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Sample records for cardiac toxicity competing

  1. New insight into epirubicin cardiac toxicity: competing risks analysis of 1097 breast cancer patients

    DEFF Research Database (Denmark)

    Ryberg, Marianne; Cortese, Giuliana; Nielsen, Gitte;

    2008-01-01

    % confidence interval = 1.21 to 1.61), patient age, predisposition to cardiac disease, history of mediastinal irradiation, or antihormonal treatment for metastatic disease. Risk factors for death from all other causes (including breast cancer) included lesser dosages of epirubicin, increased tumor burden...... and death from all other causes as the competing event. All statistical tests were two-sided. RESULTS: A total of 11.4% of patients developed cardiotoxicity. Risk factors for cardiotoxicity included increased cumulative dose of epirubicin (hazard ratio per every 100 mg/m(2) administered = 1.40, 95...

  2. 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 ...

  3. Cardiac Toxicity after definitive Radiotherapy of locally advanced NSCLC

    DEFF Research Database (Denmark)

    Schytte, Tine; Hansen, Olfred; Stohlberg-Rohr, Thomine;

    2010-01-01

    report the heart toxicities in locally-regionally advanced NSCLC (LA-NSCLC) patients (pts) treated with RT in our centre.   Methods and material: From 01.01.1995-30.11.2007, 287 pts with LA-NSCLC (stage IIB-IIIB) were treated with RT at our centre with planned dose 60-66 Gy. All RT was applied as 3D RT......    Cardiac Toxicity after definitive Radiotherapy of locally advanced NSCLC Tine Schytte, Olfred Hansen, Thomine Stolberg-Rohr* and Carsten Brink*. Dept. Oncology and Radiophysic Lab.* Odense University Hospital, Denmark   Keyword: Radiotherapy, Locally advanced NSCLC, Cardiac toxicity...

  4. Hyperoxia toxicity after cardiac arrest: What is the evidence?

    OpenAIRE

    Llitjos, Jean-François; Mira, Jean-Paul; Duranteau, Jacques; Cariou, Alain

    2016-01-01

    This review gives an overview of current knowledge on hyperoxia pathophysiology and examines experimental and human evidence of hyperoxia effects after cardiac arrest. Oxygen plays a pivotal role in critical care management as a lifesaving therapy through the compensation of the imbalance between oxygen requirements and supply. However, growing evidence sustains the hypothesis of reactive oxygen species overproduction-mediated toxicity during hyperoxia, thus exacerbating organ failure by vari...

  5. Hyperoxia toxicity after cardiac arrest: What is the evidence?

    Science.gov (United States)

    Llitjos, Jean-François; Mira, Jean-Paul; Duranteau, Jacques; Cariou, Alain

    2016-12-01

    This review gives an overview of current knowledge on hyperoxia pathophysiology and examines experimental and human evidence of hyperoxia effects after cardiac arrest. Oxygen plays a pivotal role in critical care management as a lifesaving therapy through the compensation of the imbalance between oxygen requirements and supply. However, growing evidence sustains the hypothesis of reactive oxygen species overproduction-mediated toxicity during hyperoxia, thus exacerbating organ failure by various oxidative cellular injuries. In the cardiac arrest context, evidence of hyperoxia effects on outcome is fairly conflicting. Although prospective data are lacking, retrospective studies and meta-analysis suggest that hyperoxia could be associated with an increased mortality. However, data originate from retrospective, heterogeneous and inconsistent studies presenting various biases that are detailed in this review. Therefore, after an original and detailed analysis of all experimental and clinical studies, we herein provide new ideas and concepts that could participate to improve knowledge on oxygen toxicity and help in developing further prospective controlled randomized trials on this topic. Up to now, the strategy recommended by international guidelines on cardiac arrest (i.e., targeting an oxyhemoglobin saturation of 94-98 %) should be applied in order to avoid deleterious hypoxia and potent hyperoxia. PMID:27003426

  6. Is cardiac toxicity a relevant issue in the radiation treatment of esophageal cancer?

    NARCIS (Netherlands)

    Beukema, Jannet C; van Luijk, Peter; Widder, Joachim; Langendijk, Johannes A; Muijs, Christina T

    2015-01-01

    Purpose: In recent years several papers have been published on radiation-induced cardiac toxicity, especially in breast cancer patients. However, in esophageal cancer patients the radiation dose to the heart is usually markedly higher. To determine whether radiation-induced cardiac toxicity is also

  7. Radiation Therapy, Cardiac Risk Factors, and Cardiac Toxicity in Early-Stage Breast Cancer Patients

    International Nuclear Information System (INIS)

    Purpose: The benefits of adjuvant radiation therapy (RT) for breast cancer may be counterbalanced by the risk of cardiac toxicity. We studied the cardiac effects of RT and the impact of pre-existing cardiac risk factors (CRFs) in a population-based sample of older patients with breast cancer. Methods and Materials: In the Surveillance, Epidemiology and End-Results (SEER)-Medicare database of women ≥65 years diagnosed with Stages I to III breast cancer from January 1, 1992 to December 31, 2000, we used multivariable logistic regression to model the associations of demographic and clinical variables with postmastectomy and postlumpectomy RT. Using Cox proportional hazards regression, we then modeled the association between treatment and myocardial infarction (MI) and ischemia in the 10 or more years after diagnosis, taking the predictors of treatment into account. Results: Among 48,353 women with breast cancer; 19,897 (42%) were treated with lumpectomy and 26,534 (55%) with mastectomy; the remainder had unknown surgery type (3%). Receipt of RT was associated with later year of diagnosis, younger age, fewer comorbidities, nonrural residence, and chemotherapy. Postlumpectomy RT was also associated with white ethnicity and no prior history of heart disease (HD). The RT did not increase the risk of MI. Presence of MI was associated with age, African American ethnicity, advanced stage, nonrural residence, more than one comorbid condition, a hormone receptor-negative tumor, CRFs and HD. Among patients who received RT, tumor laterality was not associated with MI outcome. The effect of RT on the heart was not influenced by HD or CRFs. Conclusion: It appears unlikely that RT would increase the risk of MI in elderly women with breast cancer, regardless of type of surgery, tumor laterality, or history of CRFs or HD, for at least 10 years

  8. The profound effects of microcystin on cardiac antioxidant enzymes, mitochondrial function and cardiac toxicity in rat

    International Nuclear Information System (INIS)

    Deaths from microcystin toxication have widely been attributed to hypovolemic shock due to hepatic interstitial hemorrhage, while some recent studies suggest that cardiogenic complication is also involved. So far, information on cardiotoxic effects of MC has been rare and the underlying mechanism is still puzzling. The present study examined toxic effects of microcystins on heart muscle of rats intravenously injected with extracted MC at two doses, 0.16LD50 (14 μg MC-LReq kg-1 body weight) and 1LD50 (87 μg MC-LReq kg-1 body weight). In the dead rats, both TTC staining and maximum elevations of troponin I levels confirmed myocardial infarction after MC exposure, besides a serious interstitial hemorrhage in liver. In the 1LD50 dose group, the coincident falls in heart rate and blood pressure were related to mitochondria dysfunction in heart, while increases in creatine kinase and troponin I levels indicated cardiac cell injury. The corresponding pathological alterations were mainly characterized as loss of adherence between cardiac myocytes and swollen or ruptured mitochondria at the ultrastructural level. MC administration at a dose of 1LD50 not only enhanced activities and up-regulated mRNA transcription levels of antioxidant enzymes, but also increased GSH content. At both doses, level of lipid peroxides increased obviously, suggesting serious oxidative stress in mitochondria. Simultaneously, complex I and III were significantly inhibited, indicating blocks in electron flow along the mitochondrial respiratory chain in heart. In conclusion, the findings of this study implicate a role for MC-induced cardiotoxicity as a potential factor that should be considered when evaluating the mechanisms of death associated with microcystin intoxication in Brazil

  9. Comparative Toxicity of Different Crude Oils on the Cardiac Function of Marine Medaka (Oryzias melastigma Embryo

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    Zhendong Zhang

    2014-12-01

    Full Text Available The acute toxic effect of different crude oils (heavy crude oil and bonny light crude oil on embryos of marine medaka Oryzias melastigma was measured and evaluated by exposure to the water-accommodated fraction (WAF in the present study. The cardiac function of medaka embryos was used as target organ of ecotoxicological effect induced by oil exposure. Results showed that the developing marine medaka heart was a sensitive target organ to crude oil exposure the heavy crude oil WAF was more toxic to cardiac function of medaka embryos than bonny light cured oil one. Cardiac function of medaka embryos was clearly affected by exposure to heavy crude oil WAF after 24 hours exposure and showed a dose-dependent slowing of heart rate. Furthermore, swelled and enlarged heart morphology, lowered blood circulation and accumulation of blood cells around the heart area were found. However, the toxic effect of bonny light crude oil on cardiac function of medaka embryos was comparatively low. Statistical results showed that the cardiac function was only affected by highest bonny light crude oil WAF (9.8 mg/L exposure treatment. These findings indicated that cardiac function of marine medaka embryo was a good toxicity model for oil pollution and could be used to compare and evaluate the toxicity of different crude oils. The heart rate was an appropriate endpoint in the acute toxicity test.

  10. Cancer treatment-related cardiac toxicity: prevention, assessment and management.

    Science.gov (United States)

    Fanous, Ibrahim; Dillon, Patrick

    2016-08-01

    Cancer therapies, especially anthracyclines and monoclonal antibodies, have been linked with increased rates of cardiotoxicity. The development of some cardiac side effects happens over several months, and changes in ejection fraction can be detected long before permanent damage or disability occurs. Advanced heart failure could be averted with better and earlier detection. Methodologies for early detection of cardiac changes include stress echocardiograms, cardiac velocity measurements, radionuclide imaging, cardiac MRI and several potential biomarkers. Many agents have been described for prophylaxis of cardiac events precipitated by cancer therapy. Prophylactic use of beta-blockers and ACE inhibitors may be considered for use with trastuzumab in breast cancer as tolerated. Recovery of cardiac function is possible early after the injury from a cancer therapy. Late complications for coronary artery disease, hypertension and arrhythmia are underappreciated. Treatments for severe cancer therapy-related cardiac complications follow the existing paradigms for congestive heart failure and coronary artery disease, although outcomes for cancer patients differ from outcomes for non-cancer patients. PMID:27372782

  11. Comparative cardiac toxicity of anthracyclines in vitro and in vivo in the mouse.

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    Stefano Toldo

    Full Text Available PURPOSE: The antineoplastic efficacy of anthracyclines is limited by their cardiac toxicity. In this study, we evaluated the toxicity of doxorubicin, non-pegylated liposomal-delivered doxorubicin, and epirubicin in HL-1 adult cardiomyocytes in culture as well as in the mouse in vivo. METHODS: The cardiomyocytes were incubated with the three anthracyclines (1 µM to assess reactive oxygen generation, DNA damage and apoptotic cell death. CF-1 mice (10/group received doxorubicin, epirubicin or non-pegylated liposomal-doxorubicin (10 mg/kg and cardiac function was monitored by Doppler echocardiography to measure left ventricular ejection fraction (LVEF, heart rate (HR and cardiac output (CO both prior to and 10 days after drug treatment. RESULTS: In HL-1 cells, non-pegylated liposomal-doxorubicin generated significantly less reactive oxygen species (ROS, as well as less DNA damage and apoptosis activation when compared with doxorubicin and epirubicin. Cultured breast tumor cells showed similar sensitivity to the three anthracyclines. In the healthy mouse, non-pegylated liposomal doxorubicin showed a minimal and non-significant decrease in LVEF with no change in HR or CO, compared to doxorubicin and epirubicin. CONCLUSION: This study provides evidence for reduced cardiac toxicity of non-pegylated-liposomal doxorubicin characterized by attenuation of ROS generation, DNA damage and apoptosis in comparison to epirubicin and doxorubicin.

  12. NEURAL AND CARDIAC TOXICITIES ASSOCIATED WITH 3,4-METHYLENEDIOXYMETHAMPHETAMINE (MDMA)

    OpenAIRE

    Baumann, Michael H.; Rothman, Richard B.

    2009-01-01

    (±)-3,4-Methylenedioxymethamphetamine (MDMA) is a commonly abused illicit drug which affects multiple organ systems. In animals, high-dose administration of MDMA produces deficits in serotonin (5-HT) neurons (e.g., depletion of forebrain 5-HT) that have been viewed as neurotoxicity. Recent data implicate MDMA in the development of valvular heart disease (VHD). The present paper reviews several issues related to MDMA-associated neural and cardiac toxicities. The hypothesis of MDMA neurotoxicit...

  13. Predicted risks of radiogenic cardiac toxicity in two pediatric patients undergoing photon or proton radiotherapy

    International Nuclear Information System (INIS)

    Hodgkin disease (HD) and medulloblastoma (MB) are common malignancies found in children and young adults, and radiotherapy is part of the standard treatment. It was reported that these patients who received radiation therapy have an increased risk of cardiovascular late effects. We compared the predicted risk of developing radiogenic cardiac toxicity after photon versus proton radiotherapies for a pediatric patient with HD and a pediatric patient with MB. In the treatment plans, each patient’s heart was contoured in fine detail, including substructures of the pericardium and myocardium. Risk calculations took into account both therapeutic and stray radiation doses. We calculated the relative risk (RR) of cardiac toxicity using a linear risk model and the normal tissue complication probability (NTCP) values using relative seriality and Lyman models. Uncertainty analyses were also performed. The RR values of cardiac toxicity for the HD patient were 7.27 (proton) and 8.37 (photon), respectively; the RR values for the MB patient were 1.28 (proton) and 8.39 (photon), respectively. The predicted NTCP values for the HD patient were 2.17% (proton) and 2.67% (photon) for the myocardium, and were 2.11% (proton) and 1.92% (photon) for the whole heart. The predicted ratios of NTCP values (proton/photon) for the MB patient were much less than unity. Uncertainty analyses revealed that the predicted ratio of risk between proton and photon therapies was sensitive to uncertainties in the NTCP model parameters and the mean radiation weighting factor for neutrons, but was not sensitive to heart structure contours. The qualitative findings of the study were not sensitive to uncertainties in these factors. We conclude that proton and photon radiotherapies confer similar predicted risks of cardiac toxicity for the HD patient in this study, and that proton therapy reduced the predicted risk for the MB patient in this study

  14. In vitro epigenetic reprogramming of human cardiac mesenchymal stromal cells into functionally competent cardiovascular precursors.

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    Matteo Vecellio

    Full Text Available Adult human cardiac mesenchymal-like stromal cells (CStC represent a relatively accessible cell type useful for therapy. In this light, their conversion into cardiovascular precursors represents a potential successful strategy for cardiac repair. The aim of the present work was to reprogram CStC into functionally competent cardiovascular precursors using epigenetically active small molecules. CStC were exposed to low serum (5% FBS in the presence of 5 µM all-trans Retinoic Acid (ATRA, 5 µM Phenyl Butyrate (PB, and 200 µM diethylenetriamine/nitric oxide (DETA/NO, to create a novel epigenetically active cocktail (EpiC. Upon treatment the expression of markers typical of cardiac resident stem cells such as c-Kit and MDR-1 were up-regulated, together with the expression of a number of cardiovascular-associated genes including KDR, GATA6, Nkx2.5, GATA4, HCN4, NaV1.5, and α-MHC. In addition, profiling analysis revealed that a significant number of microRNA involved in cardiomyocyte biology and cell differentiation/proliferation, including miR 133a, 210 and 34a, were up-regulated. Remarkably, almost 45% of EpiC-treated cells exhibited a TTX-sensitive sodium current and, to a lower extent in a few cells, also the pacemaker I(f current. Mechanistically, the exposure to EpiC treatment introduced global histone modifications, characterized by increased levels of H3K4Me3 and H4K16Ac, as well as reduced H4K20Me3 and H3s10P, a pattern compatible with reduced proliferation and chromatin relaxation. Consistently, ChIP experiments performed with H3K4me3 or H3s10P histone modifications revealed the presence of a specific EpiC-dependent pattern in c-Kit, MDR-1, and Nkx2.5 promoter regions, possibly contributing to their modified expression. Taken together, these data indicate that CStC may be epigenetically reprogrammed to acquire molecular and biological properties associated with competent cardiovascular precursors.

  15. CARDIAC TOXICITY AFTER RADIATION THERAPY FOR 52 PATIENTS WITH MALIGNANT THYMIC TUMORS

    Institute of Scientific and Technical Information of China (English)

    孙艳; 韩树奎; 邓珊明

    2003-01-01

    Objective: To analyze the influencing factors for radiation-induced heart disease (RIHD) in a panel of cases with malignant thymic tumors treated by radiotherapy. Methods: 52 consecutive patients were treated by radiotherapy for malignant thymic tumor (14 at Masaoka stage II, 23 at stage III and 15 at stage IV). Treatment included radical (in 20), postoperative (in 14), preoperative (in 2) and palliative (in 16) radiotherapy. The conventional two-dimension (2D) radiation therapy was performed in forty-seven patients and three-dimension (3D) conformal radiation therapy has been used in 5 patients since October 2000. The total tumor dose ranged from 10 Gy to 84.5 Gy (median of 55 Gy). Chemotherapy was given in twenty-five patients before or after radiotherapy. The results of following-up could be obtained from the database and updated where appropriated. The dose volume histogram (DVH) of heart in radiotherapy for all patients was analyzed for the effective volume dose of heart. Result: The median following-up was 14 months (ranged from 0.6 to 111.3 months) in the study. RIHD was observed in seven patients. Cardiac toxicity of these seven patients were evaluated as SOMA grade 1-3. The median two-third effective volume dose of heart was 47.2 Gy (ranged from 8.3 Gy to 70.1 Gy) for conventional 2D radiotherapy, which correlated with thymic tumor dose (P<0.0001). The median two-third effective volume dose of heart was 35.3 Gy (ranged from 13 Gy to 38.7 Gy) for 3D conformal radiotherapy. The effective volume doses of heart were decreased by using 3D conformal radiotherapy (P=0.048). A significant association between cardiac toxicity and effective volume dose of heart was found in this study (P<0.0001). Cardiac toxicity accounted for 10.4% and 4.1% of patients receiving and not receiving adjuvant chemotherapy, respectively, and occurred earlier in radiochemotherapy group (P=0.0528). Multivariate analysis suggested that cardiac toxicity was significantly influenced by the

  16. Subchronic dermal exposure to T-2 toxin produces cardiac toxicity in experimental Wistar rats.

    Science.gov (United States)

    Chattopadhyay, Pronobesh; Islam, Johirul; Goyary, Danswrang; Agnihotri, Amit; Karmakar, Sanjev; Banerjee, Subham; Singh, Lokendra; Veer, Vijay

    2016-03-01

    Our study aimed to determine the cardiac toxicities of T-2 toxin, a representative mycotoxin that frequently contaminates maize, cereals, and other agricultural products, harvested and stored under damp and cold conditions. Dermal exposure to T-2 toxin caused severe cardiotoxicity in experimental Wistar rats. Electrocardiography studies showed the conduction abnormalities including prolongation of the QT and corrected QT interval, shortening of the PR interval, and tachycardia. Biochemical studies also reported the toxicity of T-2 toxin. T-2 toxin induced acute cardiotoxicity in rats and characterized by significant (p lactate dehydrogenase as compared to control rats. It is concluded that cardiotoxicity effects of T-2 toxin are thought to be due to direct action on electrocardiac potentials and biochemical changes. PMID:24193048

  17. Serum Biomarkers for the Detection of Cardiac Toxicity after Chemotherapy and Radiation Therapy in Breast Cancer Patients

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    Sibo eTian

    2014-10-01

    Full Text Available Multi-modality cancer treatments that include chemotherapy, radiation therapy, and targeted agents are highly effective therapies. Their use, especially in combination, is limited by the risk of significant cardiac toxicity. The current paradigm for minimizing cardiac morbidity, based on serial cardiac function monitoring, is suboptimal. An alternative approach based on biomarker testing, has emerged as a promising adjunct and a potential substitute to routine echocardiography. Biomarkers, most prominently cardiac troponins and natriuretic peptides, have been evaluated for their ability to describe the risk of potential cardiac dysfunction in clinically asymptomatic patients. Early rises in cardiac troponin concentrations have consistently predicted the risk and severity of significant cardiac events in patients treated with anthracycline-based chemotherapy. Biomarkers represent a novel, efficient, and robust clinical decision tool for the management of cancer therapy-induced cardiotoxicity. This article aims to review the clinical evidence that supports the use of established biomarkers such as cardiac troponins and natriuretic peptides, as well as emerging data on proposed biomarkers.

  18. Microelectrode array recordings of cardiac action potentials as a high throughput method to evaluate pesticide toxicity.

    Science.gov (United States)

    Natarajan, A; Molnar, P; Sieverdes, K; Jamshidi, A; Hickman, J J

    2006-04-01

    The threat of environmental pollution, biological warfare agent dissemination and new diseases in recent decades has increased research into cell-based biosensors. The creation of this class of sensors could specifically aid the detection of toxic chemicals and their effects in the environment, such as pyrethroid pesticides. Pyrethroids are synthetic pesticides that have been used increasingly over the last decade to replace other pesticides like DDT. In this study we used a high-throughput method to detect pyrethroids by using multielectrode extracellular recordings from cardiac cells. The data from this cell-electrode hybrid system was compared to published results obtained with patch-clamp electrophysiology and also used as an alternative method to further understand pyrethroid effects. Our biosensor consisted of a confluent monolayer of cardiac myocytes cultured on microelectrode arrays (MEA) composed of 60 substrate-integrated electrodes. Spontaneous activity of these beating cells produced extracellular field potentials in the range of 100 microV to nearly 1200 microV with a beating frequency of 0.5-4 Hz. All of the tested pyrethroids; alpha-Cypermethrin, Tetramethrin and Tefluthrin, produced similar changes in the electrophysiological properties of the cardiac myocytes, namely reduced beating frequency and amplitude. The sensitivity of our toxin detection method was comparable to earlier patch-clamp studies, which indicates that, in specific applications, high-throughput extracellular methods can replace single-cell studies. Moreover, the similar effect of all three pyrethroids on the measured parameters suggests, that not only detection of the toxins but, their classification might also be possible with this method. Overall our results support the idea that whole cell biosensors might be viable alternatives when compared to current toxin detection methods. PMID:16198528

  19. Catalytic inhibitors of topoisomerase II differently modulate the toxicity of anthracyclines in cardiac and cancer cells.

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    Anna Vavrova

    Full Text Available Anthracyclines (such as doxorubicin or daunorubicin are among the most effective anticancer drugs, but their usefulness is hampered by the risk of irreversible cardiotoxicity. Dexrazoxane (ICRF-187 is the only clinically approved cardioprotective agent against anthracycline cardiotoxicity. Its activity has traditionally been attributed to the iron-chelating effects of its metabolite with subsequent protection from oxidative stress. However, dexrazoxane is also a catalytic inhibitor of topoisomerase II (TOP2. Therefore, we examined whether dexrazoxane and two other TOP2 catalytic inhibitors, namely sobuzoxane (MST-16 and merbarone, protect cardiomyocytes from anthracycline toxicity and assessed their effects on anthracycline antineoplastic efficacy. Dexrazoxane and two other TOP2 inhibitors protected isolated neonatal rat cardiomyocytes against toxicity induced by both doxorubicin and daunorubicin. However, none of the TOP2 inhibitors significantly protected cardiomyocytes in a model of hydrogen peroxide-induced oxidative injury. In contrast, the catalytic inhibitors did not compromise the antiproliferative effects of the anthracyclines in the HL-60 leukemic cell line; instead, synergistic interactions were mostly observed. Additionally, anthracycline-induced caspase activation was differentially modulated by the TOP2 inhibitors in cardiac and cancer cells. Whereas dexrazoxane was upon hydrolysis able to significantly chelate intracellular labile iron ions, no such effect was noted for either sobuzoxane or merbarone. In conclusion, our data indicate that dexrazoxane may protect cardiomyocytes via its catalytic TOP2 inhibitory activity rather than iron-chelation activity. The differential expression and/or regulation of TOP2 isoforms in cardiac and cancer cells by catalytic inhibitors may be responsible for the selective modulation of anthracycline action observed.

  20. Cardiac comorbidity is an independent risk factor for radiation-induced lung toxicity in lung cancer patients

    International Nuclear Information System (INIS)

    Purpose: To test the hypothesis that cardiac comorbidity before the start of radiotherapy (RT) is associated with an increased risk of radiation-induced lung toxicity (RILT) in lung cancer patients. Material and methods: A retrospective analysis was performed of a prospective cohort of 259 patients with locoregional lung cancer treated with definitive radio(chemo)therapy between 2007 and 2011 (ClinicalTrials.gov Identifiers: NCT00572325 and NCT00573040). We defined RILT as dyspnea CTCv.3.0 grade ⩾2 within 6 months after RT, and cardiac comorbidity as a recorded treatment of a cardiac pathology at a cardiology department. Univariate and multivariate analyses, as well as external validation, were performed. The model-performance measure was the area under the receiver operating characteristic curve (AUC). Results: Prior to RT, 75/259 (28.9%) patients had cardiac comorbidity, 44% of whom (33/75) developed RILT. The odds ratio of developing RILT for patients with cardiac comorbidity was 2.58 (p < 0.01). The cross-validated AUC of a model with cardiac comorbidity, tumor location, forced expiratory volume in 1 s, sequential chemotherapy and pretreatment dyspnea score was 0.72 (p < 0.001) on the training set, and 0.67 (p < 0.001) on the validation set. Conclusion: Cardiac comorbidity is an important risk factor for developing RILT after definite radio(chemo)therapy of lung cancer patients

  1. Cardiac toxicity and radiation dose to the heart in definitive treated non-small cell lung cancer

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    Schytte, Tine; Hansen, Olfred (Dept. of Oncology, Odense Univ. Hospital, 5000 Odense C (Denmark)), E-mail: tine.schytte@dadlnet.dk; Stolberg-Rohr, Thomine; Brink, Carsten (Radiophysic Laboratory, Odense Univ. Hospital, 5000 Odense C (Denmark))

    2010-10-15

    In this retrospective analysis of a consecutive series of NSCLC patients treated with definitive radiotherapy, we did not find a correlation between high mean-dose to three different volumes of the heart (left ventricle, both ventricles or whole heart) and cardiac toxicity defined as having an cardiac event after radiotherapy start. This is not as shown in studies with other diseases treated with radiotherapy. Darby et al. recently published a review concerning radiation related heart disease. They reported a significantly worse survival beyond ten years for breast cancer patients receiving radiotherapy. Some studies reported mortality from heart disease increased by 27%. In Hodgkin lymphoma patients an increased risk value of three to five for cardiac morbidity in general compared to general population and relative risk of death from myocardial infarction compared with general population in range 2 to 4. There may be several possible reasons why we did not experience a significant toxicity despite the high doses we delivered to the heart compared with patients receiving RT for breast cancer and lymphoma. Only relative few NSCLC patients live long enough to experience cardiac disease either due to lung cancer itself or comorbidity as a competitive risk factor. In our study the five year survival was 15% leaving very few patients at risk for developing cardiac disease. Without long-term survivors cardiac toxicity does not seem to be a problem, and this suggests that we should aim to increase tumour control by administrating larger doses of radiotherapy to the tumour and/or by adding concurrent chemotherapy. However, the latter may increase the risk of cardiac toxicity by itself, and the results given in present study, may not be extrapolated to this situation. Another reason might be that if NSCLC patients develop dyspnoea, chest pain, etc. it is interpreted as being due to a relapse of lung cancer and not cardiac disease. There are several studies indicating that

  2. Selenium in the Prevention of Anthracycline-Induced Cardiac Toxicity in Children with Cancer

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    Nurdan Tacyildiz

    2012-01-01

    Full Text Available High cumulative doses of anthracyclines (300–500 mg/m2 used in the treatment of children with cancer may result in cardiotoxicity, a major long-term adverse effect that limits clinical usefulness of this class of chemotherapeutic agents. We assessed anthracycline-induced cardiotoxicity by measuring Pro-BNP levels and echocardiographic (ECHO findings and investigated potential protective effect of selenium (Se supplementation in a group of pediatric cancer patients. Plasma level of Pro-BNP was measured, and ECHO was performed in 67 patients (45 boys, 22 girls; ages 2–18 years; median age 12 years after they completed anthracycline-containing chemotherapy. Serum Se level was measured in 37 patients. Eleven patients had high Pro-BNP levels and/or cardiac failure with Pro-BNP levels of 10–8,022 pg/mL (median 226.3 pg/mL; laboratory normal level is less than 120 pg/mL. Serum Se levels were low (20–129 mcg/L, median 62 mcg/L in ten of these eleven patients. Eight of 10 patients with low Se and high Pro-BNP levels were supplemented with Se 100 mcg/day for a period of 4–33 months (median 6 months which resulted in improvement in Pro-BNP and/or ECHO findings. These results suggest that Se supplementation may have a role in protection against anthracycline-induced cardiac toxicity.

  3. Fluorescent Reporters in Human Pluripotent Stem Cells: Contributions to Cardiac Differentiation and Their Applications in Cardiac Disease and Toxicity

    NARCIS (Netherlands)

    Hartogh, den Sabine C.; Passier, Robert

    2016-01-01

    In the last decade, since the first report of induced pluripotent stem cells, the stem cell field has made remarkable progress in the differentiation to specialized cell-types of various tissues and organs, including the heart. Cardiac lineage- and tissue-specific human pluripotent stem cell (hPSC)

  4. Protective effects of piperine against copper-ascorbate induced toxic injury to goat cardiac mitochondria in vitro.

    Science.gov (United States)

    Dutta, Mousumi; Ghosh, Arnab Kumar; Mishra, Prachi; Jain, Garima; Rangari, Vinod; Chattopadhyay, Aindrila; Das, Tridib; Bhowmick, Debajit; Bandyopadhyay, Debasish

    2014-09-01

    Piperine, the main alkaloid of black pepper, Piper nigrum Linn., is an important Indian spice used in traditional food and medicine in India. In the present study, we investigated the antioxidant activities of piperine against copper-ascorbate induced toxic injury to mitochondria obtained from a goat heart, in vitro. Incubation of isolated cardiac mitochondria with copper-ascorbate resulted in elevated levels of lipid peroxidation and protein carbonylation of the mitochondrial membrane, a reduced level of mitochondrial GSH and altered status of antioxidant enzymes as well as decreased activities of pyruvate dehydrogenase and the Kreb's cycle enzymes, altered mitochondrial morphology, mitochondrial swelling, di-tyrosine level and mitochondrial DNA damage. All these changes were found to be ameliorated when the cardiac mitochondria were co-incubated with copper-ascorbate and piperine, in vitro. Piperine, in our in vitro experiments, was found to scavenge hydrogen peroxide, superoxide anion free radicals, hydroxyl radicals and DPPH radicals, in a chemically defined system, indicating that this compound may provide protection to cardiac mitochondria against copper-ascorbate induced toxic injury through its antioxidant activities. The results of this study suggest that piperine may be considered as a future therapeutic antioxidant and may be used singly or as a co-therapeutic in the treatment of diseases associated with mitochondrial oxidative stress.

  5. Differential toxicity of heterocyclic aromatic amines and their mixture in metabolically competent HepaRG cells

    International Nuclear Information System (INIS)

    Human exposure to heterocyclic aromatic amines (HAA) usually occurs through mixtures rather than individual compounds. However, the toxic effects and related mechanisms of co-exposure to HAA in humans remain unknown. We compared the effects of two of the most common HAA, 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP) and 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx), individually or in combination, in the metabolically competent human hepatoma HepaRG cells. Various endpoints were measured including cytotoxicity, apoptosis, oxidative stress and DNA damage by the comet assay. Moreover, the effects of PhIP and/or MeIQx on mRNA expression and activities of enzymes involved in their activation and detoxification pathways were evaluated. After a 24 h treatment, PhIP and MeIQx, individually and in combination, exerted differential effects on apoptosis, oxidative stress, DNA damage and cytochrome P450 (CYP) activities. Only PhIP induced DNA damage. It was also a stronger inducer of CYP1A1 and CYP1B1 expression and activity than MeIQx. In contrast, only MeIQx exposure resulted in a significant induction of CYP1A2 activity. The combination of PhIP with MeIQx induced an oxidative stress and showed synergistic effects on apoptosis. However, PhIP-induced genotoxicity was abolished by a co-exposure with MeIQx. Such an inhibitory effect could be explained by a significant decrease in CYP1A2 activity which is responsible for PhIP genotoxicity. Our findings highlight the need to investigate interactions between HAA when assessing risks for human health and provide new insights in the mechanisms of interaction between PhIP and MeIQx.

  6. Toxic interaction between fumonisin B1 and moniliformin for cardiac lesions in Japanese quail.

    Science.gov (United States)

    Sharma, Deepa; Asrani, R K; Ledoux, D R; Rottinghaus, G E; Gupta, V K

    2012-09-01

    This study examined the effects of fumonisin B1 (FB1) and moniliformin (M) on the heart of Japanese quail (Coturnix coturnix japonica). Three hundred and ninety day-old Japanese quail were randomly divided into four groups: 1) FB1 alone (FX), 2) M alone (MX), 3) FB1 and M (FM), and 4) chick mash alone (CX). We used three pen replicates of 35 quail per pen in groups FX, MX, and FM and three pen replicates of 25 quail per pen in group CX. Gross and microscopic changes in the heart were studied in nine birds (three birds per replicate) from each group at weekly intervals up to 28 days postfeeding (DPF). Ultrastructural changes were studied in the heart of three birds (one bird per replicate) from each group at 21 DPF. Thinning of the heart was the only significant gross lesion in group FX. In contrast, mild-to-severe cardiomegaly was a significant finding in groups MX and FM throughout the study. Microscopically, thinning of cardiomyocytes was evident at 7 DPF in group FX. In addition to the hypertrophy of cardiomyocytes evident as early as 7 DPF, myocardial karyomegaly, nuclear hyperchromasia, and myofibril disarray exhibiting a wavy pattern were more pronounced at 28 DPF in group MX. Similar but more severe lesions were observed in the FM combination group that included myocardial hemorrhages, vacuolar changes, hypertrophy of cardiomyocytes, focal myocarditis, and loss of myofibrils cross-striations. Via transmission electron microscopy, the maximum effect of FB1 toxicity was observed on mitochondria. In addition to an increase in the number of mitochondria, the mitochondria seemed invariably swollen and pleomorphic, although the outer membrane was intact, and the membrane cristae were usually distinct. Myofibrils seemed thinner, without much disruption in their architecture. Large numbers of vacuolar bodies of irregular size, both in the sarcoplasm and in between the myofibrils, were conspicuous in group FX. In contrast to group FX, the increase in number of

  7. Predictive Value of Beat-to-Beat QT Variability Index across the Continuum of Left Ventricular Dysfunction: Competing Risks of Non-cardiac or Cardiovascular Death, and Sudden or Non-Sudden Cardiac Death

    Science.gov (United States)

    Tereshchenko, Larisa G.; Cygankiewicz, Iwona; McNitt, Scott; Vazquez, Rafael; Bayes-Genis, Antoni; Han, Lichy; Sur, Sanjoli; Couderc, Jean-Philippe; Berger, Ronald D.; de Luna, Antoni Bayes; Zareba, Wojciech

    2012-01-01

    Background The goal of this study was to determine the predictive value of beat-to-beat QT variability in heart failure (HF) patients across the continuum of left ventricular dysfunction. Methods and Results Beat-to-beat QT variability index (QTVI), heart rate variance (LogHRV), normalized QT variance (QTVN), and coherence between heart rate variability and QT variability have been measured at rest during sinus rhythm in 533 participants of the Muerte Subita en Insuficiencia Cardiaca (MUSIC) HF study (mean age 63.1±11.7; males 70.6%; LVEF >35% in 254 [48%]) and in 181 healthy participants from the Intercity Digital Electrocardiogram Alliance (IDEAL) database. During a median of 3.7 years of follow-up, 116 patients died, 52 from sudden cardiac death (SCD). In multivariate competing risk analyses, the highest QTVI quartile was associated with cardiovascular death [hazard ratio (HR) 1.67(95%CI 1.14-2.47), P=0.009] and in particular with non-sudden cardiac death [HR 2.91(1.69-5.01), P<0.001]. Elevated QTVI separated 97.5% of healthy individuals from subjects at risk for cardiovascular [HR 1.57(1.04-2.35), P=0.031], and non-sudden cardiac death in multivariate competing risk model [HR 2.58(1.13-3.78), P=0.001]. No interaction between QTVI and LVEF was found. QTVI predicted neither non-cardiac death (P=0.546) nor SCD (P=0.945). Decreased heart rate variability (HRV) rather than increased QT variability was the reason for increased QTVI in this study. Conclusions Increased QTVI due to depressed HRV predicts cardiovascular mortality and non-sudden cardiac death, but neither SCD nor excracardiac mortality in HF across the continuum of left ventricular dysfunction. Abnormally augmented QTVI separates 97.5% of healthy individuals from HF patients at risk. PMID:22730411

  8. Caffeine Enhances the Calcium-Dependent Cardiac Mitochondrial Permeability Transition: Relevance for Caffeine Toxicity

    OpenAIRE

    Sardão, Vilma A; Oliveira, Paulo J; Moreno, António J. M.

    2002-01-01

    Caffeine (1,3,7-trimethylxanthine), a compound present in beverages such as tea and coffee, is known to be toxic at high concentrations. Some of the observed clinical conditions include cardiovascular disease and reproductive disorders, among others. The possible toxic effects of caffeine on heart mitochondria are still poorly understood. The influence of caffeine on the mitochondrial permeability transition has not been clarified so far. The objective of this study was to investigate whether...

  9. Terbufos-sulfone exacerbates cardiac lesions in diabetic rats: a sub-acute toxicity study.

    Science.gov (United States)

    Nurulain, Syed M; Shafiullah, Mohamed; Yasin, Javed; Adem, Abdu; Kaabi, Juma Al; Tariq, Saeed; Adeghate, Ernest; Ojha, Shreesh

    2016-06-01

    Organophosphorus compounds (OPCs) have a wide range of applications, from agriculture to warfare. Exposure to these brings forward a varied kind of health issues globally. Terbufos is one of the leading OPCs used worldwide. The present study investigates the cardiac effect of no observable dose of a metabolite of terbufos, terbufos-sulfone (TS), under non-diabetic and streptozotocin-induced diabetic condition. One hundred nanomoles per rat (1/20 of LD50) was administered intraperitoneally to adult male Wister rats daily for fifteen days. The left ventricle was collected for ultrastructural changes by transmission electron microscopy. The blood samples were collected for biochemical tests including RBC acetylcholinesterase, creatinine kinase (CK), lactate dehydrogenase (LDH), cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides, ALT, AST, and GGT. The study revealed about 10 % inhibition of RBC-AChE in two weeks of TS treatment in non-diabetic rats whereas RBC-AChE activity was significantly decreased in diabetic TS treated rats. CK, LDH, and triglycerides were significantly higher in diabetic TS treated rats. Electron microscopy of the heart showed derangement and lesions of the mitochondria of cardiomyocytes in the TS treated groups. The present study concludes that a non-lethal dose of TS causes cardiac lesions which exacerbate under diabetic condition. Biochemical tests confirmed the ultrastructural changes. It is concluded that a non-lethal dose of TS may be a risk factor for a cardiovascular disease, which may be fatal under diabetic condition. PMID:27331300

  10. Protective effect of oleanolic acid on oxidative injury and cellular abnormalities in doxorubicin induced cardiac toxicity in rats.

    Science.gov (United States)

    Goyal, Sameer N; Mahajan, Umesh B; Chandrayan, Govind; Kumawat, Vivek S; Kamble, Sarika; Patil, Pradip; Agrawal, Yogeeta O; Patil, Chandragouda R; Ojha, Shreesh

    2016-01-01

    The prevention of doxorubicin (Dox) induced cardiotoxicity may be co-operative to recover future Dox treatment. The aim of this study was to explore the cardioprotective effects of oleanolic acid (OA), an antioxidant agent, on Dox induced cardiotoxicity. OA is a triterpenoid compound, which exist widely in plant kingdom in free acid form or as a glycosidic triterpenoids saponins. Cardiotoxicity was induced in Wistar rats with single intravenous injection of doxorubicin at dose of 67.75 mg/kg i.v for 48 hrs. At 12 hrs of interval following Dox administration the cardioprotective effect of OA (1.5 mg/kg, i.v.) and Amifostine (AMF) (90 mg/kg i.v., single dose prior 30 min) were evaluated. Induction of cardiotoxicity was confirmed by increase in systolic, diastolic, mean arterial pressures, maximal positive rate of developed left ventricular pressure (+LVdP/dtmax, an indicator of myocardial contraction), maximal negative rate of developed left ventricular pressure (-LVdP/dtmax, a meter of myocardial relaxation) and an increase in left ventricular end-diastolic pressure (LVEDP, a marker of pre-load). Cardiac markers in such as CK-MB, LDH and alterations in ECG. Dox administration showed alteration in Biochemical parameters and endogenous antioxidants. Administration of OA Showed maximal protection against Dox induced cardiac toxicity as observed by reduction in blood pressure, prevention of left ventricular function and attenuation of biochemical and antioxidant parameters. Based on the findings, its concluded that OA can be used as an adjuvant with Dox therapy in treating cancers. PMID:27069540

  11. Pred-hERG: A Novel web-Accessible Computational Tool for Predicting Cardiac Toxicity.

    Science.gov (United States)

    Braga, Rodolpho C; Alves, Vinicius M; Silva, Meryck F B; Muratov, Eugene; Fourches, Denis; Lião, Luciano M; Tropsha, Alexander; Andrade, Carolina H

    2015-10-01

    The blockage of the hERG K(+) channels is closely associated with lethal cardiac arrhythmia. The notorious ligand promiscuity of this channel earmarked hERG as one of the most important antitargets to be considered in early stages of drug development process. Herein we report on the development of an innovative and freely accessible web server for early identification of putative hERG blockers and non-blockers in chemical libraries. We have collected the largest publicly available curated hERG dataset of 5,984 compounds. We succeed in developing robust and externally predictive binary (CCR≈0.8) and multiclass models (accuracy≈0.7). These models are available as a web-service freely available for public at http://labmol.farmacia.ufg.br/predherg/. Three following outcomes are available for the users: prediction by binary model, prediction by multi-class model, and the probability maps of atomic contribution. The Pred-hERG will be continuously updated and upgraded as new information became available. PMID:27490970

  12. Surface-patterned SU-8 cantilever arrays for preliminary screening of cardiac toxicity.

    Science.gov (United States)

    Kim, Jong Yun; Choi, Young-Soo; Lee, Bong-Kee; Lee, Dong-Weon

    2016-06-15

    Arrays of a μgrooved SU-8 cantilever were utilized to analyze changes in the contraction force and beating frequency of cardiomyocytes in vitro. The longitudinally patterned μgrooves facilitates alignment of cardiomyocytes on top of the SU-8 cantilever, which increases the contraction force of cardiomyocytes by a factor of about 2.5. The bending displacement of the SU-8 cantilever was precisely measured in nanoscale using a laser-based measurement system combined with a motorized xyz stage. The cantilever displacement due to contraction of the cardiomyocytes showed the maximum on day 8 after their cultivation. Following preliminary experiments, Isoproterenol, Verapamil, and Astemizole were used to investigate the effect of drug toxicity on the physiology of cardiomyocytes. The experimental results indicated that 1 µM of Isoproterenol treatment increased contraction force and beating frequencies of cardiomyocytes by 30% and 200%, respectively, whereas 500 nM of Verapamil treatment decreased contraction force and beating frequencies of cardiomyocytes by 56% and 42%, respectively. A concentration of less than 5 nM of the hERG channel suppression drug Astemizole did not change the contraction forces in the displacement but slightly decreased the beating frequencies. However, irregular or abnormal heartbeats were observed at Astemizole concentrations of 5 nM and higher. We experimentally conformed that the proposed SU-8 cantilever arrays combined with the laser-based measurement systems has the great potential for a high-throughput drug toxicity screening system in future. PMID:26878482

  13. Can Stress Echocardiography Compete with Perfusion Scintigraphy in the Detection of Coronary Artery Disease and Cardiac Risk Assessment?

    NARCIS (Netherlands)

    M.L. Geleijnse (Marcel); A. Elhendy (Abdou)

    2000-01-01

    textabstractAims: The aim of this review was to define the place of stress echocardiography in the context of perfusion scintigraphy for the detection of coronary artery disease (CAD) and the assessment of cardiac risk. Stress echocardiography has the benefits of widespread availability, relatively

  14. Can Stress Echocardiography Compete with Perfusion Scintigraphy in the Detection of Coronary Artery Disease and Cardiac Risk Assessment?

    OpenAIRE

    Geleijnse, Marcel; Elhendy, Abdou

    2000-01-01

    textabstractAims: The aim of this review was to define the place of stress echocardiography in the context of perfusion scintigraphy for the detection of coronary artery disease (CAD) and the assessment of cardiac risk. Stress echocardiography has the benefits of widespread availability, relatively low cost, portability, absence of radiation, and the determination of the ischaemic threshold. However, the echocardiographic windows are variable, sometimes with poor echogenicity, and interpretat...

  15. Human breast tumor cells are more resistant to cardiac glycoside toxicity than non-tumorigenic breast cells.

    Directory of Open Access Journals (Sweden)

    Rebecca J Clifford

    Full Text Available Cardiotonic steroids (CTS, specific inhibitors of Na,K-ATPase activity, have been widely used for treating cardiac insufficiency. Recent studies suggest that low levels of endogenous CTS do not inhibit Na,K-ATPase activity but play a role in regulating blood pressure, inducing cellular kinase activity, and promoting cell viability. Higher CTS concentrations inhibit Na,K-ATPase activity and can induce reactive oxygen species, growth arrest, and cell death. CTS are being considered as potential novel therapies in cancer treatment, as they have been shown to limit tumor cell growth. However, there is a lack of information on the relative toxicity of tumor cells and comparable non-tumor cells. We have investigated the effects of CTS compounds, ouabain, digitoxin, and bufalin, on cell growth and survival in cell lines exhibiting the full spectrum of non-cancerous to malignant phenotypes. We show that CTS inhibit membrane Na,K-ATPase activity equally well in all cell lines tested regardless of metastatic potential. In contrast, the cellular responses to the drugs are different in non-tumor and tumor cells. Ouabain causes greater inhibition of proliferation and more extensive apoptosis in non-tumor breast cells compared to malignant or oncogene-transfected cells. In tumor cells, the effects of ouabain are accompanied by activation of anti-apoptotic ERK1/2. However, ERK1/2 or Src inhibition does not sensitize tumor cells to CTS cytotoxicity, suggesting that other mechanisms provide protection to the tumor cells. Reduced CTS-sensitivity in breast tumor cells compared to non-tumor cells indicates that CTS are not good candidates as cancer therapies.

  16. Prediction of drug-related cardiac adverse effects in humans--B: use of QSAR programs for early detection of drug-induced cardiac toxicities.

    Science.gov (United States)

    Frid, Anna A; Matthews, Edwin J

    2010-04-01

    This report describes the use of three quantitative structure-activity relationship (QSAR) programs to predict drug-related cardiac adverse effects (AEs), BioEpisteme, MC4PC, and Leadscope Predictive Data Miner. QSAR models were constructed for 9 cardiac AE clusters affecting Purkinje nerve fibers (arrhythmia, bradycardia, conduction disorder, electrocardiogram, palpitations, QT prolongation, rate rhythm composite, tachycardia, and Torsades de pointes) and 5 clusters affecting the heart muscle (coronary artery disorders, heart failure, myocardial disorders, myocardial infarction, and valve disorders). The models were based on a database of post-marketing AEs linked to 1632 chemical structures, and identical training data sets were configured for three QSAR programs. Model performance was optimized and shown to be affected by the ratio of the number of active to inactive drugs. Results revealed that the three programs were complementary and predictive performances using any single positive, consensus two positives, or consensus three positives were as follows, respectively: 70.7%, 91.7%, and 98.0% specificity; 74.7%, 47.2%, and 21.0% sensitivity; and 138.2, 206.3, and 144.2 chi(2). In addition, a prospective study using AE data from the U.S. Food and Drug Administration's (FDA's) MedWatch Program showed 82.4% specificity and 94.3% sensitivity. Furthermore, an external validation study of 18 drugs with serious cardiotoxicity not considered in the models had 88.9% sensitivity. PMID:19941924

  17. Efficacy and toxicity of replication-competent adenovirus-mediated double suicide gene therapy in combination with radiation therapy in an orthotopic mouse prostate cancer model

    International Nuclear Information System (INIS)

    Purpose: The purpose of this study was to evaluate the efficacy and toxicity of replication-competent adenovirus-mediated double suicide gene therapy in an adjuvant setting with external beam radiation therapy (EBRT) in an experimental prostate cancer model in preparation for a Phase I clinical study in humans. Methods: For efficacy studies, i.m. DU145 and intraprostatic LNCaP C4-2 tumors were established in immune-deficient mice. Tumors were injected with the lytic, replication-competent Ad5-CD/TKrep adenovirus containing a cytosine deaminase (CD)/herpes simplex virus thymidine kinase (HSV-1 TK) fusion gene. Two days later, mice were administered 1 week of 5-fluorocytosine + ganciclovir (GCV) prodrug therapy and fractionated doses of EBRT (trimodal therapy). Tumor control rate of trimodal therapy was compared to that of EBRT alone. For toxicology studies, immune-competent male mice received a single intraprostatic injection (1010 vp) of the replication-competent Ad5-CD/TKrep adenovirus. Two days later, mice were administered 4 weeks of 5-fluorocytosine + GCV prodrug therapy and 56 Gy EBRT to the pelvic region. The toxicity of trimodal therapy was assessed by histopathologic analysis of major organs and clinical chemistries. Results: In both the i.m. DU145 and intraprostatic LNCaP C4-2 tumor models, trimodal therapy significantly improved primary tumor control beyond that of EBRT alone. In the DU145 model, trimodal therapy resulted in a tumor growth delay (70 days) that was more than twice that (32 days) of EBRT alone. Whereas EBRT failed to eradicate DU145 tumors, trimodal therapy resulted in 25% tumor cure. In the LNCaP C4-2 tumor model, EBRT slowed the growth of intraprostatic tumors, but resulted in no tumor cures, and 57% of the mice developed retroperitoneal lymph node metastases at 3 months. By contrast, trimodal therapy resulted in 44% tumor cure and reduced significantly the percentage (13%) of lymph node metastases relative to EBRT alone. Overall

  18. Cardiac toxicity of 5-ring polycyclic aromatic hydrocarbons is differentially dependent on the aryl hydrocarbon receptor 2 isoform during zebrafish development

    Energy Technology Data Exchange (ETDEWEB)

    Incardona, John P., E-mail: john.incardona@noaa.gov; Linbo, Tiffany L.; Scholz, Nathaniel L.

    2011-12-15

    Petroleum-derived compounds, including polycyclic aromatic hydrocarbons (PAHs), commonly occur as complex mixtures in the environment. Recent studies using the zebrafish experimental model have shown that PAHs are toxic to the embryonic cardiovascular system, and that the severity and nature of this developmental cardiotoxicity varies by individual PAH. In the present study we characterize the toxicity of the relatively higher molecular weight 5-ring PAHs benzo[a]pyrene (BaP), benzo[e]pyrene (BeP), and benzo[k]fluoranthene (BkF). While all three compounds target the cardiovascular system, the underlying role of the ligand-activated aryl hydrocarbon receptor (AHR2) and the tissue-specific induction of the cytochrome p450 metabolic pathway (CYP1A) were distinct for each. BaP exposure (40 {mu}M) produced AHR2-dependent bradycardia, pericardial edema, and myocardial CYP1A immunofluorescence. By contrast, BkF exposure (4-40 {mu}M) caused more severe pericardial edema, looping defects, and erythrocyte regurgitation through the atrioventricular valve that were AHR2-independent (i.e., absent myocardial or endocardial CYP1A induction). Lastly, exposure to BeP (40 {mu}M) yielded a low level of CYP1A+ signal in the vascular endothelium of the head and trunk, without evident toxic effects on cardiac function or morphogenesis. Combined with earlier work on 3- and 4-ring PAHs, our findings provide a more complete picture of how individual PAHs may drive the cardiotoxicity of mixtures in which they predominate. This will improve toxic injury assessments and risk assessments for wild fish populations that spawn in habitats altered by overlapping petroleum-related human impacts such as oil spills, urban stormwater runoff, or sediments contaminated by legacy industrial activities. -- Highlights: Black-Right-Pointing-Pointer PAH compounds with 5 rings in different arrangements caused differential tissue-specific patterns of CYP1A induction in zebrafish embryos. Black

  19. Fructose-1, 6-diphosphate (FDP as a novel antidote for yellow oleander-induced cardiac toxicity: A randomized controlled double blind study

    Directory of Open Access Journals (Sweden)

    Dawson Andrew H

    2010-06-01

    Full Text Available Abstract Background Cardiac toxicity due to ingestion of oleander plant seeds in Sri Lanka and some other South Asian countries is very common. At present symptomatic oleander seed poisoning carries a mortality of 10% in Sri Lanka and treatment of yellow oleander poisoning is limited to gastric decontamination and atropine administration. The only proven effective antidote is digoxin antibodies but these are not available for routine use because of the high cost. The main objective of this study is to investigate the effectiveness of a new and inexpensive antidote for patients with life threatening arrhythmias due oleander poisoning. Method/design We set up a randomised double blind clinical trial to assess the effectiveness of Fructose 1, 6 diphosphate (FDP in acute yellow oleander poisoning patients admitted to the adult medical wards of a tertiary hospital in Sri Lanka. Patients will be initially resuscitated following the national guidelines and eligible patients will be randomised to receive either FDP or an equal amount of normal saline. The primary outcome measure for this study is the sustained reversion to sinus rhythm with a heart rate greater than 50/min within 2 hours of completion of FDP/placebo bolus. Secondary outcomes include death, reversal of hyperkalaemia on the 6, 12, 18 and 24 hour samples and maintenance of sinus rhythm on the holter monitor. Analysis will be on intention-to-treat. Discussion This trial will provide information on the effectiveness of FDP in yellow oleander poisoning. If FDP is effective in cardiac glycoside toxicity, it would provide substantial benefit to the patients in rural Asia. The drug is inexpensive and thus could be made available at primary care hospitals if proven to be effective. Trial Registration Current Controlled trial ISRCTN71018309

  20. 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.

  1. Competence is Competence

    DEFF Research Database (Denmark)

    Bramming, Pia

    2004-01-01

    The article will address competence, its' diffusion, application, and the consequence of this application within the field of Human Resource Management (HRM). The concept competence-in-practice will be presented and in conclusion the article will consider implications and possibilities...... of competence-in-practice as an alternative approach to Competence Development within Human Resource Management....

  2. SU-E-T-62: Cardiac Toxicity in Dynamic Conformal Arc Therapy, Intensity-Modulated Radiation Therapy and Volumetric Modulated Arc Therapy of Lung Cancers

    Energy Technology Data Exchange (ETDEWEB)

    Ming, X; Zhang, Y [Tianjin University, Tianjin (China); Yale University, New Haven, CT, US (United States); Feng, Y [Tianjin University, Tianjin (China); Zhou, L [West China Hospital, Sichuan (China); Yale University, New Haven, CT, US (United States); Deng, J [Yale University, New Haven, CT, US (United States)

    2014-06-01

    Purpose: The cardiac toxicity for lung cancer patients, each treated with dynamic conformal arc therapy (DAT), intensity-modulated radiation therapy (IMRT), or volumetric modulated arc therapy (VMAT) is investigated. Methods: 120 lung patients were selected for this study: 25 treated with DAT, 50 with IMRT and 45 with VMAT. For comparison, all plans were generated in the same treatment planning system, normalized such that the 100% isodose lines encompassed 95% of planning target volume. The plan quality was evaluated in terms of homogeneity index (HI) and 95% conformity index (%95 CI) for target dose coverage and mean dose, maximum dose, V{sub 30} Gy as well as V{sub 5} Gy for cardiac toxicity analysis. Results: When all the plans were analyzed, the VMAT plans offered the best target coverage with 95% CI = 0.992 and HI = 1.23. The DAT plans provided the best heart sparing with mean heart dose = 2.3Gy and maximum dose = 11.6Gy, as compared to 5.7 Gy and 31.1 Gy by IMRT as well as 4.6 Gy and 30.9 Gy by VMAT. The mean V30Gy and V5Gy of the heart in the DAT plans were up to 11.7% lower in comparison to the IMRT and VMAT plans. When the tumor volume was considered, the VMAT plans spared up to 70.9% more doses to the heart when the equivalent diameter of the tumor was larger than 4cm. Yet the maximum dose to the heart was reduced the most in the DAT plans with up to 139.8% less than that of the other two plans. Conclusion: Overall, the VMAT plans achieved the best target coverage among the three treatment modalities, and would spare the heart the most for the larger tumors. The DAT plans appeared advantageous in delivering the least maximum dose to the heart as compared to the IMRT and VMAT plans.

  3. A preliminary experimental study on the cardiac toxicity of glutamate and the role of α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor in rats

    Institute of Scientific and Technical Information of China (English)

    LIU Yan; ZHOU Lan; XU Hai-fei; YAN Li; DING Fan; HAO Wei; CAO Ji-min

    2013-01-01

    Background Monosodium L-glutamate (MSG) is a food flavour enhancer and its potential harmfulness to the heart remains controversial.We investigated whether MSG could induce cardiac arrhythmias and apoptosis via the α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor.Methods Myocardial infarction (MI) was created by ligating the coronary artery and ventricular arrhythmias were monitored by electrocardiogram in the rat in vivo.Neonatal rat cardiomyocytes were isolated and cultured.Cell viability was estimated by 3-(4,5)-dimethylthiahiazo(-z-yl)-3,5-di-phenytetrazoliumromide (MTT) assay.Calcium mobilization was monitored by confocal microscopy.Cardiomyocyte apoptosis was evaluated by acridine orange staining,flow cytometry,DNA laddering,reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting.Results MSG (i.v.) decreased the heart rate at 0.5 g/kg and serious bradycardia at 1.5 g/kg,but could not induce ventricular tachyarrhythmias in normal rats in vivo.In rats with acute MI in vivo,however,MSG (1.5 g/kg,i.v.) induced ventricular tachyarrhythmias and these arrhythmias could be prevented by blocking the AMPA and N-methyl-d-aspartate (NMDA) receptors.Selectively activating the AMPA or NMDA receptor induced ventricular tachyarrhythmias in MI rats.At the cellular level,AMPA induced calcium mobilization,oxidative stress,mitochondrial dysfunction and apoptosis in cultured cardiomyocytes,especially when the AMPA receptor desensitization were blocked by cyclothiazide.The above toxic cellular effects of AMPA were abolished by AMPA receptor blockade or by H2O2 scavengers.Conclusions MSG induces bradycardia in normal rats,but triggers lethal tachyarrhythmias in myocardial infarcted rats probably by hindering AMPA receptors.AMPA receptor overstimulation also induces cardiomyocyte apoptosis,which may facilitate arrhythmia.

  4. Competence articulation:

    DEFF Research Database (Denmark)

    Larsen, Simon Bo; Bardram, Jakob

    2008-01-01

    . In particular, we want to look at the dynamic quality of competences, and investigate how competence is mutually developed in coordinated work. We have termed this process competence articulation, a concept which tries to emphasize competence as well as social development of competence as part of cooperation...... communication options for competence articulation, which again improve collaboration and thus the quality of the treatment....

  5. On-chip constructive cell-network study (II: on-chip quasi-in vivo cardiac toxicity assay for ventricular tachycardia/fibrillation measurement using ring-shaped closed circuit microelectrode with lined-up cardiomyocyte cell network

    Directory of Open Access Journals (Sweden)

    Yasuda Kenji

    2011-09-01

    Full Text Available Abstract Backgrounds Conventional in vitro approach using human ether-a-go-go related gene (hERG assay has been considered worldwide as the first screening assay for cardiac repolarization safety. However, it does not always oredict the potential QT prolongation risk or pro-arrhythmic risk correctly. For adaptable preclinical strategiesto evaluate global cardiac safety, an on-chip quasi-in vivo cardiac toxicity assay for lethal arrhythmia (ventricular tachyarrhythmia measurement using ring-shaped closed circuit microelectrode chip has been developed. Results The ventricular electrocardiogram (ECG-like field potential data, which includes both the repolarization and the conductance abnormality, was acquired from the self-convolutied extracellular field potentials (FPs of a lined-up cardiomyocyte network on a circle-shaped microelectrode in an agarose microchamber. When Astemisol applied to the closed-loop cardiomyocyte network, self-convoluted FP profile of normal beating changed into an early afterdepolarization (EAD like waveform, and then showed ventricular tachyarrhythmias and ventricular fibrilations (VT/Vf. QT-prolongation-like self-convoluted FP duration prolongation and its fluctuation increase was also observed according to the increase of Astemizole concentration. Conclusions The results indicate that the convoluted FPs of the quasi-in vivo cell network assay includes both of the repolarization data and the conductance abnormality of cardiomyocyte networks has the strong potential to prediction lethal arrhythmia.

  6. Cardiac glycosides induced toxicity in human cells expressing α1-, α2-, or α3-isoforms of Na-K-ATPase.

    Science.gov (United States)

    Cherniavsky Lev, Marina; Karlish, Steven J D; Garty, Haim

    2015-07-15

    The Na+-K+-ATPase is specifically inhibited by cardiac glycosides, some of which may also function as endogenous mammalian hormones. Previous studies using Xenopus oocytes, yeast cells, or purified isoforms demonstrated that affinities of various cardiac glycosides for three isoforms of the Na+-K+-ATPase (α1-α3β1) may differ, a finding with potential clinical implication. The present study investigates isoform selectivity and effects of cardiac glycosides on cultured mammalian cells under more physiological conditions. H1299 cells (non-small cell lung carcinoma) were engineered to express only one α-isoform (α1, α2, or α3) by combining stable transfection of isoforms and silencing endogenous α1. Cardiac glycoside binding was measured by displacement of bound 3H-ouabain. The experiments confirm moderate α1/α3:α2 selectivity of ouabain, moderate α2:α1 selectivity of digoxin, and enhanced α2:α1 selectivity of synthetic derivatives (Katz A, Tal DM, Heller D, Haviv H, Rabah B, Barkana Y, Marcovich AL, Karlish SJD. J Biol Chem 289: 21153-21162, 2014). Relative α2:α1 selectivity of digoxin vs. ouabain was also manifested by enhanced internalization of α2 in response to digoxin. Cellular proliferation assays of H1299 cells confirmed the patterns of α2:α1 selectivity for ouabain, digoxin, and a synthetic derivative and reveal a crucial role of surface pump density on sensitivity to cardiac glycosides. Because cardiac glycosides are being considered as drugs for treatment of cancer, effects of ouabain on proliferation of 12 cancer and noncancer cell lines, with variable plasma membrane expression of α1, have been tested. These demonstrated that sensitivity to ouabain indeed depends linearly on the plasma membrane surface density of Na+-K+-ATPase irrespective of status, malignant or nonmalignant. PMID:25994790

  7. AAOHN Competencies.

    Science.gov (United States)

    2015-11-01

    The AAOHN Competency document is one of the core documents that define occupational health nursing practice. This article provides a description of the process used to update the competencies, as well as a description of the new competencies. PMID:26419544

  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. Oral treatment with the herbal formula B307 alleviates cardiac toxicity in doxorubicin-treated mice via suppressing oxidative stress, inflammation, and apoptosis

    Directory of Open Access Journals (Sweden)

    Lien CY

    2015-05-01

    Full Text Available Chia-Ying Lien,1 Tai-Yuan Chuang,1 Chih-Hsiang Hsu,2 Ching-Lung Lin,2 Sheue-Er Wang,2 Shuenn-Jyi Sheu,3 Chiang-Ting Chien,2 Chung-Hsin Wu2 1Department of Athletics, National Taiwan University, Taipei, Taiwan; 2Department of Life Science, National Taiwan Normal University, Taipei, Taiwan; 3Brion Research Institute of Taiwan, New Taipei City, Taiwan Objective: This study aimed to investigate whether the herbal formula B307 could alleviate doxorubicin (DOX-induced acute cardiotoxicity. If so, we further unraveled possible molecular mechanisms of cardiac protection under treatment with the herbal formula B307. Methods: Before the animal experiment, we examined relative viabilities of Huh7 cancer cells under treatment with the herbal formula B307. To test whether oral treatment with the herbal formula B307 could alleviate cardiotoxicity, equal volumes of B307 (50 mg/kg or saline (sham treatment were administered to 20-week-old male mice once daily for 14 consecutive days. Then, DOX (10 mg/kg; ip was administered to male mice under B307 and sham treatments at 22–23 weeks of age. Cardiac functions in these mice were assessed via echocardiography at 23–24 weeks of age. Then, expressions of oxidative stress, inflammation, and apoptosis-related proteins were examined in the heart tissue by immunohistochemistry and Western blotting at 24–25 weeks of age. Apart from this, mortality rate and body weight were measured during the experiment.Results: In vitro, the relative viabilities of Huh7 cancer cells under treatment with the herbal formula B307 had shown no obvious change at doses of 10–160 ng/mL. Furthermore, the relative viabilities of Huh7 cancer cells were significantly reduced under DOX treatment but showed no significant change under DOX only and DOX plus B307 treatment. In vivo, the mortality rate, body weight, and cardiac function of DOX-treated mice were obviously improved under oral treatment with the herbal formula B307. Furthermore

  10. Mathematical Competences

    DEFF Research Database (Denmark)

    Westphael, Henning; Mogensen, Arne

    2013-01-01

    In this article we present the notion of Mathematical competences as a tool to describe the mathematically gifted students.......In this article we present the notion of Mathematical competences as a tool to describe the mathematically gifted students....

  11. Managerial Competencies

    OpenAIRE

    Vopelková, Lenka

    2011-01-01

    Managerial competencies are crucially important for the prosperity of the company. The subject of this work is to identify the competencies necessary for successful performance of assigned duties of the managerial position. The chapter called Literature Review deals with the managerial competencies as described in literature. It is very important for the success of the company, how much attention is paid to the selection of its managers and used competency models and whether they are used ...

  12. Novel Toll-like receptor-4 deficiency attenuates trastuzumab (Herceptin induced cardiac injury in mice

    Directory of Open Access Journals (Sweden)

    Yousif Nasser

    2011-10-01

    Full Text Available Abstract Background Cardiac inflammation and generation of oxidative stress are known to contribute to trastuzumab (herceptin induced cardiac toxicity. Toll-like receptors (TLRs are a part of the innate immune system and are involved in cardiac stress reactions. Since TLR4 might play a relevant role in cardiac inflammatory signaling, we investigated whether or not TLR4 is involved in trastuzumab induced cardiotoxicity. Methods Seven days after a single injection of herceptin (2 mg/kg; i.p., left ventricular pressure volume loops were measured in HeN compotent (TLR4+/+ and HeJ mutant (TLR4-/- treated with trastuzumab and control mice. Immunofluorescent staining for monocyte infiltration and analyses of plasma by (ELISAs for different chemokines including: MCP-1and tumor necrosis factor-α (TNF-α, Western immunoblotting assay for ICAM-1, and used troponin I for cardiac injury marker. Results Trastuzumab injection resulted in an impairment of left ventricular function in TLR-4 competent (HeN, in contrast TLR4-/- trastuzumab mice showed improved left ventricular function EF%, CO; p -/-; p -/-, marked reduction of myocardial troponin-I levels in TLR4-deficient mice. Data are presented as means ± SE; n = 8 in each group p Conclusions Treatment with trastuzumab induces an inflammatory response that contributes to myocardial tissue TLR4 mediates chemokine expression (TNF-α, MCP-1and ICAM-1, so in experimental animals TLR4 deficiency improves left ventricular function and attenuates pathophysiological key mechanisms in trastuzumab induced cardiomyopathy.

  13. 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.

  14. On Independent Harvesting of Two Competing Fishing Species in the Presence of Toxicity%有毒素时两竞争鱼群的独立捕获问题

    Institute of Scientific and Technical Information of China (English)

    杨海霞

    2012-01-01

    对独立捕获的两鱼群的竞争系统进行了讨论。每个鱼群都遵守Logistic增长规律且向对方释放一种毒素物质。分析了系统的动力性态,结果表明毒素物质对动力系统的稳定性有一定的影响。利用Pantryagin最大值原理讨论了最优收获策略。%The present paper deals with the problem of independent harvesting of two competing fish species, each of which obeys the law of Logistic growth and releases a substance toxic to the other We discuss the dynamical behavior of the exploited system. We obtain that the toxic substance has some stabilizing effect on the dynamics of model system. Finally, we discuss the optimal harvesting policy using the Pantryagin' s Maximum Principle.

  15. 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 ...

  16. Competence Building

    DEFF Research Database (Denmark)

    Borrás, Susana; Edquist, Charles

    The main question that guides this paper is how governments are focusing (and must focus) on competence building (education and training) when designing and implementing innovation policies. With this approach, the paper aims at filling the gap between the existing literature on competences...... on the one hand, and the real world of innovation policy-making on the other, typically not speaking to each other. With this purpose in mind, this paper discusses the role of competences and competence-building in the innovation process from a perspective of innovation systems; it examines how governments...... and public agencies in different countries and different times have actually approached the issue of building, maintaining and using competences in their innovation systems; it examines what are the critical and most important issues at stake from the point of view of innovation policy, looking particularly...

  17. 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.)

  18. 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.

  19. Toxic action/toxicity.

    Science.gov (United States)

    Hathway, D E

    2000-02-01

    Some six or so physiological systems, essential to normal mammalian life, are involved in poisoning; an intoxication that causes severe injury to any one of them could be life threatening. Reversible chemical reactions showing Scatchard-type binding are exemplified by CO, CN- and cyclodiene neurotoxin insecticide intoxications, and by antigen-antibody complex formation. Haemoglobin (Hb) molecular biology accounts for the allosteric co-operativity and other characteristics of CO poisoning, CN- acts as a powerful cytochrome oxidase inhibitor, and antigen binding in a deep antibody cleft between two domains equipped with epitopes for antigen-binding groups explains hapten-specific immune reactions. Covalent chemical reactions with second-order (SN2) kinetics characterize Hg and Cd poisonings, the reactions of organophosphates and phosphonates with acetylcholinesterase and neurotoxic esterase and the reaction sequence whereby Paraquat accepts electrons and generates superoxide under aerobic conditions. Indirect carcinogens require cytochrome P450 activation to form DNA adducts in target-organ DNA and cause cancer, but a battery of detoxifying enzymes clustered with the P450 system must be overcome. Thus, S-metabolism competes ineffectively with target DNA for reactive vinyl chloride (VC) metabolites, epoxide hydrolase is important to the metabolism and carcinogenicity of alfatoxins and polycyclic aromatic hydrocarbons (benzo[a]pyrene, etc.), and the non-toxic 2-naphthylhydroxylamine N-glucuronide acts as a transport form in 2-naphthylamine bladder cancer. VC liver-cancer pathogenesis is explicable in terms of the presence of the glutathione S-transferase detoxifying system in hepatocytes and its absence from the fibroblastic elements, and of the VC concentrations reaching the liver by different administrative routes. In VC carcinogenicity, chemical reactions give imidazo-cyclization products with nucleoside residues of target DNA, and in benzene leukaemia, Z

  20. [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

  1. 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...

  2. Psychostimulant toxicity in children

    Directory of Open Access Journals (Sweden)

    Ozalp Ekinci

    2013-04-01

    Full Text Available Methylphenidate is used for the treatment of attention deficit hyperactivity disorder in children above the age of 6 with a high safety and tolerability. When used above the recommended dosage, methylphenidate has been reported to cause toxicity symptoms including neuro-psychiatric and cardiac adverse reactions. In this overview paper, the available literature on psyhcostimulant toxicity in children and the clinical symptoms and follow-up of a 4-year-old child who accidentally used high dose of methylphenidate will be discussed. [Archives Medical Review Journal 2013; 22(2.000: 184-193

  3. Competing mechanisms

    OpenAIRE

    Peters, Michael

    2014-01-01

    The recent literature on competing mechanisms has devoted a lot of effort at understanding a very complex and abstract issue. In particular, an agent's type in a competitive environment is hard to conceptualize because it depends on information the agent has about what is going on in the rest of the market. This paper explains why this is such an important practical problem and illustrates how the literature has solved it.

  4. 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

  5. Novel Toll-like receptor-4 deficiency attenuates trastuzumab (Herceptin) induced cardiac injury in mice

    OpenAIRE

    Yousif Nasser; Al-amran Fadhil G

    2011-01-01

    Abstract Background Cardiac inflammation and generation of oxidative stress are known to contribute to trastuzumab (herceptin) induced cardiac toxicity. Toll-like receptors (TLRs) are a part of the innate immune system and are involved in cardiac stress reactions. Since TLR4 might play a relevant role in cardiac inflammatory signaling, we investigated whether or not TLR4 is involved in trastuzumab induced cardiotoxicity. Methods Seven days after a single injection of herceptin (2 mg/kg; i.p.)...

  6. 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

  7. Stroke and cardiac cell death: Two peas in a pod.

    Science.gov (United States)

    Gonzales-Portillo, Chiara; Ishikawa, Hiroto; Shinozuka, Kazutaka; Tajiri, Naoki; Kaneko, Yuji; Borlongan, Cesar V

    2016-03-01

    A close pathological link between stroke brain and heart failure may exist. Here, we discuss relevant laboratory and clinical reports demonstrating neural and cardiac myocyte cell death following ischemic stroke. Although various overlapping risk factors exist between cerebrovascular incidents and cardiac incidents, stroke therapy has largely neglected the cardiac pathological consequences. Recent preclinical stroke studies have implicated an indirect cell death pathway, involving toxic molecules, that originates from the stroke brain and produces cardiac cell death. In concert, previous laboratory reports have revealed a reverse cell death cascade, in that cardiac arrest leads to ischemic cell death in the brain. A deeper understanding of the crosstalk of cell death pathways between stroke and cardiac failure will facilitate the development of novel treatments designed to arrest the global pathology of both diseases thereby improving the clinical outcomes of patients diagnosed with stroke and heart failure.

  8. 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

  9. 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

  10. Renal-sparing strategies in cardiac transplantation

    DEFF Research Database (Denmark)

    Gustafsson, Finn; Ross, Heather J

    2009-01-01

    PURPOSE OF REVIEW: Renal dysfunction due to calcineurin inhibitor (CNI) toxicity is a major clinical problem in cardiac transplantation. The aim of the article is to review the efficacy and safety of various renal sparing strategies in cardiac transplantation. RECENT FINDINGS: Small studies have...... documented that late initiation of CNI is safe in patients treated with induction therapy at the time of transplantation. Use of mycophenolate is superior when compared with azathioprine to allow for CNI reduction. More substantial reduction in CNI levels is safe and effective with the introduction...... of sirolimus or everolimus. However, studies that use very early CNI discontinuation have found an increased risk of allograft rejection, and this strategy requires further study before it can be routinely recommended. CNI discontinuation late after cardiac transplantation seems more effective than CNI...

  11. 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.

  12. 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.

  13. Competences versus Competencies in Romanian Accounting Education

    Directory of Open Access Journals (Sweden)

    Bogdan Pătruț

    2013-01-01

    Full Text Available Higher education in accounting should be formative and not informative; therefore there should be a transition from a type of education based on providing knowledge to one that is based on skill development, from teacher-centered education to student-centered education.This paper will present various points of view concerning the competencies/ competences of the accounting professional.

  14. Developing mathematical modelling competence

    DEFF Research Database (Denmark)

    Blomhøj, Morten; Jensen, Tomas Højgaard

    2003-01-01

    In this paper we introduce the concept of mathematical modelling competence, by which we mean being able to carry through a whole mathematical modelling process in a certain context. Analysing the structure of this process, six sub-competences are identified. Mathematical modelling competence...... cannot be reduced to these six sub-competences, but they are necessary elements in the development of mathematical modelling competence. Experience from the development of a modelling course is used to illustrate how the different nature of the sub-competences can be used as a tool for finding...... the balance between different kinds of activities in a particular educational setting. Obstacles of social, cognitive and affective nature for the students' development of mathematical modelling competence are reported and discussed in relation to the sub-competences....

  15. Competencies in science teaching

    OpenAIRE

    Leopold Mathelitsch

    2013-01-01

    The role of competencies is discussed with respect to science teaching. In particular, competence models from Germany, Switzerland and Austria are presented and compared. A special topical program, “Competencies in Mathematics and Science Teaching”, was started in Austria three years ago. Initial experiences with this program are reported, specifically with regard to how the teachers adopt this new idea of competencies and which kind of support is appreciated. Two aspects of the program are e...

  16. Building Project Competence

    DEFF Research Database (Denmark)

    Pemsel, Sofia; Wiewiora, Anna

    This research investigates the development of project competence, and particularly, three related dynamic capabilities (shifting, adapting, leveraging) that contribute to project competence development. In doing so, we make use of the emerging literature on knowledge governance and theorize how...... of dynamic capability building promoting project competence development....

  17. Introducing Toxics

    Directory of Open Access Journals (Sweden)

    David C. Bellinger

    2013-04-01

    Full Text Available With this inaugural issue, Toxics begins its life as a peer-reviewed, open access journal focusing on all aspects of toxic chemicals. We are interested in publishing papers that present a wide range of perspectives on toxicants and naturally occurring toxins, including exposure, biomarkers, kinetics, biological effects, fate and transport, treatment, and remediation. Toxics differs from many other journals in the absence of a page or word limit on contributions, permitting authors to present their work in as much detail as they wish. Toxics will publish original research papers, conventional reviews, meta-analyses, short communications, theoretical papers, case reports, commentaries and policy perspectives, and book reviews (Book reviews will be solicited and should not be submitted without invitation. Toxins and toxicants concern individuals from a wide range of disciplines, and Toxics is interested in receiving papers that represent the full range of approaches applied to their study, including in vitro studies, studies that use experimental animal or non-animal models, studies of humans or other biological populations, and mathematical modeling. We are excited to get underway and look forward to working with authors in the scientific and medical communities and providing them with a novel venue for sharing their work. [...

  18. 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...

  19. 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 ...

  20. Beryllium Toxicity

    Science.gov (United States)

    ... Favorites Del.icio.us Digg Facebook Google Bookmarks Yahoo MyWeb Beryllium Toxicity Patient Education Care Instruction Sheet ... Favorites Del.icio.us Digg Facebook Google Bookmarks Yahoo MyWeb Page last reviewed: May 23, 2008 Page ...

  1. Antimony Toxicity

    Directory of Open Access Journals (Sweden)

    Shyam Sundar

    2010-12-01

    Full Text Available Antimony toxicity occurs either due to occupational exposure or during therapy. Occupational exposure may cause respiratory irritation, pneumoconiosis, antimony spots on the skin and gastrointestinal symptoms. In addition antimony trioxide is possibly carcinogenic to humans. Improvements in working conditions have remarkably decreased the incidence of antimony toxicity in the workplace. As a therapeutic, antimony has been mostly used for the treatment of leishmaniasis and schistosomiasis. The major toxic side-effects of antimonials as a result of therapy are cardiotoxicity (~9% of patients and pancreatitis, which is seen commonly in HIV and visceral leishmaniasis co-infections. Quality control of each batch of drugs produced and regular monitoring for toxicity is required when antimonials are used therapeutically.

  2. [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

  3. Low-dose exposure of silica nanoparticles induces cardiac dysfunction via neutrophil-mediated inflammation and cardiac contraction in zebrafish embryos.

    Science.gov (United States)

    Duan, Junchao; Yu, Yang; Li, Yang; Li, Yanbo; Liu, Hongcui; Jing, Li; Yang, Man; Wang, Ji; Li, Chunqi; Sun, Zhiwei

    2016-06-01

    The toxicity mechanism of nanoparticles on vertebrate cardiovascular system is still unclear, especially on the low-level exposure. This study was to explore the toxic effect and mechanisms of low-dose exposure of silica nanoparticles (SiNPs) on cardiac function in zebrafish embryos via the intravenous microinjection. The dosage of SiNPs was based on the no observed adverse effect level (NOAEL) of malformation assessment in zebrafish embryos. The mainly cardiac toxicity phenotypes induced by SiNPs were pericardial edema and bradycardia but had no effect on atrioventricular block. Using o-Dianisidine for erythrocyte staining, the cardiac output of zebrafish embryos was decreased in a dose-dependent manner. Microarray analysis and bioinformatics analysis were performed to screen the differential expression genes and possible pathway involved in cardiac function. SiNPs induced whole-embryo oxidative stress and neutrophil-mediated cardiac inflammation in Tg(mpo:GFP) zebrafish. Inflammatory cells were observed in atrium of SiNPs-treated zebrafish heart by histopathological examination. In addition, the expression of TNNT2 protein, a cardiac contraction marker in heart tissue had been down-regulated compared to control group using immunohistochemistry. Confirmed by qRT-PCR and western blot assays, results showed that SiNPs inhibited the calcium signaling pathway and cardiac muscle contraction via the down-regulated of related genes, such as ATPase-related genes (atp2a1l, atp1b2b, atp1a3b), calcium channel-related genes (cacna1ab, cacna1da) and the regulatory gene tnnc1a for cardiac troponin C. Moreover, the protein level of TNNT2 was decreased in a dose-dependent manner. For the first time, our results demonstrated that SiNPs induced cardiac dysfunction via the neutrophil-mediated cardiac inflammation and cardiac contraction in zebrafish embryos. PMID:26551753

  4. Measuring translation competence acquisition

    OpenAIRE

    Orozco Jutorán, Mariana; Hurtado Albir, Amparo

    2002-01-01

    The following article describes the development of instruments for measuring the process of acquiring translation competence in written translation. Translation competence and its process of acquisition are firstly described, and then the lack of empirical research in our field is tackled. Thirdly, three measuring instruments especially developed to measure translation competence acquisition are presented: (i) to measure notions about translation, (ii) to measure students’ behaviour when face...

  5. Assessment of Innovation Competency

    DEFF Research Database (Denmark)

    Nielsen, Jan Alexis

    2015-01-01

    The author employed a 3-step qualitative research design with multiple instances of source validation to capture expert teachers’ (n = 28) reflections on which manifest signs they would look for when they asses students’ innovation competency. The author reports on the thematic analysis...... of the recorded talk in interaction that occurred in teacher group discussion sessions at 5 upper secondary schools. Based on the analysis, it was possible to extrapolate assessment criteria for 5 subcompetencies relevant to innovation (creative competency, collaboration competency, navigation competency, action...

  6. 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...

  7. 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....

  8. Toxic neuropathies

    Directory of Open Access Journals (Sweden)

    Misra Usha

    2009-01-01

    Full Text Available Toxic neuropathies generally result in length dependent axonal neuropathy with the exception of diphtheria and a few toxic neuropathies. In spite of occurrence of diphtheria in India there is paucity of published reports on diphtheritic neuropathy. Arsenic neuropathy commonly occurs in Bengal and Bangladesh because of ground water contamination whereas in Punjab it is due to contamination of opium. Lead neuropathy is rare and has been reported in battery workers and silver refining workers. It produces motor neuropathy resulting in foot drop and wrist drop. Organophosphates are used as pesticides, industrial chemicals and food adulterant. Certain organophosphates such as triorthocresyl phosphate used for or oil adulteration inhibit neurotoxic esterase and result in a delayed type of axonal neuropathy. Alcohol related neuropathy is a controversial issue whether it is due to alcohol related toxicity or due to nutritional deficiencies. Indian studies have revealed that neuropathy occurs both in alcoholic and nonalcoholic cirrhosis. Hexane neuropathy is reported in screen printers and these cases highlight the need for better preventive and occupational measures. Iatrogenic toxic neuropathies have been reported with cisplatin and vincristine. Because of geographical, occupational and health related conditions toxic neuropathies are likely to be more common than reported and greater awareness is needed.

  9. 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, ...

  10. 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 & ...

  11. 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...

  12. 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.

  13. Lean heart: Role of leptin in cardiac hypertrophy and metabolism

    Institute of Scientific and Technical Information of China (English)

    Michael; E; Hall; Romain; Harmancey; David; E; Stec

    2015-01-01

    Leptin is an adipokine that has been linked with the cardiovascular complications resulting from obesity such as hypertension and heart disease. Obese patients have high levels of circulating leptin due to increased fat mass. Clinical and population studies have correlated high levels of circulating leptin with the development of cardiac hypertrophy in obesity. Leptin has also been demonstrated to increase the growth of cultured cardiomyocytes. However, several animal studies of obese leptin deficient mice have not supported a role for leptin in promoting cardiac hypertrophy so the role of leptin in this pathological process remains unclear. Leptin is also an important hormone in the regulation of cardiac metabolism where it supports oxidation of glucose and fatty acids. In addition, leptin plays a critical role in protecting the heart from excess lipid accumulation and the formation of toxic lipids in obesity a condition known as cardiac lipotoxicity. This paper focuses on the data supporting and refuting leptin’s role in promoting cardiac hypertrophy as well as its important role in the regulation of cardiac metabolism and protection against cardiac lipotoxicity.

  14. 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.

  15. 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

  16. 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...

  17. 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

  18. Competencies and Their Assessment

    Science.gov (United States)

    Drisko, James W.

    2014-01-01

    This article explores competencies and methods for their assessment in higher education and in social work's accreditation standards. Many contemporary policy and educational accreditation efforts employ the model of competency assessment. The current emphasis on accountability in higher education, including the Council on Social Work…

  19. Analyzing ADN competencies.

    Science.gov (United States)

    Mitchell, P R

    1989-01-01

    El Paso Community College District, using the DACUM Process, identified 19 major competency areas with 313 specific competencies for AD Nursing. This article provides an overview of the DACUM Process, a discussion of the application to the ADN program, a summary of the results, and future activities.

  20. Competence, Curriculum, and Control.

    Science.gov (United States)

    Jackson, Nancy S.

    1988-01-01

    Draws upon a case study of a community college program review to examine the application of a competency-based approach to the process of curriculum design. Suggests that competency-based curriculum development shifts the basis for decision making from teacher knowledge to an objectified accounting system of employers and curriculum technicians.…

  1. Intercultural Competence Teaching

    Institute of Scientific and Technical Information of China (English)

    HUI Ran

    2015-01-01

    It is widely realized that cultural competence is playing an increasingly important role in language teaching because of the close associations between culture and language. To enhance the efficiency of language teaching, this essay will elucidate the importance of intercultural competence teaching and introduce three methods of cultural teaching.

  2. Developing Clinical Competence

    NARCIS (Netherlands)

    P.F. Wimmers (Paul)

    2006-01-01

    textabstractThe development of clinical competence is the main purpose of medical education. The long road to become clinically competent starts on the first day of medical school, and every institution strives to select the best students. The responsibility of medical schools is to train th

  3. ICT Competences: Algorithmic Thinking

    Science.gov (United States)

    Zsakó, László; Szlávi, Péter

    2012-01-01

    A lot has been said about what to teach in ICT in primary and secondary education. There are serious discussions even debates about it. Much less has been said about why ICT should be taught. [1] Competences are related actions and tasks done by people (somebody is competent in a certain field if they are able to solve common tasks related to that…

  4. The Spiritual Competency Scale

    Science.gov (United States)

    Robertson, Linda A.

    2010-01-01

    This study describes the development of the Spiritual Competency Scale, which was based on the Association for Spiritual, Ethical and Religious Values in Counseling's original Spiritual Competencies. Participants were 662 counseling students from religiously based and secular universities nationwide. Exploratory factor analysis revealed a 22-item,…

  5. Competencies in Ornamental Horticulture

    Science.gov (United States)

    Loewen, Curtis E.

    1974-01-01

    Based on the author's dissertation, this article pertains to the identification of competencies for ornamental horticulture workers in Oregon. Findings were based on interviews with 56 ornamental horticulture business employers regarding 100 competencies. The method used can serve as a model for obtaining occupational information to develop and…

  6. Toxic myopathies.

    Science.gov (United States)

    Pasnoor, Mamatha; Barohn, Richard J; Dimachkie, Mazen M

    2014-08-01

    Muscle tissue is highly sensitive to many substances. Early recognition of toxic myopathies is important, because they potentially are reversible on removal of the offending drug or toxin, with greater likelihood of complete resolution the sooner this is achieved. Clinical features range from mild muscle pain and cramps to severe weakness with rhabdomyolysis, renal failure, and even death. The pathogenic bases can be multifactorial. This article reviews some of the common toxic myopathies and their clinical presentation, histopathologic features, and possible underlying cellular mechanisms.

  7. 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.

  8. Ten-Competence: Life-Long Competence Development and Learning

    NARCIS (Netherlands)

    Koper, Rob; Specht, Marcus

    2006-01-01

    Koper, R., & Specht, M. (2008). Ten-Competence: Life-Long Competence Development and Learning. In M-A. Cicilia (Ed.), Competencies in Organizational e-learning: concepts and tools (pp. 234-252). Hershey: IGI-Global.

  9. Cardiac-Specific Knockout of ETA Receptor Mitigates Paraquat-Induced Cardiac Contractile Dysfunction.

    Science.gov (United States)

    Wang, Jiaxing; Lu, Songhe; Zheng, Qijun; Hu, Nan; Yu, Wenjun; Li, Na; Liu, Min; Gao, Beilei; Zhang, Guoyong; Zhang, Yingmei; Wang, Haichang

    2016-07-01

    Paraquat (1,1'-dim ethyl-4-4'-bipyridinium dichloride), a highly toxic quaternary ammonium herbicide widely used in agriculture, exerts potent toxic prooxidant effects resulting in multi-organ failure including the lung and heart although the underlying mechanism remains elusive. Recent evidence suggests possible involvement of endothelin system in paraquat-induced acute lung injury. This study was designed to examine the role of endothelin receptor A (ETA) in paraquat-induced cardiac contractile and mitochondrial injury. Wild-type (WT) and cardiac-specific ETA receptor knockout mice were challenged to paraquat (45 mg/kg, i.p.) for 48 h prior to the assessment of echocardiographic, cardiomyocyte contractile and intracellular Ca(2+) properties, as well as apoptosis and mitochondrial damage. Levels of the mitochondrial proteins for biogenesis and oxidative phosphorylation including UCP2, HSP90 and PGC1α were evaluated. Our results revealed that paraquat elicited cardiac enlargement, mechanical anomalies including compromised echocardiographic parameters (elevated left ventricular end-systolic and end-diastolic diameters as well as reduced factional shortening), suppressed cardiomyocyte contractile function, intracellular Ca(2+) handling, overt apoptosis and mitochondrial damage. ETA receptor knockout itself failed to affect myocardial function, apoptosis, mitochondrial integrity and mitochondrial protein expression. However, ETA receptor knockout ablated or significantly attenuated paraquat-induced cardiac contractile and intracellular Ca(2+) defect, apoptosis and mitochondrial damage. Taken together, these findings revealed that endothelin system in particular the ETA receptor may be involved in paraquat-induced toxic myocardial contractile anomalies possibly related to apoptosis and mitochondrial damage. PMID:26089164

  10. On Verbal Competence

    Directory of Open Access Journals (Sweden)

    Zhongxin Dai

    2014-04-01

    Full Text Available This paper explored a new concept, verbal competence, to present a challenge to Chomsky’s linguistic competence and Hymes’ communicative competence. It is generally acknowledged that Chomsky concerned himself only with the syntactic/grammatical structures, and viewed the speaker’s generation and transformation of syntactic structures as the production of language. Hymes challenged Chomsky’s conception of linguistic competence and argued for an ethnographic or sociolinguistic concept, communicative competence, but his concept is too broad to be adequately grasped and followed in such fields as linguistics and second language acquisition. Communicative competence can include abilities to communicate with nonverbal behaviors, e.g. gestures, postures or even silence. The concept of verbal competence concerns itself with the mental and psychological processes of verbal production in communication. These processes originate from the speaker’s personal experience, in a certain situation of human communication, and with the sudden appearance of the intentional notion, shape up as the meaning images and end up in the verbal expression.

  11. The Handbook of Competency Mapping

    CERN Document Server

    Sanghi, Seema

    2004-01-01

    The Handbook of Competency Mapping presents the reader with a definitive roadmap to understanding, designing and implementing competency models in organizations. Assuming no prior knowledge, this book introduces the reader to various fundamental issues concerning competencies. These include:. - The conceptual foundations of competencies and how they work both in people and in organizations. - How competency frameworks can be designed, developed and implemented. - The role of competencies in an organization as a vital tool for recruitment, selection and retention. - How to develop customized co

  12. Adult educators' core competences

    DEFF Research Database (Denmark)

    Wahlgren, Bjarne

    2016-01-01

    Abstract Which competences do professional adult educators need? This research note discusses the topic from a comparative perspective, finding that adult educators’ required competences are wide-ranging, heterogeneous and complex. They are subject to context in terms of national and cultural...... environment as well as the kind of adult education concerned (e.g. basic education, work-related education etc.). However, it seems that it is possible to identify certain competence requirements which transcend national, cultural and functional boundaries. This research note summarises these common or “core...

  13. Democracy, caring and competence

    DEFF Research Database (Denmark)

    Broström, Stig; Johannesson, Eva Marianne; Purola, Anna-Maija;

    2015-01-01

    The aim of the study is to explore how Nordic Early Childhood Education and Care policies frame values education in preschools with a special focus on the values of democracy, caring and competence. The study is part of a larger Nordic project, Valueseducation in Nordic preschools: Basis of...... the study. Keywords related with democratic, caring and competence values were selected. The findings reveal different dimensions and meanings of the three value fields, such as democracy as being and/or becoming; care as fulfilment of basic needs and an ethical relationship; and competence values as...

  14. Developing emergency nursing competence.

    Science.gov (United States)

    Proehl, Jean A

    2002-03-01

    Developing and maintaining the competence emergency nurses need is an important function of emergency clinical nurse specialists (CNS), educators, and other members of the emergency department (ED) leadership team. A thorough orientation is the first and most important step in developing the competence of emergency nurses. After orientation, the challenge is to maintain currency of practice in the face of incessant change such as new medications, new equipment, and new therapies in emergency care. This article focuses on the orientation of emergency nurses. A related article in this issue addresses assessment of competency. PMID:11818264

  15. Compassion Competence in Nurses.

    Science.gov (United States)

    Lee, Youngjin; Seomun, GyeongAe

    2016-01-01

    The purpose of study was to identify the attributes of the concept of compassion competence for nurses. A hybrid model was used to develop the concept, which included fieldwork performed. The concept of compassion competence was found to possess 3 dimensions: (a) acquisition of a wealth of knowledge; (b) development of skills of emotional communication, sensitivity, insight, and self-regulation; and (c) development of attitudes of respect and empathy, and maintenance of occupational distance. Compassion competence could be useful for developing ways to enhance the knowledge, skills, and attitudes required for nurses to provide compassionate care in various nursing practices. PMID:27149235

  16. Competence development in UAS

    DEFF Research Database (Denmark)

    Thorslund, Jørgen; Brodersen, Anne Mygind

    2011-01-01

    As a University of Applied Science (UAS) University College Lillebaelt in Denmark is addressing education, knowledge production and professional development in perspective of life-long and life-wide learning. It is our basic assumption that that internal competence development ? individually...... and organizationally - among UAS educators should be based on same learning concepts as used in professional development to avoid parallelism. Do for yourself, what you preach for others. Second, competence development of faculty is a central element in transformation of our institutions from schools of higher...... education to universities of applied science (UAS). Competence development strategies should thus include objectives for the institutions ability to contribute to knowledge production....

  17. Competencies, skills and assessment

    DEFF Research Database (Denmark)

    Højgaard, Tomas

    2009-01-01

    This paper is an analysis of the challenge of assessing student learning and how that is affected by using descriptions of competencies as a core element when describing the aims of the learning process. Assessment is modelled as a three step process; characterising, identifying and judging......, to allow for the following argument: Working with competency descriptions is rightly said to make judging more difficult. This potentially lowers the reliability of the assessment. But competency descriptions also carry a great potential of raising the validity of the assessment by focusing...

  18. Competence development in UAS

    DEFF Research Database (Denmark)

    Thorslund, Jørgen; Brodersen, Anne Mygind

    2011-01-01

    As a University of Applied Science (UAS) University College Lillebaelt in Denmark is addressing education, knowledge production and professional development in perspective of life-long and life-wide learning. It is our basic assumption that that internal competence development – individually...... and organizationally - among UAS educators should be based on same learning concepts as used in professional development to avoid parallelism. Do for yourself, what you preach for others. Second, competence development of faculty is a central element in transformation of our institutions from schools of higher...... education to universities of applied science (UAS). Competence development strategies should thus include objectives for the institutions ability to contribute to knowledge production....

  19. Human Toxicity

    DEFF Research Database (Denmark)

    Jolliet, Olivier; Fantke, Peter

    2015-01-01

    This chapter reviews the human toxicological impacts of chemicals and how to assess these impacts in life cycle impact assessment (LCIA), in order to identify key processes and pollutants. The complete cause-effect pathway – from emissions of toxic substances up to damages on human health...... and their coverage in LCIA methods. Section 4 provides an overview of the main LCIA methods available to address human toxicological impacts. Section 5 presents the range of variation of factor across chemicals, the main sources of uncertainty and good interpretation practice of results from human toxicity...... all chemicals and impact pathways characterizes the contribution of each factor to the total variation of 10–12 orders of magnitude in impacts per kg across all chemicals. This large variation between characterisation factors for different chemicals as well as the 3 orders of magnitude uncertainty...

  20. Production competence revisited

    DEFF Research Database (Denmark)

    Szász, Levente; Demeter, Krisztina; Boer, Harry

    2015-01-01

    Purpose – The purpose of this paper is to seek remedy to two major flaws of the production competence literature, which concern: the way the production competence construct is operationalized and the way its effects on performance are measured. Design/methodology/approach – The paper proposes...... to measure production competence as the two-dimensional operational level construct it actually is, and to use Slack’s (1994) importance performance matrix to study its business level performance effects. The three hypotheses developed are tested using a subsample of the International Manufacturing Strategy...... Survey database, which includes 465 manufacturing companies from 21 countries. Findings – The study offers additional empirical support for production competence theory. Going beyond supporting existing theory, the results give more detailed insight by indicating that low operational performance on even...

  1. TENCompetence Competence Observatory

    NARCIS (Netherlands)

    Vervenne, Luk

    2010-01-01

    Vervenne, L. (2007) TENCompetence Competence Observatory. Sources available http://tencompetence.cvs.sourceforge.net/viewvc/tencompetence/wp8/org.tencompetence.co/. Available under the three clause BSD license, copyright TENCompetence Foundation.

  2. 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.

  3. Physician Assistant Genomic Competencies.

    Science.gov (United States)

    Goldgar, Constance; Michaud, Ed; Park, Nguyen; Jenkins, Jean

    2016-09-01

    Genomic discoveries are increasingly being applied to the clinical care of patients. All physician assistants (PAs) need to acquire competency in genomics to provide the best possible care for patients within the scope of their practice. In this article, we present an updated version of PA genomic competencies and learning outcomes in a framework that is consistent with the current medical education guidelines and the collaborative nature of PAs in interprofessional health care teams. PMID:27490287

  4. Managing Regulatory Body Competence

    International Nuclear Information System (INIS)

    In 2001, the IAEA published TECDOC 1254, which examined the way in which the recognized functions of a regulatory body for nuclear facilities results in competence needs. Using the systematic approach to training (SAT), TECDOC 1254 provided a framework for regulatory bodies for managing training and developing and their maintaining their competence. It has been successfully used by many regulators. The IAEA has also introduced a methodology and an assessment tool - Guidelines for Systematic Assessment of Regulatory Competence Needs (SARCoN) - which provides practical guidance on analysing the training and development needs of a regulatory body and, through a gap analysis, guidance on establishing competence needs and how to meet them. In 2009, the IAEA established a steering committee (supported by a bureau) with the mission to advise the IAEA on how it could best assist Member States to develop suitable competence management systems for their regulatory bodies. The committee recommended the development of a safety report on managing staff competence as an integral part of a regulatory body's management system. This Safety Report was developed in response to this request. It supersedes TECDOC 1254, broadens its application to regulatory bodies for all facilities and activities, and builds upon the experience gained through the application of TECDOC 1254 and SARCoN and the feedback received from Member States. This Safety Report applies to the management of adequate competence as needs change, and as such is equally applicable to the needs of States 'embarking' on a nuclear power programme. It also deals with the special case of building up the competence of regulatory bodies as part of the overall process of establishing an 'embarking' State's regulatory system

  5. Board independence and competence

    OpenAIRE

    Wagner, Alexander F

    2011-01-01

    This paper analyzes board independence and competence as distinct, but inextricably linked aspects of board effectiveness. Competent directors add shareholder value because they have better information about the quality of projects. While a CEO cares about shareholder value, he also wants his board to behave loyally to him by agreeing to projects that give him private benefits. Because many aspects of the CEO-board relationship are not contractible, the paper studies a model of relational con...

  6. Cultural competence in nursing

    OpenAIRE

    Jirwe, Maria

    2008-01-01

    The overall aim of this thesis is to explore, analyze and clarify how cultural competence is understood. This is explored from the perspective of nurses, nursing students, nurse educators, and nurse researchers in relation to the Swedish care context. The field of transcultural nursing and cultural competence was founded in the United States in the 1950s in response to an increased awareness of cultural diversity arising from immigration. In Sweden an interest in transcultur...

  7. Assessing prescribing competence

    OpenAIRE

    Mucklow, John; Bollington, Lynne; Maxwell, Simon

    2011-01-01

    Prescribing of medicines is the key clinical activity in the working life of most doctors. In recent years, a broad consensus regarding the necessary competencies has been achieved. Each of these is a complex mix of knowledge, judgement and skills. Surveys of those on the threshold of their medical careers have revealed widespread lack of confidence in writing prescriptions. A valid and reliable assessment of prescribing competence, separate from an overall assessment of medical knowledge and...

  8. 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

  9. 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

  10. Cardiac status in bone tumor survivors up to nearly 19 years after treatment with doxorubicin : A longitudinal study

    NARCIS (Netherlands)

    Postma, A; Elzenga, NJ; Haaksma, J; Schasfoort-Van Leeuwen, MJM; Kamps, WA; Bink-Boelkens, MTE

    2002-01-01

    Background. Longitudinal assessment of cardiac toxicity in anthracycline-treated long-term bone tumor survivors. Procedures. Cardiac status was assessed in 29 patients 14.1 (range 7-18.7) years after treatment with duxorubicin (DOXO) 360 mg/m(2) (median 225-550). The median age of the patients at th

  11. Metaphorical Competence: A Neglected Component of Communicative Competence

    Directory of Open Access Journals (Sweden)

    Masoud Khalili Sabet

    2016-01-01

    Full Text Available The ability to comprehend and use metaphors in L2 which is referred to as metaphorical competence is an important issue in second language acquisition. Metaphors are so pervasive in our life that we might not realize their presence and simply neglect them even in our first language. Different models of communicative competence have been suggested in the literature; however, the model of Bachman and Palmer (1996 is the one considered in the present study. It includes two major nodes of organizational and pragmatic competences. Under the organizational competence are grammatical and textual competences, and pragmatic competence includes illocutionary and sociolinguistic competences. In this paper it is argued that among the many competences required to be considered proficient in a language, metaphorical competence is also central. As such, after illuminating the concept of metaphor and metaphorical competence, some models of communicative competence (CC are presented. Moreover, in line with Littlemore and Low (2006, it is emphasized that metaphorical competence which is present in most of the components of CC should receive more attention in L2 classrooms. In fact, it is concluded that having an acceptable metaphorical competence contributes to the learners’ overall communicative competence.Keywords: Metaphor, Metaphorical competence, Communicative competence, L2

  12. 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

  13. Recovery of toxic metal ions from washing effluent containing excess aminopolycarboxylate chelant in solution

    OpenAIRE

    Hasegawa, Hiroshi; Rahman, Ismail M. M.; Nakano, Masayoshi; Begum, Zinnat A.; Egawa, Yuji; Maki, Teruya; Furusho, Yoshiaki; Mizutani, Satoshi

    2011-01-01

    Aminopolycarboxylate chelants (APCs) are extremely useful for a variety of industrial applications, including the treatment of toxic metal-contaminated solid waste materials. Because non-toxic matrix elements compete with toxic metals for the binding sites of APCs, an excess of chelant is commonly added to ensure the adequate sequestration of toxic metal contaminants during waste treatment operations. The major environmental impacts of APCs are related to their ability to solubilize toxic hea...

  14. 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).

  15. Adapting health care competencies to a formal competency model

    OpenAIRE

    Sitthisak, Onjira; Gilbert, Lester; Davis, Hugh C.; Gobbi, Mary

    2007-01-01

    Health professions education has moved away from process-based curricula to competency-based curricula. Machine readable and processable health care competencies are still embryonic, pending the emergence of appropriate standards. The IMS Reusable Definition of Competency or Educational Objective specification and the HR-XML competency standard are introduced, compared, and their problems identified in the implementation of exemplar competencies from the UK...

  16. Recommendations of the Brazilian Society of Cardiac Arrhythmias for Holter Monitoring Services

    OpenAIRE

    Lorga Filho, Adalberto; Cintra, Fatima Dumas; Lorga, Adalberto; Grupi, Cesar José; Pinho, Claudio; Moreira, Dalmo Antonio Ribeiro; Dario C. Sobral Filho; de Brito, Fabio Sandoli; Kruse, José Claudio Lupi; Neto, José Sobral

    2013-01-01

    Background There are innumerous indicators to assure the quality of a service. However, medical competence and the proper performance of a procedure determine its final quality. The Brazilian Society of Cardiac Arrhythmias recommends minimum parameters necessary to guarantee the excellence of ambulatory electrocardiographic monitoring services. Objective To recommend minimum medical competences and the information required to issue a Holter monitoring report. Methods This study was grounded i...

  17. Thermal Stress and Toxicity

    Science.gov (United States)

    Elevating ambient temperature above thermoneutrality exacerbates toxicity of most air pollutants, insecticides, and other toxic chemicals. On the other hand, safety and toxicity testing of toxicants and drugs is usually performed in mice and rats maintained at subthermoneutral te...

  18. 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.

  19. 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

  20. 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

  1. 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...

  2. 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

  3. Cardiomyocyte differentiation induced in cardiac progenitor cells by cardiac fibroblast-conditioned medium.

    Science.gov (United States)

    Zhang, Xi; Shen, Man-Ru; Xu, Zhen-Dong; Hu, Zhe; Chen, Chao; Chi, Ya-Li; Kong, Zhen-Dong; Li, Zi-Fu; Li, Xiao-Tong; Guo, Shi-Lei; Xiong, Shao-Hu; Zhang, Chuan-Sen

    2014-05-01

    Our previous study showed that after being treated with 5-azacytidine, Nkx2.5(+) human cardiac progenitor cells (CPCs) derived from embryonic heart tubes could differentiate into cardiomyocytes. Although 5-azacytidine is a classical agent that induces myogenic differentiation in various types of cells, the drug is toxic and unspecific for myogenic differentiation. To investigate the possibility of inducing CPCs to differentiate into cardiomyocytes by a specific and non-toxic method, CPCs of passage 15 and mesenchymal stem cells (MSCs) were treated with cardiac ventricular fibroblast-conditioned medium (CVF-conditioned medium). Following this treatment, the Nkx2.5(+) CPCs underwent cardiomyogenic differentiation. Phase-contrast microscopy showed that the morphology of the treated CPCs gradually changed. Ultrastructural observation confirmed that the cells contained typical sarcomeres. The expression of cardiomyocyte-associated genes, such as alpha-cardiac actin, cardiac troponin T, and beta-myosin heavy chain (MHC), was increased in the CPCs that had undergone cardiomyogenic differentiation compared with untreated cells. In contrast, the MSCs did not exhibit changes in morphology or molecular expression after being treated with CVF-conditioned medium. The results indicated that Nkx2.5(+) CPCs treated with CVF-conditioned medium were capable of differentiating into a cardiac phenotype, whereas treated MSCs did not appear to undergo cardiomyogenic differentiation. Subsequently, following the addition of Dkk1 and the blocking of Wnt signaling pathway, CVF-conditioned medium-induced morphological changes and expression of cardiomyocyte-associated genes of Nkx2.5(+) CPCs were inhibited, which indicates that CVF-conditioned medium-induced cardiomyogenic differentiation of Nkx2.5(+) CPCs is associated with Wnt signaling pathway. In addition, we also found that the activation of Wnt signaling pathway was accompanied by higher expression of GATA-4 and the blocking of the

  4. Customer satisfaction and competencies

    DEFF Research Database (Denmark)

    Gritti, Paola; Foss, Nicolai Juul

    We empirically address how customer satisfaction and loyalty in the banking industry may affect profitability. This helps to identify the strategy and competencies necessary to benefit from customer relationships which are important sources for improved performance in the banking. We do this by a......We empirically address how customer satisfaction and loyalty in the banking industry may affect profitability. This helps to identify the strategy and competencies necessary to benefit from customer relationships which are important sources for improved performance in the banking. We do...

  5. 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.)

  6. 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.

  7. Pragmatics and Communicative Competences

    Science.gov (United States)

    Lin, Grace Hui Chin; Su, Simon Chun Feng; Ho, Max Ming Hsuang

    2009-01-01

    Pragmatics is included in one of four communicative competences (Canale, 1980). It is necessary and important to teach pragmatics at school in our globalized world in order to avoid as much as misunderstanding, which is likely to stem from cultural difference. As a result, greater importance should be attached to diverse customs and pragmatics.…

  8. Supporting Lifelong Competence Development

    OpenAIRE

    Koper, Rob

    2007-01-01

    The slides of a keynote for the EFODL conference about Demonstrating Transformation in Learning: Practice, Process and Product. 23rd & 24th May 2007, Belfast (http://efodl.belfastinstitute.ac.uk/). It introduces the core concepts of TENCompetence: Learning Networks, Personal Competence Management, Positioning, Navigation, Learner Support & summarizes some of the research in these areas.

  9. Supporting Lifelong Competence Development

    NARCIS (Netherlands)

    Koper, Rob

    2007-01-01

    The slides of a keynote for the EFODL conference about Demonstrating Transformation in Learning: Practice, Process and Product. 23rd & 24th May 2007, Belfast (http://efodl.belfastinstitute.ac.uk/). It introduces the core concepts of TENCompetence: Learning Networks, Personal Competence Management, P

  10. Competence Enhancement Behavior Management

    Science.gov (United States)

    Farmer, Thomas W.; Goforth, Jennifer B.; Hives, Jacqueline; Aaron, Annie; Jackson, Frances; Sgammato, Adrienne

    2006-01-01

    Competence Enhancement Behavior Management is presented as a framework for supporting students with challenging behaviors in general education classrooms. This approach emphasizes classroom management and discipline strategies that (a) help to build positive relations with students, (b) communicate to students that they are important, and (c)…

  11. Adult educators' core competences

    Science.gov (United States)

    Wahlgren, Bjarne

    2016-06-01

    Which competences do professional adult educators need? This research note discusses the topic from a comparative perspective, finding that adult educators' required competences are wide-ranging, heterogeneous and complex. They are subject to context in terms of national and cultural environment as well as the kind of adult education concerned (e.g. basic education, work-related education etc.). However, it seems that it is possible to identify certain competence requirements which transcend national, cultural and functional boundaries. This research note summarises these common or "core" requirements, organising them into four thematic subcategories: (1) communicating subject knowledge; (2) taking students' prior learning into account; (3) supporting a learning environment; and (4) the adult educator's reflection on his or her own performance. At the end of his analysis of different competence profiles, the author notes that adult educators' ability to train adult learners in a way which then enables them to apply and use what they have learned in practice (thus performing knowledge transfer) still seems to be overlooked.

  12. Assessing cataract surgical competency

    NARCIS (Netherlands)

    Lee, Andrew G.; Greenlee, Emily; Oetting, Thomas A.; Beaver, Hilary A.; Johnson, A. Tim; Boldt, H. Culver; Abramoff, Michael; Olson, Richard; Carter, Keith

    2007-01-01

    The Accreditation Council for Graduate Medical Education has mandated that all residency training programs teach and assess 6 general competencies.1 A.G. Lee and K.D. Carter, Managing the new mandate in resident education: A blueprint for translating a national mandate into local compliance, Ophthal

  13. Evolution of subsidiary competences

    DEFF Research Database (Denmark)

    Geisler Asmussen, Christian; Pedersen, Torben; Dhanaraj, Charles

    of competitive advantage of nations, we hypothesize the contingencies under which heterogeneity in host environments influences subsidiary competence configuration. We test our model with data from more than 2,000 subsidiaries in seven Western European countries. Our results provide new insights on the evolution...

  14. Developing professional competence

    DEFF Research Database (Denmark)

    Wahlgren, Bjarne

    2015-01-01

    The purpose of university programs for professionals is to qualify the students to act competently in a subsequent job situation. Practical experiences as well as comprehensive research studies have shown that only a limited part of what is learned during the coursework is applied in the subsequent...... for professional educational programs are suggested....

  15. Competency in the Cockpit.

    Science.gov (United States)

    Brown, H. M.

    1992-01-01

    Examines how modern technology is redefining competences, particularly those required by aircrews in state-of-the-art cockpits and how rule-based descriptions may not always be as practical as cognitive schemas and frames or case-based reasoning. Concludes that a wider systems perspective must include a balance between intuitive and analytic…

  16. Connecting to Compete 2016

    OpenAIRE

    Arvis, Jean-François; Saslavsky, Daniel; Ojala, Lauri; Shepherd, Ben; Busch, Christina; Raj, Anasuya; Naula, Tapio

    2016-01-01

    The LPI has provided valuable information for policy makers, traders, and other stakeholders, including researchers and academics, on the role of logistics for growth and the policies needed to support logistics in areas such as infrastructure planning, service provision, and crossborder trade and transport facilitation. The results of Connecting to Compete 2016 point to Germany as the bes...

  17. Promoting Intercultural Competencies

    International Nuclear Information System (INIS)

    What is culture? • Culture is the acquired knowledge people use to interpret experience and generate behavior. • It is the way of life a people pass down from one generation to the next through learning. • It is the rules for living and functioning in society that come from growing up in a specific society, and it is a set of acquired skills, habits and society-specific training that gives a group of people its identity. What is intercultural competency? • Cultures can have widely varying perspectives. • These perspectives influence the way that a person develops relationships, responds to situations, and operates in a professional setting. • Intercultural competency is the ability to comprehend and navigate the ways that culture can influence behavior, relationships, and the results of collaboration and interaction. What does becoming interculturally competent entail? • Intercultural preparedness is not merely travelling, learning a foreign language, or being exposed to other cultures. • Developing competency requires thinking about the challenges posed to our work by a multi-cultural workforce in a way that prepares employees and staff for potential incidents or misunderstandings. • It is impossible to avoid all intercultural misunderstandings, but learning to anticipate them and deal with them is key to developing any training program on culture

  18. Competing for Criminal Money

    NARCIS (Netherlands)

    Rawlings, G.; Unger, B.

    2005-01-01

    To compete for criminal money by means of low bank secrecy seems a tempting strategy for countries in order to attract additional funds. We show in a model that this “Seychelles-strategy” can increase national output, in particular if a country takes a (Stackelberg ) leadership in the competition ga

  19. Classical competing risks

    CERN Document Server

    Crowder, Martin J

    2001-01-01

    If something can fail, it can often fail in one of several ways and sometimes in more than one way at a time. There is always some cause of failure, and almost always, more than one possible cause. In one sense, then, survival analysis is a lost cause. The methods of Competing Risks have often been neglected in the survival analysis literature. Written by a leading statistician, Classical Competing Risks thoroughly examines the probability framework and statistical analysis of data of Competing Risks. The author explores both the theory of the subject and the practicalities of fitting the models to data. In a coherent, self-contained, and sequential account, the treatment moves from the bare bones of the Competing Risks setup and the associated likelihood functions through survival analysis using hazard functions. It examines discrete failure times and the difficulties of identifiability, and concludes with an introduction to the counting-process approach and the associated martingale theory.With a dearth of ...

  20. Competencies: requirements and acquisition

    NARCIS (Netherlands)

    Kuenn, A.C.; Meng, C.M.; Peters, Z.; Verhagen, A.M.C.

    2013-01-01

    Higher education is given the key task to prepare the highly talented among the young to fulfil highly qualified roles in the labour market. Successful labour market performance of graduates is generally associated with the acquisition of the correct competencies. Education as an individual investme

  1. Competence in Multilingual Education

    OpenAIRE

    Shara Mazhitaeva; Janna Balmagambetova; Nadezhda Khan

    2012-01-01

    The article deals with the competence approach towards the study of Kazakh, Russian and English languages as part of the cultural program of the "Languages Trinity" and multilingual education. Change of the educational paradigm demands close attention of the teachers of Russian language to the methodological tools of graduates’ language training as a way to enhance the competitiveness of future professionals.

  2. Competencies in Teaching English.

    Science.gov (United States)

    Purves, Alan C.

    This paper discusses suggested requirements for a competency-based English teacher training program on the high school or college level. The author argues that an English teacher needs to demonstrate a basic knowledge of the subject matter in three areas: the structure and history of the English language, rhetorical theory and practice, and…

  3. Competence preservation through education

    International Nuclear Information System (INIS)

    For fulfilling their tasks GNS depends on personnel with specific knowledge and competence. GNS answers to these challenges by various measures for education and training in order to have skilled personnel available nowadays and in the future. By these measures and the internal organisation regarding responsibilities in radiation protection requirements resulting from the expected Euratom Basic Safety Standards (BSS) are met. (orig.)

  4. Assessing Culturally Competent Scholarship.

    Science.gov (United States)

    Mendias, Elnora P.; Guevara, Edilma B.

    2001-01-01

    Eight criteria for culturally competent scholarship (contextuality, relevance, communication styles, awareness of identity and power differences, disclosure, reciprocation, empowerment, time) were applied to an international education/research nursing program. Appropriate measures for each were developed and ways to improve the program were…

  5. 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...

  6. 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...

  7. 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.)

  8. Coupling of cardiac and locomotor rhythms.

    Science.gov (United States)

    Kirby, R L; Nugent, S T; Marlow, R W; MacLeod, D A; Marble, A E

    1989-01-01

    The pressure within exercising skeletal muscle rises and falls rhythmically during normal human locomotion, the peak pressure reaching levels that intermittently impede blood flow to the exercising muscle. Speculating that a reciprocal relationship between the timing of peak intramuscular and pulsatile arterial pressures should optimize blood flow through muscle and minimize cardiac load, we tested the hypothesis that heart rate becomes entrained with walking and running cadence at some locomotion speeds, by means of electrocardiography and an accelerometer to provide signals reflecting heart rate and cadence, respectively. In 18 of 25 subjects, 1:1 coupling of heart and step rates was present at one or more speeds on a motorized treadmill, generally at moderate to high exercise intensities. To determine how exercise specific this phenomenon is, and to refute the competing hypothesis that coupling is due to vertical accelerations of the heart during locomotion, we had 12 other subjects cycle on an electronically braked bicycle ergometer. Coupling was found between heart rate and pedaling frequency in 10 of them. Cardiac-locomotor coupling appears to be a normal physiological phenomenon, and its identification provides a fresh perspective from which to study endurance.

  9. 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...

  10. 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

  11. Competency Mapping of the Employees

    Science.gov (United States)

    Anisha, N.

    2012-10-01

    Human resource management is a process of bringing people and organizations together so that the goals of each other are met. Nowadays it is not possible to show a good financial or operating report unless your personnel relations are in order. Over the years, highly skilled and knowledge based jobs are increasing while low skilled jobs are decreasing. Competency Mapping is a process of identifying key competencies for an organization, the jobs and functions within it. Competency mapping, the buzz word in any industry is not complicated as it may appear. At the heart of any successful activity lies a competence or skill. In the recent years, various thought leaders in business strategy have emphasized the need to identify what competencies a business needs, in order to compete in a specific environment. In this article explains the why competencies needed and how is measured competency of employees in the organization.

  12. Experts views' on Digital Competence

    NARCIS (Netherlands)

    Janssen, José; Stoyanov, Slavi

    2013-01-01

    Janssen, J., & Stoyanov, S. (2012, 20 November). Online Consultation for a Digital Competence Framework: Experts' views on Digital Competence. Workshop presentation at the Institute for Prospective Technological Studies, Seville, Spain.

  13. 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

  14. 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.

  15. Spiritual Competency Scale: Further Analysis

    Science.gov (United States)

    Dailey, Stephanie F.; Robertson, Linda A.; Gill, Carman S.

    2015-01-01

    This article describes a follow-up analysis of the Spiritual Competency Scale, which initially validated ASERVIC's (Association for Spiritual, Ethical and Religious Values in Counseling) spiritual competencies. The study examined whether the factor structure of the Spiritual Competency Scale would be supported by participants (i.e., ASERVIC…

  16. Physical Education Teachers' Cultural Competency

    Science.gov (United States)

    Harrison, Louis, Jr.; Carson, Russell L.; Burden, Joe, Jr.

    2010-01-01

    The purpose of this study was to evaluate the common assumption that teachers of color (TOC) are more culturally competent than White teachers by assessing physical education teachers' cultural competency. A secondary purpose was to ascertain the possible differences in cultural competence levels of White teachers in diverse school settings versus…

  17. Competing Auctions of Skills

    DEFF Research Database (Denmark)

    Kennes, John; le Maire, Christian Daniel

    The model of competing sellers McAfee (1993) is applied to a labor market environment with heterogeneous workers, who differ by outside option and skill type, and heterogeneous firms, who differ by the amount of output produced when matched to each possible worker tyoe. We derive both a static an...... benchmark model to explore further implications of the theory. For example, we find that observed inter-temporal changes in the overall distribution of wages are not predicted by a simple model of no-comparative advantage.......The model of competing sellers McAfee (1993) is applied to a labor market environment with heterogeneous workers, who differ by outside option and skill type, and heterogeneous firms, who differ by the amount of output produced when matched to each possible worker tyoe. We derive both a static...

  18. Competence and Knowledge Management

    International Nuclear Information System (INIS)

    The main objective of a nuclear regulatory body is to ensure that the nuclear energy applications fulfill the aspect of safety, security and safeguards to protect people and the environment from hazards associated with nuclear facilities or nuclear materials. Therefore, staff competencies of the regulatory body are essential and should be maintained. The continued control of nuclear facilities is needed. In addition, the retirement age of the employees should be calculated as part of human resource planning. In this context, knowledge management has a major role in transferring knowledge to ensure that nuclear energy and its associated technologies can be used safely and that society has greater confidence and trust in the regulator. The nuclear industry can then be assured that it is being regulated competently and fairly. (author)

  19. Language competence in movement

    DEFF Research Database (Denmark)

    Laursen, Helle Pia; Mogensen, Naja Dahlstrup

    2016-01-01

    multilingual children's language and literacy acquisition processes, we direct our focus to a single child's active exploration of what it means to know a language. Through analysis of interviews and researcher generated activities, we see how this child both describes and does language competence...... as a phenomenon that has several meanings, is social, is dependent on location and is unpredictable. Thus, we demonstrate how focus on the child's perspective of what it means to ‘know language’ can lead to insights into the creative, complex and dynamic processes that are part of children's active meaning making......This article examines how, in a multilingual perspective, language competence is experienced, talked about and practiced by language users themselves. By viewing children as active co-creators of the spaces in which language is used, this article contributes to a research tradition in which focus...

  20. WHO NEEDS INTERCULTURAL COMPETENCES?

    Directory of Open Access Journals (Sweden)

    Carmen – Laura ZARZU

    2013-06-01

    Full Text Available The current essay focuses on the need for formal education in the area of intercultural communication and training of intercultural competences. It builds on cultural identity and diversity literature, on the experiment conducted in the Low Countries in introducing a new topic for students from social sciences referring to intercultural communication and on reports and papers of international companies, organizations and agencies. The argument of globalization which should give equal opportunities to each and every world’s citizen adds pressure on managers dealing with multicultural teams. Intercultural competences gain importance in recruiting, while turning cultural diversity in team performance requires skills, knowledge and experience. Managing cultural diversity presupposes that people are aware, recognize, understand and deal with differences. Thus intercultural communication should be studied as a stand-alone topic or imbedded in other subjects in different forms of education or training, so people are prepared for intercultural, social and professional relationships.

  1. Competencies: requirements and acquisition

    OpenAIRE

    Kuenn, A.C.; Meng, C.M.; Peters, Z.; Verhagen, A.M.C.

    2013-01-01

    Higher education is given the key task to prepare the highly talented among the young to fulfil highly qualified roles in the labour market. Successful labour market performance of graduates is generally associated with the acquisition of the correct competencies. Education as an individual investment in human capital is a viewpoint dating back to the 17th century and the writings of Sir William Petty (1662), and includes later work by Adam Smith (1776). The idea was formalized and brought in...

  2. WHO NEEDS INTERCULTURAL COMPETENCES?

    OpenAIRE

    Carmen – Laura ZARZU

    2013-01-01

    The current essay focuses on the need for formal education in the area of intercultural communication and training of intercultural competences. It builds on cultural identity and diversity literature, on the experiment conducted in the Low Countries in introducing a new topic for students from social sciences referring to intercultural communication and on reports and papers of international companies, organizations and agencies. The argument of globalization which should give equal opportu...

  3. Determinants of International Competiveness

    OpenAIRE

    Hojjat Mehdi

    2014-01-01

    International competitiveness is a main source of economic advancement which results in higher standards of living. This paper examines the determinants of international competitiveness as it defines international competitiveness and discusses two common conceptions that are required to achieve higher level of economic competitiveness: government policies and culture. It further explains a research methodology which is known as “Innovation Matrix”. Data is collected from two areas:  competiti...

  4. Competing Orders and Anomalies.

    Science.gov (United States)

    Moon, Eun-Gook

    2016-01-01

    A conservation law is one of the most fundamental properties in nature, but a certain class of conservation "laws" could be spoiled by intrinsic quantum mechanical effects, so-called quantum anomalies. Profound properties of the anomalies have deepened our understanding in quantum many body systems. Here, we investigate quantum anomaly effects in quantum phase transitions between competing orders and striking consequences of their presence. We explicitly calculate topological nature of anomalies of non-linear sigma models (NLSMs) with the Wess-Zumino-Witten (WZW) terms. The non-perturbative nature is directly related with the 't Hooft anomaly matching condition: anomalies are conserved in renormalization group flow. By applying the matching condition, we show massless excitations are enforced by the anomalies in a whole phase diagram in sharp contrast to the case of the Landau-Ginzburg-Wilson theory which only has massive excitations in symmetric phases. Furthermore, we find non-perturbative criteria to characterize quantum phase transitions between competing orders. For example, in 4D, we show the two competing order parameter theories, CP(1) and the NLSM with WZW, describe different universality class. Physical realizations and experimental implication of the anomalies are also discussed. PMID:27499184

  5. Competence, governance, and entrepreneurship

    DEFF Research Database (Denmark)

    Foss, Nicolai Juul; Mahnke, Volker

    This title illustrates modern economics. Because it informs strategic choices, it is relevant to business administration in general, and for strategic management in particular. Two dominant streams may be identified in the literature, namely the "competence" and "governance" perspectives on the f......This title illustrates modern economics. Because it informs strategic choices, it is relevant to business administration in general, and for strategic management in particular. Two dominant streams may be identified in the literature, namely the "competence" and "governance" perspectives...... on the firm. While there has been little direct discussion between the main proponents of these perspectives, both claim that they are reaching for a "strategic theory of the firm". Such a theory would not only shed light on the classical questions considered in the theory of the firm (e.g. why firms exist......, what determines their boundaries and internal organization), but would also be helpful for informing strategy issues, such as understanding strategic flexibility, strategic options, and the sources of competitive advantage. This volume brings together prominent voices on competence, governance...

  6. Competing Orders and Anomalies

    Science.gov (United States)

    Moon, Eun-Gook

    2016-08-01

    A conservation law is one of the most fundamental properties in nature, but a certain class of conservation “laws” could be spoiled by intrinsic quantum mechanical effects, so-called quantum anomalies. Profound properties of the anomalies have deepened our understanding in quantum many body systems. Here, we investigate quantum anomaly effects in quantum phase transitions between competing orders and striking consequences of their presence. We explicitly calculate topological nature of anomalies of non-linear sigma models (NLSMs) with the Wess-Zumino-Witten (WZW) terms. The non-perturbative nature is directly related with the ’t Hooft anomaly matching condition: anomalies are conserved in renormalization group flow. By applying the matching condition, we show massless excitations are enforced by the anomalies in a whole phase diagram in sharp contrast to the case of the Landau-Ginzburg-Wilson theory which only has massive excitations in symmetric phases. Furthermore, we find non-perturbative criteria to characterize quantum phase transitions between competing orders. For example, in 4D, we show the two competing order parameter theories, CP(1) and the NLSM with WZW, describe different universality class. Physical realizations and experimental implication of the anomalies are also discussed.

  7. Toxicity and clinical tolerance of lonidamine.

    Science.gov (United States)

    Robustelli della Cuna, G; Pedrazzoli, P

    1991-04-01

    The new anticancer agent lonidamine has been recently revisited for the treatment of various solid tumors, due to its peculiar and unusual mechanism of action (ie, interference with energy metabolism of tumor cells, morphologically displayed by the appearance of "condensed mitochondria"). First generation trials have in fact demonstrated therapeutic activity and an unusual toxicity profile. Lonidamine is devoid of conventional side effects induced by antiproliferative agents (ie, myelosuppression, stomatitis, cystitis, alopecia, renal, hepatic, and cardiac toxicity). No serious or life-threatening adverse reactions have been recorded even over long term treatment periods. Given as a single agent (in daily doses ranging between 300 and 900 mg) lonidamine induces the following side effects: myalgia, testicular pain, asthenia, ototoxicity, nausea and vomiting, gastric pain, and drowsiness. Hyperesthesia and photophobia have also been reported. In combination with radiotherapy (in oral daily doses ranging between 300 and 450 mg) lonidamine was well tolerated, without any reported evidence of additional toxicity. When associated with cytotoxic agents no enhanced toxicity was observed. In particular, myelosuppression and other conventional nonhematological adverse reactions were never greater than would be expected with chemotherapy alone. The same applies to toxicity and tolerance of lonidamine when used concurrently with hypertermia. The data collected from large series of cancer patients treated with this new agent show that lonidamine is a safe drug whether used alone or in combination with other effective anticancer treatments. The reported therapeutic efficacy and the peculiar toxic profile make lonidamine an interesting new drug for future clinical trials. PMID:2031192

  8. Nuclear safety and human competence

    International Nuclear Information System (INIS)

    Competence represents a very well defined ensemble of knowledge and skills, behavior modalities, standard procedures and judgement types that can be used in a given situation, without a priori learning. It is obvious that a person competence should fulfill the needs of the company he works for. For a Nuclear Power Plant operator competence is a constitutive part of his individuality. Competence includes: 1. Knowledge that can be classified in three main items: - procedural and declarative knowledge; - practical knowledge and skills; - fundamental knowledge. 2. 'Non cognitive' knowledge components, such as 'social information', team collective competence, safety education, risks perception and management. The last item presents a special interest for nuclear safety. On the other hand, competence level defines the quality of procedures applied in different operational situations. Competence - procedures relations are presented. Competence fundament results from operator activity analysis. The analyst has to take into consideration several phases of activity in which competence is highlighted like: - genesis, during formation; - transformation, during adaptation to a technical modification; - transfer, from expert to probationer. Competence is subject to a continuous transformation process due to technical and organizational evolutions and 'operator ageing'. Cognitive ageing of operators or the technical ageing of competence often appear to be superimposed. Technical progress acceleration increases the ageing effects of competence. Knowledge - skills dynamic relations are discussed. The changing of organizational form determines appearance of new competence gained from others domains or defined by multidisciplinary studies. Ergonomics can help the changing of organizational form through analysis of operators evolution activity which will generate new competence. Ergonomics can contribute to identify means of raising competence starting from learning process

  9. 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.

  10. Distributed Structure Searchable Toxicity

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Distributed Structure Searchable Toxicity (DSSTox) online resource provides high quality chemical structures and annotations in association with toxicity data....

  11. Serum from Diesel Exhaust-Exposed Rats with Cardiac Dysfunction Alters Aortic Endothelial Cell Function In Vitro: Circulating Mediators as Causative Factors?

    Science.gov (United States)

    Although circulating inflammatory mediators are strongly associated with adverse cardiovascular outcomes triggered by inhaled air pollution, direct cause-effect linkage has not been established. Given that endothelial toxicity often precedes and precipitates cardiac dysfunction, ...

  12. Causes and prevention of sudden cardiac death in the elderly.

    Science.gov (United States)

    Tung, Patricia; Albert, Christine M

    2013-03-01

    Sudden cardiac death (SCD) is a major cause of mortality in elderly individuals owing to a high prevalence of coronary heart disease, systolic dysfunction, and congestive heart failure (CHF). Although the incidence of SCD increases with age, the proportion of cardiac deaths that are sudden decreases owing to high numbers of other cardiac causes of death in elderly individuals. Implantable cardioverter-defibrillator (ICD) therapy has been demonstrated to improve survival and prevent SCD in selected patients with systolic dysfunction and CHF. However, ICD therapy in elderly patients might not be effective because of a greater rate of pulseless electrical activity underlying SCD and other competing nonarrhythmic causes of death in this population. Although under-represented in randomized trials of ICD use, elderly patients comprise a substantial proportion of the population that qualifies for and receives an ICD for primary prevention under current guidelines. Cardiac resynchronization therapy (CRT), which has been demonstrated to reduce mortality in selected populations with heart failure, is also more commonly used in this group of patients than in younger individuals. In this Review, we examine the causes of SCD in elderly individuals, and discuss the existing evidence for effectiveness of ICD therapy and CRT in this growing population.

  13. PLURILINGUAL COMPETENCE, STYLES AND VARIATION

    Directory of Open Access Journals (Sweden)

    Jyrki Kalliokoski

    2011-01-01

    Full Text Available The paper explores plurilingual competence in respect to language proficiency, language education and pluri- and multilingualism. The notion of communicative competence was introduced by Hymes (1972 as a reaction to chomskyan view of language as an autonomous system. Hymes’ notion of communicative competence originally included plurilingualism. The concept of communicative competence was quickly adopted to applied linguistics but the idea of a linguistic repertoire consisting of the competencies of linguistic varieties was not imported to SLA or language testing. The Hymesian perspective to plurilingualism as an essential dimension of communicative competence was revived in the Common European Framework (CEFR. However,the practice of applying the CEFR has mostly neglected the dimension on plurilingualism and plurilingual competence. The focus in the use of the CEFR has been on the different areas of language skills within one single language at a time, while the application of plurilingual practices has gained very little attention. The Hymesian notion of communicative competence has lived on in the sociolinguistic research tradition, especially within interactional sociolinguistics. The present paper relates the notion of plurilingual competence to its hymesian origin, to recent trends in plurilingual and pluricultural education, and to the sociolinguistic study of style and linguistic variation in multilingual communities. The article uses Finnish L2 data to show how plurilingual competence is used as an interactional resource.From the perspective of language learning, plurilingual competence enables speakers with different linguistic backgrounds to use their shared linguistic repertoire in order to ensure smooth interaction and achieve mutual understanding.

  14. 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.

  15. 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

  16. 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.

  17. 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

  18. 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...

  19. 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

  20. Surgical Simulation and Competency.

    Science.gov (United States)

    Kim-Fine, Shunaha; Brennand, Erin A

    2016-09-01

    Simulation in surgical training is playing an increasingly important role as postgraduate medical education programs navigate an environment of increasing costs of education, increased attention on patient safety, and new duty hour restrictions. In obstetrics and gynecology, simulation has been used to teach many procedures; however, it lacks a standardized curriculum. Several different simulators exist for teaching various routes and aspects of hysterectomy. This article describes how a formal framework of increasing levels of competencies can be applied to simulation in teaching the procedure of hysterectomy. PMID:27521885

  1. Designing for competences

    DEFF Research Database (Denmark)

    Christiansen, Rene B; Gundersen, Peter Bukovica

    2014-01-01

    of these professionals has changed - and has become more cross-professional, more complex and analytic and reflective competencies have entered the policy papers of these human-professions as central, important forms of knowledge. These bachelor degrees in Denmark within the field of education (teaching and preschool......During the last decades the semi-professions have undergone dramatic changes. What has become widely known as ‘the academic’ turn has hit professions such as teachers and preschool workers demanding higher academic skills in forms of bachelor degree level. Arguments have been that the practice...

  2. Organizational Relationship Termination Competence

    DEFF Research Database (Denmark)

    Ritter, Thomas; Geersbro, Jens

    2011-01-01

    termination are found to significantly affect a firm's relationship termination competence. The findings suggest that managers should regard termination as a legitimate option in customer relationship management. In order to decrease the number of unwanted customers, managers must accept termination...... of organizational termination in order to improve our understanding of the management of termination. The impact of these termination dimensions on the percentage of unwanted customers is developed and tested using PLS on data gathered from a cross-sectional survey of more than 800 sales representatives. We find...

  3. Maintaining medical competence

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2012-11-01

    Full Text Available No abstract available. Article truncated at 150 words. I recently renewed my Arizona medical license and meet all the requirements. I far exceed the required CME hours and have no Medical Board actions, removal of hospital privileges, lawsuits, or felonies. None of the bad things are likely since I have not seen patients since July 1, 2011 and I no longer have hospital privileges. However, this caused me to pause when I came to the question of “Actively practicing”? A quick check of the status of several who do not see patients but are administrators, retired or full time editors of other medical journals revealed they were all listed as “active”. I guess that “medical journalism” is probably as much a medical activity as “administrative medicine” which is recognized by the Arizona Medical Board. This got me to thinking about competence and the Medical Board’s obligation to ensure competent physicians. Medical boards focused on preventing the unlicensed practice …

  4. 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.

  5. Warmth and Competence: Stereotype Content Issues for Clinicians and Researchers.

    Science.gov (United States)

    Fiske, Susan T

    2012-02-01

    Stereotypes are often accidents of history, based on passing configurations of groups' societal interdependence and status. This article overviews our framework for understanding all this: the Stereotype Content Model, focused on two fundamental dimension of intergroup and interpersonal cognition, perceived warmth (from interdependence) and perceived competence (from relative status); then it discusses immigrant images as a case study; next, the article focuses on the toxic and potentially curative effects of each dimension.

  6. 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.

  7. 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.

  8. 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

  9. Lecturer’s Speech Competence

    OpenAIRE

    Svetlana Viktorovna Panina; Svetlana Yurievna Zalutskaya; Galina Egorovna Zhondorova

    2014-01-01

    The analysis of the issue of lecturer’s speech competence is presented. Lecturer’s speech competence is the main component of professional image, the indicator of communicative culture, having a great impact on the quality of pedagogical activity Research objective: to define the main drawbacks of speech competence of lecturers of North-Eastern Federal University named after M. K. Ammosov (NEFU) (Russia, Yakutsk) and suggest the ways of drawbacks corrections in terms of multilingual education...

  10. Pragmatic Competence in Classroom Teaching

    Institute of Scientific and Technical Information of China (English)

    何梦宇

    2013-01-01

    Pragmatic competence is a branch of language education studies within the overall framework of linguistics. The paper discusses relationship between pragmatics and classroom teaching from the perspectives of pragmatic competence, features of class-room teaching and how to cultivate pragmatics competence in classroom teaching. It is argued that there are positive role of prag-matics in classroom teaching. This thesis tries to finally give some advise from pragmatics for further language education research.

  11. The TENCompetence Personal Competence Manager

    OpenAIRE

    Kew, Christopher

    2007-01-01

    The European Network for Lifelong Competence Development is an Integrated Project funded by the EU. Its goal is to establish an innovative technical and organizational infrastructure using open-source, standards-based technology to support lifelong competence development. In this paper the TENCompetence approach to competence development in lifelong learning is described, and the challenges which this presents users are outlined. A solution is proposed through provision of a service oriented ...

  12. Incidence of cardiac conduction disorders in patients with rheumatic disease receiving hydroxychloroquine

    Directory of Open Access Journals (Sweden)

    Vijaya Prasanna Parimi

    2015-06-01

    Conclusion: This study highlights need for periodic cardiac evaluation of patients receiving long-term antimalarials. Reversibility of antimalarial toxicity is also highlighted in this study. Conduction disorders observed were similar to that expected in general population thus adding further evidence on safety of HCQ. [Int J Basic Clin Pharmacol 2015; 4(3.000: 565-567

  13. 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.

  14. Fostering Communicative Competence through Technology

    Directory of Open Access Journals (Sweden)

    Muhammad Aslam Sipra

    2013-05-01

    Full Text Available The article explores the use of technology in EFL classes to promote communicative competence. It elucidates communicative competence and explicates obstructions in communicative tasks. Moreover, it interprets the use of technology in fostering and supporting the development of communicative competence and explains how it is pragmatic in maintaining learners’ level of motivation and interest in learning a foreign language. The present article identifies the significance and use of mobile phone, camera, computer and internet, tape recorder, projector, and language labs in EFL classes. Besides, it discusses the use of technology as an educational tool in language teaching and learning.Keywords: Educational technology, fostering, communicative competence, language teaching, learning

  15. eCompetence Case Studies

    DEFF Research Database (Denmark)

    Jensen, Helle Bækkelund

    2006-01-01

    In this paper we present some details of the processes undertaken in the European eCompetence Initiative. We present two illustrative and representative case studies. The research aims to identify and understand patterns of individual and organisational eCompetence approaches.......In this paper we present some details of the processes undertaken in the European eCompetence Initiative. We present two illustrative and representative case studies. The research aims to identify and understand patterns of individual and organisational eCompetence approaches....

  16. Juvenile Competency to Stand Trial.

    Science.gov (United States)

    Stepanyan, Sofia T; Sidhu, Shawn S; Bath, Eraka

    2016-01-01

    Competency to stand trial is interpreted as a protected due process right for all defendants and is defined as a defendant's fundamental knowledge and understanding of the criminal charges being filed, roles and procedures within the courtroom, and a general ability to work with the defense counsel. Questions of competency are most often raised by the judge, defense, or the prosecution, and competency evaluations are most often completed by psychiatrists or psychologists with forensic training or work experience. Mental illness, intellectual disability, developmental disorders, and developmental immaturity are the 4 main factors considered in most juvenile competency evaluations. PMID:26593118

  17. Understanding Discourse Competence in Translation

    Directory of Open Access Journals (Sweden)

    Masduki Masduki

    2016-01-01

    Full Text Available Discourse as a communication event is influenced by topic being communicated, interpersonal relationship between the communicants, and communication channel used in context. Whatever senses created by the communicants is fully related to culture and situation being involved. Participating in conversation, reading, writing, and translating, activates discourse competence, which requires the use of a set of strategy to realize or mobilize all declarative knowledge in the real context of communication. Further, this article highlights the discourse competence and how it is culturally implemented in translation as an activity of transferring messages. The discussion covers the overview of discourse competence, discourse approach, and discourse competence in translation.

  18. 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 ...

  19. Can this college athlete compete?

    Science.gov (United States)

    Cantwell, J D

    1996-04-01

    A 20-year-old male college sprinter and hurdler was seen for a cardiology assessment because a preseason cardiac evaluation revealed a heart murmur dating back to early childhood. He was asymptomatic.

  20. Competence Models in Technology-enhanced Competence-based Learning

    NARCIS (Netherlands)

    Sampson, Demetrios; Fytros, Demetrios

    2008-01-01

    Please cite as: Sampson, D., & Fytros, D. (2008). Competence Models in Technology-enhanced Competence-based Learning. In H. H. Adelsberger, Kinshuk, J. M. Pawlowski & D. Sampson (Eds.), International Handbook on Information Technologies for Education and Training, 2nd Edition, Springer, June 2008

  1. Competence Based Educational Metadata for Supporting Lifelong Competence Development Programmes

    NARCIS (Netherlands)

    Sampson, Demetrios; Fytros, Demetrios

    2008-01-01

    Sampson, D., & Fytros, D. (2008). Competence Based Educational Metadata for Supporting Lifelong Competence Development Programmes. In P. Diaz, Kinshuk, I. Aedo & E. Mora (Eds.), Proceedings of the 8th IEEE International Conference on Advanced Learning Technologies (ICALT 2008), pp. 288-292. July, 1-

  2. Examining Perception of Competency through Practicum Competencies Outline

    Science.gov (United States)

    Esposito, Giovanna; Freda, Maria Francesca; Bosco, Valentina

    2015-01-01

    Purpose: This study aims to examine the self-perceived competencies of 231 Italian students enrolled in a psychological degree program and involved in a practicum. It analyzes the subjective perception of the competences that students expect to develop, acknowledge as developed and that might be inferred from tasks performed during the practicum;…

  3. Competence-based education to develop digital competence

    NARCIS (Netherlands)

    Wesselink, R.; Giaffredo, Silvio

    2015-01-01

    The competence approach to learning and teaching has been described by several theoretical models. These formal models are often not integrated with concrete educational activity. On the contrary, this article proposes a practical implementation of the competence approach in education. The model of

  4. Where Cultural Competency Begins: Changes in Undergraduate Students' Intercultural Competency

    Science.gov (United States)

    Sandell, Elizabeth J.; Tupy, Samantha J.

    2015-01-01

    Teacher preparation programs and accreditation organizations have acknowledged need for educators to demonstrate intercultural knowledge, skills, and abilities. Teacher educators are responding to emphasis in higher education to assure that graduates achieve intercultural competence (NCATE, 2008). This study compared the cultural competency of…

  5. Building Intercultural Competence through Intercultural Competency Certification of Undergraduate Students

    Science.gov (United States)

    Janeiro, Maria G. Fabregas; Fabre, Ricardo Lopez; Nuno de la Parra, Jose Pablo

    2014-01-01

    The Intercultural Competency Certificate (CCI in Spanish) designed for the Universidad Popular Autonoma del Estado de Puebla (UPAEP University) is a theory based comprehensive plan to develop undergraduate students' intercultural competence. This Certificate is based in the Developmental Model of Intercultural Sensitivity (DMIS) developed by…

  6. Competence and Competency-based Training: What the Literature Says

    Science.gov (United States)

    Guthrie, Hugh

    2009-01-01

    This literature review, commissioned by the National Quality Council, provides a historical account of the development of competency-based training in Australia and summarises the issues arising from the range of reviews conducted on elements of the national training system. It also explores the variety of ways in which competence is conceived…

  7. Possible Protective Role of Carnosine against gamma-Radiation-Induced Cardiac Dysfunction in Mice

    International Nuclear Information System (INIS)

    Oxidative Stress with subsequent production of reactive oxygen species (ROS) has been postulated as one of the mechanisms of cardiac toxicity. Carnosine (β-alanyl-L-histidine) a biological antioxidant, is a relatively non-toxic dipeptide which possesses many functions (antiglycator, scavenger of ions of zinc and copper, toxic aldehydes and protein carbonyls) that are likely to suppress oxidative stress. The aim of the present work is to investigate the possible protective effects of carnosine on gamma-radiation-induced cardiac damage in mice. Carnosine was supplemented daily to mice (50 mg/ Kg body wt), by gavage, 10 days before whole body gamma-irradiation at a dose of 5 Gy (applied as a shot dose). The results obtained showed that whole body gamma-irradiation of mice produced biochemical alteration in levels of serum glucose and lipid profile fractions. Furthermore, some markers of cardiac injury enzymes as serum lactate dehydrogenase (LDH), creatin phosphokinase (CPK) and aspartate transaminase (AST) activities showed significant increases associated with alteration in the antioxidant status of cardiac tissues. Significant increases of lipid peroxidation end product malonaldehyde (MDA) and protein carbonyl levels, xanthine oxidase (XO) activity along with reduction in the activity of cardiac antioxidant enzymes; glutathione peroxidase (GPx), superoxide dismutase (SOD) and catalase (CAT) were observed. Carnosine-treatment prior irradiation has attenuated the cardiotoxic effects of radiation obvious by reduction in the levels of MDA and protein carbonyl and XO activity, rescued the depletion of endogenous antioxidant enzymes and diminished the increases of cardiac injury markers. It could be postulated that carnosine as a multi-functional dietary supplement could exert a modulator role in the radiation-induced cardiac damage and serum biochemical changes through its antioxidant properties

  8. Competing For industry Resources

    International Nuclear Information System (INIS)

    This presentation by Norway's Minister of Petroleum and Energy describes (1) Norway in the energy picture, (2) oil market developments, (3) the establishment of an energy policy and (4) the investment level of the Norwegian petroleum activities. Value creation from Norwegian petroleum resources is directly connected with the commercial companies' participation in the activities. Thus, it has been a main challenge for Norway to establish a balanced petroleum policy and a legal framework. Presumably Norway will remain a prospective and attractive petroleum province for a long time. Over the years, Norway has developed three very competent and competitive national oil companies and a significant national supply industry. This industry is highly competitive internationally. Many new petroleum provinces are opening up for foreign investors and energy consumption of the world is expected to increase significantly the next 20 - 30 years. This implies increased demand for the products, but also strong competition for industry resources

  9. Competing on analytics.

    Science.gov (United States)

    Davenport, Thomas H

    2006-01-01

    We all know the power of the killer app. It's not just a support tool; it's a strategic weapon. Companies questing for killer apps generally focus all their firepower on the one area that promises to create the greatest competitive advantage. But a new breed of organization has upped the stakes: Amazon, Harrah's, Capital One, and the Boston Red Sox have all dominated their fields by deploying industrial-strength analytics across a wide variety of activities. At a time when firms in many industries offer similar products and use comparable technologies, business processes are among the few remaining points of differentiation--and analytics competitors wring every last drop of value from those processes. Employees hired for their expertise with numbers or trained to recognize their importance are armed with the best evidence and the best quantitative tools. As a result, they make the best decisions. In companies that compete on analytics, senior executives make it clear--from the top down--that analytics is central to strategy. Such organizations launch multiple initiatives involving complex data and statistical analysis, and quantitative activity is managed atthe enterprise (not departmental) level. In this article, professor Thomas H. Davenport lays out the characteristics and practices of these statistical masters and describes some of the very substantial changes other companies must undergo in order to compete on quantitative turf. As one would expect, the transformation requires a significant investment in technology, the accumulation of massive stores of data, and the formulation of company-wide strategies for managing the data. But, at least as important, it also requires executives' vocal, unswerving commitment and willingness to change the way employees think, work, and are treated. PMID:16447373

  10. Competence development: Key issues and trends in European competence policies

    DEFF Research Database (Denmark)

    Milana, Marcella

    papers, reports, and communications that led to directives and resolutions concerning the development and recognition of skills and competences in a lifelong learning perspective. In 2005 this process led to the definition of a European Framework on Key Competences for Lifelong Learning - covering those......  In recent years there has been a rising political attention on competence development both at national and international level. At European level in particular, since 2000, with the set of the Lisbon Agenda, different bodies representing the Union have been very productive in generating working...... competences that are given priority within the Union - as well as a European Qualification Framework, a reference tool for making qualifications - here described in terms of progressive levels of competence - transparent and transferable within the European borders. The aim of the paper is to investigate...

  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. 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.

  13. 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.

  14. Review on nutritional management of cardiac disorders in canines

    Directory of Open Access Journals (Sweden)

    Sarita Devi

    Full Text Available A variety of nutritional deficiencies, dietary protein, fat, vitamins, minerals and trace elements are known to cause cardiac disease in various species. Nutritional management of dogs with cardiac problems can be handling with providing adequate calories, protein and modulating cytokine production to manage the possible cause of decreased appetite of the side effects of medications. Owners should be aware that dietary supplements are not regulated in the same way as drugs. They do not require proof of safety, efficacy, or quality control before they can be sold. Therefore, careful selection of type, dose, and brand is important to avoid toxicities or complete lack of efficacy. [Vet World 2009; 2(12.000: 482-485

  15. Nanomaterials and nanoparticles : Sources and toxicity

    CERN Document Server

    Buzea, Cristina; Robbie, Kevin

    2008-01-01

    This review is written with the goal of informing public health concerns related to nanoscience, while raising awareness of nanomaterials toxicity among scientists and manufacturers handling them. We show that humans have always been exposed to nanoparticles and dust from natural sources and human activities, the recent development of industry and combustion-based engine transportation profoundly increasing anthropogenic nanoparticulate pollution. The key to understanding the toxicity of nanoparticles is that their minute size, smaller than cells and cellular organelles, allows them to penetrate these basic biological structures, disrupting their normal function. Among diseases associated with nanoparticles are asthma, bronchitis, lung cancer, neurodegenerative diseases (such as Parkinson`s and Alzheimer`s diseases), Crohn`s disease, colon cancer. Nanoparticles that enter the circulatory system are related to occurrence of arteriosclerosis, and blood clots, arrhythmia, heart diseases, and ultimately cardiac d...

  16. 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...

  17. 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.

  18. 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...

  19. 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...

  20. 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...

  1. Conditions for Developing Communicative Competence

    Science.gov (United States)

    Zascerinska, Jelena

    2010-01-01

    Introduction. Individuals need communicative competence for personal fulfillment and development, active citizenship, social inclusion and employment. Materials and Methods. The meaning of the key concepts of "communicative competence" and "opportunities" is studied within the search for conditions to develop. Conclusion. The theoretical findings…

  2. Conversational Competence in Academic Settings

    Science.gov (United States)

    Bowman, Richard F.

    2014-01-01

    Conversational competence is a process, not a state. Ithaca does not exist, only the voyage to Ithaca. Vibrant campuses are a series of productive conversations. At its core, communicative competence in academic settings mirrors a collective search for meaning regarding the purpose and direction of a campus community. Communicative competence…

  3. Cultural competency training in psychiatry.

    Science.gov (United States)

    Qureshi, A; Collazos, F; Ramos, M; Casas, M

    2008-01-01

    Recent reports indicate that the quality of care provided to immigrant and ethnic minority patients is not at the same level as that provided to majority group patients. Although the European Board of Medical Specialists recognizes awareness of cultural issues as a core component of the psychiatry specialization, few medical schools provide training in cultural issues. Cultural competence represents a comprehensive response to the mental health care needs of immigrant and ethnic minority patients. Cultural competence training involves the development of knowledge, skills, and attitudes that can improve the effectiveness of psychiatric treatment. Cognitive cultural competence involves awareness of the various ways in which culture, immigration status, and race impact psychosocial development, psychopathology, and therapeutic transactions. Technical cultural competence involves the application of cognitive cultural competence, and requires proficiency in intercultural communication, the capacity to develop a therapeutic relationship with a culturally different patient, and the ability to adapt diagnosis and treatment in response to cultural difference. Perhaps the greatest challenge in cultural competence training involves the development of attitudinal competence inasmuch as it requires exploration of cultural and racial preconceptions. Although research is in its infancy, there are increasing indications that cultural competence can improve key aspects of the psychiatric treatment of immigrant and minority group patients. PMID:18371580

  4. Assessing Competence in Pediatric Cardiology

    Science.gov (United States)

    Johnson, Apul E.; And Others

    1976-01-01

    In response to the need to assure physician competence, a rating scale was developed at the University of Minnesota Medical School for use in evaluating clinical competence in pediatric cardiology. It was tested on first- and second-year specialists. Development and testing procedures are described. (JT)

  5. Model of Intercultural Communicative Competence

    Institute of Scientific and Technical Information of China (English)

    刘星

    2015-01-01

    Intercultural communication is regarded as both an important course in Chinese universities but also a necessary skill which global citizens must own.How to define the term of intercultural communicative competence becomes vital in developing and assessing learners’ intercultural competence.

  6. Cultural competency training in psychiatry.

    Science.gov (United States)

    Qureshi, A; Collazos, F; Ramos, M; Casas, M

    2008-01-01

    Recent reports indicate that the quality of care provided to immigrant and ethnic minority patients is not at the same level as that provided to majority group patients. Although the European Board of Medical Specialists recognizes awareness of cultural issues as a core component of the psychiatry specialization, few medical schools provide training in cultural issues. Cultural competence represents a comprehensive response to the mental health care needs of immigrant and ethnic minority patients. Cultural competence training involves the development of knowledge, skills, and attitudes that can improve the effectiveness of psychiatric treatment. Cognitive cultural competence involves awareness of the various ways in which culture, immigration status, and race impact psychosocial development, psychopathology, and therapeutic transactions. Technical cultural competence involves the application of cognitive cultural competence, and requires proficiency in intercultural communication, the capacity to develop a therapeutic relationship with a culturally different patient, and the ability to adapt diagnosis and treatment in response to cultural difference. Perhaps the greatest challenge in cultural competence training involves the development of attitudinal competence inasmuch as it requires exploration of cultural and racial preconceptions. Although research is in its infancy, there are increasing indications that cultural competence can improve key aspects of the psychiatric treatment of immigrant and minority group patients.

  7. Model of Intercultural Communicative Competence

    Institute of Scientific and Technical Information of China (English)

    刘星

    2015-01-01

    ntercultural communication is regarded as both an important course in Chinese universities but also a necessary skill which global citizens must own.How to define the term of intercultural communicative competence becomes vital in developing and assessing learners’ intercultural competence.

  8. Cultural Competency as Skilled Dialogue.

    Science.gov (United States)

    Barrera, Isaura; Corso, Robert M.

    2002-01-01

    This article describes Skilled Dialogue, an approach to cultural competency developed in response to the challenges posed by cultural linguistic diversity. Skilled Dialogue focuses on cultural competency as the ability to craft respectful, reciprocal, and responsive interactions across diverse cultural parameters. Characteristics, component…

  9. Care Competence in Nursing Education

    OpenAIRE

    Bagnasco, Annamaria; Rosa, Francesca; Aleo, Giuseppe; Sasso, Loredana

    2012-01-01

    We present this commentary to discuss the main European initiatives and issues regarding education for health professionals, specifi cally nurses, both to stimulate international debate and to learn more about what is happening in this fi eld in other continents.(Published: 26 April 2012)Keywords: nursing education , competence , critical thinking , competence-based education DOI: 10.3109/21614083.2012.677711

  10. 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

  11. 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.

  12. [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.

  13. 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.

  14. 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...

  15. 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.)

  16. 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...

  17. Mediational Competencies for Online Education

    Directory of Open Access Journals (Sweden)

    María Elena Chan Núñez

    2005-11-01

    Full Text Available Addressed in the article is a position taken within and in favor of education and virtuality, considering the importance of training constructors of the digital environment. The competencies needed by actors of educational processes, the same which are necessary for their construction, are conceptualized as mediational. Because these are not usually the competencies most visibly when teachers and students are trained for online education, we found it of interest to present part of a research project on this type of competencies. The work starts out from an axiological position on virtual education, the recognition of the way the technologies model educational interactions on line. It follows with the notion of mediation and meditational competency, and comes to a design model that would consider these competencies in the development of learning environments. The article closes with reflections about the interdisciplinary integration necessary for a technological and educational development based on a communicative paradigm.

  18. Constructivism in cultural competence education.

    Science.gov (United States)

    Hunter, Jennifer L; Krantz, Steven

    2010-04-01

    A graduate course on cultural diversity, based in constructivist theory and structured on the Process of Cultural Competence in the Delivery of Healthcare Services model, was developed and taught through classroom and online methods. The following research questions were explored: 1) Can an educational experience, built on constructivist learning theory tenets, change students' perceptions, attitudes, knowledge, and skills in the area of cultural competence? 2) Does the delivery method, online or traditional classroom, influence the degree of change? The study used a quasi-experimental, pretest-posttest control group design using the Inventory for Assessing the Process of Cultural Competence Among healthcare Professionals Revised. Findings showed significant changes (p<0.001) in cultural competence scores and subscores for all learners with both teaching modalities based on interval scale and in categories of cultural knowledge, skills, desire, and overall competence based on a nominal scale. The untaught construct of cultural desire showed the most significant improvement.

  19. Cultural competence: a constructivist definition.

    Science.gov (United States)

    Blanchet Garneau, Amélie; Pepin, Jacinthe

    2015-01-01

    In nursing education, most of the current teaching practices perpetuate an essentialist perspective of culture and make it imperative to refresh the concept of cultural competence in nursing. The purpose of this article is to propose a constructivist definition of cultural competence that stems from the conclusions of an extensive critical review of the literature on the concepts of culture, cultural competence, and cultural safety among nurses and other health professionals. The proposed constructivist definition is situated in the unitary-transformative paradigm in nursing as defined by Newman and colleagues. It makes the connection between the field of competency-based education and the nursing discipline. Cultural competence in a constructivist paradigm that is oriented toward critical, reflective practice can help us develop knowledge about the role of nurses in reducing health inequalities and lead to a comprehensive ethical reflection about the social mandate of health care professionals.

  20. 32 CFR 776.20 - Competence.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Competence. 776.20 Section 776.20 National... Professional Conduct § 776.20 Competence. (a) Competence. A covered attorney shall provide competent, diligent.... Initial determinations as to competence of a covered USG attorney for a particular assignment shall...

  1. 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...

  2. Fungal transporters involved in efflux of natural toxic compounds and fungicides

    NARCIS (Netherlands)

    Del Sorbo, G.; Schoonbeek, H.; Waard, de M.A.

    2000-01-01

    Survival of microorganisms in natural environments is favored by the capacity to produce compounds toxic to competing organisms and the ability to resist the effects of such toxic compounds. Both factors contribute to a competitive advantage of organisms in ecosystems. All organisms have evolved act

  3. Using competences and competence tools in workforce development.

    Science.gov (United States)

    Green, Tess; Dickerson, Claire; Blass, Eddie

    The NHS Knowledge and Skills Framework (KSF) has been a driving force in the move to competence-based workforce development in the NHS. Skills for Health has developed national workforce competences that aim to improve behavioural performance, and in turn increase productivity. This article describes five projects established to test Skills for Health national workforce competences, electronic tools and products in different settings in the NHS. Competences and competence tools were used to redesign services, develop job roles, identify skills gaps and develop learning programmes. Reported benefits of the projects included increased clarity and a structured, consistent and standardized approach to workforce development. Findings from the evaluation of the tools were positive in terms of their overall usefulness and provision of related training/support. Reported constraints of using the competences and tools included issues relating to their availability, content and organization. It is recognized that a highly skilled and flexible workforce is important to the delivery of high-quality health care. These projects suggest that Skills for Health competences can be used as a 'common currency' in workforce development in the UK health sector. This would support the need to adapt rapidly to changing service needs. PMID:21072016

  4. Risks, risk assessment and risk competence in toxicology

    Directory of Open Access Journals (Sweden)

    Stahlmann, Ralf

    2015-07-01

    Full Text Available Understanding the toxic effects of xenobiotics requires sound knowledge of physiology and biochemistry. The often described lack of understanding pharmacology/toxicology is therefore primarily caused by the general absence of the necessary fundamental knowledge. Since toxic effects depend on exposure (or dosage assessing the risks arising from toxic substances also requires quantitative reasoning. Typically public discussions nearly always neglect quantitative aspects and laypersons tend to disregard dose-effect-relationships. One of the main reasons for such disregard is the fact that exposures often occur at extremely low concentrations that can only be perceived intellectually but not by the human senses. However, thresholds in the low exposure range are often scientifically disputed. At the same time, ignorance towards known dangers is wide-spread. Thus, enhancing the risk competence of laypersons will have to be initially restricted to increasing the awareness of existing problems.

  5. Anthracycline-induced cardiac injury using a cardiac cell line: potential for gene therapy studies.

    Science.gov (United States)

    L'Ecuyer, T; Horenstein, M S; Thomas, R; Vander Heide, R

    2001-11-01

    Anthracyclines are effective antitumor agents whose chief limitation has been cardiotoxicity directly related to free radical production. Therefore, strategies designed to selectively overexpress antioxidant proteins in the heart could protect against drug-induced toxicity and allow higher doses of chemotherapy. However, to date an adequate cardiac model system that is susceptible to anthracycline injury and can express foreign genes in a controlled fashion has been lacking. Developing a cardiac model system would permit examination of the relationship between the expression level of a potentially protective foreign gene and the degree of protection from injury. In this study we have examined the potential of the H9C2 rat cardiac myocyte cell line in this regard. H9C2 cells differentiate in a reproducible fashion, as shown by progressive increases in muscle tropomyosin-expressing cells, the organization of this thin filament protein, and the percentage of muscle cells contained within myotubes. Exposure of this cell line to the anthracycline doxorubicin produces cell injury as indicated by release of the intracellular enzyme lactate dehydrogenase into the culture medium. This injury is preceded by generation of reactive oxygen species, indicated by fluorescence after loading with carboxy-dichlorodihydrofluorescein diacetate. Stable transfection of H9C2 cells with a plasmid producing a tetracycline transactivator protein allows foreign genes to be expressed at a level tightly controlled by the concentration of tetracycline in the culture medium. Since H9C2 cells differentiate, can be injured by anthracycline exposure, and can express foreign genes at controllable levels, this is a suitable system in which to design genetic approaches to prevent this important clinical problem. PMID:11708868

  6. EMuRgency: Addressing cardiac arrest with socio-technical innovation in a smart learning region

    Directory of Open Access Journals (Sweden)

    Sabina Jeschke

    2013-08-01

    Full Text Available This paper introduces the EMuRgency project. The project has the goal to increase awareness and competences regarding the problem of cardiac arrest in the Euregio Meuse-Rhine (EMR and to use socio-technical innovations to transfer it into a smart learning region. Based on the conscious competence framework solutions for stakeholders on different levels of the framework are introduced, namely a public display network, mobile learning apps and a volunteer notification system. Finally, a future research outlook is given.

  7. A competency transcript to assess and personalize new graduate competency.

    Science.gov (United States)

    Roberts, Kathleen; Lockhart, Robin; Sportsman, Susan

    2009-01-01

    The competence of a new registered nurse (RN) at the time of graduation influences the rapidity with which the RN becomes an effective practitioner. One school of nursing offering a bachelor of science in nursing developed a competency documentation system, a "competency transcript," to better describe the graduate's clinical judgment and psychomotor skill. This transcript was used as a communication tool between a clinical agency and a university school of nursing and was also used to help one hospital personalize orientation based on the learning needs of the graduate, with the goal of decreasing orientation time and cost. PMID:19104283

  8. Competencies for the 21st Century Information Professional: Translating the SLA Competencies into Business Competencies.

    Science.gov (United States)

    Henczel, Sue

    This paper examines how the Special Libraries Association competencies can be mapped to the broader business competencies of marketing (promoting), packaging (product development), persuading and performing (sales/customer service), and positioning (strategic maneuvering). It introduces a process whereby the skills, knowledge, understandings, and…

  9. Creating competence: perspectives and practices in organizations

    NARCIS (Netherlands)

    Mulder, Martin

    2000-01-01

    Creating competence has become a major issue in organizations. Various authors contend that competency management has the potential of integrating organizational strategy, human-resource instruments, and human-resource development; that competency development can lead to performance improvement; and

  10. Revisiting purchasing competence - In a project context

    DEFF Research Database (Denmark)

    Lutz, Salla

    2015-01-01

    purchasing and competences required undertaking these activities. Four overall purchasing competence areas were identified. Hence, four propositions related to the purchasing competence were developed by iteratively combining elements from the purchasing literature with an empirical inquiry in an offshore...

  11. Competence articulation: Alignment of competences and responsibilities in synchronous telemedical collaboration

    DEFF Research Database (Denmark)

    Larsen, Simon Bo; Bardram, Jakob Eyvind

    2008-01-01

    . In particular, we want to look at the dynamic quality of competences, and investigate how competence is mutually developed in coordinated work. We have termed this process competence articulation, a concept which tries to emphasize competence as well as social development of competence as part of cooperation...... communication options for competence articulation, which again improve collaboration and thus the quality of the treatment....

  12. 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.

  13. 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.

  14. Italian registry of cardiac magnetic resonance

    Energy Technology Data Exchange (ETDEWEB)

    Francone, Marco [Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome (Italy); Di Cesare, Ernesto, E-mail: ernesto.dicesare@cc.univaq.it [Dipartimento di Scienze Cliniche Applicate e Biotecnologie, Università di L’Aquila (Italy); Cademartiri, Filippo [Cardio-Vascular Imaging Unit, Giovanni XXIII Hospital, Monastier di Treviso, TV (Italy); Erasmus Medical Center University, Rotterdam (Netherlands); Pontone, Gianluca [IRCCS Centro Cardiologico Monzino (Italy); Lovato, Luigi [Policlinico S. Orsola Bologna (Italy); Matta, Gildo [Azienda ospedaliera G Brotzu Cagliari (Italy); Secchi, Francesco [IRCCS Policlinico San Donato, Radiology Unit, Milan (Italy); Maffei, Erica [Cardio-Vascular Imaging Unit, Giovanni XXIII Hospital, Monastier di Treviso, TV (Italy); Erasmus Medical Center University, Rotterdam (Netherlands); Pradella, Silvia [Azienda Ospedaliera Universitaria Careggi (Italy); Carbone, Iacopo [Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome (Italy); Marano, Riccardo [Policlinico Gemelli, Università Cattolica Roma (Italy); Bacigalupo, Lorenzo [Ospedale Galliera, Genova (Italy); Chiodi, Elisabetta [Ospedale S. Anna Ferrara (Italy); Donato, Rocco [Azienda Ospedaliera Universitaria G. Martino, Me (Italy); Sbarbati, Stefano [Ospedale Madre Giuseppina Vannini, Roma (Italy); De Cobelli, Francesco [IRCCS S. Raffaele, Università Vita Salute, Milano (Italy); Di Renzi, Paolo [Fate Bene Fratelli Isola tiberina, Roma (Italy); Ligabue, Guido; Mancini, Andrea [Azienda Ospedaliera-Universitaria Policlinico di Modena (Italy); Palmieri, Francesco [Diparimento di Diagnostica per immagini e radiologia interventistica, Ospedale S. Maria delle Grazie, Pozzuoli, Napoli (Italy); and others

    2014-01-15

    Objectives: Forty sites were involved in this multicenter and multivendor registry, which sought to evaluate indications, spectrum of protocols, impact on clinical decision making and safety profile of cardiac magnetic resonance (CMR). Materials and methods: Data were prospectively collected on a 6-month period and included 3376 patients (47.2 ± 19 years; range 1–92 years). Recruited centers were asked to complete a preliminary general report followed by a single form/patient. Referral physicians were not required to exhibit any specific certificate of competency in CMR imaging. Results: Exams were performed with 1.5 T scanners in 96% of cases followed by 3 T (3%) and 1 T (1%) magnets and contrast was administered in 84% of cases. The majority of cases were performed for the workup of inflammatory heart disease/cardiomyopathies representing overall 55.7% of exams followed by the assessment of myocardial viability and acute infarction (respectively 6.9% and 5.9% of patients). In 49% of cases the final diagnosis provided was considered relevant and with impact on patient's clinical/therapeutic management. Safety evaluation revealed 30 (0.88%) clinical events, most of which due to patient's preexisting conditions. Radiological reporting was recorded in 73% of exams. Conclusions: CMR is performed in a large number of centers in Italy with relevant impact on clinical decision making and high safety profile.

  15. 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

  16. Technological competence and competitiveness of Korea industry

    International Nuclear Information System (INIS)

    This book introduces technology and competitiveness and industrial policy of economics, technological competence and technological innovation system of Korea, a newly industrialized country, development of technological innovation and competence of semiconductor industry, development of technological innovation and competence of synthetic fiber industry, development of technological innovation and competence of machine tool industry, development of technological competence of automobile industry, improvement and delay of technological competence of computer industry, and development of technological innovation and competitiveness of appliance industry.

  17. Adopsi Model Competency Based Training dalam Kewirausahaan

    OpenAIRE

    I Ketut Santra

    2009-01-01

    The aim of the research is improving the teaching method in entrepreneurship subject. This research adopted the competency based training (CBT) into the entrepreneurship. The major task in this research is formulated and designed the entrepreneurship competency. Entrepreneurship competency indicated by Personal, Strategic and Situational and Business competence. All of entrepreneurship competences are described into sub topic of competence. After designing and formulating the game and simulat...

  18. Relating ICT Competencies with Personality Types

    OpenAIRE

    Ribaud, Vincent; Saliou, Philippe

    2015-01-01

    International audience ICT competency frameworks establish the definition of competences required and deployed by ICT professionals. Job profiles articulate competen-cies together with an organization needs, objectives and constraints. The evolution of the software industry impacts personality trends in the profession. This work-in-progress studies the relationship between competencies, profiles and personality types. 1 Introduction Competency frameworks, such as the e-Competences Framewor...

  19. Cardiac fatty acid oxidation in heart failure associated with obesity and diabetes.

    Science.gov (United States)

    Fukushima, Arata; Lopaschuk, Gary D

    2016-10-01

    Obesity and diabetes are major public health problems, and are linked to the development of heart failure. Emerging data highlight the importance of alterations in cardiac energy metabolism as a major contributor to cardiac dysfunction related to obesity and diabetes. Increased rates of fatty acid oxidation and decreased rates of glucose utilization are two prominent changes in cardiac energy metabolism that occur in obesity and diabetes. This metabolic profile is probably both a cause and consequence of a prominent cardiac insulin resistance, which is accompanied by a decrease in both cardiac function and efficiency, and by the accumulation of potentially toxic lipid metabolites in the heart that can further exaggerate insulin resistance and cardiac dysfunction. The high cardiac fatty acid oxidation rates seen in obesity and diabetes are attributable to several factors, including: 1) increased fatty acid supply and uptake into the cardiomyocyte, 2) increased transcription of fatty acid metabolic enzymes, 3) decreased allosteric control of mitochondrial fatty acid uptake and fatty acid oxidation, and 4) increased post-translational acetylation control of various fatty acid oxidative enzymes. Emerging evidence suggests that therapeutic approaches aimed at switching the balance of cardiac energy substrate preference from fatty acid oxidation to glucose use can prevent cardiac dysfunction associated with obesity and diabetes. Modulating acetylation control of fatty acid oxidative enzymes is also a potentially attractive strategy, although presently this is limited to precursors of nicotinamide adenine or nonspecific activators of deacetylation such as resveratrol. This review will focus on the metabolic alterations in the heart that occur in obesity and diabetes, as well as on the molecular mechanisms controlling these metabolic changes. This article is part of a Special Issue entitled: Heart Lipid Metabolism edited by G.D. Lopaschuk.

  20. Cardiac fatty acid oxidation in heart failure associated with obesity and diabetes.

    Science.gov (United States)

    Fukushima, Arata; Lopaschuk, Gary D

    2016-10-01

    Obesity and diabetes are major public health problems, and are linked to the development of heart failure. Emerging data highlight the importance of alterations in cardiac energy metabolism as a major contributor to cardiac dysfunction related to obesity and diabetes. Increased rates of fatty acid oxidation and decreased rates of glucose utilization are two prominent changes in cardiac energy metabolism that occur in obesity and diabetes. This metabolic profile is probably both a cause and consequence of a prominent cardiac insulin resistance, which is accompanied by a decrease in both cardiac function and efficiency, and by the accumulation of potentially toxic lipid metabolites in the heart that can further exaggerate insulin resistance and cardiac dysfunction. The high cardiac fatty acid oxidation rates seen in obesity and diabetes are attributable to several factors, including: 1) increased fatty acid supply and uptake into the cardiomyocyte, 2) increased transcription of fatty acid metabolic enzymes, 3) decreased allosteric control of mitochondrial fatty acid uptake and fatty acid oxidation, and 4) increased post-translational acetylation control of various fatty acid oxidative enzymes. Emerging evidence suggests that therapeutic approaches aimed at switching the balance of cardiac energy substrate preference from fatty acid oxidation to glucose use can prevent cardiac dysfunction associated with obesity and diabetes. Modulating acetylation control of fatty acid oxidative enzymes is also a potentially attractive strategy, although presently this is limited to precursors of nicotinamide adenine or nonspecific activators of deacetylation such as resveratrol. This review will focus on the metabolic alterations in the heart that occur in obesity and diabetes, as well as on the molecular mechanisms controlling these metabolic changes. This article is part of a Special Issue entitled: Heart Lipid Metabolism edited by G.D. Lopaschuk. PMID:26996746

  1. "Teaching as a Competency": competencies for medical educators.

    Science.gov (United States)

    Srinivasan, Malathi; Li, Su-Ting T; Meyers, Fredrick J; Pratt, Daniel D; Collins, John B; Braddock, Clarence; Skeff, Kelley M; West, Daniel C; Henderson, Mark; Hales, Robert E; Hilty, Donald M

    2011-10-01

    Most medical faculty receive little or no training about how to be effective teachers, even when they assume major educational leadership roles. To identify the competencies required of an effective teacher in medical education, the authors developed a comprehensive conceptual model. After conducting a literature search, the authors met at a two-day conference (2006) with 16 medical and nonmedical educators from 10 different U.S. and Canadian organizations and developed an initial draft of the "Teaching as a Competency" conceptual model. Conference participants used the physician competencies (from the Accreditation Council for Graduate Medical Education [ACGME]) and the roles (from the Royal College's Canadian Medical Education Directives for Specialists [CanMEDS]) to define critical skills for medical educators. The authors then refined this initial framework through national/regional conference presentations (2007, 2008), an additional literature review, and expert input. Four core values grounded this framework: learner engagement, learner-centeredness, adaptability, and self-reflection. The authors identified six core competencies, based on the ACGME competencies framework: medical (or content) knowledge; learner- centeredness; interpersonal and communication skills; professionalism and role modeling; practice-based reflection; and systems-based practice. They also included four specialized competencies for educators with additional programmatic roles: program design/implementation, evaluation/scholarship, leadership, and mentorship. The authors then cross-referenced the competencies with educator roles, drawing from CanMEDS, to recognize role-specific skills. The authors have explored their framework's strengths, limitations, and applications, which include targeted faculty development, evaluation, and resource allocation. The Teaching as a Competency framework promotes a culture of effective teaching and learning. PMID:21869655

  2. 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.

  3. 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

  4. 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.

  5. 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

  6. 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.

  7. Influence of mitochondrion-toxic agents on the cardiovascular system.

    Science.gov (United States)

    Finsterer, Josef; Ohnsorge, Peter

    2013-12-01

    Cardiovascular disease may be induced or worsened by mitochondrion-toxic agents. Mitochondrion-toxic agents may be classified as those with or without a clinical effect, those which induce cardiac disease only in humans or animals or both, as prescribed drugs, illicit drugs, exotoxins, or nutritiants, as those which affect the heart exclusively or also other organs, as those which are effective only in patients with a mitochondrial disorder or cardiac disease or also in healthy subjects, or as solid, liquid, or volatile agents. In humans, cardiotoxic agents due to mitochondrial dysfunction include anthracyclines (particularly doxorubicin), mitoxantrone, cyclophosphamide, cisplatin, fluorouracil, imatinib, bortezomib, trastuzumab, arsenic trioxide, cyclosporine-A, zidovudine, lamotrigine, glycosides, lidocain, isoproterenol, nitroprusside, pivalic acid, alcohol, cocaine, pesticides, cadmium, mycotoxins, cyanotoxins, meat meal, or carbon monoxide. Even more agents exhibit cardiac abnormalities due to mitochondrion-toxicity only in animals or tissue cultures. The mitochondrion-toxic effect results from impairment of the respiratory chain, the oxidative phosphorylation, the Krebs cycle, or the β-oxidation, from decrease of the mitochondrion-membrane potential, from increased oxidative stress, reduced anti-oxidative capacity, or from induction of apoptosis. Cardiac abnormalities induced via these mechanisms include cardiomyopathy, myocarditis, coronary heart disease, arrhythmias, heart failure, or Takotsubo syndrome. Discontinuation of the cardiotoxic agent results in complete recovery in the majority of the cases. Antioxidants and nutritiants may be of additional help. Particularly coenzyme-Q, riboflavin, vitamin-E, vitamin-C, L-carnitine, vitamin-D, thiamin, folic acid, omega-3 fatty acids, and D-ribose may alleviate mitochondrial cardiotoxic effects. PMID:24036395

  8. Cardiac perioperative complications in noncardiac surgery

    Directory of Open Access Journals (Sweden)

    Radovanović Dragana

    2008-01-01

    Full Text Available 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 procedure, age, presence of concurrent diseases. A total of 100 patients with cardiac diseases undergoing noncardiac surgery were included in the prospective study (Group A 50 patients undergoing intraperitoneal surgery and Group B 50 patients undergoing breast and thyroid surgery. The patients were followed up during the perioperative period and after surgery until leaving hospital to assess the occurrence of cardiac events. Cardiac complications (systemic arterial hypertension, systemic arterial hypotension, abnormalities of cardiac conduction and cardiac rhythm, perioperative myocardial ischemia and acute myocardial infarction occurred in 64% of the patients. One of the 100 patients (1% had postoperative myocardial infarction which was fatal. Systemic arterial hypertension occurred in 57% of patients intraoperatively and 33% postoperatively, abnormalities of cardiac rhythm in 31% of patients intraoperatively and 17% postoperatively, perioperative myocardial ischemia in 23% of patients intraoperatively and 11% of postoperatively. The most often cardiac complications were systemic arterial hypertension, abnormalities of cardiac rhythm and perioperative myocardial ischemia. Factors independently associated with the incidence of cardiac complications included the type of surgical procedure, advanced age, duration of anaesthesia and surgery, abnormal preoperative electrocardiogram, abnormal preoperative chest radiography and diabetes.

  9. Competency and Human Resource Management

    OpenAIRE

    Lucian CERNUŞCA; Dima, Cristina

    2008-01-01

    O relatório explica o conceito de competência e como a competência está ligada à performance e à evolução na carreira de cada indivíduo. Os autores também estudaram alguns modelos de mapas de competências e instrumentos de avaliação na gestão de desempenhos. Uma empresa pode ter uns recursos humanos muito competentes e mesmo assim estes, não responderem às necessidades da empresa. É aqui que os mapas de competências e os instrumentos de avaliação podem dar uma ajuda aos responsáveis ...

  10. Inservice Instructors: Adult Educator Competencies.

    Science.gov (United States)

    Petersen, Mary Beth Harper

    1983-01-01

    Describes how fourteen principles of adult education provide the conceptual framework for performance competencies to guide the daily practice of instructors in the centralized inservice department of a large acute-care hospital. (JOW)

  11. Intravenous lipid emulsion for treatment of local anesthetic toxicity

    Directory of Open Access Journals (Sweden)

    M Caroline Kosh

    2010-09-01

    Full Text Available M Caroline Kosh, April D Miller, Jill E Michels, , Department of Clinical Pharmacy and Outcomes Sciences, South Carolina College of Pharmacy, University of South Carolina Campus, Columbia, South Carolina, USADate of Preparation: 14th July 2010 Conflict of interest: None declaredClinical question: Is intravenous lipid emulsion a safe and effective therapy for the reversal and treatment of local anesthetic toxicity?Results: Systematic reviews, human case reports, and experimental animal studies have demonstrated the efficacy of intravenous lipid emulsion therapy in successfully reversing cardiac arrhythmias, cardiac arrest, and cardiac collapse seen with severe systemic local anesthetic toxicity. There are fewer data to support treatment of neurologic toxicities associated with local anesthetics.Implementation: Intravenous lipid emulsion 20% should be available whenever patients receive large doses of local anesthetics in operating rooms and emergency departments. Various dosing protocols have been published in the medical literature. Although the dosing protocols are based on low-level evidence, a lack of major adverse events makes lipid emulsion an appropriate therapy for treating cardiotoxic symptoms induced by local anesthetics.Keywords: intravenous lipid emulsion, local anesthetics

  12. Radiation-related heart toxicity; Toxicite cardiaque de la radiotherapie

    Energy Technology Data Exchange (ETDEWEB)

    Mege, A.; Zioueche, A.; Pourel, N.; Chauvet, B. [Radiotherapie, institut Sainte-Catherine, 1750, chemin du Lavarin, 84000 Avignon (France)

    2011-10-15

    The radiotherapy of thoracic cancers exposes the heart to late radiation-induced complications. The physiopathological and clinical consequences of heart irradiation have been mostly studied in patients with Hodgkin lymphoma and breast cancer. The main cause of cardiac morbidity is radiation-induced coronaropathy with a relative risk estimated between 2 and 3 in earlier studies. Preexisting factors of cardiovascular risk, including chemotherapy, potentalize the cardiotoxicity of radiotherapy. Conformational radiotherapy, adapting the ballistics and the energy to the delineated volumes while carefully evaluating the dose-volume distribution in the organs at risk, allowed a drastic reduction in cardiac mortality. This toxicity no longer seems to be significant if the cardiac volume has received less than 30 Gy. Nevertheless, the prolonged life expectancy of cancer patients and the expanding use of new cardio-toxic anticancer drugs underline the persistent need to further reduce the dose delivered to the heart. Indeed, 1 Gy added to the mean heart dose would increase the cardio-toxic risk by 4% (IC 95%: 2-6%, P=0.0002). A strengthened collaboration between the radiation oncologist and the cardiologist aims at detecting and treating long-term complications after thoracic radiotherapy. (authors)

  13. Electrophysiological Cardiac Modeling: A Review.

    Science.gov (United States)

    Beheshti, Mohammadali; Umapathy, Karthikeyan; Krishnan, Sridhar

    2016-01-01

    Cardiac electrophysiological modeling in conjunction with experimental and clinical findings has contributed to better understanding of electrophysiological phenomena in various species. As our knowledge on underlying electrical, mechanical, and chemical processes has improved over time, mathematical models of the cardiac electrophysiology have become more realistic and detailed. These models have provided a testbed for various hypotheses and conditions that may not be easy to implement experimentally. In addition to the limitations in experimentally validating various scenarios implemented by the models, one of the major obstacles for these models is computational complexity. However, the ever-increasing computational power of supercomputers facilitates the clinical application of cardiac electrophysiological models. The potential clinical applications include testing and predicting effects of pharmaceutical agents and performing patient-specific ablation and defibrillation. A review of studies involving these models and their major findings are provided.

  14. The Evaluation Of Clinical Competence

    OpenAIRE

    Boucher, François-Gilles; Palmer, Wilfred H.; Page, Gordon; Barriault, Ronald; Seely, Janet

    1980-01-01

    During a workshop on the evaluation of clinical competence, the participants identified the process skills that comprise clinical competence and examined the techniques available for evaluating these skills. No single technique allows satisfactory evaluation of all the process skills; the most commonly used methods (chart review and case presentation) evaluate few process skills. An adequate performance profile in all the process skills requires a combination of evaluation techniques. Medical...

  15. The Role of Imaging with Cardiac Computed Tomography in Cardio-Oncology Patients.

    Science.gov (United States)

    Pitekova, Barbora; Ravi, Sriram; Shah, Shimoli V; Mladosievicova, Beata; Heitner, Stephen; Ferencik, Maros

    2016-09-01

    Cardiovascular diseases and cancer represent the two most common causes of morbidity and mortality in industrialized countries. With the increase in long-term survival of cancer patients, cardiovascular diseases are the leading cause of mortality for many cancer survivors. In this article, we will review the most common cardiovascular toxicities of cancer therapies and will describe the role of cardiac CT in the detection and monitoring of cardiovascular disease. While there is limited evidence for the use of CT imaging in cancer patients, we will discuss the utility of cardiac CT in the detection and management of coronary artery disease, pericardial and valvular heart disease. PMID:27443383

  16. A competence executive coaching model

    Directory of Open Access Journals (Sweden)

    Pieter Koortzen

    2010-03-01

    Full Text Available Orientation: Psychologists in industry are increasingly required to provide executive coaching services in their organisations or as part of their consulting services. An evaluation of coaching models as well as the development needs of individuals being trained as coaches, both locally and internationally, has led the authors to believe that there is a need for a competence executive coaching model.Research purpose: The purpose of this article is to address the training and development needs of these consulting psychologists by presenting a competence executive coaching model for the planning, implementation and evaluation of executive coaching interventions.Research design, approach and method: The study was conducted while one of the authors was involved in teaching doctoral students in consulting psychology and executive coaching, specifically in the USA. The approach involved a literature review of executive coaching models and a qualitative study using focus groups to develop and evaluate the competence executive coaching model.Main findings: The literature review provided scant evidence of competence executive coaching models and there seems to be a specific need for this in the training of coaches in South Africa. Hence the model that was developed is an attempt to provide trainers with a structured model for the training of coaches.Contribution/value-add: The uniqueness of this competence model is not only described in terms of the six distinct coaching intervention phases, but also the competencies required in each.

  17. Complications after cardiac implantable electronic device implantations

    DEFF Research Database (Denmark)

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

    2013-01-01

    Complications after cardiac implantable electronic device (CIED) treatment, including permanent pacemakers (PMs), cardiac resynchronization therapy devices with defibrillators (CRT-Ds) or without (CRT-Ps), and implantable cardioverter defibrillators (ICDs), are associated with increased patient...

  18. Sudden Cardiac Arrest (SCA) Risk Assessment

    Science.gov (United States)

    ... Find a Specialist Share Twitter Facebook SCA Risk Assessment Sudden Cardiac Arrest (SCA) occurs abruptly and without ... of all ages and health conditions. Start Risk Assessment The Sudden Cardiac Arrest (SCA) Risk Assessment Tool ...

  19. An update on insertable cardiac monitors

    DEFF Research Database (Denmark)

    Olsen, Flemming J; Biering-Sørensen, Tor; Krieger, Derk W

    2015-01-01

    Continuous cardiac rhythm monitoring has undergone compelling progress over the past decades. Cardiac monitoring has emerged from 12-lead electrocardiograms being performed at the discretion of the treating physician to in-hospital telemetry, Holter monitoring, prolonged external event monitoring...

  20. Competence building capacity shortage

    International Nuclear Information System (INIS)

    The objective of the project 'Competence Building Capacity Shortage' has been 'to increase knowledge about central approaches aimed at solving the peaking capacity problem in restructured power systems'. With respect to reserve markets, a model was developed in the project to analyze the relations between reserve requirements and prices in the spot and reserve markets respectively. A mathematical model was also developed and implemented, which also includes the balance market, and has a good ability to predict the relations between these markets under various assumptions. With some further development, this model can be used fore realistic analyses of these markets in a Nordic context. It was also concluded that certain system requirements with respect to frequency and time deviation can be relaxed without adverse effects. However, the requirements to system bias, Frequency Activated Operating Reserves and Frequency Activated Contingency Reserves cannot be relaxed, the latter because they must cover the dimensioning fault in the system. On the other hand, Fast Contingency Reserves can be reduced by removing requirements to national balances. Costs can furthermore be reduced by increasingly adapting a Nordic as opposed to national approach. A model for stepwise power flow was developed in the project, which is especially useful to analyze slow power system dynamics. This is relevant when analysing the effects of reserve requirements. A model for the analysis of the capacity balance in Norway and Sweden was also developed. This model is useful for looking at the future balance under various assumptions regarding e.g. weather conditions, demand growth and the development of the generation system. With respect to the present situation, if there is some price flexibility on the demand side and system operators are able to use reserves from the demand side, the probability for load shedding during the peak load hour is close to zero under the weather conditions after

  1. Competence building capacity shortage

    Energy Technology Data Exchange (ETDEWEB)

    Doorman, Gerard; Wangensteen, Ivar; Bakken, Bjoern

    2005-02-01

    The objective of the project 'Competence Building Capacity Shortage' has been 'to increase knowledge about central approaches aimed at solving the peaking capacity problem in restructured power systems'. With respect to reserve markets, a model was developed in the project to analyze the relations between reserve requirements and prices in the spot and reserve markets respectively. A mathematical model was also developed and implemented, which also includes the balance market, and has a good ability to predict the relations between these markets under various assumptions. With some further development, this model can be used fore realistic analyses of these markets in a Nordic context. It was also concluded that certain system requirements with respect to frequency and time deviation can be relaxed without adverse effects. However, the requirements to system bias, Frequency Activated Operating Reserves and Frequency Activated Contingency Reserves cannot be relaxed, the latter because they must cover the dimensioning fault in the system. On the other hand, Fast Contingency Reserves can be reduced by removing requirements to national balances. Costs can furthermore be reduced by increasingly adapting a Nordic as opposed to national approach. A model for stepwise power flow was developed in the project, which is especially useful to analyze slow power system dynamics. This is relevant when analysing the effects of reserve requirements. A model for the analysis of the capacity balance in Norway and Sweden was also developed. This model is useful for looking at the future balance under various assumptions regarding e.g. weather conditions, demand growth and the development of the generation system. With respect to the present situation, if there is some price flexibility on the demand side and system operators are able to use reserves from the demand side, the probability for load shedding during the peak load hour is close to zero under the weather

  2. COMPETING CONCEPTIONS OF GLOBALIZATION

    Directory of Open Access Journals (Sweden)

    Leslie Sklair

    2015-08-01

    Full Text Available Globalization is a relatively new idea in the social sciences, although people who work in and write about the mass media, transnational corporations and international business have been using it for some time. The purpose of this paper is to critically review the ways in which sociologists and other social scientists use ideas of globalization and to evaluate the fruitfulness of these competing conceptions. The central feature of the idea of globalization is that many contemporary problems cannot be adequately studied at the level of nation-states, that is, in terms of each country and its inter-national relations. Instead, they need to be conceptualized in terms of global processes. Some have even gone so far as to predict that global forces, by which they usually mean transnational corporations and other global economic institutions, global culture or globalizing belief systems/ideologies of various types, or a combination of all of these, are becoming so powerful that the continuing existence of the nation-state is in serious doubt. This is not a necessary consequence of most theories of globalization. The argument of this paper is that much of the globalization literature is confused because not all those who use the term distinguish it clearly enough from internation-alization, and some writers appear to use the two terms interchangeably. I argue that a clear distinction must be drawn between the inter-national and the global. The hyphen in inter-national is to distinguish (inadequate conceptions of the global' founded on the existing even if changing system of nation-states, from (genuine conceptions of the global based on the emergence of global processes and a global system of social relations not founded on national characteristics or nation-states. This global system theory is the framework for my own research. Globalization studies can be categorized on the basis of four research clusters:1. The world-systems approach; 2. The global

  3. Elevated sensitivity to cardiac ischemia in proteinuric rats is independent of adverse cardiac remodeling

    NARCIS (Netherlands)

    Szymanski, Mariusz K.; Hillege, Hans L.; Danser, A. H. Jan; Garrelds, Ingrid M.; Schoemaker, Regien G.

    2013-01-01

    Objectives: Chronic renal dysfunction severely increases cardiovascular risk. Adverse cardiac remodeling is suggested to play a major role as predisposition for increased cardiac ischemic vulnerability. The aim of the present study was to examine the role of adverse cardiac remodeling in cardiac sen

  4. [Cardiac output monitoring by impedance cardiography in cardiac surgery].

    Science.gov (United States)

    Shimizu, H; Seki, S; Mizuguchi, A; Tsuchida, H; Watanabe, H; Namiki, A

    1990-04-01

    The cardiac output monitoring by impedance cardiography, NCCOM3, was evaluated in adult patients (n = 12) who were subjected to coronary artery bypass grafting. Values of cardiac output measured by impedance cardiography were compared to those by the thermodilution method. Changes of base impedance level used as an index of thoracic fluid volume were also investigated before and after cardiopulmonary bypass (CPB). Correlation coefficient (r) of the values obtained by thermodilution with impedance cardiography was 0.79 and the mean difference was 1.29 +/- 16.9 (SD)% during induction of anesthesia. During the operation, r was 0.83 and the mean difference was -14.6 +/- 18.7%. The measurement by impedance cardiography could be carried out through the operation except when electro-cautery was used. Base impedance level before CPB was significantly lower as compared with that after CPB. There was a negative correlation between the base impedance level and central venous pressure (CVP). No patients showed any signs suggesting lung edema and all the values of CVP, pulmonary artery pressure and blood gas analysis were within normal ranges. From the result of this study, it was concluded that cardiac output monitoring by impedance cardiography was useful in cardiac surgery, but further detailed examinations will be necessary on the relationship between the numerical values of base impedance and the clinical state of the patients. PMID:2362347

  5. Health Literacy Predicts Cardiac Knowledge Gains in Cardiac Rehabilitation Participants

    Science.gov (United States)

    Mattson, Colleen C.; Rawson, Katherine; Hughes, Joel W.; Waechter, Donna; Rosneck, James

    2015-01-01

    Objective: Health literacy is increasingly recognised as a potentially important patient characteristic related to patient education efforts. We evaluated whether health literacy would predict gains in knowledge after completion of patient education in cardiac rehabilitation. Method: This was a re-post observational analysis study design based on…

  6. Regulation of Cardiac Hypertrophy: the nuclear option

    OpenAIRE

    Kuster, Diederik

    2011-01-01

    textabstractCardiac hypertrophy is the response of the heart to an increased workload. After myocardial infarction (MI) the surviving muscle tissue has to work harder to maintain cardiac output. This sustained increase in workload leads to cardiac hypertrophy. Despite its apparent appropriateness, cardiac hypertrophy is an independent risk factor for the development of heart failure and is therefore called pathological hypertrophy. That hypertrophy is not bad per se, is illustrated by the hyp...

  7. The role of tissue engineering and biomaterials in cardiac regenerative medicine.

    Science.gov (United States)

    Zhao, Yimu; Feric, Nicole T; Thavandiran, Nimalan; Nunes, Sara S; Radisic, Milica

    2014-11-01

    In recent years, the development of 3-dimensional engineered heart tissue (EHT) has made large strides forward because of advances in stem cell biology, materials science, prevascularization strategies, and nanotechnology. As a result, the role of tissue engineering in cardiac regenerative medicine has become multifaceted as new applications become feasible. Cardiac tissue engineering has long been established to have the potential to partially or fully restore cardiac function after cardiac injury. However, EHTs may also serve as surrogate human cardiac tissue for drug-related toxicity screening. Cardiotoxicity remains a major cause of drug withdrawal in the pharmaceutical industry. Unsafe drugs reach the market because preclinical evaluation is insufficient to weed out cardiotoxic drugs in all their forms. Bioengineering methods could provide functional and mature human myocardial tissues, ie, physiologically relevant platforms, for screening the cardiotoxic effects of pharmaceutical agents and facilitate the discovery of new therapeutic agents. Finally, advances in induced pluripotent stem cells have made patient-specific EHTs possible, which opens up the possibility of personalized medicine. Herein, we give an overview of the present state of the art in cardiac tissue engineering, the challenges to the field, and future perspectives. PMID:25442432

  8. 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.

  9. MRI of cardiac rhabdomyoma in the fetus

    Energy Technology Data Exchange (ETDEWEB)

    Kivelitz, Dietmar E.; Muehler, Matthias [Institut fuer Radiologie, Medizinische Fakultaet, Humboldt-Universitaet zu Berlin, Charite, Schumannstrasse 20/21, 10098, Berlin (Germany); Rake, Annett; Chaoui, Rabih [Klinik fuer Gynaekologie und Geburtshilfe, Medizinische Fakultaet, Humboldt-Universitaet zu Berlin, Charite, Schumannstrasse 20/21, 10098, Berlin (Germany); Scheer, Ianina [Klinik fuer Strahlenheilkunde, Abteilung Paediatrische Radiologie, Medizinische Fakultaet, Humboldt-Universitaet zu Berlin, Charite, Schumannstrasse 20/21, 10098, Berlin (Germany)

    2004-08-01

    Primary cardiac tumors are rarely diagnosed in utero and are usually seen on prenatal echocardiography. Cardiac rhabdomyomata can be associated with tuberous sclerosis. Prenatal MRI can be performed to assess associated malformations. This case report illustrates the ability of fetal MRI to image cardiac rhabdomyata and compares it with prenatal and postnatal echocardiography. (orig.)

  10. Regulation of Cardiac Hypertrophy: the nuclear option

    NARCIS (Netherlands)

    D.W.D. Kuster (Diederik)

    2011-01-01

    textabstractCardiac hypertrophy is the response of the heart to an increased workload. After myocardial infarction (MI) the surviving muscle tissue has to work harder to maintain cardiac output. This sustained increase in workload leads to cardiac hypertrophy. Despite its apparent appropriateness, c

  11. Childhood cancer survivors: cardiac disease & social outcomes

    NARCIS (Netherlands)

    E.A.M. Feijen

    2015-01-01

    The thesis is divided in two parts; Cardiac health problems and healthcare consumption & social outcomes in CCS. The general aims of part 1 creates optimal conditions for the evaluation of cardiac events in 5-year childhood cancer survivors, evaluation of the long term risk of cardiac events, and to

  12. CHEMICAL TOXICITY OF URANIUM

    OpenAIRE

    2007-01-01

    Uranium, occurs naturally in the earth’s crust, is an alpha emitter radioactive element from the actinide group. For this reason, U-235 and U-238, are uranium isotopes with long half lives, have got radiological toxicity. But, for natural-isotopic-composition uranium (NatU), there is greater risk from chemical toxicity than radiological toxicity. When uranium is get into the body with anyway, also its chemical toxicity must be thought. [TAF Prev Med Bull 2007; 6(3.000): 215-220

  13. CHEMICAL TOXICITY OF URANIUM

    Directory of Open Access Journals (Sweden)

    Sermin Cam

    2007-06-01

    Full Text Available Uranium, occurs naturally in the earth’s crust, is an alpha emitter radioactive element from the actinide group. For this reason, U-235 and U-238, are uranium isotopes with long half lives, have got radiological toxicity. But, for natural-isotopic-composition uranium (NatU, there is greater risk from chemical toxicity than radiological toxicity. When uranium is get into the body with anyway, also its chemical toxicity must be thought. [TAF Prev Med Bull 2007; 6(3.000: 215-220

  14. Cardiac tumors: optimal cardiac MR sequences and spectrum of imaging appearances.

    LENUS (Irish Health Repository)

    O'Donnell, David H

    2012-02-01

    OBJECTIVE: This article reviews the optimal cardiac MRI sequences for and the spectrum of imaging appearances of cardiac tumors. CONCLUSION: Recent technologic advances in cardiac MRI have resulted in the rapid acquisition of images of the heart with high spatial and temporal resolution and excellent myocardial tissue characterization. Cardiac MRI provides optimal assessment of the location, functional characteristics, and soft-tissue features of cardiac tumors, allowing accurate differentiation of benign and malignant lesions.

  15. Machine Trades. Ohio's Competency Analysis Profile.

    Science.gov (United States)

    Ohio State Univ., Columbus. Vocational Instructional Materials Lab.

    This Ohio Competency Analysis Profile (OCAP), derived from a modified Developing a Curriculum (DACUM) process, is a current comprehensive and verified employer competency program list for machine trades. Each unit (with or without subunits) contains competencies and competency builders that identify the occupational, academic, and employability…

  16. Poultry Producer. Ohio's Competency Analysis Profile.

    Science.gov (United States)

    Ohio State Univ., Columbus. Vocational Instructional Materials Lab.

    This Ohio Competency Analysis Profile (OCAP), derived from a modified Developing a Curriculum (DACUM) process, is a comprehensive and verified employer competency list for a poultry producer program. It contains units (with or without subunits), competencies, and competency builders that identify the occupational, academic, and employability…

  17. Assessing Core Competencies

    Science.gov (United States)

    Narayanan, M.

    2004-12-01

    Catherine Palomba and Trudy Banta offer the following definition of assessment, adapted from one provided by Marches in 1987. Assessment in the systematic collection, review, and use of information about educational programs undertaken for the purpose of improving student learning and development. (Palomba and Banta 1999). It is widely recognized that sophisticated computing technologies are becoming a key element in today's classroom instructional techniques. Regardless, the Professor must be held responsible for creating an instructional environment in which the technology actually supplements learning outcomes of the students. Almost all academic disciplines have found a niche for computer-based instruction in their respective professional domain. In many cases, it is viewed as an essential and integral part of the educational process. Educational institutions are committing substantial resources to the establishment of dedicated technology-based laboratories, so that they will be able to accommodate and fulfill students' desire to master certain of these specific skills. This type of technology-based instruction may raise some fundamental questions about the core competencies of the student learner. Some of the most important questions are : 1. Is the utilization of these fast high-powered computers and user-friendly software programs creating a totally non-challenging instructional environment for the student learner ? 2. Can technology itself all too easily overshadow the learning outcomes intended ? 3. Are the educational institutions simply training students how to use technology rather than educating them in the appropriate field ? 4. Are we still teaching content-driven courses and analysis oriented subject matter ? 5. Are these sophisticated modern era technologies contributing to a decline in the Critical Thinking Capabilities of the 21st century technology-savvy students ? The author tries to focus on technology as a tool and not on the technology

  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. Cardiac connexins and impulse propagation

    NARCIS (Netherlands)

    J.A. Jansen; T.A.B. van Veen; J.M.T. de Bakker; H.V.M. van Rijen

    2010-01-01

    Gap junctions form the intercellular pathway for cell-to-cell transmission of the cardiac impulse from its site of origin, the sinoatrial node, along the atria, the atrioventricular conduction system to the ventricular myocardium. The component parts of gap junctions are proteins called connexins (C

  20. Cardiac abnormalities after subarachnoid hemorrhage

    NARCIS (Netherlands)

    Bilt, I.A.C. van der

    2016-01-01

    Aneurysmal subarachnoid hemorrhage(aSAH) is a devastating neurological disease. During the course of the aSAH several neurological and medical complications may occur. Cardiac abnormalities after aSAH are observed often and resemble stress cardiomyopathy or Tako-tsubo cardiomyopathy(Broken Heart Syn

  1. Molecular therapies for cardiac arrhythmias

    NARCIS (Netherlands)

    G.J.J. Boink

    2013-01-01

    Despite the ongoing advances in pharmacology, devices and surgical approaches to treat heart rhythm disturbances, arrhythmias are still a significant cause of death and morbidity. With the introduction of gene and cell therapy, new avenues have arrived for the local modulation of cardiac disease. Th

  2. 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

  3. Cardiac resynchronization therapy in China

    Institute of Scientific and Technical Information of China (English)

    Wei HUA

    2006-01-01

    @@ Congestive heart failure (HF) is a major and growing public health problem. The therapeutic approach includes non-pharmacological measures, pharmacological therapy,mechanical devices, and surgery. Despite the benefits of optimal pharmacologic therapy, the prognosis is still not ideal. At this time, cardiac resynchronization therapy (CRT)has gained wide acceptance as an alternative treatment for HF patients with conduction delay.1

  4. Cardiac pacemakers and nuclear batteries

    International Nuclear Information System (INIS)

    Following the introduction giving the indications for cardiac pacemaker therapy with special regard to the use of pacemakers powered by nuclear batteries, reference is made to the resulting radiation exposure of the patient. The activities of the Federal Health Office in this field such as recommendations and surveys including the entire Federal Republic are outlined. (orig.)

  5. CARDIAC TRANSPLANTATION: AN ANESTHETIC CHALLENGE

    OpenAIRE

    Premalatha; Jayaraman,

    2014-01-01

    : Heart transplantation has emerged as the definitive therapy for patients with end-stage cardiomyopathy. The two most common forms of cardiac disease that lead to transplantation are ischemic cardiomyopathy and dilated cardiomyopathy, which together comprise approximately 90% of cases. The other less common forms of heart disease include viral cardiomyopathy, infiltrative cardiomyopathy, postpartum cardiomyopathy, valvular heart disease and congenital heart disease

  6. Epidural analgesia for cardiac surgery

    NARCIS (Netherlands)

    V. Svircevic; M.M. Passier; A.P. Nierich; D. van Dijk; C.J. Kalkman; G.J. van der Heijden

    2013-01-01

    Background A combination of general anaesthesia (GA) with thoracic epidural analgesia (TEA) may have a beneficial effect on clinical outcomes by reducing the risk of perioperative complications after cardiac surgery. Objectives The objective of this review was to determine the impact of perioperativ

  7. The cardiac dose-sparing benefits of deep inspiration breath-hold in left breast irradiation: a systematic review

    International Nuclear Information System (INIS)

    Despite technical advancements in breast radiation therapy, cardiac structures are still subject to significant levels of irradiation. As the use of adjuvant radiation therapy after breast-conserving surgery continues to improve survival for early breast cancer patients, the associated radiation-induced cardiac toxicities become increasingly relevant. Our primary aim was to evaluate the cardiac-sparing benefits of the deep inspiration breath-hold (DIBH) technique. An electronic literature search of the PubMed database from 1966 to July 2014 was used to identify articles published in English relating to the dosimetric benefits of DIBH. Studies comparing the mean heart dose of DIBH and free breathing treatment plans for left breast cancer patients were eligible to be included in the review. Studies evaluating the reproducibility and stability of the DIBH technique were also reviewed. Ten studies provided data on the benefits of DIBH during left breast irradiation. From these studies, DIBH reduced the mean heart dose by up to 3.4 Gy when compared to a free breathing approach. Four studies reported that the DIBH technique was stable and reproducible on a daily basis. According to current estimates of the excess cardiac toxicity associated with radiation therapy, a 3.4 Gy reduction in mean heart dose is equivalent to a 13.6% reduction in the projected increase in risk of heart disease. DIBH is a reproducible and stable technique for left breast irradiation showing significant promise in reducing the late cardiac toxicities associated with radiation therapy

  8. The cardiac dose-sparing benefits of deep inspiration breath-hold in left breast irradiation: a systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Smyth, Lloyd M, E-mail: lloyd.smyth@epworth.org.au [Epworth Radiation Oncology, Level 4, The Epworth Centre, Richmond, Victoria (Australia); Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, School of Biomedical Sciences, Nursing and Health Sciences, Monash University, Clayton, Victoria (Australia); Knight, Kellie A [Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, School of Biomedical Sciences, Nursing and Health Sciences, Monash University, Clayton, Victoria (Australia); Aarons, Yolanda K; Wasiak, Jason [Epworth Radiation Oncology, Level 4, The Epworth Centre, Richmond, Victoria (Australia)

    2015-03-15

    Despite technical advancements in breast radiation therapy, cardiac structures are still subject to significant levels of irradiation. As the use of adjuvant radiation therapy after breast-conserving surgery continues to improve survival for early breast cancer patients, the associated radiation-induced cardiac toxicities become increasingly relevant. Our primary aim was to evaluate the cardiac-sparing benefits of the deep inspiration breath-hold (DIBH) technique. An electronic literature search of the PubMed database from 1966 to July 2014 was used to identify articles published in English relating to the dosimetric benefits of DIBH. Studies comparing the mean heart dose of DIBH and free breathing treatment plans for left breast cancer patients were eligible to be included in the review. Studies evaluating the reproducibility and stability of the DIBH technique were also reviewed. Ten studies provided data on the benefits of DIBH during left breast irradiation. From these studies, DIBH reduced the mean heart dose by up to 3.4 Gy when compared to a free breathing approach. Four studies reported that the DIBH technique was stable and reproducible on a daily basis. According to current estimates of the excess cardiac toxicity associated with radiation therapy, a 3.4 Gy reduction in mean heart dose is equivalent to a 13.6% reduction in the projected increase in risk of heart disease. DIBH is a reproducible and stable technique for left breast irradiation showing significant promise in reducing the late cardiac toxicities associated with radiation therapy.

  9. Competences, competences assessment, validity of instruments, Preschool Education

    Directory of Open Access Journals (Sweden)

    Rigoberto Marín Uribe

    2012-05-01

    Full Text Available The purpose of this article is to describe the design process, validation and assurance of an instrument for the assessment of the success level of competences in preschool children. Initially is presented a theoretical and contextual framework of the competences in preschool. With this, it is problematized about the absence of tools for that the educators could perform the diagnostic evaluation of competences required in the reform of preschool education 2004. In the design of the instrument, the concept of “situation” is central. The validation and assurance included a process of pilotage with 512 preschool children with the implementing in practice of three different ways of application of the instrument. The results show high levels of assurance and power of discrimination that allow to distinguish significantly people by age and socioeconomic level, not finding differences by genre.

  10. Hyperinsulinemic Euglycemic clamp for cardiac PET

    International Nuclear Information System (INIS)

    The aim of this study was to assess the adequacy of Hyperinsulinemic Euglycaemic clamp to yield technically adequate and clinically meaningful cardiac scans. The F- 18 Fluorodeoxyglucose scans obtained in diabetic patients are of sub-optimal quality as high level of glucose competes with radioactive Fluorodeoxyglucose for cardiac uptake. Thus to allow quick stabilization of metabolic environment and to get superior quality images, insulin clamp is an accepted technique. Thirty patients (20 males and 5 females) with ages ranging from 43 to 69 years, who were referred for post-myocardial infarction estimation of myocardial viability, were evaluated in this study. All patients reported for the test after 6 hours of fasting. At first myocardial perfusion studies were carried out in all patients with Tc-99m Tetrofosmin on a GE dual head gamma camera. Blood glucose levels were checked. The blood sugar levels in the patients were in the range of 130 - 190 mg%. Insulin clamp was applied depending upon the glucose level obtained, according to ASNC guidelines for PET Myocardial Glucose Metabolism and Perfusion Imaging. On stabilization of blood glucose levels, 10 mCi of F-18 FDG was injected and imaging was performed at 1 hour on a dedicated 16 slice STE GE PET -- CT scanner. Three patients had incidence of hypoglycemia as a side effect during the procedure, their blood sugar falling to 40 mg%. They were treated with 25ml of 25% dextrose intravenously following which there was stabilization of blood sugar. Entire procedure including Tetrofosmin imaging took approximately 4-6 hours. Good quality images were obtained after the use of insulin clamp. Infusion of insulin and glucose gives stable plasma glucose levels during imaging. The insulin clamp technique makes it possible to adjust and maintain a metabolic steady state during the PET study. It does not alter F-18 FDG uptake patterns in different myocardial areas and gives superior quality images. The technique is safe and

  11. One Health Core Competency Domains.

    Science.gov (United States)

    Frankson, Rebekah; Hueston, William; Christian, Kira; Olson, Debra; Lee, Mary; Valeri, Linda; Hyatt, Raymond; Annelli, Joseph; Rubin, Carol

    2016-01-01

    The emergence of complex global challenges at the convergence of human, animal, and environmental health has catalyzed a movement supporting "One Health" approaches. Despite recognition of the importance of One Health approaches to address these complex challenges, little effort has been directed at identifying the seminal knowledge, skills, and attitudes necessary for individuals to successfully contribute to One Health efforts. Between 2008 and 2011, three groups independently embarked on separate initiatives to identify core competencies for professionals involved with One Health approaches. Core competencies were considered critically important for guiding curriculum development and continuing professional education, as they describe the knowledge, skills, and attitudes required to be effective. A workshop was convened in 2012 to synthesize the various strands of work on One Health competencies. Despite having different mandates, participants, and approaches, all of these initiatives identified similar core competency domains: management; communication and informatics; values and ethics; leadership; teams and collaboration; roles and responsibilities; and systems thinking. These core competency domains have been used to develop new continuing professional education programs for One Health professionals and help university curricula prepare new graduates to be able to contribute more effectively to One Health approaches.

  12. One Health Core Competency Domains

    Science.gov (United States)

    Frankson, Rebekah; Hueston, William; Christian, Kira; Olson, Debra; Lee, Mary; Valeri, Linda; Hyatt, Raymond; Annelli, Joseph; Rubin, Carol

    2016-01-01

    The emergence of complex global challenges at the convergence of human, animal, and environmental health has catalyzed a movement supporting “One Health” approaches. Despite recognition of the importance of One Health approaches to address these complex challenges, little effort has been directed at identifying the seminal knowledge, skills, and attitudes necessary for individuals to successfully contribute to One Health efforts. Between 2008 and 2011, three groups independently embarked on separate initiatives to identify core competencies for professionals involved with One Health approaches. Core competencies were considered critically important for guiding curriculum development and continuing professional education, as they describe the knowledge, skills, and attitudes required to be effective. A workshop was convened in 2012 to synthesize the various strands of work on One Health competencies. Despite having different mandates, participants, and approaches, all of these initiatives identified similar core competency domains: management; communication and informatics; values and ethics; leadership; teams and collaboration; roles and responsibilities; and systems thinking. These core competency domains have been used to develop new continuing professional education programs for One Health professionals and help university curricula prepare new graduates to be able to contribute more effectively to One Health approaches. PMID:27679794

  13. One Health Core Competency Domains.

    Science.gov (United States)

    Frankson, Rebekah; Hueston, William; Christian, Kira; Olson, Debra; Lee, Mary; Valeri, Linda; Hyatt, Raymond; Annelli, Joseph; Rubin, Carol

    2016-01-01

    The emergence of complex global challenges at the convergence of human, animal, and environmental health has catalyzed a movement supporting "One Health" approaches. Despite recognition of the importance of One Health approaches to address these complex challenges, little effort has been directed at identifying the seminal knowledge, skills, and attitudes necessary for individuals to successfully contribute to One Health efforts. Between 2008 and 2011, three groups independently embarked on separate initiatives to identify core competencies for professionals involved with One Health approaches. Core competencies were considered critically important for guiding curriculum development and continuing professional education, as they describe the knowledge, skills, and attitudes required to be effective. A workshop was convened in 2012 to synthesize the various strands of work on One Health competencies. Despite having different mandates, participants, and approaches, all of these initiatives identified similar core competency domains: management; communication and informatics; values and ethics; leadership; teams and collaboration; roles and responsibilities; and systems thinking. These core competency domains have been used to develop new continuing professional education programs for One Health professionals and help university curricula prepare new graduates to be able to contribute more effectively to One Health approaches. PMID:27679794

  14. Applying Theory to Assess Cultural Competency

    OpenAIRE

    Blue, Amy V.; Thiedke, Carolyn; Chessman, Alexander W.; Kern, Donna H.; Keller, Albert

    2009-01-01

    Using a theoretical cultural competency model, the effectiveness of a cultural competency learning assignment was examined to determine: 1) students’ cultural competency levels as reflected through the assignment, and 2) the effectiveness of the assignment as a cultural competency learning activity. Third-year family medicine clerkship students completed a required project to research and reflect upon a patient’s “cultural belief.” Applying a model of cultural competence development, a conten...

  15. The New York State cardiac registries: history, contributions, limitations, and lessons for future efforts to assess and publicly report healthcare outcomes.

    Science.gov (United States)

    Hannan, Edward L; Cozzens, Kimberly; King, Spencer B; Walford, Gary; Shah, Nirav R

    2012-06-19

    In 1988, the New York State Health Commissioner was confronted with hospital-level data demonstrating very large, multiple-year, interhospital variations in short-term mortality and complications for cardiac surgery. The concern with the extent to which these differences were due to variations in patients' pre-surgical severity of illness versus hospitals' quality of care led to the development of clinical registries for cardiac surgery in 1989 and for percutaneous coronary interventions in 1992 in New York. In 1990, the Department of Health released hospitals' risk-adjusted cardiac surgery mortality rates for the first time, and shortly thereafter, similar data were released for hospitals and physicians for percutaneous coronary interventions, cardiac valve surgery, and pediatric cardiac surgery (only hospital data). This practice is still ongoing. The purpose of this communication is to relate the history of this initiative, including changes or purported changes that have occurred since the public release of cardiac data. These changes include decreases in risk-adjusted mortality, cessation of cardiac surgery in New York by low-volume and high-mortality surgeons, out-of-state referral or avoidance of cardiac surgery/angioplasty for high-risk patients, alteration of contracting choices by insurance companies, and modifications in market share of cardiac hospitals. Evidence related to these impacts is reviewed and critiqued. This communication also includes a summary of numerous studies that used New York's cardiac registries to examine a variety of policy issues regarding the choice and use of cardiac procedures, the comparative effectiveness of competing treatment options, and the examination of the relationship among processes, structures, and outcomes of cardiac care. PMID:22698487

  16. Management of digoxin toxicity.

    Science.gov (United States)

    Pincus, Matthew

    2016-02-01

    Digoxin toxicity can emerge during long-term therapy as well as after an overdose. It can occur even when the serum digoxin concentration is within the therapeutic range. Toxicity causes anorexia, nausea, vomiting and neurological symptoms. It can also trigger fatal arrhythmias. There is a range of indications for using digoxin-specific antibody fragments. The amount ingested and serum digoxin concentration help to determine the dose required, but are not essential. Digoxin-specific antibody fragments are safe and effective in severe toxicity. Monitoring should continue after treatment because of the small risk of rebound toxicity. Restarting therapy should take into account the indication for digoxin and any reasons why the concentration became toxic. PMID:27041802

  17. Mechanisms of Phosphine Toxicity

    Directory of Open Access Journals (Sweden)

    Nisa S. Nath

    2011-01-01

    Full Text Available Fumigation with phosphine gas is by far the most widely used treatment for the protection of stored grain against insect pests. The development of high-level resistance in insects now threatens its continued use. As there is no suitable chemical to replace phosphine, it is essential to understand the mechanisms of phosphine toxicity to increase the effectiveness of resistance management. Because phosphine is such a simple molecule (PH3, the chemistry of phosphorus is central to its toxicity. The elements above and below phosphorus in the periodic table are nitrogen (N and arsenic (As, which also produce toxic hydrides, namely, NH3 and AsH3. The three hydrides cause related symptoms and similar changes to cellular and organismal physiology, including disruption of the sympathetic nervous system, suppressed energy metabolism and toxic changes to the redox state of the cell. We propose that these three effects are interdependent contributors to phosphine toxicity.

  18. Gender-dependent effects of high-fat lard diet on cardiac function in C57Bl/6J mice.

    NARCIS (Netherlands)

    Louwe, M.C.; Hoorn, J.W. van der; Berg, S.A. van den; Jukema, J.W.; Romijn, J.A.; Willems van Dijk, K.; Rensen, P.C.; Smit, J.W.A.; Steendijk, P.

    2012-01-01

    Increased availability of fatty acids released from insulin-resistant adipose tissue may lead to excess fatty acid uptake in nonadipose organs, including the heart. Accumulation of toxic fatty acid intermediates may affect cardiac function. Our aim was to identify to which extent high-fat diet feedi

  19. Gender-dependent effects of high-fat lard diet on cardiac function in C57Bl/6J mice

    NARCIS (Netherlands)

    Louwe, M.C.; Hoorn, J.W.A. van der; Berg, S.A.A. van den; Wouter Jukema, J.; Romijn, J.A.; Dijk, K.W. van; Rensen, P.C.N.; Smit, J.W.A.; Steendijk, P.

    2012-01-01

    Increased availability of fatty acids released from insulin-resistant adipose tissue may lead to excess fatty acid uptake in nonadipose organs, including the heart. Accumulation of toxic fatty acid intermediates may affect cardiac function. Our aim was to identify to which extent high-fat diet feedi

  20. Successful strategies for competing networks

    CERN Document Server

    Aguirre, Jacobo; Buldú, Javier M

    2013-01-01

    Competitive interactions represent one of the driving forces behind evolution and natural selection in biological and sociological systems. For example, animals in an ecosystem may vie for food or mates; in a market economy, firms may compete over the same group of customers; sensory stimuli may compete for limited neural resources in order to enter the focus of attention. Here, we derive rules based on the spectral properties of the network governing the competitive interactions between groups of agents organized in networks. In the scenario studied here the winner of the competition, and the time needed to prevail, essentially depend on the way a given network connects to its competitors and on its internal structure. Our results allow assessing the extent to which real networks optimize the outcome of their interaction, but also provide strategies through which competing networks can improve on their situation. The proposed approach is applicable to a wide range of systems that can be modeled as networks.

  1. Successful strategies for competing networks

    Science.gov (United States)

    Aguirre, J.; Papo, D.; Buldú, J. M.

    2013-04-01

    Competitive interactions represent one of the driving forces behind evolution and natural selection in biological and sociological systems. For example, animals in an ecosystem may vie for food or mates; in a market economy, firms may compete over the same group of customers; sensory stimuli may compete for limited neural resources to enter the focus of attention. Here, we derive rules based on the spectral properties of the network governing the competitive interactions between groups of agents organized in networks. In the scenario studied here the winner of the competition, and the time needed to prevail, essentially depend on the way a given network connects to its competitors and on its internal structure. Our results allow assessment of the extent to which real networks optimize the outcome of their interaction, but also provide strategies through which competing networks can improve on their situation. The proposed approach is applicable to a wide range of systems that can be modelled as networks.

  2. Organizational Factors and Intrapreneurial Competences

    Directory of Open Access Journals (Sweden)

    Suzete Antonieta Lizote

    2013-12-01

    Full Text Available This study analyzes the relationship between organizational factors and entrepreneurial competencies of coordinators of undergraduate courses in two community universities in Santa Catarina, Brazil. The organizational factors studied were: management support, freedom at work, rewards, and time available and organizational limitations. Eight entrepreneurial competencies were considered; five included in an achievement set, and three in a planning set. The method was quantitative and descriptive, adopting a structured questionnaire as the data collection tool. Factor analysis, canonical analysis, and multiple regression analysis were performed. The results revealed a positive relationship between the constructs. The most relevant competencies were organizational limitations or uncertainty about tasks, and freedom at work, which indicates the importance having clarity about rules and decisions that should exist both at the level of performance expected of the coordinator, and the freedom that they must feel in their work.

  3. Interactions of cryptosin with mammalian cardiac dihydropyridine-specific calcium channels

    International Nuclear Information System (INIS)

    Cryptosin, a new cardenolide, was found to be a potent inhibitor of cardiac Na+ and K+ dependent Adenosinetri-phosphatase. In experiments with dog heart ex vivo, development of inotropic and toxic effect correlated with changes in the cardiac dihydropyridine-specific calcium channels as measured by the binding of 3[H]PN 200-110. A significant change in the PN 200-110 binding was observed when guinea pig and dog heart sarcolemmal membranes were pre-incubated with cryptosin in vitro. Binding analysis of 3[H]PN 200-110 (Isradipine), a 1,4-dihydropyridine analog with very specific calcium channel binding properties, in both in vitro and ex vivo studies were consistent and indicated a non-specific type of interaction of cryptosin with mammalian cardiac 1,4-dihydropyridine-specific calcium channels

  4. Sudden cardiac death and chronic kidney disease: From pathophysiology to treatment strategies.

    Science.gov (United States)

    Di Lullo, L; Rivera, R; Barbera, V; Bellasi, A; Cozzolino, M; Russo, D; De Pascalis, A; Banerjee, D; Floccari, F; Ronco, C

    2016-08-15

    Chronic kidney disease (CKD) patients demonstrate higher rates of cardiovascular mortality and morbidity; and increased incidence of sudden cardiac death (SCD) with declining kidney failure. Coronary artery disease (CAD) associated risk factors are the major determinants of SCD in the general population. However, current evidence suggests that in CKD patients, traditional cardiovascular risk factors may play a lesser role. Complex relationships between CKD-specific risk factors, structural heart disease, and ventricular arrhythmias (VA) contribute to the high risk of SCD. In dialysis patients, the occurrence of VA and SCD could be exacerbated by electrolyte shifts, divalent ion abnormalities, sympathetic overactivity, inflammation and iron toxicity. As outcomes in CKD patients after cardiac arrest are poor, primary and secondary prevention of SCD and cardiac arrest could reduce cardiovascular mortality in patients with CKD. PMID:27174593

  5. Amiodarone-induced pulmonary toxicity - Predisposing factors, clinical symptoms and treatment

    NARCIS (Netherlands)

    Jessurun, GAJ; Boersma, WG; Crijns, HJGM

    1998-01-01

    Amiodarone is frequently used for the treatment of cardiac arrhythmias. Although the therapeutic efficacy of amiodarone has been established, its use is limited by its safety profile. Amiodarone-induced pulmonary toxicity is one of the most life-threatening complications of this therapy. It is a rel

  6. Competence linguistique et environnement social (Linguistic Competence and Social Environment).

    Science.gov (United States)

    Laflamme, Simon; Berger, Jacques

    1988-01-01

    A study found native French-speaking and native English-speaking university students had similar writing skill levels and error patterns despite their position as language-minority or language-majority members of society. It is concluded that language competency is not necessarily linked to language difficulty or to the position of the language.…

  7. Student Competency Profile Chart: A Competency Based Vocational Education Instrument.

    Science.gov (United States)

    Martell, John L.

    This document defines, describes usage of, and provides samples of student competency profiles being used in 17 vocational programs at Rutland Area Vocational-Technical Center in Rutland, Vermont. The profiles cover the following programs: auto body, auto mechanics, business/data processing, cabinetmaking, carpentry/masonry, culinary arts,…

  8. AG10 inhibits amyloidogenesis and cellular toxicity of the familial amyloid cardiomyopathy-associated V122I transthyretin

    OpenAIRE

    Penchala, Sravan C; Connelly, Stephen; Wang, Yu; Park, Miki S; Zhao, Lei; Baranczak, Aleksandra; Rappley, Irit; Vogel, Hannes; Liedtke, Michaela; Witteles, Ronald M.; Powers, Evan T.; Reixach, Natàlia; Chan, William K.; Wilson, Ian A.; Kelly, Jeffery W.

    2013-01-01

    The misassembly of soluble proteins into toxic aggregates, including amyloid fibrils, underlies a large number of human degenerative diseases. Cardiac amyloidoses, which are most commonly caused by aggregation of Ig light chains or transthyretin (TTR) in the cardiac interstitium and conducting system, represent an important and often underdiagnosed cause of heart failure. Two types of TTR-associated amyloid cardiomyopathies are clinically important. The Val122Ile (V122I) mutation, which alter...

  9. Pacemaker interactions induce reentrant wave dynamics in engineered cardiac culture

    Science.gov (United States)

    Borek, Bartłomiej; Shajahan, T. K.; Gabriels, James; Hodge, Alex; Glass, Leon; Shrier, Alvin

    2012-09-01

    Pacemaker interactions can lead to complex wave dynamics seen in certain types of cardiac arrhythmias. We use experimental and mathematical models of pacemakers in heterogeneous excitable media to investigate how pacemaker interactions can be a mechanism for wave break and reentrant wave dynamics. Embryonic chick ventricular cells are cultured invitro so as to create a dominant central pacemaker site that entrains other pacemakers in the medium. Exposure of those cultures to a potassium channel blocker, E-4031, leads to emergence of peripheral pacemakers that compete with each other and with the central pacemaker. Waves emitted by faster pacemakers break up over the slower pacemaker to form reentrant waves. Similar dynamics are observed in a modified FitzHugh-Nagumo model of heterogeneous excitable media with two distinct sites of pacemaking. These findings elucidate a mechanism of pacemaker-induced reentry in excitable media.

  10. Proposed Core Competencies and Empirical Validation Procedure in Competency Modeling: Confirmation and Classification

    OpenAIRE

    Baczyńska, Anna K.; Rowiński, Tomasz; Cybis, Natalia

    2016-01-01

    Competency models provide insight into key skills which are common to many positions in an organization. Moreover, there is a range of competencies that is used by many companies. Researchers have developed core competency terminology to underline their cross-organizational value. The article presents a theoretical model of core competencies consisting of two main higher-order competencies called performance and entrepreneurship. Each of them consists of three elements: the performance compet...

  11. Nutritional Status and Cardiac Autophagy

    Directory of Open Access Journals (Sweden)

    Jihyun Ahn

    2013-02-01

    Full Text Available Autophagy is necessary for the degradation of long-lasting proteins and nonfunctional organelles, and is activated to promote cellular survival. However, overactivation of autophagy may deplete essential molecules and organelles responsible for cellular survival. Lifelong calorie restriction by 40% has been shown to increase the cardiac expression of autophagic markers, which suggests that it may have a cardioprotective effect by decreasing oxidative damage brought on by aging and cardiovascular diseases. Although cardiac autophagy is critical to regulating protein quality and maintaining cellular function and survival, increased or excessive autophagy may have deleterious effects on the heart under some circumstances, including pressure overload-induced heart failure. The importance of autophagy has been shown in nutrient supply and preservation of energy in times of limitation, such as ischemia. Some studies have suggested that a transition from obesity to metabolic syndrome may involve progressive changes in myocardial inflammation, mitochondrial dysfunction, fibrosis, apoptosis, and myocardial autophagy.

  12. [Cardiac support and replacement therapies].

    Science.gov (United States)

    Lotz, Christopher; Roewer, Norbert; Muellenbach, Ralf M

    2016-09-01

    Circulatory support represents an integral part within the treatment of the critically ill patient. Sophisticated pharmacologic regimens help to maintain systemic perfusion pressure by increasing vascular tone as well as mediating positive inotropic effects. Besides the administration of catecholamines and phosphodiesterase-III-inhibitors, in particular the administration of levosimendan represents a promising alternative during low-cardiac-output. Nevertheless, sufficient evidence demonstrating a survival benefit for any pharmacologic regimen is nonexistent. In case pharmacological measures do not suffice mechanical cardiopulmonary support (MCS) may be used. MCS may be used during cardiopulmonary resuscitation or a "low-cardiac-output-syndrome" as bridging towards decision, recovery or long-term support. Venoarterial extracorporeal membrane oxygenation (vaECMO) may take over cardiopulmonary function and may improve survival as well as neurological outcome after cardiogenic shock or cardiopulmonary resuscitation. PMID:27631451

  13. Heart fields and cardiac morphogenesis.

    Science.gov (United States)

    Kelly, Robert G; Buckingham, Margaret E; Moorman, Antoon F

    2014-10-01

    In this review, we focus on two important steps in the formation of the embryonic heart: (i) the progressive addition of late differentiating progenitor cells from the second heart field that drives heart tube extension during looping morphogenesis, and (ii) the emergence of patterned proliferation within the embryonic myocardium that generates distinct cardiac chambers. During the transition between these steps, the major site of proliferation switches from progenitor cells outside the early heart to proliferation within the embryonic myocardium. The second heart field and ballooning morphogenesis concepts have major repercussions on our understanding of human heart development and disease. In particular, they provide a framework to dissect the origin of congenital heart defects and the regulation of myocardial proliferation and differentiation of relevance for cardiac repair.

  14. Toxicity Estimation Software Tool (TEST)

    Science.gov (United States)

    The Toxicity Estimation Software Tool (TEST) was developed to allow users to easily estimate the toxicity of chemicals using Quantitative Structure Activity Relationships (QSARs) methodologies. QSARs are mathematical models used to predict measures of toxicity from the physical c...

  15. Decentering and recentering communicative competence

    NARCIS (Netherlands)

    K. Kataoka; K. Ikeda; N. Besnier

    2013-01-01

    Communicative competence, a concept that emerged in the 1970s, is in need of rethinking. This rethinking operates in two directions: on the one hand, by taking into account the new forms of interaction and contexts associated with globalization; on the other hand, by locating communicative competenc

  16. Developing Competency in Payroll Procedures

    Science.gov (United States)

    Jackson, Allen L.

    1975-01-01

    The author describes a sequence of units that provides for competency in payroll procedures. The units could be the basis for a four to six week minicourse and are adaptable, so that the student, upon completion, will be able to apply his learning to any payroll procedures system. (Author/AJ)

  17. Assessing Intercultural Competence: A Review

    Science.gov (United States)

    Lombardi, Marissa R.

    2010-01-01

    Educators and employers increasingly acknowledge the value of intercultural competence. While most higher education institutions consider these skills as important outcomes for their graduates, few have specifically addressed the means by which to measure the wide variety of results. Having and using intercultural assessment tools will allow…

  18. Handwriting Development, Competency, and Intervention

    Science.gov (United States)

    Feder, Katya P.; Majnemer, Annette

    2007-01-01

    Failure to attain handwriting competency during the school-age years often has far-reaching negative effects on both academic success and self-esteem. This complex occupational task has many underlying component skills that may interfere with handwriting performance. Fine motor control, bilateral and visual-motor integration, motor planning,…

  19. Death Competence: An Ethical Imperative

    Science.gov (United States)

    Gamino, Louis A.; Ritter, R. Hal, Jr.

    2012-01-01

    The authors argued that death competence, defined as specialized skill in tolerating and managing clients' problems related to dying, death, and bereavement, is a necessary prerequisite for ethical practice in grief counseling. A selected review of the literature tracing the underpinnings of this concept reveals how a robust construct of death…

  20. Automotive Technologies. State Competency Profile.

    Science.gov (United States)

    Ohio Board of Regents, Columbus.

    This document, which lists the technical automotive technologies competencies identified by representatives from business, industry, and labor as well as technical educators throughout Ohio, is intended to assist individuals and organizations in developing college tech prep programs that will prepare students from secondary through post-secondary…

  1. Instruction of Competent Psychomotor Skill

    Science.gov (United States)

    Olson, Valerie Dong

    2008-01-01

    Instruction of competent psychomotor skill necessitates an eclectic approach. The principles of learning, complemented with learning styles and sensory modalities preferences, provide a background for teaching physical skills. The use of the psychomotor domain of Bloom's Taxonomy as a map and corresponding behavioral objectives foster the mastery…

  2. Cardiac Biomarkers in Hyperthyroid Cats

    OpenAIRE

    Sangster, J.K.; Panciera, D L; Abbott, J.A.; Zimmerman, K.C.; Lantis, A.C.

    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 extensively investigated in hyperthyroidism. Hypothesis Plasma NT‐proBNP and cTNI concentrations are higher in cats with primary myocardial disease than in cats with hyperthyroidism and higher in cats with hyperthyroidism than in healthy control cats. Animals Twenty‐three hyperthyro...

  3. Historical perspectives of cardiac electrophysiology.

    Science.gov (United States)

    Lüderitz, Berndt

    2009-01-01

    The diagnosis and treatment of clinical electrophysiology has a long and fascinating history. From earliest times, no clinical symptom impressed the patient (and the physician) more than an irregular heart beat. Although ancient Chinese pulse theory laid the foundation for the study of arrhythmias and clinical electrophysiology in the 5th century BC, the most significant breakthrough in the identification and treatment of cardiac arrhythmias first occurred in this century. In the last decades, our knowledge of electrophysiology and pharmacology has increased exponentially. The enormous clinical significance of cardiac rhythm disturbances has favored these advances. On the one hand, patients live longer and thus are more likely to experience arrhythmias. On the other hand, circulatory problems of the cardiac vessels have increased enormously, and this has been identified as the primary cause of cardiac rhythm disorders. Coronary heart disease has become not just the most significant disease of all, based on the statistics for cause of death. Arrhythmias are the main complication of ischemic heart disease, and they have been directly linked to the frequently arrhythmogenic sudden death syndrome, which is now presumed to be an avoidable "electrical accident" of the heart. A retrospective look--often charming in its own right--may not only make it easier to sort through the copious details of this field and so become oriented in this universe of important and less important facts: it may also provide the observer with a chronological vantage point from which to view the subject. The study of clinical electrophysiology is no dry compendium of facts and figures, but rather a dynamic field of study evolving out of the competition between various ideas, intentions and theories. PMID:19196616

  4. Cardiac Biomarkers and Cycling Race

    OpenAIRE

    Caroline Le Goff, Jean-François Kaux, Sébastien Goffaux, Etienne Cavalier

    2015-01-01

    In cycling as in other types of strenuous exercise, there exists a risk of sudden death. It is important both to understand its causes and to see if the behavior of certain biomarkers might highlight athletes at risk. Many reports describe changes in biomarkers after strenuous exercise (Nie et al., 2011), but interpreting these changes, and notably distinguishing normal physiological responses from pathological changes, is not easy. Here we have focused on the kinetics of different cardiac bi...

  5. Functiogenesis of cardiac pacemaker activity.

    Science.gov (United States)

    Sakai, Tetsuro; Kamino, Kohtaro

    2016-07-01

    Throughout our investigations on the ontogenesis of the electrophysiological events in early embryonic chick hearts, using optical techniques to record membrane potential probed with voltage-sensitive dyes, we have introduced a novel concept of "functiogenesis" corresponding to "morphogenesis". This article gives an account of the framework of "functiogenesis", focusing on the cardiac pacemaker function and the functional organization of the pacemaking area. PMID:26719289

  6. Cardiac involvement in tuberous sclerosis.

    OpenAIRE

    Mühler, E G; Turniski-Harder, V; Engelhardt, W.; von Bernuth, G

    1994-01-01

    OBJECTIVE--To assess the incidence, importance, and history of cardiac involvement in infants and children with tuberous sclerosis. DESIGN--Prospective study; clinical examination, sector and Doppler echocardiography, standard and ambulatory electrocardiography. SETTING--A tertiary referral centre. PATIENTS--21 patients with tuberous sclerosis aged 1 day to 16 years (mean 6.3 years); follow up investigations were available in 14 cases (10 retrospective, 4 prospective; mean follow up 4.3 years...

  7. Chronic kidney disease after liver, cardiac, lung, heart–lung, and hematopoietic stem cell transplant

    OpenAIRE

    Hingorani, Sangeeta

    2008-01-01

    Patient survival after cardiac, liver, and hematopoietic stem cell transplant (HSCT) is improving; however, this survival is limited by substantial pretransplant and treatment-related toxicities. A major cause of morbidity and mortality after transplant is chronic kidney disease (CKD). Although the majority of CKD after transplant is attributed to the use of calcineurin inhibitors, various other conditions such as thrombotic microangiopathy, nephrotic syndrome, and focal segmental glomerulosc...

  8. Cardiac autonomic nerve distribution and arrhythmia

    Institute of Scientific and Technical Information of China (English)

    Quan Liu; Dongmei Chen; Yonggang Wang; Xin Zhao; Yang Zheng

    2012-01-01

    OBJECTIVE: To analyze the distribution characteristics of cardiac autonomic nerves and to explore the correlation between cardiac autonomic nerve distribution and arrhythmia.DATA RETRIEVAL: A computer-based retrieval was performed for papers examining the distribution of cardiac autonomic nerves, using "heart, autonomic nerve, sympathetic nerve, vagus nerve, nerve distribution, rhythm and atrial fibrillation" as the key words.SELECTION CRITERIA: A total of 165 studies examining the distribution of cardiac autonomic nerve were screened, and 46 of them were eventually included.MAIN OUTCOME MEASURES: The distribution and characteristics of cardiac autonomic nerves were observed, and immunohistochemical staining was applied to determine the levels of tyrosine hydroxylase and acetylcholine transferase (main markers of cardiac autonomic nerve distribution). In addition, the correlation between cardiac autonomic nerve distribution and cardiac arrhythmia was investigated.RESULTS: Cardiac autonomic nerves were reported to exhibit a disordered distribution in different sites, mainly at the surface of the cardiac atrium and pulmonary vein, forming a ganglia plexus. The distribution of the pulmonary vein autonomic nerve was prominent at the proximal end rather than the distal end, at the upper left rather than the lower right, at the epicardial membrane rather than the endocardial membrane, at the left atrium rather than the right atrium, and at the posterior wall rather than the anterior wall. The main markers used for cardiac autonomic nerves were tyrosine hydroxylase and acetylcholine transferase. Protein gene product 9.5 was used to label the immunoreactive nerve distribution, and the distribution density of autonomic nerves was determined using a computer-aided morphometric analysis system.CONCLUSION: The uneven distribution of the cardiac autonomic nerves is the leading cause of the occurrence of arrhythmia, and the cardiac autonomic nerves play an important role in the

  9. Sudden cardiac death risk stratification.

    Science.gov (United States)

    Deyell, Marc W; Krahn, Andrew D; Goldberger, Jeffrey J

    2015-06-01

    Arrhythmic sudden cardiac death (SCD) may be caused by ventricular tachycardia/fibrillation or pulseless electric activity/asystole. Effective risk stratification to identify patients at risk of arrhythmic SCD is essential for targeting our healthcare and research resources to tackle this important public health issue. Although our understanding of SCD because of pulseless electric activity/asystole is growing, the overwhelming majority of research in risk stratification has focused on SCD-ventricular tachycardia/ventricular fibrillation. This review focuses on existing and novel risk stratification tools for SCD-ventricular tachycardia/ventricular fibrillation. For patients with left ventricular dysfunction or myocardial infarction, advances in imaging, measures of cardiac autonomic function, and measures of repolarization have shown considerable promise in refining risk. Yet the majority of SCD-ventricular tachycardia/ventricular fibrillation occurs in patients without known cardiac disease. Biomarkers and novel imaging techniques may provide further risk stratification in the general population beyond traditional risk stratification for coronary artery disease alone. Despite these advances, significant challenges in risk stratification remain that must be overcome before a meaningful impact on SCD can be realized.

  10. Review Article of Cardiac Amyloidosis

    Directory of Open Access Journals (Sweden)

    Jittiporn PURATTANAMAL

    2010-06-01

    Full Text Available Cardiac amyloidosis is a term that means the deposit of abnormal proteins in the myocardium leading to global thickening of the heart walls. The clinical character is that of infiltrative cardiomyopathy. AL amyloidosis is the most common type that involves cardiac failure. Cardiac amyloid precedes clinical congestive heart failure, especially right-sided heart failure. Laboratory investigations have identified the amyloid fibril proteins deposited in the organ tissues. Immunofixation tests are the most sensitive that recognize the paraprotein mean light chain protein or immunoglobulin subtype deposit. Prognosis is poor if AL amyloidosis is untreated. Treatment of systemic involvement in AL amyloidosis is via chemotherapy such as melphalan and prednisolone. UK experts have reported the results of treatment in AL amyloidosis. Regardless of the use of adjunctive chemotherapy, the five-year survival after heart transplantation was generally poorer for AL (20 % at five years, but similar for non-AL amyloidosis (64 % at five years, than heart transplants in other cases. Progression of the systemic disease contributed to increased mortality. A specific treatment that increases the chances of survival is unknown.

  11. Cardiac MRI in restrictive cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, A. [Department of Cardiovascular Radiology, All India Institute of Medical Sciences, Ansari Nagar, Delhi (India); Singh Gulati, G., E-mail: gulatigurpreet@rediffmail.com [Department of Cardiovascular Radiology, All India Institute of Medical Sciences, Ansari Nagar, Delhi (India); Seth, S. [Department of Cardiology, All India Institute of Medical Sciences, Ansari Nagar, Delhi (India); Sharma, S. [Department of Cardiovascular Radiology, All India Institute of Medical Sciences, Ansari Nagar, Delhi (India)

    2012-02-15

    Restrictive cardiomyopathy (RCM) is a specific group of heart muscle disorders characterized by inadequate ventricular relaxation during diastole. This leads to diastolic dysfunction with relative preservation of systolic function. Although short axis systolic function is usually preserved in RCM, the long axis systolic function may be severely impaired. Confirmation of diagnosis and information regarding aetiology, extent of myocardial damage, and response to treatment requires imaging. Importantly, differentiation from constrictive pericarditis (CCP) is needed, as only the latter is managed surgically. Echocardiography is the initial cardiac imaging technique but cannot reliably suggest a tissue diagnosis; although recent advances, especially tissue Doppler imaging and spectral tracking, have improved its ability to differentiate RCM from CCP. Cardiac catheterization is the reference standard, but is invasive, two-dimensional, and does not aid myocardial characterization. Cardiac magnetic resonance (CMR) is a versatile technique providing anatomical, morphological and functional information. In recent years, it has been shown to provide important information regarding disease mechanisms, and also been found useful to guide treatment, assess its outcome and predict patient prognosis. This review describes the CMR features of RCM, appearances in various diseases, its overall role in patient management, and how it compares with other imaging techniques.

  12. Toxicity Data to Determine Refrigerant Concentration Limits

    Energy Technology Data Exchange (ETDEWEB)

    Calm, James M.

    2000-09-30

    This report reviews toxicity data, identifies sources for them, and presents resulting exposure limits for refrigerants for consideration by qualified parties in developing safety guides, standards, codes, and regulations. It outlines a method to calculate an acute toxicity exposure limit (ATEL) and from it a recommended refrigerant concentration limit (RCL) for emergency exposures. The report focuses on acute toxicity with particular attention to lethality, cardiac sensitization, anesthetic and central nervous system effects, and other escape-impairing effects. It addresses R-11, R-12, R-22, R-23, R-113, R-114, R-116, R-123, R-124, R-125, R-134, R-134a, R-E134, R-141b, R-142b, R-143a, R-152a, R-218, R-227ea, R-236fa, R-245ca, R-245fa, R-290, R-500, R-502, R-600a, R-717, and R-744. It summarizes additional data for R-14, R-115, R-170 (ethane), R-C318, R-600 (n-butane), and R-1270 (propylene) to enable calculation of limits for blends incorporating them. The report summarizes the data a nd related safety information, including classifications and flammability data. It also presents a series of tables with proposed ATEL and RCL concentrations-in dimensionless form and the latter also in both metric (SI) and inch-pound (IP) units of measure-for both the cited refrigerants and 66 zerotropic and azeotropic blends. They include common refrigerants, such as R-404A, R-407C, R-410A, and R-507A, as well as others in commercial or developmental status. Appendices provide profiles for the cited single-compound refrigerants and for R-500 and R-502 as well as narrative toxicity summaries for common refrigerants. The report includes an extensive set of references.

  13. What Core Competencies Are Related to Teachers' Innovative Teaching?

    Science.gov (United States)

    Zhu, Chang; Wang, Di; Cai, Yonghong; Engels, Nadine

    2013-01-01

    The purpose of this study is to investigate teachers' core competencies in relation to their innovative teaching performance. Based on the literature and previous studies in this field, four competencies (learning competency, educational competency, social competency and technological competency) are theorised as core competencies for teachers'…

  14. Toxicity of lunar dust

    CERN Document Server

    Linnarsson, Dag; Fubini, Bice; Gerde, Per; Karlsson, Lars L; Loftus, David J; Prisk, G Kim; Staufer, Urs; Tranfield, Erin M; van Westrenen, Wim

    2012-01-01

    The formation, composition and physical properties of lunar dust are incompletely characterised with regard to human health. While the physical and chemical determinants of dust toxicity for materials such as asbestos, quartz, volcanic ashes and urban particulate matter have been the focus of substantial research efforts, lunar dust properties, and therefore lunar dust toxicity may differ substantially. In this contribution, past and ongoing work on dust toxicity is reviewed, and major knowledge gaps that prevent an accurate assessment of lunar dust toxicity are identified. Finally, a range of studies using ground-based, low-gravity, and in situ measurements is recommended to address the identified knowledge gaps. Because none of the curated lunar samples exist in a pristine state that preserves the surface reactive chemical aspects thought to be present on the lunar surface, studies using this material carry with them considerable uncertainty in terms of fidelity. As a consequence, in situ data on lunar dust...

  15. Contact Lens Solution Toxicity

    Science.gov (United States)

    ... rash and rashes clinical tools newsletter | contact Share | Contact Lens Solution Toxicity Information for adults A A A This image shows a reaction to contact lens solution. The prominent blood vessels and redness ...

  16. Toxics Release Inventory (TRI)

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Toxics Release Inventory (TRI) is a dataset compiled by the U.S. Environmental Protection Agency (EPA). It contains information on the release and waste...

  17. Toxic Substances Portal- Arsenic

    Science.gov (United States)

    ... Favorites Del.icio.us Digg Facebook Google Bookmarks Yahoo MyWeb Page last reviewed: February 12, 2013 Page ... Favorites Del.icio.us Digg Facebook Google Bookmarks Yahoo MyWeb Contact Us: Agency for Toxic Substances and ...

  18. Aspects of aluminum toxicity

    Energy Technology Data Exchange (ETDEWEB)

    Hewitt, C.D.; Savory, J.; Wills, M.R. (Univ. of Virginia Health Sciences Center, Charlottesville (USA))

    1990-06-01

    Aluminum is the most abundant metal in the earth's crust. The widespread occurrence of aluminum, both in the environment and in foodstuffs, makes it virtually impossible for man to avoid exposure to this metal ion. Attention was first drawn to the potential role of aluminum as a toxic metal over 50 years ago, but was dismissed as a toxic agent as recently as 15 years ago. The accumulation of aluminum, in some patients with chronic renal failure, is associated with the development of toxic phenomena; dialysis encephalopathy, osteomalacic dialysis osteodystrophy, and an anemia. Aluminum accumulation also occurs in patients who are not on dialysis, predominantly infants and children with immature or impaired renal function. Aluminum has also been implicated as a toxic agent in the etiology of Alzheimer's disease, Guamiam amyotrophic lateral sclerosis, and parkinsonism-dementia. 119 references.

  19. Toxicity Reference Database

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Toxicity Reference Database (ToxRefDB) contains approximately 30 years and $2 billion worth of animal studies. ToxRefDB allows scientists and the interested...

  20. Hysteresis in coral reefs under macroalgal toxicity and overfishing

    OpenAIRE

    Bhattacharyya, Joydeb; Pal, Samares

    2015-01-01

    Macroalgae and corals compete for the available space in coral reef ecosystems.While herbivorous reef fish play a beneficial role in decreasing the growth of macroalgae, macroalgal toxicity and overfishing of herbivores leads to proliferation of macroalgae. The abundance of macroalgae changes the community structure towards a macroalgae-dominated reef ecosystem. We investigate coral-macroalgal phase shifts by means of a continuous time model in a food chain. Conditions for local asymptotic st...

  1. Cadmium toxicity and treatment.

    Science.gov (United States)

    Bernhoft, Robin A

    2013-01-01

    Cadmium is a heavy metal of considerable toxicity with destructive impact on most organ systems. It is widely distributed in humans, the chief sources of contamination being cigarette smoke, welding, and contaminated food and beverages. Toxic impacts are discussed and appear to be proportional to body burden of cadmium. Detoxification of cadmium with EDTA and other chelators is possible and has been shown to be therapeutically beneficial in humans and animals when done using established protocols.

  2. Cadmium Toxicity and Treatment

    Directory of Open Access Journals (Sweden)

    Robin A. Bernhoft

    2013-01-01

    Full Text Available Cadmium is a heavy metal of considerable toxicity with destructive impact on most organ systems. It is widely distributed in humans, the chief sources of contamination being cigarette smoke, welding, and contaminated food and beverages. Toxic impacts are discussed and appear to be proportional to body burden of cadmium. Detoxification of cadmium with EDTA and other chelators is possible and has been shown to be therapeutically beneficial in humans and animals when done using established protocols.

  3. Cadmium Toxicity and Treatment

    OpenAIRE

    Bernhoft, Robin A.

    2013-01-01

    Cadmium is a heavy metal of considerable toxicity with destructive impact on most organ systems. It is widely distributed in humans, the chief sources of contamination being cigarette smoke, welding, and contaminated food and beverages. Toxic impacts are discussed and appear to be proportional to body burden of cadmium. Detoxification of cadmium with EDTA and other chelators is possible and has been shown to be therapeutically beneficial in humans and animals when done using established proto...

  4. Crude oil exposures reveal roles for intracellular calcium cycling in haddock craniofacial and cardiac development

    Science.gov (United States)

    Sørhus, Elin; Incardona, John P.; Karlsen, Ørjan; Linbo, Tiffany; Sørensen, Lisbet; Nordtug, Trond; van der Meeren, Terje; Thorsen, Anders; Thorbjørnsen, Maja; Jentoft, Sissel; Edvardsen, Rolf B.; Meier, Sonnich

    2016-08-01

    Recent studies have shown that crude oil exposure affects cardiac development in fish by disrupting excitation-contraction (EC) coupling. We previously found that eggs of Atlantic haddock (Melanogrammus aeglefinus) bind dispersed oil droplets, potentially leading to more profound toxic effects from uptake of polycyclic aromatic hydrocarbons (PAHs). Using lower concentrations of dispersed crude oil (0.7-7 μg/L ∑PAH), here we exposed a broader range of developmental stages over both short and prolonged durations. We quantified effects on cardiac function and morphogenesis, characterized novel craniofacial defects, and examined the expression of genes encoding potential targets underlying cardiac and craniofacial defects. Because of oil droplet binding, a 24-hr exposure was sufficient to create severe cardiac and craniofacial abnormalities. The specific nature of the craniofacial abnormalities suggests that crude oil may target common craniofacial and cardiac precursor cells either directly or indirectly by affecting ion channels and intracellular calcium in particular. Furthermore, down-regulation of genes encoding specific components of the EC coupling machinery suggests that crude oil disrupts excitation-transcription coupling or normal feedback regulation of ion channels blocked by PAHs. These data support a unifying hypothesis whereby depletion of intracellular calcium pools by crude oil-derived PAHs disrupts several pathways critical for organogenesis in fish.

  5. Evaluation of Known or Suspected Cardiac Sarcoidosis.

    Science.gov (United States)

    Blankstein, Ron; Waller, Alfonso H

    2016-03-01

    Sarcoidosis is a multisystem disorder of unknown cause, and cardiac sarcoidosis affects at least 25% of patients and accounts for substantial mortality and morbidity from this disease. Cardiac sarcoidosis may present with heart failure, left ventricular systolic dysfunction, AV block, atrial or ventricular arrhythmias, and sudden cardiac death. Cardiac involvement can be challenging to detect and diagnose because of the focal nature of the disease, as well as the fact that clinical criteria have limited diagnostic accuracy. Nevertheless, the diagnosis of cardiac sarcoidosis can be enhanced by integrating both clinical and imaging findings. This article reviews the various roles that different imaging modalities provide in the evaluation and management of patients with known or suspected cardiac sarcoidosis. PMID:26926267

  6. Sensing Cardiac Electrical Activity With a Cardiac Myocyte--Targeted Optogenetic Voltage Indicator

    NARCIS (Netherlands)

    Chang Liao, Mei-Ling; de Boer, Teun P; Mutoh, Hiroki; Raad, Nour; Richter, Claudia; Wagner, Eva; Downie, Bryan R; Unsöld, Bernhard; Arooj, Iqra; Streckfuss-Bömeke, Katrin; Döker, Stephan; Luther, Stefan; Guan, Kaomei; Wagner, Stefan; Lehnart, Stephan E; Maier, Lars S; Stühmer, Walter; Wettwer, Erich; van Veen, Toon; Morlock, Michael M; Knöpfel, Thomas; Zimmermann, Wolfram-Hubertus

    2015-01-01

    RATIONALE: Monitoring and controlling cardiac myocyte activity with optogenetic tools offer exciting possibilities for fundamental and translational cardiovascular research. Genetically encoded voltage indicators may be particularly attractive for minimal invasive and repeated assessments of cardiac

  7. Competencies - a roadmap for CERN Staff

    CERN Multimedia

    CERN Bulletin

    2011-01-01

    Back in November, the new CERN Competency Model (CCM), a framework defining the competencies that “ drive performance and lead to excellence”, was introduced by Anne-Sylvie Catherin, Head of the Human Resources (HR) Department, in a special edition of the "Spotlight on CERN" interviews.   What are competencies? Competencies are the characteristics that allow you to do the job you have been assigned. In more precise terms, competencies may be described as the knowledge, skills and types of behaviour that individuals demonstrate in carrying out a given task. Listing all the competencies that make CERN work is an impossible task but one can identify the two main types: technical and behavioural. Both are needed to work effectively in this Organization. While technical competencies are simply the domains of expertise that CERN needs – examples include physics, mechanical engineering and information technology – behavioural competencies are th...

  8. Methods in pharmacology: measurement of cardiac output

    OpenAIRE

    Geerts, Bart F; Aarts, Leon P; Jansen, Jos R.

    2011-01-01

    Many methods of cardiac output measurement have been developed, but the number of methods useful for human pharmacological studies is limited. The ‘holy grail’ for the measurement of cardiac output would be a method that is accurate, precise, operator independent, fast responding, non-invasive, continuous, easy to use, cheap and safe. This method does not exist today. In this review on cardiac output methods used in pharmacology, the Fick principle, indicator dilution techniques, arterial pul...

  9. Cardiac tumours simulating collagen vascular disease.

    OpenAIRE

    Fitzpatrick, A. P.; Lanham, J. G.; Doyle, D V

    1986-01-01

    Cardiac tumours can mimic collagen vascular disease and they are often accompanied by profound systemic upset. Both benign and malignant tumours may present in this way. Three cases of cardiac tumour, two malignant and one benign, are reported with just such a presentation. A review of fifteen similar case reports showed that a spectrum of different collagen vascular diseases was diagnosed and treated before the true diagnosis emerged. In half of these cases the cardiac tumour was only diagno...

  10. Disseminated cysticercosis with pulmonary and cardiac involvement

    OpenAIRE

    Jain Bharat; Sankhe Shilpa; Agrawal Mukta; Naphade Prashant

    2010-01-01

    Pulmonary and cardiac involvement by cysticercosis is extremely rare, and is usually asymptomatic. We report the case of a 19-year-old boy who presented with a history of headache and vomiting and was found to have disseminated cysticercosis with pulmonary and cardiac involvement; the emphasis is on the rare occurrence of pulmonary, cardiac, pancreatic, intraocular, and extradural spinal canal involvement in the same patient. This case demonstrates the extent to which cysticercosis can be dis...

  11. Electrocardiographically Determination of Cardiac Enlargements in Dogs

    OpenAIRE

    Gönül, Remzi; OR, Mehmet Erman; DODURKA, Tamer

    2002-01-01

    In this study, the electrocardiographic parameters necessary to determine cardiac enlargements and to establish and distinguish such complaints from each other in the early stage in dogs with circulatory problems were assessed. The material of the study consisted of 33 dogs 1.5-15 years of age with cardiac enlargements determined from 140 dogs suspected of having cardiac disease based on clinical, radiographic and electrocardiographic analyses. In these dogs, 12 cases of left atrial hypert...

  12. Leadership Competences in Slovenian Health Care

    OpenAIRE

    Kovačič Helena; Rus Andrej

    2014-01-01

    Background Leadership competences play an important role for the success of effective leadership. The purpose of this study was to examine leadership competences of managers in the healthcare sector in Slovenia. Methods Data were collected in 2008. The research included 265 employees in healthcare and 267 business managers. Respondents assessed their level of 16 leadership relevant competences on a 7-point Likert-type scale. Results Test of differences between competences and leader position ...

  13. THE COMMUNICATIVE COMPETENCE OF FUTURE TEACHERS

    Directory of Open Access Journals (Sweden)

    Pakhomova Irina Yurevna

    2013-04-01

    Full Text Available This article describes the concept of "communicative competence of future teachers," describes the essential characteristics and features of pedagogical communication. Objective: To define the notion of "communicative competence of future teachers' Methodology of work: competence approach. Scope of the results: the preparation of future teachers at the Pedagogical University. Results: This article describes the concept of "communicative competence of future teachers," describes the essential characteristics and features of pedagogical communication.

  14. Examining Factors Predicting Students’ Digital Competence

    OpenAIRE

    Ove Edvard Hatlevik; Gréta Björk Guðmundsdóttir; Massimo Loi

    2015-01-01

    The purpose of this study was to examine factors predicting lower secondary school students’ digital competence and to explore differences between students when it comes to digital competence. Results from a digital competence test and survey in lower secondary school will be presented. It is important to learn more about and investigate what characterizes students’ digital competence. A sample of 852 ninth-grade Norwegian students from 38 schools participated in the study. The students answe...

  15. Rater Wealth Predicts Perceptions of Outgroup Competence

    OpenAIRE

    Chan, Wayne; McCrae, Robert R.; Rogers, Darrin L.; Weimer, Amy A.; Greenberg, David M.; Terracciano, Antonio

    2011-01-01

    National income has a pervasive influence on the perception of ingroup stereotypes, with high status and wealthy targets perceived as more competent. In two studies we investigated the degree to which economic wealth of raters related to perceptions of outgroup competence. Raters’ economic wealth predicted trait ratings when 1) raters in 48 other cultures rated Americans’ competence and 2) Mexican Americans rated Anglo Americans’ competence. Rater wealth also predicted ratings of interpersona...

  16. Systems Competence: Operationalization, Evaluation and Theoretic Classification

    OpenAIRE

    Paukert, Marco

    2011-01-01

    This thesis pursues the question of how trainings for counseling competences have to be laid out to be effective and how evaluation procedures have to be set up to capture the competence development in this field. The construct systems competence is the starting point for these thoughts. It lists the competences, skills, abilities, and knowledge aspects that are necessary for working with complex, social systems. It is based on the theoretical considerations of Synergetics; a systems theory t...

  17. [Out-of-hospital cardiac arrest].

    Science.gov (United States)

    Virkkunen, Ilkka; Hoppu, Sanna; Kämäräinen, Antti

    2011-01-01

    Cardiac arrest as the first symptom of coronary artery disease is not uncommon. Some of previously healthy people with sudden cardiac arrest may be saved by effective resuscitation and post-resuscitative therapy. The majority of cardiac arrest patients experience the cardiac arrest outside of the hospital, in which case early recognition of lifelessness, commencement of basic life support and entry to professional care without delay are the prerequisites for recovery. After the heart has started beating again, the clinical picture of post-resuscitation syndrome must be recognized and appropriate treatment utilized. PMID:22204143

  18. Detecting deterministic dy namics of cardiac rhythm

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Under the acceptable hypothesis that cardiac rhythm is an approximately deterministic process with a small scale noise component, an available way is provided to construct a model that can reflect its prominent dynamics of the deterministic component. When applied to the analysis of 19 heart rate data sets, three main findings are stated. The obtained model can reflect prominent dynamics of the deterministic component of cardiac rhythm; cardiac chaos is stated in a reliable way; dynamical noise plays an important role in the generation of complex cardiac rhythm.``

  19. Nurses in post-operative heart surgery: professional competencies and organization strategies

    Directory of Open Access Journals (Sweden)

    Ana Paula Azevedo Santos

    2016-06-01

    Full Text Available Abstract OBJECTIVE To analyze nurses' competencies with regard to their work in post-operative heart surgery and the strategies implemented to mobilize these competencies. METHOD This was an exploratory study with a qualitative approach and a methodological design of collective case study. It was carried out in three post-operative heart surgery units, consisting of 18 nurses. Direct observation and semi-structured interviews were employed to collect data. Data were construed through thematic analysis. RESULTS nine competencies were found, as follows: theoretical-practical knowledge; high-complexity nursing care; nursing supervision; leadership in nursing; decision making; conflict management; personnel management; material and financial resources management; and on-job continued education. Organizational and individual strategies were employed to develop and improve competencies such as regular offerings of courses and lectures, in addition to the individual pursuit for knowledge and improvement. CONCLUSION the study is expected to lead future nurses and training centers to evaluate the need for furthur training required to work in cardiac units, and also the need for implementing programs aimed at developing the competencies of these professionals.

  20. 42 CFR 410.49 - Cardiac rehabilitation program and intensive cardiac rehabilitation program: Conditions of coverage.

    Science.gov (United States)

    2010-10-01

    ... and intensive cardiac rehabilitation program: Conditions of coverage. (a) Definitions. As used in this... 42 Public Health 2 2010-10-01 2010-10-01 false Cardiac rehabilitation program and intensive cardiac rehabilitation program: Conditions of coverage. 410.49 Section 410.49 Public Health CENTERS...

  1. Tumors of the cardiac conduction system: are they an explanation for otherwise unexplained sudden cardiac death?

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    @@ Cardiac tumors are well described in the literature. The first reports of cardiac tumors date back hundreds of years.The prevalence of primary cardiac tumors at autopsy ranges from 0.001% to 0.3% with secondary tumors more common than in primary tumors.

  2. Dell Hymes's Construct of "Communicative Competence"

    Science.gov (United States)

    Cazden, Courtney B.

    2011-01-01

    Cazden reflects on theoretical and sociopolitical origins of Hymes's construct of communicative competence in events occurring just before and after 1960 in the U.S. She comments on Hymes's emphasis on competence not as abstract systemic potential of a language, but as capability located in individual persons; and she explores competence as both…

  3. Assessing clinical competency: reports from discussion groups.

    Science.gov (United States)

    Turnwald, Grant; Stone, Elizabeth; Bristol, David; Fuentealba, Carmen; Hardie, Lizette; Hellyer, Peter; Jaeger, Laurie; Kerwin, Sharon; Kochevar, Deborah; Lissemore, Kerry; Olsen, Christopher; Rogers, Kenita; Sabin, Beth; Swanson, Cliff; Warner, Angeline

    2008-01-01

    This report describes proposed new models for assessment of eight of the nine clinical competencies the American Veterinary Medical Association Council on Education requires for accreditation. The models were developed by discussion groups at the Association of American Veterinary Medical Colleges' Clinical Competency Symposium. Clinical competencies and proposed models (in parentheses) are described. Competency 1: comprehensive patient diagnosis (neurologic examination on a dog, clinical reasoning skills); Competency 2: comprehensive treatment planning (concept mapping, computerized case studies); Competency 3: anesthesia, pain management (student portfolio); Competency 4: surgery skills (objective structured clinical examination, cased-based examination, "super dog" model); Competency 5: medicine skills (clinical reasoning and case management, skills checklist); Competency 6: emergency and intensive care case management (computerized case study or scenario); Competency 7: health promotion, disease prevention/biosecurity (360 degrees evaluation, case-based computer simulation); Competency 8: client communications and ethical conduct (Web-based evaluation forms, client survey, communicating with stakeholders, telephone conversation, written scenario-based cases). The report also describes faculty recognition for participating in clinical competency assessments.

  4. Future development of project management competences.

    NARCIS (Netherlands)

    Silvius, A.J.G.; Batenburg, R.

    2009-01-01

    This paper describes a study into the expected development of the competences of the project manager in the year 2027. The study was performed amongst the members of IPMA-Netherlands during the summer of 2007. In the study the 46 competences of the International Competence Baseline 3 (ICB 3) were te

  5. Competence: Conceptual Approach and Practice in France

    Science.gov (United States)

    Le Deist, Francoise

    2009-01-01

    Purpose: The purpose of this article is to analyse the conceptual approaches to competence and practice in competence management in France. Design/methodology/approach: Extensive literature review, discussion with academic experts in the French competence network of AGRH and interviews concerning developments following the 2003 national agreement…

  6. Examining Factors Predicting Students' Digital Competence

    Science.gov (United States)

    Hatlevik, Ove Edvard; Guðmundsdóttir, Gréta Björk; Loi, Massimo

    2015-01-01

    The purpose of this study was to examine factors predicting lower secondary school students' digital competence and to explore differences between students when it comes to digital competence. Results from a digital competence test and survey in lower secondary school will be presented. It is important to learn more about and investigate what…

  7. Marketing Management. Occupational Competency Analysis Profile.

    Science.gov (United States)

    Ohio State Univ., Columbus. Vocational Instructional Materials Lab.

    This Occupational Competency Analysis Profile (OCAP) contains a competency list verified by expert workers and developed through a modified DACUM (Developing a Curriculum) involving business, industry, labor, and community agency representatives from Ohio. This OCAP identifies the occupational, academic, and employability skills (competencies)…

  8. Towards a Taxonomy for Project Management Competences

    NARCIS (Netherlands)

    Nijhuis, S.A.; Vrijhoef, R.; Kessels, J.W.M.

    2015-01-01

    Recent research on project management competences did not use a standard set of competences. Twenty-five publications, published in or after 2000, show little agreement on their competences: of the 353 only twelve percent is named more than once. Of the 353, 31 are linked to communication, but a cla

  9. Key Competencies Required of Performance Improvement Professionals.

    Science.gov (United States)

    Guerra, Ingrid J.

    2003-01-01

    Describes a study that identified competencies required of competent performance improvement professionals and determined how often performance improvement practitioners believed they should be, and are, currently applying each of the identified competencies. Reports on correlations between what they believe they should apply and what they are…

  10. Core Competencies in Information Management Education.

    Science.gov (United States)

    Gorman, G. E.; Corbitt, B. J.

    2002-01-01

    Discusses core competencies in library and information science and in information systems to use as a background for an examination of core competencies in information management. Suggests a set of core competencies and educational outcomes that might be applied to curricula in both developed and developing countries. (Author/LRW)

  11. Competency-based continuing professional development

    NARCIS (Netherlands)

    Campbell, Craig; Silver, Ivan; Sherbino, Jonathan; Ten Cate, Olle; Holmboe, Eric S.

    2010-01-01

    Competence is traditionally viewed as the attainment of a static set of attributes rather than a dynamic process in which physicians continuously use their practice experiences to "progress in competence'' toward the attainment of expertise. A competency-based continuing professional development (CP

  12. Identifying competencies of boxing coaches

    Directory of Open Access Journals (Sweden)

    Ioannis Tasiopoulos

    2014-10-01

    Full Text Available The purpose of this study was to find out the management skills required by boxing coaches to administrate their clubs. For the purposes of this study a scale was constructed which was answered by 98 boxing coaches. Explanatory factor analysis revealed seven factors: Communication-public relations (5 items, event management (4 items, management techniques (4 items, new technologies (4 items, prevention-safety (2 items, sport (5 items and sports facilities (2 items. The Cronbach of the scale was 0.85. The five competencies that rated by the coaches were: Supervisors of the area of training, maintaining excellent communication with athletes, using new technologies (e-mail, internet, handling disciplinary matters, accidents, complaints and reports on some sporting games and promoted harmony among athletes. We concluded that boxing coaches understand that the competencies required for meeting their obligations, were related to sports, prevention, safety and communications-public relations.

  13. Phytochromes in photosynthetically competent plants

    Energy Technology Data Exchange (ETDEWEB)

    Pratt, L.H.

    1990-07-01

    Plants utilize light as a source of information in photomorphogenesis and of free energy in photosynthesis, two processes that are interrelated in that the former serves to increase the efficiency with which plants can perform the latter. Only one pigment involved in photomorphogenesis has been identified unequivocally, namely phytochrome. The thrust of this proposal is to investigate this pigment and its mode(s) of action in photosynthetically competent plants. Our long term objective is to characterize phytochrome and its functions in photosynthetically competent plants from molecular, biochemical and cellular perspectives. It is anticipated that others will continue to contribute indirectly to these efforts at the physiological level. The ultimate goal will be to develop this information from a comparative perspective in order to learn whether the different phytochromes have significantly different physicochemical properties, whether they fulfill independent functions and if so what these different functions are, and how each of the different phytochromes acts at primary molecular and cellular levels.

  14. Can Power from Space Compete?

    OpenAIRE

    Macauley, Molly; Darmstadter, Joel; Fini, John; Greenberg, Joel; Maulbetsch, John; Schaal, A. Michael; Styles, Geoffrey; Vedda, James

    2000-01-01

    Satellite solar power (SSP) has been suggested as an alternative to terrestrial energy resources for electricity generation. In this study, we consider the market for electricity from the present to 2020, roughly the year when many experts expect SSP to be technically achievable. We identify several key challenges for SSP in competing with conventional electricity generation in developed and developing countries, discuss the role of market and economic analysis as technical development of SSP...

  15. Leadership competencies for managing diversity:

    OpenAIRE

    Jan Visagie; Herman Linde; Werner Havenga

    2011-01-01

    The new understanding of diversity involves more than increasing the number of different identity groups on the payroll. An important proposal is that the experience of diversity in an organisation results from pervasive styles of management. This article dealt with the specific paradigms of diversitymanagement and leadership style theory used to address the research problem in the empirical study, namely ‘Is diversity management experience related to leadership styles or competencies?’ The m...

  16. The dimensions of purchasing competence

    OpenAIRE

    Rodrigues, Cristina S.; Fernandes, Edite Manuela da G. P.; Martins, F. Vitorino

    2006-01-01

    As firms recognize the purchasing function as an important resource for obtaining high quality levels, fast deliveries and cost savings, it reveals opportunities for the purchasing management to become a key contributor. The new product development is one example where acquisition capabilities may confirm to be particularly critical. This paper presents a construct of purchasing competence using three dimensions identified from literature: purchasing interaction, purchasing importance, and...

  17. Competencies Framework for Climate Services.

    Science.gov (United States)

    Aguilar, Enric

    2016-04-01

    The World Climate Conference-3 (Geneva, 2009) established the Global Framework for Climate Services (GFCS) to enable better management of the risks of climate variability and change and adaptation to climate change at all levels, through development and incorporation of science-based climate information and prediction into planning, policy and practice. The GFCS defines Climate Services as the result of transforming climate data into climate information in a way that responds to user needs and assists decision-making by individuals and organizations. Capacity Development is a cross-cutting pillar of the GFCS to ensure that services are provided by institutions with professionals whom achieved the adequate set of competencies recommended by WMO, which are yet to be fully defined. The WMO-Commission for Climatology Expert Team on Education and Training, ET-ETR, has been working to define a Competencies Framework for Climate Services to help the institutions to deliver high quality climate services in compliance with WMO standards and regulations, specifically those defined by WMO's Commission for Climatology and the GFCS. This framework is based in 5 areas or competence, closely associated to the areas of work of climate services providers: create and manage climate data sets; derive products from climate data; create and/or interpret climate forecasts and model output; ensure the quality of climate information and services; communicate climatological information with users. With this contribution, we intend to introduce to a wider audience the rationale behind these 5 top-level competency statements and the performance criteria associated with them, as well as the plans of the ET-ETR for further developing them into an instrument to support education and training within the WMO members, specially the National Meteorological and Hydrological Services.

  18. Measuring competencies of temporary staff.

    Science.gov (United States)

    Shaffer, F; Kobs, A

    1997-05-01

    Strategic staffing requires an understanding of a new model, what Charles Handy has named the "Shamrock Organizational Model," in which you have three equally valuable groups of staff a minimal core of full-time staff; a short-term contingency workforce; and a supplemental workforce for long-range temporary staffing needs. Ensuring the competency of all three is a nontransferable, although shared, responsibility of both the hospital and the supplemental staffing company. PMID:9287795

  19. Professional Competence in Psychosociology Research

    Directory of Open Access Journals (Sweden)

    Maria Constantinescu

    2007-02-01

    Full Text Available Dealing with labour activity through perspective of factors that condition it's efficiency is a problem of great interest in psychosociology. The performances' evaluation is a manner to appreciate the degree of adequation of the human operator to professional exigences of the labour he does. "The proffesional competence" is the intrinsic potentiality of person and the performance - the achieved potentiality showen in material or spiritual products or servicies and which is, often, influenced not only by factors depending on the person (the specific skills, the motivation, the degree of implication in decisional process, but olso by factors independent of person. Through the present study we have verified the interpretative-thoretical pattern suggessted for profesional competence (mental skills of cognitional kind and socio-emotional skills, the consciousness of profesional competence of a group of subjects that carried on in army. In this study the used method is secondary analysis, analysis and interpretation in a different manner of collected information with different reasons.

  20. Professional Competence in Psychosociology Research

    Directory of Open Access Journals (Sweden)

    Maria Constantinescu

    2007-02-01

    Full Text Available Dealing with labour activity through perspective of factors that condition it’s efficiency is a problem of great interest in psychosociology. The performances’ evaluation is a manner to appreciate the degree of adequation of the human operator to professional exigences of the labour he does. "The proffesional competence" is the intrinsic potentiality of person and the performance - the achieved potentiality showen in material or spiritual products or servicies and which is, often, influenced not only by factors depending on the person (the specific skills, the motivation, the degree of implication in decisional process, but olso by factors independent of person. Through the present study we have verified the interpretative-thoretical pattern suggessted for profesional competence (mental skills of cognitional kind and socio-emotional skills, the consciousness of profesional competence of a group of subjects that carried on in army. In this study the used method is secondary analysis, analysis and interpretation in a different manner of collected information with different reasons.

  1. ECLS in Pediatric Cardiac Patients

    Science.gov (United States)

    Di Nardo, Matteo; MacLaren, Graeme; Marano, Marco; Cecchetti, Corrado; Bernaschi, Paola; Amodeo, Antonio

    2016-01-01

    Extracorporeal life support (ECLS) is an important device in the management of children with severe refractory cardiac and or pulmonary failure. Actually, two forms of ECLS are available for neonates and children: extracorporeal membrane oxygenation (ECMO) and use of a ventricular assist device (VAD). Both these techniques have their own advantages and disadvantages. The intra-aortic balloon pump is another ECLS device that has been successfully used in larger children, adolescents, and adults, but has found limited applicability in smaller children. In this review, we will present the “state of art” of ECMO in neonate and children with heart failure. ECMO is commonly used in a variety of settings to provide support to critically ill patients with cardiac disease. However, a strict selection of patients and timing of intervention should be performed to avoid the increase in mortality and morbidity of these patients. Therefore, every attempt should be done to start ECLS “urgently” rather than “emergently,” before the presence of dysfunction of end organs or circulatory collapse. Even though exciting progress is being made in the development of VADs for long-term mechanical support in children, ECMO remains the mainstay of mechanical circulatory support in children with complex anatomy, particularly those needing rapid resuscitation and those with a functionally univentricular circulation. With the increase in familiarity with ECMO, new indications have been added, such as extracorporeal cardiopulmonary resuscitation (ECPR). The literature supporting ECPR is increasing in children. Reasonable survival rates have been achieved after initiation of support during active compressions of the chest following in-hospital cardiac arrest. Contraindications to ECLS have reduced in the last 5 years and many centers support patients with functionally univentricular circulations. Improved results have been recently achieved in this complex subset of patients. PMID

  2. EVALUATION OF NEONATAL CARDIAC MURMURS

    Directory of Open Access Journals (Sweden)

    Somaiah

    2014-09-01

    Full Text Available Cardiovascular malformations are the most common cause of congenital malformations, the diagnosis of which requires a close observation in the neonatal period. Early recognition of CHD is important in the neonatal period, as many of them may be fatal if undiagnosed and may require immediate intervention. The objectives of this study are to study the epidemiology of neonatal cardiac murmurs, to identify clinical characteristics which differentiate pathological murmur from functional murmurs and to assess the reliability of clinical evaluation in diagnosing CHD. Method of study included all neonates admitted to the NICU, postnatal ward, attending pediatric OPD or neonatal follow up clinic and were detected to have cardiac murmurs. It was a cross sectional study over a period of 16months. A clinical diagnosis was made based on history and clinical examination. Then Chest X-ray and ECG, Echocardiography was done in all neonates for confirmation of the diagnosis. These neonates were again examined daily till they were in hospital and during the follow-up visit at 6 weeks. The results of 70 neonates in this study conducted over a period of 24 months included the incidence of cardiac murmurs among intramural neonates which was 13.5 for 1000 live births. Most frequent symptom was fast breathing in 10(14.3% cases. VSD was the most common diagnosis clinically in 23 (33% babies. The most frequent Echo diagnosis was acyanotic complex congenital heart disease in 25(36% cases followed by 12(17% cases each of VSD and ASD respectively. Overall in our study 77.1% (54cases of the murmurs were diagnosed correctly and confirmed by Echocardiography The study concluded that it is possible to make clinical diagnosis in many cases of congenital heart diseases, the functional murmurs could be differentiated from those arising from structural heart disease and evaluation of the infants based only on murmurs, few congenital heart diseases can be missed.

  3. Competence and competency-based nursing education: finding our way through the issues.

    Science.gov (United States)

    Pijl-Zieber, Em M; Barton, Sylvia; Konkin, Jill; Awosoga, Olu; Caine, Vera

    2014-05-01

    The language of competence is widely utilized in both the regulation of nursing practice and curricular design in nursing education. The notion of competence defines what it means to be a professional, although it is not the only way of describing nursing practice. Unfortunately, there is much confusion about the concepts of competence, competency, and competency-based education. As well, the notion of competence, despite its global popularity, has flaws. In this paper we will disentangle these terms and critique the use of competence frameworks in nursing education.

  4. Catheter-Based Educational Experiences: A Canadian Survey of Current Residents and Recent Graduates in Cardiac Surgery.

    Science.gov (United States)

    Juanda, Nadzir; Chan, Vincent; Chan, Ryan; Rubens, Fraser D

    2016-03-01

    The past decade has witnessed significant developments in the use of catheter-based therapies in cardiovascular medicine. We sought to assess the educational opportunities for cardiac surgery trainees to determine their readiness for participation in these strategies. A web-based survey was distributed to current residents, recent graduates, and program directors in Canadian cardiac surgery residency programs from 2008-2013. The survey was distributed to 110 residents and graduates. Forty-five percent completed the survey. Thirty-five percent expressed that they experienced resistance organizing their rotations because they had to compete with non-cardiac surgery colleagues, and 6 were denied local cardiac catheterization rotations. By the end of the rotation, 56% were comfortable performing a diagnostic cardiac catheterization independently. Exposure to being the operator performing diagnostic catheterization was significantly associated with the positive perception of being able to perform a diagnostic catheterization independently (odds ratio [OR], 5.14; 95% confidence interval [CI], 1.33-19.81; P = 0.017). Eighty-eight percent of respondents expressed the need for more exposure in catheter-based rotations. Seven of 11 program directors completed the survey. All believed such rotations should be mandatory and foresaw a bigger role for hybrid catheter-based/cardiac surgery procedures in the future. Trainees and program directors perceive that increased exposure to catheter-based therapies is important to career development as a cardiac surgeon. This survey will contribute to the development of a cardiac surgery training curriculum as we foresee more hybrid and team procedures.

  5. Cerebral oximetry in cardiac anesthesia

    Science.gov (United States)

    Vretzakis, George; Georgopoulou, Stauroula; Stamoulis, Konstantinos; Stamatiou, Georgia; Tsakiridis, Kosmas; Katsikogianis, Nikolaos; Kougioumtzi, Ioanna; Machairiotis, Nikolaos; Tsiouda, Theodora; Mpakas, Andreas; Beleveslis, Thomas; Koletas, Alexander; Siminelakis, Stavros N.; Zarogoulidis, Konstantinos

    2014-01-01

    Cerebral oximetry based on near-infrared spectroscopy (NIRS) is increasingly used during the perioperative period of cardiovascular operations. It is a noninvasive technology that can monitor the regional oxygen saturation of the frontal cortex. Current literature indicates that it can stratify patients preoperatively according their risk. Intraoperatively, it provides continuous information about brain oxygenation and allows the use of brain as sentinel organ indexing overall organ perfusion and injury. This review focuses on the clinical validity and applicability of this monitor for cardiac surgical patients. PMID:24672700

  6. Cardiac leiomyosarcoma, a case report

    DEFF Research Database (Denmark)

    Andersen, Rikke; Kristensen, Bjarne W; Gill, Sabine

    2013-01-01

    In this case report we present the history of a patient admitted with recurrent pulmonary edema. Transesophageal chocardiography showed a tumour in the left atrium, occluding the ostium of the mitral valve and mimicking intermittent mitral stenosis. Cardiac surgery followed by pathological...... examination revealed that the tumour was a leiomyosarcoma. Images from the echocardiography as well as the pathological findings are shown and discussed. The present case report illustrates that atrial tumors comprise also sarcomas, suggesting the use of careful, rapid diagnostic procedures and treatment...

  7. Cardiac imaging: does radiation matter?

    Science.gov (United States)

    Einstein, Andrew J.; Knuuti, Juhani

    2012-01-01

    The use of ionizing radiation in cardiovascular imaging has generated considerable discussion. Radiation should not be considered in isolation, but rather in the context of a careful examination of the benefits, risks, and costs of cardiovascular imaging. Such consideration requires an understanding of some fundamental aspects of the biology, physics, epidemiology, and terminology germane to radiation, as well as principles of radiological protection. This paper offers a concise, contemporary perspective on these areas by addressing pertinent questions relating to radiation and its application to cardiac imaging. PMID:21828062

  8. Autologous Transfusion in Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    Radmehr H

    2003-11-01

    Full Text Available Preoperative autologous blood donation is commonly used to reduce exposure to homologous blood transfusions among patients undergoing elective cardiac surgery. The aim of this study was to evaluate the effect of autologous transfusion on patients' hematocryte value, intra and postoperative blood loss, hospitalization time, the development of infective complications and other factors. Materials and Methods: Between June 2001 to April 2002, 208 patients were underwent cardiac surgery in cardiac surgery ward in Imam Khomeini Medical Center. One or more blood units donate from 104 Patients before cardiopulmonary bypass and heparin injection, and transfused to them after CPB and Protamin injection (autologous Group, group 1. 104 patients underwent cardiac surgery routinely (control group, group 2."nResults: Mean of age was 55.9±8.6 in group 1 and 56.6±9.3 in group 2 (P=NS. 73 male and 31 females were in group 1 and 79 males and 25 females were in group 2 (P=NS. Smoking, familial history, hyperlipidemia, diabetes mellitus, renal failure, hypertension, stroke, and history of myocardial infarction was similar in two groups."nSeverity of angina, urgency operation, number vessels disease, duration of cardiopulmonary bypass, duration of aortic cross clamp time, use of internal thoracic artery graft, and number of grafts was similar in both groups. Mean of bleeding post operation was 548 cc in group 1 and 803 cc in-group 2 (P=0.003. Bleeding that need to operation was 1.8% in group 1 and 8.6% in group 2 (P=0.002. Wound infection, mediastinitis, renal failure, ventilatory prolonged, stroke, need to Intra-aortic Balloon Pump (IABP, intraoperative bleeding, and hospital stay was similar in both groups. Mean of extubationt time was 10.2 hours in group 1 and 14.8 hours in group 2 (P=0.001."nConclusion: Preoperative and intra-operative donations are safe and continue to contribute uniquely to blood conservation, providing important options in comprehensive

  9. [Acute cardiac failure in pheochromocytoma.

    DEFF Research Database (Denmark)

    Jønler, Morten; Munk, Kim

    2008-01-01

    Pheochromocytoma (P) is an endocrine catecholamine-secreting tumor. Classical symptoms like hypertension, attacks of sweating, palpitations, headache and palor are related to catecholamine discharge. We provide a case of P in a 71 year-old man presenting with acute cardiac failure, severe reduction...... in left ventricular function and elevated myocardial enzymes. No coronary stenoses were found. The myocardium regained nearly normal systolic function in one and a half month. A renal P was laparoscopicaly removed. We discuss the pathophysiology of catecholamine cardiomyopathy. Udgivelsesdato: 2008-Jun-2...

  10. Introduction to noninvasive cardiac mapping.

    Science.gov (United States)

    Bear, Laura; Cuculich, Phillip S; Bernus, Olivier; Efimov, Igor; Dubois, Rémi

    2015-03-01

    From the dawn of the twentieth century, the electrocardiogram (ECG) has revolutionized the way clinical cardiology has been practiced, and it has become the cornerstone of modern medicine today. Driven by clinical and research needs for a more precise understanding of cardiac electrophysiology beyond traditional ECG, inverse solution electrocardiography has been developed, tested, and validated. This article outlines the important progress from ECG development, through more extensive measurement of body surface potentials, and the fundamental leap to solving the inverse problem of electrocardiography, with a focus on mathematical methods and experimental validation. PMID:25784020

  11. 10.2.Cardiac arrhythmias

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930257 Electrophysiologic study of reperfu-sion arrhythmias.YIN Hong (尹红),et al.Af-fil Hosp,Shandong Med Univ,Jinan.Chin CirJ 1993;8(1):37—39.Twenty dogs of experimental ischemic reper-fusion were studied with a three-dimensionalmapping system of cardiac electric activity andmultiple—level myocardial recordings by bipolarplunge—needle electrodes.27% of the nonsus-tained ventricular tachycardia (NSVT) of intra-mural reentry occurred in the ischemic subendo-

  12. Assessing Physical Activity as a Core Component in Cardiac Rehabilitation: A POSITION STATEMENT OF THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION.

    Science.gov (United States)

    Kaminsky, Leonard A; Brubaker, Peter H; Guazzi, Marco; Lavie, Carl J; Montoye, Alexander H K; Sanderson, Bonnie K; Savage, Patrick D

    2016-01-01

    Physical inactivity is a well-established major risk factor for cardiovascular disease. As such, physical activity counseling is 1 of the 10 core components of cardiac rehabilitation/secondary prevention programs recommended by the American Heart Association and the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR). In addition, the ability to perform a physical activity assessment and report outcomes is 1 of the 10 core competencies of cardiac rehabilitation/secondary prevention professionals published by the AACVPR. Unfortunately, standardized procedures for physical activity assessment of cardiac rehabilitation patients have not been developed and published. Thus, the objective of this AACVPR statement is to provide an overview of physical activity assessment concepts and procedures and to provide a recommended approach for performing a standardized assessment of physical activity in all comprehensive cardiac rehabilitation programs following the core components recommendations. PMID:27307067

  13. Competency Based Hospital Radiopharmacy Training

    International Nuclear Information System (INIS)

    Quality management systems in nuclear medicine are vital to a high level of nuclear medicine (NM) practice. Trained and competent staffs are essential for achieving high standards and growth in NM. One of the key bottlenecks for NM is the shortfall in human resources, especially of radiopharmacists. There is an acute shortage in most Member States and in some countries an absence of nationally registered pharmacists with radiopharmacy experience. Most nuclear medicine facilities operate their radiopharmacies (commonly referred to as the hot laboratories) with the support of technologists and radiographers. Recent surveys have found the level of training amongst technologists to be extremely variable. Most had little or no training in hot laboratory practices. The survey also indicated the poor state of hot laboratories in many countries. Basic quality systems in the hot laboratory could be improved significantly with better training. This competency-based education manual is designed with those radiopharmacy practitioners in mind. This competency-based trainer's manual provides trainers in each of the IAEA regions with the essentials of a training programme for all radiopharmacy practitioners. The competency-based training is a two week programme followed up with three months of practice achievements. The syllabus provides a standardized approach to lectures, practical sessions, and interactive workshops focusing on critical aspects of hot laboratory practices. The trainers, with the assistance of this manual, can deliver essential skills, competencies, and underpinning knowledge to operate safely and effectively in their hot laboratory. The course focuses on simple but practical steps that could be undertaken to improve staff performance. In addition, a basic framework of quality management principles related to radiopharmacy practices is also covered. Further, the syllabus can be adapted to the particular needs and characteristics of any training centre, country

  14. Toxicity of silver nanoparticles in zebrafish models

    Energy Technology Data Exchange (ETDEWEB)

    Asharani, P V; Valiyaveettil, Suresh [Department of Chemistry, Faculty of Science, National University of Singapore, 3 Science Drive 3, 117543 (Singapore); Wu Yilian; Gong Zhiyuan [Department of Biological Sciences, National University of Singapore, Science Drive 4, 117543 (Singapore)], E-mail: chmsv@nus.edu.sg

    2008-06-25

    This study was initiated to enhance our insight on the health and environmental impact of silver nanoparticles (Ag-np). Using starch and bovine serum albumin (BSA) as capping agents, silver nanoparticles were synthesized to study their deleterious effects and distribution pattern in zebrafish embryos (Danio rerio). Toxicological endpoints like mortality, hatching, pericardial edema and heart rate were recorded. A concentration-dependent increase in mortality and hatching delay was observed in Ag-np treated embryos. Additionally, nanoparticle treatments resulted in concentration-dependent toxicity, typified by phenotypes that had abnormal body axes, twisted notochord, slow blood flow, pericardial edema and cardiac arrhythmia. Ag{sup +} ions and stabilizing agents showed no significant defects in developing embryos. Transmission electron microscopy (TEM) of the embryos demonstrated that nanoparticles were distributed in the brain, heart, yolk and blood of embryos as evident from the electron-dispersive x-ray analysis (EDS). Furthermore, the acridine orange staining showed an increased apoptosis in Ag-np treated embryos. These results suggest that silver nanoparticles induce a dose-dependent toxicity in embryos, which hinders normal development.

  15. Glyphosate induces cardiovascular toxicity in Danio rerio.

    Science.gov (United States)

    Roy, Nicole M; Ochs, Jeremy; Zambrzycka, Ewelina; Anderson, Ariann

    2016-09-01

    Glyphosate is a broad spectrum herbicide used aggressively in agricultural practices as well as home garden care. Although labeled "safe" by the chemical industry, doses tested by industry do not mimic chronic exposures to sublethal doses that organisms in the environment are exposed to over long periods of time. Given the widespread uses of and exposure to glyphosate, studies on developmental toxicity are needed. Here we utilize the zebrafish vertebrate model system to study early effects of glyphosate on the developing heart. Treatment by embryo soaking with 50μg/ml glyphosate starting at gastrulation results in structural abnormalities in the atrium and ventricle, irregular heart looping, situs inversus as well as decreased heartbeats by 48h as determined by live imaging and immunohistochemistry. Vasculature in the body was also affected as determined using fli-1 transgenic embryos. To determine if the effects noted at 48h post fertilization are due to early stage alterations in myocardial precursors, we also investigate cardiomyocyte development with a Mef2 antibody and by mef2ca in situ hybridization and find alterations in the Mef2/mef2ca staining patterns during early cardiac patterning stages. We conclude that glyphosate is developmentally toxic to the zebrafish heart.

  16. Acute Liver Failure Secondary to Niacin Toxicity

    Directory of Open Access Journals (Sweden)

    Marc A. Ellsworth

    2014-01-01

    Full Text Available A 17-year-old male was transferred to the pediatric intensive care unit for evaluation of acute liver failure. He was recently released from an alcohol treatment center with acute onset of chest pain. Cardiac workup was negative but he was found to have abnormal coagulation studies and elevated liver transaminases. Other evaluations included a normal toxicology screen and negative acetaminophen level. Autoimmune and infectious workups were normal providing no identifiable cause of his acute liver failure. He initially denied any ingestions or illicit drug use but on further query he admitted taking niacin in an attempt to obscure the results of an upcoming drug test. Niacin has been touted on the Internet as an aid to help pass urine drug tests though there is no evidence to support this practice. Niacin toxicity has been associated with serious multisystem organ failure and fulminant hepatic failure requiring liver transplantation. Pediatric providers should be aware of the risks associated with niacin toxicity and other experimental medical therapies that may be described on the Internet or other nonreputable sources.

  17. Assessment of cardiac sympathetic nerve integrity with positron emission tomography

    Energy Technology Data Exchange (ETDEWEB)

    Raffel, David M. E-mail: raffel@umich.edu; Wieland, Donald M

    2001-07-01

    The autonomic nervous system plays a critical role in the regulation of cardiac function. Abnormalities of cardiac innervation have been implicated in the pathophysiology of many heart diseases, including sudden cardiac death and congestive heart failure. In an effort to provide clinicians with the ability to regionally map cardiac innervation, several radiotracers for imaging cardiac sympathetic neurons have been developed. This paper reviews the development of neuronal imaging agents and discusses their emerging role in the noninvasive assessment of cardiac sympathetic innervation.

  18. The Cardiac Conduction System: Generation and Conduction of the Cardiac Impulse.

    Science.gov (United States)

    Kennedy, Alan; Finlay, Dewar D; Guldenring, Daniel; Bond, Raymond; Moran, Kieran; McLaughlin, James

    2016-09-01

    In this article, the authors outline the key components behind the automated generation of the cardiac impulses and the effect these impulses have on cardiac myocytes. Also, a description of the key components of the normal cardiac conduction system is provided, including the sinoatrial node, the atrioventricular node, the His bundle, the bundle branches, and the Purkinje network. Finally, an outline of how each stage of the cardiac conduction system is represented on the electrocardiogram is described, allowing the reader of the electrocardiogram to translate background information about the normal cardiac conduction system to everyday clinical practice. PMID:27484656

  19. Competence-based Competence Management: a Pragmatic and Interpretive Approach. The Case of a Telecommunications Company

    OpenAIRE

    Lorino, Philippe

    2007-01-01

    In this research we explore the issue of “competence management”, as usually defined in the corporate vocabulary, mostly in the human resource (HR) function, and more particularly of “strategic competence management” (long run management of competences which are critical to achieve strategic goals). We try to show that competence management is a dynamic organizational competence. We analyze it in the case of a large European telecommunications company, France Télécom, in the years 2001-2003. ...

  20. Competences and life management programmes

    International Nuclear Information System (INIS)

    surveillance. In some cases, it may be impossible to rebuild information. As a consequence assumptions may have to be made that cannot be easily substantiated. It is therefore essential that the strategies for plant life management are developed with sufficient clarity to enable the associated human resource strategy or long term Human Resources plan to be developed. This strategy/plan should be reviewed and updated periodically to verify that it is consistent with and supports the nuclear power plant life cycle needs. In this work we analyze the competences of young peoples for working in the Life Management and Life Extension of Nuclear Power Plants Programmes. Competences and skills are understood as including knowing and understanding (theoretical knowledge of an academic field, the capacity to know and understand), knowing how to act (practical and operational application of knowledge to certain situations), knowing how to be (values as an integral element of the way of perceiving and living with others and in a social context). Competences represent a combination of attributes (with respect to knowledge and its application, attitudes, skills and responsibilities) that describe the level or degree to which a person is capable of performing them. In this context, a competence or a set of competences mean that a person puts into play a certain capacity or skill and performs a task, where he/she is able to demonstrate that he/she can do so in a way that allows evaluation of the level of achievement. Competences can be carried out and assessed. It also means that a normally person does not either possess or lack a competence in absolute terms, but commands it to a varying degree, so that competences can be placed on a continuum. The following was taken as a working classification: - Instrumental Competences: Those having an instrumental function. They include: Cognitive abilities, capacity to understand and manipulate ideas and thoughts; Methodological capacities to

  1. Critical appraisal of cardiac implantable electronic devices: complications and management

    Directory of Open Access Journals (Sweden)

    Padeletti L

    2011-09-01

    Full Text Available Luigi Padeletti1, Giosuè Mascioli2, Alessandro Paoletti Perini1, Gino Grifoni1, Laura Perrotta1, Procolo Marchese3, Luca Bontempi3, Antonio Curnis31Istituto di Clinica Medica e Cardiologia, Università degli Studi di Firenze, Italia; 2Elettrofisiologia, Istituto Humanitas Gavazzeni, Bergamo, Italia; 3Elettrofisiologia, Spedali Civili, Brescia, ItaliaAbstract: Population aging and broader indications for the implant of cardiac implantable electronic devices (CIEDs are the main reasons for the continuous increase in the use of pacemakers (PMs, implantable cardioverter-defibrillators (ICDs and devices for cardiac resynchronization therapy (CRT-P, CRT-D. The growing burden of comorbidities in CIED patients, the greater complexity of the devices, and the increased duration of procedures have led to an augmented risk of infections, which is out of proportion to the increase in implantation rate. CIED infections are an ominous condition, which often implies the necessity of hospitalization and carries an augmented risk of in-hospital death. Their clinical presentation may be either at pocket or at endocardial level, but they can also manifest themselves with lone bacteremia. The management of these infections requires the complete removal of the device and subsequent, specific, antibiotic therapy. CIED failures are monitored by competent public authorities, that require physicians to alert them to any failures, and that suggest the opportune strategies for their management. Although the replacement of all potentially affected devices is often suggested, common practice indicates the replacement of only a minority of devices, as close follow-up of the patients involved may be a safer strategy. Implantation of a PM or an ICD may cause problems in the patients' psychosocial adaptation and quality of life, and may contribute to the development of affective disorders. Clinicians are usually unaware of the psychosocial impact of implanted PMs and ICDs. The

  2. Sudden death of cardiac origin and psychotropic drugs

    Directory of Open Access Journals (Sweden)

    Quadiri eTimour

    2012-05-01

    Full Text Available Mortality rate is high in psychiatric patients versus general population. An important cause of this increased mortality is sudden cardiac death (SCD as a major side-effect of psychotropic drugs. These SCDs generally result from arrhythmias occurring when the posology is high and may attain a toxic threshold but also at dosages within therapeutic range, in the presence of risk factors. There are three kinds of risk factors: physiological (e.g.: low cardiac rate of sportsmen, physiopathological (e.g.: hepatic insufficiency, hypothyroidism and "therapeutic" (due to interactions between psychotropic drugs and other medicines. Association of pharmacological agents may increase the likelihood of SCDs either by i a pharmacokinetic mechanism (e.g.: increased torsadogenic potential of a psychotropic drug when its destruction and/or elimination are compromised or ii a pharmacodynamical mechanism (e.g.: mutual potentiation of proarrhythmic properties of two drugs. In addition, some psychotropic drugs may induce sudden death in cases of pre-existing congenital cardiopathies such as i congenital long QT syndrome, predisposing to torsade de pointes that eventually cause syncope and sudden death. ii a Brugada syndrome, that may directly cause ventricular fibrillation due to reduced sodium current through Nav1.5 channels. Moreover, psychotropic drugs may be a direct cause of cardiac lesions also leading to SCD. This is the case, for example, of phenothiazines responsible for ischemic coronaropathies and of clozapine that is involved in the occurrence of myocarditis. The aims of this work are to delineate: i the risk of SCD related to the use of psychotropic drugs; ii mechanisms involved in the occurrence of such SCD; iii preventive actions of psychotropic drugs side effects, on the basis of the knowledge of patient-specific risk factors, documented from clinical history, ionic balance and ECG investigation by the psychiatrist.

  3. 75 FR 52596 - Financial Education Core Competencies; Comment Request

    Science.gov (United States)

    2010-08-26

    ... Financial Education Core Competencies; Comment Request AGENCY: Department of the Treasury. ACTION: Notice... proposed set of financial education core competencies (``Core Competencies''). Comments are requested specifically on whether the list of Core Competencies referenced in the Supplementary Section is complete...

  4. [INFLAMMATION AND CARDIAC INSUFFICIENCY ASSOCIATED WITH INFECTIOUS ENDOCARDITIS].

    Science.gov (United States)

    Fedorova, T A; Tazina, S Ya; Kaktursky, L V; Kanareitseva, T D; Stefanenko, N I; Burtsev, V I; Semenenko, N A

    2016-01-01

    The study included 62 patients with uncomplicated primary and secondary infectious endocarditis admitted to S.PBotkin city hospital from 2011 to 2014. The emphasis is laid on diagnostic significance of dynamic measurements of the levels of C-reactive protein, tumour necrosis factor and highly sensitive troponin-1 for the evaluation of activity of the infectious/toxic process, severity of the disease, and detection of complications. The study revealed the relationship of the enhanced level of troponin-1 with changes of inflammation markers, morphofunctional characteristics of myocardium, and circulatory failure. Morphologicl study demonstrated inflammatory and dystrophic changes in myocardium, focal and diffuse cardiofibrosis suggesting development of non-coronarogenic myocardial lesions that play an important role in the progress of cardiac failure associated with infectious endocarditis.

  5. Competency model and standards for media education

    Directory of Open Access Journals (Sweden)

    Gerhard TULODZIECKI

    2012-12-01

    Full Text Available In Germany, educational standards for key school subjects have been developed as a consequence of the results of international comparative studies like PISA. Subsequently, supporters of interdisciplinary fields such as media education have also started calling for goals in the form of competency models and standards. In this context a competency standard model for media education will be developed with regard to the discussion about media competence and media education. In doing so the development of a competency model and the formulation of standards is described consequently as a decision making process. In this process decisions have to be made on competence areas and competence aspects to structure the model, on criteria to differentiate certain levels of competence, on the number of competence levels, on the abstraction level of standard formulations and on the tasks to test the standards. It is shown that the discussion on media education as well as on competencies and standards provides different possibilities of structuring, emphasizing and designing a competence standard model. Against this background we describe and give reasons for our decisions and our competency standards model. At the same time our contribution is meant to initiate further developments, testing and discussion.

  6. Bortezomib-Induced Complete Heart Block and Myocardial Scar: The Potential Role of Cardiac Biomarkers in Monitoring Cardiotoxicity

    Directory of Open Access Journals (Sweden)

    Sachin Diwadkar

    2016-01-01

    Full Text Available Bortezomib is a proteasome inhibitor used to treat multiple myeloma and mantle cell lymphoma. Traditionally, bortezomib was thought to have little cardiovascular toxicity; however, there is increasing evidence that bortezomib can lead to cardiac complications including left ventricular dysfunction and atrioventricular block. We present the case of a 66-year-old man with multiple myeloma and persistent asymptomatic elevations of cardiac biomarkers who developed complete heart block and evidence of myocardial scar after his eighth cycle of bortezomib, requiring permanent pacemaker placement. In addition to discussing the cardiovascular complications of bortezomib therapy, we propose a potential role for biomarkers in the prediction and monitoring of bortezomib cardiotoxicity.

  7. Cardiac cell proliferation assessed by EdU, a novel analysis of cardiac regeneration.

    Science.gov (United States)

    Zeng, Bin; Tong, Suiyang; Ren, Xiaofeng; Xia, Hao

    2016-08-01

    Emerging evidence suggests that mammalian hearts maintain the capacity for cardiac regeneration. Rapid and sensitive identification of cardiac cellular proliferation is prerequisite for understanding the underlying mechanisms and strategies of cardiac regeneration. The following immunologically related markers of cardiac cells were analyzed: cardiac transcription factors Nkx2.5 and Gata 4; specific marker of cardiomyocytes TnT; endothelial cell marker CD31; vascular smooth muscle marker smooth muscle myosin IgG; cardiac resident stem cells markers IsL1, Tbx18, and Wt1. Markers were co-localized in cardiac tissues of embryonic, neonatal, adult, and pathological samples by 5-ethynyl-2'-deoxyuridine (EdU) staining. EdU was also used to label isolated neonatal cardiomyocytes in vitro. EdU robustly labeled proliferating cells in vitro and in vivo, co-immunostaining with different cardiac cells markers. EdU can rapidly and sensitively label proliferating cardiac cells in developmental and pathological states. Cardiac cell proliferation assessed by EdU is a novel analytical tool for investigating the mechanism and strategies of cardiac regeneration in response to injury. PMID:25480318

  8. Thoracic skeletal defects and cardiac malformations: a common epigenetic link?

    Science.gov (United States)

    Weston, Andrea D; Ozolins, Terence R S; Brown, Nigel A

    2006-12-01

    Congenital heart defects (CHDs) are the most common birth defects in humans. In addition, cardiac malformations represent the most frequently identified anomaly in teratogenicity experiments with laboratory animals. To explore the mechanisms of these drug-induced defects, we developed a model in which pregnant rats are treated with dimethadione, resulting in a high incidence of heart malformations. Interestingly, these heart defects were accompanied by thoracic skeletal malformations (cleft sternum, fused ribs, extra or missing ribs, and/or wavy ribs), which are characteristic of anterior-posterior (A/P) homeotic transformations and/or disruptions at one or more stages in somite development. A review of other teratogenicity studies suggests that the co-occurrence of these two disparate malformations is not unique to dimethadione, rather it may be a more general phenomenon caused by various structurally unrelated agents. The coexistence of cardiac and thoracic skeletal malformations has also presented clinically, suggesting a mechanistic link between cardiogenesis and skeletal development. Evidence from genetically modified mice reveals that several genes are common to heart development and to formation of the axial skeleton. Some of these genes are important in regulating chromatin architecture, while others are tightly controlled by chromatin-modifying proteins. This review focuses on the role of these epigenetic factors in development of the heart and axial skeleton, and examines the hypothesis that posttranslational modifications of core histones may be altered by some developmental toxicants.

  9. "I'm No Superman": Understanding Diabetic Men, Masculinity, and Cardiac Rehabilitation.

    Science.gov (United States)

    Dale, Craig M; Angus, Jan E; Seto Nielsen, Lisa; Kramer-Kile, Marnie; Pritlove, Cheryl; Lapum, Jennifer; Price, Jennifer; Marzolini, Susan; Abramson, Beth; Oh, Paul; Clark, Alex

    2015-12-01

    Exercise-based cardiac rehabilitation (CR) programs help patients with coronary heart disease (CHD) reduce their risk of recurrent cardiac illness, disability, and death. However, men with CHD and Type 2 diabetes mellitus (T2DM) demonstrate lower attendance and completion of CR despite having a poor prognosis. Drawing on gender and masculinity theory, we report on a qualitative study of 16 Canadian diabetic men recently enrolled in CR. Major findings reflect two discursive positions men assumed to regain a sense of competency lost in illness: (a) working with the experts, or (b) rejection of biomedical knowledge. These positions underscore the varied and sometimes contradictory responses of seriously ill men to health guidance. Findings emphasize the priority given to the rehabilitation of a positive masculine identity. The analysis argues that gender, age, and employment status are powerful mechanisms of variable CR participation.

  10. Toxic and Metabolic Myelopathies.

    Science.gov (United States)

    Ramalho, Joana; Nunes, Renato Hoffmann; da Rocha, Antonio José; Castillo, Mauricio

    2016-10-01

    Myelopathy describes any neurologic deficit related to the spinal cord. It is most commonly caused by its compression by neoplasms, degenerative disc disease, trauma, or infection. Less common causes of myelopathy include spinal cord tumors, infection, inflammatory, neurodegenerative, vascular, toxic, and metabolic disorders. Conditions affecting the spinal cord must be recognized as early as possible to prevent progression that may lead to permanent disability. Biopsy is rarely performed, thus the diagnosis and management rely on patient׳s history, physical examination, laboratory results, and imaging findings. Here we review the clinical presentations, pathophysiological mechanisms, and magnetic resonance imaging findings of myelopathies related to metabolic or toxic etiologies. PMID:27616316

  11. Cardiac hydatid cyst revealed by ventricular tachycardia

    OpenAIRE

    Ibn Elhadj, Zied; Boukhris, Marouane; Kammoun, Ikram; Halima, Afef Ben; Addad, Faouzi; Kachboura, Salem

    2013-01-01

    Hydatid disease is a human parasitic infestation caused by the larval stage of Echinococcus Granulosus. The liver and the lungs are the most common locations. Cardiac involvement is rare and accounts for 0.5–2% of all hydatid disease. We report an unusual presentation of cardiac hydatid cyst revealed by ventricular tachycardia in a patient with a history of cerebral hydatid cyst.

  12. Acute cardiac failure in neuroleptic malignant syndrome.

    LENUS (Irish Health Repository)

    Sparrow, Patrick

    2012-02-03

    We present a case of rapid onset acute cardiac failure developing as part of neuroleptic malignant syndrome in a 35-year-old woman following treatment with thioridazine and lithium. Post mortem histology of cardiac and skeletal muscle showed similar changes of focal cellular necrosis and vacuolation suggesting a common disease process.

  13. Cardiac MRI of the athlete's heart

    NARCIS (Netherlands)

    Prakken, N.H.J.

    2010-01-01

    The increase in pre-participation cardiovascular screening using the Lausanne protocol will ultimately lead to an increased use of cardiac MRI and MDCT in the cardiovascular work-up of athletes. The role of cardiac MRI is well established in the evaluation of cardiomyopathies, myocarditis, aortic st

  14. The Western Denmark Cardiac Computed Tomography Registry

    DEFF Research Database (Denmark)

    Nielsen, Lene Hüche; Nørgaard, Bjarne Linde; Tilsted, Hans Henrik;

    2015-01-01

    BACKGROUND: As a subregistry to the Western Denmark Heart Registry (WDHR), the Western Denmark Cardiac Computed Tomography Registry (WDHR-CCTR) is a clinical database established in 2008 to monitor and improve the quality of cardiac computed tomography (CT) in Western Denmark. OBJECTIVE: We...

  15. 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

  16. Is fetal cardiac function gender dependent?

    NARCIS (Netherlands)

    Clur, S. A. B.; Rengerink, K. Oude; Mol, B. W.; Ottenkamp, J.; Bilardo, C. M.

    2011-01-01

    Introduction An increased nuchal translucency (NT) is more common in males. A delayed diastolic cardiac function maturation has been proposed to explain this and the reported gender-related differences in ductus venosus (DV) flow. Objective To investigate gender-related differences in fetal cardiac

  17. Is fetal cardiac function gender dependent?

    NARCIS (Netherlands)

    S.A.B. Clur; K. Oude Rengerink; B.W. Mol; J. Ottenkamp; C.M. Bilardo

    2011-01-01

    An increased nuchal translucency (NT) is more common in males. A delayed diastolic cardiac function maturation has been proposed to explain this and the reported gender-related differences in ductus venosus (DV) flow. To investigate gender-related differences in fetal cardiac function. One hundred a

  18. Preoperative respiratory physical therapy in cardiac surgery

    NARCIS (Netherlands)

    Hulzebos, H.J.

    2006-01-01

    Cardiac surgery is one of the most common surgical procedures and accounts for more resources expended in cardiovascular medicine than any other single procedure. Because cardiac surgery involves sternal incision and cardiopulmonary bypass, patients usually have a restricted respiratory function in

  19. Cardiac Diseases in People with Intellectual Disability

    Science.gov (United States)

    van den Akker, M.; Maaskant, M. A.; van der Meijden, R. J. M.

    2006-01-01

    Background: In people with ID there is more morbidity than in the general population, including cardiac diseases. Dutch figures on this subject are scarce. Methods: Descriptive study of the prevalence of cardiac diseases in 436 residential clients in Echt, the Netherlands, and comparisons between men and women, age groups, and level and aetiology…

  20. Coagulopathy and hemostatic monitoring in cardiac surgery

    DEFF Research Database (Denmark)

    Johansson, Pär I; Sølbeck, Sacha; Genet, Gustav;

    2012-01-01

    Cardiac surgery with cardiopulmonary bypass (CPB) causes severe derangements in the hemostatic system, which in turn puts the patient at risks of microvascular bleeding. Excessive transfusion and surgical re-exploration after cardiac surgery are potentially associated with a number of adverse...

  1. Athletes at Risk for Sudden Cardiac Death

    Science.gov (United States)

    Subasic, Kim

    2010-01-01

    High school athletes represent the largest group of individuals affected by sudden cardiac death, with an estimated incidence of once or twice per week. Structural cardiovascular abnormalities are the most frequent cause of sudden cardiac death. Athletes participating in basketball, football, track, soccer, baseball, and swimming were found to…

  2. CARDIAC SIZE IN THE SUPINE CHESTFILM

    NARCIS (Netherlands)

    VANDERJAGT, EJ; SMITS, HJ

    1992-01-01

    The aim of this study was to find a normal value for the cardiac size in the supine position because such a standard is hardly known in the literature. Cardiac size in the erect and supine positions were compared in 165 patients in whom both chest radiographs were performed prior to kidney transplan

  3. Using the Trajectory Framework: reconceptualizing cardiac illness.

    Science.gov (United States)

    Hawthorne, M H

    1991-01-01

    Cardiac disease is known to be the leading cause of premature morbidity and mortality in the United States. Nursing management of cardiac illnesses, as such, is a primary concern for most practicing nurses. Dramatic changes in cardiac patient populations and associated technology available for treatment indicate a need to reconceptualize the nature of cardiac illness and to consider alternative approaches to guide the care of these patients. Traditional care, to a large degree, has focused upon acute illness, consequently limiting needed attention to the increasing group of patients suffering chronic illness and disability. In the present paper, the major changes in the cardiac patient population and in utilization of available technology are presented. The application of the Corbin and Strauss trajectory framework as an appropriate and useful framework for conceptualizing cardiac illness and care is then discussed. Five characteristics of the framework which render the model particularly well suited to address cardiac care are identified and discussed. These characteristics are: 1) comprehensiveness of care, 2) patient-centered care, 3) gender issues in care, 4) family-focused care, 5) technology and cardiac care. PMID:1763241

  4. Cardiac arrhythmia classification using autoregressive modeling

    OpenAIRE

    Srinivasan Narayanan; Ge Dingfei; Krishnan Shankar M

    2002-01-01

    Abstract Background Computer-assisted arrhythmia recognition is critical for the management of cardiac disorders. Various techniques have been utilized to classify arrhythmias. Generally, these techniques classify two or three arrhythmias or have significantly large processing times. A simpler autoregressive modeling (AR) technique is proposed to classify normal sinus rhythm (NSR) and various cardiac arrhythmias including atrial premature contraction (APC), premature ventricular contraction (...

  5. Conditional shape models for cardiac motion estimation

    DEFF Research Database (Denmark)

    Metz, C.T.; Baka, N.; Kirisli, H.A.;

    2010-01-01

    We propose a conditional statistical shape model to predict patient specific cardiac motion from the 3D end-diastolic CTA scan. The model is built from 4D CTA sequences by combining atlas based segmentation and 4D registration. Cardiac motion estimation is, for example, relevant in the dynamic al...

  6. Drugs, QTc prolongation and sudden cardiac death

    NARCIS (Netherlands)

    S.M.J.M. Straus (Sabine)

    2005-01-01

    textabstract__Abstract__ The term sudden cardiac death pertains to an unexpected death from cardiac causes within a short time period and has been described throughout history. The ancient Egyptians inscribed on the tomb of a nobleman some 4500 years ago that he had died suddenly and without appare

  7. Clinical study of cardiac diseases during pregnancy

    Directory of Open Access Journals (Sweden)

    Amitha Vijay Kamat

    2016-03-01

    Conclusions: Cardiac diseases in pregnancy constitute high risk pregnancy and require special attention during antepartum, intrapartum and postpartum period. Rheumatic heart disease was the major contribution of cardiac diseases in pregnancy and is seen to be associated with increased maternal morbidity. [Int J Reprod Contracept Obstet Gynecol 2016; 5(3.000: 855-859

  8. Primary cardiac hemangioendothelioma: a case report

    Institute of Scientific and Technical Information of China (English)

    WANG Li-feng; LIU Ming; ZHU Hong; HAN Wei; HU Cheng-yi; QI Ji-ping; MEI Huan-lin; GE Re-le; ZHOU Min

    2006-01-01

    @@ Primary cardiac hemangioendothelioma is extremely rare.1-3 Up to now less than twenty cases have been reported in English literature, the data about this kind of cardiac tumors are scanty. In this report, a case of a huge hemangio-endothelioma that arose from the right atrium and was successfully resected is presented.

  9. Cardiac manifestations of inborn errors of metabolism.

    NARCIS (Netherlands)

    Evangeliou, A.; Papadopoulou-Legbelou, K.; Daphnis, E.; Ganotakis, E.; Vavouranakis, I.; Michailidou, H.; Hitoglou-Makedou, A.; Nicolaidou, P.; Wevers, R.A.; Varlamis, G.

    2007-01-01

    AIM: The aim of the study was to investigate the frequency and type of cardiac manifestations in a defined group of patients with inborn errors of metabolism. This paper also explores the key role of cardiac manifestations in the diagnosis of inborn errors of metabolism in daily practice. METHODS: O

  10. Ultrasound Imaging in Teaching Cardiac Physiology

    Science.gov (United States)

    Johnson, Christopher D.; Montgomery, Laura E. A.; Quinn, Joe G.; Roe, Sean M.; Stewart, Michael T.; Tansey, Etain A.

    2016-01-01

    This laboratory session provides hands-on experience for students to visualize the beating human heart with ultrasound imaging. Simple views are obtained from which students can directly measure important cardiac dimensions in systole and diastole. This allows students to derive, from first principles, important measures of cardiac function, such…

  11. Stem cell sources for cardiac regeneration

    NARCIS (Netherlands)

    Roccio, M.; Goumans, M. J.; Sluijter, J. P. G.; Doevendans, P. A.

    2008-01-01

    Cell-based cardiac repair has the ambitious aim to replace the malfunctioning cardiac muscle developed after myocardial infarction, with new contractile cardiomyocytes and vessels. Different stem cell populations have been intensively studied in the last decade as a potential source of new cardiomyo

  12. Cardiac Vagal Regulation and Early Peer Status

    Science.gov (United States)

    Graziano, Paulo A.; Keane, Susan P.; Calkins, Susan D.

    2007-01-01

    A sample of 341 5 1/2-year-old children participating in an ongoing longitudinal study was the focus of a study on the relation between cardiac vagal regulation and peer status. To assess cardiac vagal regulation, resting measures of respiratory sinus arrhythmia (RSA) and RSA change (suppression) to 3 cognitively and emotionally challenging tasks…

  13. Cardiac cachexia: hic et nunc

    Science.gov (United States)

    Loncar, Goran; Springer, Jochen; Anker, Markus; Doehner, Wolfram

    2016-01-01

    Abstract Cardiac cachexia (CC) is the clinical entity at the end of the chronic natural course of heart failure (HF). Despite the efforts, even the most recent definition of cardiac cachexia has been challenged, more precisely, the addition of new criteria on top of obligatory weight loss. The pathophysiology of CC is complex and multifactorial. A better understanding of pathophysiological pathways in body wasting will contribute to establish potentially novel treatment strategies. The complex biochemical network related with CC and HF pathophysiology underlines that a single biomarker cannot reflect all of the features of the disease. Biomarkers that could pick up the changes in body composition before they convey into clinical manifestations of CC would be of great importance. The development of preventive and therapeutic strategies against cachexia, sarcopenia, and wasting disorders is perceived as an urgent need by healthcare professionals. The treatment of body wasting remains an unresolved challenge to this day. As CC is a multifactorial disorder, it is unlikely that any single agent will be completely effective in treating this condition. Among all investigated therapeutic strategies, aerobic exercise training in HF patients is the most proved to counteract skeletal muscle wasting and is recommended by treatment guidelines for HF. PMID:27386168

  14. Cardiac cachexia: hic et nunc.

    Science.gov (United States)

    Loncar, Goran; Springer, Jochen; Anker, Markus; Doehner, Wolfram; Lainscak, Mitja

    2016-06-01

    Cardiac cachexia (CC) is the clinical entity at the end of the chronic natural course of heart failure (HF). Despite the efforts, even the most recent definition of cardiac cachexia has been challenged, more precisely, the addition of new criteria on top of obligatory weight loss. The pathophysiology of CC is complex and multifactorial. A better understanding of pathophysiological pathways in body wasting will contribute to establish potentially novel treatment strategies. The complex biochemical network related with CC and HF pathophysiology underlines that a single biomarker cannot reflect all of the features of the disease. Biomarkers that could pick up the changes in body composition before they convey into clinical manifestations of CC would be of great importance. The development of preventive and therapeutic strategies against cachexia, sarcopenia, and wasting disorders is perceived as an urgent need by healthcare professionals. The treatment of body wasting remains an unresolved challenge to this day. As CC is a multifactorial disorder, it is unlikely that any single agent will be completely effective in treating this condition. Among all investigated therapeutic strategies, aerobic exercise training in HF patients is the most proved to counteract skeletal muscle wasting and is recommended by treatment guidelines for HF. PMID:27386168

  15. Cardiac involvement in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    V. De Gennaro Colonna

    2011-06-01

    Full Text Available Rheumatoid arthritis (RA is a systemic disease of unknown etiology characterized by a chronic inflammatory process mainly leading to destruction of synovial membrane of small and major diarthrodial joints. The prevalence of RA within the general adult population is about 1% and female subjects in fertile age result mostly involved. It’s an invalidating disease, associated with changes in life quality and a reduced life expectancy. Moreover, we can observe an increased mortality rate in this population early after the onset of the disease. The mortality excess can be partially due to infective, gastrointestinal, renal or pulmonary complications and malignancy (mainly lung cancer and non- Hodgkin lymphoma. Among extra-articular complications, cardiovascular (CV involvement represents one of the leading causes of morbidity and mortality. Every cardiac structure can be affected by different pathogenic pathways: heart valves, conduction system, myocardium, endocardium, pericardium and coronary arteries. Consequently, different clinical manifestations can be detected, including: pericarditis, myocarditis, myocardial fibrosis, arrhythmias, alterations of conduction system, coronaropathies and ischemic cardiopathy, valvular disease, pulmonary hypertension and heart failure. Considering that early cardiac involvement negatively affects the prognosis, it is mandatory to identify high CV risk RA patients to better define long-term management of this population.

  16. [Technologies for cardiac valve prostheses].

    Science.gov (United States)

    Nakano, Kiyoharu

    2009-07-01

    To show the technological development of cardiac valve prostheses, a historical review of both mechanical and biological valve prostheses and a current overview of modern cardiac valve devices are provided. Scince the 1st implantation of Starr-Edwards ball valve in 1960, both mechanical and biological valve prostheses have advanced. The valve design, the material of the leaflet and the hausing of mechanical prostheses have improved. Currently, the majority of the mechanical prostheses are bileaflet tilting disc valves made of pyrolytic carbon, which is antithromboembolic. However, anticoagulation therapy with warfarin is still required. As for the bioprostheses, although the fixation and anti-mineralization methods of the tissues improved, the durability of these valves is still limited. For the material of the current biological valves, the porcine aortic valve or bovine pericardium are used. The tissues are fixed by non-pressure or low-pressure method in glutaraldehyde solution. A stented and non-stented valves are available. Epoch-making events in this field are the implantation of new bioprosthetic valves using tissue engineering methods and the development of the transcatheter valve replacement therapies.

  17. Cardiac Rehabilitation in Older Adults.

    Science.gov (United States)

    Schopfer, David W; Forman, Daniel E

    2016-09-01

    The biology of aging and the pathophysiology of cardiovascular disease (CVD) overlap, with the effect that CVD is endemic in the growing population of older adults. Moreover, CVD in older adults is usually complicated by age-related complexities, including multimorbidity, polypharmacy, frailty, and other intricacies that add to the risks of ambiguous symptoms, deconditioning, iatrogenesis, falls, disability, and other challenges. Cardiac rehabilitation (CR) is a comprehensive lifestyle program that can have particular benefit for older patients with cardiovascular conditions. Although CR was originally designed primarily as an exercise training program for younger adults after a myocardial infarction or coronary artery bypass surgery, it has evolved as a comprehensive lifestyle program (promoting physical activity as well as education, diet, risk reduction, and adherence) for a broader range of CVD (coronary heart disease, heart failure, and valvular heart disease). It provides a valuable opportunity to address and moderate many of the challenges pertinent for the large and growing population of older adults with CVD. Cardiac rehabilitation promotes physical function (cardiorespiratory fitness as well as strength and balance) that helps overcome disease and deconditioning as well as related vulnerabilities such as disability, frailty, and falls. Similarly, CR facilitates education, monitoring, and guidance to reduce iatrogenesis and promote adherence. Furthermore, CR fosters cognition, socialization, and independence in older patients. Yet despite all its conceptual benefits, CR is significantly underused in older populations. This review discusses benefits and the paradoxical underuse of CR, as well as evolving models of care that may achieve greater application and efficacy. PMID:27297002

  18. Lipid partitioning during cardiac stress.

    Science.gov (United States)

    Kolwicz, Stephen C

    2016-10-01

    It is well documented that fatty acids serve as the primary fuel substrate for the contracting myocardium. However, extensive research has identified significant changes in the myocardial oxidation of fatty acids during acute or chronic cardiac stress. As a result, the redistribution or partitioning of fatty acids due to metabolic derangements could have biological implications. Fatty acids can be stored as triacylglycerols, serve as critical components for biosynthesis of phospholipid membranes, and form the potent signaling molecules, diacylglycerol and ceramides. Therefore, the contribution of lipid metabolism to health and disease is more intricate than a balance of uptake and oxidation. In this review, the available data regarding alterations that occur in endogenous cardiac lipid pathways during the pathological stressors of ischemia-reperfusion and pathological hypertrophy/heart failure are highlighted. In addition, changes in endogenous lipids observed in exercise training models are presented for comparison. This article is part of a Special Issue entitled: Heart Lipid Metabolism edited by G.D. Lopaschuk. PMID:27040509

  19. Gene transfer to promote cardiac regeneration.

    Science.gov (United States)

    Collesi, Chiara; Giacca, Mauro

    2016-12-01

    There is an impelling need to develop new therapeutic strategies for patients with myocardial infarction and heart failure. Leading from the large quantity of new information gathered over the last few years on the mechanisms controlling cardiomyocyte proliferation during embryonic and fetal life, it is now possible to devise innovative therapies based on cardiac gene transfer. Different protein-coding genes controlling cell cycle progression or cardiomyocyte specification and differentiation, along with microRNA mimics and inhibitors regulating pre-natal and early post-natal cell proliferation, are amenable to transformation in potential therapeutics for cardiac regeneration. These gene therapy approaches are conceptually revolutionary, since they are aimed at stimulating the intrinsic potential of differentiated cardiac cells to proliferate, rather than relying on the implantation of exogenously expanded cells to achieve tissue regeneration. For efficient and prolonged cardiac gene transfer, vectors based on the Adeno-Associated Virus stand as safe, efficient and reliable tools for cardiac gene therapy applications.

  20. Gender differences in cardiac hypertrophic remodeling.

    Science.gov (United States)

    Patrizio, Mario; Marano, Giuseppe

    2016-01-01

    Cardiac remodeling is a complex process that occurs in response to different types of cardiac injury such as ischemia and hypertension, and that involves cardiomyocytes, fibroblasts, vascular smooth muscle cells, vascular endothelial cells, and inflammatory cells. The end result is cardiomyocyte hypertrophy, fibrosis, inflammation, vascular, and electrophysiological remodeling. This paper reviews a large number of studies on the influence of gender on pathological cardiac remodeling and shows how sex differences result in different clinical outcomes and therapeutic responses, with males which generally develop greater cardiac remodeling responses than females. Although estrogens appear to have an important role in attenuating adverse cardiac remodeling, the mechanisms through which gender modulates myocardial remodeling remain to be identified. PMID:27364397

  1. Cardiac, Skeletal, and smooth muscle mitochondrial respiration

    DEFF Research Database (Denmark)

    Park, Song-Young; Gifford, Jayson R; Andtbacka, Robert H I;

    2014-01-01

    Unlike cardiac and skeletal muscle, little is known about vascular smooth muscle mitochondrial function. Therefore, this study examined mitochondrial respiratory rates in the smooth muscle of healthy human feed arteries and compared with that of healthy cardiac and skeletal muscle. Cardiac......, skeletal, and smooth muscle was harvested from a total of 22 subjects (53±6 yrs) and mitochondrial respiration assessed in permeabilized fibers. Complex I+II, state 3 respiration, an index of oxidative phosphorylation capacity, fell progressively from cardiac, skeletal, to smooth muscle (54±1; 39±4; 15......±1 pmol•s(-1)•mg (-1), pmitochondrial density, also fell progressively from cardiac, skeletal, to smooth muscle (222±13; 115±2; 48±2 umol•g(-1)•min(-1), p

  2. A neonatal blueprint for cardiac regeneration

    Directory of Open Access Journals (Sweden)

    Enzo R. Porrello

    2014-11-01

    Full Text Available Adult mammals undergo minimal regeneration following cardiac injury, which severely compromises cardiac function and contributes to the ongoing burden of heart failure. In contrast, the mammalian heart retains a transient capacity for cardiac regeneration during fetal and early neonatal life. Recent studies have established the importance of several evolutionarily conserved mechanisms for heart regeneration in lower vertebrates and neonatal mammals including induction of cardiomyocyte proliferation, epicardial cell activation, angiogenesis, extracellular matrix deposition and immune cell infiltration. In this review, we provide an up-to-date account of the molecular and cellular basis for cardiac regeneration in lower vertebrates and neonatal mammals. The historical context for these recent findings and their ramifications for the future development of cardiac regenerative therapies are also discussed.

  3. Beyond the Frame of Management Competenc(i)es: Towards a Contextually Embedded Framework of Managerial Competence in Organizations.

    Science.gov (United States)

    Stuart, Roger; Lindsay, Philip

    1997-01-01

    Describes a framework that defines management competence and locates competencies within a coherent whole. Uses organizational competence as a lens through which to view managerial competence embedded within the context of organizational environment and culture. (SK)

  4. Core Competencies: What They Are and How To Use Them.

    Science.gov (United States)

    Naylor, Richard J.

    2000-01-01

    Describes characteristics of core competencies. Examines the competencies a librarian should possess. Discusses types of competence and reviews advantages of developing and improving core competencies. Looks at core competencies in terms of the major service areas of public libraries. Presents several steps for building core competencies.…

  5. Normal tissue tolerance to external beam radiation therapy: Cardiac structures; Dose de tolerance des tissus sains: le coeur

    Energy Technology Data Exchange (ETDEWEB)

    Doyen, J. [Service d' oncologie-radiotherapie, centre Antoine-Lacassagne, 06 - Nice (France); Giraud, P. [Universite Rene-Descartes Paris 5, 75 - Paris (France); Service d' oncologie-radiotherapie, hopital europeen Georges-Pompidou, 75 - Paris (France); Belkacemi, Y. [Faculte de medecine de Creteil, universite Paris 12, 94 - Creteil (France); Service d' oncologie-radiotherapie, CHU Henri-Mondor, 94 - Creteil (France)

    2010-07-15

    Radiation thoracic tumors may be associated with cardiac toxicity because of the central position of the heart in the thorax. The present review aims to describe the cardiotoxicity during radiotherapy of different tumor sites most associated with this complication and the risk factors of cardiotoxicity during radiation therapy. Medline literature searches were performed using the following cardiac - heart - radiotherapy - toxicity - cardiotoxicity - breast cancer - lymphoma. Cardiac toxicity after breast cancer and mediastinal lymphoma is the most reported radiation-induced complication. The most frequent clinical complications are pericarditis, congestive heart failure, and heart infarction. These events are mostly asymptomatic. Thus clinicians have to give particular attention to these complications. Anthracycline treatment is a major risk factor for additional cardiotoxicity during radiotherapy with a synergistic effect. Correction of cardiovascular risk is an important point of the prevention of heart complications. Total dose delivered to the planned target volume (PTV), the dose per fraction and the irradiated volume were correlated to the risk of cardiotoxicity. Volume of heart receiving 35 Gy must be inferior to 30% and dose per fraction should not exceed 2 Gy when dose of prescription exceeds 30 Gy. Maximum heart distance (maximal thickness of heart irradiated) must be less than 1 cm during irradiation of breast cancer. Modern irradiation techniques seem to be associated with a limited risk of heart complication. The use of anthracycline, other cardio-toxic chemotherapies and targeted therapies should incite for great caution by performing a careful treatment planning and optimisation. (authors)

  6. Respiratory Toxicity Biomarkers

    Science.gov (United States)

    The advancement in high throughput genomic, proteomic and metabolomic techniques have accelerated pace of lung biomarker discovery. A recent growth in the discovery of new lung toxicity/disease biomarkers have led to significant advances in our understanding of pathological proce...

  7. Peptide-enhanced mRNA transfection in cultured mouse cardiac fibroblasts and direct reprogramming towards cardiomyocyte-like cells

    Directory of Open Access Journals (Sweden)

    Lee K

    2015-03-01

    Full Text Available Kunwoo Lee,1,2 Pengzhi Yu,3 Nithya Lingampalli,1 Hyun Jin Kim,1 Richard Tang,1 Niren Murthy1,2 1Department of Bioengineering, University of California, Berkeley, CA, USA; 2UC Berkeley and UCSF Joint Graduate Program in Bioengineering, Berkeley/San Francisco, CA, USA; 3Gladstone Institute of Cardiovascular Disease, San Francisco, CA, USA Abstract: The treatment of myocardial infarction is a major challenge in medicine due to the inability of heart tissue to regenerate. Direct reprogramming of endogenous cardiac fibroblasts into functional cardiomyocytes via the delivery of transcription factor mRNAs has the potential to regenerate cardiac tissue and to treat heart failure. Even though mRNA delivery to cardiac fibroblasts has the therapeutic potential, mRNA transfection in cardiac fibroblasts has been challenging. Herein, we develop an efficient mRNA transfection in cultured mouse cardiac fibroblasts via a polyarginine-fused heart-targeting peptide and lipofectamine complex, termed C-Lipo and demonstrate the partial direct reprogramming of cardiac fibroblasts towards cardiomyocyte cells. C-Lipo enabled the mRNA-induced direct cardiac reprogramming due to its efficient transfection with low toxicity, which allowed for multiple transfections of Gata4, Mef2c, and Tbx5 (GMT mRNAs for a period of 2 weeks. The induced cardiomyocyte-like cells had α-MHC promoter-driven GFP expression and striated cardiac muscle structure from a-actinin immunohistochemistry. GMT mRNA transfection of cultured mouse cardiac fibroblasts via C-Lipo significantly increased expression of the cardiomyocyte marker genes, Actc1, Actn2, Gja1, Hand2, and Tnnt2, after 2 weeks of transfection. Moreover, this study provides the first direct evidence that the stoichiometry of the GMT reprogramming factors influence the expression of cardiomyocyte marker genes. Our results demonstrate that mRNA delivery is a potential approach for cardiomyocyte generation. Keywords: direct cardiac

  8. Ontologies used for Competence Management

    Directory of Open Access Journals (Sweden)

    Victoria Iordan

    2008-05-01

    Full Text Available Developing multi-agent systems requires an adequate modeling of knowledge inorder that the agents and the human person are able to understand and accept the conceptsof domain area in the same way. Ontologies allow developing an coherent framework for aspecified domain. Based on the concepts used ant the relations between them, the agentsare able to understand, reason and act in the domain in order to accomplish their goalsand finally the system functions. Based on appropriate ontologies defined for a particulardomain, a multi-agent system that allows managing, searching and matching the usercompetences with the existent competences is presented.

  9. Literacy competence based on fiction

    DEFF Research Database (Denmark)

    Broström, Stig

      The teacher's selection of theories of reading and attached methods for learning to read influence what kind of texts the children will be presented in the first years of school. A teaching strategy based on phonetic theory of reading result in the fact that children will meet less fiction texts...... we want to get more knowledge ablout following questions:   How to define fiction which holds a personal and language "Bildung"? How to define the importance of fiction related to children's literacy competence? What kind of fiction do teachers use? How do teachers mediate fiction, how and in what...

  10. Leadership between skill and competency

    Directory of Open Access Journals (Sweden)

    Manole Diana Alina

    2013-05-01

    Full Text Available The following paper aims to present the way in which leaders are made up in nowadays, and which are the big differences between a born leader and a person that is working hard every day to become one. The history is full of examples of true leaders, but the present has shown to us that leaders can also be created in time. The purpose of this article is to bring up front examples of leadership and also methods through which you can practice your skills and gain competency in leading people.

  11. Leadership between skill and competency

    OpenAIRE

    Manole Diana Alina

    2013-01-01

    The following paper aims to present the way in which leaders are made up in nowadays, and which are the big differences between a born leader and a person that is working hard every day to become one. The history is full of examples of true leaders, but the present has shown to us that leaders can also be created in time. The purpose of this article is to bring up front examples of leadership and also methods through which you can practice your skills and gain competency in leading people.

  12. Teaching Competences and Inclusive Education

    Directory of Open Access Journals (Sweden)

    José María Fernández Batanero

    2013-08-01

    Full Text Available This paper focuses on teaching competencies that are conducive to good educational practices in relation to inclusion, from the perspective of teachers. The methodology employed in the study is descriptive/comprehensive, and of an exploratory nature. By means of four case studies, the perceptions of teachers from two secondary schools—characterized by the Spanish Educational Administration as having “good practices”— are examined. The techniques used for information collection in this study include documentary analysis, in-depth interviews and focus groups. The findings emphasize the importance of strategic skills, combined with innovation and creativity, among others.

  13. COMPETING VIA CREATION OF DISTINCTIVE ORGANIZATIONAL COMPETENCES: "HOW TO DO IT"

    Directory of Open Access Journals (Sweden)

    Melita Balas Rant

    2015-07-01

    Full Text Available The purpose of this paper is to twofold: (1 to identify specific and generic organizational competences that compose three different types of competitive advantages – product leadership, customer intimacy and operational excellence – and (2 to identify processes and approaches by which identified organizational competences are developed. Using multi-case study approach, the main findings come into two tentative theory building conclusions. (1 Behind different ways of competing there there are only four distinct organizational competences – innovation competence, competence of managing business risks, operational competence and stakeholder influence competence. These four competences form three distinct ways of competing: competing via product leadership, competing via customer intimacy and competing via operational excellence. (2 All four organizational competences are composed of nine organizational processes and approaches: bonding, attracting, showcasing, specialization, capitalization, internationalization, specialization, quality control, cost monitoring, and shielding. However, due to the case study research design this paper provides limited generalizability and thus calls for validations via quantitative research approaches.

  14. [How to promote health competence at work].

    Science.gov (United States)

    Eickholt, Clarissa; Hamacher, W; Lenartz, N

    2015-09-01

    Health competence is a key concept in occupational health and safety and workplace health promotion for maintaining and enhancing health resources. The effects of governmental or occupational measures to protect or improve health fall short of what is required with regard to the challenges of a changing workplace, e.g., due to the delimitation of work. To secure employability it is becoming more and more important to encourage the personal responsibility of employees. To offer new conclusions on how employers and employees can promote health competence, a survey is required of the research within the fields of health competence and competence development, and of the status quo in enterprises. In this context, a Delphi Study provides an important contribution, with a focus on small and medium-sized enterprises. The development of an extensive understanding of health competence is essential in a work-related context. Beyond knowledge-based health literacy, an action-oriented concept of competence implies the ability and willingness to act in a reasonable and creative manner in complex situations. The development of health competence requires learning embedded in working processes, which challenges competent behaviour. Enabling informal learning is a promising innovative approach and therefore coordinated operational activities are necessary. Ultimately, this is a matter of suitable organisational measures being implemented to meet the health competence needs of an enterprise. Even though the each individual employee bears his or her own health competence, the development potential lies largely within the prevailing working conditions. PMID:26159771

  15. Examining Factors Predicting Students’ Digital Competence

    Directory of Open Access Journals (Sweden)

    Ove Edvard Hatlevik

    2015-02-01

    Full Text Available The purpose of this study was to examine factors predicting lower secondary school students’ digital competence and to explore differences between students when it comes to digital competence. Results from a digital competence test and survey in lower secondary school will be presented. It is important to learn more about and investigate what characterizes students’ digital competence. A sample of 852 ninth-grade Norwegian students from 38 schools participated in the study. The students answered a 26 item multiple-choice digital competence test and a self-report questionnaire about family background, motivation, and previous grades. Structural equation modeling was used to test a model of the hypothesised relationship between family background, mastery orientation, previous achievements, and digital competence. The results indicate variation in digital competence among the ninth-graders. Further, analyses showed that students’ conditions at home, i.e., language integration and cultural capital, together with mastery orientation and academic achievements predict students digital competence. This study indicates that that there is evidence of digital diversity between lower secondary students. It does not seem like the development of digital competence among the students happens automatically. Students’ family background and school performance are the most important factors. Therefore, as this study shows, it is necessary to further investigate how schools can identify students’ level of competence and to develop plans and actions for how schools can help to try to equalize differences.

  16. Adopsi Model Competency Based Training dalam Kewirausahaan

    Directory of Open Access Journals (Sweden)

    I Ketut Santra

    2009-01-01

    Full Text Available The aim of the research is improving the teaching method in entrepreneurship subject. This research adopted the competency based training (CBT into the entrepreneurship. The major task in this research is formulated and designed the entrepreneurship competency. Entrepreneurship competency indicated by Personal, Strategic and Situational and Business competence. All of entrepreneurship competences are described into sub topic of competence. After designing and formulating the game and simulation the research continuing to implement the competency based training in the real class. The time consumed to implementing the CBT one semester, starting on September 2006 to early February 2007. The lesson learnt from the implementation period, the CBT could improve the student competence in Personal, Situational Strategic and Business. The three of the competencies are important for the success entrepreneur. It is a sign of application of “Kurikulum Berbasis Kompetensi”. There are many evidences to describe the achievement of the CBT in entrepreneurship subject. Firstly, physically achievement, that all of the student’s business plan could became the real business. The evidences are presented by picture of the student’s real business. Secondly theoretically achievement, that the Personal, Situational Strategic and Business competence statistically have significant relation with Business Plan even Real Business quality. The effect of the Personal, Situational Strategic and Business competence to Business Plan quality is 84.4%. and, to the Real Business quality 77.2%. The statistic’s evidence suggests that the redesign of the entrepreneurship subject is the right way. The content of the entrepreneur competence (Personal, Situational and Strategic and Business competence have impact to the student to conduct and running for own business.

  17. The impact of a company’s network competence and technology management competence on its innovation performance

    OpenAIRE

    Sheng-Bin Hao; Bo Yu

    2012-01-01

    Past research has consistently shown that companies with high level of technological competence are more likely to have higher product and process innovation performance. However, apart from technological competence, companies need other competences to promote innovation performance. In this paper, a theoretical model analyzing the impact of managerial competences on innovation performance is developed, consisting of four elements: network competence, technology management competence, technol...

  18. Estudo comparativo entre estibogluconato de sódio BP 88® e antimoniato de meglumina no tratamento da leishmaniose cutânea II. Toxicidade bioquímica e cardíaca Comparative study between sodium stibogluconate BP 88®and meglumine antimoniate in cutaneous leishmaniasis treatment. II. Biochemical and cardiac toxicity

    Directory of Open Access Journals (Sweden)

    Ana Cristina R. Saldanha

    2000-08-01

    Full Text Available Foi avaliada a toxicidade de dois antimoniais pentavalentes em 111 pacientes com leishmaniose cutânea. Quarenta e sete pacientes receberam antimoniato de meglumina (Grupo I e 64 pacientes, estibogluconato de sódio BP 88® (Grupo II, 20mg SbV/kg/dia por 20 dias. Realizou-se a avaliação de aminotransferases, fosfatase alcalina, amilase, creatinina, uréia, exame de urina e eletrocardiograma, antes do tratamento e no décimo e vigésimo dias. Observou-se maior freqüência de valores anormais de aminotransferases no décimo e vigésimo dias de tratamento no grupo II (p Toxicity of two antimonial pentavalents were evaluated in 111 patients with cutaneous leishmaniasis. Forty seven patients received meglumine antimoniate (Group I and 64 patients, sodium stibogluconate BP 88® (Group II, 20mg SbV/kg/day for 20 days. Evaluation of aminotransferases, alkaline phosphatase, amilase, creatinine, urea, urine analysis and electrocardiogram were performed at baseline, on the tenth and twentieth day of treatment. Greater frequency of aminotransferase abnormal levels were observed on the tenth and twentieth days in group II (p < 0,001 and a greater proportion of amilase abnormal levels at the tenth day in the same group (p < 0,001. There was a greater variation of aminotransferases, alkaline phosphatase and amilase in the first ten days of treatment in group II (p < 0,01. On the twentieth day there was a greater variation of aminotransferase levels in group II (p = 0,02 and p = 0,03, respectively. Forty three percent of group I and 54% of group II showed electrocardiographic abnormalities (p = 0,30.

  19. INFLUENCE OF MIMIC CARDIAC RATE ON HYDRODYNAMICS OF DIFFERENT MECHANICAL PROSTHETIC CARDIAC VALVES IN VITRO

    Institute of Scientific and Technical Information of China (English)

    Yin-ping Chu; Jin-lian Cheng; Ru-kun Chen; Yu-bo Fan; Fang Pu

    2005-01-01

    Objective To assess the influence of mimic cardiac rate on hydrodynamics of different mechanical prosthetic cardiac valves.Methods US-made CarboMedics bileaflet valve, China-made Jiuling bileaflet valve and C-L tilting disc valve were tested via a pulsatile flow simulator in the aortic position. Testing conditions were set at mimic cardiac rates of 55 bpm, 75 bpm, 100bpm with a constant mimic cardiac output of 4 L/min. The mean pressure differences (△P), leakage volumes (LEV) and closing volumes (CLV) across each valve, and effective orifice areas (EOA) were analyzed.Results Within physiological range, △p, LEV, and CLV decreased as mimic cardiac rate increased, with a large extent of variance. EOA increased along with an increase in mimic cardiac rate. It was a different response in terms of cardiac rate alteration for different types of mechanical prosthetic cardiac valves.Conclusion Mimic cardiac rate change affects hydrodynamics of mechanical prosthetic cardiac valves. Within physiological range, the hydrodynamic of prosthetic bileaflet valve is better than that of tilting disc valve.

  20. Cardiac Exposure in the Dynamic Conformal Arc Therapy, Intensity-Modulated Radiotherapy and Volumetric Modulated Arc Therapy of Lung Cancer.

    Directory of Open Access Journals (Sweden)

    Xin Ming

    Full Text Available To retrospectively evaluate the cardiac exposure in three cohorts of lung cancer patients treated with dynamic conformal arc therapy (DCAT, intensity-modulated radiotherapy (IMRT, or volumetric modulated arc therapy (VMAT at our institution in the past seven years.A total of 140 lung cancer patients were included in this institutional review board approved study: 25 treated with DCAT, 70 with IMRT and 45 with VMAT. All plans were generated in a same commercial treatment planning system and have been clinically accepted and delivered. The dose distribution to the heart and the effects of tumor laterality, the irradiated heart volume and the beam-to-heart distance on the cardiac exposure were investigated.The mean dose to the heart among all 140 plans was 4.5 Gy. Specifically, the heart received on average 2.3, 5.2 and 4.6 Gy in the DCAT, IMRT and VMAT plans, respectively. The mean heart doses for the left and right lung tumors were 4.1 and 4.8 Gy, respectively. No patients died with evidence of cardiac disease. Three patients (2% with preexisting cardiac condition developed cardiac disease after treatment. Furthermore, the cardiac exposure was found to increase linearly with the irradiated heart volume while decreasing exponentially with the beam-to-heart distance.Compared to old technologies for lung cancer treatment, modern radiotherapy treatment modalities demonstrated better heart sparing. But the heart dose in lung cancer radiotherapy is still higher than that in the radiotherapy of breast cancer and Hodgkin's disease where cardiac complications have been extensively studied. With strong correlations of mean heart dose with beam-to-heart distance and irradiated heart volume, cautions should be exercised to avoid long-term cardiac toxicity in the lung cancer patients undergoing radiotherapy.