAX (3 μM) and iberiotoxin (230 nM), respectively. Furthermore, baseline firing rates from Kcnma1(-/-) SANCs were 33% lower than wild-type SANCs. The slowed firing upon BK current inhibition or genetic deletion was due to lengthening of the diastolic depolarization phase of the SANC action potential. Finally, BK channel immunoreactivity and PAX-sensitive currents were identified in SANCs with HCN4 expression and pacemaker current, respectively, and BK channels cloned from SANCs recapitulated similar activation as the PAX-sensitive current. Together, these data localize BK channels to SANCs and demonstrate that loss of BK current decreases SANC automaticity, consistent with slowed sinus pacing after PAX injection in vivo. Furthermore, these findings suggest BK channels are potential therapeutic targets for disorders of heart rate.

  12. Automated Electrophysiology Makes the Pace for Cardiac Ion Channel Safety Screening

    Directory of Open Access Journals (Sweden)

    Clemens eMoeller

    2011-11-01

    Full Text Available The field of automated patch-clamp electrophysiology has emerged from the tension between the pharmaceutical industry’s need for high-throughput compound screening versus its need to be conservative due to regulatory requirements. On the one hand, hERG channel screening was increasingly requested for new chemical entities, as the correlation between blockade of the ion channel coded by hERG and Torsades de Pointes cardiac arrhythmia gained increasing attention. On the other hand, manual patch-clamping, typically quoted as the gold-standard for understanding ion channel function and modulation, was far too slow (and, consequently, too expensive for keeping pace with the numbers of compounds submitted for hERG channel investigations from pharmaceutical R&D departments. In consequence it became more common for some pharmaceutical companies to outsource safety pharmacological investigations, with a focus on hERG channel interactions. This outsourcing has allowed those pharmaceutical companies to build up operational flexibility and greater independence from internal resources, and allowed them to obtain access to the latest technological developments that emerged in automated patch-clamp electrophysiology – much of which arose in specialized biotech companies. Assays for nearly all major cardiac ion channels are now available by automated patch-clamping using heterologous expression systems, and recently, automated action potential recordings from stem-cell derived cardiomyocytes have been demonstrated. Today, most of the large pharmaceutical companies have acquired automated electrophysiology robots and have established various automated cardiac ion channel safety screening assays on these, in addition to outsourcing parts of their needs for safety screening.

  13. INDICACIONES DE ESTIMULACIÓN ELÉCTRICA TRANSITORIA, COMPLICACIONES Y NECESIDAD DE ESTIMULACIÓN CARDÍACA PERMANENTE / Use of temporary cardiac pacing, its complications and need for permanent cardiac pacing

    Directory of Open Access Journals (Sweden)

    Humberto Ramos González

    2013-07-01

    Full Text Available Resumen: Introducción: La estimulación cardíaca temporal está indicada en diversas situaciones de extrema urgencia, en pacientes con bradiarritmias graves y bloqueos aurículo-ventriculares de II o III grados.Su indicación siempre se considera ante la presencia de síntomas como: compromiso hemodinámico importante, que no responde a los medicamentos, y poca tolerancia el ritmo lento. Objetivo: Describir las principales indicaciones de estimulación eléctrica transitoria que pueden llevar a la estimulación eléctrica permanente, así como las complicaciones que se presentan al utilizarla. Método: Se realizó un estudio descriptivo donde se estudiaron 266 pacientes de 281 ingresados en el Hospital "Arnaldo Milián Castro", a los cuales se les implantó un marcapasos transitorio. Se describen las indicaciones y complicaciones del procedimiento. Resultados: Se observó un mayor número de indicaciones de estimulación eléctrica transitoria cuando aumenta la edad de la población en estudio, 45,86 % para los mayores de 80 años. El sexo femenino predominó (156 pacientes, con una relación mujer-hombre de 1,56:1. La causa degenerativa (42,1 % fue la mayor indicación de estimulación eléctrica permanente. La punción de vasos no deseados fue la complicación más frecuente (7,1 %. Conclusiones: La indicación de estimulación eléctrica transitoria es más frecuente en los mayores de 80 años, principalmente por causa degenerativa, que finalmente lleva a la estimulación eléctrica permanente. El porcentaje de complicaciones no se muestra elevado cuando se tiene en cuenta que este procedimiento no se realizó bajo visión fluoroscópica. / Abstract: Introduction: Temporary cardiac pacing is used in various extreme emergency situations, in patients with severe bradyarrhythmias and second and third degree atrioventricular block. Its use is always considered when there are symptoms such as a significant hemodynamic compromise, not responding

  14. A comparison of sympathoadrenal activity and cardiac performance at rest and during exercise in patients with ventricular demand or atrial synchronous pacing.

    OpenAIRE

    Pehrsson, S K; Hjemdahl, P; Nordlander, R; Aström, H

    1988-01-01

    Cardiac sympathetic function was assessed by measuring the coronary sinus overflow of noradrenaline and dopamine at rest and during supine exercise in eight patients with high degree atrioventricular block treated with dual chamber pacemakers (DDD). Patients exercised (30-60 W) during both ventricular inhibited (VVI) and atrial synchronous (VAT) pacing. During exercise cardiac output increased less markedly in the VVI mode than in the VAT mode. The cardiac output response was entirely stroke ...

  15. Cardiac Pacing in Cienfuegos from 2005 to 2009 Comportamiento de la estimulación cardiaca en Cienfuegos durante el quinquenio 2005 – 2009

    Directory of Open Access Journals (Sweden)

    Yanier Coll Muñoz

    2011-03-01

    Full Text Available Introduction: permanent artificial pacemaker implantation improves cardiac function and life quality of patients requiring cardiac pacing. Objective: to describe the characteristics of patients undergoing permanent artificial pacemaker implantation and their results, in the period from January 2005 to December 2009 in the General University Hospital “Dr. Gustavo Aldereguía Lima". Methods: a descriptive study was conducted. The sample consisted of 300 patients who were implanted with permanent artificial pacemakers in the Cardiology Service of the General University Hospital “Dr. Gustavo Aldereguía Lima" in Cienfuegos, from 2005 to 2009. General data were collected from patients such as diagnosis, pacing mode used, surgical approach and complications. Results: the predominant age group was that of elderlies over 75 years old, and mostly males were predominant. The main action taken was that of a first implant using the cephalic vein dissection. The most common causes of implant were blocks the atrioventricular conduction and sinus node disease. The type of stimulation used was the VV-VVIR. Major complications included displacement of the electrode, hematomas and the pacemaker syndrome. Conclusion: the number of patients requiring cardiac electrical stimulation continues to increase in Cienfuegos. Elderly patients and the type of single-chamber pacing are predominant. Good results have been obtained with few complications.Introducción: la implantación de un marcapaso permanente mejora la función cardiaca y la calidad de vida de los pacientes con necesidad de estimulación eléctrica cardiaca. Objetivo: describir las características de los pacientes sometidos a implante de marcapasos permanentes y sus resultados, en el quinquenio de enero de 2005 a diciembre de 2009 en el Hospital General Universitario ¨Dr. Gustavo

  16. IN VIVO CHARACTERIZATION OF ATTACHMENT SAFETY BETWEEN CARDIAC PACING LEAD AND CANINE HEART MUSCLE

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    In vivo experiments of screwing the electrode of canine hearts and assigning external excitation on the lead-myocardium interface was carried out to evaluate the lead/myocardium adherence safety. The electrode is specially designed to host a measurement unit of strain gauges.We obtained the lead/heart interactions data from 12 dogs under natural heart beating and beating with external excitations. The data recorded from the acute phase and the chronic phase of pulling out pacing leads were compared with each other. The electrode/heart interaction is caused by the heart beat and influenced by the lung breath. This process induced tolerable damage to the lead or myocardium. The interaction decreases as the frequency of external excitations increases. The lead is more likely to be detached from myocardium under higher excitation frequency. At the same implanting sites, safer pacing lead/myocardium attachment can be realized in the chronic tests than in the acute tests.

  17. Pacing to treat low cardiac output syndrome following elective aortic valve replacement

    Directory of Open Access Journals (Sweden)

    Muhammad Ishaq

    2012-01-01

    Full Text Available We report a case of low cardiac output syndrome caused by dynamic left ventricular (LV outflow obstruction after aortic valve replacement (AVR. This recognized phenomenon probably occurs more frequently than appreciated, and the author suggests that this should be considered when managing patients with severe hemodynamic instability after AVR. In addition, we also focus on the fact that invasive pacemaker systems have significant effects on cardiac output augmentation postoperatively and in long-term management of patients with LV outflow tract (LVOT obstruction following AVR. The possible mechanisms and subsequent treatments are discussed.

  18. Relationship between seasonal weather changes, risk of dehydration, and incidence of severe bradyarrhythmias requiring urgent temporary transvenous cardiac pacing in an elderly population

    Science.gov (United States)

    Palmisano, Pietro; Accogli, Michele; Zaccaria, Maria; Vergari, Alessandra; De Luca De Masi, Gabriele; Negro, Luca; De Blasi, Sergio

    2014-09-01

    There is little information on any seasonal variations or meteorological factors associated with symptomatic bradyarrhythmias requiring cardiac pacing. The aim of this single-center study was to investigate the seasonal distribution of the incidence of severe, life-threatening bradyarrhythmias requiring urgent temporary transvenous cardiac pacing in an elderly population. Consecutive patients who underwent urgent temporary transvenous cardiac pacing between 2007 and 2012 were enrolled. The baseline characteristics of the patients and some meteorological parameters, including the calculation the daily heat index (HI), were recorded. During the study period, 79 consecutive patients (mean age 82 ± 8 years, 41 % male) underwent urgent temporary transvenous cardiac pacing, mainly for third-degree atrioventricular block (79 %). The incidence of bradyarrhythmias was significantly higher in summer than in the other seasons ( P 90 °F for >3 h per day for at least 10 days ( P increased incidence of severe bradyarrhythmias in an elderly population during the hottest months of the year. In these months, in subjects characterized by increased susceptibility to dehydration, the risk of developing bradyarrhythmias was increased significantly.

  19. Qualitative and Quantitative Assessment of Metal Artifacts Arising from Implantable Cardiac Pacing Devices in Oncological PET/CT Studies : A Phantom Study

    NARCIS (Netherlands)

    Ay, Mohammad R.; Mehranian, Abolfazl; Abdoli, Mehrsima; Ghafarian, Pardis; Zaidi, Habib

    2011-01-01

    Purpose: We evaluate the magnitude of metallic artifacts caused by various implantable cardiac pacing devices (without leads) on both attenuation maps (mu-maps) and positron emission tomography (PET) images using experimental phantom studies. We also assess the efficacy of a metal artifact reduction

  20. Keeping Pace with New Technology: An Introduction to Robotics, FORTH, and Artificial Intelligence.

    Science.gov (United States)

    Reck, Gene

    A course was developed to introduce students at a community college to four major areas of emphasis in emerging technologies: FORTH programming language, elementary electronic theory, robotics, and artificial intelligence. After a needs assessment indicated the importance of such a course, a pretest focusing on the four areas was given to students…

  1. OPTOGENETICS: A NOVEL APPROACH IN PACING HAERT TISSUE AND ENGENDER PROPAGATING CARDIAC IMPULSES

    Directory of Open Access Journals (Sweden)

    Pasam Naga Abhinay

    2012-04-01

    Full Text Available The cardiac pacemaker controls the rhythmicity of heart contractions and these can be substituted by battery-operated devices as last resource. Optogenetics involves insertion of light-sensitive proteins into human embryonic stem cell to encode DNA making mammalian tissues light-sensitive. The first discovered protein of this type is Channelrhodopsin2 (ChR2, which is widely used in neuroscience. The limitation of electrical stimulation of heart, a standard technique can be overcome by using ChR2.The various methods involved in optogenetics and energy needs were discussed in this section. Initially, optogenetics is confined only to neuronal system, later on extended to heart and other organs. This method involves precise localized stimulation and constant prolonged depolarization of cardiomyocytes and cardiac tissue resulting in alterations of pacemaking, Ca2+ homeostasis, electrical coupling and arrhythmogenic spontaneous extra beats.

  2. Association between frequency of atrial and ventricular ectopic beats and biventricular pacing percentage and outcomes in patients with cardiac resynchronization therapy

    DEFF Research Database (Denmark)

    Ruwald, Martin H; Mittal, Suneet; Ruwald, Anne-Christine;

    2014-01-01

    -defibrillator device with data available on biventricular pacing percentage and pre-implantation 24-h Holter recordings were included. Using logistic regression, we estimated the influence of ectopic beats on the percentage of biventricular pacing. Reverse remodeling was measured as reductions in atrial and left...... ventricular end-systolic volumes (LVESV) at 1 year. Cox models were used to assess the influence of ectopic beats on the outcomes of heart failure (HF) or death, ventricular tachyarrhythmias (VTAs), and death. RESULTS: In the pre-implantation Holter recording, ectopic beats accounted for a mean 3.2 ± 5...... biventricular pacing (Holter monitoring of patients selected for CRT for optimal outcome. (MADIT-CRT: Multicenter Automatic Defibrillator Implantation With Cardiac Resynchronization...

  3. Left ventricular pacing vector selection by novel echo-particle imaging velocimetry analysis for optimization of quadripolar cardiac resynchronization device: a case report

    OpenAIRE

    Martiniello, Alfonso/A. Roberto/R.; Pedrizzetti, Gianni/G.; Bianchi, Valter/V.; Tonti, Giovanni/G.; D’Onofrio, Antonio/A.; Caso, Pio/P.

    2016-01-01

    Background The availability of pacing configurations offered by quadripolar left ventricular leads could improve patients’ response to cardiac resynchronization therapy; however, the selection of an optimal setting remains a challenge. Echo-particle imaging velocimetry has shown that regional anomalies of synchrony/synergy of the left ventricle are related to the alteration, reduction, or suppression of the physiological intracavitary pressure gradients. These observations are also supported ...

  4. Organ Protective Effect of Isoflurane Anesthesia in Cardiac Surgeries with Artificial Circulation

    OpenAIRE

    Eldyrev А.Y.; Medvedev А.P.; Bober V.M.; Bogush А.V.; Yakovleva Е.I.; Leckwantee Rittoo; Pichugin V.V.

    2012-01-01

    The aim of the investigation is to give full estimation of organ protective effect of isoflurane anesthesia in cardiac surgeries with artificial circulation. Materials and Methods. There were analyzed the results of clinical, functional, biochemical and morphological examinations of 424 patients operated under the conditions of artificial circulation using two variants of anesthesia: 203 patients were given isoflurane (experimental group); 221 patients — propofol (control group). There we...

  5. Relationship Between Changes in Pulse Pressure and Frequency Domain Components of Heart Rate Variability During Short-Term Left Ventricular Pacing in Patients with Cardiac Resynchronization Therapy

    Science.gov (United States)

    Urbanek, Bożena; Ruta, Jan; Kudryński, Krzysztof; Ptaszyński, Paweł; Klimczak, Artur; Wranicz, Jerzy Krzysztof

    2016-01-01

    Background The aim of the study was to explore the relationship between changes in pulse pressure (PP) and frequency domain heart rate variability (HRV) components caused by left ventricular pacing in patients with implanted cardiac resynchronization therapy (CRT). Material/Methods Forty patients (mean age 63±8.5 years) with chronic heart failure (CHF) and implanted CRT were enrolled in the study. The simultaneous 5-minute recording of beat-to-beat arterial systolic and diastolic blood pressure (SBP and DBP) by Finometer and standard electrocardiogram with CRT switched off (CRT/0) and left ventricular pacing (CRT/LV) was performed. PP (PP=SBP-DBP) and low- and high-frequency (LF and HF) HRV components were calculated, and the relationship between these parameters was analyzed. Results Short-term CRT/LV in comparison to CRT/0 caused a statistically significant increase in the values of PP (P<0.05), LF (P<0.05), and HF (P<0.05). A statistically significant correlation between ΔPP and ΔHF (R=0.7384, P<0.05) was observed. The ΔHF of 6 ms2 during short-term CRT/LV predicted a PP increase of ≥10% with 84.21% sensitivity and 85.71% specificity. Conclusions During short-term left ventricular pacing in patients with CRT, a significant correlation between ΔPP and ΔHF was observed. ΔHF ≥6 ms2 may serve as a tool in the selection of a suitable site for placement of a left ventricular lead. PMID:27305349

  6. Effects of pacing site and stimulation history on alternans dynamics and the development of complex spatiotemporal patterns in cardiac tissue

    Directory of Open Access Journals (Sweden)

    Alessio eGizzi

    2013-04-01

    Full Text Available Alternans of action potential duration has been associated with T-wave alternans and the development of arrhythmias because it produces large gradients of repolarization. However, little is known about alternans dynamics in large mammalian hearts. Using optical mapping to record electrical activations simultaneously from the epicardium and endocardium of 9 canine right ventricles, we demonstrate novel arrhythmogenic complex spatiotemporal dynamics. (i Alternans predominantly develops first on the endocardium. (ii The postulated simple progression from normal rhythm to concordant to discordant alternans is not always observed; concordant alternans can develop from discordant alternans as the pacing period is decreased. (iii In contrast to smaller tissue preparations, multiple stationary nodal lines may exist and need not be perpendicular to the pacing site or to each other. (iv Alternans has fully three-dimensional dynamics and the epicardium and endocardium can show significantly different dynamics: multiple nodal surfaces can be transmural or intramural and can form concave/convex surfaces resulting in islands of discordant alternans. (v The complex spatiotemporal patterns observed during alternans are very sensitive to both the site of stimulation and the stimulation history. Alternans in canine ventricles not only exhibit larger amplitudes and persist for longer cycle length regimes compared those found in smaller mammalian hearts, but also show novel dynamics not previously described that enhance dispersion and show high sensitivity to initial conditions. This indicate some underlying predisposition to chaos and can help the design of new drugs and devices controlling and preventing arrhythmic events.

  7. Effects of Calcium-Channel Noise on Dynamics of Excitation-Contraction Coupling in Paced Cardiac Cells

    Directory of Open Access Journals (Sweden)

    Jiying Ma

    2013-01-01

    Full Text Available We study a simple discrete model with the impact of calcium-channel noise on the beat-to-beat dynamics of cardiac cells. The effects of the noise are assessed by bifurcation analysis and power spectrum analysis, respectively. It is shown that this model can undergo period-doubling bifurcation and Hopf bifurcation if there are not random perturbations. Under random perturbations, the period-doubling bifurcations of the model can be observed, and the invariant curve from Hopf bifurcation is perturbed to an annulus on the plane and then becomes a totally disordered and randomly scattered region. By the power spectrum analysis, we find that the existence of high-frequency peak in the power spectra links to the period-doubling orbits, while the existence of low-frequency peak corresponds to quasiperiodic orbit.

  8. The influence of different SPECT reconstruction algorithms on cardiac ischemia with the use artificial neural networks

    International Nuclear Information System (INIS)

    The aim of the study was the attempt to evaluate the influence of two different methods of cardiac perfusion SPECT reconstruction (FBP and ITW) on clinical efficacy in diagnosing the coronary artery disease as well as the cardiac ischemia detection in three areas of heart vascularized by main coronary arteries: LAD, LCX and RCA with the use of artificial neural networks (ANN). The study was performed retrospectively with the use of the diagnostic image records as well as clinical dataset of 43 patients. Myocardial perfusion stress/rest SPECT study and X-ray coronarography data were evaluated for each patient. The results of coronary angiography were considered the reference method. The cardiac SPECT data were reconstructed using the two different methods: filtered backprojection (FBP) and iterative Wallis method (ITW). The local perfusion deficits denominated in stress and rest study in three main vessel cardiac segments were the main input values for the ANN. The sensitivity of detection of coronary artery disease with the of ANN was 95% for both FBP and ITW reconstruction technique (p≥0.05). The sensitivity analysis of regional ischemia detection by ANN in areas LAD, LCX and RCA provided 97%, 65% and 64%, correspondingly for FDP method. With the use of ITW algorithm the sensitivity in the respective regions was: 65%, 55% and 60%. The difference in sensitivity of ANN ischemia detection for the LAD region was statistically significant for FDP versus ITW reconstruction algorithm (p=0.0007). No statistical discrepancy in sensitivity was stated in the other regions due to reconstruction technique (p≥0.005). The compared method of reconstruction of myocardial perfusion SPECT studies the do not influence the clinical efficacy in diagnosing the coronary disease with the use of ANN. In case of ANN application for local ischemia recognition results of the study indicate the FBP algorithm effective. (author)

  9. Design and Application of Cardiac Stimulator for Rapid Atrial Pacing Animal Model%心房快速起搏动物模型刺激器的设计与应用

    Institute of Scientific and Technical Information of China (English)

    秦勇; 于佳慧; 周真; 魏宏明

    2014-01-01

    该文设计一种用于心房快速起搏动物模型的刺激器。刺激器可根据临床研究的需要,设计刺激输出脉冲频率,通过体外控制实现刺激器的启停。并通过动物实验,初步验证了刺激器用于心房颤动模型建立的有效性。%A cardiac stimulator for rapid atrial pacing animal model was designed in this paper. According to the needs of clinical research, output pulse parameters of the cardiac stimulator can be designed. The cardiac stimulator wil be control ed through magnet. Efficiency of the cardiac stimulator was validated by animal experiments.

  10. 球囊漂浮电极导管床旁心脏临时起搏术40例临床分析%Clinical analysis of floating catheter in bedside temporary cardiac pacing in 40 patients

    Institute of Scientific and Technical Information of China (English)

    叶剑飞; 刘晓凯; 郑林; 茅焕豪; 郑伟峰; 张茗茗

    2012-01-01

    Objectives To observe the clinical effect of floating catheter in bedside temporary cardiac pacing. Methods Forty patients with severe bradyarrhythmia were included in this study and floating catheter for temporary cardiac pacing was propelled into right ventricle by Seldinger technique without fluoroscopy, under the guidance of bedside electrocardiography monitoring. The location of electrods were confirmed by QRS wave. The duration of placing floating catheter and the average time of pacing were recorded, and the complications of pacing were observed. Results Forty patients were successfully punctured, with an average duration of placing floating catheter of(9.1±2.1) min, pacing time of 1-15 days (median time of 5.5 days). Two cases were on loosen electrode, but no other complications were found. Conclusions Bedside floating electrode catheter can be used without fluoroscopy and replacement of critical patients in emergent pacing, with characters of easy performing, rapid pacing, definite effects and relative safety, and it is suitable for promotion in primary hospitals.%目的 观察漂浮电极导管床旁临时心脏起搏的临床应用效果.方法 对40例严重缓慢型心律失常患者在床旁体表心电图临护指导下,通过Seldinger穿刺技术,在无X线透视条件下将临时起搏漂浮电极导管送人右心室,通过体表心电图QRS波群确定电极位置.记录放置电极导管所花费的时间与平均起搏时间,观察临时起搏操作并发症.结果 40例患者穿刺均获成功,安置球囊漂浮电极导管平均操作时间(9.1±2.1) min,起搏时间1-15 d,中位时间5.5d.电极脱位2例,无其他并发症.结论 床旁漂浮电极导管可在没有X线设备下紧急起搏而不需搬动危重患者,具有操作简单、起搏迅速、疗效肯定及相对安全的特点,适合在基层医院推广应用.

  11. Vector flow mapping for assessing Beagle dogs′ left ventricular vortex in selective bi-polar single site cardiac pacing%超声血流向量成像评价健康比格犬心脏不同位点起搏左心室血流涡旋

    Institute of Scientific and Technical Information of China (English)

    丁戈琦; 尹立雪; 王志刚; 陆景; 李文华; 张红梅

    2015-01-01

    Objective To investigate the changes of left ventricular(LV) vortex strength(VS) and distribution during selective cardiac pacing in a phases of cardiac cycle using vector flow mapping techniques ,and associate with LV mechanical performance ,so as to provide basic experimental database for optimizing the sites of the artificial cardiac pacing in clinic conditions .Methods Eight heathy open‐chest Beagle dog models were employed for selective right ventricular apical (RVAP ) ,left ventricular apical (LVAP) and lateral wall pacing (LVLP) .The standard two‐dimensional apical three views with color Doppler flow and dynamic two‐dimensional images were acquired consecutively in three cardiac cycles for further off‐line analysis ,conventional parameters were measured at same time .Results Compared with baseline ,LVSV ,LVEF ,LVCO and dp/dtmax were both reduced ,and the parameters obtained leftside cardiac pacing were lower than that of right ventricular pacing ( P < 0 0.5) ,there′s no significant difference in E/Vp .The vortex pattern ,distribution and vorticity at six typical phases induced by selective cardiac pacing were totally different from those at baseline with sinus rhythm ,and leftside pacing were worsen than RVAP ,the LVAP were most obvious .On multivariable regression analysis ,the VS during ES (VSES ) at baseline was independently related to late‐diastolic VS and longitudinal strain (R2 = 0 6.3 ,P < 0 0.01 and P=0 0.03 ,respectively) .Conclusions The selective cardiac pacing could induce intracardiac vortex changes and differ from that at baseline ,and the persistence of vortex from late diastole into ES is a haemodynamic measure of coupling between diastole and systole .%目的:应用超声血流向量成像(VFM)技术评价健康比格犬心脏不同位点起搏心动周期内左室流场涡旋分布、强度变化及心肌力学参数,探讨起搏状态下心腔内涡旋变化特征,为临床优化人工心脏起搏位点提供流体

  12. Temporary Cardiac Pacing Experiment in Self-Developed Intervention Treatment Shelter in Maneuver Environment%模拟野战条件,自主研制介入方舱内临时起搏实验

    Institute of Scientific and Technical Information of China (English)

    霍煜; 梁延春; 姚天明; 孙景阳; 梁卓; 韩雅玲

    2011-01-01

    Objective: To assess the feasibility and timeliness of emergency temporary cardiac pacing in self-developed intervention treatment shelter in maneuver environment.Methods:Five dogs were temporarily paced in the shelter,and we observe the time,success rates of the rescue procedure and copperation of the faculties.Results:Five dogs were all successfully paced by the common temporary overdriving endocardium pacing electrode.They all complete in eight minutes.there was no any complication like hcmatoma at siteofparacentesis,infection,thromboembolism,cardiac perforation in all dogs.Conclusions:The process of emergency temporary cardiac pacing in high-speed minimally invasive intervention treatment shelter in wild environment is safe,practical and fast.It may play an important role during emergency aid either in wartime or peacetime.%目的:研究模拟野战条件下在自主创新研制介入方舱内行临时起搏实验的可行性和时效性.方法:对5例正常狗在微创介入方舱内使用普通电极导管进行急诊心脏临时起搏模拟操作,观察该过程的时间,和操作效果,以及舱内人员的配合.结果:应用普通电极导管急诊心脏超速起搏5例全部成功,股静脉穿刺,无穿刺部位血肿、感染,血栓栓塞,心脏穿孔等并发症发生.时间在10分钟以内.结论:依托微创介入方舱,在野外恶劣条件下进行临时起搏的急救过程安全,实用,快捷.可用于战时以及非战争卫勤急救任务中,发挥重要作用.

  13. Optogenetic pacing in Drosophila melanogaster (Conference Presentation)

    Science.gov (United States)

    Alex, Aneesh; Li, Airong; Men, Jing; Jerwick, Jason; Tanzi, Rudolph E.; Zhou, Chao

    2016-03-01

    A non-invasive, contact-less cardiac pacing technology can be a powerful tool in basic cardiac research and in clinics. Currently, electrical pacing is the gold standard for cardiac pacing. Although highly effective in controlling the cardiac function, the invasive nature, non-specificity to cardiac tissues and possible tissue damage limits its capabilities. Optical pacing of heart is a promising alternative, which is non-invasive and more specific, has high spatial and temporal precision, and avoids shortcomings in electrical stimulation. Optical coherence tomography has been proved to be an effective technique in non-invasive imaging in vivo with ultrahigh resolution and imaging speed. In the last several years, non-invasive specific optical pacing in animal hearts has been reported in quail, zebrafish, and rabbit models. However, Drosophila Melanogaster, which is a significant model with orthologs of 75% of human disease genes, has rarely been studied concerning their optical pacing in heart. Here, we combined optogenetic control of Drosophila heartbeat with optical coherence microscopy (OCM) technique for the first time. The light-gated cation channel, channelrhodopsin-2 (ChR2) was specifically expressed by transgene as a pacemaker in drosophila heart. By stimulating the pacemaker with 472 nm pulsed laser light at different frequencies, we achieved non-invasive and more specific optical control of the Drosophila heart rhythm, which demonstrates the wide potential of optical pacing for studying cardiac dynamics and development. Imaging capability of our customized OCM system was also involved to observe the pacing effect visually. No tissue damage was found after long exposure to laser pulses, which proved the safety of optogenetic control of Drosophila heart.

  14. The association between biventricular pacing and cardiac resynchronization therapy-defibrillator efficacy when compared with implantable cardioverter defibrillator on outcomes and reverse remodelling

    DEFF Research Database (Denmark)

    Ruwald, Anne-Christine; Kutyifa, Valentina; Ruwald, Martin H;

    2015-01-01

    : Using Kaplan-Meier plots, we estimated the threshold of BIV pacing percentage needed for CRT-D to be superior to ICD on the end-point of heart failure (HF) or death in 1219 left bundle branch block (LBBB) patients in the MADIT-CRT trial. Patients were censored at the time of crossover. In multivariable...

  15. Study on Apoptosis and Expression of P53, Bcl-2, Bax in Cardiac Myocytys of Congestive Heart Failure Induced by Ventricular Pacing

    Institute of Scientific and Technical Information of China (English)

    QI; Benling; CAO; Linsheng; WANG; Lin; ZHOU; Jingqun

    2001-01-01

    The apoptosis and the expression of p53, bcl-2 and Bax in myocytes of chronic rapid ventricular pacing-induced congestive heart failure (CHF) in rabbits were investigated. The CHF rabbit model (P, n= 7) was established by chronic rapid ventricular pacing for 3 weeks. By using TUNEL technique the apoptosis in the myocytes in the rabbit model was studied and the expression of p53,bcl-2 and Bax in myocytes was detected by using immunohistochemical method. Sham-operated (C,n = 9) group served as control group. The results showed that there were about 4033± 884.56 apoptotic cells/106 myocytes in P group, but no apoptotic cells were found in C group. Myocytes positive for p53 immunoreactivity (18. 86±8. 48 vs 5. 06±0. 87, P<0.01) and positive for Bax immunoreactivity (7. 15±1.91 vs 0. 43±0. 09, P<0.01) were increased in P group as compared with those in C group, while the myocytes positive for bcl-2 immunoreactivity (7. 08±1.05 vs 14. 97±4.47,P<0. 01) and the ratio of bcl-2/Bax were decreased in P group as compared with those in C group.Apoptosis was involved in the development of CHF induced by continuously rapid ventricular pacing in rabbit. The expression of p53 and Bax was increased, while the expression of bcl-2 was inhibited.These might play an important role in the acceleration of the apoptosis.

  16. Development of Pacing, Electrophysiology and Defibrillation in India

    OpenAIRE

    Nair, Mohan; Francis, Johnson; Venugopal, K

    2002-01-01

    History of cardiac pacing in India dates back to late 1960s. Kar1 reported that cardiac pacing was introduced in India in 1966. Basu2 while discussing on cardiac pacemaking in Calcutta, mentions that the first pacing was performed in April 1967 at the Institute of Post Graduate Medical Education and Research (IPGME&R). Bhatia et al3 started pacemaker implantation at AIIMS, New Delhi in 1968. Their first patient was a doctor from Assam and the pulse generator was supplied by Medtronic Inc. Th...

  17. Sensing and stimulation of the vagus nerve for artificial cardiac control

    NARCIS (Netherlands)

    Ordelman, Simone Cornelia Maria Anna

    2012-01-01

    This thesis focuses on sensing cardiovascular signals from the vagus nerve and electrically stimulating the vagus nerve for cardiovascular effects. Sensing cardiovascular signals was attempted on both spontaneous and evoked neural activity. A cardiac-modulated vagus nerve activity pattern was found

  18. Influence of High Right Ventricular Septal Pacing and Right Ventricular Apical Pacing on Cardiac Function%高位右室间隔部起搏与右室心尖部起搏对患者心功能的影响

    Institute of Scientific and Technical Information of China (English)

    贾国力; 邢程; 王海珠; 韩彩萍

    2015-01-01

    Objective:To explore the influence of high right ventricular septal(HRVS)pacing and right ventricular apical(RVA)pacing on patients’ cardiac function,left ventricular remodeling and ventricular synchrony.Method:126 patients who implanted VVI pacemaker because ofⅢdegree atrioventricular block(ⅢAVB)or sick sinus syndrome(SSS)in our hospital from January 2008 to December 2012 were selected as the research objects.Among them,there were 61 cases with RVA pacing and 65 cases with HRVS.The left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD), QRS wave group width and New York Heart Association(NYHA)functional classification of the two groups were observed and compared before operation and six months,1 year after operation.The number of hospitalizations for heart failure after operation was compared between the two groups.Result:Before treatment,the differences in the indexes of the two groups were not statistically significant(P>0.05).Six months and one year after surgery,the LVEF of the HRVS group was higher than that of the RVA group,the LVEDD and QRS wave width of the HRVS group were lower than those of the RVA group,the differences above were all statistically significant(P0.05),术后6个月及1年,HRVS组LVEF高于RVA组,LVEDD及QRS波宽度均低于RVA组,比较差异均有统计学意义(P<0.05);术后1年,HRVS组NYHA心功能Ⅲ/Ⅳ级及因心力衰竭住院患者数低于RVA组,比较差异均有统计学意义(P<0.05)。结论:HRVS起搏对心脏起搏治疗患者心功能的不利影响低于RVA起搏,是更理想的起搏部位。

  19. Effects of VAT and DDD pacing on left cardiac function in the patients of high right ventricular septal pacing with third degree atrioventricular block%Ⅲ度房室传导阻滞患者高位右室间隔部起搏VAT与DDD模式对左心功能的影响

    Institute of Scientific and Technical Information of China (English)

    王燕; 章蓉; 王旭; 邵一兵

    2012-01-01

    目的 通过研究Ⅲ度房室传导阻滞患者高位右室间隔部起搏( HRVS)时,VAT与DDD模式对心功能的影响,探讨心房的生理收缩和舒张对左心功能的作用.方法 32例Ⅲ度房室传导阻滞患者,在HRVS时,分别给予DDD模式或VAT模式工作,于调控即刻通过超声心动图测定二尖瓣口快速充盈期峰值血流速度(Ep),二尖瓣口左房收缩期峰值血流速度(Ap),二尖瓣环后壁处收缩期脉冲组织多普勒峰值速度平均值(Vs),二尖瓣环后壁处舒张早期脉冲组织多普勒峰值速度平均值(Ve),二尖瓣环后壁处舒张晚期脉冲组织多普勒峰值速度平均值(Va),二尖瓣血流频谱等容舒张时间(IVRT),通过Ep/Ap,Ve/Va,Ep/Ve和IVRT评价左室舒张功能,通过Vs,LVEF和LVFS评价收缩功能.结果 HRVS时DDD较VAT模式Ep/Ap、Ve/Va、Ep/Ve,IVRT差异有显著性(0.97 ±0.11 vs 1.01±0.11,0.89 ±0.09 vs 0.97 ±0.07,6.00 ±0.45 vs 6.24 ±0.36,100.4±14.32 vs 89.99 ±7.94;P均<0.01),Vs、左室射血分数和左室短轴缩短率无显著性差异.结论 Ⅲ度房室传导阻滞时,HRVS起搏时,DDD模式较VAT模式使左室舒张功能下降,收缩功能无影响,表明了心房生理性起搏的重要性.%Objective To analyze the effects of physiologic systole and diastole of atrium, through the influence of VAT and DDD pacing mode on left cardiac function in patients of high right ventricular septal( HRVS) pacing with third degree atrioventricular block. Methods Thirty-two patients of HRVS pacing with third degree atrioventricular block with pacemaker mode of VAT or DDD underwent complete standard echocardiography (2D,M-mode, pulsed Doppler) and PW-DTI. Transmitral inflow velocity Ep and Ap, peak systolic velocity ( Vs ) , peak early diastolic velocity ( Ve) , peak late diastolic velocity (Va) of posterior mitral annulus and the isovolumic relaxation time(IVRT) were obtained . Then left ventricular diastolic function were evaluated through Ep/Ap, Ve/Va and Ep

  20. Indeterminacy of Spatiotemporal Cardiac Alternans

    CERN Document Server

    Zhao, Xiaopeng

    2007-01-01

    Cardiac alternans, a beat-to-beat alternation in action potential duration (at the cellular level) or in ECG morphology (at the whole heart level), is a marker of ventricular fibrillation, a fatal heart rhythm that kills hundreds of thousands of people in the US each year. Investigating cardiac alternans may lead to a better understanding of the mechanisms of cardiac arrhythmias and eventually better algorithms for the prediction and prevention of such dreadful diseases. In paced cardiac tissue, alternans develops under increasingly shorter pacing period. Existing experimental and theoretical studies adopt the assumption that alternans in homogeneous cardiac tissue is exclusively determined by the pacing period. In contrast, we find that, when calcium-driven alternans develops in cardiac fibers, it may take different spatiotemporal patterns depending on the pacing history. Because there coexist multiple alternans solutions for a given pacing period, the alternans pattern on a fiber becomes unpredictable. Usin...

  1. Design of an exterior-chargeable implanted artificial cardiac pacemaker%体外充电植入式人工心脏起搏器的设计

    Institute of Scientific and Technical Information of China (English)

    温志浩; 陈海军

    2011-01-01

    背景:人工心脏起搏器长期植入人体,使用寿命至关重要,目前尚没有可充电的植入式人工心脏起搏器问世.目的:探讨植入式人工心脏起搏器体外充电技术,以期降低人工心脏起搏器寿命对电池能量的依赖.方法:利用某种对人体无创、无害的介质,把体外能量隔离传输给植入体内的接收转换装置,进而对人工心脏起搏器可充电电池的能量给予补充,以延长使用寿命.结果与结论:试制了可充电人工心脏起搏器实验样机,完成了一期动物实验,同时以超声波为能量传输载体进行了隔离无创充电试验,对相关技术做了探讨.%BACKGROUND: An artificial cardiac pacemaker has to be implanted into human body for a long time, so its life-span is very important. The cell energy is an important factor, especially in energy-consuming implanted artificial cardiac pacemaker.Currently, an exterior-chargeable implanted artificial cardiac pacemaker has not been invented.OBJECTIVE: To study on the exterior-chargeable technology, reduce artificial cardiac pacemaker's dependence on the cell energy, hoping to solve the technology problem of tremble-removing implanted artificial cardiac pacemaker.METHODS: The author proposed to use a certain medium, which is woundless and harmless to human body, transfers exterior energy to the receiver implanted into human body, providing the chargeable cell with energy, thus prolong pacemaker's life-span.RESU LTS AND CONCLUSION: The author trial-manufactured a chargeable artificial cardiac pacemaker, carried experiments on animals, using ultrasonic transferring energy. Thus, the author made further study on concerned technology.

  2. Instrumentation to study myofibril mechanics from static to artificial simulations of cardiac cycle.

    Science.gov (United States)

    Vikhorev, Petr G; Ferenczi, Michael A; Marston, Steven B

    2016-01-01

    Many causes of heart muscle diseases and skeletal muscle diseases are inherited and caused by mutations in genes of sarcomere proteins which play either a structural or contractile role in the muscle cell. Tissue samples from human hearts with mutations can be obtained but often samples are only a few milligrams and it is necessary to freeze them for storage and transportation. Myofibrils are the fundamental contractile components of the muscle cell and retain all structural elements and contractile proteins performing in contractile event; moreover viable myofibrils can be obtained from frozen tissue.•We are describing a versatile technique for measuring the contractility and its Ca(2+) regulation in single myofibrils. The control of myofibril length, incubation medium and data acquisition is carried out using a digital acquisition board via computer software. Using computer control it is possible not only to measure contractile and mechanical parameters but also simulate complex protocols such as a cardiac cycle to vary length and medium independently.•This single myofibril force assay is well suited for physiological measurements. The system can be adapted to measure tension amplitude, rates of contraction and relaxation, Ca(2+) dependence of these parameters in dose-response measurements, length-dependent activation, stretch response, myofibril elasticity and response to simulated cardiac cycle length changes. Our approach provides an all-round quantitative way to measure myofibrils performance and to observe the effect of mutations or posttranslational modifications. The technique has been demonstrated by the study of contraction in heart with hypertrophic or dilated cardiomyopathy mutations in sarcomere proteins. PMID:27047763

  3. Self-Paced Fortran.

    Science.gov (United States)

    Burnett, James

    1979-01-01

    This paper describes the instructional format of the lecture and the self-paced methods of teaching FORTRAN at Michigan State University and compares end-of-term grades of students taking a second computer science course based on whether they took the first course in the self-paced or the traditional lecture format. (Author/BB)

  4. Pacing stress echocardiography

    Directory of Open Access Journals (Sweden)

    Agrusta Marco

    2005-12-01

    Full Text Available Abstract Background High-rate pacing is a valid stress test to be used in conjunction with echocardiography; it is independent of physical exercise and does not require drug administration. There are two main applications of pacing stress in the echo lab: the noninvasive detection of coronary artery disease through induction of a regional transient dysfunction; and the assessment of contractile reserve through peak systolic pressure/ end-systolic volume relationship at increasing heart rates to assess global left ventricular contractility. Methods The pathophysiologic rationale of pacing stress for noninvasive detection of coronary artery disease is obvious, with the stress determined by a controlled increase in heart rate, which is a major determinant of myocardial oxygen demand, and thereby tachycardia may exceed a fixed coronary flow reserve in the presence of hemodynamically significant coronary artery disease. The use of pacing stress echo to assess left ventricular contractile reserve is less established, but promising. Positive inotropic interventions are mirrored by smaller end-systolic volumes and higher end-systolic pressures. An increased heart rate progressively increases the force of ventricular contraction (Bowditch treppe or staircase phenomenon. To build the force-frequency relationship, the force is determined at different heart rate steps as the ratio of the systolic pressure (cuff sphygmomanometer/end-systolic volume index (biplane Simpson rule. The heart rate is determined from ECG. Conclusion Two-dimensional echocardiography during pacing is a useful tool in the detection of coronary artery disease. Because of its safety and ease of repeatability noninvasive pacing stress echo can be the first-line stress test in patients with permanent pacemaker. The force-frequency can be defined as up- sloping (normal when the peak stress pacing systolic pressure/end-systolic volume index is higher than baseline and intermediate stress

  5. PACE Status Update

    Energy Technology Data Exchange (ETDEWEB)

    M., Zimring,; Hoffman, I.; Fuller, M.

    2010-08-11

    The Federal Housing Finance Agency (FHFA) regulates Fannie Mae, Freddie Mac, and the 12 Federal Home Loan Banks (the government-sponsored enterprises - GSEs). On July 6, 2010, FHFA and the Office of the Comptroller of the Currency (OCC) concluded that Property Assessed Clean Energy (PACE) programs 'present significant safety and soundness concerns' to the housing finance industry. This statement came after a year of discussions with state and federal agencies in which PACE, a novel mechanism for financing energy efficiency and renewable energy improvements, has gone from receiving support from the White House, canonization as one of Scientific American's 'World Changing Ideas' and legislative adoption in 24 states to questionable relevance, at least in the residential sector. Whether PACE resumes its expansion as an innovative tool for financing energy efficiency and clean generation depends on outcomes in each of the three branches of government - discussions on a PACE pilot phase among federal agencies, litigation in federal court, and legislation in Congress - all highly uncertain. This policy brief addresses the practical impacts of these possible outcomes on existing and emerging PACE programs across the United States and potential paths forward.

  6. Regional blood flow distribution in dog during induced hypotension and low cardiac output. Spontaneous breathing versus artificial ventilation.

    OpenAIRE

    Viires, N; Sillye, G; Aubier, M.; Rassidakis, A; Roussos, C

    1983-01-01

    Respiratory muscle blood flow and organ blood flow was studied in two groups of dogs with radioactively labeled microspheres to assess the influence of the working respiratory muscles on the regional distribution of blood flow when arterial pressure and cardiac output were lowered by pericardial tamponade. In one group (n = 6), the dogs were paralyzed and mechanically ventilated (Mv), while in the other (n = 6), they were left to breathe spontaneously (Sb). Cardiac output fell to 30% of contr...

  7. Effect of atrial pacing therapy with selective pacing algorithms on paroxysmal atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    潘晓宏; 张雪华; 徐耕; 傅国胜; 单江

    2004-01-01

    @@ Atrial fibrillation (AF) is the most common cardiac arrhythmia among the elderly. Its incidence increases dramatically with increasing age and decreasing left ventricular function, peaking in subjects with overt congestive heart failure.1 Because of the unsatisfactory efficacy and possible serious side effects of clinically available anti-AF drugs for AF patients with sick sinus syndrome, pacing techniques have recently been applied in the treatment of AF. The cardiac pacemaker Vitatron Selection 900E has special AF diagnostic and prophylactic therapy algorithms. The objective of this study was to use the diagnostic information concerning the onset mechanisms of AF to program the preventive pacing algorithms for each patient individually and to find out whether a reduction in AF burden could be achieved.

  8. Classification of Atrial Septal Defect and Ventricular Septal Defect with Documented Hemodynamic Parameters via Cardiac Catheterization by Genetic Algorithms and Multi-Layered Artificial Neural Network

    Directory of Open Access Journals (Sweden)

    Mustafa Yıldız

    2012-08-01

    Full Text Available Introduction: We aimed to develop a classification method to discriminate ventricular septal defect and atrial septal defect by using severalhemodynamic parameters.Patients and Methods: Forty three patients (30 atrial septal defect, 13 ventricular septal defect; 26 female, 17 male with documentedhemodynamic parameters via cardiac catheterization are included to study. Such parameters as blood pressure values of different areas,gender, age and Qp/Qs ratios are used for classification. Parameters, we used in classification are determined by divergence analysismethod. Those parameters are; i pulmonary artery diastolic pressure, ii Qp/Qs ratio, iii right atrium pressure, iv age, v pulmonary arterysystolic pressure, vi left ventricular sistolic pressure, vii aorta mean pressure, viii left ventricular diastolic pressure, ix aorta diastolicpressure, x aorta systolic pressure. Those parameters detected from our study population, are uploaded to multi-layered artificial neuralnetwork and the network was trained by genetic algorithm.Results: Trained cluster consists of 14 factors (7 atrial septal defect and 7 ventricular septal defect. Overall success ratio is 79.2%, andwith a proper instruction of artificial neural network this ratio increases up to 89%.Conclusion: Parameters, belonging to artificial neural network, which are needed to be detected by the investigator in classical methods,can easily be detected with the help of genetic algorithms. During the instruction of artificial neural network by genetic algorithms, boththe topology of network and factors of network can be determined. During the test stage, elements, not included in instruction cluster, areassumed as in test cluster, and as a result of this study, we observed that multi-layered artificial neural network can be instructed properly,and neural network is a successful method for aimed classification.

  9. Recognition of ventricular fibrillation concomitant with pacing artifacts

    OpenAIRE

    Zysko, Dorota; Smereka, Jacek; CHÊCIÑSKI, IGOR; WRÓBLEWSKI, PAWE£; TERPI£OWSKI, £UKASZ; JACEK, GAJEK; WALDEMAR, GOZDZIK; KUMAR AGRAWAL, ANIL

    2013-01-01

    Introduction. In pre-hospital settings recognition of underlying rhythm in patients with ventricular stimulation can be difficult especially when a 3-lead electrocardiogram (ECG) is analyzed. This fact is particularly important in patients with life-threatening cardiac dysrhythmias. The pacing spikes in the ECG of a patient with cardiac arrest due to ventricular fibrillation may be misdiagnosed as QRS complexes. Aim of the study. The aim of this study was to assess emergency medical care stud...

  10. 左心室不同部位起搏对心脏再同步治疗效果的影响%Impact of different left ventricular pacing sites on clinical outcome of cardiac resynchronization therapy

    Institute of Scientific and Technical Information of China (English)

    刘启明; 肖宜超; 周胜华; 刘振江; 李旭平

    2014-01-01

    ,以及位于基底部和室中部者相比CRT疗效差异可能不明显.%Objective To explore the impact of different left ventricular (LV) lead pacing sites on clinical outcome of cardiac resynchronization therapy (CRT) or the device with defibrillator (CRT-D).Methods The location of the LV lead was assessed by means of coronary venograms in right and left anterior oblique views which were recorded at the time of device implantation in 41 patients of CRT with a pacemaker or a defibrillator from January 2008 to December 2011 in the Second Xiangya Hospital of Central South University.The LV lead location was classified along the short axis into anterior (n =9),anterolateral (n =10),lateral (n =12),posterolateral (n=10),or posterior position(n=0) and along the long axis into a basal (n=15),midventricular (n =26),or apical region (n =0).All patients were evaluated at baseline,7 days,3 months,6 months,12 months,18 months and 24 months after the implementation by such indices as LV ejection fraction (LVEF),LV end-diastolic dimension (LVEDD),New York Heart Association (NYHA) class,6 min walking distance,quality of life (QOL),CRT parameters and the incidence rate of adverse events.Results ①The incidence of nonresponse to CRT was 19.5% (8/41).Improvement in LVEF,LVEDD,NYHA class,6 min walking distance and QOL was found in all groups (P<0.05).②Improvement in LVEF,NYHA class,6 min walking distance and QOL was significantly greater in non-anterior location than anterior location during 3 months follow-up (P<0.05).The extent of CRT benefit was similar for leads in the anterolateral,lateral and posterolateral position (P<0.05).③The extent of CRT benefit was similar for leads in the basal and midventricular position (P<0.05).④There were no presentation of abnormal CRT parameters,readmission of heart failure,lead dislocation,phrenic nerve stimulation,CRT associated infection and other events.Conclusion ①CRT recipients are profiting by 2 years follow

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

    Science.gov (United States)

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

    2016-03-01

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

  12. Atrial Fibrillation and Pacing Algorithms

    OpenAIRE

    Terranova, Paolo; Severgnini, Barbara; Valli, Paolo; Dell'Orto, Simonetta; Greco, Enrico Maria

    2006-01-01

    Pacing prevention algorithms have been introduced in order to maximize the benefits of atrial pacing in atrial fibrillation prevention. It has been demonstrated that algorithms actually keep overdrive atrial pacing, reduce atrial premature contractions, and prevent short-long atrial cycle phenomenon, with good patient tolerance. However, clinical studies showed inconsistent benefits on clinical endpoints such as atrial fibrillation burden. Factors which may be responsible for neutral results ...

  13. Far field pacing supersedes anti-tachycardia pacing in a generic model of excitable media

    Energy Technology Data Exchange (ETDEWEB)

    Bittihn, Philip; Parlitz, Ulrich [Drittes Physikalisches Institut, Goettingen University, Friedrich-Hund-Platz 1, 37077 Goettingen (Germany); Luther, Gisela; Bodenschatz, Eberhard; Krinsky, Valentin; Luther, Stefan [Max Planck Institute for Dynamics and Self-Organization, Bunsenstrasse 10, 37073 Goettingen (Germany)], E-mail: bittihn@physik3.gwdg.de

    2008-10-15

    Removing anchored spirals from obstacles is an important step in terminating cardiac arrhythmia. Conventional anti-tachycardia pacing (ATP) has this ability, but only under very restrictive conditions. In a generic model of excitable media, we demonstrate that for unpinning spiral waves from obstacles this profound limitation of ATP can be overcome by far field pacing (FFP). More specifically, an argument is presented for why FFP includes and thus can only extend the capabilities of ATP in the configurations considered. By numerical simulations, we show that in the model there exists a parameter region in which unpinning is possible by FFP but not by ATP. The relevance of this result regarding clinical applications is discussed.

  14. The value of right lateral decubitus position to decrease artificial defect of cardiac anterior wall in 99Tcm-MIBI SPECT myocardial perfusion imaging for women

    International Nuclear Information System (INIS)

    Objective: To explore the value of right lateral decubitus position MPI for differentiating myocardial perfusion defect from cardiac anterior wall attenuation artificial defect, caused by breast of woman. Methods: Forty-nine patients(average age (61.5±8.4) years) who had low likelihood of coronary artery disease and had perfusion defect in the anterior wall after exercise stress 99Tcm-MIBI MPI were included. All underwent supine and right lateral decubitus position during resting SPECT images. The myocardial perfusion SPECT images at left ventricle were reconstructed and were measured by Bull's-eye, based on the counts. Results from both supine position imaging and right lateral decubitus position imaging were compared. Paired t test was used to statistically analyse the data by SPSS 13.0. Results: Compared with supine position, the counts of the anterior, inferior, apex and lateral wall in right lateral decubitus position were significantly higher: (71.30±3.53)% vs (66.50±3.85)%, (70.06±4.45)% vs (65.44±4.16)%, (77.90±3.00)% vs (75.81±4.08)%,(79.30±2.26)% vs (72.60±3.87)% (t=6.731, 5.286, 3.555, 10.885, all P<0.01). The counts of septal wall were significantly lower ((66.60±3.98)% vs (70.06±4.51)%, t=-4.625, P<0.01) in right lateral decubitus position than that in supine position. Among the different regions of anterior wall, the counts of the anterior-middle ((76.40 ± 3.80)% vs (68.60 ± 4.76)%) and anterior-apex region ((77.10±3.24)% vs (69.00±3.54)%) were significantly higher (t=9.916, 8.870, both P<0.01) in right lateral decubitus position than those in supine position, but there was insignificance ((56.94±6.06)% vs (58.50±4.98)%, t=-1.493, P>0.05) at anterior-basal region. The artificial defect of different degrees in anterior wall was observed in all patients in supine position, 23 cases (46.9%, 23/49) showed artificial defect in the anterior-middle region and 16 cases (32.7%, 16/49) in the anterior-apex region. All artificial defect

  15. Marathon pacing and elevation change

    CERN Document Server

    Elliott, J B

    2012-01-01

    An analysis of marathon pacing and elevation change is presented. It is based on an empirical observation of how the pace of elite and non-elite marathon runners change over the course of the marathon and a simple approximation of the energy cost of ascent and decent. It was observed that the pace of the runners slowed in a regular manner that could be broken up into four regions. That observation can be used to project target paces for a desired marathon finish time. However, that estimate fails to take in to account the energetic costs of elevation changes (hills) along the marathon course. Several approximations are made to give a coarse estimate of target paces for marathon run on courses with significant elevation changes, i.e. a hilly course. The 2012 Oakland Marathon course is used as and example of a hilly course and the times of 23 finishers are examined.

  16. Pacing the right ventricular outflow tract septum: time to embrace the future.

    Science.gov (United States)

    Hillock, Richard J; Mond, Harry G

    2012-01-01

    Transvenous pacing has revolutionized the management of patients with potentially life-threatening bradycardias and at its most basic level ensures rate support to maintain cardiac output. However, we have known for at least a decade that pacing from the right ventricle (RV) apex can induce left ventricle (LV) dysfunction, atrial fibrillation, heart failure, and maybe an increased mortality. Although pacemaker manufacturers have developed successful pacing algorithms designed to minimize unnecessary ventricular pacing, it cannot be avoided in a substantial proportion of pacemaker-dependent patients. Just as there is undoubted evidence that RV apical pacing is injurious, there is emerging evidence that pacing from the RV septum is associated with a shorter duration of activation, improved haemodynamics, and less LV remodelling. The move from traditional RV apical pacing to RV septal pacing requires a change in mindset for many practitioners. The anatomical landmarks and electrocardiograph features of RV septal pacing are well described and easily recognized. While active fixation is required to place the lead on the septum, shaped stylets are now available to assist the implanter. In addition, concerns about the stability and longevity of steroid-eluting active fixation leads have proven to be unfounded. We therefore encourage all implanters to adopt RV septal pacing to minimize the potential of harm to their patients. PMID:21846639

  17. Leadless Cardiac Pacemakers: Back to the Future.

    Science.gov (United States)

    Miller, Marc A; Neuzil, Petr; Dukkipati, Srinivas R; Reddy, Vivek Y

    2015-09-01

    Despite significant advances in battery longevity, lead performance, and programming features since the first implanted permanent pacemaker was developed, the basic design of cardiac pacemakers has remained relatively unchanged over the past 50 years. Because of inherent limitations in their design, conventional (transvenous) pacemakers are prone to multiple potential short- and long-term complications. Accordingly, there has been intense interest in a system able to provide the symptomatic and potentially lifesaving therapies of cardiac pacemakers while mitigating many of the risks associated with their weakest link-the transvenous lead. Leadless cardiac pacing represents the future of cardiac pacing systems, similar to the transition that occurred from the use of epicardial pacing systems to the familiar transvenous systems of today. This review summarizes the current evidence and potential benefits of leadless pacing systems, which are either commercially available (in Europe) or under clinical investigation. PMID:26337997

  18. Hemodynamic aspects of biventricular pacing in heart failure

    OpenAIRE

    Ståhlberg, Marcus

    2010-01-01

    Background and aims Biventricular pacing or cardiac resynchronization therapy (CRT) is an established treatment option for selected heart failure (HF) patients. We aimed at evaluating acute and longer-term hemodynamic effects of different pacemaker programmings in CRT patients. For the latter purpose, 10 CRT patients also received an implantable hemodynamic monitor (IHM), allowing for long-term hemodynamic monitoring during ambulatory periods. Study I The hemodynamic ...

  19. ECG Database Applicable for Development and Testing of Pace Detection Algorithms

    Directory of Open Access Journals (Sweden)

    Irena Jekova

    2014-12-01

    Full Text Available This paper presents an ECG database, named 'PacedECGdb' (available at http://biomed.bas.bg/bioautomation/2014/vol_18.4/files/PacedECGdb.zip, which contains different arrhythmias generated by HKP (Heidelberger Praxisklinik simulator, combined with artificially superimposed pacing pulses that cover the wide ranges of rising edge (from <10 µs to 100 µs and total pulse durations (from 100 µs to 2 ms and correspond to various pacemaker modes. It involves a total number of 1404 recordings - 780 representing 'pure' ECG with pacing pulses and 624 that comprise paced ECGs corrupted by tremor. The signals are recorded with 9.81 µV/LSB amplitude resolution at 128 kHz sampling rate in order to preserve the steep raising and trailing edges of the pace pulses. To the best of our knowledge, 'PacedECGdb' is the first publicly available paced ECG database. It could be used for development and testing of methods for pace detection in the ECG. The existence of ECGs corrupted by tremor (the only physiological noise that could compromise the methods for pacing pulses detection is an advantage, since such signals could be applied to define the signal-to-noise level for correct operation of the algorithm, or for improvement of the noise immunity of a method that is under development. The open access of the database makes it suitable for comparative studies including different algorithms.

  20. Primary prevention of sudden cardiac death of the young athlete: the controversy about the screening electrocardiogram and its innovative artificial intelligence solution.

    Science.gov (United States)

    Chang, Anthony C

    2012-03-01

    The preparticipation screening for athlete participation in sports typically entails a comprehensive medical and family history and a complete physical examination. A 12-lead electrocardiogram (ECG) can increase the likelihood of detecting cardiac diagnoses such as hypertrophic cardiomyopathy, but this diagnostic test as part of the screening process has engendered considerable controversy. The pro position is supported by argument that international screening protocols support its use, positive diagnosis has multiple benefits, history and physical examination are inadequate, primary prevention is essential, and the cost effectiveness is justified. Although the aforementioned myriad of justifications for routine ECG screening of young athletes can be persuasive, several valid contentions oppose supporting such a policy, namely, that the sudden death incidence is very (too) low, the ECG screening will be too costly, the false-positive rate is too high, resources will be allocated away from other diseases, and manpower is insufficient for its execution. Clinicians, including pediatric cardiologists, have an understandable proclivity for avoiding this prodigious national endeavor. The controversy, however, should not be focused on whether an inexpensive, noninvasive test such as an ECG should be mandated but should instead be directed at just how these tests for young athletes can be performed in the clinical imbroglio of these disease states (with variable genetic penetrance and phenotypic expression) with concomitant fiscal accountability and logistical expediency in this era of economic restraint. This monumental endeavor in any city or region requires two crucial elements well known to business scholars: implementation and execution. The eventual solution for the screening ECG dilemma requires a truly innovative and systematic approach that will liberate us from inadequate conventional solutions. Artificial intelligence, specifically the process termed "machine

  1. Factors influencing pacing in triathlon

    Directory of Open Access Journals (Sweden)

    Wu SSX

    2014-09-01

    Full Text Available Sam SX Wu,1 Jeremiah J Peiffer,2 Jeanick Brisswalter,3 Kazunori Nosaka,1 Chris R Abbiss1 1Centre for Exercise and Sports Science Research, School of Exercise and Health Sciences, Edith Cowan University, Perth, WA, Australia; 2School of Psychology and Exercise Science, Murdoch University, Perth, WA, Australia; 3Laboratory of Human Motricity, Education Sport and Health, University of Nice Sophia Antipolis, Nice, France Abstract: Triathlon is a multisport event consisting of sequential swim, cycle, and run disciplines performed over a variety of distances. This complex and unique sport requires athletes to appropriately distribute their speed or energy expenditure (ie, pacing within each discipline as well as over the entire event. As with most physical activity, the regulation of pacing in triathlon may be influenced by a multitude of intrinsic and extrinsic factors. The majority of current research focuses mainly on the Olympic distance, whilst much less literature is available on other triathlon distances such as the sprint, half-Ironman, and Ironman distances. Furthermore, little is understood regarding the specific physiological, environmental, and interdisciplinary effects on pacing. Therefore, this article discusses the pacing strategies observed in triathlon across different distances, and elucidates the possible factors influencing pacing within the three specific disciplines of a triathlon. Keywords: cycle, endurance, multisport, pacing strategy, run, swim

  2. Left ventricular pacing improves haemodynamic variables in patients with heart failure with a normal QRS duration

    Science.gov (United States)

    Turner, M S; Bleasdale, R A; Mumford, C E; Frenneaux, M P; Morris-Thurgood, J A

    2004-01-01

    Objectives: To assess whether patients with congestive heart failure (CHF) and a normal QRS duration can benefit from left ventricular (VDD-LV) pacing. Design: Cardiac resynchronisation is reserved for patients with a broad QRS duration on the premise that systolic resynchronisation is the mechanism of benefit, yet improvement from pacing correlates poorly with QRS duration. In CHF patients with a broad QRS duration, those with a high resting pulmonary capillary wedge pressure (PCWP) > 15 mm Hg benefit. In this acute haemodynamic VDD-LV pacing study, patients with CHF with a normal QRS duration were divided into two groups—patients with a resting PCWP > 15 mm Hg and patients with a resting PCWP 15 mm Hg (n  =  10), cardiac output increased from 3.9 (1.5) to 4.5 (1.65) l/min (p 15 mm Hg derive acute haemodynamic benefit from VDD-LV pacing. PMID:15084543

  3. Artificial vision.

    Science.gov (United States)

    Zarbin, M; Montemagno, C; Leary, J; Ritch, R

    2011-09-01

    A number treatment options are emerging for patients with retinal degenerative disease, including gene therapy, trophic factor therapy, visual cycle inhibitors (e.g., for patients with Stargardt disease and allied conditions), and cell transplantation. A radically different approach, which will augment but not replace these options, is termed neural prosthetics ("artificial vision"). Although rewiring of inner retinal circuits and inner retinal neuronal degeneration occur in association with photoreceptor degeneration in retinitis pigmentosa (RP), it is possible to create visually useful percepts by stimulating retinal ganglion cells electrically. This fact has lead to the development of techniques to induce photosensitivity in cells that are not light sensitive normally as well as to the development of the bionic retina. Advances in artificial vision continue at a robust pace. These advances are based on the use of molecular engineering and nanotechnology to render cells light-sensitive, to target ion channels to the appropriate cell type (e.g., bipolar cell) and/or cell region (e.g., dendritic tree vs. soma), and on sophisticated image processing algorithms that take advantage of our knowledge of signal processing in the retina. Combined with advances in gene therapy, pathway-based therapy, and cell-based therapy, "artificial vision" technologies create a powerful armamentarium with which ophthalmologists will be able to treat blindness in patients who have a variety of degenerative retinal diseases.

  4. Successful treatment with biventricular pacing in a patient with hypertrophic obstructive cardiomyopathy

    Institute of Scientific and Technical Information of China (English)

    HE Ji-qiang; JIANG Teng-yong; WANG Yun-long; WANG Yan; L(U) Shu-zheng

    2011-01-01

    We report the effects of biventricular pacing in a patient with hypertrophic obstructive cardiomyopathy (HOCM) refractory to medical therapy. A 58-year-old man with HOCM had suffered from dyspnea,chest pain and palpitation for 5 years. Cardiac catheterization showed a left ventricular outflow tract (LVOT) gradient of 80 mmHg. He refused septal myomectomy and the septal ablation was not available. Based on intraoperative pressure measurements,he was implanted with biventricular pacing and LVOT gradient decreased to 10 mmHg. During the follow-up period of 6 months, the patient's symptoms were markedly improved. Biventricular pacing may be an alternative therapy for patients with HOCM.

  5. Presentation Time Concerning System-Paced Multimedia Instructions and the Superiority of Learner Pacing

    Science.gov (United States)

    Stiller, Klaus D.; Petzold, Kirstin; Zinnbauer, Peter

    2011-01-01

    The superiority of learner-paced over system-paced instructions was demonstrated in multiple experiments. In these experiments, the system-paced presentations were highly speeded, causing cognitive overload, while the learner-paced instructions allowed adjustments of the presentational flow to the learner's needs by pacing facilities, mostly…

  6. CARDIAC RESYNCHRONIZATION THERAPY ON PATIENTS WITH HEART FAILURE AND CONCOMITANT ATRIAL FIBRILLATION SUITABLE FOR CONVENTIONAL PACING THERAPY%具备常规起搏治疗适应症的心力衰竭合并心房颤动的心脏再同步化治疗

    Institute of Scientific and Technical Information of China (English)

    刘君; 靳文; 李冬义; 杜作义

    2015-01-01

    目的:探讨具备常规起搏治疗适应症的心力衰竭合并心房颤动患者行心脏再同步化治疗的短期疗效。方法收集2008年1月~2013年1月具备常规起搏治疗适应症的心力衰竭合并心房颤动的患者12例,行心脏再同步化治疗,治疗前以及治疗后的3、6、12个月分别测量6分钟步行实验(6MWT)、左室舒张末内径(LVEDD)、左室射血分数(LVEF)和心排血量(CO),并用SPSS18.0作统计分析。结果12例患者三腔起搏器各电极植入过程顺利,手术成功,起搏器工作良好,无手术相关并发症。术后第3、第6、第12个月的6MWT、LVEDD、LVEF和CO指标较术前各指标均有明显改善,差异有统汁学意义(p<0.05),且随时间的延长心功能指标持续性优化。结论心脏再同步化治疗短期内可有效改善心力衰竭合并心房颤动患者的心功能水平。%Objective To discuss the short-term effect of Cardiac Resynchronization Therapy ( CRT) on patients with heart failure and concomitant atrial fibrillation suitable for conventional pacing therapy .Methods 12 patients with heart failure and con-comitant atrial fibrillation suitable for conventional pacing therapy were treated with CRT in our hospital , and their cardiac parameters such as 6 minutes walk test (6MWT), left ventrieular end -diastolic diameter (LVDD), left ventrieular ejection fraction (LVEF) and cardiac output (CO) were measured before operation and 3, 6 and 12 months after operation respectively.Finally the measured data was analyzed with SPSS 18.0.Results All electrodes of three -chamber pacemaker were implanted successfully without any complication.Compared with those at baseline, the four heart function parameters of the 12 patients at three, six, twelve months after CRT were improved significantly and successively (p<0.05).Conclusion CRT can help the patients with heart failure and con-comitant atrial fibrillation to improve their heart

  7. 右室间隔部不同部位起搏对心功能和心室收缩同步性的影响%Effects of pacing sites in the right ventricular septum on cardiac function and ventricular systolic synchrony

    Institute of Scientific and Technical Information of China (English)

    陈文苏; 张超群; 程明月; 李承宗

    2015-01-01

    followed-up visits one year after surgery, when data were collected including cumulative ventricular pacing proportion ( Cum VP%) , electrocardiogram and Color Doppler sonographic in assessment of the heart.Their QRS com-plex, Crochetage (notch) on R wave, left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter ( LVEDD) , left ventricular fractional shortening ( FS) , septal-to-posterior wall motion delay ( SPWMD) and interven-tricular mechanical delay ( IVMD) were compared to determine the optimal pacing site in the right ventricular septum. Results There were no statistic differences among the three groups as to baseline information like age, gender, primary disease, EF, LVEDD and FS before operation.After surgery, the pacing modes were all DDD, while no significant differences were seen in the Cum%VP among the three groups.For the follow-up visit one year later, compared with the low-septal implantation group, the mid-septal group produced narrower QRS complex, shorter SPWMD and IVMD, as well as less frequency in notch on R wave and higher values of FS.There was no statistic difference in EF and LVEDD between the two groups.Compared with the high-septal implantation group, the mid-septal group produced narrower QRS complex, shorter SPWMD and IVMD, as well as less frequency in notch on R wave and higher values of EF.There was no statistic difference in FS and LVEDD between the two groups.Compared with the high -septal implantation group, the low-septal group produced narrower QRS complex and higher values of LVEF.There was no statistic differ-ence in LVEDD, FS, SPWMD and IVMD between the two groups.Conclusion Pacing from the middle site of the right ventricle results in narrower QRS complex with the least effects on cardiac function and ventricular systolic synchrony and better hemodynamic results, in comparison with other pacing sites.

  8. A method for permanent transvenous left ventricular pacing.

    Science.gov (United States)

    Blanc, J J; Benditt, D G; Gilard, M; Etienne, Y; Mansourati, J; Lurie, K G

    1998-11-01

    LV-based pacing has recently been reported to be of benefit in patients with severe cardiac failure and left bundle branch block. LV permanent pacing has been reported using epicardial leads but the surgical mortality is excessive. A transvenous approach is now favored. In this regard, cannulation of the coronary sinus and of one of its tributaries using only the permanent electrode is feasible but technically challenging. We describe a "long guiding sheath" method using catheterization, and a long radiopaque and peelable sheath. Once the coronary sinus is cannulated with the electrophysiological catheter, the long sheath is advanced to the mid-part of the coronary sinus. The permanent pacing electrode is then placed through the sheath and into a tributary of the coronary sinus. This method has been attempted in 10 patients and was successful in 8, with an average lead insertion time of 21 +/- 5.5 minutes and an average fluoroscopic time of 11 +/- 5.5 minutes. In conclusion, although transvenous left ventricular pacing remains a challenge, the "long guiding sheath" approach appears to facilitate this procedure with both a high success rate and an acceptable procedure time. PMID:9826852

  9. The PACE evaluation: initial findings.

    Science.gov (United States)

    Branch, L G; Coulam, R F; Zimmerman, Y A

    1995-06-01

    As of mid-1994 there were nine replications of the On Lok model operating under dual capitation payments as sites in the Program of All-inclusive Care for the Elderly (PACE). A tenth site had begun operating under capitation, but was unable to remain viable. The present descriptive study documents the growth and development of the first seven of these sites, all that had been operating under capitation during 1992. Comparisons among these sites and with On Lok are presented in the areas of organizational structure, client characteristics, approaches to case management, service delivery options, and financing. There is considerable variability in the implementation of the PACE model. Combined Medicare and Medicaid capitation monthly payments range from $2,147 to $5,973. These seven PACE sites (excluding On Lok) served a total of 888 current clients at the end of 1992, after a cumulative 136 months of experience under capitation. The very slow enrollment rates may imply that the target clients are less enthusiastic about this model than are its architects. The client selection process may suggest niche-marketing or skimming, but not the full representation of the nursing home population in their states. Given both the slow enrollment and the niche-marketing (the benevolent term) or skimming (the pejorative term) that has occurred, caution about the long-term viability of the PACE model may be warranted. PMID:7622088

  10. Low atrial septum pacing in pacemaker patients

    NARCIS (Netherlands)

    Voogt, Willem Gijsbert de

    2006-01-01

    In patients with an indication for anti bradycardia pacing, atrial fibrillation (AF) is a common arrhythmia (30-50%) even in the absence of atrial tachy arrhythmias before pacemaker implantation. Pace prevention and pace intervention for atrial tachy arrhythmias could be an interesting adjuvant trea

  11. 42 CFR 460.186 - PACE premiums.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false PACE premiums. 460.186 Section 460.186 Public...) Payment § 460.186 PACE premiums. The amount that a PACE organization can charge a participant as a monthly premium depends on the participant's eligibility under Medicare and Medicaid, as follows: (a)...

  12. Cardiac applications of optogenetics.

    Science.gov (United States)

    Ambrosi, Christina M; Klimas, Aleksandra; Yu, Jinzhu; Entcheva, Emilia

    2014-08-01

    In complex multicellular systems, such as the brain or the heart, the ability to selectively perturb and observe the response of individual components at the cellular level and with millisecond resolution in time, is essential for mechanistic understanding of function. Optogenetics uses genetic encoding of light sensitivity (by the expression of microbial opsins) to provide such capabilities for manipulation, recording, and control by light with cell specificity and high spatiotemporal resolution. As an optical approach, it is inherently scalable for remote and parallel interrogation of biological function at the tissue level; with implantable miniaturized devices, the technique is uniquely suitable for in vivo tracking of function, as illustrated by numerous applications in the brain. Its expansion into the cardiac area has been slow. Here, using examples from published research and original data, we focus on optogenetics applications to cardiac electrophysiology, specifically dealing with the ability to manipulate membrane voltage by light with implications for cardiac pacing, cardioversion, cell communication, and arrhythmia research, in general. We discuss gene and cell delivery methods of inscribing light sensitivity in cardiac tissue, functionality of the light-sensitive ion channels within different types of cardiac cells, utility in probing electrical coupling between different cell types, approaches and design solutions to all-optical electrophysiology by the combination of optogenetic sensors and actuators, and specific challenges in moving towards in vivo cardiac optogenetics.

  13. [Competitive pacing in a patient with DDD pacemaker and bigeminal ventricular extrasystoles].

    Science.gov (United States)

    Carbone, Vincenzo; Candelmo, Fiore; Todaro, Chiara; Oreto, Giuseppe

    2008-11-01

    The ECG recorded from a patient with DDD pacemaker showed variable responses of the pacing system to bigeminal ventricular extrasystoles, dependent on the coupling interval of premature beats. For relatively short coupling intervals, the premature spontaneous event was detected by the pacemaker, inhibiting both atrial and ventricular output, and resulting in a relatively long pacing pause. In slightly less premature end-diastolic extrasystoles, in contrast, the pacing system delivered an atrial spike that was superimposed upon the spontaneous premature QRS complex (pseudo-pseudofusion); under these circumstances, the atrial spike was followed, at the end of the programmed atrioventricular interval, by a ventricular spike falling on the extrasystolic T wave apex (competitive ventricular pacing). This phenomenon, however, did not express a sensing malfunction, but was due to post-atrial ventricular blanking (PAVB), a short period initiated by the atrial spike during which ventricular sensing is temporarily disabled, so that no signal can be detected. Finally, whenever premature end-diastolic impulses occurred after PAVB, during the brief interval defined ventricular safety pacing, the spontaneous event was sensed, being followed by an earlier-than-expected ventricular spike, whose prematurity was aimed at avoiding the occurrence of an artificial impulse upon the T wave of extrasystole. In conclusion, despite several not sensed ventricular extrasystoles and competitive pacing, no sensing malfunction was present. This case demonstrates how complex can be the electrocardiographic analysis of a DDD pacemaker, owing to the many complicating phenomena related to this pacing mechanism.

  14. Speckle-tracking echocardiography elucidates the effect of pacing site on left ventricular synchronization in the normal and infarcted rat myocardium.

    Directory of Open Access Journals (Sweden)

    Michal Mor

    Full Text Available BACKGROUND: Right ventricular (RV pacing generates regional disparities in electrical activation and mechanical function (ventricular dyssynchrony. In contrast, left ventricular (LV or biventricular (BIV pacing can improve cardiac efficiency in the setting of ventricular dyssynchrony, constituting the rationale for cardiac resynchronization therapy (CRT. Animal models of ventricular dyssynchrony and CRT currently relay on large mammals which are expensive and not readily available to most researchers. We developed a methodology for double-site epicardial pacing in conscious rats. Here, following post-operative recovery, we compared the effects of various pacing modes on LV dyssynchrony in normal rats and in rats with ischemic cardiomyopathy. METHODS: Two bipolar electrodes were implanted in rats as follows: Group A (n = 6 right atrial (RA and RV sites; Group B (n = 7 RV and LV sites; Group C (n = 8 as in group B in combination with left coronary artery ligation. Electrodes were exteriorized through the back. Following post-operative recovery, two-dimensional transthoracic echocardiography was performed during pacing through the different electrodes. Segmental systolic circumferential strain (Ecc was used to evaluate LV dyssynchrony. RESULTS: In normal rats, RV pacing induced marked LV dyssynchrony compared to RA pacing or sinus rhythm, as measured by the standard deviation (SD of segmental time to peak Ecc, SD of peak Ecc, and the average delay between opposing ventricular segments. LV pacing and, to a greater extend BIV pacing diminished the LV dyssynchrony compared to RV pacing. In rats with extensive MI, the effects of LV and BIV pacing were markedly attenuated, and the response of individual animals was variable. CONCLUSIONS: Rodent cardiac pacing mimics important features seen in humans. This model may be developed as a simple new tool to study the pathophysiology of ventricular dyssynchrony and CRT.

  15. Low atrial septum pacing in pacemaker patients

    OpenAIRE

    Voogt, Willem Gijsbert de

    2006-01-01

    In patients with an indication for anti bradycardia pacing, atrial fibrillation (AF) is a common arrhythmia (30-50%) even in the absence of atrial tachy arrhythmias before pacemaker implantation. Pace prevention and pace intervention for atrial tachy arrhythmias could be an interesting adjuvant treatment in the prevention of the arrhythmia related complications. These treatment modalities when available in pacemaker systems could come at a relative low cost as the indication for pacemaker imp...

  16. Web Tools: Keeping Learners on Pace

    Science.gov (United States)

    Kosloski, Mickey

    2016-01-01

    One of the greatest challenges in teaching technology and engineering is pacing. Some students grasp new technological concepts quickly, while others need repetition and may struggle to keep pace. This poses an obstacle for the technology and engineering teacher, and is particularly true when teaching students to build a website. However, there…

  17. Optimized cardiac resynchronization therapy in patients with congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    NIU Hong-xia; HUA Wei; ZHANG Shu; SUN Xin; CHEN Ke-ping; WANG Fang-zheng; CHEN Xin

    2007-01-01

    @@ Heart failure was a major and increasing public health problem, with an almost "epidemic increase in the number of patients.1 Despite recent advances in pharmacotherapy, the prognosis remains poor. Cardiac resynchronization therapy (CRT), by pacing right and left ventricles, has been proved to improve symptoms and reduce mortality for heart failure patients with cardiac dyssynchrony.

  18. 42 CFR 460.60 - PACE organizational structure.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false PACE organizational structure. 460.60 Section 460... ELDERLY (PACE) PACE Administrative Requirements § 460.60 PACE organizational structure. (a) A PACE organization must be, or be a distinct part of, one of the following: (1) An entity of city, county, State,...

  19. The pace of cultural evolution.

    Directory of Open Access Journals (Sweden)

    Charles Perreault

    Full Text Available Today, humans inhabit most of the world's terrestrial habitats. This observation has been explained by the fact that we possess a secondary inheritance mechanism, culture, in addition to a genetic system. Because it is assumed that cultural evolution occurs faster than biological evolution, humans can adapt to new ecosystems more rapidly than other animals. This assumption, however, has never been tested empirically. Here, I compare rates of change in human technologies to rates of change in animal morphologies. I find that rates of cultural evolution are inversely correlated with the time interval over which they are measured, which is similar to what is known for biological rates. This correlation explains why the pace of cultural evolution appears faster when measured over recent time periods, where time intervals are often shorter. Controlling for the correlation between rates and time intervals, I show that (1 cultural evolution is faster than biological evolution; (2 this effect holds true even when the generation time of species is controlled for; and (3 culture allows us to evolve over short time scales, which are normally accessible only to short-lived species, while at the same time allowing for us to enjoy the benefits of having a long life history.

  20. Observation of functional remodeling of Ca2+-activated Cl- channel in pacing-induced canine failing heart

    Institute of Scientific and Technical Information of China (English)

    浦介麟

    2006-01-01

    Objective To study whether Ca2+-activated Cl-current (Ito2) contributes to the functional remodeling of the failing heart. Methods The cardiac myocytes were isolated enzymatically from rapidly pacing-induced failing canine hearts (HF) at room temperature. Patch-Clamp whole cell recording technique was employed to record the Ito2.The Cl- transport blocker 4,4’-diisothiocyanos-

  1. Comparison of longevity, paging, and sensing characteristics of steroid-eluting epicardial versus conventional endocardial pacing leads in children

    NARCIS (Netherlands)

    Beaufort-Krol, GCM; Mulder, H; Nagelkerke, D; Waterbolk, TW; Bink-Boelkens, MTE

    1999-01-01

    Objective: Because of either cardiac anatomy or small size, pacing in children often occurs by means of epicardial leads. The disadvantage of epicardial leads is the shorter longevity of these leads compared with endocardial leads. During short-term follow-up, improved stimulation thresholds were fo

  2. Ischemic Stroke Due to Cardiac Involvement: Emery Dreifuss Patient

    Directory of Open Access Journals (Sweden)

    Ersin Kasım Ulusoy

    2015-08-01

    Full Text Available Emery-Dreifuss muscular dystrophy (EDMD is a hereditary disease. It is characterized by early-onset contractures, slowly progressive weakness, fatigue related to skapulo-humero-peroneal muscle weakness, cardiomyopathy which develops in adulthood and cardiac conduction system block. Cardiac involvement has a prognostic significance in patients with EDMD and even sudden cardiac death may be the first clinical presentation. In this article, an EDMD patient with ischemic stroke clinic who didn’t have regular cardiac follow-up was reported and the importance of the treatment of cardiac diseases which could play a role in ischemic stroke etiology and the implantation of pace-maker was mentioned.

  3. Transferring PACE Assessments Upon Home Sale

    Energy Technology Data Exchange (ETDEWEB)

    National Renewable Energy Laboratory (NREL); Coughlin, Jason; Fuller, Merrian; Zimring, Mark

    2010-04-12

    A significant barrier to investing in renewable energy and comprehensive energy efficiency improvements to homes across the country is the initial capital cost. Property Assessed Clean Energy (PACE) financing is one of several new financial models broadening access to clean energy by addressing this upfront cost issue. Recently, the White House cited PACE programs as an important element of its 'Recovery through Retrofit' plan. The residential PACE model involves the creation of a special clean energy financing district that homeowners elect to opt into. Once opted in, the local government (usually at the city or county level) finances the upfront investment of the renewable energy installation and/or energy efficiency improvements. A special lien is attached to the property and the assessment is paid back as a line item on the property tax bill. As of April 2010, 17 states have passed legislation to allow their local governments to create PACE programs, two already have the authority to set up PACE programs, and over 10 additional states are actively developing enabling legislation. This policy brief analyzes one of the advantages of PACE, which is the transferability of the special assessment from one homeowner to the next when the home is sold. This analysis focuses on the potential for the outstanding lien to impact the sales negotiation process, rather than the legal nature of the lien transfer itself. The goal of this paper is to consider what implications a PACE lien may have on the home sales negotiation process so that it can be addressed upfront rather than risk a future backlash to PACE programs. If PACE programs do expand at a rapid rate, the chances are high that there will be other cases where prospective buyers uses PACE liens to negotiate lower home prices or require repayment of the lien as a condition of sale. As a result, PACE programs should highlight this issue as a potential risk factor for the sake of full disclosure. A good example

  4. Pollution Abatement and Control Expenditures Survey (PACE)

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Pollution Abatement Costs and Expenditures (PACE) survey is the most comprehensive national source of pollution abatement costs and expenditures related to...

  5. Improved Cardiac Contractility of Human Recombinant Growth Hormone on the Congestive Heart Failure of Pig

    Institute of Scientific and Technical Information of China (English)

    Yang Ping; He Yu-quan; Zeng Hong; Ni Jin-song; Yun Qing-jun; Huang Xiao-ping; Li Shu-mei

    2005-01-01

    The enhanced cardiac contractility effect of human recombinant growth hormone (hr-GH) on the congestive heart failure (CHF) was studied on the pig. To build a pig model of congestive heart failure, a temporary artificial cardiac pacemaker was implanted in the pig's body and paced at 220 beats to 240 beats per minute for 1 week. After the model of congestive heart failure was successfully set up, the frequency of the pacemaker was changed to 150 beats to 180 beats per minute to maintain the CHF model stable. Pigs were divided into three groups: The hr-GH group in which 0.5 mg/kg per day of hr-GH was administrated intramuscularly for 15 days, the injection control group in which an equal amount of physiological saline was injected intramuscularly, and a normal control group. The left ventricular diastolic end pressure was (10.60±2.41 ) mmHg in the hr-GH group, but (19.00±3.81) mmHg in the saline control group (P<0.01); Cardiac output was (1.86±0.13) L/min in the hr-GH group, but (1.56 ±0.18) L/min in the saline control group (P<0.05); Peripheral min) -1 in the saline control group (P<0.05); ± dp/dtmax was (2900 ±316.23) and (2280 ±286.36) in the hr-HG group and the saline control group respectively (P<0.05). The results show that hr-GH enhances myocardial contractility of CHF, and the CHF model built by a temporary artificial cardiac pacemaker at a high rate of stimulation is reasonable and applicable.

  6. Cardiac fluid dynamics anticipates heart adaptation.

    Science.gov (United States)

    Pedrizzetti, Gianni; Martiniello, Alfonso R; Bianchi, Valter; D'Onofrio, Antonio; Caso, Pio; Tonti, Giovanni

    2015-01-21

    Hemodynamic forces represent an epigenetic factor during heart development and are supposed to influence the pathology of the grown heart. Cardiac blood motion is characterized by a vortical dynamics, and it is common belief that the cardiac vortex has a role in disease progressions or regression. Here we provide a preliminary demonstration about the relevance of maladaptive intra-cardiac vortex dynamics in the geometrical adaptation of the dysfunctional heart. We employed an in vivo model of patients who present a stable normal heart function in virtue of the cardiac resynchronization therapy (CRT, bi-ventricular pace-maker) and who are expected to develop left ventricle remodeling if pace-maker was switched off. Intra-ventricular fluid dynamics is analyzed by echocardiography (Echo-PIV). Under normal conditions, the flow presents a longitudinal alignment of the intraventricular hemodynamic forces. When pacing is temporarily switched off, flow forces develop a misalignment hammering onto lateral walls, despite no other electro-mechanical change is noticed. Hemodynamic forces result to be the first event that evokes a physiological activity anticipating cardiac changes and could help in the prediction of longer term heart adaptations.

  7. Estimulação cardíaca com tele-anodo: uma nova técnica para estimulação elétrica do coração Cardiac stimulation with tele-anode: a new technique for electrical pacing of the heart

    Directory of Open Access Journals (Sweden)

    Décio S Kormann

    1986-08-01

    chamber, can be inhibited or reverted to the asynchronous mode, by skeletal muscle myopotentials. Dual chamber pacemakers may even stimulate the ventricle at the upper rate limit because of myopotential sensing via the atrial channel. A unipolar anti-tachycardia generator may be triggered by myopotentials to provoke an arrhythmia. During bipolar implanted pacing, episodic ventricular tachycardia has been induced in three patients with Chagasic cardiomyopathy and anodal stimulation has been shown to be the cause. Both unipolar and bipolar stimulation modes present problems. A stimulation mode with the cathode intracardiac and the anode remote from the generator and the patient's heart, called "tele-anode" was developed to be implanted in the presternal area or in venous system and avoid pacemaker triggering and inhibition. The subcutaneous "tele-anode" may be a spiral or a cylinder while an intravascular "tele-anode" may be positioned in the superior or inferior vena cava. Until March, 1986, 62 patients underwent "tele-anode" implantation, 57 at the sternum (51 spiral and 6 cylindrical and 5 intramuscular. Thirty five generators were single chamber ventricular inhibited, 23 were dual chamber, 3 were atrial inhibited and 1 ventricular anti-tachycardia. In all cases the stimulation thresholds and electrogram characteristics were similar between intracardiac cathode and "tele-anode" and cathode and the puise generator site. Only electromyographic signals were consistently attenuated. One patient with an intravascular "tele-anode" died postoperatively of ventricular arrhythmias and one required ventricular lead repositioning. The 61 living patients, followed from one to twenty-one months, have shown no inhibition, triggering or noise mode reversion at nominal sensitivity setting. The authors conclude that pacemakers implanted with "tele-anode" show a clear evidence of decrease of associated complications, inherent to the conventional unipolar and bipolar cardiac stimulation

  8. Cardiac arrest

    Science.gov (United States)

    ... Article.jsp. Accessed June 16, 2014. Myerburg RJ, Castellanos A. Approach to cardiac arrest and life-threatening ... PA: Elsevier Saunders; 2011:chap 63. Myerburg RJ, Castellanos A. Cardiac arrest and audden aardiac death. In: ...

  9. Optimal pacing for symptomatic AV block: a comparison of VDD and DDD pacing.

    Science.gov (United States)

    Huang, Max; Krahn, Andrew D; Yee, Raymond; Klein, George J; Skanes, Allan C

    2004-01-01

    VDD pacing provides the physiological benefits of atrioventricular synchronous pacing with the convenience of a single lead system, but is hampered by uncertainty regarding long term atrial sensing and potential development of sinus node disease. To examine the long-term reliability and complication rates of VDD pacing, we compared the outcome of 112 consecutive patients (age 70 +/- 13 years, 59% men) with symptomatic AV block who received a single pass bipolar VDD system, to 80 patients (age 63 +/- 16 years, 70% men) who received DDD pacing for the same indication. All patients were judged to have intact sinus node function based on submitted ECGs and monitoring results at the time of implant. Implant time was reduced in VDD patients compared to DDD patients (63 +/- 20 vs 97 +/- 36 minutes, P DDD patients compared to 3 (3%) VDD patients (P = 0.15). The implant P wave was lower with VDD pacing compared to DDD patients (2.91 +/- 1.48 vs 4.0 +/- 1.7 mv, P DDD patients. Physiological atrioventricular activation was maintained in 94%-99% of beats throughout the follow-up period in the VDD group. VDD pacing is an excellent strategy for treatment of patients with symptomatic AV block. The lower cost, high reliability, and abbreviated implantation time suggest that VDD pacing is a viable alternative to DDD pacing in patients with high degree AV block and normal sinus node function.

  10. Are Electronic Cardiac Devices Still Evolving?

    Science.gov (United States)

    Mabo, P.

    2014-01-01

    Summary Objectives The goal of this paper is to review some important issues occurring during the past year in Implantable devices. Methods First cardiac implantable device was proposed to maintain an adequate heart rate, either because the heart’s natural pacemaker is not fast enough, or there is a block in the heart’s electrical conduction system. During the last forty years, pacemakers have evolved considerably and become programmable and allow to configure specific patient optimum pacing modes. Various technological aspects (electrodes, connectors, algorithms diagnosis, therapies, …) have been progressed and cardiac implants address several clinical applications: management of arrhythmias, cardioversion / defibrillation and cardiac resynchronization therapy. Results Observed progress was the miniaturization of device, increased longevity, coupled with efficient pacing functions, multisite pacing modes, leadless pacing and also a better recognition of supraventricular or ventricular tachycardia’s in order to deliver appropriate therapy. Subcutaneous implant, new modes of stimulation (leadless implant or ultrasound lead), quadripolar lead and new sensor or new algorithm for the hemodynamic management are introduced and briefly described. Each times, the main result occurring during the two past years are underlined and repositioned from the history, remaining limitations are also addressed. Conclusion Some important technological improvements were described. Nevertheless, news trends for the future are also considered in a specific session such as the remote follow-up of the patient or the treatment of heart failure by neuromodulation. PMID:25123732

  11. 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

  12. An integrated optical coherence microscopy imaging and optical stimulation system for optogenetic pacing in Drosophila melanogaster (Conference Presentation)

    Science.gov (United States)

    Alex, Aneesh; Li, Airong; Men, Jing; Jerwick, Jason; Tanzi, Rudolph E.; Zhou, Chao

    2016-03-01

    Electrical stimulation is the clinical standard for cardiac pacing. Although highly effective in controlling cardiac rhythm, the invasive nature, non-specificity to cardiac tissues and possible tissue damage limits its applications. Optogenetic pacing of the heart is a promising alternative, which is non-invasive and more specific, has high spatial and temporal precision, and avoids the shortcomings in electrical stimulation. Drosophila melanogaster, which is a powerful model organism with orthologs of nearly 75% of human disease genes, has not been studied for optogenetic pacing in the heart. Here, we developed a non-invasive integrated optical pacing and optical coherence microscopy (OCM) imaging system to control the heart rhythm of Drosophila at different developmental stages using light. The OCM system is capable of providing high imaging speed (130 frames/s) and ultrahigh imaging resolutions (1.5 μm and 3.9 μm for axial and transverse resolutions, respectively). A light-sensitive pacemaker was developed in Drosophila by specifically expressing the light-gated cation channel, channelrhodopsin-2 (ChR2) in transgenic Drosophila heart. We achieved non-invasive and specific optical control of the Drosophila heart rhythm throughout the fly's life cycle (larva, pupa, and adult) by stimulating the heart with 475 nm pulsed laser light. Heart response to stimulation pulses was monitored non-invasively with OCM. This integrated non-invasive optogenetic control and in vivo imaging technique provides a novel platform for performing research studies in developmental cardiology.

  13. No incremental benefit of multisite atrial pacing compared with right atrial pacing in patients with drug refractory paroxysmal atrial fibrillation

    OpenAIRE

    Levy, T; Walker, S; Rex, S; Rochelle, J; Paul, V.

    2001-01-01

    OBJECTIVE—To evaluate the incremental antifibrillatory effect of multisite atrial pacing compared with right atrial pacing in patients with drug refractory paroxysmal atrial fibrillation paced for arrhythmia prevention alone.
METHODS—In 20 of these patients (mean (SD) age 64 (8) years; 14 female, six male), a single blinded randomised crossover study was performed to investigate the incremental benefit of one month of multisite atrial pacing compared with one month of right atrial pacing. Out...

  14. Atrioventricular Junction Ablation in Atrial Fibrillation: Choosing The Right Patient and Pacing Device

    Directory of Open Access Journals (Sweden)

    Finn Akerstr�m; Mois�s Rodr�guez-Ma�ero; Marta Pach�n; Alberto Puchol; X. Alberte Fern�ndez-L�pez; Luis Mart�nez-Sande; Miguel Valderr�bano MD; Miguel A. Arias.

    2015-08-01

    Full Text Available Atrial fibrillation (AF is the most common cardiac arrhythmia and despite advancements in rhythm control through direct catheter ablation, maintaining sinus rhythm is currently not possible in a large proportion of AF patients. Furthermore, in some instances pharmacological rate control may be insufficient, resulting in a highly symptomatic patient at risk of developing tachycardia-induced cardiomyopathy and heart failure (HF. Catheter ablation of the atrioventricular junction (AVJ with subsequent permanent pacemaker implantation provides definite rate control and represents an attractive therapeutic option when pharmacological rate control is not achieved. In those with reduced ventricular function, cardiac resynchronization therapy (CRT should be considered over right ventricular apical (RVA pacing in order to avoid the deleterious effects associated with a high amount of chronic RVA pacing. Another group of patients that may also benefit from AVJ ablation are HF patients with concomitant AF receiving CRT. In this patient cohort AVJ ablation ensures near 100% biventricular pacing, thus allowing optimization of the therapeutic effects of CRT.

  15. Physics of Cardiac Arrhythmogenesis

    Science.gov (United States)

    Karma, Alain

    2013-04-01

    A normal heartbeat is orchestrated by the stable propagation of an excitation wave that produces an orderly contraction. In contrast, wave turbulence in the ventricles, clinically known as ventricular fibrillation (VF), stops the heart from pumping and is lethal without prompt defibrillation. I review experimental, computational, and theoretical studies that have shed light on complex dynamical phenomena linked to the initiation, maintenance, and control of wave turbulence. I first discuss advances made to understand the precursor state to a reentrant arrhythmia where the refractory period of cardiac tissue becomes spatiotemporally disordered; this is known as an arrhythmogenic tissue substrate. I describe observed patterns of transmembrane voltage and intracellular calcium signaling that can contribute to this substrate, and symmetry breaking instabilities to explain their formation. I then survey mechanisms of wave turbulence and discuss novel methods that exploit electrical pacing stimuli to control precursor patterns and low-energy pulsed electric fields to control turbulence.

  16. Self-Paced Instruction: Hello, Education

    Science.gov (United States)

    Leuba, Richard J.; Flammer, Gordon H.

    1975-01-01

    Answers criticisms of self-paced instruction (SPI) by citing advantages of SPI over lecture methods. Concludes that criticisms of SPI are useful since they indicate in which areas further research should be conducted to improve this method of instruction. (MLH)

  17. Artificial Limbs

    Science.gov (United States)

    ... you are missing an arm or leg, an artificial limb can sometimes replace it. The device, which ... activities such as walking, eating, or dressing. Some artificial limbs let you function nearly as well as ...

  18. Leave-one-out prediction error of systolic arterial pressure time series under paced breathing

    CERN Document Server

    Ancona, N; Marinazzo, D; Nitti, L; Pellicoro, M; Pinna, G D; Stramaglia, S

    2004-01-01

    In this paper we show that different physiological states and pathological conditions may be characterized in terms of predictability of time series signals from the underlying biological system. In particular we consider systolic arterial pressure time series from healthy subjects and Chronic Heart Failure patients, undergoing paced respiration. We model time series by the regularized least squares approach and quantify predictability by the leave-one-out error. We find that the entrainment mechanism connected to paced breath, that renders the arterial blood pressure signal more regular, thus more predictable, is less effective in patients, and this effect correlates with the seriousness of the heart failure. The leave-one-out error separates controls from patients and, when all orders of nonlinearity are taken into account, alive patients from patients for which cardiac death occurred.

  19. Pre-operative MRI in heart failure patients scheduled for cardiac resynchronization therapy

    NARCIS (Netherlands)

    Manzke, R.; Lutz, A.; Bornstedt , A.; Binner, L.; Merkle, N.; Gradinger, R..; Hombach, V.; Rasche, V.

    2009-01-01

    Cardiac resynchronization therapy (CRT) aims at improving the pumping function of the heart using bi-ventricular pacing. For the lead implantation procedure, knowledge of the heart function, the relevant anatomy (i.e. coro-nary sinus (CS), great cardiac vein (GCV) and its tributaries) and left ventr

  20. Normalisation of left ventricular systolic function after change from VVI pacing to biventricular pacing in a child with congenital complete atrioventricular block, long-QT syndrome, and congenital muscular dystrophy

    DEFF Research Database (Denmark)

    Ellesøe, Sabrina G; Reimers, Jesper I; Andersen, Henrik

    2013-01-01

    Development of dilated cardiomyopathy in patients with congenital complete atrioventricular block with or without pacemaker is well described. We report a case of dilated cardiomyopathy in a child with congenital complete atrioventricular block, long-QT syndrome, and VVI pacemaker. Temporary paci...... in the right ventricular outflow tract demonstrated a 63% increase in cardiac output. After change to biventricular DDD pacing, left ventricular systolic function and diastolic dimensions normalised....

  1. Fetal cardiac interventions: clinical and experimental research.

    Science.gov (United States)

    Yuan, Shi-Min; Humuruola, Gulimila

    2016-01-01

    Fetal cardiac interventions for congenital heart diseases may alleviate heart dysfunction, prevent them evolving into hypoplastic left heart syndrome, achieve biventricular outcome and improve fetal survival. Candidates for clinical fetal cardiac interventions are now restricted to cases of critical aortic valve stenosis with evolving hypoplastic left heart syndrome, pulmonary atresia with an intact ventricular septum and evolving hypoplastic right heart syndrome, and hypoplastic left heart syndrome with an intact or highly restrictive atrial septum as well as fetal heart block. The therapeutic options are advocated as prenatal aortic valvuloplasty, pulmonary valvuloplasty, creation of interatrial communication and fetal cardiac pacing. Experimental research on fetal cardiac intervention involves technical modifications of catheter-based cardiac clinical interventions and open fetal cardiac bypass that cannot be applied in human fetuses for the time being. Clinical fetal cardiac interventions are plausible for midgestation fetuses with the above-mentioned congenital heart defects. The technical success, biventricular outcome and fetal survival are continuously being improved in the conditions of the sophisticated multidisciplinary team, equipment, techniques and postnatal care. Experimental research is laying the foundations and may open new fields for catheter-based clinical techniques. In the present article, the clinical therapeutic options and experimental fetal cardiac interventions are described. PMID:27279868

  2. 42 CFR 460.122 - PACE organization's appeals process.

    Science.gov (United States)

    2010-10-01

    ...) PACE organization's written appeals process. The PACE organization must have a formal written appeals... process must include written procedures for the following: (1) Timely preparation and processing of a... writing. (e) Services furnished during appeals process. During the appeals process, the PACE...

  3. Visual aided pacing in respiratory maneuvers

    International Nuclear Information System (INIS)

    A visual aid to pace self-controlled respiratory cycles in humans is presented. Respiratory manoeuvres need to be accomplished in several clinic and research procedures, among others, the studies on Heart Rate Variability. Free running respiration turns to be difficult to correlate with other physiologic variables. Because of this fact, voluntary self-control is asked from the individuals under study. Currently, an acoustic metronome is used to pace respiratory frequency, its main limitation being the impossibility to induce predetermined timing in the stages within the respiratory cycle. In the present work, visual driven self-control was provided, with separate timing for the four stages of a normal respiratory cycle. This visual metronome (ViMet) was based on a microcontroller which power-ON and -OFF an eight-LED bar, in a four-stage respiratory cycle time series handset by the operator. The precise timing is also exhibited on an alphanumeric display

  4. Visual aided pacing in respiratory maneuvers

    Energy Technology Data Exchange (ETDEWEB)

    Rambaudi, L R [Laboratorio de Biofisica y Fisiologia ' Antonio Sadi Frumento' (Argentina); Rossi, E [Catedra de Bioingenieria II (Argentina); Mantaras, M C [Catedra de Bioingenieria II (Argentina); Perrone, M S [Laboratorio de Biofisica y Fisiologia ' Antonio Sadi Frumento' (Argentina); Siri, L Nicola [Catedra de Bioingenieria II (Argentina)

    2007-11-15

    A visual aid to pace self-controlled respiratory cycles in humans is presented. Respiratory manoeuvres need to be accomplished in several clinic and research procedures, among others, the studies on Heart Rate Variability. Free running respiration turns to be difficult to correlate with other physiologic variables. Because of this fact, voluntary self-control is asked from the individuals under study. Currently, an acoustic metronome is used to pace respiratory frequency, its main limitation being the impossibility to induce predetermined timing in the stages within the respiratory cycle. In the present work, visual driven self-control was provided, with separate timing for the four stages of a normal respiratory cycle. This visual metronome (ViMet) was based on a microcontroller which power-ON and -OFF an eight-LED bar, in a four-stage respiratory cycle time series handset by the operator. The precise timing is also exhibited on an alphanumeric display.

  5. Cardiac Malpositions

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Shi Joon; Im, Chung Gie; Yeon, Kyung Mo; Hasn, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1979-06-15

    Cardiac Malposition refers to any position of the heart other than a left-sided heart in a situs solitus individual. Associated cardiac malformations are so complex that even angiocardiographic and autopsy studies may not afford an accurate information. Although the terms and classifications used to describe the internal cardiac anatomy and their arterial connections in cardiac malpositions differ and tend to be confusing, common agreement exists on the need for a segmental approach to diagnosis. Authors present 18 cases of cardiac malpositions in which cardiac catheterization and angiocardiography were done at the Department of Radiology, Seoul National University Hospital between 1971 and 1979. Authors analyzed the clinical, radiographic, operative and autopsy findings with the emphasis on the angiocardiographic findings. The results are as follows: 1. Among 18 cases with cardiac malpositions, 6 cases had dextrocardia with situs inversus, 9 cases had dextrocardia with situs solitus and 3 cases had levocardia with situs inversus. 2. There was no genuine exception to visceroatrial concordance rule. 3. Associated cardiac malpositions were variable and complex with a tendency of high association of transposition and double outlet varieties with dextrocardia in situs solitus and levocardia in situs inversus. Only one in 6 cases of dextrocardia with situs inversus had pure transposition. 4. In two cases associated pulmonary atresia was found at surgery which was not predicted by angiocardiography. 5. Because many of the associated complex lesions can be corrected surgically provided the diagnosis is accurate, the selective biplane angiocardiography with or without cineradiography is essential.

  6. Multi-Leu PACE4 Inhibitor Retention within Cells Is PACE4 Dependent and a Prerequisite for Antiproliferative Activity

    Directory of Open Access Journals (Sweden)

    Frédéric Couture

    2015-01-01

    Full Text Available The overexpression as well as the critical implication of the proprotein convertase PACE4 in prostate cancer progression has been previously reported and supported the development of peptide inhibitors. The multi-Leu peptide, a PACE4-specific inhibitor, was further generated and its capability to be uptaken by tumor xenograft was demonstrated with regard to its PACE4 expression status. To investigate whether the uptake of this inhibitor was directly dependent of PACE4 levels, uptake and efflux from cancer cells were evaluated and correlations were established with PACE4 contents on both wild type and PACE4-knockdown cell lines. PACE4-knockdown associated growth deficiencies were established on the knockdown HepG2, Huh7, and HT1080 cells as well as the antiproliferative effects of the multi-Leu peptide supporting the growth capabilities of PACE4 in cancer cells.

  7. Gait Alterations During Constant Pace Treadmill Racewalking.

    Science.gov (United States)

    Hanley, Brian

    2015-08-01

    Racewalking is an Olympic event requiring great endurance, and racewalkers often use treadmills in training because of the benefits of having a flat unchanging surface where pace judgment can be learned and because inclement weather can be avoided. The effects of fatigue associated with racewalking on a treadmill have not been studied and could be informative with regard to the maintenance of legal technique. The aim of this study was to measure key gait variables during a physically demanding treadmill racewalk. Fourteen international racewalkers completed 10 km on an instrumented treadmill at a pace equivalent to 103% of their recent best time. Spatiotemporal and ground reaction force data were recorded at 4 distances. High-speed videography data were simultaneously recorded to analyze changes in knee angle between the early and late stages. Increases in step length and corresponding decreases in cadence were found, although the small changes were not considered meaningful. There was also a small increase in flight time and a small decrease in push-off force. There were no other significant changes for any other variables (including knee angles). The increase in flight time might be important given that racewalkers are not permitted a visible loss of contact and suggests that fatiguing sessions on a treadmill can lead to the adoption of nonlegal technique. However, this disadvantage of treadmill training can be negated if the coach scrutinizes athletes throughout the session, and overall the consistent technique used is of benefit with regard to learning correct form and pacing ability. PMID:25647657

  8. Temporary emergency pacing-an orphan in district hospitals

    DEFF Research Database (Denmark)

    Gjesdal, Knut; Johansen, Jens Brock; Gadler, Fredrik

    2012-01-01

    This editorial discusses a report on the 1 year experience with temporary pacing, especially in the emergency setting, in several Norwegian district hospitals. The vast majority of the patients received transvenous temporary pacing, and the majority of leads were placed by noncardiologists....... The procedure times were long and complications were frequent. The organization of emergency pacing is discussed, and we suggest that unless qualified physicians can establish transvenous pacing, the patients who need that should be transferred with transcutaneous pacing as back-up during transport...

  9. Optimized multisite ventricular pacing in postoperative single-ventricle patients.

    Science.gov (United States)

    Havalad, Vinod; Cabreriza, Santos E; Cheung, Eva W; Aponte-Patel, Linda; Wang, Alice; Cheng, Bin; Wang, Daniel Y; Silver, Eric; Bacha, Emile A; Spotnitz, Henry M

    2014-10-01

    Ventricular dyssynchrony is associated with morbidity and mortality after palliation of a single ventricle. The authors hypothesized that resynchronization with optimized temporary multisite pacing postoperatively would be safe, feasible, and effective. Pacing was assessed in the intensive care unit within the first 24 h after surgery. Two unipolar atrial pacing leads and four bipolar ventricular pacing leads were placed at standardized sites intraoperatively. Pacing was optimized to maximize mean arterial pressure. The protocol tested 11 combinations of the 4 different ventricular lead sites, 6 atrioventricular delays (50-150 ms), and 14 intraventricular delays. Optimal pacing settings were thus determined and ultimately compared in four configurations: bipolar, unipolar, single-site atrioventricular pacing, and intrinsic rhythm. Each patient was his or her own control, and all pacing comparisons were implemented in random sequence. Single-ventricle palliation was performed for 17 children ages 0-21 years. Pacing increased mean arterial pressure (MAP) versus intrinsic rhythm, with the following configurations: bipolar multisite pacing increased MAP by 2.2 % (67.7 ± 2.4 to 69.2 ± 2.4 mmHg; p = 0.013) and unipolar multisite pacing increased MAP by 2.8 % (67.7 ± 2.4 to 69.6 ± 2.7 mmHg; p = 0.002). Atrioventricular single-site pacing increased MAP by 2.1 % (67.7 ± 2.4 to 69.1 ± 2.5 mmHg: p = 0.02, insignificant difference under Bonferroni correction). The echocardiographic fractional area change in nine patients increased significantly only with unipolar pacing (32 ± 3.1 to 36 ± 4.2 %; p = 0.02). No study-related adverse events occurred. Multisite pacing optimization is safe and feasible in the early postoperative period after single-ventricle palliation, with improvements in mean arterial pressure and fractional area shortening. Further study to evaluate clinical benefits is required. PMID:24827078

  10. Cardiac rehabilitation

    Science.gov (United States)

    ... attack or other heart problem. You might consider cardiac rehab if you have had: Heart attack Coronary heart disease (CHD) Heart failure Angina (chest pain) Heart or heart valve surgery Heart transplant Procedures such as angioplasty and stenting In some ...

  11. Artificial blood

    Directory of Open Access Journals (Sweden)

    Sarkar Suman

    2008-01-01

    Full Text Available Artificial blood is a product made to act as a substitute for red blood cells. While true blood serves many different functions, artificial blood is designed for the sole purpose of transporting oxygen and carbon dioxide throughout the body. Depending on the type of artificial blood, it can be produced in different ways using synthetic production, chemical isolation, or recombinant biochemical technology. Development of the first blood substitutes dates back to the early 1600s, and the search for the ideal blood substitute continues. Various manufacturers have products in clinical trials; however, no truly safe and effective artificial blood product is currently marketed. It is anticipated that when an artificial blood product is available, it will have annual sales of over $7.6 billion in the United States alone.

  12. Preliminary steps toward artificial protocell computation

    OpenAIRE

    McMullin, Barry; Kelly, Ciaran; O'Brien, Darragh; Mitchell, George G.; Decraene, James, Lobo, Victor

    2007-01-01

    Protocells are hypothesised as a transitional phase in the origin of life, prior to the evolution of fully functional prokaryotic cells. The work reported here is being done in the context of the PACE project, which is investigating the fabrication of artificial protocells de novo. We consider here the important open question of whether or how articifial protocells (if or when they are successfully fabricated) might be applied as “computing” devices—what sort of computing might they be sui...

  13. Efficacy of paced breathing for insomnia: enhances vagal activity and improves sleep quality.

    Science.gov (United States)

    Tsai, H J; Kuo, Terry B J; Lee, Guo-She; Yang, Cheryl C H

    2015-03-01

    Fourteen self-reported insomniacs (SRI) and 14 good sleepers (GS) had their cardiac neuronal activity assessed by heart rate variability (HRV) under controlled respiration at a slow frequency rate of 0.1 Hz, and a forced rate of 0.2 Hz during daytime rest. Nighttime sleep was measured by polysomnography. The SRI showed depressed high frequency power of HRV compared to the GS. An increased total power of HRV was observed among the SRI during slow, paced breathing compared with spontaneous breathing and 0.2 Hz. Sleep onset latency, number of awakenings, and awakening time during sleep were decreased and sleep efficiency was increased if SRI practiced slow, paced breathing exercises for 20 min before going to sleep. Our results indicate that there is autonomic dysfunction among insomniacs, especially in relation to vagal activity; however, this decreased vagal activity can be facilitated by practicing slow, paced breathing, thereby improving sleep quality. PMID:25234581

  14. Cardiovascular strain impairs prolonged self-paced exercise in the heat.

    Science.gov (United States)

    Périard, Julien D; Cramer, Matthew N; Chapman, Phillip G; Caillaud, Corinne; Thompson, Martin W

    2011-02-01

    It has been proposed that self-paced exercise in the heat is regulated by an anticipatory reduction in work rate based on the rate of heat storage. However, performance may be impaired by the development of hyperthermia and concomitant rise in cardiovascular strain increasing relative exercise intensity. This study evaluated the influence of thermal strain on cardiovascular function and power output during self-paced exercise in the heat. Eight endurance-trained cyclists performed a 40 km simulated time trial in hot (35°C) and thermoneutral conditions (20°C), while power output, mean arterial pressure, heart rate, oxygen uptake and cardiac output were measured. Time trial duration was 64.3 ± 2.8 min (242.1 W) in the hot condition and 59.8 ± 2.6 min (279.4 W) in the thermoneutral condition (P heat was depressed from 20 min onwards compared with exercise in the thermoneutral condition (P temperature reached 39.8 ± 0.3 (hot) and 38.9 ± 0.2°C (thermoneutral; P skin temperature was ~7.5°C higher in the heat, and skin blood flow was significantly elevated (P stroke volume, cardiac output and mean arterial pressure were significantly depressed compared with the thermoneutral condition (P heat. PMID:20851861

  15. Artificial urushi.

    Science.gov (United States)

    Kobayashi, S; Uyama, H; Ikeda, R

    2001-11-19

    A new concept for the design and laccase-catalyzed preparation of "artificial urushi" from new urushiol analogues is described. The curing proceeded under mild reaction conditions to produce the very hard cross-linked film (artificial urushi) with a high gloss surface. A new cross-linkable polyphenol was synthesized by oxidative polymerization of cardanol, a phenol derivative from cashew-nut-shell liquid, by enzyme-related catalysts. The polyphenol was readily cured to produce the film (also artificial urushi) showing excellent dynamic viscoelasticity. PMID:11763444

  16. 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

  17. Cardiac Alternans Arising from an Unfolded Border-Collision Bifurcation

    CERN Document Server

    Zhao, Xiaopeng; Berger, Carolyn M; Krassowska, Wanda; Gauthier, Daniel J

    2007-01-01

    Following an electrical stimulus, the transmembrane voltage of cardiac tissue rises rapidly and remains at a constant value before returning to the resting value, a phenomenon known as an action potential. When the pacing rate of a periodic train of stimuli is increased above a critical value, the action potential undergoes a period-doubling bifurcation, where the resulting alternation of the action potential duration is known as alternans in the medical literature. Existing cardiac models treat alternans either as a smooth or as a border-collision bifurcation. However, recent experiments in paced cardiac tissue reveal that the bifurcation to alternans exhibits hybrid smooth/nonsmooth behaviors, which can be qualitatively described by a model of so-called unfolded border-collision bifurcation. In this paper, we obtain analytical solutions of the unfolded border-collision model and use it to explore the crossover between smooth and nonsmooth behaviors. Our analysis shows that the hybrid smooth/nonsmooth behavi...

  18. Artificial Reefs

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — An artificial reef is a human-made underwater structure, typically built to promote marine life in areas with a generally featureless bottom, control erosion, block...

  19. A comparative study of right ventricular outflow tract pacing and right ventricular apical pacing in children%儿童右室流出道起搏与右室心尖起搏的对比研究

    Institute of Scientific and Technical Information of China (English)

    陈晶; 曾国洪; 曾少颖; 王树水

    2014-01-01

    目的:回顾性对比研究儿童行VVI起搏治疗的右室流出道起搏与右室心尖部起搏对近期心功能、QRS波时限及起搏参数的影响。方法:回顾2006年7月至2013年11月,在我科行VVI起搏治疗的38例患儿病例资料,根据术中记录螺旋电极植入的部位分为右室流出道组(n=22)和右室心尖部组(n=16)。记录术前和术后的心脏彩超心功能指标及QRS波时限,术中与术后起搏参数指标进行比较。结果:右室流出道组与右室心尖组在术前及术后心功能指标、术中及术后的起搏阈值差值、导线阻抗差值、R波幅度差值差异无统计学意义。右室流出道起搏组与右室心尖起搏组术后QRS波时限增宽,差异有统计学意义。术前与术后的QRS波时限差值[(134.95±12.86)ms vs(147.44±22.35)ms,t=1.35,P=0.01],差异有统计学意义。结论:儿童右室流出道起搏安全可行,两者起搏术后QRS波时限增宽,但右室心尖起搏组QRS波时限增宽更明显。%Objective To compare the impacts of right ventricular outflow tract pacing and right ventricular apical pacing on short-term cardiac function, QRS duration and pacing parameters in children undergoing VVI pacemaker therapy. Methods The clinical data of 38 children undergoing VVI pacemaker treatment in our department from July 2006 to November 2013 were retrospectively reviewed and analyzed to make grouping: 22 with right ventricular outflow tract pacing based on the operational records were assigned in one group and 16 with right ventricular apical pacing as the other group. The two groups were compared in terms of cardiac function indexes , QRS complex width and intra- and post- operative parameters of the implanted pacemakers. Results There were no significant differences between the two groups in pre-and post-operative cardiac function indexes , intra- and post-operative difference in pacing thresholds

  20. Cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Dewey, Marc [Charite - Universitaetsmedizin Berlin (Germany). Inst. fuer Radiologie

    2011-07-01

    Computed tomography of the heart has become a highly accurate diagnostic modality that is attracting increasing attention. This extensively illustrated book aims to assist the reader in integrating cardiac CT into daily clinical practice, while also reviewing its current technical status and applications. Clear guidance is provided on the performance and interpretation of imaging using the latest technology, which offers greater coverage, better spatial resolution, and faster imaging. The specific features of scanners from all four main vendors, including those that have only recently become available, are presented. Among the wide range of applications and issues to be discussed are coronary artery bypass grafts, stents, plaques, and anomalies, cardiac valves, congenital and acquired heart disease, and radiation exposure. Upcoming clinical uses of cardiac CT, such as plaque imaging and functional assessment, are also explored. (orig.)

  1. Cardiac echinococcosis

    Directory of Open Access Journals (Sweden)

    Ivanović-Krstić Branislava A.

    2002-01-01

    Full Text Available Cardiac hydatid disease is rare. We report on an uncommon hydatid cyst localized in the right ventricular wall, right atrial wall tricuspid valve left atrium and pericard. A 33-year-old woman was treated for cough, fever and chest pain. Cardiac echocardiograpic examination revealed a round tumor (5.8 x 4 cm in the right ventricular free wall and two smaller cysts behind that tumor. There were cysts in right atrial wall and tricuspidal valve as well. Serologic tests for hydatidosis were positive. Computed tomography finding was consistent with diagnosis of hydatid cyst in lungs and right hylar part. Surgical treatment was rejected due to great risk of cardiac perforation. Medical treatment with albendazole was unsuccessful and the patient died due to systemic hydatid involvement of the lungs, liver and central nervous system.

  2. Increases in myocardial workload induced by rapid atrial pacing trigger alterations in global metabolism.

    Directory of Open Access Journals (Sweden)

    Aslan T Turer

    Full Text Available To determine whether increases in cardiac work lead to alterations in the plasma metabolome and whether such changes arise from the heart or peripheral organs.There is growing evidence that the heart influences systemic metabolism through endocrine effects and affecting pathways involved in energy homeostasis.Nineteen patients referred for cardiac catheterization were enrolled. Peripheral and selective coronary sinus (CS blood sampling was performed at serial timepoints following the initiation of pacing, and metabolite profiling was performed by liquid chromatography-mass spectrometry (LC-MS.Pacing-stress resulted in a 225% increase in the median rate·pressure product from baseline. Increased myocardial work induced significant changes in the peripheral concentration of 43 of 125 metabolites assayed, including large changes in purine [adenosine (+99%, p = 0.006, ADP (+42%, p = 0.01, AMP (+79%, p = 0.004, GDP (+69%, p = 0.003, GMP (+58%, p = 0.01, IMP (+50%, p = 0.03, xanthine (+61%, p = 0.0006], and several bile acid metabolites. The CS changes in metabolites qualitatively mirrored those in the peripheral blood in both timing and magnitude, suggesting the heart was not the major source of the metabolite release.Isolated increases in myocardial work can induce changes in the plasma metabolome, but these changes do not appear to be directly cardiac in origin. A number of these dynamic metabolites have known signaling functions. Our study provides additional evidence to a growing body of literature on metabolic 'cross-talk' between the heart and other organs.

  3. [Cardiac amyloidosis].

    Science.gov (United States)

    Hoyer, Caroline; Angermann, Christiane E; Knop, Stefan; Ertl, Georg; Störk, Stefan

    2008-03-15

    Amyloidoses are a heterogeneous group of multisystem disorders, which are characterized by an extracellular deposition of amyloid fibrils. Typically affected are the heart, liver, kidneys, and nervous system. More than half of the patients die due to cardiac involvement. Clinical signs of cardiac amyloidosis are edema of the lower limbs, hepatomegaly, ascites and elevated jugular vein pressure, frequently in combination with dyspnea. There can also be chest pain, probably due to microvessel disease. Dysfunction of the autonomous nervous system or arrhythmias may cause low blood pressure, dizziness, or recurrent syncope. The AL amyloidosis caused by the deposition of immunoglobulin light chains is the most common form. It can be performed by monoclonal gammopathy. The desirable treatment therapy consists of high-dose melphalan therapy twice followed by autologous stem cell transplantation. Due to the high peritransplantation mortality, selection of appropriate patients is mandatory. The ATTR amyloidosis is an autosomal dominant disorder caused by the amyloidogenic form of transthyretin, a plasmaprotein that is synthesized in the liver. Therefore, liver transplantation is the only curative therapy. The symptomatic treatment of cardiac amyloidosis is based on the current guidelines for chronic heart failure according to the patient's New York Heart Association (NYHA) state. Further types of amyloidosis with possible cardiac involvement comprise the senile systemic amyloidosis caused by the wild-type transthyretin, secondary amyloidosis after chronic systemic inflammation, and the beta(2)-microglobulin amyloidosis after long-term dialysis treatment. PMID:18344065

  4. PACE3 - front-end chip for the CMS Preshower

    CERN Multimedia

    Aspel, Paul

    2003-01-01

    This is PACE3 which is the front-end chip for the CMS Preshower. In fact PACE3 is the combination of two ASICs called Delta3 and PACEAM3. Delta3 is on the left and PACEAM3 is on the right. The two ASICs are bonded together and then packaged within a single 196 pin fpBGA package.

  5. Artificial intelligence

    International Nuclear Information System (INIS)

    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

  6. 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

  7. How do we perceive activity pacing in rheumatology care?

    DEFF Research Database (Denmark)

    Cuperus, N.; Vliet Vlieland, T.; Brodin, N.;

    2015-01-01

    Background: Activity pacing is a recommended non-pharmacological intervention for the management of rheumatic and musculoskeletal diseases in international clinical guidelines. In clinical practice, activity pacing aims at adapting daily activities, and is often an important component of self-management......-pharmacological rheumatology care. Methods: An international, multidisciplinary expert panel comprising 60 clinicians and/or healthcare providers experienced with activity pacing across 12 different countries participated in a Delphi survey. Over four Delphi rounds, the panellists identified and ranked the most important...... for future research on activity pacing were formulated and prioritized. Results: Of the 60 panelists, nearly two third (63%) completed all four Delphi rounds. The panel prioritized 9 goals, 11 behaviours, 9 strategies to change behaviour and 10 contextual factors of activity pacing. These items were...

  8. Electrical stimulation to optimize cardioprotective exosomes from cardiac stem cells.

    Science.gov (United States)

    Campbell, C R; Berman, A E; Weintraub, N L; Tang, Y L

    2016-03-01

    Injured or ischemic cardiac tissue has limited intrinsic capacity for regeneration. While stem cell transplantation is a promising approach to stimulating cardiac repair, its success in humans has thus far been limited. Harnessing the therapeutic benefits of stem cells requires a better understanding of their mechanisms of action and methods to optimize their function. Cardiac stem cells (CSC) represent a particularly effective cellular source for cardiac repair, and pre-conditioning CSC with electrical stimulation (EleS) was demonstrated to further enhance their function, although the mechanisms are unknown. Recent studies suggest that transplanted stem cells primarily exert their effects through communicating with endogenous tissues via the release of exosomes containing cardioprotective molecules such as miRNAs, which upon uptake by recipient cells may stimulate survival, proliferation, and angiogenesis. Exosomes are also effective therapeutic agents in isolation and may provide a feasible alternative to stem cell transplantation. We hypothesize that EleS enhances CSC-mediated cardiac repair through its beneficial effects on production of cardioprotective exosomes. Moreover, we hypothesize that the beneficial effects of biventricular pacing in patients with heart failure may in part result from EleS-induced preconditioning of endogenous CSC to promote cardiac repair. With future research, our hypothesis may provide applications to optimize stem cell therapy and augment current pacing protocols, which may significantly advance the treatment of patients with heart disease. PMID:26880625

  9. An Undergraduate Intern Program at PACES

    Science.gov (United States)

    Starks, Scott A.

    1997-01-01

    The University of Texas at El Paso (UTEP) established the Pan American Center for Earth and Environmental Studies (PACES) in 1995 to conduct basic and applied research that contributes to NASA's Mission to Planet Earth. Specifically, PACES provides a repository of remote sensing and other information that supports investigations into an improved understanding of geological, ecological and environmental processes occurring in the southwestern United States and Northern Mexico. Approximately 85% of UTEP's students come from El Paso County, a fast growing urban region representative of many large cities in the Southwest that have, or will soon have, a majority of their population composed of groups currently underrepresented in the scientific and technical workforce. UTEP's student population has an ethnic distribution (63% Hispanic, 32% Anglo, 3% African American, 1.5 % Asian American, and less than 1% Native American) that closely matches the demographics of the region it serves. Thus, UTEP has a mission to serve a multicultural population where minority students comprise the majority. Most Hispanic students at UTEP are primarily of Mexican origin. A large number are first or second-generation U.S. citizens. Characteristics that unite Hispanic students, in particular those of Mexican-origin, are a strong sense of family loyalty and a belief that all family members are responsible for contributing to the economic stability and well-being of the family. Most of their families are larger in number than the national average, and a variety of generations live together or share considerable resources. Thus, many young people feel an obligation and a desire to go to work at a young age and to continue working while in college, thereby assisting their parents and other family members. Older siblings understand that they have responsibilities to do household chores, to aid their younger siblings economically, and to assist elderly family members. This "work ethic" within the

  10. Biventricular Pacing Therapy for Heart Failure

    Institute of Scientific and Technical Information of China (English)

    Henry; Cheuk - Man Yu

    2001-01-01

    @@eart failure is a disease with high morbidity and mortality. It is also the commonest cause of medical ward admission. The incidence of heart failure has been increasing world-wide in the past decade.Studies observed that about 25 - 50 % of patients with heart failure had evidence of electromechanical delay,commonly in the form of left bundle branch block or intraventricular conduction delay on surface electrocardiogram. This condition results in dyssynchronous contraction, mitral regurgitation and was associated with a worse prognosis. These patients may therefore benefit from cardiac resynchronization therapy.

  11. A comparison of single-lead atrial pacing with dual-chamber pacing in sick sinus syndrome

    DEFF Research Database (Denmark)

    Nielsen, Jens Cosedis; Thomsen, Poul Erik B; Højberg, Søren;

    2011-01-01

    In patients with sick sinus syndrome, bradycardia can be treated with a single-lead pacemaker or a dual-chamber pacemaker. Previous trials have revealed that pacing modes preserving atrio-ventricular synchrony are superior to single-lead ventricular pacing, but it remains unclear if there is any ...

  12. 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...

  13. Cardiac rhabdomyosarcoma

    OpenAIRE

    Chlumský, Jaromír; Holá, Dana; Hlaváček, Karel; Michal, Michal; Švec, Alexander; Špatenka, Jaroslav; Dušek, Jan

    2001-01-01

    Cardiac sarcoma is a very rare neoplasm and is difficult to diagnose. The case of a 51-year-old man with a left atrial tumour, locally recurrent three months after its surgical removal, is presented. Computed tomography showed metastatic spread to the lung parenchyma. On revised histology, the mass extirpated was a sarcoma. Because of the metastatic spread, further therapy was symptomatic only; the patient died 15 months after the first manifestation of his problems. Immunohistochemical stain...

  14. Pushing the pace of tree species migration.

    Directory of Open Access Journals (Sweden)

    Eli D Lazarus

    Full Text Available Plants and animals have responded to past climate changes by migrating with habitable environments, sometimes shifting the boundaries of their geographic ranges by tens of kilometers per year or more. Species migrating in response to present climate conditions, however, must contend with landscapes fragmented by anthropogenic disturbance. We consider this problem in the context of wind-dispersed tree species. Mechanisms of long-distance seed dispersal make these species capable of rapid migration rates. Models of species-front migration suggest that even tree species with the capacity for long-distance dispersal will be unable to keep pace with future spatial changes in temperature gradients, exclusive of habitat fragmentation effects. Here we present a numerical model that captures the salient dynamics of migration by long-distance dispersal for a generic tree species. We then use the model to explore the possible effects of assisted colonization within a fragmented landscape under a simulated tree-planting scheme. Our results suggest that an assisted-colonization program could accelerate species-front migration rates enough to match the speed of climate change, but such a program would involve an environmental-sustainability intervention at a massive scale.

  15. Artificial life: The coming evolution

    Energy Technology Data Exchange (ETDEWEB)

    Farmer, J.D. (Los Alamos National Lab., NM (USA) Santa Fe Inst., NM (USA)); Belin, A.d' A. (Shute, Mihaly, and Weinberger, Santa Fe, NM (USA))

    1990-01-01

    Within fifty to a hundred years a new class of organisms is likely to emerge. These organisms will be artificial in the sense that they will originally be designed by humans. However, they will reproduce, and will evolve into something other than their initial form; they will be alive'' under any reasonable definition of the word. These organisms will evolve in a fundamentally different manner than contemporary biological organisms, since their reproduction will be under at least partial conscious control, giving it a Lamarckian component. The pace of evolutionary change consequently will be extremely rapid. The advent of artificial life will be the most significant historical event since the emergence of human beings. The impact on humanity and the biosphere could be enormous, larger than the industrial revolution, nuclear weapons, or environmental pollution. We must take steps now to shape the emergence of artificial organisms; they have potential to be either the ugliest terrestrial disaster, or the most beautiful creation of humanity. 22 refs., 3 figs.

  16. Pacing: A Concept Analysis of a Chronic Pain Intervention

    Directory of Open Access Journals (Sweden)

    Kathryn Jamieson-Lega

    2013-01-01

    Full Text Available BACKGROUND: The intervention of pacing is regularly recommended for chronic pain patients. However, pacing is poorly defined and appears to be interpreted in varying, potentially contradictory manners within the field of chronic pain. This conceptual lack of clarity has implications for effective service delivery and for researchers’ ability to conduct rigorous study. An examination of the background literature demonstrates that while pacing is often one part of a multidisciplinary pain management program, outcome research is hindered by a lack of a clear and shared definition of this currently ill-defined construct.

  17. Artificial Intelligence.

    Science.gov (United States)

    Lawrence, David R; Palacios-González, César; Harris, John

    2016-04-01

    It seems natural to think that the same prudential and ethical reasons for mutual respect and tolerance that one has vis-à-vis other human persons would hold toward newly encountered paradigmatic but nonhuman biological persons. One also tends to think that they would have similar reasons for treating we humans as creatures that count morally in our own right. This line of thought transcends biological boundaries-namely, with regard to artificially (super)intelligent persons-but is this a safe assumption? The issue concerns ultimate moral significance: the significance possessed by human persons, persons from other planets, and hypothetical nonorganic persons in the form of artificial intelligence (AI). This article investigates why our possible relations to AI persons could be more complicated than they first might appear, given that they might possess a radically different nature to us, to the point that civilized or peaceful coexistence in a determinate geographical space could be impossible to achieve.

  18. Fast Paced, Low Cost Projects at MSFC

    Science.gov (United States)

    Watson-Morgan, Lisa; Clinton, Raymond

    2012-01-01

    What does an orbiting microsatellite, a robotic lander and a ruggedized camera and telescope have in common? They are all fast paced, low cost projects managed by Marshall Space Flight Center (MSFC) teamed with successful industry partners. MSFC has long been synonymous with human space flight large propulsion programs, engineering acumen and risk intolerance. However, there is a growing portfolio/product line within MSFC that focuses on these smaller, fast paced projects. While launching anything into space is expensive, using a managed risk posture, holding to schedule and keeping costs low by stopping at egood enough f were key elements to their success. Risk is defined as the possibility of loss or failure per Merriam Webster. The National Aeronautics and Space Administration (NASA) defines risk using procedural requirement 8705.4 and establishes eclasses f to discern the acceptable risk per a project. It states a Class D risk has a medium to significant risk of not achieving mission success. MSFC, along with industry partners, has created a niche in Class D efforts. How did the big, cautious MSFC succeed on these projects that embodied the antithesis of its heritage in human space flight? A key factor toward these successful projects was innovative industry partners such as Dynetics Corporation, University of Alabama in Huntsville (UAHuntsville), Johns Hopkins Applied Physics Laboratory (JHU APL), Teledyne Brown Engineering (TBE), Von Braun Center for Science and Innovation (VCSI), SAIC, and Jacobs. Fast Affordable Satellite Technology (FastSat HSV01) is a low earth orbit microsatellite that houses six instruments with the primary scientific objective of earth observation and technology demonstration. The team was comprised of Dynetics, UAHuntsvile, SAIC, Goddard Space Flight Center (GSFC) and VCSI with the United States Air Force Space Test Program as the customer. The team completed design, development, manufacturing, environmental test and integration in

  19. Thermal and Cardiovascular Strain Mitigate the Potential Benefit of Carbohydrate Mouth Rinse During Self-Paced Exercise in the Heat

    OpenAIRE

    Cramer, Matthew N; Thompson, Martin W.; PÉRIARD, JULIEN D.

    2015-01-01

    Purpose: To determine whether a carbohydrate mouth rinse can alter self-paced exercise performance independently of a high degree of thermal and cardiovascular strain. Methods: Eight endurance-trained males performed two 40-km cycling time trials in 35°C, 60% RH while swilling a 20-ml bolus of 6.5% maltodextrin (CHO) or a color- and taste-matched placebo (PLA) every 5 km. Heart rate, power output, rectal temperature (Tre), and mean skin temperature (Tsk) were recorded continuously; cardiac...

  20. Thermal and cardiovascular strain mitigate the potential benefit of carbohydrate mouth rinse during self-paced exercise in the heat

    OpenAIRE

    Matthew eCramer; Martin eThompson; Julien ePériard

    2015-01-01

    Purpose: To determine whether a carbohydrate mouth rinse can alter self-paced exercise performance independently of a high degree of thermal and cardiovascular strain.Methods: Eight endurance-trained males performed two 40-km cycling time trials in 35°C, 60% RH while swilling a 20-ml bolus of 6.5% maltodextrin (CHO) or a colour- and taste-matched placebo (PLA) every 5 km. Heart rate, power output, rectal temperature (Tre), and mean skin temperature (Tsk) were recorded continuously; cardiac ou...

  1. Artificial intelligence

    OpenAIRE

    Duda, Antonín

    2009-01-01

    Abstract : Issue of this work is to acquaint the reader with the history of artificial inteligence, esspecialy branch of chess computing. Main attention is given to progress from fifties to the present. The work also deals with fighting chess programs against each other, and against human opponents. The greatest attention is focused on 1997 and duel Garry Kasparov against chess program Deep Blue. The work is divided into chapters according to chronological order.

  2. Characterizing Spatial Dynamics of Bifurcation to Alternans in Isolated Whole Rabbit Hearts Based on Alternate Pacing

    Directory of Open Access Journals (Sweden)

    Kanchan Kulkarni

    2015-01-01

    Full Text Available Sudden cardiac death instigated by ventricular fibrillation (VF is the largest cause of natural death in the USA. Alternans, a beat-to-beat alternation in the action potential duration, has been implicated as being proarrhythmic. The onset of alternans is mediated via a bifurcation, which may occur through either a smooth or a border-collision mechanism. The objective of this study was to characterize the mechanism of bifurcation to alternans based on experiments in isolated whole rabbit hearts. High resolution optical mapping was performed and the electrical activity was recorded from the left ventricle (LV epicardial surface of the heart. Each heart was paced using an “alternate pacing protocol,” where the basic cycle length (BCL was alternatively perturbed by ±δ. Local onset of alternans in the heart, BCLstart, was measured in the absence of perturbations (δ=0 and was defined as the BCL at which 10% of LV exhibited alternans. The influences of perturbation size were investigated at two BCLs: one prior to BCLstart (BCLprior=BCLstart+20 ms and one preceding BCLprior (BCLfar=BCLstart+40 ms. Our results demonstrate significant spatial correlation of the region exhibiting alternans with smooth bifurcation characteristics, indicating that transition to alternans in isolated rabbit hearts occurs predominantly through smooth bifurcation.

  3. Functional remodeling of Ca2+-activated Cl- channel in pacing induced canine failing heart

    Institute of Scientific and Technical Information of China (English)

    Ning Li; Kejuan Ma; Siyong Teng; Jonathan C.Makielski; Jielin Pu

    2008-01-01

    Objective To determine whether Ca2+ activated Cl- current(Icl(Ca)) contributes to the functional remodeling of the failing heart.Methods Whole cell patch-clamp recording technique was employed to record the Icl(Ca) in cardiac myocytes enzymatically isolatedfrom rapidly pacing induced canine failing hearts at room temperature and compared that of the normal hearts (Nor).Results Thecurrent density of DIDS(200M)sensitive Icl(Ca) induced by intracellular Ca2+ release trigged by L-type Ca2+ current(Ica,L)wassignificantly decreased in heart failare(HE)cells compared to Nor cells.At membrane voltage of 20mV,the Icl(Ca) density was 3.02±0.54 pA/pF in Nor(n=6)vs.1.31±0.25 pA/pF in HF(n=8)cells,(P<0.01),while the averaged Ica,L density did not show differencebetween two groups.The time constant of current decay of Icl(Ca) was similar in both types of cells.On the other hand,in intra cellularCa2+ clamped mode,where the[Ca2+];was maintained at 100nmol/L,Icl(Ca) density be increased significantly in HF cells when themembrane voltage at+30mV or higher.Conclusions Our results suggest that Icl(Ca) density was decreased in pacing induced failingheart but the channel function be enhanced.Impaired Ca2+ handing in HF cells rather than reduced,Icl(Ca) channel function itself may havecaused this abnormality.The Icl(Ca) density reduction might contribute to the prolongation of action potential in failing heart.The Icl(Ca)channel function up-rugulation is likely to cause cardiac arrhythmia by inducing a delayed after depolarization,when Ca2+ overloadoccurred in diastolic failing heart cells.

  4. [Electromagnetic interference of electrical dental equipment with cardiac pacemakers].

    Science.gov (United States)

    Brand, H S; van der Hoeff, E V; Schrama, T A M; Entjes, M L; van Nieuw, Amerongen A

    2007-09-01

    Eight different electrical dental appliances were tested at different intervals for their ability to interfere with the function of a contemporary cardiac pacemaker. The normal atrial and ventricular pacing was inhibited by an ultrasonic bath cleaner at a distance of less than 15 cm. In contrast, a dental chair, an electrosurgical unit, an ultrasonic tooth scaler, 2 handpieces, and 2 amalgamators failed to produce electromagnetic interference at the minimum distance of 2.5 cm. In conclusion, the results suggest that normal clinical use of dental electrical equipment does not have any significant effect on the cardiac pacemaker tested. PMID:17937372

  5. Factors explaining voluntary participation in PACE-Vaquita

    OpenAIRE

    Sara Avila

    2011-01-01

    Vaquita marina, a small species of porpoise endemic to the Northern Gulf of California in Mexico, is the world’s most endangered cetacean species. With the purpose of preserving vaquita, the Mexican government launched PACE-Vaquita in 2008. This voluntary program offers an innovative schedule of compensations: as in a payment for conservation program, PACE-Vaquita compensates for temporary reductions in fishing reductions in fishing effort; as in a program to accelerate technology adoption,PA...

  6. Cardiac involvement in Emery Dreifuss muscular dystrophy: a case series

    OpenAIRE

    Buckley, A.; Dean, J.; Mahy, I

    1999-01-01

    Three patients with Emery Dreifuss muscular dystrophy are reported. Emery Dreifuss muscular dystrophy is an X linked muscular dystrophy, in which locomotor involvement is characteristically mild and slowly progressive. The effect on the heart becomes apparent in the teenage years and is characterised by cardiac conduction defects and infiltration of the myocardium by fibrous and adipose tissue. It first affects the atria, which results in atrial paralysis; treatment with ventricular pacing is...

  7. Cardiac resynchronization therapy guided by cardiovascular magnetic resonance

    OpenAIRE

    Leyva Francisco

    2010-01-01

    Abstract Cardiac resynchronization therapy (CRT) is an established treatment for patients with symptomatic heart failure, severely impaired left ventricular (LV) systolic dysfunction and a wide (> 120 ms) complex. As with any other treatment, the response to CRT is variable. The degree of pre-implant mechanical dyssynchrony, scar burden and scar localization to the vicinity of the LV pacing stimulus are known to influence response and outcome. In addition to its recognized role in the assessm...

  8. PACE and the Federal Housing Finance Agency (FHFA)

    Energy Technology Data Exchange (ETDEWEB)

    Zimring, Mark; Fuller, Merrian

    2010-03-17

    The FHFA regulates Fannie Mae, Freddie Mac, and the 12 Federal Home Loan Banks (the government-sponsored enterprises - GSEs). On June 18, 2009, James B. Lockhart III, then Director of FHFA, released a letter expressing concern about the negative impact of energy loan tax assessment programs (ELTAPs) - also known as Property Assessed Clean Energy (PACE) programs - on both the housing finance system and homeowner program participants. Subsequently, a number of PACE proponents responded to the concerns laid out in the FHFA letter. In early Fall 2009, word circulated that FHFA was planning to follow its June letter with guidance to other agencies, possibly including Fannie Mae and Freddie Mac, discouraging them from buying loans on properties subject to PACE-type assessment liens. This triggered a second round of stakeholder letters, several of which were addressed to President Obama. On October 18, 2009, the White House, in what some believe was an attempt to obviate the need for FHFA guidance, released a Policy Framework for PACE Financing Programs that outlined best practices guidance for homeowner and lender protection. As of February 2010, FHFA and the GSEs have agreed to monitor PACE programs and work with stakeholders and the Administration to consider additional guidance beyond the Policy Framework and to collect more information on PACE program efficacy and risks. A summary of the communications timeline and highlights of the communications are provided.

  9. The Pace of Perceivable Extreme Climate Change

    Science.gov (United States)

    Tan, X.; Gan, T. Y.

    2015-12-01

    When will the signal of obvious changes in extreme climate emerge over climate variability (Time of Emergence, ToE) is a key question for planning and implementing measures to mitigate the potential impact of climate change to natural and human systems that are generally adapted to potential changes from current variability. We estimated ToEs for the magnitude, duration and frequency of global extreme climate represented by 24 extreme climate indices (16 for temperature and 8 for precipitation) with different thresholds of the signal-to-noise (S/N) ratio based on projections of CMIP5 global climate models under RCP8.5 and RCP4.5 for the 21st century. The uncertainty of ToE is assessed by using 3 different methods to calculate S/N for each extreme index. Results show that ToEs of the projected extreme climate indices based on the RCP4.5 climate scenarios are generally projected to happen about 20 years later than that for the RCP8.5 climate scenarios. Under RCP8.5, the projected magnitude, duration and frequency of extreme temperature on Earth will all exceed 2 standard deviations by 2100, and the empirical 50th percentile of the global ToE for the frequency and magnitude of hot (cold) extreme are about 2040 and 2054 (2064 and 2054) for S/N > 2, respectively. The 50th percentile of global ToE for the intensity of extreme precipitation is about 2030 and 2058 for S/N >0.5 and S/N >1, respectively. We further evaluated the exposure of ecosystems and human societies to the pace of extreme climate change by determining the year of ToE for various extreme climate indices projected to occur over terrestrial biomes, marine realms and major urban areas with large populations. This was done by overlaying terrestrial, ecoregions and population maps with maps of ToE derived, to extract ToEs for these regions. Possible relationships between GDP per person and ToE are also investigated by relating the mean ToE for each country and its average value of GDP per person.

  10. Effects of gastric pacing on gastric emptying and plasma motilin

    Institute of Scientific and Technical Information of China (English)

    Min Yang; Dian-Chun Fang; Qian-Wei Li; Nian-Xu Sun; Qing-Lin Long; Jian-Feng Sui; Lu Gan

    2004-01-01

    AIM: To invertigate the effects of gastric pacing on gastric emptying and plasma motilin level in a canine model of gastric motility disorders and the correlation between gastric emptying and plasma motilin level.METHODS: Ten healthy Mongrel dogs were divided into:experimental group of six dogs and control group of four dogs. A model of gastric motility disorders was established in the experimental group undergone truncal vagotomy combined with injection of glucagon. Gastric half-emptying time (GEt1/2) was monitored with single photon emission computerized tomography (SPECT), and the half-solid test meal was labeled with an isotope-99m Tc sulfur colloid. Plasma motilin concentration was measured with radioimmunoassay (RIA) kit. Surface gastric pacing at 1.1-1.2 times the intrinsic slow-wave frequency and a superimposed series of high frequency pulses (10-30 Hz) was performed for 45 min daily for a month in conscious dogs.RESULTS: After surgery, GEt1/2 in dogs undergone truncal vagotomy was increased significantly from 56.35±2.99 min to 79.42±l.91 min (P<0.001), but surface gastric pacing markedly accelerated gastric emptying and significantly decreased GEt1/2 to 64,94±l.75 min (P<0.001) in animals undergone vagotomy. There was a significant increase of plasma level of motilin at the phase of IMCⅢ (interdigertive myoelectrical complex, IMCⅢ) in the dogs undergone bilateral truncal vagotomy (baseline vs vagotomy, 184.29±9.81 pg/ml vs 242.09±17,22 pg/ml; P<0.01). But plasma motilin concentration (212.55±11.20 pg/ml; P<0.02) was decreased significantly after a long-term treatment with gastric pacing.Before gastric pacing, GEt1/2 and plasma motilin concentration of the dogs undergone vagotomy showed a positive correlation (r=0.867, P<0.01), but after a long-term gastric pacing, GEt1/2 and motilin level showed a negative correlation (r=-0.733, P<0,04).CONCLUSION: Surface gastric pacing with optimal pacing parameters can improve gastric emptying

  11. Biomechanically and electromyographically assessed load on the spine in self-paced and force-paced lifting work.

    Science.gov (United States)

    Leskinen, T P; Stålhammar, H R; Rautanen, M T; Troup, J D

    1992-01-01

    The purpose of this study was to measure dose of spinal load when different pacing methods were applied to lifting work and to develop methodology for such measurements. The compressive load on the spine computed by a dynamic biomechanical model and the electromyographic activity of back muscles were used for describing the spinal load. Five men and five women worked in a laboratory on two days lifting a box up and down for 30 min on both days, on one day force-paced (4 lifts/min), and on the other self-paced in random order. The weight of the box was rated by the subjects to be acceptable for the work done. The lift rate of our female subjects was higher and that of the male subjects lower in self-paced than in force-paced work. There were no significant differences in peak lumbosacral compressions nor in the amplitude distributions of electromyography between the two pacing methods. The biomechanically-calculated compressive forces on the spine were lower (about 2.7 kN for the men and 2.3 kN for women) than the biomechanical recommendations for safe lifting, but the EMG activity showed quite high peaks so that for 1% of work time the activity was on women above 60% and on men above 40% of the activity during maximum isometric voluntary test contraction. PMID:1633794

  12. 生理性起搏的研究进展%Advances in Study of Physiological Pacing

    Institute of Scientific and Technical Information of China (English)

    李林; 李兴德

    2014-01-01

    Cur ently ,Cardiac pacemaker is the preferred treatment of sinus node dysfunction , high degree atrioventricular block and other slow ar hythmia disease , and the clinical indications has been extended to refractory congestive heart failure , ventricular fibril ation , carotid sinus hypersensitivity induced syncope and other non-pacing and conduction system diseases . However, mimicking the physiological pacing maximum has been the main direction of electric physiologists to research , we do the fol owing review on the research progress of physiological pacing.%心脏起搏器是目前治疗窦房结功能障碍、高度房室传导阻滞等缓慢型心律失常的首选治疗方案,且临床适应症已经扩展到顽固性充血性心力衰竭、心室颤动、颈动脉窦过敏所致晕厥等非起搏及传导系统疾病的治疗。然而最大程度的模仿生理性起搏,一直是起搏电生理学家们所研究的主要方向,现就生理性起搏的研究进展做如下综述。

  13. Cardiac adaptation to endurance exercise in rats.

    Science.gov (United States)

    Fenning, Andrew; Harrison, Glenn; Dwyer, Dan; Rose'Meyer, Roselyn; Brown, Lindsay

    2003-09-01

    Endurance exercise is widely assumed to improve cardiac function in humans. This project has determined cardiac function following endurance exercise for 6 (n = 30) or 12 (n = 25) weeks in male Wistar rats (8 weeks old). The exercise protocol was 30 min/day at 0.8 km/h for 5 days/week with an endurance test on the 6th day by running at 1.2 km/h until exhaustion. Exercise endurance increased by 318% after 6 weeks and 609% after 12 weeks. Heart weight/kg body weight increased by 10.2% after 6 weeks and 24.1% after 12 weeks. Echocardiography after 12 weeks showed increases in left ventricular internal diameter in diastole (6.39 +/- 0.32 to 7.90 +/- 0.17 mm), systolic volume (49 +/- 7 to 83 +/- 11 miccrol) and cardiac output (75 +/- 3 to 107 +/- 8 ml/min) but not left wall thickness in diastole (1.74 +/- 0.07 to 1.80 +/- 0.06 mm). Isolated Langendorff hearts from trained rats displayed decreased left ventricular myocardial stiffness (22 +/- 1.1 to 19.1 +/- 0.3) and reduced purine efflux during pacing-induced workload increases. 31P-NMR spectroscopy in isolated hearts from trained rats showed decreased PCr and PCr/ATP ratios with increased creatine, AMP and ADP concentrations. Thus, this endurance exercise protocol resulted in physiological hypertrophy while maintaining or improving cardiac function. PMID:14575304

  14. Diagnosis and treatment of cardiac sarcoidosis.

    Science.gov (United States)

    Kusano, Kengo F; Satomi, Kazuhiro

    2016-02-01

    Sarcoidosis is a systemic granulomatous disease of unknown aetiology. The frequency of cardiac involvement (cardiac sarcoidosis (CS)) varies in the different geographical regions, but it has been reported that it is an absolutely important prognostic factor in this disease. Complete atrioventricular block is the most common, and ventricular tachycardia/ventricular fibrillation the second most common arrhythmia in this disease, both of which are associated with cardiac sudden death. Diagnosing CS is sometimes difficult because of the non-specific ECG and echocardiographic findings, and CS is sometimes misdiagnosed as dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy or an idiopathic ventricular aneurysm, and therefore, endomyocardial biopsy is important, but has a low sensitivity. Another problem is the recognition of isolated types of CS. Recently, MRI and (18)F-fluorodeoxyglucose positron emission tomography have been demonstrated to be useful tools for the non-invasive diagnosis of CS as well as therapeutic evaluation tools, but are still unsatisfactory. Treatment of CS is usually done by corticosteroid therapy to control inflammation, prevent fibrosis and protect from any deterioration of the cardiac function, but the long-term outcome is still in debate. Despite the advancement of non-pharmacological approaches for CS (pacing, defibrillators and catheter ablation) to improve the prognosis, there are still many issues remaining to resolve diagnosing and managing CS. Here, we attempt a review of the clinical evidence, with special focus on the current understanding of this disease and showing the current strategies and remaining problems of diagnosing and managing CS. PMID:26643814

  15. Right ventricular pacing: the best site is yet to be defined

    Institute of Scientific and Technical Information of China (English)

    Li ZHOU; Brian Olshansky

    2005-01-01

    @@ The right ventricular (RV) apex is the traditional site to provide stable and reliable chronic ventricular pacing. Interest in alternate site pacing has grown since RV apical pacing has been associated with increased mortality and morbidity compared to normal atrio-ventricular conduction. 1-4 Alternate pacing sites include the RV septum and outflow tract.

  16. Cardiac MRI in Athletes

    NARCIS (Netherlands)

    Luijkx, T.

    2012-01-01

    Cardiac magnetic resonance imaging (CMR) is often used in athletes to image cardiac anatomy and function and is increasingly requested in the context of screening for pathology that can cause sudden cardiac death (SCD). In this thesis, patterns of cardiac adaptation to sports are investigated with C

  17. Artificial Heart and Self-making

    Science.gov (United States)

    Imachi, Kou

    Artificial heart (AH) study has been started in 1957. After the accomplishments of various difficulties, the AH can become to use clinically as a postcardiotomy cardiac assist or bridge to heart transplantation. However, there remain many obstacles to realize an implantable total artificial heart. The history of AH was the self-making. Although self-making is important in all the experimental sciences, it is the most important factor to develop AH. In this paper, the author would like to introduce the present status of AH and the importance of self-making.

  18. Clinicohemodynamic and roentgenologic correlations in patients with artificial pacemakers

    International Nuclear Information System (INIS)

    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

  19. Generation of cardiac pacemaker cells by programming and differentiation.

    Science.gov (United States)

    Husse, Britta; Franz, Wolfgang-Michael

    2016-07-01

    A number of diseases are caused by faulty function of the cardiac pacemaker and described as "sick sinus syndrome". The medical treatment of sick sinus syndrome with electrical pacemaker implants in the diseased heart includes risks. These problems may be overcome via "biological pacemaker" derived from different adult cardiac cells or pluripotent stem cells. The generation of cardiac pacemaker cells requires the understanding of the pacing automaticity. Two characteristic phenomena the "membrane-clock" and the "Ca(2+)-clock" are responsible for the modulation of the pacemaker activity. Processes in the "membrane-clock" generating the spontaneous pacemaker firing are based on the voltage-sensitive membrane ion channel activity starting with slow diastolic depolarization and discharging in the action potential. The influence of the intracellular Ca(2+) modulating the pacemaker activity is characterized by the "Ca(2+)-clock". The generation of pacemaker cells started with the reprogramming of adult cardiac cells by targeted induction of one pacemaker function like HCN1-4 overexpression and enclosed in an activation of single pacemaker specific transcription factors. Reprogramming of adult cardiac cells with the transcription factor Tbx18 created cardiac cells with characteristic features of cardiac pacemaker cells. Another key transcription factor is Tbx3 specifically expressed in the cardiac conduction system including the sinoatrial node and sufficient for the induction of the cardiac pacemaker gene program. For a successful cell therapeutic practice, the generated cells should have all regulating mechanisms of cardiac pacemaker cells. Otherwise, the generated pacemaker cells serve only as investigating model for the fundamental research or as drug testing model for new antiarrhythmics. 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.

  20. Generation of cardiac pacemaker cells by programming and differentiation.

    Science.gov (United States)

    Husse, Britta; Franz, Wolfgang-Michael

    2016-07-01

    A number of diseases are caused by faulty function of the cardiac pacemaker and described as "sick sinus syndrome". The medical treatment of sick sinus syndrome with electrical pacemaker implants in the diseased heart includes risks. These problems may be overcome via "biological pacemaker" derived from different adult cardiac cells or pluripotent stem cells. The generation of cardiac pacemaker cells requires the understanding of the pacing automaticity. Two characteristic phenomena the "membrane-clock" and the "Ca(2+)-clock" are responsible for the modulation of the pacemaker activity. Processes in the "membrane-clock" generating the spontaneous pacemaker firing are based on the voltage-sensitive membrane ion channel activity starting with slow diastolic depolarization and discharging in the action potential. The influence of the intracellular Ca(2+) modulating the pacemaker activity is characterized by the "Ca(2+)-clock". The generation of pacemaker cells started with the reprogramming of adult cardiac cells by targeted induction of one pacemaker function like HCN1-4 overexpression and enclosed in an activation of single pacemaker specific transcription factors. Reprogramming of adult cardiac cells with the transcription factor Tbx18 created cardiac cells with characteristic features of cardiac pacemaker cells. Another key transcription factor is Tbx3 specifically expressed in the cardiac conduction system including the sinoatrial node and sufficient for the induction of the cardiac pacemaker gene program. For a successful cell therapeutic practice, the generated cells should have all regulating mechanisms of cardiac pacemaker cells. Otherwise, the generated pacemaker cells serve only as investigating model for the fundamental research or as drug testing model for new antiarrhythmics. 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

  1. Mechanical Blood Pumps for Cardiac Assistance

    OpenAIRE

    Akdis, M; Reul, H

    2005-01-01

    Cardiac assist devices are classified into the traditional engineering categories of displacement and rotary pumps. Clinical use and indications of the various pump categories are outlined and a detailed description of currently available systems is given. The first part deals with extracorporeal as well as implantable ventricular assist devices (VAD) of the displacement type and is followed by a section on current developments in the field of total artificial hearts (TAH). The second part co...

  2. Pacing accuracy during an incremental step test in adolescent swimmers

    Directory of Open Access Journals (Sweden)

    Scruton A

    2015-08-01

    Full Text Available Adrian Scruton, James Baker, Justin Roberts, Itay Basevitch, Viviane Merzbach, Dan Gordon Sport and Exercise Sciences Research Group, Anglia Ruskin University, Cambridge, UK Abstract: To assess pacing accuracy in a group of adolescent swimmers during an incremental step test. Fifteen well-trained swimmers (age 15±1.5 years; height 170.2±8.8 cm; mass 60.2±6.6 kg, completed two 7×200 m tests, separated by ~72 hours. They swam to a predetermined incrementally increasing pace per step and were instructed to swim at even pace. Upon completion of each step, rating of perceived exertion, heart rate and blood lactate were recorded. Significant differences observed for both trials between actual and predicted swim time (P<0.05. Significant differences also observed between the first and second 100 m of each step in trial 1 for step 1 (P=0.001, effect size [ES] =0.54, step 2 (P=0.0001, ES =0.57, step 4 (P=0.0001, ES =0.53, step 5 (P=0.005, ES =0.65, step 6 (P=0.0001, ES =0.50, and step 7 (P=0.0001, ES =0.70. Similar responses witnessed for trial 2 (P<0.05. Findings suggest that the finite anaerobic capacity was engaged sooner than would normally be anticipated, as a function of an inability to regulate pace. This is proposed to be a consequence of the volume of exposure to the biological and psychological sensations and cognitive developmental status. Given the apparent error in pacing judgment exhibited in this population group, caution should be applied when adopting such tests to monitor training responses with adolescent athletes, and alternate means of modulating pace be investigated. Keywords: effort regulation, children, exercise testing, perception

  3. International piping benchmarks: Use of simplified code PACE 2

    International Nuclear Information System (INIS)

    This report compares the results obtained using the code PACE 2 with the International Working Group on Fast Reactors (IWGFR) International Piping Benchmark solutions. PACE 2 is designed to analyse systems of pipework using a simplified method which is economical of computer time and hence inexpensive. This low cost is not achieved without some loss of accuracy in the solution, but for most parts of a system this inaccuracy is acceptable and those sections of particular importance may be reanalysed using more precise methods in order to produce a satisfactory analysis of the complete system at reasonable cost. (author)

  4. Artificial Economy

    Directory of Open Access Journals (Sweden)

    Alexandru JIVAN

    2011-08-01

    Full Text Available This paper proposes to eliminate, a routine in the economic thinking, claimed to be responsible for the negative essence of economic developments, from the point of view, of the ecological implications (employment in the planetary ecosystem. The methodological foundations start from the natural origins of the functionality of the human economic society according to the originary physiocrat liberalism, and from specific natural characteristics of the humankind. This paper begins with a comment-analysis of the difference between natural and artificial within the economy, and then explains some of the most serious diversions from the natural essence of economic liberalism. It shall be explained the original (heterodox interpretation of the Classical political economy (economics, by making calls to the Romanian economic thinking from aggravating past century. Highlighting the destructive impact of the economy - which, under the invoked doctrines, we call unnatural - allows an intuitive presentation of a logical extension of Marshall's market price, based on previous research. Besides the doctrinal arguments presented, the economic realities inventoried along the way (major deficiencies and effects, determined demonstrate the validity of the hypothesis of the unnatural character and therefore necessarily to be corrected, of the concept and of the mechanisms of the current economy.The results of this paper consist of original heterodox methodspresented, intuitive or developed that can be found conclusively within the key proposals for education and regulation.

  5. Cardiac perception and cardiac control. A review.

    Science.gov (United States)

    Carroll, D

    1977-12-01

    The evidence regarding specific cardiac perception and discrimination, and its relationship to voluntary cardiac control, is critically reviewed. Studies are considered in three sections, depending on the method used to assess cardiac perception: questionnaire assessment, discrimination procedures, and heartbeat tracking. The heartbeat tracking procedure would appear to suffer least from interpretative difficulties. Recommendations are made regarding the style of analysis used to assess heartbeat perception in such tracking tasks. PMID:348240

  6. Investigating possible ethnicity and sex bias in clinical examiners: an analysis of data from the MRCP(UK) PACES and nPACES examinations

    OpenAIRE

    McManus, I C; Elder, A T; DACRE, J

    2013-01-01

    Background Bias of clinical examiners against some types of candidate, based on characteristics such as sex or ethnicity, would represent a threat to the validity of an examination, since sex or ethnicity are ‘construct-irrelevant’ characteristics. In this paper we report a novel method for assessing sex and ethnic bias in over 2000 examiners who had taken part in the PACES and nPACES (new PACES) examinations of the MRCP(UK). Method PACES and nPACES are clinical skills examinations that have ...

  7. The effects of fluid ingestion on free-paced intermittent-sprint performance and pacing strategies in the heat.

    Science.gov (United States)

    Skein, Melissa; Duffield, Rob

    2010-02-01

    The purpose of this study was to examine the effects of fluid ingestion on pacing strategies and performance during intermittent-sprint exercise in the heat. Nine male rugby players performed a habituation session and 2 x 50-min intermittent-sprint protocols at a temperature of 31 degrees C, either with or without fluid. Participants were informed of a third session (not performed) to ensure that they remained blind to all respective conditions. The protocol consisted of a 15-m sprint every minute separated by self-paced bouts of hard running, jogging, and walking for the remainder of the minute. Sprint time, distance covered during self-paced exercise, and vertical jump height before and after exercise were recorded. Heart rate, core temperature, nude mass, capillary blood haematocrit, pH, lactate concentration, perceptual ratings of perceived exertion, thermal stress, and thirst were also recorded. Sprint times (fluid vs. no-fluid: 2.82 +/- 0.11 vs. 2.82 +/- 0.14) and distance covered during self-paced exercise (fluid vs. no-fluid: 4168 +/- 419 vs. 3981 +/- 263 m) were not different between conditions (P = 0.10-0.98) but were progressively reduced to a greater extent in the no-fluid trial (7 +/- 13%) (d = 0.56-0.58). There were no differences (P = 0.22-1.00; d = stress did not differ between conditions (P = 0.34-0.91; d < or =0.20-0.48). Rating of thirst after exercise was lower in the fluid trial (P = 0.02; d = 0.62-0.73). The present results suggest that fluid availability did not improve intermittent-sprint performance, however did affect pacing strategies with a greater reduction in distance covered of self-paced exercise during the no-fluid trial. PMID:20077276

  8. Improved quality of life after treatment of prolonged asystole during breath holding spells with a cardiac pacemaker

    Directory of Open Access Journals (Sweden)

    Bruno Kolterer

    2015-01-01

    Conclusion: Cardiac pacing using appropriate pacemaker settings seems effective in the prevention of LOC and reduction of the frequency of BHS. Our results imply a reduction of subjective stress levels of patients and parents as well as an increased quality of everyday life. After all, randomized controlled trials of the influence of cardiac pacemaker implantation on subjective stress levels in patients with BHS are needed.

  9. "Set the Pace": Nutrition Education DVD for Head Start Parents

    Science.gov (United States)

    Adedze, Pascasie; Orr, Robin A.; Chapman-Novakofski, Karen; Donovan, Sharon M.

    2013-01-01

    Childhood overweight remains a major public health problem and innovative nutrition education programs are still needed. Thus, the "Set the Pace" is a nutrition education DVD for Head Start parents which provides visual nutrition education and physical activities to incorporate in their daily routines. (Contains 1 table.)

  10. Gait coordination after stroke: Benefits of acoustically paced treadmill walking

    NARCIS (Netherlands)

    Roerdink, Melvyn; Lamoth, Claudine J.C.; Kwakkel, Gert; Van Wieringen, Piet C.W.; Beek, Peter J.

    2007-01-01

    Background and Purpose: Gait coordination often is compromised after stroke. The purpose of this study was to evaluate the efficacy of acoustically paced treadmill walking as a method for improving gait coordination in people after stroke. Participants: Ten people after stroke volunteered for the st

  11. 'Human paced' walking: Followers adopt stride time dynamics of leaders

    NARCIS (Netherlands)

    Marmelat, V.C.M.; Delignières, D.; Torre, K.; Beek, P.J.; Daffertshofer, A.

    2014-01-01

    Isochronous cueing is widely used in gait rehabilitation even though it alters the stride-time dynamics toward anti-persistent rather than the persistent, fractal fluctuations characteristic of human walking. In the present experiment we tested an alternative cueing method: pacing by a human. To thi

  12. Hardware packet pacing using a DMA in a parallel computer

    Science.gov (United States)

    Chen, Dong; Heidelberger, Phillip; Vranas, Pavlos

    2013-08-13

    Method and system for hardware packet pacing using a direct memory access controller in a parallel computer which, in one aspect, keeps track of a total number of bytes put on the network as a result of a remote get operation, using a hardware token counter.

  13. Self-Paced Physics, Segments 24-27.

    Science.gov (United States)

    New York Inst. of Tech., Old Westbury.

    Four study segments of the Self-Paced Physics Course materials are presented in this fifth problems and solutions book used as a part of student course work. The subject matter is related to work in electric fields, potential differences, parallel plates, electric potential energies, potential gradients, capacitances, and capacitor circuits.…

  14. Self-Paced Physics, Segments 28-31.

    Science.gov (United States)

    New York Inst. of Tech., Old Westbury.

    Four study segments of the Self-Paced Physics Course materials are presented in this sixth problems and solutions book used as a part of student course work. The subject matter is related to electric currents, current densities, resistances, Ohm's law, voltages, Joule heating, electromotive forces, single loop circuits, series and parallel…

  15. 42 CFR 460.180 - Medicare payment to PACE organizations.

    Science.gov (United States)

    2010-10-01

    ... risk adjustment model. (5) CMS may adjust the monthly capitation amount to take into account other... or Federal workers' compensation, any no-fault insurance, or any liability insurance policy or plan, including a self-insured plan, the PACE organization may charge any of the following: (i) The...

  16. Gait coordination after stroke: benefits of acoustically paced treadmill walking.

    NARCIS (Netherlands)

    Roerdink, M.; Lamoth, C.J.; Kwakkel, G.; Wieringen, P.C. van; Beek, P.J.

    2007-01-01

    BACKGROUND AND PURPOSE: Gait coordination often is compromised after stroke. The purpose of this study was to evaluate the efficacy of acoustically paced treadmill walking as a method for improving gait coordination in people after stroke. PARTICIPANTS: Ten people after stroke volunteered for the st

  17. MFTF-B PACE tests and final cost report

    International Nuclear Information System (INIS)

    The Mirror Fusion Test Facility (MFTF-B) construction project was successfully completed in February 1986, with the conclusion of the Plant and Capital Equipment (PACE) Tests. This series of tests, starting in September 1985 and running through February 1986, demonstrated the overall machine capabilities and special facilities accomplishments for the Mirror Fusion Test Facility Project

  18. Cardiac resynchronization therapy guided by late gadolinium-enhancement cardiovascular magnetic resonance

    Directory of Open Access Journals (Sweden)

    Smith Russell EA

    2011-06-01

    Full Text Available Abstract Background Myocardial scarring at the LV pacing site leads to incomplete resynchronization and a suboptimal symptomatic response to CRT. We sought to determine whether the use of late gadolinium cardiovascular magnetic resonance (LGE-CMR to guide left ventricular (LV lead deployment influences the long-term outcome of cardiac resynchronization therapy (CRT. Methods 559 patients with heart failure (age 70.4 ± 10.7 yrs [mean ± SD] due to ischemic or non-ischemic cardiomyopathy underwent CRT. Implantations were either guided (+CMR or not guided (-CMR by LGE-CMR prior to implantation. Fluoroscopy and LGE-CMR were used to localize the LV lead tip and and myocardial scarring retrospectively. Clinical events were assessed in three groups: +CMR and pacing scar (+CMR+S; CMR and not pacing scar (+CMR-S, and; LV pacing not guided by CMR (-CMR. Results Over a maximum follow-up of 9.1 yrs, +CMR+S had the highest risk of cardiovascular death (HR: 6.34, cardiovascular death or hospitalizations for heart failure (HR: 5.57 and death from any cause or hospitalizations for major adverse cardiovascular events (HR: 4.74 (all P Conclusions Compared with a conventional implantation approach, the use of LGE-CMR to guide LV lead deployment away from scarred myocardium results in a better clinical outcome after CRT. Pacing scarred myocardium was associated with the worst outcome, in terms of both pump failure and sudden cardiac death.

  19. 3D engineered cardiac tissue models of human heart disease: learning more from our mice.

    Science.gov (United States)

    Ralphe, J Carter; de Lange, Willem J

    2013-02-01

    Mouse engineered cardiac tissue constructs (mECTs) are a new tool available to study human forms of genetic heart disease within the laboratory. The cultured strips of cardiac cells generate physiologic calcium transients and twitch force, and respond to electrical pacing and adrenergic stimulation. The mECT can be made using cells from existing mouse models of cardiac disease, providing a robust readout of contractile performance and allowing a rapid assessment of genotype-phenotype correlations and responses to therapies. mECT represents an efficient and economical extension to the existing tools for studying cardiac physiology. Human ECTs generated from iPSCMs represent the next logical step for this technology and offer significant promise of an integrated, fully human, cardiac tissue model.

  20. [The best of cardiac failure in 1999].

    Science.gov (United States)

    Desnos, M

    2000-01-01

    Cardiac failure has become a major but underestimated public health problem. The EPICAL study in France confirmed the severity of this condition. In addition to the neuro-hormones, the role played by inflammatory cytokines in the progression of the disease has been emphasized. The importance of the "genetic background" in the development and evolution of cardiac failure has been demonstrated (deletion or prospective polymorphism). From the therapeutic point of view, besides the hopes raised by multisite pacing, the betablockers and spironolactone have been shown to provide major functional improvement and prolonged survival, and they take their place with the angiotensin converting enzyme inhibitors in our pharmacological arsenal. Cellular transplantation is associated with encouraging pre-clinical results which open up a new field of interest. Finally, global management, including physical rehabilitation and patient education by plury-disciplinary teams, provides medical and economic benefits. The year 1999 has been particularly rich in the field of cardiac failure from the basis of fundamental research to the organisation of health care. PMID:10721444

  1. Potential proarrhythmic effect of cardiac resynchronization therapy during perioperative period: data from a single cardiac center

    Institute of Scientific and Technical Information of China (English)

    LUO Nian-sang; YUAN Wo-liang; LIN Yong-qing; CHEN Yang-xin; MAO Xiao-qun; XIE Shuang-lun; KONG Min-yi; ZHOU Shu-xian; WANG Jing-feng

    2010-01-01

    Background Cardiac resynchronization therapy (CRT) could improve heart function, symptom status, quality of life and reduce hospitalization and mortality in patients with severe heart failure (HF) with optimal medical management. However,the possible adverse effects of CRT are often ignored by clinicians.Method A retrospective analysis of CRT over a 6-year period was made in a single cardiac center.Results Fifty-four patients were treated with CRT(D) device, aged (57±11) years, with left ventricular ejection fraction of (32.1±9.8)%, of which 4 (7%) developed ventricular tachycardia/ventricular fibrillation (VT/VF) or junctional tachycardia after operation. Except for one with frequent ventricular premature beat before operation, the others had no previous history of ventricular arrhythmia. Of the 4 patients, 3 had dilated cardiomyopathy and 1 had ischemic cardiomyopathy,and tachycardia occurred within 3 days after operation. Sustained, refractory VT and subsequent VF occurred in one patient, frequent nonsustained VT in two patients and nonparoxysmal atrioventricular junctional tachycardia in one patient. VT was managed by amiodarone in two patients, amiodarone together with beta-blocker in one patient, and junctional tachycardia was terminated by overdrive pacing. During over 12-month follow-up, except for one patient's death due to refractory heart and respiratory failure in hospital, the others remain alive and arrhythmia-free.Conclusions New-onset VT/VF or junctional tachycardia may occur in a minority of patients with or without prior history of tachycardia after biventricular pacing. Arrhythmia can be managed by conventional therapy, but may require temporary discontinuation of pacing. More observational studies should be performed to determine the potential proarrhythmic effect of CRT.

  2. Cardiac sodium channelopathies

    NARCIS (Netherlands)

    A.S. Amin; A. Asghari-Roodsari; H.L. Tan

    2010-01-01

    Cardiac sodium channel are protein complexes that are expressed in the sarcolemma of cardiomyocytes to carry a large inward depolarizing current (I-Na) during phase 0 of the cardiac action potential. The importance of I-Na for normal cardiac electrical activity is reflected by the high incidence of

  3. Diffuse infiltrative cardiac tuberculosis

    International Nuclear Information System (INIS)

    We present the cardiac magnetic resonance images of an unusual form of cardiac tuberculosis. Nodular masses in a sheet-like distribution were seen to infiltrate the outer myocardium and pericardium along most of the cardiac chambers. The lesions showed significant resolution on antitubercular therapy

  4. Atrial fibrillation after cardiac surgery

    Directory of Open Access Journals (Sweden)

    Nair Suresh

    2010-01-01

    Full Text Available Once considered as nothing more than a nuisance after cardiac surgery, the importance of postoperative atrial fibrillation (POAF has been realized in the last decade, primarily because of the morbidity associated with the condition. Numerous causative factors have been described without any single factor being singled out as the cause of this complication. POAF has been associated with stroke, renal failure and congestive heart failure, although it is difficult to state whether POAF is directly responsible for these complications. Guidelines have been formulated for prevention of POAF. However, very few cardiothoracic centers follow any form of protocol to prevent POAF. Routine use of prophylaxis would subject all patients to the side effects of anti-arrhythmic drugs, while only a minority of the patients do actually develop this problem postoperatively. Withdrawal of beta blockers in the postoperative period has been implicated as one of the major causes of POAF. Amiodarone, calcium channel blockers and a variety of other pharmacological agents have been used for the prevention of POAF. Atrial pacing is a non-pharmacological measure which has gained popularity in the prevention of POAF. There is considerable controversy regarding whether rate control is superior to rhythm control in the treatment of established atrial fibrillation (AF. Amiodarone plays a central role in both rate control and rhythm control in postoperative AF. Newer drugs like dronedarone and ranazoline are likely to come into the market in the coming years.

  5. Recent progress of pediatric cardiac surgery in China

    Institute of Scientific and Technical Information of China (English)

    WU Kai-hong; L(U) Xiao-dong; LIU Ying-long

    2006-01-01

    @@ Pediatric cardiac surgery in China has made great progress since the first successful open heart operation for correction of ventricular septal defect (VSD) with an artificial heart-lung machine in 1958.1 In recent years, the state has paid much attention to both the basic research and the primary,secondary and tertiary prevention of congenital heart disease.

  6. Enhancing Cardiac Resynchronization Therapy for Patients with Atrial Fibrillation: The Role of AV Node Ablation

    Directory of Open Access Journals (Sweden)

    Jeff M. Berry, MD

    2012-04-01

    Full Text Available Cardiac resynchronization therapy (CRT has evolved as an effective therapy for patients with congestive heart failure (CHF and ventricular dyssynchrony, currently defined as a wide QRS on the electrocardiogram. While multiple randomized controlled trials have confirmed the favorable effects of CRT on mortality and heart failure symptoms for patients in sinus rhythm, only recently observational studies have begun to suggest a similar benefit for patients with atrial fibrillation (AF and dyssynchrony. Yet, implementing effective biventricular pacing in patients with AF can be problematic due to competing intrinsic AV conduction. For patients with depressed ejection fractions needing AV node (AVN ablation to control fast ventricular rates, biventricular pacing has been shown to be superior to right ventricular pacing alone. When consistent pacing (over 90% of the time cannot be achieved in AF patients due to a rapid ventricular response despite pharmacological therapy, AVN ablation should be considered. The additional benefit of performing AVN ablation to promote biventricular pacing in patients without rapid ventricular rates remains uncertain. A randomized controlled trial is needed to test the incremental benefit of AVN ablation to promote biventricular pacing in heart failure patients with AF and wide QRS.

  7. Cardiac tumours in children

    Directory of Open Access Journals (Sweden)

    Parsons Jonathan M

    2007-03-01

    Full Text Available Abstract Cardiac tumours are benign or malignant neoplasms arising primarily in the inner lining, muscle layer, or the surrounding pericardium of the heart. They can be primary or metastatic. Primary cardiac tumours are rare in paediatric practice with a prevalence of 0.0017 to 0.28 in autopsy series. In contrast, the incidence of cardiac tumours during foetal life has been reported to be approximately 0.14%. The vast majority of primary cardiac tumours in children are benign, whilst approximately 10% are malignant. Secondary malignant tumours are 10–20 times more prevalent than primary malignant tumours. Rhabdomyoma is the most common cardiac tumour during foetal life and childhood. It accounts for more than 60% of all primary cardiac tumours. The frequency and type of cardiac tumours in adults differ from those in children with 75% being benign and 25% being malignant. Myxomas are the most common primary tumours in adults constituting 40% of benign tumours. Sarcomas make up 75% of malignant cardiac masses. Echocardiography, Computing Tomography (CT and Magnetic Resonance Imaging (MRI of the heart are the main non-invasive diagnostic tools. Cardiac catheterisation is seldom necessary. Tumour biopsy with histological assessment remains the gold standard for confirmation of the diagnosis. Surgical resection of primary cardiac tumours should be considered to relieve symptoms and mechanical obstruction to blood flow. The outcome of surgical resection in symptomatic, non-myxomatous benign cardiac tumours is favourable. Patients with primary cardiac malignancies may benefit from palliative surgery but this approach should not be recommended for patients with metastatic cardiac tumours. Surgery, chemotherapy and radiotherapy may prolong survival. The prognosis for malignant primary cardiac tumours is generally extremely poor.

  8. What Pace Is Best? Assessing Adults' Learning from Slideshows and Video

    Science.gov (United States)

    Sage, Kara

    2014-01-01

    When acquiring information from a 2D platform, self-control and/or optimal pacing may help reduce cognitive load and enhance learning outcomes. In the present research, adults viewed novel action sequences via one of four learning media: (1) self-paced slideshows, where viewers advanced through slides at their own pace by clicking a mouse, (2)…

  9. Effects of Modality and Pace on Achievement, Mental Effort, and Positive Affect in Multimedia Learning Environments

    Science.gov (United States)

    Izmirli, Serkan; Kurt, Adile Askim

    2016-01-01

    The purpose of the study was to examine the effects of instruction given with different multimedia modalities (written text + animation or narration + animation) on the academic achievement, cognitive load, and positive affect in different paces (learner-paced or system-paced); 97 freshmen university students divided into four groups taught in…

  10. "U-Pace" Instruction: Improving Student Success by Integrating Content Mastery and Amplified Assistance

    Science.gov (United States)

    Reddy, Diane M.; Pfeiffer, Heidi M.; Fleming, Raymond; Ports, Katie A.; Pedrick, Laura E.; Barnack-Tavlaris, Jessica L.; Jirovec, Danielle L.; Helion, Alicia M.; Swain, Rodney A.

    2013-01-01

    "U-Pace," an instructional intervention, has potential for widespread implementation because student behavior recorded in any learning management system is used by "U-Pace" instructors to tailor coaching of student learning based on students' strengths and motivations. "U-Pace" utilizes an online learning…

  11. Cardiac Optogenetics: Enhancement by All-trans-Retinal.

    Science.gov (United States)

    Yu, Jinzhu; Chen, Kay; Lucero, Rachel V; Ambrosi, Christina M; Entcheva, Emilia

    2015-11-16

    All-trans-Retinal (ATR) is a photosensitizer, serving as the chromophore for depolarizing and hyperpolarizing light-sensitive ion channels and pumps (opsins), recently employed as fast optical actuators. In mammalian optogenetic applications (in brain and heart), endogenous ATR availability is not considered a limiting factor, yet it is unclear how ATR modulation may affect the response to optical stimulation. We hypothesized that exogenous ATR may improve light responsiveness of cardiac cells modified by Channelrhodopsin2 (ChR2), hence lowering the optical pacing energy. In virally-transduced (Ad-ChR2(H134R)-eYFP) light-sensitive cardiac syncytium in vitro, ATR supplements ≤2 μM improved cardiomyocyte viability and augmented ChR2 membrane expression several-fold, while >4 μM was toxic. Employing integrated optical actuation (470 nm) and optical mapping, we found that 1-2 μM ATR dramatically reduced optical pacing energy (over 30 times) to several μW/mm(2), lowest values reported to date, but also caused action potential prolongation, minor changes in calcium transients and no change in conduction. Theoretical analysis helped explain ATR-caused reduction of optical excitation threshold in cardiomyocytes. We conclude that cardiomyocytes operate at non-saturating retinal levels, and carefully-dosed exogenous ATR can enhance the performance of ChR2 in cardiac cells and yield energy benefits over orders of magnitude for optogenetic stimulation.

  12. 640 X 480 Pace HgCdTe FPA

    Science.gov (United States)

    Kozlowski, Lester J.; Bailey, Robert B.; Cabelli, Scott A.; Cooper, Donald E.; McComas, Gail D.; Vural, Kadri; Tennant, William E.

    1992-12-01

    A hybrid HgCdTe 640 X 480 infrared (IR) focal plane array (FPA) that meets the sensitivity, resolution, and field-of-view requirements of high-performance medium wavelength infrared (MWIR) imaging systems has been developed. The key technology making this large, high sensitivity device producible is the epitaxial growth of HgCdTe on a CdTe-buffered, sapphire substrate (referred to as PACE, for Producible Alternative to CdTe for Epitaxy; PACE-I refers to sapphire). The device offers TV resolution with excellent sensitivity at temperatures below 120 K. Mean NE(Delta) T as low as 13 mK has been achieved at operating temperatures nonuniformity compensation.

  13. The Pace and Shape of Senescence in Angiosperms

    DEFF Research Database (Denmark)

    Baudisch, Annette; Salguero-Gómez, Roberto; Jones, Owen;

    2013-01-01

    (‘senescence’), decreases (‘negative senescence’) or remains constant over age (‘negligible senescence’). 3. We extract mortality trajectories from ComPADRe III, a data base that contains demographic information for several hundred plant species. We apply age-from-stage matrix decomposition methods to obtain...... age-specific trajectories from 290 angiosperm species of various growth forms distributed globally. From these trajectories, we survey pace and shape values and investigate how growth form and ecoregion influence these two aspects of mortality using a Bayesian regression analysis that accounts...... analysis that accounts for phylogenetic history and in the distinction between metrics of pace and shape as two separate aspects of mortality. We believe that our approach could prove useful in future comparative studies of mortality patterns....

  14. Optimal pacing strategy for a race of two competing cyclists

    OpenAIRE

    Dahmen, Thorsten; Saupe, Dietmar

    2014-01-01

    For optimal pacing strategies in the case of two or more competing or cooperating cyclists only few approaches take slipstreaming into account. However, by incorporating the slipstream effect in the model of a race of two runners on a flat course , it has been shown, how the trailing runner can position himself at striking distance behind the other and when he should start the final sprint. (Pitcher, 2009: Optimal strategies for a two - runner model of middle - distance running. SIAM Journal ...

  15. Optimal implantation depth and adherence to guidelines on permanent pacing to improve the results of transcatheter aortic valve replacement with the medtronic corevalve system: The CoreValve prospective, international, post-market ADVANCE-II study

    OpenAIRE

    Petronio, Anna S; Sinning, Jan-Malte; Van Mieghem, Nicolas; Zucchelli, Giulio; Nickenig, Georg; Bekeredjian, Raffi; Bosmans, B.; Bedogni, Francesco; Branny, Marian; Stangl, Karl; Kovac, Jan; Schiltgen, Molly; Kraus, Stacia; De Jaegere, Peter

    2015-01-01

    textabstractObjectives The aim of the CoreValve prospective, international, post-market ADVANCE-II study was to define the rates of conduction disturbances and permanent pacemaker implantation (PPI) after transcatheter aortic valve replacement with the Medtronic CoreValve System (Minneapolis, Minnesota) using optimized implantation techniques and application of international guidelines on cardiac pacing. Background Conduction disturbances are a frequent complication of transcatheter aortic va...

  16. Alternate Pacing of Border-Collision Period-Doubling Bifurcations.

    Science.gov (United States)

    Zhao, Xiaopeng; Schaeffer, David G

    2007-11-01

    Unlike classical bifurcations, border-collision bifurcations occur when, for example, a fixed point of a continuous, piecewise C1 map crosses a boundary in state space. Although classical bifurcations have been much studied, border-collision bifurcations are not well understood. This paper considers a particular class of border-collision bifurcations, i.e., border-collision period-doubling bifurcations. We apply a subharmonic perturbation to the bifurcation parameter, which is also known as alternate pacing, and we investigate the response under such pacing near the original bifurcation point. The resulting behavior is characterized quantitatively by a gain, which is the ratio of the response amplitude to the applied perturbation amplitude. The gain in a border-collision period-doubling bifurcation has a qualitatively different dependence on parameters from that of a classical period-doubling bifurcation. Perhaps surprisingly, the differences are more readily apparent if the gain is plotted vs. the perturbation amplitude (with the bifurcation parameter fixed) than if plotted vs. the bifurcation parameter (with the perturbation amplitude fixed). When this observation is exploited, the gain under alternate pacing provides a useful experimental tool to identify a border-collision period-doubling bifurcation.

  17. Factors affecting the regulation of pacing: current perspectives

    Directory of Open Access Journals (Sweden)

    Mauger AR

    2014-09-01

    Full Text Available Alexis R Mauger Endurance Research Group, School of Sport and Exercise Sciences, Faculty of Science, University of Kent, Chatham, UK Abstract: During prolonged dynamic and rhythmic exercise, muscular pain and discomfort arises as a result of an increased concentration of deleterious metabolites. Sensed by peripheral nociceptors and transmitted via afferent feedback to the brain, this provides important information regarding the physiological state of the muscle. These sensations ultimately contribute to what is termed "exercise-induced pain". Despite being well recognized by athletes and coaches, and suggested to be integral to exercise performance, this construct has largely escaped attention in experimental work. This perspective article highlights the current understanding of pacing in endurance performance, and the causes of exercise-induced pain. A new perspective is described, which proposes how exercise-induced pain may be a contributing factor in helping individuals to regulate their work rate during exercise and thus provides an important construct in pacing. Keywords: pain, exercise-induced pain, discomfort, exercise performance, self-paced

  18. Pharmacological treatment of cardiac glycoside poisoning.

    Science.gov (United States)

    Roberts, Darren M; Gallapatthy, Gamini; Dunuwille, Asunga; Chan, Betty S

    2016-03-01

    Cardiac glycosides are an important cause of poisoning, reflecting their widespread clinical usage and presence in natural sources. Poisoning can manifest as varying degrees of toxicity. Predominant clinical features include gastrointestinal signs, bradycardia and heart block. Death occurs from ventricular fibrillation or tachycardia. A wide range of treatments have been used, the more common including activated charcoal, atropine, β-adrenoceptor agonists, temporary pacing, anti-digoxin Fab and magnesium, and more novel agents include fructose-1,6-diphosphate (clinical trial in progress) and anticalin. However, even in the case of those treatments that have been in use for decades, there is debate regarding their efficacy, the indications and dosage that optimizes outcomes. This contributes to variability in use across the world. Another factor influencing usage is access. Barriers to access include the requirement for transfer to a specialized centre (for example, to receive temporary pacing) or financial resources (for example, anti-digoxin Fab in resource poor countries). Recent data suggest that existing methods for calculating the dose of anti-digoxin Fab in digoxin poisoning overstate the dose required, and that its efficacy may be minimal in patients with chronic digoxin poisoning. Cheaper and effective medicines are required, in particular for the treatment of yellow oleander poisoning which is problematic in resource poor countries. PMID:26505271

  19. Pacemaker Prevention Therapy in Drug-refractory Paroxysmal Atrial Fibrillation: Reliability of Diagnostics and Effectiveness of Prevention Pacing Therapy in Vitatron™ Selection® Device

    OpenAIRE

    2006-01-01

    Introduction. Atrial fibrillation (AF), the most common and rising disorder of cardiac rhythm, is quite difficult to control and/or to treat. Non pharmacological therapies for AF may involve the use of dedicated pacing algorithms to detect and prevent atrial arrhythmia that could be a trigger for AF onset. Selection 900E/AF2.0 Vitatron DDDRP pacemaker (1) keeps an atrial arrhythmia diary thus providing detailed onset reports of arrhythmias of interest, (2) provides us data about the number of...

  20. Stimulating endogenous cardiac regeneration

    Directory of Open Access Journals (Sweden)

    Amanda eFinan

    2015-09-01

    Full Text Available The healthy adult heart has a low turnover of cardiac myocytes. The renewal capacity, however, is augmented after cardiac injury. Participants in cardiac regeneration include cardiac myocytes themselves, cardiac progenitor cells, and peripheral stem cells, particularly from the bone marrow compartment. Cardiac progenitor cells and bone marrow stem cells are augmented after cardiac injury, migrate to the myocardium, and support regeneration. Depletion studies of these populations have demonstrated their necessary role in cardiac repair. However, the potential of these cells to completely regenerate the heart is limited. Efforts are now being focused on ways to augment these natural pathways to improve cardiac healing, primarily after ischemic injury but in other cardiac pathologies as well. Cell and gene therapy or pharmacological interventions are proposed mechanisms. Cell therapy has demonstrated modest results and has passed into clinical trials. However, the beneficial effects of cell therapy have primarily been their ability to produce paracrine effects on the cardiac tissue and recruit endogenous stem cell populations as opposed to direct cardiac regeneration. Gene therapy efforts have focused on prolonging or reactivating natural signaling pathways. Positive results have been demonstrated to activate the endogenous stem cell populations and are currently being tested in clinical trials. A potential new avenue may be to refine pharmacological treatments that are currently in place in the clinic. Evidence is mounting that drugs such as statins or beta blockers may alter endogenous stem cell activity. Understanding the effects of these drugs on stem cell repair while keeping in mind their primary function may strike a balance in myocardial healing. To maximize endogenous cardiac regeneration,a combination of these approaches couldameliorate the overall repair process to incorporate the participation ofmultiple cell players.

  1. Trends in Artificial Intelligence.

    Science.gov (United States)

    Hayes, Patrick

    1978-01-01

    Discusses the foundations of artificial intelligence as a science and the types of answers that may be given to the question, "What is intelligence?" The paradigms of artificial intelligence and general systems theory are compared. (Author/VT)

  2. Artificial Inteligence and Law

    OpenAIRE

    Fuková, Kateřina

    2012-01-01

    Submitted diploma work Artificial Intelligence and Law deals with the rule of law and its position in the process of new advanced technologies in computer cybernetics and further scientific disciplines related with artificial intelligence and its creation. The first part of the work introduces the history of the first imagines about artificial intelligence and concerns with its birth. This chapter presents main theoretical knowledge and hypotheses defined artificial intelligence and progre...

  3. Marketing cardiac CT programs.

    Science.gov (United States)

    Scott, Jason

    2010-01-01

    There are two components of cardiac CT discussed in this article: coronary artery calcium scoring (CACS) and coronary computed tomography angiography (CCTA).The distinctive advantages of each CT examination are outlined. In order to ensure a successful cardiac CT program, it is imperative that imaging facilities market their cardiac CT practices effectively in order to gain a competitive advantage in this valuable market share. If patients receive quality care by competent individuals, they are more likely to recommend the facility's cardiac CT program. Satisfied patients will also be more willing to come back for any further testing.

  4. Unidirectional Pinning and Hysteresis of Spatially Discordant Alternans in Cardiac Tissue

    CERN Document Server

    Skardal, Per Sebastian; Restrepo, Juan G

    2011-01-01

    Spatially discordant alternans is a widely observed pattern of voltage and calcium signals in cardiac tissue that can precipitate lethal cardiac arrhythmia. Using spatially coupled iterative maps of the beat-to-beat dynamics, we explore this pattern's dynamics in the regime of a calcium-dominated period-doubling instability at the single cell level. We find a novel nonlinear bifurcation associated with the formation of a discontinuous jump in the amplitude of calcium alternans at nodal lines separating discordant regions. We show that this jump unidirectionally pins nodal lines by preventing their motion away from the pacing site following a pacing rate decrease, but permitting motion towards this site following a rate increase. This unidirectional pinning leads to strongly history-dependent nodal line motion that is strongly arrhythmogenic.

  5. An evaluation of two conducted electrical weapons using a swine comparative cardiac safety model.

    Science.gov (United States)

    Dawes, Donald M; Ho, Jeffrey D; Moore, Johanna C; Laudenbach, Andrew P; Reardon, Robert F; Miner, James R

    2014-09-01

    Arrest-related deaths proximate to the use of a conducted electrical weapon (CEW) continue to generate controversy despite a better understanding of the multi-factorial nature of many of these deaths. With the rapid adoption of this technology by law enforcement, and the proliferation of companies entering the marketplace, it is important to have a method to assess the relative safety of these weapons. We had previously developed a model to assess the relative cardiac safety of CEWs. In this study, we use this model to compare the TASER X2 and the Karbon Arms MPID. Our results suggest that the TASER X2 may have an improved cardiac safety margin over the Karbon Arms MPID as determined by a smaller area of cardiac pacing on the anterior chest in our model. This model seems to offer a reproducible means of comparing the cardiac effects of CEWs. PMID:24895072

  6. Current topics in glycemic control by wearable artificial pancreas or bedside artificial pancreas with closed-loop system.

    Science.gov (United States)

    Hanazaki, Kazuhiro; Munekage, Masaya; Kitagawa, Hiroyuki; Yatabe, Tomoaki; Munekage, Eri; Shiga, Mai; Maeda, Hiromichi; Namikawa, Tsutomu

    2016-09-01

    The incidence of diabetes is increasing at an unprecedented pace and has become a serious health concern worldwide during the last two decades. Despite this, adequate glycemic control using an artificial pancreas has not been established, although the 21st century has seen rapid developments in this area. Herein, we review current topics in glycemic control for both the wearable artificial pancreas for type 1 and type 2 diabetic patients and the bedside artificial pancreas for surgical diabetic patients. In type 1 diabetic patients, nocturnal hypoglycemia associated with insulin therapy remains a serious problem that could be addressed by the recent development of a wearable artificial pancreas. This smart phone-like device, comprising a real-time, continuous glucose monitoring system and insulin pump system, could potentially significantly reduce nocturnal hypoglycemia compared with conventional glycemic control. Of particular interest in this space are the recent inventions of a low-glucose suspend feature in the portable systems that automatically stops insulin delivery 2 h following a glucose sensor value artificial pancreas with the closed-loop system has also proved safe and effective for not only avoiding hypoglycemia, but also for reducing blood glucose level variability resulting in good surgical outcomes. We hope that a more sophisticated artificial pancreas with closed-loop system will now be taken up for routine use worldwide, providing enormous relief for patients suffering from uncontrolled hyperglycemia, hypoglycemia, and/or variability in blood glucose concentrations.

  7. Pajarito Aerosol Couplings to Ecosystems (PACE) Field Campaign Report

    Energy Technology Data Exchange (ETDEWEB)

    Dubey, M [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-03-01

    Laboratory (LANL) worked on the Pajarito Aerosol Couplings to Ecosystems (PACE) intensive operational period (IOP). PACE’s primary goal was to demonstrate routine Mobile Aerosol Observing System (MAOS) field operations and improve instrumental and operational performance. LANL operated the instruments efficiently and effectively with remote guidance by the instrument mentors. This was the first time a complex suite of instruments had been operated under the ARM model and it proved to be a very successful and cost-effective model to build upon.

  8. X-ray and magnetic resonance imaging fusion for cardiac resynchronization therapy.

    Science.gov (United States)

    Choi, Jinwoo; Radau, Perry; Xu, Robert; Wright, Graham A

    2016-07-01

    Cardiac Resynchronization Therapy (CRT) can effectively treat left ventricle (LV) driven Heart Failure (HF). However, 30% of the CRT recipients do not experience symptomatic benefit. Recent studies show that the CRT response rate can reach 95% when the LV pacing lead is placed at an optimal site at a region of maximal LV dyssynchrony and away from myocardial scars. Cardiac Magnetic Resonance (CMR) can identify the optimal site in three dimensions (3D). 3D CMR data can be registered to clinical standard x-ray fluoroscopy to achieve an optimal pacing of the LV. We have developed a 3D CMR to 2D x-ray image registration method for CRT procedures. We have employed the LV pacing lead on x-ray images and coronary sinus on MR data as landmarks. The registration method makes use of a guidewire simulation algorithm, edge based image registration technique and x-ray C-arm tracking to register the coronary sinus and pacing lead landmarks. PMID:27025953

  9. Model-based imaging of cardiac electrical function in human atria

    Science.gov (United States)

    Modre, Robert; Tilg, Bernhard; Fischer, Gerald; Hanser, Friedrich; Messnarz, Bernd; Schocke, Michael F. H.; Kremser, Christian; Hintringer, Florian; Roithinger, Franz

    2003-05-01

    Noninvasive imaging of electrical function in the human atria is attained by the combination of data from electrocardiographic (ECG) mapping and magnetic resonance imaging (MRI). An anatomical computer model of the individual patient is the basis for our computer-aided diagnosis of cardiac arrhythmias. Three patients suffering from Wolff-Parkinson-White syndrome, from paroxymal atrial fibrillation, and from atrial flutter underwent an electrophysiological study. After successful treatment of the cardiac arrhythmia with invasive catheter technique, pacing protocols with stimuli at several anatomical sites (coronary sinus, left and right pulmonary vein, posterior site of the right atrium, right atrial appendage) were performed. Reconstructed activation time (AT) maps were validated with catheter-based electroanatomical data, with invasively determined pacing sites, and with pacing at anatomical markers. The individual complex anatomical model of the atria of each patient in combination with a high-quality mesh optimization enables accurate AT imaging, resulting in a localization error for the estimated pacing sites within 1 cm. Our findings may have implications for imaging of atrial activity in patients with focal arrhythmias.

  10. Sick sinus syndrome in a patient with extensive cardiac lipomatosis (sinus node dysfunction in lipomatosis).

    Science.gov (United States)

    Kadmon, Ehud; Paz, Rami; Kusniec, Jairo; Strasberg, Boris

    2010-04-01

    We present a case of a 45-year-old man with an incidental and longstanding diagnosis of extensive mediastinal and cardiac lipomatosis. Along the years, he had experienced various arrhythmias, mainly bradyarrhythmias, mostly asymptomatic. Recently after documenting a sinus pause of 6 seconds and runs of nonsustained ventricular tachycardias, he underwent an implantation of a cardioverter-defibrillator. There are many reports of cardiac lipomatosis in the literature, including reports of related ventricular arrhythmias, some of which are fatal. (PACE 2010; 513-515).

  11. Cardiac contraction induces discordant alternans and localized block

    Science.gov (United States)

    Radszuweit, M.; Alvarez-Lacalle, E.; Bär, M.; Echebarria, B.

    2015-02-01

    In this paper we use a simplified model of cardiac excitation-contraction coupling to study the effect of tissue deformation on the dynamics of alternans, i.e., alternations in the duration of the cardiac action potential, that occur at fast pacing rates and are known to be proarrhythmic. We show that small stretch-activated currents can produce large effects and cause a transition from in-phase to off-phase alternations (i.e., from concordant to discordant alternans) and to conduction blocks. We demonstrate numerically and analytically that this effect is the result of a generic change in the slope of the conduction velocity restitution curve due to electromechanical coupling. Thus, excitation-contraction coupling can potentially play a relevant role in the transition to reentry and fibrillation.

  12. Exploring the Role of Calcium in Cardiac Cell Dynamics

    Science.gov (United States)

    Berger, Carolyn; Idriss, Salim; Rouze, Ned; Hall, David; Gauthier, Daniel

    2007-03-01

    Bifurcations in the electrical response of cardiac tissue can destabilize spatio-temporal waves of electrochemical activity in the heart, leading to tachycardia or even fibrillation. Therefore, it is important to understand the mechanisms that cause instabilities in cardiac tissue.Traditionally, researchers have focused on understanding how the transmembrane voltage is altered in response to an increase in pacing rate, i.e. a shorter time interval between propagating electrochemical waves. However, the dynamics of the transmembrane voltage are coupled to the activity of several ions that traverse the membrane. Therefore, to fully understand the mechanisms that drive these bifurcations, we must include an investigation of the ionic behavior. We will present our recent investigation of the role of intracellular calcium in an experimental testbed of frog ventricle. Calcium and voltage are measured simultaneously, allowing for the previous research regarding voltage to guide our understanding of the calcium dynamics.

  13. Mechanical communication in cardiac cell synchronized beating

    Science.gov (United States)

    Nitsan, Ido; Drori, Stavit; Lewis, Yair E.; Cohen, Shlomi; Tzlil, Shelly

    2016-05-01

    Cell-cell communication, which enables cells to coordinate their activity and is essential for growth, development and function, is usually ascribed a chemical or electrical origin. However, cells can exert forces and respond to environment elasticity and to mechanical deformations created by their neighbours. The extent to which this mechanosensing ability facilitates intercellular communication remains unclear. Here we demonstrate mechanical communication between cells directly for the first time, providing evidence for a long-range interaction that induces long-lasting alterations in interacting cells. We show that an isolated cardiac cell can be trained to beat at a given frequency by mechanically stimulating the underlying substrate. Deformations are induced using an oscillatory mechanical probe that mimics the deformations generated by a beating neighbouring cardiac cell. Unlike electrical field stimulation, the probe-induced beating rate is maintained by the cell for an hour after the stimulation stops, implying that long-term modifications occur within the cell. These long-term alterations provide a mechanism for cells that communicate mechanically to be less variable in their electromechanical delay. Mechanical coupling between cells therefore ensures that the final outcome of action potential pacing is synchronized beating. We further show that the contractile machinery is essential for mechanical communication.

  14. Perfil clínico de pacientes chagásicos e não-chagásicos portadores de marca-passo cardíaco artificial Clinical profile of Chagas and non-Chagas' disease patients with cardiac pacemaker

    Directory of Open Access Journals (Sweden)

    Leonor Garcia Rincon

    2006-06-01

    Full Text Available O objetivo do estudo foi comparar pacientes chagásicos e não-chagásicos com marca-passo cardíaco artificial uni ou bicameral quanto à fração de ejeção do ventrículo esquerdo, o limiar de estimulação ventricular e a incidência de arritmias cardíacas. Entre janeiro/2001 e novembro/2002 foram avaliados 45 pacientes chagásicos e 35 não-chagásicos portadores de marca-passo quanto à história clínica, radiografia do tórax, ecocardiograma, Holter 24h e análise telemétrica do marca-passo. Embora os chagásicos fossem mais jovens, os dois grupos foram semelhantes quanto a variáveis radiológicas e o limiar de estimulação ventricular direito. Os chagásicos apresentaram menor fração de ejeção do ventrículo esquerdo ao ecocardiograma e maior incidência de arritmia ventricular ao Holter 24h. Observou-se correlação positiva entre a baixa fração de ejeção do ventrículo esquerdo e a intensidade da arritmia ventricular ao Holter 24h. Em pacientes com marca-passo, a doença de Chagas está associada a marcadores cardíacos de prognóstico adverso.The aim of this study was to compare Chagas and non-Chagas' disease patients using single or dual-chamber pacemaker in relation to the ejection fraction of the left ventricle, the ventricular stimulation threshold and the occurrence of ventricular arrhythmia. From January, 2001 to November, 2002, 45 Chagas' disease patients and 35 non-Chagas' disease patients, all pacemaker users, were evaluated considering clinical history, echocardiographic study, Holter monitoring and analysis of the pacemaker telemetry data. Chagas' disease patients were significantly younger, but both groups were similar when chest X-Ray variables and right ventricular stimulation threshold were analyzed. Chagas' disease patients had a lower left ventricular ejection fraction and more frequent ventricular arrhythmia during Holter monitoring. A positive correlation between the low ejection fraction of the left

  15. Mechanical Blood Pumps for Cardiac Assistance

    Directory of Open Access Journals (Sweden)

    M. Akdis

    2005-01-01

    Full Text Available Cardiac assist devices are classified into the traditional engineering categories of displacement and rotary pumps. Clinical use and indications of the various pump categories are outlined and a detailed description of currently available systems is given. The first part deals with extracorporeal as well as implantable ventricular assist devices (VAD of the displacement type and is followed by a section on current developments in the field of total artificial hearts (TAH. The second part covers the rotary pump category from cardiopulmonary bypass applications to implantable systems, including specific design aspects of radial, diagonal, and axial pumps.

  16. Thermal and cardiovascular strain mitigate the potential benefit of carbohydrate mouth rinse during self-paced exercise in the heat

    Directory of Open Access Journals (Sweden)

    Matthew eCramer

    2015-11-01

    Full Text Available Purpose: To determine whether a carbohydrate mouth rinse can alter self-paced exercise performance independently of a high degree of thermal and cardiovascular strain.Methods: Eight endurance-trained males performed two 40-km cycling time trials in 35°C, 60% RH while swilling a 20-ml bolus of 6.5% maltodextrin (CHO or a colour- and taste-matched placebo (PLA every 5 km. Heart rate, power output, rectal temperature (Tre, and mean skin temperature (Tsk were recorded continuously; cardiac output, oxygen uptake (VO2, mean arterial pressure (MAP, and perceived exertion (RPE were measured every 10 min. Results: Performance time and mean power output were similar between treatments, averaging 63.9 ± 3.2 and 64.3 ± 2.8 min, and 251 ± 23 and 242 ± 18 W in CHO and PLA, respectively. Power output, stroke volume, cardiac output, MAP, and VO2 decreased during both trials, increasing slightly or remaining stable during a final 2-km end-spurt. Tre, Tsk, heart rate, and RPE increased throughout exercise similarly with both treatments. Changes in RPE correlated with those in Tre (P<0.005 and heart rate (P<0.001.Conclusions: These findings suggest that carbohydrate mouth rinsing does not improve ~1-h time trial performance in hot-humid conditions, possibly due to a failure in down-regulating RPE, which may be influenced more by severe thermal and cardiovascular strain.

  17. Mathematical cardiac electrophysiology

    CERN Document Server

    Colli Franzone, Piero; Scacchi, Simone

    2014-01-01

    This book covers the main mathematical and numerical models in computational electrocardiology, ranging from microscopic membrane models of cardiac ionic channels to macroscopic bidomain, monodomain, eikonal models and cardiac source representations. These advanced multiscale and nonlinear models describe the cardiac bioelectrical activity from the cell level to the body surface and are employed in both the direct and inverse problems of electrocardiology. The book also covers advanced numerical techniques needed to efficiently carry out large-scale cardiac simulations, including time and space discretizations, decoupling and operator splitting techniques, parallel finite element solvers. These techniques are employed in 3D cardiac simulations illustrating the excitation mechanisms, the anisotropic effects on excitation and repolarization wavefronts, the morphology of electrograms in normal and pathological tissue and some reentry phenomena. The overall aim of the book is to present rigorously the mathematica...

  18. Biomaterials for cardiac regeneration

    CERN Document Server

    Ruel, Marc

    2015-01-01

    This book offers readers a comprehensive biomaterials-based approach to achieving clinically successful, functionally integrated vasculogenesis and myogenesis in the heart. Coverage is multidisciplinary, including the role of extracellular matrices in cardiac development, whole-heart tissue engineering, imaging the mechanisms and effects of biomaterial-based cardiac regeneration, and autologous bioengineered heart valves. Bringing current knowledge together into a single volume, this book provides a compendium to students and new researchers in the field and constitutes a platform to allow for future developments and collaborative approaches in biomaterials-based regenerative medicine, even beyond cardiac applications. This book also: Provides a valuable overview of the engineering of biomaterials for cardiac regeneration, including coverage of combined biomaterials and stem cells, as well as extracellular matrices Presents readers with multidisciplinary coverage of biomaterials for cardiac repair, including ...

  19. Paced QRS duration and myocardial scar amount: predictors of long-term outcome of right ventricular apical pacing.

    Science.gov (United States)

    Lee, Seung-Ah; Cha, Myung-Jin; Cho, Youngjin; Oh, Il-Young; Choi, Eue-Keun; Oh, Seil

    2016-07-01

    Long-term right ventricular apical pacing (RVAP) is reportedly associated with heart failure (HF) development. However, the predictors of pacing-induced HF (PHF) remained unclear. We retrospectively enrolled 234 patients without structural heart disease who underwent a permanent pacemaker implantation with RVAP between 1982 and 2004. RVAP-induced HF was defined as left ventricular ejection fraction decrease >5 % with HF symptom without other HF development etiology. The QRS duration of a paced beat (pQRSd) and myocardial scar score were analyzed from each patient's 12-lead ECG. During a mean 15.6 years (range 3.3-30.0 years), 48 patients (20.5 %) patients developed RVAP-induced HF. The PHF group patients had a longer pQRSd (192.4 ± 13.5 vs. 175.7 ± 14.7 ms in non-PHF patients, p scar score (5.2 ± 1.9 vs. 2.7 ± 1.9, respectively p scar score (HR 1.23, 95 % CI 1.03-1.49, p = 0.037), and a higher percentage of ventricular pacing (HR 1.31, 95 % CI 1.01-1.49, p = 0.010) were independent predictors of PHF. Based on the results of the receiver-operating characteristic (ROC) curve, the pQRSd cutoff was 185 ms (AUC 0.79, sensitivity 66.7 %, specificity 76.3 %) and myocardial scar score cutoff value was 4 (AUC 0.81, sensitivity 81.3 %, specificity 66.1 %). The pQRSd was positively correlated with scar score (r = 0.70, p scar score ≥4 might be independent long-term prognostic markers of PHF.

  20. Pilot trial of an age-paced parenting newsletter.

    Science.gov (United States)

    Keane, Brigid; Waterston, Tony; McConachie, Helen; Towner, Elizabeth; Cook, Margaret; Birks, Eileen

    2005-10-01

    Supporting parents in the first three years of a child's life has the potential to produce successful outcomes. Present government initiatives such as Sure Start focus on this age group. An American educational intervention, in the style of a monthly newsletter, was adapted for use in the UK for parents of young children. Topics were presented in an easy-to-read format and focused on infant emotional development, parent interaction and play. Newsletters, called Baby Express were posted at monthly intervals to the family home providing age-paced information which could meet the specific needs of parents at that stage of their child's life. The aim of the study was to determine the applicability of the newsletter to UK parents and evaluate their satisfaction. Sixty home-based interviews were conducted and 95 per cent of mothers reported reading all or part of the newsletter. Changes in parenting style were spontaneously reported by 28 per cent of mothers. This study found that an aged-paced parenting newsletter was an acceptable and useful method of supporting parents in the early months of a child's life and promotes positive changes in parenting behaviour. PMID:16245675

  1. Social Interaction in Self-paced Distance Education

    Directory of Open Access Journals (Sweden)

    Terry Anderson

    2015-02-01

    Full Text Available In this paper we present a case study of a self-paced university course that was originally designed to support independent, self-paced study at distance. We developed a social media intervention, in design-based research terms, that allows these independent students to contribute archived content to enhance the course, to engage in discussions with other students and to share as little or as much personal information with each other as they wished. We describe the learning design for the intervention and present survey data of student and tutor perception of value and content analysis of the archived contributions. The results indicate that the intervention was positively received by tutors and by the majority (but not all students and that the archive created by the students’ contributions was adding value to the course. We conclude that the intervention was a modest, yet manageable example of a learning enhancement to a traditional cognitive-behavioral, course that has positive impact and potential with little negative impact on workload.

  2. The influence of collective behaviour on pacing in endurance competitions

    Directory of Open Access Journals (Sweden)

    Andrew eRenfree

    2015-12-01

    Full Text Available A number of theoretical models have been proposed to explain pacing strategies in individual competitive endurance events. These have typically related to internal regulatory processes informing the making of decisions relating to muscular work rate. Despite a substantial body of research investigating the influence of collective group dynamics on individual behaviours in various animal species, this issue has not been comprehensively studied in individual athletic events. This is surprising given that athletes directly compete in close proximity to one another, and that collective behaviour has also been observed in other human environments. Whilst reasons for adopting collective behaviour are not fully understood, it is thought to result from individual agents following simple local rules resulting in seemingly complex large systems acting to confer some biological advantage to the collective as a whole. Although such collective behaviours may generally be beneficial, endurance events are complicated by the fact that increasing levels of physiological disruption as activity progresses may compromise the ability of individuals to continue to interact with other group members. This could result in early fatigue and relative underperformance due to suboptimal utilisation of physiological resources by some athletes. Alternatively, engagement with a collective behaviour may benefit all due to a reduction in the complexity of decisions to be made and a subsequent reduction in cognitive loading and mental fatigue. This paper seeks evidence for collective behaviour in previously published analyses of pacing behaviour and proposes mechanisms through which it could potentially be either beneficial, or detrimental to individual performance.

  3. Pilot trial of an age-paced parenting newsletter.

    Science.gov (United States)

    Keane, Brigid; Waterston, Tony; McConachie, Helen; Towner, Elizabeth; Cook, Margaret; Birks, Eileen

    2005-10-01

    Supporting parents in the first three years of a child's life has the potential to produce successful outcomes. Present government initiatives such as Sure Start focus on this age group. An American educational intervention, in the style of a monthly newsletter, was adapted for use in the UK for parents of young children. Topics were presented in an easy-to-read format and focused on infant emotional development, parent interaction and play. Newsletters, called Baby Express were posted at monthly intervals to the family home providing age-paced information which could meet the specific needs of parents at that stage of their child's life. The aim of the study was to determine the applicability of the newsletter to UK parents and evaluate their satisfaction. Sixty home-based interviews were conducted and 95 per cent of mothers reported reading all or part of the newsletter. Changes in parenting style were spontaneously reported by 28 per cent of mothers. This study found that an aged-paced parenting newsletter was an acceptable and useful method of supporting parents in the early months of a child's life and promotes positive changes in parenting behaviour.

  4. Analysis of endocardial acceleration during intraoperative optimization of cardiac resynchronization therapy

    Science.gov (United States)

    Hernandez, Alfredo I.; Ziglio, Filippo; Amblard, Amel; Senhadji, Lotfi; Leclercq, Christophe

    2013-01-01

    Cardiac resynchronization therapy (CRT) is the therapy of choice for selected patients suffering from drug-refractory congestive heart failure and presenting an interventricular desynchronization. CRT is delivered by an implantable biventricular pacemaker, which stimulates the right atrium and both ventricles at specific timings. The optimization and personalization of this therapy requires to quantify both the electrical and the mechanical cardiac functions during the intraoperative and postoperative phases. The objective of this paper is to evaluate the feasibility of the calculation of features extracted from endocardial acceleration (EA) signals and the potential utility of these features for the intraoperative optimization of CRT. Endocardial intraoperative data from one patient are analyzed for 33 different pacing configurations, including changes in the atrio-ventricular and inter-ventricular delays and different ventricular stimulation sites. The main EA features are extracted for each pacing configuration and analyzed so as to estimate the intra-configuration and inter-configuration variability. Results show the feasibility of the proposed approach and suggest the potential utility of EA for intraoperative monitoring of the cardiac function and defining optimal, adaptive pacing configurations. PMID:24111356

  5. Artificial neural interfaces for bionic cardiovascular treatments.

    Science.gov (United States)

    Kawada, Toru; Sugimachi, Masaru

    2009-01-01

    An artificial nerve, in the broad sense, may be conceptualized as a physical and logical interface system that reestablishes the information traffic between the central nervous system and peripheral organs. Studies on artificial nerves targeting the autonomic nervous system are in progress to explore new treatment strategies for several cardiovascular diseases. In this article, we will review our research targeting the autonomic nervous system to treat cardiovascular diseases. First, we identified the rule for decoding native sympathetic nerve activity into a heart rate using transfer function analysis, and established a framework for a neurally regulated cardiac pacemaker. Second, we designed a bionic baroreflex system to restore the baroreflex buffering function using electrical stimulation of the celiac ganglion in a rat model of orthostatic hypotension. Third, based on the hypothesis that autonomic imbalance aggravates chronic heart failure, we implanted a neural interface into the right vagal nerve and demonstrated that intermittent vagal stimulation significantly improved the survival rate in rats with chronic heart failure following myocardial infarction. Although several practical problems need to be resolved, such as those relating to the development of electrodes feasible for long-term nerve activity recording, studies of artificial neural interfaces with the autonomic nervous system have great possibilities in the field of cardiovascular treatment. We expect further development of artificial neural interfaces as novel strategies to cope with cardiovascular diseases resistant to conventional therapeutics.

  6. Animal personality and pace-of-life syndromes: do fast-exploring fairy-wrens die young?

    Directory of Open Access Journals (Sweden)

    Michelle L Hall

    2015-03-01

    Full Text Available The pace-of-life syndrome (POLS hypothesis for animal personality proposes that variation among individuals in life-history strategies is associated with consistent differences in behavior. We tested predictions of this hypothesis in the superb fairy-wren, Malurus cyaneus, by investigating long-term individual differences in risk-related behaviors (latency to enter a novel artificial environment, exploration, activity and response to mirror image stimulation and survival. We found consistent differences between individuals in these behaviors (adjusted repeatability of exploration of artificial novel environment = 0.37. Individual differences were consistent over several years and bi-variate analyses showed a significant among-individual correlation (‘behavioral syndrome’ between exploration behavior at two life stages (young adult and old adult. Docility at the nestling stage predicted exploration behavior of juveniles. Behavioral traits measured in a risky context were correlated with one another, forming a behavioral syndrome of coping strategies ranging from ‘proactive’ to ‘reactive’. Nestlings that were more active and exploratory in isolation were less docile during handling, while adults that entered the artificial environment fast were more exploratory, active, and aggressive in the artificial environment. Exploration behavior increased within individuals as they aged and when they were in poorer condition, consistent with expectations of more risk-prone behavior with lower residual reproductive value (reduced ‘asset protection’. Risk-related behavior predicted the probability of apparent survival: more exploratory individuals were less likely to be present in the population twelve months later. Our findings suggest that, consistent with the predictions of the POLS hypothesis, individual variation in survival is associated with consistent individual differences in risk-related behavior that are maintained long-term and

  7. Anticipatory Artificial Autopoiesis

    OpenAIRE

    DuBois, Daniel; Holmberg, Stig C.

    2010-01-01

    In examining relationships between autopoiesis and anticipation in artificial life (Alife) systems it is demonstrated that anticipation may increase efficiency and viability in artificial autopoietic living systems. This paper, firstly, gives a review of the Varela et al [1974] automata algorithm of an autopoietic living cell. Some problems in this algorithm must be corrected. Secondly, a new and original anticipatory artificial autopoiesis algorithm for automata is presented. ...

  8. 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.

  9. 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

  10. [Cardiac evaluation before non-cardiac surgery].

    Science.gov (United States)

    Menzenbach, Jan; Boehm, Olaf

    2016-07-01

    Before non-cardiac surgery, evaluation of cardiac function is no frequent part of surgical treatment. European societies of anesthesiology and cardiology published consensus-guidelines in 2014 to present a reasonable approach for preoperative evaluation. This paper intends to differentiate the composite of perioperative risk and to display the guidelines methodical approach to handle it. Features to identify patients at risk from an ageing population with comorbidities, are the classification of surgical risk, functional capacity and risk indices. Application of diagnostic means, should be used adjusted to this risk estimation. Cardiac biomarkers are useful to discover risk of complications or mortality, that cannot be assessed by clinical signs. After preoperative optimization and perioperative cardiac protection, the observation of the postoperative period remains, to prohibit complications or even death. In consideration of limited resources of intensive care department, postoperative ward rounds beyond intensive care units are considered to be an appropriate instrument to avoid or recognize complications early to reduce postoperative mortality. PMID:27479258

  11. Pacing a data transfer operation between compute nodes on a parallel computer

    Science.gov (United States)

    Blocksome, Michael A.

    2011-09-13

    Methods, systems, and products are disclosed for pacing a data transfer between compute nodes on a parallel computer that include: transferring, by an origin compute node, a chunk of an application message to a target compute node; sending, by the origin compute node, a pacing request to a target direct memory access (`DMA`) engine on the target compute node using a remote get DMA operation; determining, by the origin compute node, whether a pacing response to the pacing request has been received from the target DMA engine; and transferring, by the origin compute node, a next chunk of the application message if the pacing response to the pacing request has been received from the target DMA engine.

  12. Controlling Spiral Dynamics in Excitable Media by a Weakly Localized Pacing

    Institute of Scientific and Technical Information of China (English)

    LI Bing-Wei; SUN Li-Li; CHEN Bin; YING He-Ping

    2007-01-01

    @@ Spiral dynamics controlled by a weakly localized pacing around the spiral tip is investigated. Numerical simulations show two distinct characteristics when the pacing is applied with the weak amplitude for suitable frequencies:for a rigidly rotating spiral, a transition from rigid rotation to meandering motion is observed, and for unstable spiral waves, spiral breakup can be prevented. Successfully preventing spiral breakup is relevant to the modulation of the tip trajectory induced by a localized pacing.

  13. Design and Implementation of programmable Cardiac Pacemaker Using VHDL

    Directory of Open Access Journals (Sweden)

    Omkar Dwivedi

    2015-05-01

    Full Text Available Pacemaker design has evolved very rapidly over the last several years. There has been a great deal of work in enhancing the programmability of pacemakers, to enable them to be programmed to work with different selected operating parameters, and indeed to work in different modes. In Taiwan, about 70%of cardiac pacemakerpatients are paced only from the ventricle with some pacing parameter programmability. This paper goal is to design a cardiac pacemaker with various NBG modes. A state machine approach has been followed to achieve the desired purpose. The pacemaker system is divide into three main sections i.e. controlling unit, sensing unit and pulse generator. In this paper we mainly concentrate on controlling unit and pulse generator. It has been developed using VHDL coding and implemented in hardware using FPGA. In a simple pacemaker process i.e. single chamber or dual chamber pacemaker, first an input signal or an event is detected in heart through leads. When the input signal is detected a timer generates a delay for approximately 0.8 sec. It is the time between two consecutive heartbeats, thus giving us 72 heartbeats per minute. Once the generated delay expires, sensing unit again start detecting a new event. If any event is detected we repeat the process of detection and waiting. If no event is detected we need to provide an electrical pulse to the heart and then repeat the whole process of detection and waiting. The code has been optimized and modified for different pacemaker modes.

  14. Feasibility of dual-chamber (DDD) pacing via a single-pass (VDD) pacing lead employing a floating atrial ring (dipole): case series, future considerations, and refinements.

    Science.gov (United States)

    Kassotis, John; Voigt, Louis; Mongwa, Mbu; Reddy, C V R

    2005-01-01

    The objective of this study was to assess the feasibility of DDD pacing from a standard single-pass VDD pacemaker system. Over the past 2 decades significant advances have been made in the development of single-pass VDD pacing systems. These have been shown in long-term prospective studies to effectively preserve atrioventricular (AV)synchrony in patients with AV block and normal sinus node function. What remains problematic is the development of a single-pass pacing system capable of DDD pacing. Such a lead configuration would be useful in those patients with peripheral venous anomalies and in younger patients with congenital anomalies, which may require lead revisions in the future. In addition, with the increased use of resynchronization (biventricular pacing) therapy, the availability of a reliable single-pass lead will minimize operative time, enhance patient safety, and minimize the amount of hardware within the heart. The feasibility of DDD pacing via a Medtronic Capsure VDD-2 (Model #5038) pacing lead was evaluated. Twenty patients who presented with AV block and normal sinus node function were recruited for this study. Atrial pacing thresholds and sensitivities were assessed intraoperatively in the supine position with various respiratory maneuvers. Five patients who agreed to participate in long-term follow-up received a dual-chamber generator and were evaluated periodically over a 12-month period. Mean atrial sensitivity was 2.35 +/- 0.83 mV at the time of implantation. Effective atrial stimulation was possible in all patients at the time of implantation (mean stimulation threshold 3.08 +/- 1.04 V at 0.5 ms [bipolar], 3.34 +/- 0.95 V at 0.5 ms [unipolar]). Five of the 20 patients received a Kappa KDR701 generator, and atrial electrical properties were followed up over a 1-year period. There was no significant change in atrial pacing threshold or incidence of phrenic nerve stimulation over the 1-year follow-up. A standard single-pass VDD pacing lead

  15. Cardiac metabolism and arrhythmias

    OpenAIRE

    Barth, Andreas S.; Tomaselli, Gordon F.

    2009-01-01

    Sudden cardiac death remains a leading cause of mortality in the Western world, accounting for up to 20% of all deaths in the U.S.1, 2 The major causes of sudden cardiac death in adults age 35 and older are coronary artery disease (70–80%) and dilated cardiomyopathy (10–15%).3 At the molecular level, a wide variety of mechanisms contribute to arrhythmias that cause sudden cardiac death, ranging from genetic predisposition (rare mutations and common polymorphisms in ion channels and structural...

  16. Comprehensive cardiac rehabilitation

    DEFF Research Database (Denmark)

    Kruse, Marie; Hochstrasser, Stefan; Zwisler, Ann-Dorthe O;

    2006-01-01

    OBJECTIVES: The costs of comprehensive cardiac rehabilitation are established and compared to the corresponding costs of usual care. The effect on health-related quality of life is analyzed. METHODS: An unprecedented and very detailed cost assessment was carried out, as no guidelines existed...... and may be as high as euro 1.877. CONCLUSIONS: Comprehensive cardiac rehabilitation is more costly than usual care, and the higher costs are not outweighed by a quality of life gain. Comprehensive cardiac rehabilitation is, therefore, not cost-effective....

  17. Effects of Amiodarone plus Losartan on Electrical Remodeling in Rapid Atrial Pacing in Rabbits

    Institute of Scientific and Technical Information of China (English)

    Liye Wei; Yue Xia; Guoqing Qi; Qingwen Zhang

    2008-01-01

    Objectives To investigate the electrical remodeling and the effects of amiodarone and losartan on electrical remode-ling in rapid atrial pacing on rabbit model. Methods 40 normal rabbits were randomly divided into 4 groups: the sa-line group (control group), amiodarone group, losartan group, ami + los group. All rabbits were raised drugs in a week. The atrial effective refractory period (AERP) was measured. Then, take a rapid atrial pacing (600 bpm) and the AERP was measured after 0. 5, 1, 2, 4, 6 and 8 hours pacing and 30 minutes after the termination of rapid pacing. Results ① In control group, after 8 hours rapid pacing, AERP 200 and AERP 150 were significantly shortened 16. 11%± 3. 1% (P <0. 01) and 9. 99%±4. 2% (P <0. 01). And the degree of AERP shortening induced by rapid pacing was greater at basic cycle lengths of 200 ms (BCL200) than that at BCL150. The AERP of amiodarone, losartan group and anti + los group were not shortened during rapid pacing.② In the control group, after the termination of rapid pacing, the AERP gradually increased. The AERP at all of the BCLS examined recovered to almost the 95.78% and 96. 76% of baseline values within the first 10 minutes and recovered to almost the 99. 07% and 99. 39% of baseline values within the first 30 minutes. Condusions Short-term atrial rapid pacing can induce the atrial electrical remodeling. Amiodarone and losartan can prevent the electrical remodeling.

  18. 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.

  19. Prevalence of sleep-disordered breathing in elderly patients with cardiac pacemaker: a case-control study

    Institute of Scientific and Technical Information of China (English)

    Haiyun WU; Shiwen WANG; Jianping JIA; Wenli ZHANG; Qiang XU

    2005-01-01

    Objective To investigate the prevalence of sleep-disordered breathing in elderly patients with permanent cardiac pacemaker implantation due to bradyarrhythmias, and the relationship between pacing mode and patients' sleep apnea-hypopnea index.Methods Forty-four elderly patients (>60 years) with cardiac pacemaker and their 44 controls matched for gender, age, body mass index and cardiovascular morbidity were studied using polysomnography or portable sleep monitoring device. Results Prevalence of sleep-disordered breathing (apnea-hypopnea index ≥5/h) was 44.7% and the mean apnea-hypopnea index was 8.2 ±4.1/h in the cardiac pacemaker group, which were significantly higher than those in control subjects (25% and 4.6±2.4/h, respectively, P<0.01 and P<0.05). The mean apnea-hypopnea index of patients with DDD or AAI pacemaker was significantly lower than that of patients with VVI pacemaker. Conclusions Sleep-disordered breathing was more common in patients who had their cardiac pacemaker implanted due to bradyarrhythmias than in their matched controls. Compared with VVI pacing, DDD or AAI pacing may be more beneficial to patients with bradyarrhythmias and sleep-disordered breathing.

  20. Artificial insemination in poultry

    Science.gov (United States)

    Artificial insemination is a relative simple yet powerful tool geneticists can employ for the propagation of economically important traits in livestock and poultry. In this chapter, we address the fundamental methods of the artificial insemination of poultry, including semen collection, semen evalu...

  1. The pace of shifting climate in marine and terrestrial ecosystems

    DEFF Research Database (Denmark)

    Burrows, Michael T.; Schoeman, David S.; Buckley, Lauren B.;

    2011-01-01

    Climate change challenges organisms to adapt or move to track changes in environments in space and time. We used two measures of thermal shifts from analyses of global temperatures over the past 50 years to describe the pace of climate change that species should track: the velocity of climate...... change (geographic shifts of isotherms over time) and the shift in seasonal timing of temperatures. Both measures are higher in the ocean than on land at some latitudes, despite slower ocean warming. These indices give a complex mosaic of predicted range shifts and phenology changes that deviate from...... simple poleward migration and earlier springs or later falls. They also emphasize potential conservation concerns, because areas of high marine biodiversity often have greater velocities of climate change and seasonal shifts....

  2. 1974 Arizona P.A.C.E. participation.

    Science.gov (United States)

    Zabezensky, F

    1976-12-01

    Members of the Arizona State Society for Medical Technology were contacted to ascertain their knowledge of the P.A.C.E. program as well as to obtain release of the transcripts for those who participated during 1974. Observations regarding reported credits were noted. The Analysis of Variance test with Scheffe comparison was utilized to determine if any characteristic accounted for the difference in total continuing education hours reported. It was concluded that residence location, marital status, sex, age, degree level, length of membership in ASMT, years experience, employment extent, place of employment, and number of beds at place of employment had no significant effect on the total hours reported. A significant difference in total hours reported was noted for those individuals who reported either CEU or college credits. A significant difference was also noted in the total hours reported with respect to job description. PMID:998653

  3. Cardiac Risk Assessment

    Science.gov (United States)

    ... to assess cardiac risk include: High-sensitivity C-reactive protein (hs-CRP) : Studies have shown that measuring ... LDL-C but does not respond to typical strategies to lower LDL-C such as diet, exercise, ...

  4. Sudden Cardiac Arrest

    Science.gov (United States)

    ... Heart Risk Factors & Prevention Heart Diseases & Disorders Atrial Fibrillation (AFib) Sudden Cardiac Arrest (SCA) SCA: Who's At Risk? Prevention of SCA What Causes SCA? SCA Awareness Atrial Flutter Heart Block Heart Failure Sick Sinus Syndrome Substances & Heart Rhythm Disorders Symptoms & ...

  5. Socially differentiated cardiac rehabilitation

    DEFF Research Database (Denmark)

    Meillier, Lucette Kirsten; Nielsen, Kirsten Melgaard; Larsen, Finn Breinholt;

    2012-01-01

    to a standard rehabilitation programme (SRP). If patients were identified as socially vulnerable, they were offered an extended version of the rehabilitation programme (ERP). Excluded patients were offered home visits by a cardiac nurse. Concordance principles were used in the individualised programme elements......%. Patients were equally distributed to the SRP and the ERP. No inequality was found in attendance and adherence among referred patients. Conclusions: It seems possible to overcome unequal referral, attendance, and adherence in cardiac rehabilitation by organisation of systematic screening and social......Aim: The comprehensive cardiac rehabilitation (CR) programme after myocardial infarction (MI) improves quality of life and results in reduced cardiac mortality and recurrence of MI. Hospitals worldwide face problems with low participation rates in rehabilitation programmes. Inequality...

  6. Seasonal Pacing - Match Importance Affects Activity in Professional Soccer

    Science.gov (United States)

    Link, Daniel; de Lorenzo, Michael F.

    2016-01-01

    This research explores the influence of match importance on player activity in professional soccer. Therefore, we used an observational approach and analyzed 1,211 matches of German Bundesliga and 2nd Bundesliga. The importance measurement employed is based on post season consequences of teams involved in a match. This means, if a match result could potentially influence the final rank, and this rank would lead to different consequences for a team, such as qualification for Champions League opposed to qualification for Europe League, then this match is classified as important; otherwise not. Activity was quantified by TOTAL DISTANCE COVERED, SPRINTS, FAST RUNS, DUELS, FOULS and ATTEMPTS. Running parameters were recorded using a semi-automatic optical tracking system, while technical variables were collected by professional data loggers. Based on our importance classification, low important matches occurred at the beginning of round 29. A two-way ANOVA indicates significantly increased FAST RUNS (+4%, d = 0.3), DUELS (+16%, d = 1.0) and FOULS (+36%, d = 1.2) in important matches compared to low important ones. For FAST RUNS and FOULS, this effect only exists in Bundesliga. A comparison of the two leagues show that TOTAL DISTANCE COVERED (+3%, d = 0.9), SPRINTS (+25%, d = 1.4) and FAST RUNS (+15%, d = 1.4) are higher compared to 2nd Bundesliga, whilst FOULS is less in Bundesliga (-7%, d = 0.3). No difference in player activity was found between matches at the beginning of a season (round 1–6) and at the end of a season (round 29–34). We conclude that match importance influences player activity in German professional soccer. The most reasonable explanation is a conscious or unconscious pacing strategy, motivated by preserving abilities or preventing injury. Since this tendency mainly exists in Bundesliga, this may suggest that more skilled players show a higher awareness for the need of pacing. PMID:27281051

  7. Specific Intensity for Peaking: Is Race Pace the Best Option?

    Science.gov (United States)

    Munoz, Iker; Seiler, Stephen; Alcocer, Alberto; Carr, Natasha; Esteve-Lanao, Jonathan

    2015-01-01

    Background: The peaking period for endurance competition is characterized for a relative increase of the intensity of training, after a longer period of training relatively dominated by lower intensity and higher volume Objectives: The present study was designed to compare physiological and 10 km performance effects of high intensity training (HIT) versus race pace interval training (RP) during peaking for competition in well-trained runners. Patients and Methods: 13 athletes took part in the study, they were divided into two groups: HIT and RP. HIT performed short intervals at ~105% of the maximal aerobic velocity (MAV), while RP trained longer intervals at a speed of ~90% of the MAV (a speed approximating 10 km race pace). After 12 weeks of baseline training, the athletes trained for 6 weeks under one of the two peaking regimes. Subjects performed 10 km prior to and after the intervention period. The total load of training was matched between groups during the treatment phase. Subjects completed a graded treadmill running test until volitional exhaustion prior to each 10 km race. MAV was determined as the minimal velocity eliciting maximal oxygen consumption (VO2max). Results: Both groups significantly improved their 10 km time (35 minutes 29 seconds ± 1 minutes 41 seconds vs 34 minutes 53 seconds ± 1 minutes 55 seconds, P 0.05). In contrast, running economy decreased significantly after HIT (210 ± 6 ml.Kg-1.km-1 vs 218 ± 9, P < 0.05). Conclusions: A 6 week period of training at either 105% of MAV or 90% of MAV yielded similar performance gains in a 10km race performed at ~90% MAV. Therefore, the physiological impact of HIT training seems to be positive for VO2max but negative for running economy. PMID:26448854

  8. Specific Intensity for Peaking: Is Race Pace the Best Option?

    Directory of Open Access Journals (Sweden)

    Munoz

    2015-09-01

    Full Text Available Background The peaking period for endurance competition is characterized for a relative increase of the intensity of training, after a longer period of training relatively dominated by lower intensity and higher volume Objectives The present study was designed to compare physiological and 10 km performance effects of high intensity training (HIT versus race pace interval training (RP during peaking for competition in well-trained runners. Patients and Methods 13 athletes took part in the study, they were divided into two groups: HIT and RP. HIT performed short intervals at ~105% of the maximal aerobic velocity (MAV, while RP trained longer intervals at a speed of ~90% of the MAV (a speed approximating 10 km race pace. After 12 weeks of baseline training, the athletes trained for 6 weeks under one of the two peaking regimes. Subjects performed 10 km prior to and after the intervention period. The total load of training was matched between groups during the treatment phase. Subjects completed a graded treadmill running test until volitional exhaustion prior to each 10 km race. MAV was determined as the minimal velocity eliciting maximal oxygen consumption (VO2max. Results Both groups significantly improved their 10 km time (35 minutes 29 seconds ± 1 minutes 41 seconds vs 34 minutes 53 seconds ± 1 minutes 55 seconds, P 0.05. In contrast, running economy decreased significantly after HIT (210 ± 6 ml.Kg-1.km-1 vs 218 ± 9, P < 0.05. Conclusions A 6 week period of training at either 105% of MAV or 90% of MAV yielded similar performance gains in a 10km race performed at ~90% MAV. Therefore, the physiological impact of HIT training seems to be positive for VO2max but negative for running economy.

  9. Seasonal Pacing - Match Importance Affects Activity in Professional Soccer.

    Science.gov (United States)

    Link, Daniel; de Lorenzo, Michael F

    2016-01-01

    This research explores the influence of match importance on player activity in professional soccer. Therefore, we used an observational approach and analyzed 1,211 matches of German Bundesliga and 2nd Bundesliga. The importance measurement employed is based on post season consequences of teams involved in a match. This means, if a match result could potentially influence the final rank, and this rank would lead to different consequences for a team, such as qualification for Champions League opposed to qualification for Europe League, then this match is classified as important; otherwise not. Activity was quantified by TOTAL DISTANCE COVERED, SPRINTS, FAST RUNS, DUELS, FOULS and ATTEMPTS. Running parameters were recorded using a semi-automatic optical tracking system, while technical variables were collected by professional data loggers. Based on our importance classification, low important matches occurred at the beginning of round 29. A two-way ANOVA indicates significantly increased FAST RUNS (+4%, d = 0.3), DUELS (+16%, d = 1.0) and FOULS (+36%, d = 1.2) in important matches compared to low important ones. For FAST RUNS and FOULS, this effect only exists in Bundesliga. A comparison of the two leagues show that TOTAL DISTANCE COVERED (+3%, d = 0.9), SPRINTS (+25%, d = 1.4) and FAST RUNS (+15%, d = 1.4) are higher compared to 2nd Bundesliga, whilst FOULS is less in Bundesliga (-7%, d = 0.3). No difference in player activity was found between matches at the beginning of a season (round 1-6) and at the end of a season (round 29-34). We conclude that match importance influences player activity in German professional soccer. The most reasonable explanation is a conscious or unconscious pacing strategy, motivated by preserving abilities or preventing injury. Since this tendency mainly exists in Bundesliga, this may suggest that more skilled players show a higher awareness for the need of pacing. PMID:27281051

  10. Onion artificial muscles

    Science.gov (United States)

    Chen, Chien-Chun; Shih, Wen-Pin; Chang, Pei-Zen; Lai, Hsi-Mei; Chang, Shing-Yun; Huang, Pin-Chun; Jeng, Huai-An

    2015-05-01

    Artificial muscles are soft actuators with the capability of either bending or contraction/elongation subjected to external stimulation. However, there are currently no artificial muscles that can accomplish these actions simultaneously. We found that the single layered, latticed microstructure of onion epidermal cells after acid treatment became elastic and could simultaneously stretch and bend when an electric field was applied. By modulating the magnitude of the voltage, the artificial muscle made of onion epidermal cells would deflect in opposing directions while either contracting or elongating. At voltages of 0-50 V, the artificial muscle elongated and had a maximum deflection of -30 μm; at voltages of 50-1000 V, the artificial muscle contracted and deflected 1.0 mm. The maximum force response is 20 μN at 1000 V.

  11. Cardiac arrest - cardiopulmonary resuscitation

    Institute of Scientific and Technical Information of China (English)

    Basri Lenjani; Besnik Elshani; Nehat Baftiu; Kelmend Pallaska; Kadir Hyseni; Njazi Gashi; Nexhbedin Karemani; Ilaz Bunjaku; Taxhidin Zaimi; Arianit Jakupi

    2014-01-01

    Objective:To investigate application of cardiopulmonary resuscitation(CPR) measures within the golden minutes inEurope.Methods:The material was taken from theUniversityClinical Center ofKosovo -EmergencyCentre inPristina, during the two(2) year period(2010-2011).The collected date belong to the patients with cardiac arrest have been recorded in the patients' log book protocol at the emergency clinic.Results:During the2010 to2011 in the emergency center of theCUCK inPristina have been treated a total of269 patients with cardiac arrest, of whom159 or59.1% have been treated in2010, and110 patients or40.9% in2011.Of the269 patients treated in the emergency centre,93 or34.6% have exited lethally in the emergency centre, and176 or 65.4% have been transferred to other clinics.In the total number of patients with cardiac arrest, males have dominated with186 cases, or69.1%.The average age of patients included in the survey was56.7 year oldSD±16.0 years.Of the269 patients with cardiac arrest, defibrillation has been applied for93 or34.6% of patients.In the outpatient settings defibrillation has been applied for3 or3.2% of patients.Patients were defibrillated with application of one to four shocks. Of27 cases with who have survived cardiac arrest, none of them have suffered cardiac arrest at home,3 or11.1% of them have suffered cardiac arrest on the street, and24 or88.9% of them have suffered cardiac arrest in the hospital.5 out of27 patients survived have ended with neurological impairment.Cardiac arrest cases were present during all days of the week, but frequently most reported cases have been onMonday with32.0% of cases, and onFriday with24.5% of cases. Conclusions:All survivors from cardiac arrest have received appropriate medical assistance within10 min from attack, which implies that if cardiac arrest occurs near an institution health care(with an opportunity to provide the emergent health care) the rate of survival is higher.

  12. Awareness in cardiac anesthesia.

    LENUS (Irish Health Repository)

    Serfontein, Leon

    2010-02-01

    Cardiac surgery represents a sub-group of patients at significantly increased risk of intraoperative awareness. Relatively few recent publications have targeted the topic of awareness in this group. The aim of this review is to identify areas of awareness research that may equally be extrapolated to cardiac anesthesia in the attempt to increase understanding of the nature and significance of this scenario and how to reduce it.

  13. Cardiac rehabilitation in Germany.

    Science.gov (United States)

    Karoff, Marthin; Held, Klaus; Bjarnason-Wehrens, Birna

    2007-02-01

    The purpose of this review is to give an overview of the rehabilitation measures provided for cardiac patients in Germany and to outline its legal basis and outcomes. In Germany the cardiac rehabilitation system is different from rehabilitation measures in other European countries. Cardiac rehabilitation in Germany since 1885 is based on specific laws and the regulations of insurance providers. Cardiac rehabilitation has predominantly been offered as an inpatient service, but has recently been complemented by outpatient services. A general agreement on the different indications for offering these two services has yet to be reached. Cardiac rehabilitation is mainly offered after an acute cardiac event and bypass surgery. It is also indicated in severe heart failure and special cases of percutaneous coronary intervention. Most patients are men (>65%) and the age at which events occur is increasing. The benefits obtained during the 3-4 weeks after an acute event, and confirmed in numerous studies, are often later lost under 'usual care' conditions. Many attempts have been made by rehabilitation institutions to improve this deficit by providing intensive aftercare. One instrument set up to achieve this is the nationwide institution currently comprising more than 6000 heart groups with approximately 120000 outpatients. After coronary artery bypass grafting or acute coronary syndrome cardiac rehabilitation can usually be started within 10 days. The multidisciplinary rehabilitation team consists of cardiologists, psychologists, exercise therapists, social workers, nutritionists and nurses. The positive effects of cardiac rehabilitation are also important economically, for example, for the improvement of secondary prevention and vocational integration. PMID:17301623

  14. Cardiac tumours in infancy

    OpenAIRE

    Yadava, O.P.

    2012-01-01

    Cardiac tumours in infancy are rare and are mostly benign with rhabdomyomas, fibromas and teratomas accounting for the majority. The presentation depends on size and location of the mass as they tend to cause cavity obstruction or arrhythmias. Most rhabdomyomas tend to regress spontaneously but fibromas and teratomas generally require surgical intervention for severe haemodynamic or arrhythmic complications. Other relatively rare cardiac tumours too are discussed along with an Indian perspect...

  15. Infected cardiac hydatid cyst

    OpenAIRE

    Ceviz, M; Becit, N; Kocak, H.

    2001-01-01

    A 24 year old woman presented with chest pain and palpitation. The presence of a semisolid mass—an echinococcal cyst or tumour—in the left ventricular apex was diagnosed by echocardiography, computed tomography, and magnetic resonance imaging. The infected cyst was seen at surgery. The cyst was removed successfully by using cardiopulmonary bypass with cross clamp.


Keywords: cardiac hydatid cyst; infected cardiac hydatid cyst

  16. Total Artificial Heart Implantation after Excision of Right Ventricular Angiosarcoma

    OpenAIRE

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

    2016-01-01

    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 p...

  17. Artificial intelligence in medicine.

    Science.gov (United States)

    Ramesh, A. N.; Kambhampati, C.; Monson, J. R. T.; Drew, P. J.

    2004-01-01

    INTRODUCTION: Artificial intelligence is a branch of computer science capable of analysing complex medical data. Their potential to exploit meaningful relationship with in a data set can be used in the diagnosis, treatment and predicting outcome in many clinical scenarios. METHODS: Medline and internet searches were carried out using the keywords 'artificial intelligence' and 'neural networks (computer)'. Further references were obtained by cross-referencing from key articles. An overview of different artificial intelligent techniques is presented in this paper along with the review of important clinical applications. RESULTS: The proficiency of artificial intelligent techniques has been explored in almost every field of medicine. Artificial neural network was the most commonly used analytical tool whilst other artificial intelligent techniques such as fuzzy expert systems, evolutionary computation and hybrid intelligent systems have all been used in different clinical settings. DISCUSSION: Artificial intelligence techniques have the potential to be applied in almost every field of medicine. There is need for further clinical trials which are appropriately designed before these emergent techniques find application in the real clinical setting. PMID:15333167

  18. Effect of right ventricular pacing on ventricular rhythm during atrial fibrillation

    NARCIS (Netherlands)

    Wittkampf, F.H.M.; Jongste, M.J.L. de; Lie, H.I.; Meijler, F.L.

    1988-01-01

    In 13 patients with atrial fibrillation, the effect of right ventricular pacing at various rates on spontaneous RR intervals was studied. Five hundred consecutive RR intervals were recorded and measured before and during varying right ventricular pacing rates. As anticipated, all RR intervals longer

  19. Effects of permanent dual chamber pacing on myocardial perfusion in symptomatic hypertrophic cardiomyopathy

    NARCIS (Netherlands)

    Posma, JL; Blanksma, PK; VanderWall, EE; Vaalburg, W; Crijns, HJGM; Lie, KI

    1996-01-01

    Objective-Angina and the presence of myocardial ischaemia are common in hypertrophic cardiomyopathy. Dual chamber pacing results in clinical improvement in these patients. This study evaluates the effects of permanent dual chamber pacing on absolute regional myocardial perfusion and perfusion reserv

  20. Right ventricular outflow and apical pacing comparably worsen the echocardioghraphic normal left ventricle

    NARCIS (Netherlands)

    T.J.F. ten Cate (Tim); M.G. Scheffer (Michael); G.R. Sutherland (George); J.F. Verzijlbergen (Fred); N.M. van Hemel (Norbert)

    2008-01-01

    textabstractAims: A depressed left ventricular function (LVF) is sometimes observed during right ventricular apical (RVA) pacing, but any prediction of this adverse effect cannot be done. Right ventricular outflow tract (RVOT) pacing is thought to deteriorate LVF less frequently because of a more no

  1. Research on Electrical Remodeling After Short Term Pacing in Canine Model

    Institute of Scientific and Technical Information of China (English)

    Kebbati A Hafid; Huang Congxin; Wang Xi; Zhao Qingyan

    2007-01-01

    Objectives To evaluate the changes in atrial effective refractory period (AERP) proprieties and in ionic currents in PVs myocytes from dogs subjected to rapid atrial pacing in PVs and right atrial appendage (RAA) and to relate these changes to the ability to induce AF. Methods Twelve mongrel dogs in normal sinus rhythm were paced from the superior left PVs or RAA at 500 bpm for 4 hours. Electrophysiologic studies conducted to determine changes in AERP, dispersion and rhythm. Ionic currents were studies with the patch clamp technique in single PVs myocytes in sham operated dogs and compared with those from PVs pacing and RAA pacing groups. Results The presence of rapid atrial pacing was associated with a marked shortening in AERP in both PVs and RAA pacing group with a marked increase of AERP dispersion in PVs pacing. Both L-type calcium current (ICa, L) and the transient outward current (Ito)were reduced in both groups with an increased significance in PVs pacing group. The density of ICa-L WaS decreased significantly from ( - 6.03 ± 0.63 ) pA/pF in the control group to ( -3.21±0.34) pA/pF in PVs pacing group and ( - 4,75 ± 0.41 ) pA/pF in RAA pacing group (n = 6, P<0.05) while the density of Ito was decreased significantly from (8.45±0.71 ) pA/pF in the control group to (5.21 ±0.763 ) pA/pF in PVs pacing group and (6,84 ± 0.69) pA/pF in RAA pacing group (n = 6, P<0.05). Conclusions Our findings provide likely ionic mechanisms of shortened repolarization in induced atrial tachycardia with a decrease in Ica,L and Ito current densities which is the likely mechanism for a decrease in Action potential duration (APD) rate adaptation in the canine rapid pacing model more pronounced in PVs pacing group underlying the crucial role of PVs in initiating AF.

  2. Anesthesia for robotic cardiac surgery: An amalgam of technology and skill

    Directory of Open Access Journals (Sweden)

    Chauhan Sandeep

    2010-01-01

    Full Text Available The surgical procedures performed with robtic assitance and the scope for its future assistance is endless. To keep pace with the developing technologies in this field it is imperative for the cardiac anesthesiologists to have aworking knowledge of these systems, recognize potential complications and formulate an anesthetic plan to provide safe patient care. Challenges posed by the use of robotic systems include, long surgical times, problems with one lung anesthesia in presence of coronary artery disease, minimally invasive percutaneous cardiopulmonary bypass management and expertise in Trans-Esophageal Echocardiography. A long list of cardiac surgeries are performed with the use of robotic assistance, and the list is continuously growing as surgical innovation crosses new boundaries. Current research in robotic cardiac surgery like beating heart off pump intracardic repair, prototype epicardial crawling device, robotic fetal techniques etc. are in the stage of animal experimentation, but holds a lot of promise in future

  3. Principles of artificial intelligence

    CERN Document Server

    Nilsson, Nils J

    1980-01-01

    A classic introduction to artificial intelligence intended to bridge the gap between theory and practice, Principles of Artificial Intelligence describes fundamental AI ideas that underlie applications such as natural language processing, automatic programming, robotics, machine vision, automatic theorem proving, and intelligent data retrieval. Rather than focusing on the subject matter of the applications, the book is organized around general computational concepts involving the kinds of data structures used, the types of operations performed on the data structures, and the properties of th

  4. The Artificial Anal Sphincter

    OpenAIRE

    Christiansen, John

    2000-01-01

    The artificial anal sphincter as treatment for end stage anal incontinence was first described in 1987. Published series concern a total of 42 patients, with a success rate of approximately 80%. Infection has been the most serious complication, but a number of technical complications related to the device have also occurred and required revisional procedures in 40% to 60% of the patients. The artificial anal sphincter may be used for the same indications as dynamic graciloplasty except in pat...

  5. Pediatric cardiac postoperative care

    Directory of Open Access Journals (Sweden)

    Auler Jr. José Otávio Costa

    2002-01-01

    Full Text Available The Heart Institute of the University of São Paulo, Medical School is a referral center for the treatment of congenital heart diseases of neonates and infants. In the recent years, the excellent surgical results obtained in our institution may be in part due to modern anesthetic care and to postoperative care based on well-structured protocols. The purpose of this article is to review unique aspects of neonate cardiovascular physiology, the impact of extracorporeal circulation on postoperative evolution, and the prescription for pharmacological support of acute cardiac dysfunction based on our cardiac unit protocols. The main causes of low cardiac output after surgical correction of heart congenital disease are reviewed, and methods of treatment and support are proposed as derived from the relevant literature and our protocols.

  6. The cardiac anxiety questionnaire: cross-validation among cardiac inpatients

    NARCIS (Netherlands)

    Beek, M.H. van; Oude Voshaar, R.C.; Deelen, F.M. van; Balkom, A.J. van; Pop, G.A.; Speckens, A.E.

    2012-01-01

    OBJECTIVE: General anxiety symptoms are common in patients with cardiac disease and considered to have an adverse effect on cardiac prognosis. The role of specific cardiac anxiety, however, is still unknown. The aim of this study is to examine the factor structure, reliability, and validity of the D

  7. THE CARDIAC ANXIETY QUESTIONNAIRE : CROSS-VALIDATION AMONG CARDIAC INPATIENTS

    NARCIS (Netherlands)

    van Beek, M. H. C. T.; Voshaar, R. C. Oude; van Deelen, F. M.; van Balkom, A. J. L. M.; Pop, G.; Speckens, A. E. M.

    2012-01-01

    Objective: General anxiety symptoms are common in patients with cardiac disease and considered to have an adverse effect on cardiac prognosis. The role of specific cardiac anxiety, however, is still unknown. The aim of this study is to examine the factor structure, reliability, and validity of the D

  8. Comparison of permanent left ventricular and biventricular pacing in patients with heart failure and chronic atrial fibrillation: prospective haemodynamic study

    OpenAIRE

    Garrigue, S; Bordachar, P.; Reuter, S.; Jaïs, P.; Kobeissi, A; Gaggini, G; Haïssaguerre, M; Clementy, J

    2002-01-01

    Objective: To compare clinical and haemodynamic variables between left ventricular and biventricular pacing in patients with severe heart failure; and to analyse haemodynamic changes during daily life and maximum exercise during chronic left ventricular and biventricular pacing.

  9. Giant Cardiac Cavernous Hemangioma.

    Science.gov (United States)

    Unger, Eric; Costic, Joseph; Laub, Glenn

    2015-07-01

    We report the case of an asymptomatic giant cardiac cavernous hemangioma in a 71-year-old man. The intracardiac mass was discovered incidentally during surveillance for his prostate cancer; however, the patient initially declined intervention. On presentation to our institution 7 years later, the lesion had enlarged significantly, and the patient consented to excision. At surgery, an 8 × 6.5 × 4.8 cm intracardiac mass located on the inferior heart border was excised with an intact capsule through a median sternotomy approach. The patient had an uneventful postoperative course. We discuss the diagnostic workup, treatment, and characteristics of this rare cardiac tumor. PMID:26140782

  10. Perioperative management of cardiac disease.

    Science.gov (United States)

    Aresti, N A; Malik, A A; Ihsan, K M; Aftab, S M E; Khan, W S

    2014-01-01

    Pre-existing cardiac disease contributes significantly to morbidity and mortality amongst patients undergoing non cardiac surgery. Patients with pre-existing cardiac disease or with risk factors for it, have as much as a 3.9% risk of suffering a major perioperative cardiac event (Lee et al 1999, Devereaux 2005). Furthermore, the incidence of perioperative myocardial infarction (MI) is increased 10 to 50 fold in patients with previous coronary events (Jassal 2008).

  11. Effects of thallium on membrane currents at diastolic potentials in canine cardiac Purkinje strands.

    Science.gov (United States)

    Cohen, I S; Mulrine, N K

    1986-01-01

    A two-micro-electrode voltage-clamp technique was used to record membrane currents from canine cardiac Purkinje strands during hyperpolarizing steps to potentials between -70 and -150 mV in Tyrode solutions containing K+ and/or Tl+. Complete replacement of external K+ by equimolar Tl+ increases the instantaneous inwardly rectifying current. The inwardly rectifying region of the instantaneous I-V relation is shifted to more positive potentials and its slope is increased. The diastolic time-dependent current is reduced or reversed. Partial substitution of equimolar Tl+ for K+ reduces the diastolic time-dependent current. The instantaneous I-V relation is shifted inward for molar fractions of Tl+ (YTl) greater than 0.5, and is slightly more inward or unchanged for YTl less than or equal to 0.5. Addition of small amounts of Tl+ shifts the instantaneous I-V relation inward and reduces the diastolic time-dependent current. Addition of Tl+ in solutions containing Ba2+ to block the background inward rectifier has no effect on the instantaneous I-V relation; the diastolic time-dependent (pace-maker) current is reduced. Block of the pace-maker current by Tl+ is largely independent of potential in Ba2+ Tyrode solution. Since Tl+ has opposite effects on the pace-maker current and the inward rectifier, these findings support other evidence that the pace-maker current is not part of the background inward rectifier.

  12. Ventilation patterns mimicking COPD in patients with diaphragmatic pacing for Ondine's curse

    International Nuclear Information System (INIS)

    Ventilation was studied with 133Xe in 18 patients with central hypoventilation (Ondine's Curse) in whom diaphragmatic pacers were implanted. Three distinct patterns emerged: Type I, improvement in ventilation on the paced side (11 of 18 patients); Type II, improvement on both the paced and unpaced side (4 of 18); and Type III, no improvement (3 of 18). With the pacer off, many of these patients have patterns that mimic chronic obstructive pulmonary disease and that revert to normal with pacing. This retention, clearly reversible, cannot reflect permanent airways or airspace disease

  13. Assessment of Ventricular Dissynchrony in Right Ventricular Single Chamber Pacing using Echocardiografic Parameters

    Directory of Open Access Journals (Sweden)

    Vita I

    2014-04-01

    Full Text Available Background: Right ventricular apical pacing has been used since the early years of pace-makers, despite the fact that it determined nonphysiological ventricular depolarization. As medical technologies developed, septal lead implantation became feasible, in order to outrun the above mentioned inconveniences. The question whether the apical or septal lead position is better still gives rise to a lot of controversies. Different echocardiographic parameters are currently used to assess the impact of specific sites of stimulation on ventricular function. The aim of the study was to determine which of the followed synchronicity parameters varied significantly during apical stimulation, compared to septal stimulation in patients requiring single chamber pacing.

  14. The cardiac malpositions.

    Science.gov (United States)

    Perloff, Joseph K

    2011-11-01

    Dextrocardia was known in the 17th century and was 1 of the first congenital malformations of the heart to be recognized. Fifty years elapsed before Matthew Baillie published his account of complete transposition in a human of the thoracic and abdominal viscera to the opposite side from what is natural. In 1858, Thomas Peacock stated that "the heart may be congenitally misplaced in various ways, occupying either an unusual position within the thorax, or being situated external to that cavity." In 1915, Maude Abbott described ectopia cordis, and Richard Paltauf's remarkable illustrations distinguished the various types of dextrocardia. In 1928, the first useful classification of the cardiac malpositions was proposed, and in 1966, Elliott et al's radiologic classification set the stage for clinical recognition. The first section of this review deals with the 3 basic cardiac malpositions in the presence of bilateral asymmetry. The second section deals with cardiac malpositions in the presence of bilateral left-sidedness or right-sidedness. Previous publications on cardiac malpositions are replete with an arcane vocabulary that confounds rather than clarifies. Even if the terms themselves are understood, inherent complexity weighs against clarity. This review was designed as a guided tour of an unfamiliar subject.

  15. Hepato-cardiac disorders

    Institute of Scientific and Technical Information of China (English)

    Yasser; Mahrous; Fouad; Reem; Yehia

    2014-01-01

    Understanding the mutual relationship between the liver and the heart is important for both hepatologists and cardiologists. Hepato-cardiac diseases can be classified into heart diseases affecting the liver, liver diseases affecting the heart, and conditions affecting the heart and the liver at the same time. Differential diagnoses of liver injury are extremely important in a cardiologist’s clinical practice calling for collaboration between cardiologists and hepatologists due to the many other diseases that can affect the liver and mimic haemodynamic injury. Acute and chronic heart failure may lead to acute ischemic hepatitis or chronic congestive hepatopathy. Treatment in these cases should be directed to the primary heart disease. In patients with advanced liver disease, cirrhotic cardiomyopathy may develop including hemodynamic changes, diastolic and systolic dysfunctions, reduced cardiac performance and electrophysiological abnormalities. Cardiac evaluation is important for patients with liver diseases especially before and after liver transplantation. Liver transplantation may lead to the improvement of all cardiac changes and the reversal of cirrhotic cardiomyopathy. There are systemic diseases that may affect both the liver and the heart concomitantly including congenital, metabolic and inflammatory diseases as well as alcoholism. This review highlights these hepatocardiac diseases

  16. Cardiac effects of vasopressin.

    Science.gov (United States)

    Pelletier, Jean-Sébastien; Dicken, Bryan; Bigam, David; Cheung, Po-Yin

    2014-07-01

    Vasopressin is an essential hormone involved in the maintenance of cardiovascular homeostasis. It has been in use therapeutically for many decades, with an emphasis on its vasoconstrictive and antidiuretic properties. However, this hormone has a ubiquitous influence and has specific effects on the heart. Although difficult to separate from its powerful vascular effects in the clinical setting, a better understanding of vasopressin's direct cardiac effects could lead to its more effective clinical use for a variety of shock states by maximizing its therapeutic benefit. The cardiac-specific effects of vasopressin are complex and require further elucidation. Complicating our understanding include the various receptors and secondary messengers involved in vasopressin's effects, which may lead to various results based on differing doses and varying environmental conditions. Thus, there have been contradictory reports on vasopressin's action on the coronary vasculature and on its effect on inotropy. However, beneficial results have been found and warrant further study to expand the potential therapeutic role of vasopressin. This review outlines the effect of vasopressin on the coronary vasculature, cardiac contractility, and on hypertrophy and cardioprotection. These cardiac-specific effects of vasopressin represent an interesting area for further study for potentially important therapeutic benefits. PMID:24621650

  17. Cardiac potassium channel subtypes

    DEFF Research Database (Denmark)

    Schmitt, Nicole; Grunnet, Morten; Olesen, Søren-Peter

    2014-01-01

    About 10 distinct potassium channels in the heart are involved in shaping the action potential. Some of the K(+) channels are primarily responsible for early repolarization, whereas others drive late repolarization and still others are open throughout the cardiac cycle. Three main K(+) channels...

  18. Cardiac pacemaker power sources

    International Nuclear Information System (INIS)

    A review of chemical and radioisotope batteries used in cardiac pacemakers is presented. The battery systems are examined in terms of longevity, reliability, cost, size and shape, energy density, weight, internal resistance versus time, end-of-life voltage, chemical compatibility, and potential failure mechanisms

  19. Utility of a Novel Biofeedback Device for Within-Breath Modulation of Heart Rate in Rats: A Quantitative Comparison of Vagus Nerve vs. Right Atrial Pacing.

    Science.gov (United States)

    O'Callaghan, Erin L; Chauhan, Ashok S; Zhao, Le; Lataro, Renata M; Salgado, Helio C; Nogaret, Alain; Paton, Julian F R

    2016-01-01

    In an emerging bioelectronics era, there is a clinical need for physiological devices incorporating biofeedback that permits natural and demand-dependent control in real time. Here, we describe a novel device termed a central pattern generator (CPG) that uses cutting edge analog circuitry producing temporally controlled, electrical stimulus outputs based on the real time integration of physiological feedback. Motivated by the fact that respiratory sinus arrhythmia (RSA), which is the cyclical changes in heart rate every breath, is an essential component of heart rate variability (HRV) (an indicator of cardiac health), we have explored the versatility and efficiency of the CPG for producing respiratory modulation of heart rate in anesthetized, spontaneously breathing rats. Diaphragmatic electromyographic activity was used as the input to the device and its output connected to either the right cervical vagus nerve or the right atrium for pacing heart rate. We found that the CPG could induce respiratory related heart rate modulation that closely mimicked RSA. Whether connected to the vagus nerve or right atrium, the versatility of the device was demonstrated by permitting: (i) heart rate modulation in any phase of the respiratory cycle, (ii) control of the magnitude of heart rate modulation, and (iii) instant adaptation to changes in respiratory frequency. Vagal nerve pacing was only possible following transection of the nerve limiting its effective use chronically. Pacing via the right atrium permitted better flexibility and control of heart rate above its intrinsic level. This investigation now lays the foundation for future studies using this biofeedback technology permitting closer analysis of both the function and dysfunction of RSA. PMID:26869940

  20. Utility of a novel biofeedback device for within-breath modulation of heart rate in rats: a quantitative comparison of vagus nerve versus right atrial pacing.

    Directory of Open Access Journals (Sweden)

    Erin Louise O'Callaghan

    2016-02-01

    Full Text Available In an emerging bioelectronics era, there is a clinical need for physiological devices incorporating biofeedback that permits natural and demand-dependent control in real time. Here, we describe a novel device termed a central pattern generator (CPG that uses cutting edge analogue circuitry producing temporally controlled, electrical stimulus outputs based on the real time integration of physiological feedback. Motivated by the fact that respiratory sinus arrhythmia (RSA, which is the cyclical changes in heart rate every breath, is an essential component of heart rate variability (an indicator of cardiac health, we have explored the versatility and efficiency of the CPG for producing respiratory modulation of heart rate in anaesthetised, spontaneously breathing rats. Diaphragmatic electromyographic activity was used as the input to the device and its output connected to either the right cervical vagus nerve or the right atrium for pacing heart rate. We found that the CPG could induce respiratory related heart rate modulation that closely mimicked RSA. Whether connected to the vagus nerve or right atrium, the versatility of the device was demonstrated by permitting: (i heart rate modulation in any phase of the respiratory cycle, (ii control of the magnitude of heart rate modulation and (iii instant adaptation to changes in respiratory frequency. Vagal nerve pacing was only possible following transection of the nerve limiting its effective use chronically. Pacing via the right atrium permitted better flexibility and control of heart rate above its intrinsic level. This investigation now lays the foundation for future studies using this biofeedback technology permitting closer analysis of both the function and dysfunction of RSA.

  1. Obliquity-paced Pliocene West Antarctic ice sheet oscillations

    Science.gov (United States)

    Naish, T.; Powell, R.; Levy, R.; Wilson, G.; Scherer, R.; Talarico, F.; Krissek, L.; Niessen, F.; Pompilio, M.; Wilson, T.; Carter, L.; DeConto, R.; Huybers, P.; McKay, R.; Pollard, D.; Ross, J.; Winter, D.; Barrett, P.; Browne, G.; Cody, R.; Cowan, E.; Crampton, J.; Dunbar, G.; Dunbar, N.; Florindo, F.; Gebhardt, C.; Graham, I.; Hannah, M.; Hansaraj, D.; Harwood, D.; Helling, D.; Henrys, S.; Hinnov, L.; Kuhn, G.; Kyle, P.; Laufer, A.; Maffioli, P.; Magens, D.; Mandernack, K.; McIntosh, W.; Millan, C.; Morin, R.; Ohneiser, C.; Paulsen, T.; Persico, D.; Raine, I.; Reed, J.; Riesselman, C.; Sagnotti, L.; Schmitt, D.; Sjunneskog, C.; Strong, P.; Taviani, M.; Vogel, S.; Wilch, T.; Williams, T.

    2009-01-01

    Thirty years after oxygen isotope records from microfossils deposited in ocean sediments confirmed the hypothesis that variations in the Earth's orbital geometry control the ice ages, fundamental questions remain over the response of the Antarctic ice sheets to orbital cycles. Furthermore, an understanding of the behaviour of the marine-based West Antarctic ice sheet (WAIS) during the 'warmer-than-present' early-Pliocene epoch (???5-3 Myr ago) is needed to better constrain the possible range of ice-sheet behaviour in the context of future global warming. Here we present a marine glacial record from the upper 600 m of the AND-1B sediment core recovered from beneath the northwest part of the Ross ice shelf by the ANDRILL programme and demonstrate well-dated, ???40-kyr cyclic variations in ice-sheet extent linked to cycles in insolation influenced by changes in the Earth's axial tilt (obliquity) during the Pliocene. Our data provide direct evidence for orbitally induced oscillations in the WAIS, which periodically collapsed, resulting in a switch from grounded ice, or ice shelves, to open waters in the Ross embayment when planetary temperatures were up to ???3??C warmer than today and atmospheric CO 2 concentration was as high as ???400 p.p.m.v. (refs 5, 6). The evidence is consistent with a new ice-sheet/ice-shelf model that simulates fluctuations in Antarctic ice volume of up to +7 m in equivalent sea level associated with the loss of the WAIS and up to +3 m in equivalent sea level from the East Antarctic ice sheet, in response to ocean-induced melting paced by obliquity. During interglacial times, diatomaceous sediments indicate high surface-water productivity, minimal summer sea ice and air temperatures above freezing, suggesting an additional influence of surface melt under conditions of elevated CO2. ??2009 Macmillan Publishers Limited. All rights reserved.

  2. Effect of renal sympathetic denervation on atrial substrate remodeling in ambulatory canines with prolonged atrial pacing.

    Directory of Open Access Journals (Sweden)

    Xule Wang

    Full Text Available We have previously demonstrated that catheter-based renal sympathetic denervation (RSD could suppress atrial fibrillation (AF in canines with short-time rapid right atrial pacing (RAP. However, the role of renal denervation on atrial remodeling is unclear. The aim of the present study was to explore the long-term effect of RSD on the atrial remodeling during prolonged RAP. Twenty mongrel dogs were implanted with a high-frequency cardiac pacemaker with a transvenous lead inserted into the right atrial appendage. The dogs were divided into three groups: a sham-operated group (n = 6, the chronic RAP (CRAP group (n = 7, and the CRAP+RSD group (n = 7. In the CRAP+RSD group, a pacemaker was implanted 6 weeks after RSD was performed bilaterally for recovery. RAP was maintained for 5 weeks in CRAP group and CRAP+RSD group. The plasma levels of Angiotensin II and aldosterone were significantly increased in CRAP group compared with sham-operated group, but the increasing trend was inhibited in CRAP+RSD group compared with CRAP group (P<0.05. Similarly, RSD suppressed the increasing trend that prolonged RAP produced in the left atrial levels of ANP, TNF-α and IL-6. Compared with the sham-operated group, the CRAP group had significantly increased levels of caspase-3, bax and Cx40 whereas the level of Bcl-2 decreased (P<0.05. RSD markedly reduced the upregulation of caspase-3, bax and Cx40 and the downregulation of Bcl-2 expression compared with the CRAP group (P<0.05. Picric acid-sirius red staining study suggested that RSD could markedly alleviate the lesion degree of cardic fibrosis induced by CRAP (P<0.05. Immunohistochemistry results showed that the densities of TH- and GAP43- positive nerves were significantly elevated in the CRAP group compared with the sham-operated group, while RSD operation signicantly inhibited the these changes produced by CRAP. These findings suggest that renal denervation could suppress the atrial remodeling after

  3. Artificial muscles on heat

    Science.gov (United States)

    McKay, Thomas G.; Shin, Dong Ki; Percy, Steven; Knight, Chris; McGarry, Scott; Anderson, Iain A.

    2014-03-01

    Many devices and processes produce low grade waste heat. Some of these include combustion engines, electrical circuits, biological processes and industrial processes. To harvest this heat energy thermoelectric devices, using the Seebeck effect, are commonly used. However, these devices have limitations in efficiency, and usable voltage. This paper investigates the viability of a Stirling engine coupled to an artificial muscle energy harvester to efficiently convert heat energy into electrical energy. The results present the testing of the prototype generator which produced 200 μW when operating at 75°C. Pathways for improved performance are discussed which include optimising the electronic control of the artificial muscle, adjusting the mechanical properties of the artificial muscle to work optimally with the remainder of the system, good sealing, and tuning the resonance of the displacer to minimise the power required to drive it.

  4. Artificial vision workbench.

    Science.gov (United States)

    Frenger, P

    1997-01-01

    Machine vision is an important component of medical systems engineering. Inexpensive miniature solid state cameras are now available. This paper describes how these devices can be used as artificial retinas, to take snapshots and moving pictures in monochrome or color. Used in pairs, they produce a stereoscopic field of vision and enable depth perception. Macular and peripheral vision can be simulated electronically. This paper also presents the author's design of an artificial orbit for this synthetic eye. The orbit supports the eye, protects it, and provides attachment points for the ocular motion control system. Convergence and image fusion can be produced, and saccades simulated, along with the other ocular motions. The use of lenses, filters, irises and focusing mechanisms are also discussed. Typical camera-computer interfaces are described, including the use of "frame grabbers" and analog-to-digital image conversion. Software programs for eye positioning, image manipulation, feature extraction and object recognition are discussed, including the application of artificial neural networks.

  5. 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.

  6. Artificial intelligence in nanotechnology

    International Nuclear Information System (INIS)

    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)

  7. 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.

  8. Artificial human vision.

    Science.gov (United States)

    Dowling, Jason

    2005-01-01

    Can vision be restored to the blind? As early as 1929 it was discovered that stimulating the visual cortex of an individual led to the perception of spots of light, known as phosphenes [1] . The aim of artificial human vision systems is to attempt to utilize the perception of phosphenes to provide a useful substitute for normal vision. Currently, four locations for electrical stimulation are being investigated; behind the retina (subretinal), in front of the retina (epiretinal), the optic nerve and the visual cortex (using intra- and surface electrodes). This review discusses artificial human vision technology and requirements, and reviews the current development projects.

  9. Spatially Resolved Artificial Chemistry

    DEFF Research Database (Denmark)

    Fellermann, Harold

    2009-01-01

    Although spatial structures can play a crucial role in chemical systems and can drastically alter the outcome of reactions, the traditional framework of artificial chemistry is a well-stirred tank reactor with no spatial representation in mind. Advanced method development in physical chemistry has...... made a class of models accessible to the realms of artificial chemistry that represent reacting molecules in a coarse-grained fashion in continuous space. This chapter introduces the mathematical models of Brownian dynamics (BD) and dissipative particle dynamics (DPD) for molecular motion and reaction...

  10. Bayesian artificial intelligence

    CERN Document Server

    Korb, Kevin B

    2003-01-01

    As the power of Bayesian techniques has become more fully realized, the field of artificial intelligence has embraced Bayesian methodology and integrated it to the point where an introduction to Bayesian techniques is now a core course in many computer science programs. Unlike other books on the subject, Bayesian Artificial Intelligence keeps mathematical detail to a minimum and covers a broad range of topics. The authors integrate all of Bayesian net technology and learning Bayesian net technology and apply them both to knowledge engineering. They emphasize understanding and intuition but also provide the algorithms and technical background needed for applications. Software, exercises, and solutions are available on the authors' website.

  11. Classifying running-related injuries based upon etiology, with emphasis on volume and pace

    DEFF Research Database (Denmark)

    Nielsen, Rasmus Oestergaard; Nohr, Ellen Aagaard; Rasmussen, Sten;

    2013-01-01

    of patellofemoral pain syndrome, iliotibial band syndrome, and patellar tendinopathy, while change in running pace may be associated with the development of achilles tendinopathy, gastrocnemius injuries, and plantar fasciitis. DISCUSSIONRELATION TO CLINICAL PRACTICE: If this assertion is correct, bias may...

  12. The role of adrenaline as a modulator of cardiac performance in three Notothenioid fishes

    DEFF Research Database (Denmark)

    Skov, Peter Vilhelm; Bushnell, P.; Tirsgaard, Bjørn;

    2008-01-01

    -fold difference in force of contraction at the lowest pacing frequency and tonic adrenaline level between species. Increasing adrenaline enhanced peak tension for all ventricular tissues, yet the response was highly species specific, increasing force of contraction two to four-fold. Only in one species did......The present work was performed to test the hypothesis that Antarctic teleosts rely mostly on cholinergic inhibition to modulate cardiac performance. Isometric muscle preparations were used to examine the inotropic and chronotropic properties of the ventricle and atrium in three Antarctic teleosts....... The importance of adrenaline as a neurotransmitter was evaluated through a series of dose-response experiments in conjunction with increasing pacing frequencies, to establish whether adrenaline modulated force of contraction and the maximum frequency with which tissues could contract. Only in Chaenocephalus...

  13. An integrated platform for image-guided cardiac resynchronization therapy

    Science.gov (United States)

    Ma, Ying Liang; Shetty, Anoop K.; Duckett, Simon; Etyngier, Patrick; Gijsbers, Geert; Bullens, Roland; Schaeffter, Tobias; Razavi, Reza; Rinaldi, Christopher A.; Rhode, Kawal S.

    2012-05-01

    Cardiac resynchronization therapy (CRT) is an effective procedure for patients with heart failure but 30% of patients do not respond. This may be due to sub-optimal placement of the left ventricular (LV) lead. It is hypothesized that the use of cardiac anatomy, myocardial scar distribution and dyssynchrony information, derived from cardiac magnetic resonance imaging (MRI), may improve outcome by guiding the physician for optimal LV lead positioning. Whole heart MR data can be processed to yield detailed anatomical models including the coronary veins. Cine MR data can be used to measure the motion of the LV to determine which regions are late-activating. Finally, delayed Gadolinium enhancement imaging can be used to detect regions of scarring. This paper presents a complete platform for the guidance of CRT using pre-procedural MR data combined with live x-ray fluoroscopy. The platform was used for 21 patients undergoing CRT in a standard catheterization laboratory. The patients underwent cardiac MRI prior to their procedure. For each patient, a MRI-derived cardiac model, showing the LV lead targets, was registered to x-ray fluoroscopy using multiple views of a catheter looped in the right atrium. Registration was maintained throughout the procedure by a combination of C-arm/x-ray table tracking and respiratory motion compensation. Validation of the registration between the three-dimensional (3D) roadmap and the 2D x-ray images was performed using balloon occlusion coronary venograms. A 2D registration error of 1.2 ± 0.7 mm was achieved. In addition, a novel navigation technique was developed, called Cardiac Unfold, where an entire cardiac chamber is unfolded from 3D to 2D along with all relevant anatomical and functional information and coupled to real-time device detection. This allowed more intuitive navigation as the entire 3D scene was displayed simultaneously on a 2D plot. The accuracy of the unfold navigation was assessed off-line using 13 patient data sets

  14. EFFECT OF ADAPTIVE PACED CARDIOLOCOMOTOR SYNCHRONIZATION DURING RUNNING: A PRELIMINARY STUDY

    Directory of Open Access Journals (Sweden)

    Bill Phillips

    2013-09-01

    Full Text Available Cardiolocomotor synchronization (CLS has been well established for individuals engaged in rhythmic activity, such as walking, running, or cycling. When frequency of the activity is at or near the heart rate, entrainment occurs. CLS has been shown in many cases to improve the efficiency of locomotor activity, improving stroke volume, reducing blood pressure variability, and lowering the oxygen uptake (VO2. Instead of a 1:1 frequency ratio of activity to heart rate, an investigation was performed to determine if different harmonic coupling at other simple integer ratios (e.g. 1:2, 2:3, 3:2 could achieve any performance benefits. CLS was ensured by pacing the stride rate according to the measured heartbeat (i.e., adaptive paced CLS, or forced CLS. An algorithm was designed that determined the simplest ratio (lowest denominator that, when multiplied by the heart rate will fall within an individualized, predetermined comfortable pacing range for the user. The algorithm was implemented on an iPhone 4, which generated a 'tick-tock' sound through the iPhone's headphones. A sham-controlled crossover study was performed with 15 volunteers of various fitness levels. Subjects ran a 3 mile (4.83 km simulated training run at their normal pace on two consecutive days (randomized one adaptive pacing, one sham. Adaptive pacing resulted in faster runs run times, with subjects running an average of 26:03 ± 3:23 for adaptive pacing and 26:38 ± 3:31 for sham (F = 5.46, p < 0.05. The increase in heart rate from the start of the race as estimated by an exponential time constant was significantly longer during adaptive pacing, τ = 0.99 ± 0.30, compared to sham, τ = 1.53 ± 0.34 (t = -6.62, p < 0.01. Eighty-seven percent of runners found it easy to adjust their stride length to match the pacing signal with seventy-nine percent reporting that pacing helped their performance. These results suggest that adaptive paced CLS may have a beneficial effect on running

  15. The effect of shared temporal cognitions and Pacing styles on intragroup conflict in portuguese healthcare teams

    OpenAIRE

    Queimado, Alexandra Coelho de Meireles de Oliveira

    2015-01-01

    Master in Human Resources Management This study aimed to evaluate the impact of two specific dimensions of time-related matters (shared temporal cognitions and pacing styles), as a cognitive contextual factor, on different types of team conflict. We hypothesized that the relationship between shared temporal cognitions and the different types of conflict is moderated by pacing styles. A total of 30 teams (245 individuals) participated in this study. All teams were part of different Portugue...

  16. The impact of the perception of rhythmic music on self-paced oscillatory movements

    OpenAIRE

    Peckel, Mathieu; Pozzo, Thierry; Bigand, Emmanuel

    2014-01-01

    Inspired by theories of perception-action coupling and embodied music cognition, we investigated how rhythmic music perception impacts self-paced oscillatory movements. In a pilot study, we examined the kinematic parameters of self-paced oscillatory movements, walking and finger tapping using optical motion capture. In accordance with biomechanical constraints accounts of motion, we found that movements followed a hierarchical organization depending on the proximal/distal characteristic of th...

  17. PACE - A test bed for the dynamics and control of flexible multibody systems

    Science.gov (United States)

    Kwak, M. K.; Schlaegel, W. T.; Das, A.

    1993-04-01

    The Phillips Laboratory at Edwards AFB has constructed a test bed for the validation and comparison of modeling and control theories for the dynamics and control of flexible multibody systems. This project is called the Planar Articulating Controls Experiment (PACE). This paper presents the experimental apparatus for PACE and the equations of motion are derived by using the Hamilton principle and the assumed mode method. Control techniques for the slewing control and vibration suppression are also discussed.

  18. The impact of the perception of rhythmic music on oscillatory self-paced movements

    OpenAIRE

    Mathieu ePeckel; Thierry ePozzo; Emmanuel eBigand

    2014-01-01

    Inspired by theories of perception-action coupling and embodied music cognition, we investigated how rhythmic music perception impacts self-paced oscillatory movements. In a pilot study, we examined the kinematic parameters of self-paced oscillatory movements, walking and finger tapping using optical motion capture. In accordance with biomechanical constraints accounts of motion, we found that movements followed a hierarchical organization depending on the proximal/distal characteristic of th...

  19. Study of Access and Quality of Care in For-Profit PACE

    OpenAIRE

    David Jones; Nancy Duda; Bob Schmitz; Sandi Nelson; Chelsea Swete; Alex Bryce; Jared Coopersmith; Karen CyBulski

    2013-01-01

    This report summarizes a study to address quality of and access to care for participants of for-profit Programs of All-Inclusive Care for the Elderly (PACE) organizations. The PACE model allows people who otherwise need a nursing home-level of care to remain in the community by providing health care and related support services, such as social supports, meals and chore services, and transportation.

  20. Cardiac fusion and complex congenital cardiac defects in thoracopagus twins: diagnostic value of cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Goo, Hyun Woo [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea, Republic of); Park, Jeong-Jun [University of Ulsan College of Medicine, Asan Medical Center, Department of Pediatric Cardiac Surgery, Seoul (Korea, Republic of); Kim, Ellen Ai-Rhan [University of Ulsan College of Medicine, Asan Medical Center, Division of Neonatology, Department of Pediatrics, Seoul (Korea, Republic of); Won, Hye-Sung [University of Ulsan College of Medicine, Asan Medical Center, Department of Obstetrics and Gynecology, Seoul (Korea, Republic of)

    2014-09-15

    Most thoracopagus twins present with cardiac fusion and associated congenital cardiac defects, and assessment of this anatomy is of critical importance in determining patient care and outcome. Cardiac CT with electrocardiographic triggering provides an accurate and quick morphological assessment of both intracardiac and extracardiac structures in newborns, making it the best imaging modality to assess thoracopagus twins during the neonatal period. In this case report, we highlight the diagnostic value of cardiac CT in thoracopagus twins with an interatrial channel and complex congenital cardiac defects. (orig.)

  1. The effect of visitor number and spice provisioning in pacing expression by jaguars evaluated through a case study.

    Science.gov (United States)

    Vidal, L S; Guilherme, F R; Silva, V F; Faccio, M C S R; Martins, M M; Briani, D C

    2016-06-01

    Captive animals exhibit stereotypic pacing in response to multiple causes, including the inability to escape from human contact. Environmental enrichment techniques can minimize pacing expression. By using an individual-based approach, we addressed whether the amount of time two males and a female jaguar (Panthera onca) devote to pacing varied with the number of visitors and tested the effectiveness of cinnamon and black pepper in reducing pacing. The amount of time that all jaguars engaged in pacing increased significantly with the number of visitors. Despite the difference between the males regarding age and housing conditions, both devoted significantly less time to pacing following the addition of both spices, which indicates their suitability as enrichment techniques. Mean time devoted to pacing among the treatments did not differ for the female. Our findings pointed out to the validity of individual-based approaches, as they can reveal how suitable olfactory stimuli are to minimizing stereotypies irrespective of particular traits. PMID:26959957

  2. Paralympic athletes with cerebral palsy display altered pacing strategies in distance-deceived shuttle running trials.

    Science.gov (United States)

    Runciman, P; Tucker, R; Ferreira, S; Albertus-Kajee, Y; Derman, W

    2016-10-01

    This study investigated performance and physiology to understand pacing strategies in elite Paralympic athletes with cerebral palsy (CP). Six Paralympic athletes with CP and 13 able-bodied (AB) athletes performed two trials of eight sets of 10 shuttles (total 1600m). One trial was distance-deceived (DEC, 1000 m + 600 m) one trial was nondeceived (N-DEC, 1600 m). Time (s), heart rate (HR, bpm), ratings of perceived exertion (RPE, units), and electromyography of five bilateral muscles (EMG) were recorded for each set of both trials. The CP group ran slower than the AB group, and pacing differences were seen in the CP DEC trial, presenting as a flat pacing profile over the trial (P < 0.05). HR was higher and RPE was lower in the CP group in both trials (P < 0.05). EMG showed small differences between groups, sides, and trials. The present study provides evidence for a possible pacing strategy underlying exercise performance and fatigue in CP. The results of this study show (1) underperformance of the CP group, and (2) altered pacing strategy utilization in the CP group. We proposed that even at high levels of performance, the residual effects of CP may negatively affect performance through selection of conservative pacing strategies during exercise.

  3. Colony pace: a life-history trait affecting social insect epidemiology.

    Science.gov (United States)

    Buechel, Séverine Denise; Schmid-Hempel, Paul

    2016-01-13

    Among colonies of social insects, the worker turnover rate (colony 'pace') typically shows considerable variation. This has epidemiological consequences for parasites, because in 'fast-paced' colonies, with short-lived workers, the time of parasite residence in a given host will be reduced, and further transmission may thus get less likely. Here, we test this idea and ask whether pace is a life-history strategy against infectious parasites. We infected bumblebees (Bombus terrestris) with the infectious gut parasite Crithidia bombi, and experimentally manipulated birth and death rates to mimic slow and fast pace. We found that fewer workers and, importantly, fewer last-generation workers that are responsible for rearing sexuals were infected in colonies with faster pace. This translates into increased fitness in fast-paced colonies, as daughter queens exposed to fewer infected workers in the nest are less likely to become infected themselves, and have a higher chance of founding their own colonies in the next year. High worker turnover rate can thus act as a strategy of defence against a spreading infection in social insect colonies. PMID:26763696

  4. Climatic controls on the pace of glacier erosion

    Science.gov (United States)

    Koppes, Michele; Hallet, Bernard; Rignot, Eric; Mouginot, Jeremie; Wellner, Julia; Love, Katherine

    2016-04-01

    precipitation rates at the end of glaciations favor the production of water from rainfall, surface melting and internal melting, which promotes sliding, erosion and sediment production and evacuation from under the ice. Hence, climatic variation, more than the extent of ice cover or ice volume, controls the pace at which glaciers shape mountains.

  5. Experimental and computational studies on complex spiral waves in 2-D cardiac substrates

    Science.gov (United States)

    Bursac, Nenad

    2005-03-01

    A variety of chemical and biological nonlinear excitable media including heart tissue can support stable, self-organized waves of activity in a form of rotating single-arm spirals. In the heart tissue, stable single-arm spirals can underlie highly periodic activity such as monomorphic ventricular tachycardia (VT), while unstable spirals that continuously form and break up are shown to underlie aperiodic and lethal heart activity, namely fibrillation. Although fast pacing from a point in the heart is commonly used to terminate VT, it can occasionally yield a transient or stable acceleration of tachicardia rate and/or fibrillation. In this study we tested the effect of rapid point pacing on sustained spiral waves in the uniformly anisotropic cultures of cardiac myocytes. In 15/79 cultures, rapid pacing induced a stable formation of multiple bound spiral waves (a complex spiral) and acceleration of overall excitation rate in the tissue, as assessed by pseudo ECG (pECG). The level of rate acceleration correlated with the number of rotating waves. Further rapid point pacing decelerated, terminated, or further accelerated the complex spiral activity via a change in the number of coexisting rotating waves. The dynamic restitution analysis revealed no alternans in action potential duration in any of the cultures. Stable formation of complex spirals was accomplished only in the cultures that showed relatively broad and steep impulse wavelength and conduction velocity restitutions. A necessary condition for rate acceleration in a medium with monotonic restitution is that the rate of rotation of a single spiral wave is significantly lower than maximum sustainable rate of excitation in the medium. Preliminary data in a homogeneous medium using 3-variable Fenton-Karma (FK) based model of cardiac tissue suggest that decrease of fast inward current (excitability) can shift the spiral rate away from the break point on the restitution curve, enabling a necessary condition for rate

  6. Amplify scientific discovery with artificial intelligence

    Energy Technology Data Exchange (ETDEWEB)

    Gil, Yolanda; Greaves, Mark T.; Hendler, James; Hirsch, Hyam

    2014-10-10

    Computing innovations have fundamentally changed many aspects of scientific inquiry. For example, advances in robotics, high-end computing, networking, and databases now underlie much of what we do in science such as gene sequencing, general number crunching, sharing information between scientists, and analyzing large amounts of data. As computing has evolved at a rapid pace, so too has its impact in science, with the most recent computing innovations repeatedly being brought to bear to facilitate new forms of inquiry. Recently, advances in Artificial Intelligence (AI) have deeply penetrated many consumer sectors, including for example Apple’s Siri™ speech recognition system, real-time automated language translation services, and a new generation of self-driving cars and self-navigating drones. However, AI has yet to achieve comparable levels of penetration in scientific inquiry, despite its tremendous potential in aiding computers to help scientists tackle tasks that require scientific reasoning. We contend that advances in AI will transform the practice of science as we are increasingly able to effectively and jointly harness human and machine intelligence in the pursuit of major scientific challenges.

  7. Artificial intelligence within AFSC

    Science.gov (United States)

    Gersh, Mark A.

    1990-01-01

    Information on artificial intelligence research in the Air Force Systems Command is given in viewgraph form. Specific research that is being conducted at the Rome Air Development Center, the Space Technology Center, the Human Resources Laboratory, the Armstrong Aerospace Medical Research Laboratory, the Armamant Laboratory, and the Wright Research and Development Center is noted.

  8. Artificial Left Ventricle

    CERN Document Server

    Ranjbar, Saeed; Meybodi, Mahmood Emami

    2014-01-01

    This Artificial left ventricle is based on a simple conic assumption shape for left ventricle where its motion is made by attached compressed elastic tubes to its walls which are regarded to electrical points at each nodal .This compressed tubes are playing the role of myofibers in the myocardium of the left ventricle. These elastic tubes have helical shapes and are transacting on these helical bands dynamically. At this invention we give an algorithm of this artificial left ventricle construction that of course the effect of the blood flow in LV is observed with making beneficiary used of sensors to obtain this effecting, something like to lifegates problem. The main problem is to evaluate powers that are interacted between elastic body (left ventricle) and fluid (blood). The main goal of this invention is to show that artificial heart is not just a pump, but mechanical modeling of LV wall and its interaction with blood in it (blood movement modeling) can introduce an artificial heart closed to natural heart...

  9. Artificial Gravity Research Plan

    Science.gov (United States)

    Gilbert, Charlene

    2014-01-01

    This document describes the forward working plan to identify what countermeasure resources are needed for a vehicle with an artificial gravity module (intermittent centrifugation) and what Countermeasure Resources are needed for a rotating transit vehicle (continuous centrifugation) to minimize the effects of microgravity to Mars Exploration crewmembers.

  10. Micromachined Artificial Haircell

    Science.gov (United States)

    Liu, Chang (Inventor); Engel, Jonathan (Inventor); Chen, Nannan (Inventor); Chen, Jack (Inventor)

    2010-01-01

    A micromachined artificial sensor comprises a support coupled to and movable with respect to a substrate. A polymer, high-aspect ratio cilia-like structure is disposed on and extends out-of-plane from the support. A strain detector is disposed with respect to the support to detect movement of the support.

  11. Terahertz Artificial Dielectric Lens

    Science.gov (United States)

    Mendis, Rajind; Nagai, Masaya; Wang, Yiqiu; Karl, Nicholas; Mittleman, Daniel M.

    2016-03-01

    We have designed, fabricated, and experimentally characterized a lens for the THz regime based on artificial dielectrics. These are man-made media that mimic properties of naturally occurring dielectric media, or even manifest properties that cannot generally occur in nature. For example, the well-known dielectric property, the refractive index, which usually has a value greater than unity, can have a value less than unity in an artificial dielectric. For our lens, the artificial-dielectric medium is made up of a parallel stack of 100 μm thick metal plates that form an array of parallel-plate waveguides. The convergent lens has a plano-concave geometry, in contrast to conventional dielectric lenses. Our results demonstrate that this lens is capable of focusing a 2 cm diameter beam to a spot size of 4 mm, at the design frequency of 0.17 THz. The results further demonstrate that the overall power transmission of the lens can be better than certain conventional dielectric lenses commonly used in the THz regime. Intriguingly, we also observe that under certain conditions, the lens boundary demarcated by the discontinuous plate edges actually resembles a smooth continuous surface. These results highlight the importance of this artificial-dielectric technology for the development of future THz-wave devices.

  12. Observations of artificial satellites

    Directory of Open Access Journals (Sweden)

    A. MAMMANO

    1964-06-01

    Full Text Available The following publication gives the results of photographic
    observations of artificial satellites made at Asiago during the second
    and third year of this programme. The fixed camera technique and that
    with moving film (the latter still in its experimental stage have been used.

  13. Beating heart on a chip: a novel microfluidic platform to generate functional 3D cardiac microtissues.

    Science.gov (United States)

    Marsano, Anna; Conficconi, Chiara; Lemme, Marta; Occhetta, Paola; Gaudiello, Emanuele; Votta, Emiliano; Cerino, Giulia; Redaelli, Alberto; Rasponi, Marco

    2016-02-01

    In the past few years, microfluidic-based technology has developed microscale models recapitulating key physical and biological cues typical of the native myocardium. However, the application of controlled physiological uniaxial cyclic strains on a defined three-dimension cellular environment is not yet possible. Two-dimension mechanical stimulation was particularly investigated, neglecting the complex three-dimensional cell-cell and cell-matrix interactions. For this purpose, we developed a heart-on-a-chip platform, which recapitulates the physiologic mechanical environment experienced by cells in the native myocardium. The device includes an array of hanging posts to confine cell-laden gels, and a pneumatic actuation system to induce homogeneous uniaxial cyclic strains to the 3D cell constructs during culture. The device was used to generate mature and highly functional micro-engineered cardiac tissues (μECTs), from both neonatal rat and human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CM), strongly suggesting the robustness of our engineered cardiac micro-niche. Our results demonstrated that the cyclic strain was effectively highly uniaxial and uniformly transferred to cells in culture. As compared to control, stimulated μECTs showed superior cardiac differentiation, as well as electrical and mechanical coupling, owing to a remarkable increase in junction complexes. Mechanical stimulation also promoted early spontaneous synchronous beating and better contractile capability in response to electric pacing. Pacing analyses of hiPSC-CM constructs upon controlled administration of isoprenaline showed further promising applications of our platform in drug discovery, delivery and toxicology fields. The proposed heart-on-a-chip device represents a relevant step forward in the field, providing a standard functional three-dimensional cardiac model to possibly predict signs of hypertrophic changes in cardiac phenotype by mechanical and biochemical co-stimulation.

  14. Beating heart on a chip: a novel microfluidic platform to generate functional 3D cardiac microtissues.

    Science.gov (United States)

    Marsano, Anna; Conficconi, Chiara; Lemme, Marta; Occhetta, Paola; Gaudiello, Emanuele; Votta, Emiliano; Cerino, Giulia; Redaelli, Alberto; Rasponi, Marco

    2016-02-01

    In the past few years, microfluidic-based technology has developed microscale models recapitulating key physical and biological cues typical of the native myocardium. However, the application of controlled physiological uniaxial cyclic strains on a defined three-dimension cellular environment is not yet possible. Two-dimension mechanical stimulation was particularly investigated, neglecting the complex three-dimensional cell-cell and cell-matrix interactions. For this purpose, we developed a heart-on-a-chip platform, which recapitulates the physiologic mechanical environment experienced by cells in the native myocardium. The device includes an array of hanging posts to confine cell-laden gels, and a pneumatic actuation system to induce homogeneous uniaxial cyclic strains to the 3D cell constructs during culture. The device was used to generate mature and highly functional micro-engineered cardiac tissues (μECTs), from both neonatal rat and human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CM), strongly suggesting the robustness of our engineered cardiac micro-niche. Our results demonstrated that the cyclic strain was effectively highly uniaxial and uniformly transferred to cells in culture. As compared to control, stimulated μECTs showed superior cardiac differentiation, as well as electrical and mechanical coupling, owing to a remarkable increase in junction complexes. Mechanical stimulation also promoted early spontaneous synchronous beating and better contractile capability in response to electric pacing. Pacing analyses of hiPSC-CM constructs upon controlled administration of isoprenaline showed further promising applications of our platform in drug discovery, delivery and toxicology fields. The proposed heart-on-a-chip device represents a relevant step forward in the field, providing a standard functional three-dimensional cardiac model to possibly predict signs of hypertrophic changes in cardiac phenotype by mechanical and biochemical co

  15. Short-term cardiac memory and mother rotor fibrillation.

    Science.gov (United States)

    Baher, Ali; Qu, Zhilin; Hayatdavoudi, Ashkan; Lamp, Scott T; Yang, Ming-Jim; Xie, Fagen; Turner, Stephen; Garfinkel, Alan; Weiss, James N

    2007-01-01

    Short-term cardiac memory refers to the effects of pacing history on action potential duration (APD). Although the ionic mechanisms for short-term memory occurring over many heartbeats (also called APD accommodation) are poorly understood, they may have important effects on reentry and fibrillation. To explore this issue, we incorporated a generic memory current into the Phase I Luo and Rudy action potential model, which lacks short-term memory. The properties of this current were matched to simulate quantitatively human ventricular monophasic action potential accommodation. We show that, theoretically, short-term memory can resolve the paradox of how mother rotor fibrillation is initiated in heterogeneous tissue by physiological pacing. In simulated heterogeneous two-dimensional tissue and three-dimensional ventricles containing an inward rectifier K(+) current gradient, short-term memory could spontaneously convert multiple wavelet fibrillation to mother rotor fibrillation or to a mixture of both fibrillation types. This was due to progressive acceleration and stabilization of rotors as accumulation of memory shortened APD and flattened APD restitution slope nonuniformly throughout the tissue. PMID:16891403

  16. Sudden Cardiac Death

    Directory of Open Access Journals (Sweden)

    Yipsy María Gutiérrez Báez

    2015-09-01

    Full Text Available Since the second half of the twentieth century, dying suddenly due to heart-related problems has become the main health issue in all countries where infectious diseases are not prevalent. Sudden death from cardiac causes is an important global health problem. Major databases were searched for the leading causes of sudden cardiac death. It has been demonstrated that there is a group of hereditary diseases with structural alterations or without apparent organic cause that explains many cases of sudden death in young people, whether related or not to physical exertion. Certain population groups are at higher risk for this disease. They are relatively easy to identify and can be the target of primary prevention measures.

  17. Inherited cardiac disease

    Directory of Open Access Journals (Sweden)

    Philippe Charron

    2012-06-01

    Full Text Available Major advances have been achieved over the two last decades in the field of genetic cardiovascular diseases, not only through increased recognition and understanding of underlying molecular defects but also through rapid translation of knowledge into clinical practice. Genetic counseling and organization of cardiac family screening has become part of the medical management of these diseases, and these should be performed systematically unless an acquired cause has been diagnosed...

  18. Cardiac Tissue Engineering

    OpenAIRE

    MILICA RADISIC; GORDANA VUNJAK-NOVAKOVIC

    2009-01-01

    We hypothesized that clinically sized (1-5 mm thick),compact cardiac constructs containing physiologically high density of viable cells (~108 cells/cm3) can be engineered in vitro by using biomimetic culture systems capable of providing oxygen transport and electrical stimulation, designed to mimic those in native heart. This hypothesis was tested by culturing rat heart cells on polymer scaffolds, either with perfusion of culture medium (physiologic interstitial velocity, supplementation of p...

  19. Cardiac developmental toxicity

    OpenAIRE

    Mahler, Gretchen J.; Jonathan T Butcher

    2011-01-01

    Congenital heart disease is a highly prevalent problem with mostly unknown origins. Many cases of CHD likely involve an environmental exposure coupled with genetic susceptibility, but practical and ethical considerations make nongenetic causes of CHD difficult to assess in humans. The development of the heart is highly conserved across all vertebrate species, making animal models an excellent option for screening potential cardiac teratogens. This review will discuss exposures known to cause ...

  20. Introduction to Artificial Neural Networks

    DEFF Research Database (Denmark)

    Larsen, Jan

    1999-01-01

    The note addresses introduction to signal analysis and classification based on artificial feed-forward neural networks.......The note addresses introduction to signal analysis and classification based on artificial feed-forward neural networks....

  1. Cardiac hybrid imaging

    Energy Technology Data Exchange (ETDEWEB)

    Gaemperli, Oliver [University Hospital Zurich, Cardiac Imaging, Zurich (Switzerland); University Hospital Zurich, Nuclear Cardiology, Cardiovascular Center, Zurich (Switzerland); Kaufmann, Philipp A. [University Hospital Zurich, Cardiac Imaging, Zurich (Switzerland); Alkadhi, Hatem [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland)

    2014-05-15

    Hybrid cardiac single photon emission computed tomography (SPECT)/CT imaging allows combined assessment of anatomical and functional aspects of cardiac disease. In coronary artery disease (CAD), hybrid SPECT/CT imaging allows detection of coronary artery stenosis and myocardial perfusion abnormalities. The clinical value of hybrid imaging has been documented in several subsets of patients. In selected groups of patients, hybrid imaging improves the diagnostic accuracy to detect CAD compared to the single imaging techniques. Additionally, this approach facilitates functional interrogation of coronary stenoses and guidance with regard to revascularization procedures. Moreover, the anatomical information obtained from CT coronary angiography or coronary artery calcium scores (CACS) adds prognostic information over perfusion data from SPECT. The use of cardiac hybrid imaging has been favoured by the dissemination of dedicated hybrid systems and the release of dedicated image fusion software, which allow simple patient throughput for hybrid SPECT/CT studies. Further technological improvements such as more efficient detector technology to allow for low-radiation protocols, ultra-fast image acquisition and improved low-noise image reconstruction algorithms will be instrumental to further promote hybrid SPECT/CT in research and clinical practice. (orig.)

  2. Disruption of Epac1 protects the heart from adenylyl cyclase type 5-mediated cardiac dysfunction.

    Science.gov (United States)

    Cai, Wenqian; Fujita, Takayuki; Hidaka, Yuko; Jin, Huiling; Suita, Kenji; Prajapati, Rajesh; Liang, Chen; Umemura, Masanari; Yokoyama, Utako; Sato, Motohiko; Okumura, Satoshi; Ishikawa, Yoshihiro

    2016-06-17

    Type 5 adenylyl cyclase (AC5) plays an important role in the development of chronic catecholamine stress-induced heart failure and arrhythmia in mice. Epac (exchange protein activated by cAMP), which is directly activated by cAMP independent of protein kinase A, has been recently identified as a novel mediator of cAMP signaling in the heart. However, the role of Epac in AC5-mediated cardiac dysfunction and arrhythmias remains poorly understood. We therefore generated AC5 transgenic mice (AC5TG) with selective disruption of the Epac1 gene (AC5TG-Epac1KO), and compared their phenotypes with those of AC5TG after chronic isoproterenol (ISO) infusion. Decreased cardiac function as well as increased susceptibility to pacing-induced atrial fibrillation (AF) in response to ISO were significantly attenuated in AC5TG-Epac1KO mice, compared to AC5TG mice. Increased cardiac apoptosis and cardiac fibrosis were also concomitantly attenuated in AC5TG-Epac1KO mice compared to AC5TG mice. These findings indicate that Epac1 plays an important role in AC5-mediated cardiac dysfunction and AF susceptibility. PMID:27117748

  3. Short-term effect of cardiac resynchronization therapy in patients with ischaemic or nonischaemic cardiomyopathy

    Institute of Scientific and Technical Information of China (English)

    HUA Wei; NIU Hong-xia; WANG Fang-zheng; ZHANG Shu; CHEN Ke-ping; CHEN Xin

    2006-01-01

    Background Patients with heart failure were candidates for cardiac resynchronization therapy (CRT)regardless of underlying aetiology. This study observed the effect of CRT in patients with ischaemic or nonischaemic cardiomyopathy.Methods One hundred and forty-two patients with refractory chronic heart failure and left bundle branch block received cardiac resynchronization therapy, 91 men and 51 women, average age 60 years. Left ventricular ejection fraction (LVEF) was severely depressed (mean 29%), left ventricular end diastolic diameter (LVEDD)enlarged (mean 72 mm) and QRS width was lengthened (mean 147 ms). Ninety-eight had nonischaemic cardiomyopathy and 44 had ischaemic cardiomyopathy.Results After cardiac resynchronization therapy, the heart function was significantly improved. The mean LVEF increased from 29% to 36% after pacing. In patients with nonischaemic cardiomyopathy, the LVEF was improved from 28% to 37%, and in patients with ischaemic cardiomyopathy, the LVEF was improved from 30% to 36%. No significant difference of the improvement was found between the two groups (P>0.05).Conclusions Cardiac resynchronization therapy could significantly improve cardiac function in patients with chronic heart failure regardless of the underlying heart disease.

  4. Regional evidence of modulation of cardiac adiponectin level in dilated cardiomyopathy: pilot study in a porcine animal model

    Directory of Open Access Journals (Sweden)

    Caselli Chiara

    2012-11-01

    Full Text Available Abstract Background The role of systemic and myocardial adiponectin (ADN in dilated cardiomyopathy is still debated. We tested the regulation of both systemic and myocardial ADN and the relationship with AMP-activated protein kinase (AMPK activity in a swine model of non-ischemic dilated cardiomyopathy. Methods and results Cardiac tissue was collected from seven instrumented adult male minipigs by pacing the left ventricular (LV free wall (180 beats/min, 3 weeks, both from pacing (PS and opposite sites (OS, and from five controls. Circulating ADN levels were inversely related to global and regional cardiac function. Myocardial ADN in PS was down-regulated compared to control (p Conclusions Paradoxically, circulating ADN did not show any cardioprotective effect, confirming its role as negative prognostic biomarker of heart failure. Myocardial ADN was reduced in PS compared to control in an AMPK-independent fashion, suggesting the occurrence of novel mechanisms by which reduced cardiac ADN levels may regionally mediate the decline of cardiac function.

  5. An overview of cardiac morphogenesis.

    Science.gov (United States)

    Schleich, Jean-Marc; Abdulla, Tariq; Summers, Ron; Houyel, Lucile

    2013-11-01

    Accurate knowledge of normal cardiac development is essential for properly understanding the morphogenesis of congenital cardiac malformations that represent the most common congenital anomaly in newborns. The heart is the first organ to function during embryonic development and is fully formed at 8 weeks of gestation. Recent studies stemming from molecular genetics have allowed specification of the role of cellular precursors in the field of heart development. In this article we review the different steps of heart development, focusing on the processes of alignment and septation. We also show, as often as possible, the links between abnormalities of cardiac development and the main congenital heart defects. The development of animal models has permitted the unraveling of many mechanisms that potentially lead to cardiac malformations. A next step towards a better knowledge of cardiac development could be multiscale cardiac modelling. PMID:24138816

  6. Diritto internazionale umanitario, guerra e pace, diritti delle persone

    Directory of Open Access Journals (Sweden)

    Giovanni Barberini

    2011-11-01

    Full Text Available SOMMARIO: 1. Il diritto umanitario nei conflitti armati - 2. La codificazione del diritto umanitario - 3. Diritto della guerra e diritto della pace - 4. L’articolo 11 della costituzione italiana - 5. La protezione internazionale dei diritti e delle libertà della persona - 6. Conclusioni. Abstract: The military operators must also assure the peace with the weapons and, above all, the persons responsible of the operations must give test of great sensibility because busy to conjugate laws and rules war with the objectives of pacification. The authorities responsible for the operations at any time they need to know what they can or must do and what orders impart; they must know what it cannot do or what should be avoided. The international humanitarian law, important part of the international law, is constituted by conventional and consuetudinary norms that are applied in the relationships among States with a specific objective: to protect in time of armed conflict the people who do not take part or do not take more part in hostilities and impose bans or limits to the use of means offensive, of sophisticated weapons and methods of warfare in situations of armed conflict in act or to avoid sleepwalking. The codification of the international humanitarian law is initiated in the century XIX, above all when it was tried to introduce with the Declaration of Petersbourg in 1868 a principle that individualized in the contrariety to the laws of the humanity the impassable limit to respect in the armed conflicts. The codification has received then force and importance after the second world conflict that the consciences of the people had struck with the systematic practice of the most merciless violence making to record million of deads. The fundamental importance of the 1949 Geneva four Conventions is unanimously recognized. They are based on ratio of the existence and the responsibilities of the Organization of United Nations; they have properly

  7. Sudden Cardiac Death in Athletes.

    Science.gov (United States)

    Wasfy, Meagan M; Hutter, Adolph M; Weiner, Rory B

    2016-01-01

    There are clear health benefits to exercise; even so, patients with cardiac conditions who engage in exercise and athletic competition may on rare occasion experience sudden cardiac death (SCD). This article reviews the epidemiology and common causes of SCD in specific athlete populations. There is ongoing debate about the optimal mechanism for SCD prevention, specifically regarding the inclusion of the ECG and/or cardiac imaging in routine preparticipation sports evaluation. This controversy and contemporary screening recommendations are also reviewed. PMID:27486488

  8. A fast-start pacing strategy speeds pulmonary oxygen uptake kinetics and improves supramaximal running performance.

    Directory of Open Access Journals (Sweden)

    Tiago Turnes

    Full Text Available The focus of the present study was to investigate the effects of a fast-start pacing strategy on running performance and pulmonary oxygen uptake (VO2 kinetics at the upper boundary of the severe-intensity domain. Eleven active male participants (28±10 years, 70±5 kg, 176±6 cm, 57±4 mL/kg/min visited the laboratory for a series of tests that were performed until exhaustion: 1 an incremental test; 2 three laboratory test sessions performed at 95, 100 and 110% of the maximal aerobic speed; 3 two to four constant speed tests for the determination of the highest constant speed (HS that still allowed achieving maximal oxygen uptake; and 4 an exercise based on the HS using a higher initial speed followed by a subsequent decrease. To predict equalized performance values for the constant pace, the relationship between time and distance/speed through log-log modelling was used. When a fast-start was utilized, subjects were able to cover a greater distance in a performance of similar duration in comparison with a constant-pace performance (constant pace: 670 m±22%; fast-start: 683 m±22%; P = 0.029; subjects also demonstrated a higher exercise tolerance at a similar average speed when compared with constant-pace performance (constant pace: 114 s±30%; fast-start: 125 s±26%; P = 0.037. Moreover, the mean VO2 response time was reduced after a fast start (constant pace: 22.2 s±28%; fast-start: 19.3 s±29%; P = 0.025. In conclusion, middle-distance running performances with a duration of 2-3 min are improved and VO2 response time is faster when a fast-start is adopted.

  9. Exercise performance in young patients with complete atrioventricular block: the relevance of synchronous atrioventricular pacing.

    Science.gov (United States)

    Gonzalez Corcia, M Cecilia; Remy, Lorraine Saint; Marchandise, Sebastien; Moniotte, Stephane

    2016-08-01

    At present, there are many pacing strategies for young patients with complete atrioventricular block. The most frequent policy is to attempt placing a dual-chamber system when possible; however, there is a group of patients that is functioning with a non-synchronous ventricular pacing, raising the question of the ideal timing to upgrade their systems. We investigated the exercise performance of a group of children and young adults with complete atrioventricular block and dual-chamber pacemakers in both single- and dual-chamber pacing modalities. A total of 15 patients performed maximal exercise stress testing after programming the VVIR or DDD modes with 2 hours of interval in a double-blind study protocol. Compared with VVIR pacing, DDD pacing resulted in increase in the peak VO2, longer test duration, major increase in the heart rate achieved during peak exercise, decreased systemic non-invasive arterial blood pressure measured at maximal exercise, higher maximal workload, prolongation of the anaerobic threshold timing, and better self-rated performance perception in all the patients. Synchronous atrioventricular pacing contributes to an increase in both the exercise performance and the performance perception in 100% of the patients. This difference contributes to create a sense of "fitness" with repercussions in the overall health, self-esteem, and life quality, as well as encourages youngster to practice sports. Our experience tends to favour upgrading patients' systems to dual-chamber systems before reaching the adolescent years, even if the centre policy is to prolong as long as possible the epicardial site in order to avoid long years of right ventricular pacing. PMID:26796814

  10. Case Report: Penetrating Cardiac Injury

    Directory of Open Access Journals (Sweden)

    Adem Grbolar

    2013-10-01

    Full Text Available Summary: Penetrating cardiac injurys caused by gunshots and penetrating tools have high mortality rates. The way of injury, how the cardiac area is effected and the presence of cardiac tamponadecauses mortality in different rates. However the better treatment quality of hospitals, increasingoperative techniques, and internel care unit quality has not been change during the years. Searching the literature, we want to present a 42 years old male patient whowas injured by knife and had a 1 cm skin wound on chest with cardiac tamponade. After sternotomy a 7 cm laseration was observed in heart. Cardioraphy was performed.

  11. Artificial organisms that sleep.

    OpenAIRE

    Mirolli, Marco; Parisi, Domenico

    2003-01-01

    Abstract Populations of artificial organisms live in an environment in which light is cyclically present (day) or absent (night). Since being active during night is non-adaptive (activity consumes energy which is not compensated by the food found at night) the organisms evolve a sleep/wake behavioral pattern of being active during daytime and sleeping during nighttime. When the population moves to a different environment that contains "caves", they have to get out of a cave although the dark ...

  12. Artificial Neural Network

    Directory of Open Access Journals (Sweden)

    Kapil Nahar

    2012-12-01

    Full Text Available An artificial neural network is an information-processing paradigm that is inspired by the way biological nervous systems, such as the brain, process information. The key element of this paradigm is the novel structure of the information processing system. It is composed of a large number of highly interconnected processing elements (neurons working in unison to solve specific problems. Ann’s, like people, learn by example.

  13. Artificial Neural Network

    Directory of Open Access Journals (Sweden)

    Kapil Nahar

    2012-12-01

    Full Text Available An artificial neural network is an information-processing paradigm that is inspired by the way biological nervous systems, such as the brain, process information.The key element of this paradigm is the novel structure of the information processing system. It is composed of a large number of highly interconnected processing elements (neurons working in unison to solve specific problems.Ann’s, like people, learn by example.

  14. Artificial neural network modelling

    CERN Document Server

    Samarasinghe, Sandhya

    2016-01-01

    This book covers theoretical aspects as well as recent innovative applications of Artificial Neural networks (ANNs) in natural, environmental, biological, social, industrial and automated systems. It presents recent results of ANNs in modelling small, large and complex systems under three categories, namely, 1) Networks, Structure Optimisation, Robustness and Stochasticity 2) Advances in Modelling Biological and Environmental Systems and 3) Advances in Modelling Social and Economic Systems. The book aims at serving undergraduates, postgraduates and researchers in ANN computational modelling. .

  15. Artificial sweetener; Jinko kanmiryo

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-08-01

    The patents related to the artificial sweetener that it is introduced to the public in 3 years from 1996 until 1998 are 115 cases. The sugar quality which makes an oligosaccharide and sugar alcohol the subject is greatly over 28 cases of the non-sugar quality in the one by the kind as a general tendency of these patents at 73 cases in such cases as the Aspartame. The method of manufacture patent, which included new material around other peptides, the oligosaccharide and sugar alcohol isn`t inferior to 56 cases of the formation thing patent at 43 cases, and pays attention to the thing, which is many by the method of manufacture, formation. There is most improvement of the quality of sweetness with 31 cases in badness of the aftertaste which is characteristic of the artificial sweetener and so on, and much stability including the improvement in the flavor of food by the artificial sweetener, a long time and dissolution, fluid nature and productivity and improvement of the economy such as a cost are seen with effect on a purpose. (NEDO)

  16. Antifibrinolytics in cardiac surgery

    Directory of Open Access Journals (Sweden)

    Achal Dhir

    2013-01-01

    Full Text Available Cardiac surgery exerts a significant strain on the blood bank services and is a model example in which a multi-modal blood-conservation strategy is recommended. Significant bleeding during cardiac surgery, enough to cause re-exploration and/or blood transfusion, increases morbidity and mortality. Hyper-fibrinolysis is one of the important contributors to increased bleeding. This knowledge has led to the use of anti-fibrinolytic agents especially in procedures performed under cardiopulmonary bypass. Nothing has been more controversial in recent times than the aprotinin controversy. Since the withdrawal of aprotinin from the world market, the choice of antifibrinolytic agents has been limited to lysine analogues either tranexamic acid (TA or epsilon amino caproic acid (EACA. While proponents of aprotinin still argue against its non-availability. Health Canada has approved its use, albeit under very strict regulations. Antifibrinolytic agents are not without side effects and act like double-edged swords, the stronger the anti-fibrinolytic activity, the more serious the side effects. Aprotinin is the strongest in reducing blood loss, blood transfusion, and possibly, return to the operating room after cardiac surgery. EACA is the least effective, while TA is somewhere in between. Additionally, aprotinin has been implicated in increased mortality and maximum side effects. TA has been shown to increase seizure activity, whereas, EACA seems to have the least side effects. Apparently, these agents do not differentiate between pathological and physiological fibrinolysis and prevent all forms of fibrinolysis leading to possible thrombotic side effects. It would seem prudent to select the right agent knowing its risk-benefit profile for a given patient, under the given circumstances.

  17. Potential Effect of Physical Activity Calorie Equivalent (PACE Labeling on Adult Fast Food Ordering and Exercise.

    Directory of Open Access Journals (Sweden)

    Ray Antonelli

    Full Text Available Numeric calorie content labels show limited efficacy in reducing the number of calories ordered from fast food meals. Physical activity calorie equivalent (PACE labels are an alternative that may reduce the number of calories ordered in fast food meals while encouraging patrons to exercise.A total of 1000 adults from 47 US states were randomly assigned via internet survey to one of four generic fast food menus: no label, calories only, calories + minutes, or calories + miles necessary to walk to burn off the calories. After completing hypothetical orders participants were asked to rate the likelihood of calorie-only and PACE labels to influence (1 food choice and (2 physical activity.Respondents (n = 823 ordered a median of 1580 calories from the no-label menu, 1200 from the calories-only menu, 1140 from the calories + minutes menu, and 1210 from the calories + miles menu (p = 0.0001. 40% of respondents reported that PACE labels were "very likely" to influence food item choice vs. 28% for calorie-only labels (p<0.0001. 64% of participants reported that PACE labels were "somewhat likely" or "very likely" to influence their level of physical activity vs. 49% for calorie-only labels (p<0.0001.PACE labels may be helpful in reducing the number of calories ordered in fast food meals and may have the added benefit of encouraging exercise.

  18. Ventricular evoked response in patients with hypertrophic obstructive cardiomyopathy treated with DDD pacing

    Directory of Open Access Journals (Sweden)

    João Ricardo M. Sant'Anna

    1999-08-01

    Full Text Available OBJECTIVE: To assess the changes in ventricular evoked responses (VER produced by the decrease in left ventricular outflow tract gradient (LVOTG in patients with hypertrophic obstructive cardiomyopathy (HOCM treated with dual-chamber (DDD pacing. METHODS: A pulse generator Physios CTM (Biotronik, Germany was implanted in 9 patients with severe drug-refractory HOCM. After implantation, the following conditions were assessed: 1 Baseline evaluation: different AV delay (ranging from 150ms to 50 ms were sequentially programmed during 5 to 10 minutes, and the LVOTG (as determined by Doppler echocardiography and VER recorded; 2 standard evaluation, when the best AV delay (resulting in the lowest LVOTG programmed at the initial evaluation was maintained so that its effect on VER and LVOTG could be assessed during each chronic pacing evaluation. RESULTS: LVOTG decreased after DDD pacing, with a mean value of 59 ± 24 mmHg after dual chamber pacemaker, which was significantly less than the gradient before pacing (98 + 22mmHg. An AV delay >100ms produced a significantly lower decrease in VER depolarization duration (VER DD when compared to an AV delay <=100ms. Linear regression analyses showed a significant correlation between the LVOTG values and the magnitude of VER (r=0.69; p<0.05 in the 9 studied patients. CONCLUSION: The telemetry obtained intramyocardial electrogram is a sensitive means to assess left ventricular dynamics in patients with HOCM treated with DDD pacing.

  19. Influence of filling on left ventricular diastolic pressure-volume curve during pacing ischemia in dogs.

    Science.gov (United States)

    Shintani, H; Glantz, S A

    1994-04-01

    The reversible upward shift of the diastolic pressure-volume curve that occurs during pacing-induced ischemia has not been fully explained by increases in passive chamber stiffness or reductions in relaxation rate. We measured the fully relaxed pressure-volume relation defined by both filling and nonfilling beats and the isovolumic relaxation time constant in nonfilling beats before and during demand ischemia using our in situ left ventricular volume clamping technique in 10 dogs. Pacing-induced ischemia shifted the diastolic pressure-volume curves in filling beats upward compared with the end-diastolic pressure-volume relation of the normally perfused heart. In contrast, the end-diastolic points for nonfilling beats during pacing-induced ischemia fell on the fully relaxed pressure-volume relation defined by the normally perfused heart. Left ventricular filling per se was necessary for the upward shift of the diastolic pressure-volume curve observed during pacing-induced ischemia. We speculate that active force developed during diastole induced by stretch activation or, perhaps, length-dependent changes in calcium sensitivity of the myofilaments in the ischemic myocardium due to stretch of the myocardium during rapid diastolic filling may contribute to the upward shift of the diastolic pressure-volume curve observed during pacing-induced ischemia. PMID:8184915

  20. Aliskiren protecting atrial structural remodeling from rapid atrial pacing in a canine model.

    Science.gov (United States)

    Zhao, Zhiqiang; Chen, Yan; Li, Weimin; Wang, Xinghua; Li, Jian; Yang, Wansong; Cheng, Lijun; Liu, Tong; Liu, Enzhao; Li, Guangping

    2016-08-01

    Atrial fibrillation (AF) contributing to the increasing mortality risk is the most common disease in clinical practice. Owing to the side effects and relative inefficacy of current antiarrhythmic drugs, some research focuses on renin-angiotensin-aldosterone system (RAS) for finding out the new treatment of AF. The purpose of this study is to confirm whether aliskiren as a proximal inhibitor of renin, which completely inhibits RAS, has beneficial effects on atrial structural remodeling in AF. In this study, rapid atrial pacing was induced at 500 beats per minute for 2 weeks in a canine model. A different dose of aliskiren was given orally for 2 weeks before rapid atrial pacing. HE staining and Masson's staining were used for analysis of myocardial fibrosis. TGF-β1, signal pathways, and pro-inflammatory cytokines were shown for the mechanism of structural remodeling after the treatment of aliskiren. Serious atrial fibrosis was induced by rapid atrial pacing, followed by the elevated TGF-β1, upregulated MEK and ERK1/2, and increased inflammatory factors. Aliskiren could apparently improve myocardial fibrosis by reducing the expression of TGF-β1, inhibiting MEK and ERK1/2 signal pathways, and decreasing IL-18 and TLR4 in both serum and atrial tissue. In conclusion, aliskiren could prevent atrial structural remodeling from rapid atrial pacing for 2 weeks. Aliskiren may play a potential beneficial role in the treatment of AF induced by rapid atrial pacing. PMID:27118660

  1. Application of PACE Principles for Population Health Management of Frail Older Adults.

    Science.gov (United States)

    Stefanacci, Richard G; Reich, Shelley; Casiano, Alex

    2015-10-01

    To determine which practices would have the most impact on reducing hospital and emergency department admissions and nursing home placement among older adults with multiple comorbid conditions, a literature search and survey were conducted to identify and prioritize comprehensive care principles as practiced in the Program of All-inclusive Care for the Elderly (PACE). PACE medical directors and members of the PACE interdisciplinary team (IDT) were surveyed to gain their insights on the most impactful practices, which were identified as: End-of-Life Management, Caregiver Support, Management of Red Flags, Medication Management, Participant and Caregiver Health Care System Literacy, and Care Coordination. In addition, this research evaluated measures that could be used to assess an organization's level of success with regard to each of the 6 PACE practices identified. The results reported in this article, found through a survey with PACE medical directors and IDT members concerning effective interventions, can be viewed as strategies to improve care for older adults, enabling them to maintain their independence in the community, avoid the expense of facility-based care, and enhance their quality of life. PMID:25647691

  2. Application of PACE Principles for Population Health Management of Frail Older Adults.

    Science.gov (United States)

    Stefanacci, Richard G; Reich, Shelley; Casiano, Alex

    2015-10-01

    To determine which practices would have the most impact on reducing hospital and emergency department admissions and nursing home placement among older adults with multiple comorbid conditions, a literature search and survey were conducted to identify and prioritize comprehensive care principles as practiced in the Program of All-inclusive Care for the Elderly (PACE). PACE medical directors and members of the PACE interdisciplinary team (IDT) were surveyed to gain their insights on the most impactful practices, which were identified as: End-of-Life Management, Caregiver Support, Management of Red Flags, Medication Management, Participant and Caregiver Health Care System Literacy, and Care Coordination. In addition, this research evaluated measures that could be used to assess an organization's level of success with regard to each of the 6 PACE practices identified. The results reported in this article, found through a survey with PACE medical directors and IDT members concerning effective interventions, can be viewed as strategies to improve care for older adults, enabling them to maintain their independence in the community, avoid the expense of facility-based care, and enhance their quality of life.

  3. Anatomical reconstructions of the human cardiac venous system using contrast-computed tomography of perfusion-fixed specimens.

    Science.gov (United States)

    Spencer, Julianne; Fitch, Emily; Iaizzo, Paul A

    2013-01-01

    A detailed understanding of the complexity and relative variability within the human cardiac venous system is crucial for the development of cardiac devices that require access to these vessels. For example, cardiac venous anatomy is known to be one of the key limitations for the proper delivery of cardiac resynchronization therapy (CRT)(1) Therefore, the development of a database of anatomical parameters for human cardiac venous systems can aid in the design of CRT delivery devices to overcome such a limitation. In this research project, the anatomical parameters were obtained from 3D reconstructions of the venous system using contrast-computed tomography (CT) imaging and modeling software (Materialise, Leuven, Belgium). The following parameters were assessed for each vein: arc length, tortuousity, branching angle, distance to the coronary sinus ostium, and vessel diameter. CRT is a potential treatment for patients with electromechanical dyssynchrony. Approximately 10-20% of heart failure patients may benefit from CRT(2). Electromechanical dyssynchrony implies that parts of the myocardium activate and contract earlier or later than the normal conduction pathway of the heart. In CRT, dyssynchronous areas of the myocardium are treated with electrical stimulation. CRT pacing typically involves pacing leads that stimulate the right atrium (RA), right ventricle (RV), and left ventricle (LV) to produce more resynchronized rhythms. The LV lead is typically implanted within a cardiac vein, with the aim to overlay it within the site of latest myocardial activation. We believe that the models obtained and the analyses thereof will promote the anatomical education for patients, students, clinicians, and medical device designers. The methodologies employed here can also be utilized to study other anatomical features of our human heart specimens, such as the coronary arteries. To further encourage the educational value of this research, we have shared the venous models on our

  4. Theorems for Testing Local Activity of CNN and Application to Cardiac Equations

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    The theorems for testing the local activity in one-port cellular neural/nonlinear network (CNN) cells with four local state variables are presented. Using the theorems computes the bifurcation diagrams of the cardiac Purkinje fiber (CPF) equations which describe the long-lasting action and pace-maker potentials of the Purkinje fiber of the heart. The computer simulation shows that periodic trajectories or convergent trajectories of the CPF Equations can be found if the corresponding cell parameters are located in a positive domain but nearby edge of chaos. In particular, a heart with approximate normal frequency of heartbeat but non-normal electrocardiogram may suddenly stop beating by slightly perturbing the parameters of the corresponding CPF Equations when the parameters are located nearby the edge of chaos in the bifurcation diagrams. This research seems to interpret reasonably the phenomena that patients with cardiac diseases might suddenly die without warning.

  5. Management of radiation therapy patients with cardiac defibrillator or pacemaker.

    Science.gov (United States)

    Salerno, Francesca; Gomellini, Sara; Caruso, Cristina; Barbara, Raffaele; Musio, Daniela; Coppi, Tamara; Cardinale, Mario; Tombolini, Vincenzo; de Paula, Ugo

    2016-06-01

    The increasing growth of population with cardiac implantable electronic devices (CIEDs) such as Pacemaker (PM) and Implantable Cardiac Defibrillators (ICD), requires particular attention in management of patients needing radiation treatment. This paper updates and summarizes some recommendations from different international guidelines. Ionizing radiation and/or electromagnetic interferences could cause device failure. Current approaches to treatment in patients who have these devices vary among radiation oncology centres. We refer to the German Society of Radiation Oncology and Cardiology guidelines (ed. 2015); to the Society of Cardiology Australia and New Zealand Statement (ed. 2015); to the guidelines in force in the Netherlands (ed. 2012) and to the Italian Association of Radiation Oncology recommendations (ed. 2013) as reported in the guidelines for the treatment of breast cancer in patients with CIED. Although there is not a clear cut-off point, risk of device failure increases with increasing doses. Cumulative dose and pacing dependency have been combined to categorize patients into low-, medium- and high-risk groups. Measures to secure patient safety are described for each category. The use of energy ≤6MV is preferable and it's strongly recommended not to exceed a total dose of 2 Gy to the PM and 1 Gy for ICD. Given the dangers of device malfunction, radiation oncology departments should adopt all the measures designed to minimize the risk to patients. For this reason, a close collaboration between cardiologist, radiotherapist and physicist is necessary.

  6. Practical aspects of cardiac tissue engineering with electrical stimulation.

    Science.gov (United States)

    Cannizzaro, Christopher; Tandon, Nina; Figallo, Elisa; Park, Hyoungshin; Gerecht, Sharon; Radisic, Milica; Elvassore, Nicola; Vunjak-Novakovic, Gordana

    2007-01-01

    Heart disease is a leading cause of death in western society. Despite the success of heart transplantation, a chronic shortage of donor organs, along with the associated immunological complications of this approach, demands that alternative treatments be found. One such option is to repair, rather than replace, the heart with engineered cardiac tissue. Multiple studies have shown that to attain functional tissue, assembly signaling cues must be recapitulated in vitro. In their native environment, cardiomyocytes are directed to beat in synchrony by propagation of pacing current through the tissue. Recently, we have shown that electrical stimulation directs neonatal cardiomyocytes to assemble into native-like tissue in vitro. This chapter provides detailed methods we have employed in taking this "biomimetic" approach. After an initial discussion on how electric field stimulation can influence cell behavior, we examine the practical aspects of cardiac tissue engineering with electrical stimulation, such as electrode selection and cell seeding protocols, and conclude with what we feel are the remaining challenges to be overcome.

  7. Cardiac arrest – cardiopulmonary resuscitation

    Directory of Open Access Journals (Sweden)

    Basri Lenjani

    2014-01-01

    Conclusions: All survivors from cardiac arrest have received appropriate medical assistance within 10 min from attack, which implies that if cardiac arrest occurs near an institution health care (with an opportunity to provide the emergent health care the rate of survival is higher.

  8. Leadership in cardiac surgery.

    Science.gov (United States)

    Rao, Christopher; Patel, Vanash; Ibrahim, Michael; Ahmed, Kamran; Wong, Kathie A; Darzi, Ara; von Segesser, Ludwig K; Athanasiou, Thanos

    2011-06-01

    Despite the efficacy of cardiac surgery, less invasive interventions with more uncertain long-term outcomes are increasingly challenging surgery as first-line treatment for several congenital, degenerative and ischemic cardiac diseases. The specialty must evolve if it is to ensure its future relevance. More importantly, it must evolve to ensure that future patients have access to treatments with proven long-term effectiveness. This cannot be achieved without dynamic leadership; however, our contention is that this is not enough. The demands of a modern surgical career and the importance of the task at hand are such that the serendipitous emergence of traditional charismatic leadership cannot be relied upon to deliver necessary change. We advocate systematic analysis and strategic leadership at a local, national and international level in four key areas: Clinical Care, Research, Education and Training, and Stakeholder Engagement. While we anticipate that exceptional individuals will continue to shape the future of our specialty, the creation of robust structures to deliver collective leadership in these key areas is of paramount importance. PMID:20884217

  9. Interventional cardiac catheterization.

    Science.gov (United States)

    Pihkala, J; Nykanen, D; Freedom, R M; Benson, L N

    1999-04-01

    Over the past decade, transcatheter interventions have become increasingly important in the treatment of patients with congenital heart lesions. These procedures may be broadly grouped as dilations (e.g., septostomy, valvuloplasty, angioplasty, and endovascular stenting) or as closures (e.g., vascular embolization and device closure of defects). Balloon valvuloplasty has become the treatment of choice for patients in all age groups with simple valvar pulmonic stenosis and, although not curative, seems at least comparable to surgery for congenital aortic stenosis in newborns to young adults. Balloon angioplasty is successfully applied to a wide range of aortic, pulmonary artery, and venous stenoses. Stents are useful in dilating lesions of which the intrinsic elasticity results in vessel recoil after balloon dilation alone. Catheter-delivered coils are used to embolize a wide range of arterial, venous, and prosthetic vascular connections. Although some devices remain investigational, they have been successfully used for closure of many arterial ducts and atrial and ventricular septal defects. In the therapy for patients with complex CHD, best results may be achieved by combining cardiac surgery with interventional catheterization. The cooperation among interventional cardiologists and cardiac surgeons was highlighted in a report of an algorithm to manage patients with tetralogy of Fallot or pulmonary atresia with diminutive pulmonary arteries, involving balloon dilation, coil embolization of collaterals, and intraoperative stent placement. In this setting, well-planned catheterization procedures have an important role in reducing the overall number of procedures that patients may require over a lifetime, with improved outcomes.

  10. Ictal Cardiac Ryhthym Abnormalities.

    Science.gov (United States)

    Ali, Rushna

    2016-01-01

    Cardiac rhythm abnormalities in the context of epilepsy are a well-known phenomenon. However, they are under-recognized and often missed. The pathophysiology of these events is unclear. Bradycardia and asystole are preceded by seizure onset suggesting ictal propagation into the cortex impacting cardiac autonomic function, and the insula and amygdala being possible culprits. Sudden unexpected death in epilepsy (SUDEP) refers to the unanticipated death of a patient with epilepsy not related to status epilepticus, trauma, drowning, or suicide. Frequent refractory generalized tonic-clonic seizures, anti-epileptic polytherapy, and prolonged duration of epilepsy are some of the commonly identified risk factors for SUDEP. However, the most consistent risk factor out of these is an increased frequency of generalized tonic-clonic seizures (GTC). Prevention of SUDEP is extremely important in patients with chronic, generalized epilepsy. Since increased frequency of GTCS is the most consistently reported risk factor for SUDEP, effective seizure control is the most important preventive strategy. PMID:27347227

  11. The Post-Myocardial Infarction Pacing Remodeling Prevention Therapy (PRomPT) Trial

    DEFF Research Database (Denmark)

    Chung, Eugene S; Fischer, Trent M; Kueffer, Fred;

    2015-01-01

    BACKGROUND: Despite considerable improvements in the medical management of patients with myocardial infarction (MI), patients with large MI still have substantial risk of developing heart failure. In the early post-MI setting, implantable cardioverter defibrillators have reduced arrhythmic deaths...... but have no impact on overall mortality. Therefore, additional interventions are required to further reduce the overall morbidity and mortality of patients with large MI. METHODS: The Pacing Remodeling Prevention Therapy (PRomPT) trial is designed to study the effects of peri-infarct pacing in preventing...... adverse post-MI remodeling. Up to 120 subjects with peak creatine phosphokinase >3,000 U/L (or troponin T >10 μg/L) at time of MI will be randomized to either dual-site or single-site biventricular pacing with the left ventricular lead implanted in a peri-infarct region or to a nonimplanted control group...

  12. Affect intensity and cardiac arousal.

    Science.gov (United States)

    Blascovich, J; Brennan, K; Tomaka, J; Kelsey, R M; Hughes, P; Coad, M L; Adlin, R

    1992-07-01

    Relationships between affect intensity and basal, evoked, and perceived cardiac arousal were investigated in 3 experiments. Affect intensity was assessed using Larsen and Diener's (1987) Affect Intensity Measure (AIM). Cardiac arousal was evoked with exercise in the 1st study and with mental arithmetic in the 2nd and 3rd. Perceived cardiac arousal was measured under optimal conditions using a standard heartbeat discrimination procedure. Women as a group scored higher on the AIM. Affect intensity was unrelated to basal or evoked cardiac arousal and was negatively related to perceived cardiac arousal in all 3 studies. Data suggest that affect intensity, although unrelated to actual physiological arousal, is negatively related to the accuracy with which individuals perceive their own arousal. Results are discussed within the context of an expanded arousal-regulation model (Blascovich, 1990). PMID:1494983

  13. Evaluation of a dual sensor rate responsive pacing system based on a new concept. French Talent DR Pacemaker Investigators.

    Science.gov (United States)

    Bonnet, J L; Géroux, L; Cazeau, S

    1998-11-01

    The minute ventilation is known to be one of the most physiological indicators of exercise. A curvilinear relationship between VE and the normal sinus rhythm (NSR) has been demonstrated in healthy patients. The aim of this study is to show that a pacemaker based on a VE sensor can reproduce such a relationship. Eighty-one patients received a Talent DR 213 (ELA Medical, Montrouge, France) pacemaker with a third-generation rate responsive algorithm. At 1-month follow-up, the patients underwent a treadmill exercise test, after which three groups were defined: group 1 had 6 patients who were 100% paced throughout the exercise test; group 2 had 10 patients who maintained NSR throughout the test; and group 3 had 12 patients who had cardiopulmonary recording during the exercise test. In group 1 patients, the simulation function computed the simulated rate (sim-rate), which was compared to the sensor-driven rate (SDR). In group 2 patients, sim-rate was compared to the NSR. In group 3 patients, cardiac and metabolic reserves were compared to determine the appropriateness of the rate response to exercise (HRR% vs MR%). The results showed that the mean correlation coefficient between sim-rate and SDR was 0.983 +/- 0.005 (P < 0.001); the mean correlation coefficient between NSR and SDR was 0.92 +/- 0.07 (P < 0.001); and a linear relationship was found between HRR% and MR%, with a mean slope of 1.1 +/- 0.2 that was significantly equal to the theoretical value of 1 (P = NS). In conclusion, combining an activity-driven sensor with a physiological sensor allows the preservation of a physiological rate response during exercise. PMID:9825318

  14. 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.

  15. Polymer artificial muscles

    Directory of Open Access Journals (Sweden)

    Tissaphern Mirfakhrai

    2007-04-01

    Full Text Available The various types of natural muscle are incredible material systems that enable the production of large deformations by repetitive molecular motions. Polymer artificial muscle technologies are being developed that produce similar strains and higher stresses using electrostatic forces, electrostriction, ion insertion, and molecular conformational changes. Materials used include elastomers, conducting polymers, ionically conducting polymers, and carbon nanotubes. The mechanisms, performance, and remaining challenges associated with these technologies are described. Initial applications are being developed, but further work by the materials community should help make these technologies applicable in a wide range of devices where muscle-like motion is desirable.

  16. 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.

  17. Bayesian artificial intelligence

    CERN Document Server

    Korb, Kevin B

    2010-01-01

    Updated and expanded, Bayesian Artificial Intelligence, Second Edition provides a practical and accessible introduction to the main concepts, foundation, and applications of Bayesian networks. It focuses on both the causal discovery of networks and Bayesian inference procedures. Adopting a causal interpretation of Bayesian networks, the authors discuss the use of Bayesian networks for causal modeling. They also draw on their own applied research to illustrate various applications of the technology.New to the Second EditionNew chapter on Bayesian network classifiersNew section on object-oriente

  18. The effects of presentation pace and modality on learning a multimedia science lesson

    Science.gov (United States)

    Chung, Wen-Hung

    Working memory is a system that consists of multiple components. The visuospatial sketchpad is the main entrance for visual and spatial information, whereas acoustic and verbal information is processed in the phonological loop. The central executive works as a coordinator of information from these two subsystems. Numerous studies have shown that working memory has a very limited capacity. Based on these characteristics of working memory, theories such as cognitive load theory and the cognitive theory of multimedia learning provide multimedia design principles. One of these principles is that when verbal information accompanying pictures is presented in audio mode instead of visually, learning can be more effective than if both text and pictures are presented visually. This is called the modality effect. However, some studies have found that the modality effect does not occur in some situations. In most experiments examining the modality effect, the multimedia is presented as system-paced. If learners are able to repeat listening as many times as they need, the superiority of spoken text over visual text seems lessened. One aim of this study was to examine the modality effect in a learner-controlled condition. This study also used the one-word-at-a-time technique to investigate whether the modality effect would still occur if both reading and listening rates were equal. There were 182 college students recruited for this study. Participants were randomly assigned to seven groups: a self-paced listening group, a self-paced reading group, a self text-block reading group, a general-paced listening group, a general-paced reading group, a fast-paced listening group, and a fast-paced reading group. The experimental material was a cardiovascular multimedia module. A three-by-two between-subjects design was used to test the main effect. Results showed that modality effect was still present but not between the self-paced listening group and the self text-block reading group

  19. Trame di Pace. Simboli, carte, azioni di un’utopia possibile. 1945-2003

    OpenAIRE

    Nadia Baiesi; Gianluca Gabrielli; Elda Guerra; Rossella Ropa

    2014-01-01

    La mostra racconta la storia degli uomini e delle donne che hanno ragionato di pace non più come di una nobile speranza, ma come dell’unica chance di salvezza per l’umanità. La scansione cronologica, per decenni, parte dal 1945 e arriva al 2003 con la diffusione della bandiera arcobaleno in occasione della campagna «Pace da tutti i balconi», nata per scongiurare il secondo conflitto in Iraq. Al centro della mostra un percorso sui simboli che sono stati in...

  20. Pacing Lead-Induced Granuloma in the Atrium: A Foreign Body Reaction to Polyurethane

    Directory of Open Access Journals (Sweden)

    Shinagawa Yoko

    2013-01-01

    Full Text Available We described a case of an 82-year-old male who presented with a granuloma entrapping the polyurethane-coated pacing lead at the site of contact on the atrium. He had been paced for 8 years without symptoms or signs suggestive of an allergic reaction to the pacemaker system and died from thrombosis of the superior mesenteric artery and heart failure. A histological examination of the nodule showed an incidental granuloma with multinucleated giant cells. No granuloma was found in the heart or the lung.

  1. MCTS self-paced training kit (exam 70-680) configuring Windows 7

    CERN Document Server

    McLean, Ian

    2010-01-01

    NOTE: The most recent printings of this title incorporate corrections to errors found in the earlier printings. This Self-Paced Training Kit is designed to help maximize your performance on 70-680, the required exam for the Microsoft® Certified Technology Specialist (MCTS): Windows 7, Configuration certification.This 2-in-1 kit includes the official Microsoft study guide, plus practice tests on CD to help you assess your skills. It comes packed with the tools and features exam candidates want most-including in-depth, self-paced training based on final exam content; rigorous, objective-by-obj

  2. First Observation Of ELM Pacing With Vertical Jogs In A Spherical Torus

    Energy Technology Data Exchange (ETDEWEB)

    Gerhardt, S P; Canik, J M; Maingi, R; Bell, R; Gates, d; Goldston, R; Hawryluk, R; Le Blanc, B P; Menard, J; Sontag, A C; Sabbagh, S

    2010-07-15

    Experiments in a number of conventional aspect ratio tokamaks have been successful in pacing edge localized modes (ELMs) by rapid vertical jogging of the plasma. This paper demonstrates the first pacing of ELMs in a spherical torus plasma. Applied 30 Hz vertical jogs synchronized the ELMs with the upward motion of the plasma. 45 Hz jogs also lead to an increase in the ELM frequency, though the synchronization of the ELMs and jogs was unclear. A reduction in the ELM energy was observed at the higher driven ELM frequencies. __________________________________________________

  3. How to teach artificial organs.

    Science.gov (United States)

    Zapanta, Conrad M; Borovetz, Harvey S; Lysaght, Michael J; Manning, Keefe B

    2011-01-01

    Artificial organs education is often an overlooked field for many bioengineering and biomedical engineering students. The purpose of this article is to describe three different approaches to teaching artificial organs. This article can serve as a reference for those who wish to offer a similar course at their own institutions or incorporate these ideas into existing courses. Artificial organ classes typically fulfill several ABET (Accreditation Board for Engineering and Technology) criteria, including those specific to bioengineering and biomedical engineering programs.

  4. Development of artificial empathy.

    Science.gov (United States)

    Asada, Minoru

    2015-01-01

    We have been advocating cognitive developmental robotics to obtain new insight into the development of human cognitive functions by utilizing synthetic and constructive approaches. Among the different emotional functions, empathy is difficult to model, but essential for robots to be social agents in our society. In my previous review on artificial empathy (Asada, 2014b), I proposed a conceptual model for empathy development beginning with emotional contagion to envy/schadenfreude along with self/other differentiation. In this article, the focus is on two aspects of this developmental process, emotional contagion in relation to motor mimicry, and cognitive/affective aspects of the empathy. It begins with a summary of the previous review (Asada, 2014b) and an introduction to affective developmental robotics as a part of cognitive developmental robotics focusing on the affective aspects. This is followed by a review and discussion on several approaches for two focused aspects of affective developmental robotics. Finally, future issues involved in the development of a more authentic form of artificial empathy are discussed.

  5. Artificial Heart Fluid Dynamics.

    Science.gov (United States)

    Mussivand, Tofigh Varcaneh

    Flow characteristics within pneumatic, pulsatile, and pusher plate prosthetic hearts were studied. The blood pumps evaluated were duplicates of pumps used for in vivo calf and for clinical implantation at the Cleveland Clinic Foundation. Human dura mater bioprosthetic, caged disk, and Bjork-Shiley tilting disk valves were employed in the pumps. Dual camera video tape and synchronized still photography were used to study flow patterns. Diffused light and a planar laser source provided illumination. The laser light was fanned into a plane with a thickness of 0.2 mm to 10 mm. Magnesium oxide and Amberlite particles were used as tracers. Aqueous-glycerol, aqueous-sucrose solutions and mineral oil were used as blood analog fluids. Inflow, outflow, drive, and afterload pressures, diaphragm motion, cardiac output, and heart rate were measured and recorded. An electrical circuit was developed to synchronize pump diaphragm motion with captured images of flow trajectories. After digitizing the trajectories, velocities, global and local turbulence, and shear stresses were obtained. Disturbed and recirculating zones were identified. Qualitative and quantitative analyses were performed using data obtained from the digitization of flow trajectories. Simultaneous turbulence and stasis were observed during most phases of the cardiac cycles in all the pumps tested. A maximum Reynold's shear stress of 2889 dynes/cm ^2 occurred at 120 beats per minute (bpm). The peak velocity was 146 cm/sec during systole. The identified regions of recirculation, low velocity and disturbed flow were shown to correlate with thrombosed areas of explanted blood pumps. The maximum calculated turbulence intensity was 106 cm/sec which occurred at 120 bpm during systole.

  6. Caquexia cardíaca Cardiac cachexia

    Directory of Open Access Journals (Sweden)

    Alberto Miján

    2006-05-01

    .Chronic heart failure (CHF, especially affecting the right heart, frequently leads to malnutrition. If the latter is severe and is combined to other factors, it may lead to cardiac cachexia. This one is associated to increased mortality and lower survival of patients suffering from it. The causes of cardiac cachexia are diverse, generally associated to maintenance of a negative energy balance, with increasing evidence of its multifactorial origin. Neurohumoral, inflammatory, immunological, and metabolic factors, among others, are superimposed in the patient with CHF, leading to involvement and deterioration of several organs and systems, since this condition affects both lean (or active cellular mass and adipose and bone tissue - osteoporosis. Among all, the most pronounced deterioration may be seen at skeletal muscle tissue, at both structural and functional levels, the heart not being spared. As for treatment, it should be based on available scientific evidence. Assessment of nutritional status of any patient with CHF is a must, with the requirement of nutritional intervention in case of malnutrition. In this situation, especially if accompanied by cardiac cachexia, it is required to modify energy intake and oral diet quality, and to consider the indication of specific complementary or alternative artificial nutrition. Besides, the causal relationship of the beneficial role of moderate physical exertion is increasing, as well as modulation of metabolic and inflammatory impairments observed in cardiac cachexia with several drugs, leading to a favorable functional and structural response in CHF patients.

  7. Mediastinitis after cardiac transplantation

    Directory of Open Access Journals (Sweden)

    Noedir A. G. Stolf

    2000-05-01

    Full Text Available OBJECTIVE: Assessment of incidence and behavior of mediastinitis after cardiac transplantation. METHODS: From 1985 to 1999, 214 cardiac transplantations were performed, 12 (5.6% of the transplanted patients developed confirmed mediastinitis. Patient's ages ranged from 42 to 66 years (mean of 52.3±10.0 years and 10 (83.3% patients were males. Seven (58.3% patients showed sternal stability on palpation, 4 (33.3% patients had pleural empyema, and 2 (16.7% patients did not show purulent secretion draining through the wound. RESULTS: Staphylococcus aureus was the infectious agent identified in the wound secretion or in the mediastinum, or both, in 8 (66.7% patients. Staphylococcus epidermidis was identified in 2 (16.7% patients, Enterococcus faecalis in 1 (8.3% patient, and the cause of mediastinitis could not be determined in 1 (8.3% patient. Surgical treatment was performed on an emergency basis, and the extension of the débridement varied with local conditions. In 2 (16.7% patients, we chose to leave the surgical wound open and performed daily dressings with granulated sugar. Total sternal resection was performed in only 1 (8.3% patient. Out of this series, 5 (41.7% patients died, and the causes of death were related to the infection. Autopsy revealed persistence of mediastinitis in 1 (8.3% patient. CONCLUSION: Promptness in diagnosing mediastinitis and precocious surgical drainage have changed the natural evolution of this disease. Nevertheless, observance of the basic precepts of prophylaxis of infection is still the best way to treat mediastinitis.

  8. Platelets and cardiac arrhythmia

    Directory of Open Access Journals (Sweden)

    Jonas S De Jong

    2010-12-01

    Full Text Available Sudden cardiac death remains one of the most prevalent modes of death in industrialized countries, and myocardial ischemia due to thrombotic coronary occlusion is its primary cause. The role of platelets in the occurrence of SCD extends beyond coronary flow impairment by clot formation. Here we review the substances released by platelets during clot formation and their arrhythmic properties. Platelet products are released from three types of platelet granules: dense core granules, alpha-granules, and platelet lysosomes. The physiologic properties of dense granule products are of special interest as a potential source of arrhythmic substances. They are released readily upon activation and contain high concentrations of serotonin, histamine, purines, pyrimidines, and ions such as calcium and magnesium. Potential arrhythmic mechanisms of these substances, e.g. serotonin and high energy phosphates, include induction of coronary constriction, calcium overloading, and induction of delayed after-depolarizations. Alpha-granules produce thromboxanes and other arachidonic acid products with many potential arrhythmic effects mediated by interference with cardiac sodium, calcium and potassium channels. Alpha-granules also contain hundreds of proteins that could potentially serve as ligands to receptors on cardiomyocytes. Lysosomal products probably do not have an important arrhythmic effect. Platelet products and ischemia can induce coronary permeability, thereby enhancing interaction with surrounding cardiomyocytes. Antiplatelet therapy is known to improve survival after myocardial infarction. Although an important part of this effect results from prevention of coronary clot formation, there is evidence to suggest that antiplatelet therapy also induces anti-arrhythmic effects during ischemia by preventing the release of platelet activation products.

  9. Metoclopramide-induced cardiac arrest

    Directory of Open Access Journals (Sweden)

    Martha M. Rumore

    2011-11-01

    Full Text Available The authors report a case of cardiac arrest in a patient receiving intravenous (IV metoclopramide and review the pertinent literature. A 62-year-old morbidly obese female admitted for a gastric sleeve procedure, developed cardiac arrest within one minute of receiving metoclopramide 10 mg via slow intravenous (IV injection. Bradycardia at 4 beats/min immediately appeared, progressing rapidly to asystole. Chest compressions restored vital function. Electrocardiogram (ECG revealed ST depression indicative of myocardial injury. Following intubation, the patient was transferred to the intensive care unit. Various cardiac dysrrhythmias including supraventricular tachycardia (SVT associated with hypertension and atrial fibrillation occurred. Following IV esmolol and metoprolol, the patient reverted to normal sinus rhythm. Repeat ECGs revealed ST depression resolution without pre-admission changes. Metoclopramide is a non-specific dopamine receptor antagonist. Seven cases of cardiac arrest and one of sinus arrest with metoclopramide were found in the literature. The metoclopramide prescribing information does not list precautions or adverse drug reactions (ADRs related to cardiac arrest. The reaction is not dose related but may relate to the IV administration route. Coronary artery disease was the sole risk factor identified. According to Naranjo, the association was possible. Other reports of cardiac arrest, severe bradycardia, and SVT were reviewed. In one case, five separate IV doses of 10 mg metoclopramide were immediately followed by asystole repeatedly. The mechanism(s underlying metoclopramide’s cardiac arrest-inducing effects is unknown. Structural similarities to procainamide may play a role. In view of eight previous cases of cardiac arrest from metoclopramide having been reported, further elucidation of this ADR and patient monitoring is needed. Our report should alert clinicians to monitor patients and remain diligent in surveillance and

  10. 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

  11. Postoperative Arrhythmias after Cardiac Surgery: Incidence, Risk Factors, and Therapeutic Management

    Directory of Open Access Journals (Sweden)

    Giovanni Peretto

    2014-01-01

    Full Text Available Arrhythmias are a known complication after cardiac surgery and represent a major cause of morbidity, increased length of hospital stay, and economic costs. However, little is known about incidence, risk factors, and treatment of early postoperative arrhythmias. Both tachyarrhythmias and bradyarrhythmias can present in the postoperative period. In this setting, atrial fibrillation is the most common heart rhythm disorder. Postoperative atrial fibrillation is often self-limiting, but it may require anticoagulation therapy and either a rate or rhythm control strategy. However, ventricular arrhythmias and conduction disturbances can also occur. Sustained ventricular arrhythmias in the recovery period after cardiac surgery may warrant acute treatment and long-term preventive strategy in the absence of reversible causes. Transient bradyarrhythmias may be managed with temporary pacing wires placed at surgery, but significant and persistent atrioventricular block or sinus node dysfunction can occur with the need for permanent pacing. We provide a complete and updated review about mechanisms, risk factors, and treatment strategies for the main postoperative arrhythmias.

  12. Postoperative arrhythmias after cardiac surgery: incidence, risk factors, and therapeutic management.

    Science.gov (United States)

    Peretto, Giovanni; Durante, Alessandro; Limite, Luca Rosario; Cianflone, Domenico

    2014-01-01

    Arrhythmias are a known complication after cardiac surgery and represent a major cause of morbidity, increased length of hospital stay, and economic costs. However, little is known about incidence, risk factors, and treatment of early postoperative arrhythmias. Both tachyarrhythmias and bradyarrhythmias can present in the postoperative period. In this setting, atrial fibrillation is the most common heart rhythm disorder. Postoperative atrial fibrillation is often self-limiting, but it may require anticoagulation therapy and either a rate or rhythm control strategy. However, ventricular arrhythmias and conduction disturbances can also occur. Sustained ventricular arrhythmias in the recovery period after cardiac surgery may warrant acute treatment and long-term preventive strategy in the absence of reversible causes. Transient bradyarrhythmias may be managed with temporary pacing wires placed at surgery, but significant and persistent atrioventricular block or sinus node dysfunction can occur with the need for permanent pacing. We provide a complete and updated review about mechanisms, risk factors, and treatment strategies for the main postoperative arrhythmias. PMID:24511410

  13. A Study of Mechanical Optimization Strategy for Cardiac Resynchronization Therapy Based on an Electromechanical Model

    Directory of Open Access Journals (Sweden)

    Jianhong Dou

    2012-01-01

    Full Text Available An optimal electrode position and interventricular (VV delay in cardiac resynchronization therapy (CRT improves its success. However, the precise quantification of cardiac dyssynchrony and magnitude of resynchronization achieved by biventricular (BiV pacing therapy with mechanical optimization strategies based on computational models remain scant. The maximum circumferential uniformity ratio estimate (CURE was used here as mechanical optimization index, which was automatically computed for 6 different electrode positions based on a three-dimensional electromechanical canine model of heart failure (HF caused by complete left bundle branch block (CLBBB. VV delay timing was adjusted accordingly. The heart excitation propagation was simulated with a monodomain model. The quantification of mechanical intra- and interventricular asynchrony was then investigated with eight-node isoparametric element method. The results showed that (i the optimal pacing location from maximal CURE of 0.8516 was found at the left ventricle (LV lateral wall near the equator site with a VV delay of 60 ms, in accordance with current clinical studies, (ii compared with electrical optimization strategy of ERMS, the LV synchronous contraction and the hemodynamics improved more with mechanical optimization strategy. Therefore, measures of mechanical dyssynchrony improve the sensitivity and specificity of predicting responders more. The model was subject to validation in future clinical studies.

  14. Radiofrequency and microwave tumor ablation in patients with implanted cardiac devices: Is it safe?

    Energy Technology Data Exchange (ETDEWEB)

    Skonieczki, Brendan D., E-mail: bskonieczki@lifespan.org [Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University/Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903 (United States); Wells, Catherine, E-mail: cwells1@bidmc.harvard.edu [Department of Radiology, Harvard Medical School/Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215 (United States); Wasser, Elliot J., E-mail: ewasser@lifespan.org [Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University/Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903 (United States); Dupuy, Damian E., E-mail: ddupuy@lifespan.org [Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University/Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903 (United States)

    2011-09-15

    Purpose: To identify malfunction of implanted cardiac devices during or after thermal ablation of tumors in lung, kidney, liver or bone, using radiofrequency (RF) or microwave (MW) energy. Materials and methods: After providing written consent, 19 patients (15 men and 4 women; mean age 78 years) with pacemakers or pacemaker/defibrillators underwent 22 CT image-guided percutaneous RF or MW ablation of a variety of tumors. Before and after each procedure, cardiac devices were interrogated and reprogrammed by a trained cardiac electrophysiology fellow. Possible pacer malfunctions included abnormalities on electrocardiographic (EKG) monitoring and alterations in device settings. Our institutional review board approved this Health Insurance Portability and Accountability Act-compliant study. Informed consent for participation in this retrospective study was deemed unnecessary by our review board. Results: During 20 of 22 sessions, no abnormalities were identified in continuous, EKG tracings or pacemaker functions. However, in two sessions significant changes, occurred in pacemaker parameters: inhibition of pacing during RF application in one, session and resetting of mode by RF energy in another session. These changes did not, result in hemodynamic instability of either patient. MW ablation was not associated with, any malfunction. In all 22 sessions, pacemakers were undamaged and successfully reset to original parameters. Conclusion: RF or MW ablation of tumors in liver, kidney, bone and lung can be performed safely in patients with permanent intra-cardiac devices, but careful planning between radiology and cardiology is essential to avoid adverse outcomes.

  15. Cardiorespiratory Mechanical Simulator for In Vitro Testing of Impedance Minute Ventilation Sensors in Cardiac Pacemakers.

    Science.gov (United States)

    Marcelli, Emanuela; Cercenelli, Laura

    2016-01-01

    We developed a cardiorespiratory mechanical simulator (CRMS), a system able to reproduce both the cardiac and respiratory movements, intended to be used for in vitro testing of impedance minute ventilation (iMV) sensors in cardiac pacemakers. The simulator consists of two actuators anchored to a human thorax model and a software interface to control the actuators and to acquire/process impedance signals. The actuators can be driven separately or simultaneously to reproduce the cardiac longitudinal shortening at a programmable heart rate and the diaphragm displacement at a programmable respiratory rate (RR). A standard bipolar pacing lead moving with the actuators and a pacemaker case fixed to the thorax model have been used to measure impedance (Z) variations during the simulated cardiorespiratory movements. The software is able to discriminate the low-frequency component because of respiration (Z(R)) from the high-frequency ripple because of cardiac effect (Z(C)). Impedance minute ventilation is continuously calculated from Z(R) and RR. From preliminary tests, the CRMS proved to be a reliable simulator for in vitro evaluation of iMV sensors. Respiration impedance recordings collected during cardiorespiratory movements reproduced by the CRMS were comparable in morphology and amplitude with in vivo assessments of transthoracic impedance variations. PMID:26501915

  16. Evaluation of cardiac vulnerability and antifibrillatory properties of anti-arrhythmic drugs.

    Science.gov (United States)

    Smailys, A; Gasiunas, V; Gasiuniene, G

    1989-10-01

    A method of evaluating the antifibrillatory properties of drugs by their effect on the acceleration of the cardiac rhythm by electric pulses was developed. It permitted measurement of fibrillation thresholds and the maximal driving frequency of stimulation. The heart was accelerated in closed chest dogs, and this increased the fibrillation thresholds after the application of lidocaine (1 mg/kg), quinidine (5 mg/kg), and novocainamide (15 mg/kg body wt.). The development of an original programmed stimulator increased the accuracy of the method by means of establishing the initial and terminal stimulation rates and observing the constant steps of change of pulse intervals. Four methods of causing fibrillation were compared: (1) a single pulse during the vulnerable phase of the cardiac cycle; (2) a train of pulses overlapping the vulnerable phase; (3) sequential R on T pacing; (4) simple acceleration of the cardiac rhythm. In addition to the other methods, the method of accelerating the heart rate differs in that only a small amplitude of stimulating pulses is needed. The present method may be used in the case of an unstable initial cardiac rhythm.

  17. Cardiorespiratory Mechanical Simulator for In Vitro Testing of Impedance Minute Ventilation Sensors in Cardiac Pacemakers.

    Science.gov (United States)

    Marcelli, Emanuela; Cercenelli, Laura

    2016-01-01

    We developed a cardiorespiratory mechanical simulator (CRMS), a system able to reproduce both the cardiac and respiratory movements, intended to be used for in vitro testing of impedance minute ventilation (iMV) sensors in cardiac pacemakers. The simulator consists of two actuators anchored to a human thorax model and a software interface to control the actuators and to acquire/process impedance signals. The actuators can be driven separately or simultaneously to reproduce the cardiac longitudinal shortening at a programmable heart rate and the diaphragm displacement at a programmable respiratory rate (RR). A standard bipolar pacing lead moving with the actuators and a pacemaker case fixed to the thorax model have been used to measure impedance (Z) variations during the simulated cardiorespiratory movements. The software is able to discriminate the low-frequency component because of respiration (Z(R)) from the high-frequency ripple because of cardiac effect (Z(C)). Impedance minute ventilation is continuously calculated from Z(R) and RR. From preliminary tests, the CRMS proved to be a reliable simulator for in vitro evaluation of iMV sensors. Respiration impedance recordings collected during cardiorespiratory movements reproduced by the CRMS were comparable in morphology and amplitude with in vivo assessments of transthoracic impedance variations.

  18. Epigenetic regulation in cardiac fibrosis

    Institute of Scientific and Technical Information of China (English)

    Li-Ming; Yu; Yong; Xu

    2015-01-01

    Cardiac fibrosis represents an adoptive response in the heart exposed to various stress cues. While resolution of the fibrogenic response heralds normalization of heart function, persistent fibrogenesis is usually associated with progressive loss of heart function and eventually heart failure. Cardiac fibrosis is regulated by a myriad of factors that converge on the transcription of genes encoding extracellular matrix proteins, a process the epigenetic machinery plays a pivotal role. In this minireview, we summarize recent advances regarding the epigenetic regulation of cardiac fibrosis focusing on the role of histone and DNA modifications and non-coding RNAs.

  19. Cardiac perioperative complications in noncardiac surgery

    OpenAIRE

    Radovanović Dragana; Kolak Radmila; Stokić Aleksandar; Radovanović Zoran; Jovanović Gordana

    2008-01-01

    Anesthesiologists are confronted with an increasing population of patients undergoing noncardiac surgery who are at risk for cardiac complications in the perioperative period. Perioperative cardiac complications are responsible for significant mortality and morbidity. The aim of the present study was to determine the incidence of perioperative (operative and postoperative) cardiac complications and correlations between the incidence of perioperative cardiac complications and type of surgical ...

  20. 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. PMID:19330498

  1. Self-Pacing a Gross Motor Skills Course: Crawler Tractor Operator, MOS 62E20.

    Science.gov (United States)

    Brennan, Mark F.; Taylor, John E.

    As part of the Army's emphasis on performance-oriented instruction in training centers, a study was conducted to determine the feasibility of using self-paced instruction in a gross motor skills course. The Crawler Tractor Operator Course, a seven-week heavy equipment course conducted at Fort Leonard Wood, Missouri was selected for the study…

  2. Respiratory muscle pacing with chronically implanted intramuscular Permaloc electrodes: A feasibility study

    Directory of Open Access Journals (Sweden)

    James S. Walter, PhD

    2011-02-01

    Full Text Available We tested the feasibility of stimulating upper-intercostal and abdominal muscles plus the diaphragm by using chronically implanted intramuscular electrodes. During two survival surgeries with six dogs, intramuscular electrodes were implanted bilaterally in the three respiratory muscles. Standard stimulation of the diaphragm was conducted. The dorsolateral and ventrolateral abdominal wall areas were stimulated with a 25 mA current. The second to fourth intercostal spaces were stimulated to elicit the largest tidal volume associated with the least coactivation of the serratus and latissimus muscles. Lone diaphragm and upper-intercostal muscle pacing produced inhaled tidal volumes (mean +/- standard error of the mean of 293 +/- 36 mL and 59 +/- 17 mL, respectively. Lone abdominal muscle pacing produced an exhaled volume of 55 +/- 17 mL. Combined pacing of diaphragm and intercostal muscles increased the inhaled volume to 389 +/- 39 mL. The addition of abdominal pacing following the combined stimulation of diaphragm and intercostals increased the exhaled volume to 472 +/- 54 mL. During autopsy, dislodgement of the electrodes overlying the ribs was a concern and probably resulted from loose animal jackets. Chronic intramuscular Permaloc electrodes can be implanted in several respiratory muscles and increase tidal volumes more than diaphragm stimulation alone.

  3. Language switch costs in sentence comprehension depend on language dominance: Evidence from self-paced reading

    NARCIS (Netherlands)

    Bultena, S.S.; Dijkstra, A.F.J.; Hell, J.G. van

    2015-01-01

    This study investigated two prominent issues in the comprehension of language switches. First, how does language switching direction affect switch costs in sentence context? Second, are switch costs modulated by L2 proficiency and cross-linguistic activation? We conducted a self-paced reading task i

  4. Modeling Pacing Behavior and Test Speededness Using Latent Growth Curve Models

    Science.gov (United States)

    Kahraman, Nilufer; Cuddy, Monica M.; Clauser, Brian E.

    2013-01-01

    This research explores the usefulness of latent growth curve modeling in the study of pacing behavior and test speededness. Examinee response times from a high-stakes, computerized examination, collected before and after the examination was subjected to a timing change, were analyzed using a series of latent growth curve models to detect…

  5. Investigating the Effects of Concurrent Performance of Physical and Cognitive Demanding Task in Paced Assembly Lines

    Directory of Open Access Journals (Sweden)

    Shakil Ahmed Shaikh

    2013-07-01

    Full Text Available The study was undertaken to investigate the effects of pacing on aspects of performance at an assembly task and on the operators' responses related to work behaviour, perceived workload and perceived stress. A particular objective of the study was to investigate whether physical and cognitive demands may interact in their influences on these effects. An assembly task was simulated in the laboratory and the level of pacing imposed, work height and memory load within the task were all varied. The results showed that the type of pacing commonly imposed (as is common with a lean manufacturing Takt time system in industry can significantly affect both performance and perceived workload and stress. Physical demands (through work height affecting posture and mental demand (through memory load were also found to have significant effects, as would be expected from the many studies of these in the literature. More importantly, some interactions were found between pacing and work height in their effects on quality of assembly and the operator's own rating of performance, and between work height and memory load in their effects on errors. These findings will need to be taken into account by companies when implementing Takt time systems.

  6. Diagnostic accuracy of metronome-paced tachypnea to detect dynamic hyperinflation

    NARCIS (Netherlands)

    Lahaije, A.J.M.C.; Willems, L.M.; Hees, H.W. van; Dekhuijzen, P.N.R.; Helvoort, H.A.C. van; Heijdra, Y.F.

    2013-01-01

    INTRODUCTION: This prospective study was carried out to investigate if metronome-paced tachypnea (MPT) can serve as an accurate diagnostic tool to identify patients with chronic obstructive pulmonary disease (COPD) who are susceptible to develop dynamic hyperinflation during exercise. Commonly, this

  7. Dynamic hyperinflation after metronome-paced hyperventilation in COPD--a 2 year follow-up.

    NARCIS (Netherlands)

    Hannink, J.D.C.; Lahaije, A.; Bischoff, E.W.M.A.; Helvoort, H.A.C. van; Dekhuijzen, R.; Schermer, T.R.J.; Heijdra, Y.F.

    2010-01-01

    In contrast to the decline in FEV(1), the behavior of dynamic hyperinflation (DH) over time is unknown in patients with COPD. Metronome-paced hyperventilation (MPH) is a simple applicable surrogate for exercise to detect DH. OBJECTIVE: To evaluate changes in MPH-induced DH during two years follow-up

  8. Molecular mechanisms of early atrial remodeling by rapid atrial pacing in rabbits

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective: To establish a rabbit atrial fibrillation model with rapid atrial pacing (RAP) and investigate its ultrastructural changes and expressions of L-type calcium channel subunits and potassium channel Ky4.3. Methods: Thirty-six rabbits were performed electrical stimulation through bipolar endocardial led by surgical technique, 600 beat per min from 0 to 48 h. Atrial ultrastructure was observed by transmission electron microscope (TEM) after different pacing times. mRNA were measured by reverse transcription-polymerase chain reaction (RT-PCR). Results: Atrial ultrastructure had alteration after 3 hours' pacing, such as mitochondria vacuolization, myofilament lysis and glucogen aggregation. The mRNA of the Ca2+ channel β1 and α1 subunits began to decrease after pacing of 6 h, which were paralleled with the change of Kv4.3 mRNA. But the auxiliary subunit α2 were not affected. Conclusion: Ultrastructural changes and mRNA levels of L-type calcium channel subunits and potassium channel Kv4.3 are decreased after RAP, with a mechanism of transcriptional down-regulation of underlying ion channels due to calcium overloading after RAP.

  9. Effects of wind application on thermal perception and self-paced performance

    NARCIS (Netherlands)

    Teunissen, L.P.J.; Haan, A. de; Koning, J.J. de; Daanen, H.A.M.

    2013-01-01

    Physiological and perceptual effects of wind cooling are often intertwined and have scarcely been studied in self-paced exercise. Therefore, we aimed to investigate (1) the independent perceptual effect of wind cooling and its impact on performance and (2) the responses to temporary wind cooling dur

  10. Mobitz type I atrio-ventricular block in dengue myocarditis, requiring temporary pacing

    Directory of Open Access Journals (Sweden)

    S. de Mel

    2015-01-01

    Full Text Available We present a case of dengue myocarditis related Mobitz type I atrio-ventricular (A-V block. To our knowledge, this is the first report of such a patient requiring pacing. An early response to methylprednisolone suggests the possibility of a therapeutic role for steroids in these patients.

  11. Characterizing the concept of activity pacing as a non-pharmacological intervention in rheumatology care

    DEFF Research Database (Denmark)

    Cuperus, N; Vliet Vlieland, Tpm; Brodin, N;

    2016-01-01

    OBJECTIVE: To develop a consensual list of the most important aspects of activity pacing (AP) as an intervention within the context of non-pharmacological rheumatology care. METHOD: An international, multidisciplinary expert panel comprising 60 clinicians and/or healthcare providers experienced i...

  12. The Effects of TV Program Pacing on the Behavior of Preschool Children

    Science.gov (United States)

    Anderson, Daniel R.; And Others

    1977-01-01

    Assertions that television (Sesame Street in particular) produces hyperactivity, impulsivity, disorganized behavior, and shortened attention spans in pre-school children were investigated. No evidence was found that rapid television pacing has an immediate negative impact on behavior of preschool children. (Author/STS)

  13. Pacing, the missing piece of the puzzle to high-intensity interval training.

    Science.gov (United States)

    Zadow, E K; Gordon, N; Abbiss, C R; Peiffer, J J

    2015-03-01

    This study examined physiological and perceptual responses to matched work high-intensity interval training using all-out and 2 even-paced methodologies. 15 trained male cyclists performed 3 interval sessions of three 3-min efforts with 3 min of active recovery between efforts. The initial interval session was completed using all-out pacing, with the following 2 sessions being completed with computer- and athlete-controlled pacing in a randomised and semi-counterbalanced manner. Computer- and athlete-controlled intervals were completed at the mean power from the corresponding interval during the all-out trial. Oxygen consumption and ratings of perceived exertion were recorded during each effort. 20 min following each session, participants completed a 4-km time trial and provided sessional rating of perceived exertion. Oxygen consumption was greater during all-out (54.1±6.6 ml.kg(-1).min(-1); pintervals. Distribution of pace throughout high-intensity interval training can influence perceptual and metabolic stress along with subsequent performance and should be considered during the prescription of such training.

  14. Managing after-work stress: paced breathing while watching video content (abstract)

    NARCIS (Netherlands)

    Tijs, T.J.W.; Weda, J.; Weffers-Albu, M.A.; Hoogenstraaten, W.

    2011-01-01

    Objectives. After a hard day’s work, we need to recover from work stress. Two frequently reported activities to relieve stress are television (TV) watching and paced breathing exercises. We investigated the potential of combining these techniques. Method. Two explorativeexperiments were conducted.

  15. Classifying running-related injuries based upon etiology, with emphasis on volume and pace

    DEFF Research Database (Denmark)

    Nielsen, R.O.; Nohr, Ellen Aagaard; Rasmussen, Sten;

    2013-01-01

    Many researchers acknowledge the importance of "training errors" as the main cause of running-related injuries. The purpose of this clinical commentary is to present a theoretical framework for the assumption that some running-related injuries among rear-foot strikers develop due to rapidly...... changing running volume, while others develop due to rapidly changing running pace....

  16. Cross-sectional Association between Walking Pace and Sleep-disordered Breathing.

    Science.gov (United States)

    Suri, S V; Batterham, A M; Ells, L; Danjoux, G; Atkinson, G

    2015-10-01

    Sleep-disordered breathing is an important comorbidity for several diseases, including stroke. Initial screening tools comprise simple yes/no questions about known risk factors for sleep-disordered breathing, e.g., obesity, sex. But walking speed has not been investigated in this context. We examined the cross-sectional association between walking pace and sleep-disordered breathing in the population-level Multi-Ethnic Study of Atherosclerosis. A sample of 2912 men and 3213 women (46-87 years) reported perceived walking pace outside their homes. A walking pacesleep apnoea (3.5%), self-reported apnoeas (8.4%), loud snoring (20.5%), daytime tiredness (22.2%) and slow-walking pace (26.9%). The 95% CI risk differences (multivariable-adjusted) for slow vs. faster walking pace were; sleep apnoea (0.4-2.5%), self-reported apnoeas (0.1-3.8%), loud snoring (1.2-8.3%), and daytime tiredness (3.0-7.8%). Risk differences were similar between sexes. The multivariable-adjusted risk ratio indicated that slower walkers had 1.5 (95% CI: 1.0 to 2.1) times the risk of sleep apnoea vs. faster walkers. In conclusion, a slower walking speed was associated with a greater prevalence of sleep-disordered breathing, independently from other common screening factors. Therefore, a simple walking speed question may help consolidate screening for this disorder. PMID:26090878

  17. Effect of heat and heat acclimatization on cycling time trial performance and pacing

    DEFF Research Database (Denmark)

    Racinais, Sebastien; Périard, Julien D; Karlsen, Anders;

    2015-01-01

    PURPOSE: To determine the effects of heat-acclimatization on performance and pacing during outdoor cycling time-trials (TT, 43.4km) in the heat. METHODS: Nine cyclists performed 3 TTs in hot ambient conditions (TTH, ∼37ºC) on the first (TTH-1), sixth (TTH-2) and fourteenth (TTH-3) days of trainin...

  18. Managing the Finances. PACE Revised. Level 2. Unit 16. Research & Development Series No. 240BB16.

    Science.gov (United States)

    Ashmore, M. Catherine; Pritz, Sandra G.

    This unit on managing the finances of a small business, the 16th in a series of 18 modules, is on the second level of the revised PACE (Program for Acquiring Competence in Entrepreneurship) comprehensive curriculum. Geared to advanced secondary and beginning postsecondary or adult students, the modules provide an opportunity to learn about and try…

  19. A Procedure to Establish Self-Pacing Behaviors in Academically Deficient First Year Students.

    Science.gov (United States)

    Opdahl, Chris A.

    Research investigating the performance of students enrolled in courses taught by a Personalized System of Instruction (PSI) has tended to support the claim that PSI is a superior teaching method. The present research study isolated the self-pacing aspect of PSI courses and attempted to teach 13 academically deficient first year college students…

  20. Team Performance and Risk-Adjusted Health Outcomes in the Program of All-Inclusive Care for the Elderly (PACE)

    Science.gov (United States)

    Mukamel, Dana B.; Temkin-Greener, Helena; Delavan, Rachel; Peterson, Derick R.; Gross, Diane; Kunitz, Stephen; Williams, T. Franklin

    2006-01-01

    Purpose: The Program of All-Inclusive Care for the Elderly (PACE) is a community-based program providing primary, acute, and long-term care to frail elderly individuals. A central component of the PACE model is the interdisciplinary care team, which includes both professionals and non-professionals. The purpose of this study was to examine the…

  1. Pyruvate stabilizes electrocardiographic and hemodynamic function in pigs recovering from cardiac arrest.

    Science.gov (United States)

    Cherry, Brandon H; Nguyen, Anh Q; Hollrah, Roger A; Williams, Arthur G; Hoxha, Besim; Olivencia-Yurvati, Albert H; Mallet, Robert T

    2015-12-01

    Cardiac electromechanical dysfunction may compromise recovery of patients who are initially resuscitated from cardiac arrest, and effective treatments remain elusive. Pyruvate, a natural intermediary metabolite, energy substrate, and antioxidant, has been found to protect the heart from ischemia-reperfusion injury. This study tested the hypothesis that pyruvate-enriched resuscitation restores hemodynamic, metabolic, and electrolyte homeostasis following cardiac arrest. Forty-two Yorkshire swine underwent pacing-induced ventricular fibrillation and, after 6 min pre-intervention arrest, 4 min precordial compressions followed by transthoracic countershocks. After defibrillation and recovery of spontaneous circulation, the pigs were monitored for another 4 h. Sodium pyruvate or NaCl were infused i.v. (0.1 mmol·kg(-1)·min(-1)) throughout precordial compressions and the first 60 min recovery. In 8 of the 24 NaCl-infused swine, the first countershock converted ventricular fibrillation to pulseless electrical activity unresponsive to subsequent countershocks, but only 1 of 18 pyruvate-treated swine developed pulseless electrical activity (relative risk 0.17; 95% confidence interval 0.13-0.22). Pyruvate treatment also lowered the dosage of vasoconstrictor phenylephrine required to maintain systemic arterial pressure at 15-60 min recovery, hastened clearance of excess glucose, elevated arterial bicarbonate, and raised arterial pH; these statistically significant effects persisted up to 3 h after sodium pyruvate infusion, while infusion-induced hypernatremia subsided. These results demonstrate that pyruvate-enriched resuscitation achieves electrocardiographic and hemodynamic stability in swine during the initial recovery from cardiac arrest. Such metabolically based treatment may offer an effective strategy to support cardiac electromechanical recovery immediately after cardiac arrest. PMID:26088865

  2. Artificial sweeteners - a review.

    Science.gov (United States)

    Chattopadhyay, Sanchari; Raychaudhuri, Utpal; Chakraborty, Runu

    2014-04-01

    Now a days sugar free food are very much popular because of their less calorie content. So food industry uses various artificial sweeteners which are low in calorie content instead of high calorie sugar. U.S. Food and Drug Administration has approved aspartame, acesulfame-k, neotame, cyclamate and alitame for use as per acceptable daily intake (ADI) value. But till date, breakdown products of these sweeteners have controversial health and metabolic effects. On the other hand, rare sugars are monosaccharides and have no known health effects because it does not metabolize in our body, but shows same sweet taste and bulk property as sugar. Rare sugars have no such ADI value and are mainly produced by using bioreactor and so inspite of high demand, rare sugars cannot be produced in the desired quantities. PMID:24741154

  3. Artificial Immune Systems (2010)

    CERN Document Server

    Greensmith, Julie; Aickelin, Uwe

    2010-01-01

    The human immune system has numerous properties that make it ripe for exploitation in the computational domain, such as robustness and fault tolerance, and many different algorithms, collectively termed Artificial Immune Systems (AIS), have been inspired by it. Two generations of AIS are currently in use, with the first generation relying on simplified immune models and the second generation utilising interdisciplinary collaboration to develop a deeper understanding of the immune system and hence produce more complex models. Both generations of algorithms have been successfully applied to a variety of problems, including anomaly detection, pattern recognition, optimisation and robotics. In this chapter an overview of AIS is presented, its evolution is discussed, and it is shown that the diversification of the field is linked to the diversity of the immune system itself, leading to a number of algorithms as opposed to one archetypal system. Two case studies are also presented to help provide insight into the m...

  4. Artificial Enzymes, "Chemzymes"

    DEFF Research Database (Denmark)

    Bjerre, Jeannette; Rousseau, Cyril Andre Raphaël; Pedersen, Lavinia Georgeta M;

    2008-01-01

    "Chemzymes", based on cyclodextrins and other molecules. Only the chemzymes that have shown enzyme-like activity that has been quantified by different methods will be mentioned. This review will summarize the work done in the field of artificial glycosidases, oxidases, epoxidases, and esterases, as well...... as chemzymes that catalyze conjugate additions, cycloadditions, and self-replicating processes. The focus will be mainly on cyclodextrin-based chemzymes since they have shown to be good candidate structures to base an enzyme model skeleton on. In addition hereto, other molecules that encompass binding......Enzymes have fascinated scientists since their discovery and, over some decades, one aim in organic chemistry has been the creation of molecules that mimic the active sites of enzymes and promote catalysis. Nevertheless, even today, there are relatively few examples of enzyme models...

  5. Remote Sensing Ocean Color Observations from NASA's PACE Mission: Applications and Societal Benefits

    Science.gov (United States)

    Tzortziou, M.; Omar, A. H.; Turner, W.

    2014-12-01

    The PACE (Pre- Aerosol, Clouds and ocean Ecosystems) mission is a strategic Climate Continuity mission, included in NASA's 2010 plan: "Responding to the Challenge of Climate and Environmental Change: NASA's Plan for a Climate-Centric Architecture for Earth Observations and Applications from Space". On a polar orbit, PACE will make climate-quality global measurements that are essential for understanding ocean biology, biogeochemistry and ecology, and determining how the ocean's role in global biogeochemical cycling and ocean ecology both affects and is affected by climate change. With advanced global remote sensing capabilities that include high spectral-resolution imaging, extended spectral coverage to the UV and SWIR, improved spatial resolution in inland, estuarine and coastal waters, enhanced atmospheric correction and higher signal-to-noise, PACE is expected to provide high quality observations that, over the long-term, will contribute to an extended time series of records on inland, coastal, and ocean ecosystems—all of which have substantial value beyond basic science and research. The combination of climate-quality, global atmospheric and oceanic observations provided by the PACE mission will provide a unique capability to help understand changes that affect our ecosystem services, implement science-based management strategies of coastal, marine and inland aquatic resources, and support assessments, policy analyses, and design approaches to plan adaptation and responses to impacts of climate change. Here we discuss the PACE applications program, the new capabilities afforded by this future satellite mission, and how they could potentially advance applications across a range of areas, including Oceans, Climate, Water Resources, Ecological Forecasting, Disasters, Human Health and Air Quality.

  6. The effect of three recovery protocols on blood lactate clearance after race-paced swimming.

    Science.gov (United States)

    Lomax, Mitch

    2012-10-01

    The purpose of the present study was to assess the impact of 3 recovery protocols on blood lactate clearance after maximal intensity swimming. Thirty-three regional standard swimmers were tested throughout the course a year and were required to complete a race-paced 200-m swim in their main stroke or individual medley. After the race-paced swim, swimmers were assigned a self-paced continuous steady rate swim of 20 minutes (self-prescribed); a 20-minute coach-administered modified warm-up consisting of various swimming modes, intensities, and rest intervals (coach prescribed); or a 20-minute land-based recovery consisting of light-intensity walking, skipping, and stretching (land based). Blood lactate concentration was measured from the fingertip before and after the race-paced swim and after the recovery activity. The concentration of blood lactate was higher (p swimming (range of 10.5-11.0 mmol·L(-1)) compared with baseline (range 1.3-1.4 mmol·L(-1)). However, there were no differences (p > 0.05) between the groups (recovery protocols) at these time points. Conversely, differences were observed between groups after the recovery activities (p swimming protocols. The results of the present study suggest that it does not matter whether a self-paced continuous steady rate swimming velocity or a swimming recovery consisting of various strokes, intensities, and rest intervals is adopted as a recovery activity. As both swimming recoveries removed more blood lactate than the land-based recovery, swimmers should therefore be advised to undertake a swimming-based recovery rather than a land-based recovery.

  7. Instructional Applications of Artificial Intelligence.

    Science.gov (United States)

    Halff, Henry M.

    1986-01-01

    Surveys artificial intelligence and the development of computer-based tutors and speculates on the future of artificial intelligence in education. Includes discussion of the definitions of knowledge, expert systems (computer systems that solve tough technical problems), intelligent tutoring systems (ITS), and specific ITSs such as GUIDON, MYCIN,…

  8. Sucrose compared with artificial sweeteners

    DEFF Research Database (Denmark)

    Sørensen, Lone Brinkmann; Vasilaras, Tatjana H; Astrup, Arne;

    2014-01-01

    There is a lack of appetite studies in free-living subjects supplying the habitual diet with either sucrose or artificially sweetened beverages and foods. Furthermore, the focus of artificial sweeteners has only been on the energy intake (EI) side of the energy-balance equation. The data are from...

  9. Artificial Ligaments: Promise or Panacea?

    Science.gov (United States)

    Lubell, Adele

    1987-01-01

    The Food and Drug Administration has approved a prosthetic ligament for limited use in persons with damaged anterior cruciate ligaments (ACL). This article addresses ligament repair, ACL tears, current treatment, development of the Gore-Tex artificial ligament, other artificial ligaments in process, and arguments for and against their use.…

  10. A Case Exemplar for National Policy Leadership: Expanding Program of All-Inclusive Care for the Elderly (PACE).

    Science.gov (United States)

    Cortes, Tara A; Sullivan-Marx, Eileen M

    2016-03-01

    In November 2015, President Obama signed the Program of All-Inclusive Care for the Elderly (PACE) Innovation Act, which expands a proven model of care to serve high-cost and high-need populations. Specifically, the law provides the Centers for Medicare & Medicaid Services with the authority to waive Medicaid requirements that could not be waived without additional statutory authority. Those requirements include the age of the beneficiary to be served and nursing home eligibility as a condition for PACE enrollment. The law also allows providers and other entities who are not current PACE providers the opportunity to become PACE providers and serve a predominately dually eligible population that has high needs and high cost through a coordinated, integrated model. The current article describes the impact of nursing on the legislation and policy that has shaped the evolution of the PACE program for more than 40 years. [Journal of Gerontological Nursing, 42(3), 9-14.]. PMID:26934968

  11. Robot-assisted cardiac surgery.

    Science.gov (United States)

    Ishikawa, Norihiko; Watanabe, Go

    2015-01-01

    Recognition of the significant advantages of minimizing surgical trauma has resulted in the development of minimally invasive surgical procedures. Endoscopic surgery offers patients the benefits of minimally invasive surgery, and surgical robots have enhanced the ability and precision of surgeons. Consequently, technological advances have facilitated totally endoscopic robotic cardiac surgery, which has allowed surgeons to operate endoscopically rather than through a median sternotomy during cardiac surgery. Thus, repairs for structural heart conditions, including mitral valve plasty, atrial septal defect closure, multivessel minimally invasive direct coronary artery bypass grafting (MIDCAB), and totally endoscopic coronary artery bypass graft surgery (CABG), can be totally endoscopic. Robot-assisted cardiac surgery as minimally invasive cardiac surgery is reviewed. PMID:26134073

  12. Robotic Applications in Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    Alan P. Kypson

    2008-11-01

    Full Text Available Traditionally, cardiac surgery has been performed through a median sternotomy, which allows the surgeon generous access to the heart and surrounding great vessels. As a paradigm shift in the size and location of incisions occurs in cardiac surgery, new methods have been developed to allow the surgeon the same amount of dexterity and accessibility to the heart in confined spaces and in a less invasive manner. Initially, long instruments without pivot points were used, however, more recent robotic telemanipulation systems have been applied that allow for improved dexterity, enabling the surgeon to perform cardiac surgery from a distance not previously possible. In this rapidly evolving field, we review the recent history and clinical results of using robotics in cardiac surgery.

  13. 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...

  14. 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...

  15. Cardiac Biomarkers in Hyperthyroid Cats

    OpenAIRE

    Sangster, Jodi Kirsten

    2013-01-01

    Background: Hyperthyroidism has substantial effects on the circulatory system. The cardiac biomarkers NT-proBNP and troponin I (cTNI) have proven useful in identifying cats with myocardial disease but have not been as extensively investigated in hyperthyroidism.Hypothesis: Plasma NT-proBNP and cTNI concentrations are higher in cats with primary cardiac disease than in cats with hyperthyroidism and higher in cats with hyperthyroidism than in healthy control cats.Animals: Twenty-three hyperthyr...

  16. Cardiac manifestations in systemic sclerosis

    Institute of Scientific and Technical Information of China (English)

    Sevdalina; Lambova

    2014-01-01

    Primary cardiac involvement, which develops as a direct consequence of systemic sclerosis(SSc), may manifest as myocardial damage, fibrosis of the conduction system, pericardial and, less frequently, as valvular disease. In addition, cardiac complications in SSc may develop as a secondary phenomenon due to pulmonary arterial hypertension and kidney pathology. The prevalence of primary cardiac involvement in SSc is variable and difficult to determine because of the diversity of cardiac manifestations, the presence of subclinical periods, the type of diagnostic tools applied, and the diversity of patient populations. When clinically manifested, cardiac involvement is thought to be an important prognostic factor. Profound microvascular disease is a pathognomonic feature of SSc, as both vasospasm and structural alterations are present. Such alterations are thought to predict macrovascular atherosclerosis over time. There are contradictory reports regarding the prevalence of atherosclerosis in SSc. According to some authors, the prevalence of atherosclerosis of the large epicardial coronary arteries is similar to that of the general population, in contrast with other rheumatic diseases such as rheumatoid arthritis and systemic lupus erythematosus. However, the level of inflammation in SSc is inferior. Thus, the atherosclerotic process may not be as aggressive and not easily detectable in smaller studies. Echocardiography(especially tissue Doppler imaging), single-photon emission computed tomography, magnetic resonance imaging and cardiac computed tomography are sensitive techniques for earlier detection of both structural and functional scleroderma-related cardiac pathologies. Screening for subclinical cardiac involvement via modern, sensitive tools provides an opportunity for early diagnosis and treatment, which is of crucial importance for a positive outcome.

  17. Computational Modeling of Cardiac Electromechanics

    OpenAIRE

    Krishnamoorthi, Shankarjee

    2013-01-01

    Cardiac arrhythmias are a leading cause of death worldwide. Notably, the electrophysiologiy and microstructural requirements for a fatal ventricular arrhythmia remain incompletely understood, thereby the treatment remains largely empirical. Standard antiarrhythmic drug therapy has failed to reduce, and in some instances has increased, the incidence of Sudden Cardiac Death (SCD). Hence, a more complete understanding of the mechanisms that foment a fatal arrhythmia is needed and computational m...

  18. Current trends in cardiac rehabilitation

    OpenAIRE

    Dafoe, W; Huston, P

    1997-01-01

    Cardiac rehabilitation can reduce mortality and morbidity for patients with many types of cardiac disease cost-effectively, yet is generally underutilized. Rehabilitation is helpful not only for patients who have had a myocardial infarction but also for those with stable angina or congestive heart failure or those who have undergone myocardial revascularization procedures, a heart transplant or heart valve surgery. The beneficial effects of rehabilitation include a reduction in the rate of de...

  19. An overview of cardiac morphogenesis.

    OpenAIRE

    Schleich, Jean-Marc; Abdulla, Tariq; Summers, Ron; Houyel, Lucile

    2013-01-01

    International audience Accurate knowledge of normal cardiac development is essential for properly understanding the morphogenesis of congenital cardiac malformations that represent the most common congenital anomaly in newborns. The heart is the first organ to function during embryonic development and is fully formed at 8 weeks of gestation. Recent studies stemming from molecular genetics have allowed specification of the role of cellular precursors in the field of heart development. In th...

  20. Echocardiography in evaluating right ventricular function of patients with sick sinus syndrome and atrioventricular delay with perianal abscesson under AAI and DDD pacing modes%病态窦房结综合征伴房室传导延迟AAI与DDD起搏模式右心功能的超声评价

    Institute of Scientific and Technical Information of China (English)

    陈晓栋; 许迪; 丁文波; 沈建平; 娄彬; 于圣永

    2012-01-01

    Objective To explore the right ventricular function of patients with sick sinus syndrome and atrioventricular delay under AAI and DDD pacing modes. Methods Thirty - five sick sinus syndrome combined with I degree atrioventricular block implantation of DDD patients with dual chamber pacemaker were included in the study. The program- controlled instrument was used to change the pacemaker to DDD mode first,and then to AAI mode. Echocardiography was employed to detect parameter changes of patients with two kinds of pacing mode. Results RVPEP RVPEP/RVET and Sm,Tei index of DDD pacing mode were significantly higher than those of AAI pacing mode (P<0. 05). The E/Em of DDD pacing mode was less than that of AAI pacing mode (P<0.05). Conclusion The right cardiac systolic and diastolic function of the patients with AV is better under the AAI mode pacing mode than under the DDD mode pacing mode.%目的 探讨AAI与DDD起搏模式下病态窦房结综合征伴房室传导阻滞患者的右心功能.方法 35例病态窦房结综合征伴Ⅰ度房室传导阻滞植入DDD双腔起搏器患者,先用程控仪将起搏器程控为DDD模式,最后程控为AAI模式.超声心动图检测患者2种起搏模式下的各参数变化情况.结果 DDD起搏模式下的RVPEP、RVPEP/RVET、Sm、Tei指数明显高于AAI起搏模式(P<0 05),E/Em低于AAI起搏模式(P<0.05).结论 AAI起搏模式右心的收缩和舒张功能均优于AV间期优化的DDD起搏模式.

  1. Physiological and pathological cardiac hypertrophy.

    Science.gov (United States)

    Shimizu, Ippei; Minamino, Tohru

    2016-08-01

    The heart must continuously pump blood to supply the body with oxygen and nutrients. To maintain the high energy consumption required by this role, the heart is equipped with multiple complex biological systems that allow adaptation to changes of systemic demand. The processes of growth (hypertrophy), angiogenesis, and metabolic plasticity are critically involved in maintenance of cardiac homeostasis. Cardiac hypertrophy is classified as physiological when it is associated with normal cardiac function or as pathological when associated with cardiac dysfunction. Physiological hypertrophy of the heart occurs in response to normal growth of children or during pregnancy, as well as in athletes. In contrast, pathological hypertrophy is induced by factors such as prolonged and abnormal hemodynamic stress, due to hypertension, myocardial infarction etc. Pathological hypertrophy is associated with fibrosis, capillary rarefaction, increased production of pro-inflammatory cytokines, and cellular dysfunction (impairment of signaling, suppression of autophagy, and abnormal cardiomyocyte/non-cardiomyocyte interactions), as well as undesirable epigenetic changes, with these complex responses leading to maladaptive cardiac remodeling and heart failure. This review describes the key molecules and cellular responses involved in physiological/pathological cardiac hypertrophy. PMID:27262674

  2. FGF21 and cardiac physiopathology

    Directory of Open Access Journals (Sweden)

    Anna ePlanavila

    2015-08-01

    Full Text Available The heart is not traditionally considered either a target or a site of fibroblast growth factor-21 (FGF21 production. However, recent findings indicate that FGF21 can act as a cardiomyokine; that is, it is produced by cardiac cells at significant levels and acts in an autocrine manner on the heart itself. The heart is sensitive to the effects of FGF21, both systemic and locally generated, owing to the expression in cardiomyocytes of β-Klotho, the key co-receptor known to confer specific responsiveness to FGF21 action. FGF21 has been demonstrated to protect against cardiac hypertrophy, cardiac inflammation, and oxidative stress. FGF21 expression in the heart is induced in response to cardiac insults, such as experimental cardiac hypertrophy and myocardial infarction in rodents, as well as in failing human hearts. Intracellular mechanisms involving PPARα and Sirt1 mediate transcriptional regulation of the FGF21 gene in response to exogenous stimuli. In humans, circulating FGF21 levels are elevated in coronary heart disease and atherosclerosis, and are associated with a higher risk of cardiovascular events in patients with type 2 diabetes. These findings provide new insights into the role of FGF21 in the heart and may offer potential therapeutic strategies for cardiac disease.

  3. [Stem cells and cardiac regeneration].

    Science.gov (United States)

    Perez Millan, Maria Ines; Lorenti, Alicia

    2006-01-01

    Stem cells are defined by virtue of their functional attributes: absence of tissue specific differentitated markers, capable of proliferation, able to self-maintain the population, able to produce a large number of differentiated, functional progeny, able to regenerate the tissue after injury. Cell therapy is an alternative for the treatment of several diseases, like cardiac diseases (cell cardiomyoplasty). A variety of stem cells could be used for cardiac repair: from cardiac and extracardiac sources. Each cell type has its own profile of advantages, limitations, and practicability issues in specific clinical settings. Differentiation of bone marrow stem cells to cardiomyocyte-like cells have been observed under different culture conditions. The presence of resident cardiac stem cell population capable of differentiation into cardiomyocyte or vascular lineage suggests that these cells could be used for cardiac tissue repair, and represent a great promise for clinical application. Stem cells mobilization by cytokines may also offer a strategy for cardiac regeneration. The use of stem cells (embryonic and adult) may hold the key to replacing cells lost in many devastating diseases. This potential benefit is a major focus for stem cell research.

  4. Cardiac Regeneration and Stem Cells.

    Science.gov (United States)

    Zhang, Yiqiang; Mignone, John; MacLellan, W Robb

    2015-10-01

    After decades of believing the heart loses the ability to regenerate soon after birth, numerous studies are now reporting that the adult heart may indeed be capable of regeneration, although the magnitude of new cardiac myocyte formation varies greatly. While this debate has energized the field of cardiac regeneration and led to a dramatic increase in our understanding of cardiac growth and repair, it has left much confusion in the field as to the prospects of regenerating the heart. Studies applying modern techniques of genetic lineage tracing and carbon-14 dating have begun to establish limits on the amount of endogenous regeneration after cardiac injury, but the underlying cellular mechanisms of this regeneration remained unclear. These same studies have also revealed an astonishing capacity for cardiac repair early in life that is largely lost with adult differentiation and maturation. Regardless, this renewed focus on cardiac regeneration as a therapeutic goal holds great promise as a novel strategy to address the leading cause of death in the developed world.

  5. Cardiac involvement in myotonic dystrophy

    DEFF Research Database (Denmark)

    Lund, Marie; Diaz, Lars Jorge; Ranthe, Mattis Flyvholm;

    2014-01-01

    genetic testing for DM1. Information on incident cardiac diseases was obtained from the NPR. We estimated standardized incidence ratios (SIRs) of cardiac disease compared with the background population, overall and according to selected diagnostic subgroups (cardiomyopathy, heart failure, conduction...... disorders, arrhythmias, and device implantation). In the DM cohort, SIR for any cardiac disease was 3.42 [95% confidence interval (CI) 3.01-3.86]; for a cardiac disease belonging to the selected subgroups 6.91 (95% CI: 5.93-8.01) and for other cardiac disease 2.59 (95% CI: 2.03-3.25). For a cardiac disease...... belonging to the selected subgroups, the risk was particularly high in the first year after DM diagnosis [SIR 15.4 (95% CI: 10.9-21.3)] but remained significantly elevated in subsequent years [SIR 6.07 (95% CI: 5.11-7.16]). The risk was higher in young cohort members [e.g. 20-39 years: SIR 18.1 (95% CI: 12...

  6. Cardiac imaging. A multimodality approach

    Energy Technology Data Exchange (ETDEWEB)

    Thelen, Manfred [Johannes Gutenberg University Hospital, Mainz (Germany); Erbel, Raimund [University Hospital Essen (Germany). Dept. of Cardiology; Kreitner, Karl-Friedrich [Johannes Gutenberg University Hospital, Mainz (Germany). Clinic and Polyclinic for Diagnostic and Interventional Radiology; Barkhausen, Joerg (eds.) [University Hospital Schleswig-Holstein, Luebeck (Germany). Dept. of Radiology and Nuclear Medicine

    2009-07-01

    An excellent atlas on modern diagnostic imaging of the heart Written by an interdisciplinary team of experts, Cardiac Imaging: A Multimodality Approach features an in-depth introduction to all current imaging modalities for the diagnostic assessment of the heart as well as a clinical overview of cardiac diseases and main indications for cardiac imaging. With a particular emphasis on CT and MRI, the first part of the atlas also covers conventional radiography, echocardiography, angiography and nuclear medicine imaging. Leading specialists demonstrate the latest advances in the field, and compare the strengths and weaknesses of each modality. The book's second part features clinical chapters on heart defects, endocarditis, coronary heart disease, cardiomyopathies, myocarditis, cardiac tumors, pericardial diseases, pulmonary vascular diseases, and diseases of the thoracic aorta. The authors address anatomy, pathophysiology, and clinical features, and evaluate the various diagnostic options. Key features: - Highly regarded experts in cardiology and radiology off er image-based teaching of the latest techniques - Readers learn how to decide which modality to use for which indication - Visually highlighted tables and essential points allow for easy navigation through the text - More than 600 outstanding images show up-to-date technology and current imaging protocols Cardiac Imaging: A Multimodality Approach is a must-have desk reference for cardiologists and radiologists in practice, as well as a study guide for residents in both fields. It will also appeal to cardiac surgeons, general practitioners, and medical physicists with a special interest in imaging of the heart. (orig.)

  7. The cardiac implantable electronic device power source: evolution and revolution.

    Science.gov (United States)

    Mond, Harry G; Freitag, Gary

    2014-12-01

    Although the first power source for an implantable pacemaker was a rechargeable nickel-cadmium battery, it was rapidly replaced by an unreliable short-life zinc-mercury cell. This sustained the small pacemaker industry until the early 1970s, when the lithium-iodine cell became the dominant power source for low voltage, microampere current, single- and dual-chamber pacemakers. By the early 2000s, a number of significant advances were occurring with pacemaker technology which necessitated that the power source should now provide milliampere current for data logging, telemetric communication, and programming, as well as powering more complicated pacing devices such as biventricular pacemakers, treatment or prevention of atrial tachyarrhythmias, and the integration of innovative physiologic sensors. Because the current delivery of the lithium-iodine battery was inadequate for these functions, other lithium anode chemistries that can provide medium power were introduced. These include lithium-carbon monofluoride, lithium-manganese dioxide, and lithium-silver vanadium oxide/carbon mono-fluoride hybrids. In the early 1980s, the first implantable defibrillators for high voltage therapy used a lithium-vanadium pentoxide battery. With the introduction of the implantable cardioverter defibrillator, the reliable lithium-silver vanadium oxide became the power source. More recently, because of the demands of biventricular pacing, data logging, and telemetry, lithium-manganese dioxide and the hybrid lithium-silver vanadium oxide/carbon mono-fluoride laminate have also been used. Today all cardiac implantable electronic devices are powered by lithium anode batteries. PMID:25387600

  8. Risk factors and the effect of cardiac resynchronization therapy on cardiac and non-cardiac mortality in MADIT-CRT

    DEFF Research Database (Denmark)

    Perkiomaki, Juha S; Ruwald, Anne-Christine; Kutyifa, Valentina;

    2015-01-01

    causes, 108 (63.9%) deemed cardiac, and 61 (36.1%) non-cardiac. In multivariate analysis, increased baseline creatinine was significantly associated with both cardiac and non-cardiac deaths [hazard ratio (HR) 2.97, P ...AIMS: To understand modes of death and factors associated with the risk for cardiac and non-cardiac deaths in patients with cardiac resynchronization therapy with implantable cardioverter-defibrillator (CRT-D) vs. implantable cardioverter-defibrillator (ICD) therapy, which may help clarify...... the action and limitations of cardiac resynchronization therapy (CRT) in relieving myocardial dysfunction. METHODS AND RESULTS: In Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy (MADIT-CRT), during 4 years of follow-up, 169 (9.3%) of 1820 patients died of known...

  9. Cardiac output during exercise

    DEFF Research Database (Denmark)

    Siebenmann, C; Rasmussen, P.; Sørensen, H.;

    2015-01-01

    Several techniques assessing cardiac output (Q) during exercise are available. The extent to which the measurements obtained from each respective technique compares to one another, however, is unclear. We quantified Q simultaneously using four methods: the Fick method with blood obtained from...... the right atrium (Q(Fick-M)), Innocor (inert gas rebreathing; Q(Inn)), Physioflow (impedance cardiography; Q(Phys)), and Nexfin (pulse contour analysis; Q(Pulse)) in 12 male subjects during incremental cycling exercise to exhaustion in normoxia and hypoxia (FiO2  = 12%). While all four methods reported...... a progressive increase in Q with exercise intensity, the slopes of the Q/oxygen uptake (VO2) relationship differed by up to 50% between methods in both normoxia [4.9 ± 0.3, 3.9 ± 0.2, 6.0 ± 0.4, 4.8 ± 0.2 L/min per L/min (mean ± SE) for Q(Fick-M), Q(Inn), QP hys and Q(Pulse), respectively; P = 0...

  10. Self-powered cardiac pacemaker enabled by flexible single crystalline PMN-PT piezoelectric energy harvester.

    Science.gov (United States)

    Hwang, Geon-Tae; Park, Hyewon; Lee, Jeong-Ho; Oh, SeKwon; Park, Kwi-Il; Byun, Myunghwan; Park, Hyelim; Ahn, Gun; Jeong, Chang Kyu; No, Kwangsoo; Kwon, HyukSang; Lee, Sang-Goo; Joung, Boyoung; Lee, Keon Jae

    2014-07-23

    A flexible single-crystalline PMN-PT piezoelectric energy harvester is demonstrated to achieve a self-powered artificial cardiac pacemaker. The energy-harvesting device generates a short-circuit current of 0.223 mA and an open-circuit voltage of 8.2 V, which are enough not only to meet the standard for charging commercial batteries but also for stimulating the heart without an external power source.

  11. Self-powered cardiac pacemaker enabled by flexible single crystalline PMN-PT piezoelectric energy harvester.

    Science.gov (United States)

    Hwang, Geon-Tae; Park, Hyewon; Lee, Jeong-Ho; Oh, SeKwon; Park, Kwi-Il; Byun, Myunghwan; Park, Hyelim; Ahn, Gun; Jeong, Chang Kyu; No, Kwangsoo; Kwon, HyukSang; Lee, Sang-Goo; Joung, Boyoung; Lee, Keon Jae

    2014-07-23

    A flexible single-crystalline PMN-PT piezoelectric energy harvester is demonstrated to achieve a self-powered artificial cardiac pacemaker. The energy-harvesting device generates a short-circuit current of 0.223 mA and an open-circuit voltage of 8.2 V, which are enough not only to meet the standard for charging commercial batteries but also for stimulating the heart without an external power source. PMID:24740465

  12. natural or artificial diets

    Directory of Open Access Journals (Sweden)

    A. O. Meyer-Willerer

    2005-01-01

    Full Text Available Se probaron alimentos artificiales y naturales con larva de camarón (Litopenaeus vannamei cultivados en diferentes recipientes. Estos fueron ocho frascos cónicos con 15L, ocho acuarios con 50L y como grupo control, seis tanques de fibra de vidrio con 1500L; todos con agua marina fresca y filtrada. La densidad inicial en todos los recipientes fue de 70 nauplios/L. Aquellos en frascos y acuarios recibieron ya sea dieta natural o artificial. El grupo control fue cultivado con dieta natural en los tanques grandes que utilizan los laboratorios para la producción masiva de postlarvas. El principal producto de excreción de larva de camarón es el ión amonio, que es tóxico cuando está presente en concentraciones elevadas. Se determinó diariamente con el método colorimétrico del indofenol. Los resultados muestran diferencias en la concentración del ión amonio y en la sobrevivencia de larvas entre las diferentes dietas y también entre los diferentes recipientes. En aquellos con volúmenes pequeños comparados con los grandes, se presentó mayor concentración de amonio (500 a 750µg/L, en aquellos con dietas naturales, debido a que este ión sirve de fertilizante a las algas adicionadas, necesitando efectuar recambios diarios de agua posteriores al noveno día de cultivo para mantener este ión a una concentración subletal. Se obtuvo una baja cosecha de postlarvas (menor a 15% con el alimento artificial larvario, debido a la presencia de protozoarios, alimentándose con el producto comercial precipitado en el fondo de los frascos o acuarios. Los acuarios con larvas alimentadas con dieta natural también mostraron concentraciones subletales de amonio al noveno día; sin embargo, la sobrevivencia fue cuatro veces mayor que con dietas artificiales. Los tanques control con dietas naturales presentaron tasas de sobrevivencia (70 ± 5% similares a la reportada por otros laboratorios.

  13. [Research and development of artificial retina material].

    Science.gov (United States)

    Hu, Ning; Yang, Jun; Peng, Chenglin; Wang, Xing; Zhang, Sijie; Zhang, Ying; Zheng, Erxin

    2008-04-01

    The application of artificial retina was introduced. The principal characteristics of artificial retina material were reviewed in particular. Moreover, the recent research development and application prospect were discussed.

  14. Bioengineering of Artificial Lymphoid Organs.

    Science.gov (United States)

    Nosenko, M A; Drutskaya, M S; Moisenovich, M M; Nedospasov, S A

    2016-01-01

    This review addresses the issue of bioengineering of artificial lymphoid organs.Progress in this field may help to better understand the nature of the structure-function relations that exist in immune organs. Artifical lymphoid organs may also be advantageous in the therapy or correction of immunodefficiencies, autoimmune diseases, and cancer. The structural organization, development, and function of lymphoid tissue are analyzed with a focus on the role of intercellular contacts and on the cytokine signaling pathways regulating these processes. We describe various polymeric materials, as scaffolds, for artificial tissue engineering. Finally, published studies in which artificial lymphoid organs were generated are reviewed and possible future directions in the field are discussed.

  15. Controlling activation site density by low-energy far-field stimulation in cardiac tissue

    Science.gov (United States)

    Hörning, Marcel; Takagi, Seiji; Yoshikawa, Kenichi

    2012-06-01

    Tachycardia and fibrillation are potentially fatal arrhythmias associated with the formation of rotating spiral waves in the heart. Presently, the termination of these types of arrhythmia is achieved by use of antitachycardia pacing or cardioversion. However, these techniques have serious drawbacks, in that they either have limited application or produce undesirable side effects. Low-energy far-field stimulation has recently been proposed as a superior therapy. This proposed therapeutic method would exploit the phenomenon in which the application of low-energy far-field shocks induces a large number of activation sites (“virtual electrodes”) in tissue. It has been found that the formation of such sites can lead to the termination of undesired states in the heart and the restoration of normal beating. In this study we investigate a particular aspect of this method. Here we seek to determine how the activation site density depends on the applied electric field through in vitro experiments carried out on neonatal rat cardiac tissue cultures. The results indicate that the activation site density increases exponentially as a function of the intracellular conductivity and the level of cell isotropy. Additionally, we report numerical results obtained from bidomain simulations of the Beeler-Reuter model that are quantitatively consistent with our experimental results. Also, we derive an intuitive analytical framework that describes the activation site density and provides useful information for determining the ratio of longitudinal to transverse conductivity in a cardiac tissue culture. The results obtained here should be useful in the development of an actual therapeutic method based on low-energy far-field pacing. In addition, they provide a deeper understanding of the intrinsic properties of cardiac cells.

  16. Artificial Immune Systems Tutorial

    CERN Document Server

    Aickelin, Uwe

    2008-01-01

    The biological immune system is a robust, complex, adaptive system that defends the body from foreign pathogens. It is able to categorize all cells (or molecules) within the body as self-cells or non-self cells. It does this with the help of a distributed task force that has the intelligence to take action from a local and also a global perspective using its network of chemical messengers for communication. There are two major branches of the immune system. The innate immune system is an unchanging mechanism that detects and destroys certain invading organisms, whilst the adaptive immune system responds to previously unknown foreign cells and builds a response to them that can remain in the body over a long period of time. This remarkable information processing biological system has caught the attention of computer science in recent years. A novel computational intelligence technique, inspired by immunology, has emerged, called Artificial Immune Systems. Several concepts from the immune have been extracted an...

  17. Artificial Immune Systems

    CERN Document Server

    Aickelin, Uwe

    2009-01-01

    The biological immune system is a robust, complex, adaptive system that defends the body from foreign pathogens. It is able to categorize all cells (or molecules) within the body as self-cells or non-self cells. It does this with the help of a distributed task force that has the intelligence to take action from a local and also a global perspective using its network of chemical messengers for communication. There are two major branches of the immune system. The innate immune system is an unchanging mechanism that detects and destroys certain invading organisms, whilst the adaptive immune system responds to previously unknown foreign cells and builds a response to them that can remain in the body over a long period of time. This remarkable information processing biological system has caught the attention of computer science in recent years. A novel computational intelligence technique, inspired by immunology, has emerged, called Artificial Immune Systems. Several concepts from the immune have been extracted an...

  18. Sequential biventricular pacing improves regional contractility, longitudinal function and dyssynchrony in patients with heart failure and prolonged QRS

    Directory of Open Access Journals (Sweden)

    Ring Margareta

    2010-04-01

    Full Text Available Abstract Aims Biventricular pacing (BiP is an effective treatment in systolic heart failure (HF patients with prolonged QRS. However, approximately 35% of the patients receiving BiP are classified as non-responders. The aim of this study is to evaluate the acute effects of VV-optimization on systolic heart function. Methods Twenty-one HF patients aged 72 (46-88 years, QRS 154 (120-190 ms, were studied with echocardiography, Tissue Doppler Imaging (TDI and 3D-echo the first day after receiving a BiP device. TDI was performed; during simultaneous pacing (LV-lead pacing 4 ms before the RV-lead and during sequential pacing (LV 20 and 40 ms before RV and RV 20 and 40 ms before LV-lead pacing. Systolic heart function was studied by tissue tracking (TT for longitudinal function and systolic maximal velocity (SMV for regional contractility and signs of dyssynchrony assessed by time-delays standard deviation of aortic valve opening to SMV, AVO-SMV/SD and tissue synchronization imaging (TSI. Results The TT mean value preoperatively was 4,2 ± 1,5 and increased at simultaneous pacing to 5,0 ± 1,2 mm (p Conclusions VV-optimization in the acute phase improves systolic heart function more than simultaneous BiP pacing. Long-term effects should be evaluated in prospective randomized trials.

  19. Patch in Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    Alireza Alizadeh Ghavidel

    2014-06-01

    Full Text Available Introduction: Excessive bleeding presents a risk for the patient in cardiovascular surgery. Local haemostatic agents are of great value to reduce bleeding and related complications. TachoSil (Nycomed, Linz, Austria is a sterile, haemostatic agent that consists of an equine collagen patchcoated with human fibrinogen and thrombin. This study evaluated the safety and efficacy of TachoSil compared to conventional technique.Methods: Forty-two patients scheduled for open heart surgeries, were entered to this study from August 2010 to May 2011. After primary haemostatic measures, patients divided in two groups based on surgeon’s judgment. Group A: 20 patients for whom TachoSil was applied and group B: 22 patients that conventional method using Surgicel (13 patients or wait and see method (9 cases, were performed in order to control the bleeding. In group A, 10 patients were male with mean age of 56.95±15.67 years and in group B, 9 cases were male with mean age of 49.95±14.41 years. In case group 70% (14/20 of the surgeries were redo surgeries versus 100% (22/22 in control group.Results: Baseline characteristics were similar in both groups. In TachoSil group 75% of patients required transfusion versus 90.90% in group B (P=0.03.Most transfusions consisted of packed red blood cell; 2±1.13 units in group A versus 3.11±1.44 in group B (P=0.01, however there were no significant differences between two groups regarding the mean total volume of intra and post-operative bleeding. Re-exploration was required in 10% in group A versus 13.63% in group B (P=0.67.Conclusion: TachoSil may act as a superior alternative in different types of cardiac surgery in order to control the bleeding and therefore reducing transfusion requirement.

  20. Cardiac output monitoring

    Directory of Open Access Journals (Sweden)

    Mathews Lailu

    2008-01-01

    Full Text Available Minimally invasive and non-invasive methods of estimation of cardiac output (CO were developed to overcome the limitations of invasive nature of pulmonary artery catheterization (PAC and direct Fick method used for the measurement of stroke volume (SV. The important minimally invasive techniques available are: oesophageal Doppler monitoring (ODM, the derivative Fick method (using partial carbon dioxide (CO 2 breathing, transpulmonary thermodilution, lithium indicator dilution, pulse contour and pulse power analysis. Impedance cardiography is probably the only non-invasive technique in true sense. It provides information about haemodynamic status without the risk, cost and skill associated with the other invasive or minimally invasive techniques. It is important to understand what is really being measured and what assumptions and calculations have been incorporated with respect to a monitoring device. Understanding the basic principles of the above techniques as well as their advantages and limitations may be useful. In addition, the clinical validation of new techniques is necessary to convince that these new tools provide reliable measurements. In this review the physics behind the working of ODM, partial CO 2 breathing, transpulmonary thermodilution and lithium dilution techniques are dealt with. The physical and the physiological aspects underlying the pulse contour and pulse power analyses, various pulse contour techniques, their development, advantages and limitations are also covered. The principle of thoracic bioimpedance along with computation of CO from changes in thoracic impedance is explained. The purpose of the review is to help us minimize the dogmatic nature of practice favouring one technique or the other.

  1. Brief time-based activity pacing instruction as a singular behavioral intervention was not effective in participants with symptomatic osteoarthritis.

    Science.gov (United States)

    Murphy, Susan L; Kratz, Anna L; Kidwell, Kelley; Lyden, Angela K; Geisser, Michael E; Williams, David A

    2016-07-01

    Osteoarthritis (OA) of the lower extremities is a prevalent cause of disability in which symptoms interfere with mobility and activity participation. Behavioral self-management for OA symptomatology is commonly recommended; but these interventions are underutilized, unstandardized in application, and at times, unavailable in the context of clinical care. For people with chronic pain, rehabilitation professionals may select to apply activity pacing instruction as one behavioral strategy to manage symptoms. Activity pacing is widely used in combination with other pharmacological and behavioral interventions but has not been studied as a singular behavioral intervention for people with OA. The purpose of this study was to evaluate the effectiveness of an occupational therapist-delivered, time-based activity pacing program for treatment of pain, fatigue, and physical function in people with symptomatic knee or hip OA. A 3-arm randomized controlled trial was conducted in which 193 people were randomized into tailored activity pacing, general activity pacing, or usual care arms. Assessments were done at 10 weeks and 6 months after baseline. Using linear mixed models, Western Ontario and McMaster Universities Osteoarthritis Index pain scores changed over time, decreasing the most in the general and usual care groups; only the usual care group had decreased pain over 6 months. The tailored and general activity pacing groups reported higher frequency of pacing behaviors than the usual care group at 10 weeks, but pacing was not sustained at 6 months. This trial does not support the use of time-based pacing as a singular behavioral strategy for people with knee or hip OA. PMID:26963847

  2. Computed tomography of cardiac pseudotumors and neoplasms.

    Science.gov (United States)

    Anavekar, Nandan S; Bonnichsen, Crystal R; Foley, Thomas A; Morris, Michael F; Martinez, Matthew W; Williamson, Eric E; Glockner, James F; Miller, Dylan V; Breen, Jerome F; Araoz, Philip A

    2010-07-01

    Important features of cardiac masses can be clearly delineated on cardiac computed tomography (CT) imaging. This modality is useful in identifying the presence of a mass, its relationship with cardiac and extracardiac structures, and the features that distinguish one type of mass from another. A multimodality approach to the evaluation of cardiac tumors is advocated, with the use of echocardiography, CT imaging and magnetic resonance imaging as appropriately indicated. In this article, various cardiac masses are described, including pseudotumors and true cardiac neoplasms, and the CT imaging findings that may be useful in distinguishing these rare entities are presented. PMID:20705174

  3. Towards Development of a 3-State Self-Paced Brain-Computer Interface

    Directory of Open Access Journals (Sweden)

    Ali Bashashati

    2007-01-01

    the presence of a right- or a left-hand movement and the second classifies the detected movement as a right or a left one. In an offline analysis of the EEG data collected from four able-bodied individuals, the 3-state brain-computer interface shows a comparable performance with a 2-state system and significant performance improvement if used as a 2-state BCI, that is, in detecting the presence of a right- or a left-hand movement (regardless of the type of movement. It has an average true positive rate of 37.5% and 42.8% (at false positives rate of 1% in detecting right- and left-hand extensions, respectively, in the context of a 3-state self-paced BCI and average detection rate of 58.1% (at false positive rate of 1% in the context of a 2-state self-paced BCI.

  4. Trame di Pace. Simboli, carte, azioni di un’utopia possibile. 1945-2003

    Directory of Open Access Journals (Sweden)

    Nadia Baiesi

    2014-06-01

    Full Text Available La mostra racconta la storia degli uomini e delle donne che hanno ragionato di pace non più come di una nobile speranza, ma come dell’unica chance di salvezza per l’umanità. La scansione cronologica, per decenni, parte dal 1945 e arriva al 2003 con la diffusione della bandiera arcobaleno in occasione della campagna «Pace da tutti i balconi», nata per scongiurare il secondo conflitto in Iraq. Al centro della mostra un percorso sui simboli che sono stati inventati, ripresi, risignificati in diversi contesti, movimenti radicali del pacifismo antimilitarista e nonviolento e movimenti contro singole guerre. Accompagnano i materiali iconografici (bandiere e manifesti originali, opere d’arte del maestro Anastasi, due percorsi documentari con immagini d’epoca, locandine, testi di decreti, opuscoli, volantini, articoli di quotidiani e riviste.

  5. Self-Paced E-Training in E-Learning for University Teaching Staff

    Directory of Open Access Journals (Sweden)

    Norah Ahmed Al-Malki

    2015-03-01

    Full Text Available The shift towards adopting e-training methods and practices in the workplace to equip staff with soft and hard skills have become an essential component of training in many Higher Education institutions. The aim of this paper is to advocate such a shift in Saudi universities through presenting the preliminary outcomes of a short-scale pilot study conducted by the Deanship of E-learning and Distance Education (DELDE during August 2014. Basically, the paper introduces the results of a first run of a self-paced e-training program focusing on introducing topics related to e-learning development and instruction. The paper 1 explores the pedagogical motivation for adopting the self-paced learning model, 2 outlines the elements of the developed course, and 3 discusses the results of the first run of the e-training program.

  6. Interaction Equivalency in Self-Paced Online Learning Environments: An Exploration of Learner Preferences

    Directory of Open Access Journals (Sweden)

    Jason F. Rhode

    2009-02-01

    Full Text Available This mixed methods study explored the dynamics of interaction within a self-paced online learning environment. It used rich media and a mix of traditional and emerging asynchronous computer-mediated communication tools to determine what forms of interaction learners in a self-paced online course value most and what impact they perceive interaction to have on their overall learning experience. This study demonstrated that depending on the specific circumstance, not all forms of interaction may be either equally valued by learners or effective. Participants differentiated among the various learning interactions available and indicated that informal interactions were as important as formal interactions in determining the quality of the online learning experience. Participants also reported the activity of blogging as being equally valued and in some ways superior to instructor-directed asynchronous discussion via the discussion board in a learning management system.

  7. Permanent pacing system malfunction due to hidden adjacent fractures of atrial and ventricular leads.

    Science.gov (United States)

    Wang, L; Davis, M J

    1997-03-01

    Periods of failure of ventricular pacing and atrial sensing were discovered on Holter recording in a 10-year-old boy 4 years after the implantation of a dual-chamber pacemaker with endocardial bipolar leads brought out through the right atrial wall. The old generator was explanted and the old leads tested. There was considerable atrial oversensing of an electrical artefact. The pacing threshold of ventricular lead was 1.8 V compared with 0.3 V 6 days post implantation. Post-operative lateral chest X-ray disclosed fractures of both atrial and ventricular leads at the approximate site of exit from the right atriotomy. Review of the preoperative lateral film showed that the fractures had been hidden by an ECG electrode.

  8. Pacing, packing and sex-based differences in Olympic and IAAF World Championship marathons.

    Science.gov (United States)

    Hanley, Brian

    2016-09-01

    The aim of this study was to describe pacing profiles and packing behaviours of athletes in Olympic and World Championship marathons. Finishing and split times were collated for 673 men and 549 women across nine competitions. The mean speeds for each intermediate 5 km and end 2.2 km segments were calculated. Medallists of both sexes maintained even-paced running from 10 km onwards whereas slower finishers dropped off the lead pack at approximately half-distance. Athletes who ran with the same opponents throughout slowed the least in the second half (P sex-based differences in tactics adopted and design training programmes accordingly. PMID:26736042

  9. BET 2: Diagnosing acute myocardial infarction in the presence of ventricular pacing: can Sgarbossa criteria help?

    Science.gov (United States)

    Jothieswaran, Arunan; Body, Richard

    2016-09-01

    The Sgarbossa criteria can be used to identify patients who have acute myocardial infarction (AMI) in the presence of left bundle branch block, which obscures the usual changes associated with ST elevation myocardial infarction. Patients with ventricular paced rhythm have ECG changes with similar morphology to left bundle branch block. A short-cut systematic review was carried out to establish whether the Sgarbossa criteria can accurately diagnose AMI in the presence of ventricular paced rhythm. Three studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line is that. PMID:27539980

  10. DiPALS: Diaphragm Pacing in patients with Amyotrophic Lateral Sclerosis - a randomised controlled trial.

    Science.gov (United States)

    McDermott, Christopher J; Bradburn, Mike J; Maguire, Chin; Cooper, Cindy L; Baird, Wendy O; Baxter, Susan K; Cohen, Judith; Cantrill, Hannah; Dixon, Simon; Ackroyd, Roger; Baudouin, Simon; Bentley, Andrew; Berrisford, Richard; Bianchi, Stephen; Bourke, Stephen C; Darlison, Roy; Ealing, John; Elliott, Mark; Fitzgerald, Patrick; Galloway, Simon; Hamdalla, Hisham; Hanemann, C Oliver; Hughes, Philip; Imam, Ibrahim; Karat, Dayalan; Leek, Roger; Maynard, Nick; Orrell, Richard W; Sarela, Abeezar; Stradling, John; Talbot, Kevin; Taylor, Lyn; Turner, Martin; Simonds, Anita K; Williams, Tim; Wedzicha, Wisia; Young, Carolyn; Shaw, Pamela J

    2016-01-01

    BACKGROUND Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease resulting in death, usually from respiratory failure, within 2-3 years of symptom onset. Non-invasive ventilation (NIV) is a treatment that when given to patients in respiratory failure leads to improved survival and quality of life. Diaphragm pacing (DP), using the NeuRx/4(®) diaphragm pacing system (DPS)™ (Synapse Biomedical, Oberlin, OH, USA), is a new technique that may offer additional or alternative benefits to patients with ALS who are in respiratory failure. OBJECTIVE The Diaphragm Pacing in patients with Amyotrophic Lateral Sclerosis (DiPALS) trial evaluated the effect of DP on survival over the study duration in patients with ALS with respiratory failure. DESIGN The DiPALS trial was a multicentre, parallel-group, open-label, randomised controlled trial incorporating health economic analyses and a qualitative longitudinal substudy. PARTICIPANTS Eligible participants had a diagnosis of ALS (ALS laboratory-supported probable, clinically probable or clinically definite according to the World Federation of Neurology revised El Escorial criteria), had been stabilised on riluzole for 30 days, were aged ≥ 18 years and were in respiratory failure. We planned to recruit 108 patients from seven UK-based specialist ALS or respiratory centres. Allocation was performed using 1 : 1 non-deterministic minimisation. INTERVENTIONS Participants were randomised to either standard care (NIV alone) or standard care (NIV) plus DP using the NeuRX/4 DPS. MAIN OUTCOME MEASURES The primary outcome was overall survival, defined as the time from randomisation to death from any cause. Secondary outcomes were patient quality of life [assessed by European Quality of Life-5 Dimensions, three levels (EQ-5D-3L), Short Form questionnaire-36 items and Sleep Apnoea Quality of Life Index questionnaire]; carer quality of life (EQ-5D-3L and Caregiver Burden Inventory); cost-utility analysis and health

  11. THE STUDY OF CLINICAL APPLICATION OF ARTIFICIAL HEART%人工心脏临床应用研究

    Institute of Scientific and Technical Information of China (English)

    陈国涵; 刘中民; 卢蓉; 郭建华; 范慧敏; 刘泳; 李高平; 施巍巍; 李健

    2002-01-01

    Objective:To summarize practical experiences of clinical application of artificial heart and discuss its indications and prevention of complications. Methods: Before operation, all the four patients underwent regular treatment of internal medicine, and after its failure they were implanted with artificial hearts. Operations were performed under general anesthesia and external circulation at low temperature. Left ventricle assistant devices (LVAD) were used for three patients, and double ventricle assistant device (DVAP) for one. Two patients were embeded with Berlin artificial hearts (Melipot company). The other two were implanted with Medos artificial hearts ( Medos company). Results:All the patients had no infection and haemorrhage, while their cardiac functions were restored apparently. Three to five days after operation, patients could take off- bed activities. Two had been taken away their artificial hearts on 52th and 53th postoperative day, and arrhythmia disappeared. Half year follow- up revealed favorable results. One died,on 271st day,of bleeding from congenital cerebrovascular deformity. One died, on 10th postoperative day, of renal dysfunction and DIC. Conclusion: Artificial heart or Ventricle assistant devices (VAD) could be used as temporary substitute for heart transplantation, and used in emergent heart attacks in order to restore cardiac function.

  12. Cardiac Penetrating Injuries and Pseudoaneurysm

    Institute of Scientific and Technical Information of China (English)

    CHEN Shifeng

    2002-01-01

    Objective To discuss the early diagnosis and treatment of cardiac penetrating injuries and pseudoaneurysm. Methods 18 cases of cardiac penetrating injuries, in which 2 cases were complicated with pseudoaneurysm, were diagnosed by emergency operation and color Doppler echocardiography between May 1973 and Dec. 2001 in our hospital. The basis for emergency operation is the injured path locating in cardiac dangerous zone, severe shock or pericardial tamponade. ResultsAmong 18 cases of this study, 17 cases underwent emergency operation. During the operation, 11 cases were found injured in right ventricle, 2 cases were found injured in right atrium, 1 case was found injured in pulmonary artery,4 cases were found injured in left ventricle, 2 cases were found complicated with pseudoaneurysm. 17cases underwent cardiac repair including 1 case of rupture of aneurysm. 1 case underwent elective aneurysm resection. In whole group, 15 cases survived(83.33% ), 3 cases died( 16.67%). The cause of death is mainly hemorrhagic shock. Conclusion Highly suspicious cardiac penetrating injuries or hemopericaridium should undergo direct operative exploration. Pseudoaneurysm should be resected early,which can prevent severe complications.

  13. Vitamin D and Cardiac Differentiation.

    Science.gov (United States)

    Kim, Irene M; Norris, Keith C; Artaza, Jorge N

    2016-01-01

    Calcitriol (1,25-dihydroxycholecalciferol or 1,25-D3) is the hormonally active metabolite of vitamin D. Experimental studies of vitamin D receptors and 1,25-D3 establish calcitriol to be a critical regulator of the structure and function of the heart. Clinical studies link vitamin D deficiency with cardiovascular disease (CVD). Emerging evidence demonstrates that calcitriol is highly involved in CVD-related signaling pathways, particularly the Wnt signaling pathway. Addition of 1,25-D3 to cardiomyocyte cells and examination of its effects on cardiomyocytes and mainly Wnt11 signaling allowed the specific characterization of the role of calcitriol in cardiac differentiation. 1,25-D3 is demonstrated to: (i) inhibit cell proliferation without promoting apoptosis; (ii) decrease expression of genes related to the regulation of the cell cycle; (iii) promote formation of cardiomyotubes; (iv) induce expression of casein kinase-1-α1, a negative regulator of the canonical Wnt signaling pathway; and (v) increase expression of noncanonical Wnt11, which has been recognized to induce cardiac differentiation during embryonic development and in adult cells. Thus, it appears that vitamin D promotes cardiac differentiation through negative modulation of the canonical Wnt signaling pathway and upregulation of noncanonical Wnt11 expression. Future work to elucidate the role(s) of vitamin D in cardiovascular disorders will hopefully lead to improvement and potentially prevention of CVD, including abnormal cardiac differentiation in settings such as postinfarction cardiac remodeling. PMID:26827957

  14. Cardiac factors in orthostatic hypotension

    Science.gov (United States)

    Löllgen, H.; Dirschedl, P.; Koppenhagen, K.; Klein, K. E.

    Cardiac function is determined by preload, afterload, heart rate and contractility. During orthostatic stress, the footward blood shift is compensated for by an increase of afterload. LBNP is widely used to analyze effects of volume displacement during orthostatic stress. Comparisons of invasive ( right heart catheterization) and non-invasive approach (echocardiography) yielded similar changes. Preload and afterload change with graded LBNP, heart rate increases, and stroke volume and cardiac output decrease. Thus, the working point on the left ventricular function curve is shifted to the left and downward, similar to hypovolemia. However, position on the Frank-Starling curve, the unchanged ejection fraction, and the constant Vcf indicate a normal contractile state during LBNP. A decrease of arterial oxygen partial pressure during LBNP shwos impaired ventilation/perfusion ratio. Finally, LBNP induced cardiac and hemodynamic changes can be effectively countermeasured by dihydroergotamine, a potent venoconstrictor. Comparison of floating catheter data with that of echocardiography resulted in close correlation for cardiac output and stroke volume. In addition, cardiac dimensions changed in a similar way during LBNP. From our findings, echocardiography as a non-invasive procedure can reliably used in LBNP and orthostatic stress tests. Some informations can be obtained on borderline values indicating collaps or orthostatic syncope. Early fainters can be differentiated from late fainters by stroke volume changes.

  15. Animal models of cardiac cachexia.

    Science.gov (United States)

    Molinari, Francesca; Malara, Natalia; Mollace, Vincenzo; Rosano, Giuseppe; Ferraro, Elisabetta

    2016-09-15

    Cachexia is the loss of body weight associated with several chronic diseases including chronic heart failure (CHF). The cachectic condition is mainly due to loss of skeletal muscle mass and adipose tissue depletion. The majority of experimental in vivo studies on cachexia rely on animal models of cancer cachexia while a reliable and appropriate model for cardiac cachexia has not yet been established. A critical issue in generating a cardiac cachexia model is that genetic modifications or pharmacological treatments impairing the heart functionality and used to obtain the heart failure model might likely impair the skeletal muscle, this also being a striated muscle and sharing with the myocardium several molecular and physiological mechanisms. On the other hand, often, the induction of heart damage in the several existing models of heart failure does not necessarily lead to skeletal muscle loss and cachexia. Here we describe the main features of cardiac cachexia and illustrate some animal models proposed for cardiac cachexia studies; they include the genetic calsequestrin and Dahl salt-sensitive models, the monocrotaline model and the surgical models obtained by left anterior descending (LAD) ligation, transverse aortic constriction (TAC) and ascending aortic banding. The availability of a specific animal model for cardiac cachexia is a crucial issue since, besides the common aspects of cachexia in the different syndromes, each disease has some peculiarities in its etiology and pathophysiology leading to cachexia. Such peculiarities need to be unraveled in order to find new targets for effective therapies. PMID:27317993

  16. Epicardial Lineages and Cardiac Repair

    Directory of Open Access Journals (Sweden)

    Manvendra K. Singh

    2013-08-01

    Full Text Available The death of cardiac myocytes resulting from myocardial infarction is a major cause of heart failure worldwide. Effective therapies for regenerating lost cardiac myocytes are lacking. Recently, the epicardium has been implicated as a source of inflammatory cytokines, growth factors and progenitor cells that modulate the response to myocardial injury. During embryonic development, epicardially-derived cells have the potential to differentiate into multiple cardiac lineages, including fibroblasts, vascular smooth muscle and potentially other cell types. In the healthy adult heart, epicardial cells are thought to be generally quiescent. However, injury of the adult heart results in reactivation of a developmental gene program in the epicardium, which leads to increased epicardial cell proliferation and differentiation of epicardium-derived cells (EPDCs into various cardiac lineages. Recent work suggests that epicardial reactivation after injury is accompanied by, and contributes to, a robust inflammatory response. In this review, we describe the current status of research related to epicardial biology in cardiac development and regeneration, highlighting important recent discoveries and ongoing controversies.

  17. Artificial Intelligence in Civil Engineering

    Directory of Open Access Journals (Sweden)

    Pengzhen Lu

    2012-01-01

    Full Text Available Artificial intelligence is a branch of computer science, involved in the research, design, and application of intelligent computer. Traditional methods for modeling and optimizing complex structure systems require huge amounts of computing resources, and artificial-intelligence-based solutions can often provide valuable alternatives for efficiently solving problems in the civil engineering. This paper summarizes recently developed methods and theories in the developing direction for applications of artificial intelligence in civil engineering, including evolutionary computation, neural networks, fuzzy systems, expert system, reasoning, classification, and learning, as well as others like chaos theory, cuckoo search, firefly algorithm, knowledge-based engineering, and simulated annealing. The main research trends are also pointed out in the end. The paper provides an overview of the advances of artificial intelligence applied in civil engineering.

  18. Artificial Life Meets Computational Creativity?

    OpenAIRE

    McMullin, Barry

    2009-01-01

    I (briefly) review the history of work in Artificial Life on the problem of the open-ended evolutionary growth of complexity in computational worlds. This is then put into the context of evolutionary epistemology and human creativity.

  19. Darwin, artificial selection, and poverty.

    Science.gov (United States)

    Sanchez, Luis

    2010-03-01

    This paper argues that the processes of evolutionary selection are becoming increasingly artificial, a trend that goes against the belief in a purely natural selection process claimed by Darwin's natural selection theory. Artificial selection is mentioned by Darwin, but it was ignored by Social Darwinists, and it is all but absent in neo-Darwinian thinking. This omission results in an underestimation of probable impacts of artificial selection upon assumed evolutionary processes, and has implications for the ideological uses of Darwin's language, particularly in relation to poverty and other social inequalities. The influence of artificial selection on genotypic and phenotypic adaptations arguably represents a substantial shift in the presumed path of evolution, a shift laden with both biological and political implications.

  20. Artificial Reefs and Ocean Dumping.

    Science.gov (United States)

    Glueck, Richard D.

    1983-01-01

    Activities and instructional strategies for two multigrade lessons are provided. Activity objectives include describing an artificial reef (such as a sunken ocean liner) as an ecosystem, knowing animal types in the ecosystem, and describing a food web. (JN)

  1. 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....

  2. Food analysis using artificial senses.

    Science.gov (United States)

    Śliwińska, Magdalena; Wiśniewska, Paulina; Dymerski, Tomasz; Namieśnik, Jacek; Wardencki, Waldemar

    2014-02-19

    Nowadays, consumers are paying great attention to the characteristics of food such as smell, taste, and appearance. This motivates scientists to imitate human senses using devices known as electronic senses. These include electronic noses, electronic tongues, and computer vision. Thanks to the utilization of various sensors and methods of signal analysis, artificial senses are widely applied in food analysis for process monitoring and determining the quality and authenticity of foods. This paper summarizes achievements in the field of artificial senses. It includes a brief history of these systems, descriptions of most commonly used sensors (conductometric, potentiometric, amperometic/voltammetric, impedimetric, colorimetric, piezoelectric), data analysis methods (for example, artificial neural network (ANN), principal component analysis (PCA), model CIE L*a*b*), and application of artificial senses to food analysis, in particular quality control, authenticity and falsification assessment, and monitoring of production processes.

  3. Induction of atrial fibrillation with rapid high voltage ventricular pacing for ventricular fibrillation conversion testing

    OpenAIRE

    Schuchert, A; Kuhl, M; Ruppel, R; Meinertz, T

    2000-01-01

    OBJECTIVE—To assess whether rapid high voltage ventricular pacing can also induce atrial fibrillation, and whether the induction of atrial fibrillation during ventricular fibrillation conversion testing is related to the patient's heart disease.
DESIGN—Prospective study of 50 patients who received the dual chamber implantable cardioverter-defibrillator (ICD) Ventak AV II DR (Guidant) as a first implant. This device can record atrial activity even during a ventricular fibrillation episode and ...

  4. PACE: Pattern Accurate Computationally Efficient Bootstrapping for Timely Discovery of Cyber-Security Concepts

    OpenAIRE

    McNeil, Nikki; Bridges, Robert A.; Iannacone, Michael D.; Czejdo, Bogdan; Perez, Nicolas; Goodall, John R.

    2013-01-01

    Public disclosure of important security information, such as knowledge of vulnerabilities or exploits, often occurs in blogs, tweets, mailing lists, and other online sources months before proper classification into structured databases. In order to facilitate timely discovery of such knowledge, we propose a novel semi-supervised learning algorithm, PACE, for identifying and classifying relevant entities in text sources. The main contribution of this paper is an enhancement of the traditional ...

  5. Managing after-work stress: paced breathing while watching video content (abstract)

    OpenAIRE

    Tijs, T.J.W.; Weda, J.; Weffers-Albu, M.A.; Hoogenstraaten, W.

    2011-01-01

    Objectives. After a hard day’s work, we need to recover from work stress. Two frequently reported activities to relieve stress are television (TV) watching and paced breathing exercises. We investigated the potential of combining these techniques. Method. Two explorativeexperiments were conducted. In both experiments, stress was measured through physiological monitoring (heart rate, blood pressure, skinconductance, peripheral temperature, and respiration) and the Stress Arousal Checklist [3]....

  6. Explaining the Slow Pace of Energy Technological Innovation: Why Market Conditions Matter

    OpenAIRE

    Jin, Wei; Zhang, ZhongXiang

    2014-01-01

    As a useful complement to numerous innovation policy studies from a normative perspective, this paper provides a positive framework to analyze the basic economic mechanism of energy technological innovation and explains its slow pace of technological progress. We find that the capital-intensiveness of energy technology is an inhibiting factor to catalyze market size effect and slows innovations and diffusions of energy technology in the market. We also show that the substantial homogeneity of...

  7. The impact of the perception of rhythmic music on self-paced oscillatory movements.

    Science.gov (United States)

    Peckel, Mathieu; Pozzo, Thierry; Bigand, Emmanuel

    2014-01-01

    Inspired by theories of perception-action coupling and embodied music cognition, we investigated how rhythmic music perception impacts self-paced oscillatory movements. In a pilot study, we examined the kinematic parameters of self-paced oscillatory movements, walking and finger tapping using optical motion capture. In accordance with biomechanical constraints accounts of motion, we found that movements followed a hierarchical organization depending on the proximal/distal characteristic of the limb used. Based on these findings, we were interested in knowing how and when the perception of rhythmic music could resonate with the motor system in the context of these constrained oscillatory movements. In order to test this, we conducted an experiment where participants performed four different effector-specific movements (lower leg, whole arm and forearm oscillation and finger tapping) while rhythmic music was playing in the background. Musical stimuli consisted of computer-generated MIDI musical pieces with a 4/4 metrical structure. The musical tempo of each song increased from 60 BPM to 120 BPM by 6 BPM increments. A specific tempo was maintained for 20 s before a 2 s transition to the higher tempo. The task of the participant was to maintain a comfortable pace for the four movements (self-paced) while not paying attention to the music. No instruction on whether to synchronize with the music was given. Results showed that participants were distinctively influenced by the background music depending on the movement used with the tapping task being consistently the most influenced. Furthermore, eight strategies put in place by participants to cope with the task were unveiled. Despite not instructed to do so, participants also occasionally synchronized with music. Results are discussed in terms of the link between perception and action (i.e., motor/perceptual resonance). In general, our results give support to the notion that rhythmic music is processed in a motoric

  8. The impact of the perception of rhythmic music on oscillatory self-paced movements

    Directory of Open Access Journals (Sweden)

    Mathieu ePeckel

    2014-09-01

    Full Text Available Inspired by theories of perception-action coupling and embodied music cognition, we investigated how rhythmic music perception impacts self-paced oscillatory movements. In a pilot study, we examined the kinematic parameters of self-paced oscillatory movements, walking and finger tapping using optical motion capture. In accordance with biomechanical constraints accounts of motion, we found that movements followed a hierarchical organization depending on the proximal/distal characteristic of the limb used. Based on these findings, we were interested in knowing how and when the perception of rhythmic music could resonate with the motor system in the context of these constrained oscillatory movements. In order to test this, we conducted an experiment where participants performed four different effector-specific movements (lower leg, whole arm and forearm oscillation and finger tapping while rhythmic music was playing in the background. Musical stimuli consisted of computer-generated MIDI musical pieces with a 4/4 metrical structure. The musical tempo of each song increased from 60 BPM to 120 BPM by 6 BPM increments. A specific tempo was maintained for 20s before a 2s transition to the higher tempo. The task of the participant was to maintain a comfortable pace for the four movements (self-paced while not paying attention to the music. No instruction on whether to synchronize with the music was given. Results showed that participants were distinctively influenced by the background music depending on the movement used with the tapping task being consistently the most influenced. Furthermore, eight strategies put in place by participants to cope with task were unveiled. Despite not instructed to do so, participants also occasionally synchronized with music. Results are discussed in terms of the link between perception and action (i.e. motor/perceptual resonance. In general, our results give support to the notion that rhythmic music is processed in a

  9. RETARDATION OF PACE OF LIFE AND RESOURCES TRANSFORMATION – SOME IMPLICATIONS OF CITIZENS

    OpenAIRE

    Joanna Kostecka

    2014-01-01

    The article attempts to explain the term retardation of pace of life and transforming natural resources, highlights the complexity of the concept and presents proposals for action for its dissemination. Retardation of resources transformation is an important tool for the implementation of the new approach on those environmental resources and services that are left. Environmental education that supports the implementation of retardation should use active methods of education and should be inte...

  10. Hemodynamic Surveillance of Ventricular Pacing Effectiveness with the Transvalvular Impedance Sensor

    OpenAIRE

    Valeria Calvi; Giovanni Pizzimenti; Marco Lisi; Giuseppe Doria; Ludovico Vasquez; Francesco Lisi; Salvatore Felis; Donatella Tempio; Alfredo Virgilio; Alberto Barbetta; Franco Di Gregorio

    2014-01-01

    The Transvalvular Impedance (TVI) is derived between atrial and ventricular pacing electrodes. A sharp TVI increase in systole is an ejection marker, allowing the hemodynamic surveillance of ventricular stimulation effectiveness in pacemaker patients. At routine follow-up checks, the ventricular threshold test was managed by the stimulator with the supervision of a physician, who monitored the surface ECG. When the energy scan resulted in capture loss, the TVI system must detect the failure a...

  11. Potential Effect of Physical Activity Calorie Equivalent (PACE) Labeling on Adult Fast Food Ordering and Exercise

    OpenAIRE

    Ray Antonelli; Viera, Anthony J.

    2015-01-01

    Introduction Numeric calorie content labels show limited efficacy in reducing the number of calories ordered from fast food meals. Physical activity calorie equivalent (PACE) labels are an alternative that may reduce the number of calories ordered in fast food meals while encouraging patrons to exercise. Methods A total of 1000 adults from 47 US states were randomly assigned via internet survey to one of four generic fast food menus: no label, calories only, calories + minutes, or calories + ...

  12. Artificial weathering of granite

    Directory of Open Access Journals (Sweden)

    Silva Hermo, B.

    2008-06-01

    Full Text Available This article summarizes a series of artificial weathering tests run on granite designed to: simulate the action of weathering agents on buildings and identify the underlying mechanisms, determine the salt resistance of different types of rock; evaluate consolidation and water-repellent treatment durability; and confirm hypotheses about the origin of salts such as gypsum that are often found in granite buildings. Salt crystallization tests were also conducted, using sodium chloride, sodium sulphate, calcium sulphate and seawater solutions. One of these tests was conducted in a chamber specifically designed to simulate salt spray weathering and another in an SO2 chamber to ascertain whether granite is subject to sulphation. The test results are analyzed and discussed, along with the shortcomings of each type of trial as a method for simulating the decay observed in monuments. The effect of factors such as wet-dry conditions, type of saline solution and the position of the planes of weakness on the type of decay is also addressed.En este trabajo se hace una síntesis de varios ensayos de alteración artificial realizados con rocas graníticas. Estos ensayos tenían distintos objetivos: reproducir las formas de alteración encontradas en los edificios para llegar a conocer los mecanismos que las generan, determinar la resistencia de las diferentes rocas a la acción de las sales, evaluar la durabilidad de tratamientos de consolidación e hidrofugación y constatar hipótesis acerca del origen de algunas sales, como el yeso, que aparecen frecuentemente en edificios graníticos. En los ensayos de cristalización de sales se utilizaron disoluciones de cloruro de sodio, sulfato de sodio, sulfato de calcio y agua de mar. Uno de estos ensayos se llevó a cabo en una cámara especialmente diseñada para reproducir la alteración por aerosol marino y otro se realizó en una cámara de SO2, con el objeto de comprobar si en rocas graníticas se puede producir

  13. Medical applications of artificial intelligence

    CERN Document Server

    Agah, Arvin

    2013-01-01

    Enhanced, more reliable, and better understood than in the past, artificial intelligence (AI) systems can make providing healthcare more accurate, affordable, accessible, consistent, and efficient. However, AI technologies have not been as well integrated into medicine as predicted. In order to succeed, medical and computational scientists must develop hybrid systems that can effectively and efficiently integrate the experience of medical care professionals with capabilities of AI systems. After providing a general overview of artificial intelligence concepts, tools, and techniques, Medical Ap

  14. Mechanical properties of artificial snow

    OpenAIRE

    Lintzén, Nina

    2013-01-01

    Mechanical properties of snow have been a subject of research since the mid-20th century. Theresearch done is based on natural snow. During the last decades the winter business industryhas been growing and also the interest for constructing buildings and artwork of snow. Suchconstructions are generally built using artificial snow, i.e. snow produced by snow guns. Up tothe present constructions of snow are designed based on knowledge by experience. Only minorscientific studies on artificial sn...

  15. What are artificial neural networks?

    DEFF Research Database (Denmark)

    Krogh, Anders

    2008-01-01

    Artificial neural networks have been applied to problems ranging from speech recognition to prediction of protein secondary structure, classification of cancers and gene prediction. How do they work and what might they be good for? Udgivelsesdato: 2008-Feb......Artificial neural networks have been applied to problems ranging from speech recognition to prediction of protein secondary structure, classification of cancers and gene prediction. How do they work and what might they be good for? Udgivelsesdato: 2008-Feb...

  16. The handbook of artificial intelligence

    CERN Document Server

    Barr, Avron

    1982-01-01

    The Handbook of Artificial Intelligence, Volume II focuses on the improvements in artificial intelligence (AI) and its increasing applications, including programming languages, intelligent CAI systems, and the employment of AI in medicine, science, and education. The book first elaborates on programming languages for AI research and applications-oriented AI research. Discussions cover scientific applications, teiresias, applications in chemistry, dependencies and assumptions, AI programming-language features, and LISP. The manuscript then examines applications-oriented AI research in medicine

  17. Effects of artificial gravity on the cardiovascular system: Computational approach

    Science.gov (United States)

    Diaz Artiles, Ana; Heldt, Thomas; Young, Laurence R.

    2016-09-01

    Artificial gravity has been suggested as a multisystem countermeasure against the negative effects of weightlessness. However, many questions regarding the appropriate configuration are still unanswered, including optimal g-level, angular velocity, gravity gradient, and exercise protocol. Mathematical models can provide unique insight into these questions, particularly when experimental data is very expensive or difficult to obtain. In this research effort, a cardiovascular lumped-parameter model is developed to simulate the short-term transient hemodynamic response to artificial gravity exposure combined with ergometer exercise, using a bicycle mounted on a short-radius centrifuge. The model is thoroughly described and preliminary simulations are conducted to show the model capabilities and potential applications. The model consists of 21 compartments (including systemic circulation, pulmonary circulation, and a cardiac model), and it also includes the rapid cardiovascular control systems (arterial baroreflex and cardiopulmonary reflex). In addition, the pressure gradient resulting from short-radius centrifugation is captured in the model using hydrostatic pressure sources located at each compartment. The model also includes the cardiovascular effects resulting from exercise such as the muscle pump effect. An initial set of artificial gravity simulations were implemented using the Massachusetts Institute of Technology (MIT) Compact-Radius Centrifuge (CRC) configuration. Three centripetal acceleration (artificial gravity) levels were chosen: 1 g, 1.2 g, and 1.4 g, referenced to the subject's feet. Each simulation lasted 15.5 minutes and included a baseline period, the spin-up process, the ergometer exercise period (5 minutes of ergometer exercise at 30 W with a simulated pedal cadence of 60 RPM), and the spin-down process. Results showed that the cardiovascular model is able to predict the cardiovascular dynamics during gravity changes, as well as the expected

  18. Spontaneous Velocity Effect of Musical Expression on Self-Paced Walking.

    Science.gov (United States)

    Buhmann, Jeska; Desmet, Frank; Moens, Bart; Van Dyck, Edith; Leman, Marc

    2016-01-01

    The expressive features of music can influence the velocity of walking. So far, studies used instructed (and intended) synchronization. But is this velocity effect still present with non-instructed (spontaneous) synchronization? To figure that out, participants were instructed to walk in their own comfort tempo on an indoor track, first in silence and then with tempo-matched music. We compared velocities of silence and music conditions. The results show that some music has an activating influence, increasing velocity and motivation, while other music has a relaxing influence, decreasing velocity and motivation. The influence of musical expression on the velocity of self-paced walking can be predicted with a regression model using only three sonic features explaining 56% of the variance. Phase-coherence between footfall and beat did not contribute to the velocity effect, due to its implied fixed pacing. The findings suggest that the velocity effect depends on vigor entrainment that influences both stride length and pacing. Our findings are relevant for preventing injuries, for gait improvement in walking rehabilitation, and for improving performance in sports activities. PMID:27167064

  19. Spontaneous Velocity Effect of Musical Expression on Self-Paced Walking.

    Directory of Open Access Journals (Sweden)

    Jeska Buhmann

    Full Text Available The expressive features of music can influence the velocity of walking. So far, studies used instructed (and intended synchronization. But is this velocity effect still present with non-instructed (spontaneous synchronization? To figure that out, participants were instructed to walk in their own comfort tempo on an indoor track, first in silence and then with tempo-matched music. We compared velocities of silence and music conditions. The results show that some music has an activating influence, increasing velocity and motivation, while other music has a relaxing influence, decreasing velocity and motivation. The influence of musical expression on the velocity of self-paced walking can be predicted with a regression model using only three sonic features explaining 56% of the variance. Phase-coherence between footfall and beat did not contribute to the velocity effect, due to its implied fixed pacing. The findings suggest that the velocity effect depends on vigor entrainment that influences both stride length and pacing. Our findings are relevant for preventing injuries, for gait improvement in walking rehabilitation, and for improving performance in sports activities.

  20. Migration of a retained temporary epicardial pacing wire into an abdominal aortic aneurysm.

    Science.gov (United States)

    Mukaihara, Kosuke; Yotsumoto, Goichi; Matsumoto, Kazuhisa; Imoto, Yutaka

    2015-07-01

    A 69-year old male was referred to our hospital for the treatment of coronary artery disease. Preoperative computed tomography (CT) revealed an abdominal aortic aneurysm (AAA) and a giant tumour of the left kidney. He underwent off-pump coronary artery bypass grafting (OPCAB) prior to aneurysmectomy and nephrectomy. Temporary epicardial pacing wires (TEPWs) were placed on the right atrium and right ventricle. The bipolar ventricular wire was removed and the unipolar atrial wire was cut flush with the skin surface on postoperative day 5. CT 7 days after the OPCAB procedure revealed a retained TEPW sutured to the right atrial wall. One month later, the patient underwent a repair of the AAA and left nephrectomy. We found that a TEPW had migrated inside the AAA intraoperatively. The retained TEPW was thus no longer observed on postoperative CT. Migration of the atrial pacing wire through the aortic lumen was suspected, although the detailed mechanism is unknown. This is the first reported case of a migrated temporary pacing wire into the aorta under noninfectious conditions. PMID:25173602